Universal Health Care Practicalities

[Johnez]

Frankly I'm surprised that a party so concerned with private activities of it's citizens (bedrooms, living rooms, AND bathrooms) does not jump at the chance to better guide it's citizens toward a more moral and responsible path. I'd have thought the "shared responsibility" that universal health care encourages would dovetail nicely with the principles taught in the good book.

Jesus never had police, guns, and prisons to enforce his Commandments.  You obeyed His commandments voluntarily, and never with a gun to your head.  And He never really thought much of Earthly governments.

It is easy to spend other people's money.  His way is much harder.

I apologize for invoking religion, I don't like using the bible *against* people.  My point is that we are a society.  Is it not for the benefit of the whole that each individual person be given complete and affordable access to health care regardless of their station in life?  Our society, whether we know it or not, is interdependent on each other.   

[EvenSteven]

Several people in this thread are wanting to get rid of subsidies to corn syrup. What subsidies exactly are you all talking about?

I can think of three that apply to corn.

1) Tariffs on sugar cane could be considered an indirect subsidy to corn in the US, but that would raise, not lower, the price of sugar.

2) Ethanol mandate for gasoline could also be considered an indirect subsidy to corn, but ethanol production uses the fermentable sugars.

3) Crop insurance subsidies that apply to all crops equally. These go disproportionally to corn and soy, but that is because the US grows a lot of corn and soy. This subsidy does not encourage the growing of any crop over another, because all crops can get it.

Are there any that I am missing?

I can't speak for everyone, but I listed a few things we have subsidies on including corn.

1. Why do we need a subsidy on sugar? Short of tobacco and alcohol, which are controlled and heavily taxed, excessive amounts of sugar likely contribute the most harm to health in western society.

2. That's a great point. Why do we need a subsidy or mandate for ethanol?

3. Makes sense.

I agree with the sentiment that we should not subsidize sugar, and that lowering the price of sugar will lead to worse health outcomes. But my point was that I don't think that there are any subsidies for sugar. I don't have encyclopedic knowledge of all the US farm subsidies, so was wondering if there exist any that I didn't know about.

[pecunia]

Isn't there anyone left out there that can make a cogent argument for sustaining the current US health care system?  Isn't there pleasure in seeing odd little bills in the mail six months after a doctor visit for the big portion not covered by insurance?  Don't you like the idea of paying the equivalent of a car payment of house payment every month for insurance that is "supposed" to cover you in the event of a catastrophic event?

[Metalcat]

+1 to that!
It's not perfect, but there's no way in hell I'd ever trade it for the US system.

Universal Health Care means that people are able to take risks like starting businesses or other ventures even when they have kids.

A year ago I left my adequate job with good benefits to buy a business and work on upgrading it.  It did mean losing my 'extended health insurance'.  If we were in the US there is NO WAY I could have done that with 2 kids at home (DW's job has no benefits either). 

We will still pay for dental and I hope one of the kids doesn't knock his teeth out, but I don't worry about a bankruptcy inducing health crisis that is not covered (like when my 9 year old spent a week in hospital in November with pneumonia).  I was able to take a risk, unlike a middle aged American in the same situation. 

You can pry my health card from my cold dead hands.  It is pro business, pro innovation and makes everything better.  I am continually astonished at the bizarre pretzel logic that happens in the US debates on health care.

Ah yes...

I forgot about the entrepreneurial benefits of universal healthcare in my previous diatribe.

It horrifies me how stifled US entrepreneurialism is by the current healthcare system. It makes no sense in such a pro-industry culture that people support a system that discourages people from taking business risks.

I read so many posts on here talking about life plans/goals/dreams and the weight of this ridiculous insurance issue is just so omnipresent. The concept is so foreign to us.

I can't even fathom a life where I have to think about that, where I have to balance the fear of a financially crippling hospital stay into my potential career plans.
I can just move jobs, drop to part time, and start businesses as I see fit. I can randomly take a year off. It's all good.

Another business aspect is that it's a lot easier to become an employer when you don't have to provide insurance (or 401K plans, ours are run centrally by the government as well) to attract quality staff, which makes growing a business a whole lot simpler here. I could hire a team tomorrow with minimal administrative set up or cost.

I know it's all ideologically supposed to be about having the "freedom" to choose through the markets, but on an individual scale, it actually really suppresses freedom.

You Americans have this terrifying axe hanging over your heads at all times, and it truly saddens us up north to see it. We genuinely feel really terrible for you.

It just seems so...uncivilized.

Truthfully, I wonder what will happen up here if you guys ever get a decent universal healthcare system, because your epically fucked up insurance system is a frequently cited reason why Canadians refuse to move south...even when it's so cold that our dogs refuse to pee outside.

It would be interesting to see what affect that would have on the "brain drain", because it's a frequent conversation up here:
-"Would you ever consider moving to the states? You could make so much more money, pay less taxes, and housing is cheaper in a lot of areas"
-"Yeah...but healthcare..."
-"Right...there's that. Better stay put in our arctic-fucking-polar-vortex-frozen-hellscape and pay 13% sales tax on everything, because there's no way we're putting up with that shit. My fingers might fall off from frostbite, but at least I don't have to worry about a 600K bill for sewing them back on!"

[Kris]

Several people in this thread are wanting to get rid of subsidies to corn syrup. What subsidies exactly are you all talking about?

I can think of three that apply to corn.

1) Tariffs on sugar cane could be considered an indirect subsidy to corn in the US, but that would raise, not lower, the price of sugar.

2) Ethanol mandate for gasoline could also be considered an indirect subsidy to corn, but ethanol production uses the fermentable sugars.

3) Crop insurance subsidies that apply to all crops equally. These go disproportionally to corn and soy, but that is because the US grows a lot of corn and soy. This subsidy does not encourage the growing of any crop over another, because all crops can get it.

Are there any that I am missing?

I can't speak for everyone, but I listed a few things we have subsidies on including corn.

1. Why do we need a subsidy on sugar? Short of tobacco and alcohol, which are controlled and heavily taxed, excessive amounts of sugar likely contribute the most harm to health in western society.

2. That's a great point. Why do we need a subsidy or mandate for ethanol?

3. Makes sense.

I agree with the sentiment that we should not subsidize sugar, and that lowering the price of sugar will lead to worse health outcomes. But my point was that I don't think that there are any subsidies for sugar. I don't have encyclopedic knowledge of all the US farm subsidies, so was wondering if there exist any that I didn't know about.

https://www.washingtonpost.com/news/business/wp/2018/05/17/house-defeats-divisive-sugar-amendment-that-threatened-to-sink-farm-bill/?utm_term=.4dcd760e779f

[Poundwise]

@Even Steven  found this interesting article. https://grist.org/article/farm-subsidies-bitter-and-sweet/
I can see the rationale for boosting production of staples like corn, sugar, and soy... they keep well, they can be used for many purposes.  What is the answer to obesity?  Taxing sweets on the consumer end?  It seems like making communities more walkable would be the most desirable answer, but it is expensive (there are many barriers to putting sidewalks into my community, for instance.)  But this is quite the sidetrack!

A friend of mine recently brought up a point in favor of universal health care that I hadn't even thought of (guess it should have been obvious)... savings to local government because health benefits will no longer have to be part of pension plans. Have the calculations of costs included savings on state and local taxes?

No idea.  My health plan in retirement was negotiated by my (para-public) union on behalf of all its retired members.  But even if health insurance is part of a retirement package, it is a health plan that covers the extras, not the basics, so much less expensive.

Oops, I meant to also include the health benefits that municipalities pay to active firefighters, police, teachers,  and other civil workers as well as after retirement. 

[pecunia]

 





- SNIP -


It would be interesting to see what affect that would have on the "brain drain", because it's a frequent conversation up here:
-"Would you ever consider moving to the states? You could make so much more money, pay less taxes, and housing is cheaper in a lot of areas"
-"Yeah...but healthcare..."
-"Right...there's that. Better stay put in our arctic-fucking-polar-vortex-frozen-hellscape and pay 13% sales tax on everything, because there's no way we're putting up with that shit. My fingers might fall off from frostbite, but at least I don't have to worry about a 600K bill for sewing them back on!"

In the event of US Socialist medicine, we might need another wall and the Canucks will pay for it.

[Metalcat]

 





- SNIP -


It would be interesting to see what affect that would have on the "brain drain", because it's a frequent conversation up here:
-"Would you ever consider moving to the states? You could make so much more money, pay less taxes, and housing is cheaper in a lot of areas"
-"Yeah...but healthcare..."
-"Right...there's that. Better stay put in our arctic-fucking-polar-vortex-frozen-hellscape and pay 13% sales tax on everything, because there's no way we're putting up with that shit. My fingers might fall off from frostbite, but at least I don't have to worry about a 600K bill for sewing them back on!"

In the event of US Socialist medicine, we might need another wall and the Canucks will pay for it.

HAHAHAHAHA

[gentmach]

I think we've entered that late stage of the debate that comes down to "what is human nature?" As a jaded, cynical person who has been dealing with borderline psychopaths most of his life, the idea that my healthcare is their hands is unsettling.

And before you say "get away from them", we will be linked by the healthcare system whether I wish it or not.

So let's give healthcare a try.

I am so confused...

I was saying it was a "personal" problem. Right now I am dealing with people who have no empathy, respect or loyalty to anyone else. That they CAN take everything they want because they think the world OWES them. It has biased my thinking and caused problems.

[EvenSteven]

Several people in this thread are wanting to get rid of subsidies to corn syrup. What subsidies exactly are you all talking about?

I can think of three that apply to corn.

1) Tariffs on sugar cane could be considered an indirect subsidy to corn in the US, but that would raise, not lower, the price of sugar.

2) Ethanol mandate for gasoline could also be considered an indirect subsidy to corn, but ethanol production uses the fermentable sugars.

3) Crop insurance subsidies that apply to all crops equally. These go disproportionally to corn and soy, but that is because the US grows a lot of corn and soy. This subsidy does not encourage the growing of any crop over another, because all crops can get it.

Are there any that I am missing?

I can't speak for everyone, but I listed a few things we have subsidies on including corn.

1. Why do we need a subsidy on sugar? Short of tobacco and alcohol, which are controlled and heavily taxed, excessive amounts of sugar likely contribute the most harm to health in western society.

2. That's a great point. Why do we need a subsidy or mandate for ethanol?

3. Makes sense.

I agree with the sentiment that we should not subsidize sugar, and that lowering the price of sugar will lead to worse health outcomes. But my point was that I don't think that there are any subsidies for sugar. I don't have encyclopedic knowledge of all the US farm subsidies, so was wondering if there exist any that I didn't know about.

https://www.washingtonpost.com/news/business/wp/2018/05/17/house-defeats-divisive-sugar-amendment-that-threatened-to-sink-farm-bill/?utm_term=.4dcd760e779f

Thanks, interesting article. But doesn't it say that there were amendments to the farm bill that, if passed, would lower the price of sugar? And that those amendments were defeated and not included in the farm bill? So the subsidies that go to sugar are all policies that raise the price of sugar, thus decreasing its consumption? If we were to end those, and lower the price of sugar, wouldn't that lead to more consumption and worse health outcomes?

[Kris]

Several people in this thread are wanting to get rid of subsidies to corn syrup. What subsidies exactly are you all talking about?

I can think of three that apply to corn.

1) Tariffs on sugar cane could be considered an indirect subsidy to corn in the US, but that would raise, not lower, the price of sugar.

2) Ethanol mandate for gasoline could also be considered an indirect subsidy to corn, but ethanol production uses the fermentable sugars.

3) Crop insurance subsidies that apply to all crops equally. These go disproportionally to corn and soy, but that is because the US grows a lot of corn and soy. This subsidy does not encourage the growing of any crop over another, because all crops can get it.

Are there any that I am missing?

I can't speak for everyone, but I listed a few things we have subsidies on including corn.

1. Why do we need a subsidy on sugar? Short of tobacco and alcohol, which are controlled and heavily taxed, excessive amounts of sugar likely contribute the most harm to health in western society.

2. That's a great point. Why do we need a subsidy or mandate for ethanol?

3. Makes sense.

I agree with the sentiment that we should not subsidize sugar, and that lowering the price of sugar will lead to worse health outcomes. But my point was that I don't think that there are any subsidies for sugar. I don't have encyclopedic knowledge of all the US farm subsidies, so was wondering if there exist any that I didn't know about.

https://www.washingtonpost.com/news/business/wp/2018/05/17/house-defeats-divisive-sugar-amendment-that-threatened-to-sink-farm-bill/?utm_term=.4dcd760e779f

Thanks, interesting article. But doesn't it say that there were amendments to the farm bill that, if passed, would lower the price of sugar? And that those amendments were defeated and not included in the farm bill? So the subsidies that go to sugar are all policies that raise the price of sugar, thus decreasing its consumption? If we were to end those, and lower the price of sugar, wouldn't that lead to more consumption and worse health outcomes?

Very doubtful. You are right, and I apologize, if I seemed to be implying that the subsidies are to lower the price of sugar for the consumer. The subsidies are to protect sugar farmers. As the corn syrup subsidies are to keep the corn farmers in business. My posting of that was just in answer to your question about whether sugar was subsidized, which it is.

That said, I highly doubt at this point that ending sugar subsidies, with the subsequent lowering of the price of sugar, would lead to more consumption at this point. Corn syrup is the biggest problem at this point, and it has so pervaded every aspect of our food industry in the US that it would be hard to pack more of it in than we already do. The cat is sort of out of the bag.

[Metalcat]

I think we've entered that late stage of the debate that comes down to "what is human nature?" As a jaded, cynical person who has been dealing with borderline psychopaths most of his life, the idea that my healthcare is their hands is unsettling.

And before you say "get away from them", we will be linked by the healthcare system whether I wish it or not.

So let's give healthcare a try.

I am so confused...

I was saying it was a "personal" problem. Right now I am dealing with people who have no empathy, respect or loyalty to anyone else. That they CAN take everything they want because they think the world OWES them. It has biased my thinking and caused problems.

Still confused...

My post that you quoted was about national policy...not sure what that has to do with some people being assholes. Good policy accounts for assholes because they're a normal part of the population, so policy makers know to put integrity programs in place in their policy.

You can't make policy based on not having assholes in your system, that would be sloppy and ineffective.

[Mississippi Mudstache]

Several people in this thread are wanting to get rid of subsidies to corn syrup. What subsidies exactly are you all talking about?

I can think of three that apply to corn.

1) Tariffs on sugar cane could be considered an indirect subsidy to corn in the US, but that would raise, not lower, the price of sugar.

2) Ethanol mandate for gasoline could also be considered an indirect subsidy to corn, but ethanol production uses the fermentable sugars.

3) Crop insurance subsidies that apply to all crops equally. These go disproportionally to corn and soy, but that is because the US grows a lot of corn and soy. This subsidy does not encourage the growing of any crop over another, because all crops can get it.

Are there any that I am missing?

I can't speak for everyone, but I listed a few things we have subsidies on including corn.

1. Why do we need a subsidy on sugar? Short of tobacco and alcohol, which are controlled and heavily taxed, excessive amounts of sugar likely contribute the most harm to health in western society.

2. That's a great point. Why do we need a subsidy or mandate for ethanol?

3. Makes sense.

I agree with the sentiment that we should not subsidize sugar, and that lowering the price of sugar will lead to worse health outcomes. But my point was that I don't think that there are any subsidies for sugar. I don't have encyclopedic knowledge of all the US farm subsidies, so was wondering if there exist any that I didn't know about.

https://www.washingtonpost.com/news/business/wp/2018/05/17/house-defeats-divisive-sugar-amendment-that-threatened-to-sink-farm-bill/?utm_term=.4dcd760e779f

Thanks, interesting article. But doesn't it say that there were amendments to the farm bill that, if passed, would lower the price of sugar? And that those amendments were defeated and not included in the farm bill? So the subsidies that go to sugar are all policies that raise the price of sugar, thus decreasing its consumption? If we were to end those, and lower the price of sugar, wouldn't that lead to more consumption and worse health outcomes?

The various price controls on sugar, such as domestic production limits and tariffs on imports, make substitutes (such as high fructose corn syrup) more economical. I'm not an expert on farm subsidies, but National Geographic does a nice, brief synopsis here. The deficiency payments pioneered in the 70s definitely caused a glut of corn and other crops, so our intrepid scientists figured out how to use the excessive production to squeeze corn into everything from Coke to gasoline. But as the National Geographic article points out, corn is not really the only culprit - almost every subsidized crop in the U.S. is a commodity crop associated with worse health outcomes, while the fruits and vegetables that are associated with positive health outcomes go unsubsidized. The reasoning is obvious: Farm subsidies are intended to improve farm income, not public health.

I'm not opposed to reasonable farm subsidies, because farmers face a classic economic problem: Inelastic supply (they grow what they're able grow in any given year) combined with inelastic demand (the public eats what it needs to eat in any given year). It is a difficult problem to solve, and our politicians have "solved" it by forcing excess supplies of inexpensive nutrients into the supply chain. Intuitively, I would prefer an approach that places more weight on the demand side - subsidizing healthy foods for consumers, thus increasing demand for those products and encouraging more farmers to grow them. But I'm not a public policy expert, I simply believe that solving one problem (food shortages in year of inadequate productions & struggling farmers in years of excessive production) has led to another one (constant, excessive supplies of unhealthy foods) that has led to negative health consequences. I believe that the system has room to improve.

[Kris]

Several people in this thread are wanting to get rid of subsidies to corn syrup. What subsidies exactly are you all talking about?

I can think of three that apply to corn.

1) Tariffs on sugar cane could be considered an indirect subsidy to corn in the US, but that would raise, not lower, the price of sugar.

2) Ethanol mandate for gasoline could also be considered an indirect subsidy to corn, but ethanol production uses the fermentable sugars.

3) Crop insurance subsidies that apply to all crops equally. These go disproportionally to corn and soy, but that is because the US grows a lot of corn and soy. This subsidy does not encourage the growing of any crop over another, because all crops can get it.

Are there any that I am missing?

I can't speak for everyone, but I listed a few things we have subsidies on including corn.

1. Why do we need a subsidy on sugar? Short of tobacco and alcohol, which are controlled and heavily taxed, excessive amounts of sugar likely contribute the most harm to health in western society.

2. That's a great point. Why do we need a subsidy or mandate for ethanol?

3. Makes sense.

I agree with the sentiment that we should not subsidize sugar, and that lowering the price of sugar will lead to worse health outcomes. But my point was that I don't think that there are any subsidies for sugar. I don't have encyclopedic knowledge of all the US farm subsidies, so was wondering if there exist any that I didn't know about.

https://www.washingtonpost.com/news/business/wp/2018/05/17/house-defeats-divisive-sugar-amendment-that-threatened-to-sink-farm-bill/?utm_term=.4dcd760e779f

Thanks, interesting article. But doesn't it say that there were amendments to the farm bill that, if passed, would lower the price of sugar? And that those amendments were defeated and not included in the farm bill? So the subsidies that go to sugar are all policies that raise the price of sugar, thus decreasing its consumption? If we were to end those, and lower the price of sugar, wouldn't that lead to more consumption and worse health outcomes?

The various price controls on sugar, such as domestic production limits and tariffs on imports, make substitutes (such as high fructose corn syrup) more economical. I'm not an expert on farm subsidies, but National Geographic does a nice, brief synopsis here. The deficiency payments pioneered in the 70s definitely caused a glut of corn and other crops, so our intrepid scientists figured out how to use the excessive production to squeeze corn into everything from Coke to gasoline. But as the National Geographic article points out, corn is not really the only culprit - almost every subsidized crop in the U.S. is a commodity crop associated with worse health outcomes, while the fruits and vegetables that are associated with positive health outcomes go unsubsidized. The reasoning is obvious: Farm subsidies are intended to improve farm income, not public health.

I'm not opposed to reasonable farm subsidies, because farmers face a classic economic problem: Inelastic supply (they grow what they're able grow in any given year) combined with inelastic demand (the public eats what it needs to eat in any given year). It is a difficult problem to solve, and our politicians have "solved" it by forcing excess supplies of inexpensive nutrients into the supply chain. Intuitively, I would prefer an approach that places more weight on the demand side - subsidizing healthy foods for consumers, thus increasing demand for those products and encouraging more farmers to grow them. But I'm not a public policy expert, I simply believe that solving one problem (food shortages in year of inadequate productions & struggling farmers in years of excessive production) has led to another one (constant, excessive supplies of unhealthy foods) that has led to negative health consequences. I believe that the system has room to improve.

Exactly.

Which is, as someone said above, a good argument for universal health care: because it might actually prompt the government to factor in the cost of public health when they make choices on which crops to subsidize.

Instead of farm income, the fast food industry, etc., at the expense of the American people as a whole.

[RetiredAt63]

Exactly.

Which is, as someone said above, a good argument for universal health care: because it might actually prompt the government to factor in the cost of public health when they make choices on which crops to subsidize.

Instead of farm income, the fast food industry, etc., at the expense of the American people as a whole.

Um, that would depend on how well the various government agencies involved do their homework.  I have no idea what Canadian subsidies are on agricultural products, apart from the obvious policies on dairy. And so much seems to be driven by other agendas - the wheat boards are an example.  Canada is not a lot better than the US re health and obesity and type 2 diabetes, but of course so much of our food is either from the US or from US subsidiaries in Canada (not to mention advertising for all these profitable barely-foods) that food-wise we might as well be part of US agricultural policy.

[Kris]

Exactly.

Which is, as someone said above, a good argument for universal health care: because it might actually prompt the government to factor in the cost of public health when they make choices on which crops to subsidize.

Instead of farm income, the fast food industry, etc., at the expense of the American people as a whole.

Um, that would depend on how well the various government agencies involved do their homework.  I have no idea what Canadian subsidies are on agricultural products, apart from the obvious policies on dairy. And so much seems to be driven by other agendas - the wheat boards are an example.  Canada is not a lot better than the US re health and obesity and type 2 diabetes, but of course so much of our food is either from the US or from US subsidiaries in Canada (not to mention advertising for all these profitable barely-foods) that food-wise we might as well be part of US agricultural policy.

Yes, true. It would at least potentially prompt them to consider those things -- as I said above.

Then again, these days you would probably lose money if you bet on the US government making decisions that are in the best interests of its people, over corporate interests and powerful lobby groups.

[gentmach]

I think we've entered that late stage of the debate that comes down to "what is human nature?" As a jaded, cynical person who has been dealing with borderline psychopaths most of his life, the idea that my healthcare is their hands is unsettling.

And before you say "get away from them", we will be linked by the healthcare system whether I wish it or not.

So let's give healthcare a try.

I am so confused...

I was saying it was a "personal" problem. Right now I am dealing with people who have no empathy, respect or loyalty to anyone else. That they CAN take everything they want because they think the world OWES them. It has biased my thinking and caused problems.

Still confused...

My post that you quoted was about national policy...not sure what that has to do with some people being assholes. Good policy accounts for assholes because they're a normal part of the population, so policy makers know to put integrity programs in place in their policy.

You can't make policy based on not having assholes in your system, that would be sloppy and ineffective.

I'm extrapolating local conditions to a national scale. If the assholes outnumber the productive people, then the system operates at a deficit. Operating at a deficit is unsustainable in the long run because at some point all the accounts must balance.

Essentially my doubts stem from the idea that America is too big to police effectively, let alone tax effectively, leaving what integrity programs are created woefully inadequate, leading to a failing system.

[RetiredAt63]

Essentially my doubts stem from the idea that America is too big to police effectively, let alone tax effectively, leaving what integrity programs are created woefully inadequate, leading to a failing system.

Run by the states?  With general coordination by the feds?  We do that, it works.

[DadJokes]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

[Metalcat]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

That's literally the exact system we have in Canada.

[DadJokes]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

That's literally the exact system we have in Canada.

Does each province have its own law, or do they have to adapt a national law to work for them? Could a province choose not to offer universal care in its boundaries?

[shenlong55]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

I think I would accept something like the federal government setting up incentives for states to adopt systems of universal coverage while allowing individual states to work out the details.  But I don't think I trust red states to expand coverage without those incentives, and I don't believe the people in those states are any less deserving of basic healthcare because they don't live in the same state as me.

[DadJokes]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

I think I would accept something like the federal government setting up incentives for states to adopt systems of universal coverage while allowing individual states to work out the details.  But I don't think I trust red states to expand coverage without those incentives, and I don't believe the people in those states are any less deserving of basic healthcare because they don't live in the same state as me.

However, then they would have more options. Our country was set up in such a way that each state could operate as its own sovereign government but still have a central government to address things that were not feasible on a state level, such as the military and a common currency. It also gave citizens the option to move between states if the policies of one better suited them. When we pass these laws on a federal level (violating the intent of the Constitution), it takes that ability away from citizens.

[shenlong55]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

I think I would accept something like the federal government setting up incentives for states to adopt systems of universal coverage while allowing individual states to work out the details.  But I don't think I trust red states to expand coverage without those incentives, and I don't believe the people in those states are any less deserving of basic healthcare because they don't live in the same state as me.

However, then they would have more options. Our country was set up in such a way that each state could operate as its own sovereign government but still have a central government to address things that were not feasible on a state level, such as the military and a common currency. It also gave citizens the option to move between states if the policies of one better suited them. When we pass these laws on a federal level (violating the intent of the Constitution), it takes that ability away from citizens.

I feel that if that's the solution that you prefer, then you should be advocating for the federal government to implement policies that make it easier to move between states.

[ixtap]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

I think I would accept something like the federal government setting up incentives for states to adopt systems of universal coverage while allowing individual states to work out the details.  But I don't think I trust red states to expand coverage without those incentives, and I don't believe the people in those states are any less deserving of basic healthcare because they don't live in the same state as me.

However, then they would have more options. Our country was set up in such a way that each state could operate as its own sovereign government but still have a central government to address things that were not feasible on a state level, such as the military and a common currency. It also gave citizens the option to move between states if the policies of one better suited them. When we pass these laws on a federal level (violating the intent of the Constitution), it takes that ability away from citizens.

I feel that if that's the solution that you prefer, then you should be advocating for the federal government to implement policies that make it easier to move between states.

Or jobs, even.

[Metalcat]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

That's literally the exact system we have in Canada.

Does each province have its own law, or do they have to adapt a national law to work for them? Could a province choose not to offer universal care in its boundaries?

Each province is single payer, but yes, they run autonomously.

I suppose a province could go fully private, I suppose, but that would never happen, because as every Canadian has posted so far, you would have to rip our healthcards from our cold dead hands before we would give them up. Proposing that would be political suicide for any ruling party.

Various parties toss out the idea of incorporating a two-tier semi-private system into the mix in different provinces at different times, depending on what problems there are in their healthcare at a given point. It's a hiiiighly controversial proposal though.

Canada isn't a monoculture at all. Don't think that because we all value a non-broken medical system that doesn't bankrupt people that we're somehow all on the same page. We've got boat loads of hostility between us. This is like the ONE thing that Canadians seem to universally agree on. That's how big a deal it is.

So we are actually comparing apples to apples when you talk about one state being very different from another and requiring customized systems. The US is not unique in that respect.

I mean...you do realize we have Quebec, right? They literally operate in a completely different language, culture, ideology, etc. Then you have y'know the whole north, which is a totally different reality where many communities are so remote that everything needs to be flown in, etc, etc.

So no, it's not a case that it's so much easier because Canada is smaller population-wise because we're just as spread out as you guys are and perhaps even more different from one another.

[DadJokes]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

That's literally the exact system we have in Canada.

Does each province have its own law, or do they have to adapt a national law to work for them? Could a province choose not to offer universal care in its boundaries?

Each province is single payer, but yes, they run autonomously.

I suppose a province could go fully private, I suppose, but that would never happen, because as every Canadian has posted so far, you would have to rip our healthcards from our cold dead hands before we would give them up. Proposing that would be political suicide for any ruling party.

Various parties toss out the idea of incorporating a two-tier semi-private system into the mix in different provinces at different times, depending on what problems there are in their healthcare at a given point. It's a hiiiighly controversial proposal though.

Canada isn't a monoculture at all. Don't think that because we all value a non-broken medical system that doesn't bankrupt people that we're somehow all on the same page. We've got boat loads of hostility between us. This is like the ONE thing that Canadians seem to universally agree on. That's how big a deal it is.

So we are actually comparing apples to apples when you talk about one state being very different from another and requiring customized systems. The US is not unique in that respect.

I mean...you do realize we have Quebec, right? They literally operate in a completely different language, culture, ideology, etc. Then you have y'know the whole north, which is a totally different reality where many communities are so remote that everything needs to be flown in, etc, etc.

So no, it's not a case that it's so much easier because Canada is smaller population-wise because we're just as spread out as you guys are and perhaps even more different from one another.

Thanks for the input. I certainly wasn't advocating for one province to get rid of the system or anything- just trying to get a better idea of it.

As for differences between the people, I remember seeing a hockey forum where Canadians were asked if there team couldn't win the Cup, which Canadian team would they want to win. A significant number would rather the Cup not go back to Canada than any other Canadian team win it first. So I get that.

[LennStar]

82 million people in Germany have (basically) one system of health care, not per state-level. And as far as I know, that is true for every other european country.

Which makes the EU bigger than the US with less states.
btw. in Germany the maximum you pay (after 7,X% right from your pay) is 2% of your income, for drugs. Heart surgery? Can't even say how much the one costs that my dad had. We have never seen the bill.
Yeah, there are some things you have to pay out of your pocket. Hearing aids better than the most basic one for example. But most things just happen. For everyone. I think that is worth the <10%

[Davnasty]

For those that support universal healthcare, would you accept your individual state using a universal healthcare system instead?

I feel that the US is too big for a one-size-fits-all approach to most policies. What works in Massachusetts is not likely to work in Montana and vice-versa.

If you mean every state would have some form of basic universal healthcare but tailor the specifics to the state, then maybe. If you mean allowing states to opt out and maintain the status quo, then no. I can see a number of problems with that scenario but the first that comes to mind is that those who can't afford private insurance would move to a state with universal healthcare. The burden of low/no income earners would be shifted to states who will take care of them.

[austin944]

I apologize for invoking religion, I don't like using the bible *against* people.  My point is that we are a society.  Is it not for the benefit of the whole that each individual person be given complete and affordable access to health care regardless of their station in life?  Our society, whether we know it or not, is interdependent on each other.   

Americans don't live in a Socialist or Communist country.  Individuals have rights under the US Constitution; "society" has no rights.  And those individual rights should include the ability to opt out of any government-created health care scheme.

[LennStar]

I apologize for invoking religion, I don't like using the bible *against* people.  My point is that we are a society.  Is it not for the benefit of the whole that each individual person be given complete and affordable access to health care regardless of their station in life?  Our society, whether we know it or not, is interdependent on each other.   

Americans don't live in a Socialist or Communist country.  Individuals have rights under the US Constitution; "society" has no rights.  And those individual rights should include the ability to opt out of any government-created health care scheme.

Only if you never use any hospital build with public money, never use an ambulance funded by public money rolling on a streeet build by public money and doctors trained at universities with public money. Oh, and of course never use any drugs or machines invented by public money research.

[rocketpj]

As for differences between the people, I remember seeing a hockey forum where Canadians were asked if there team couldn't win the Cup, which Canadian team would they want to win. A significant number would rather the Cup not go back to Canada than any other Canadian team win it first. So I get that.

Most Canadians I know tend to hope for a descending series of Canadian teams.  I will root for my team, then a few others, and won't start rooting for any American teams unless the last Canuck team is the Flames.  At that point I usually root for a player (such as Crosby).

/thread diversion

[anisotropy]

I think there is an issue that's being largely overlooked here. Effectively, the US pharma market is subsidizing countries like Australia, the UK, Canada, etc. If the US gets on the UHC bandwagon with some sort of meaningful drug plan, I wouldn't be surprised if drug prices in those countries go up by at least 50-100%.  Actually, to maintain the sort of profit margins these companies currently have, i think the prices in these countries would need to go up almost 300%.

Which boggles my mind really, this is about as clear of an example of "other countries taking advantage of American generosity", shouldn't a drug plan be part of the MAGA platform? lol.

[shenlong55]

I apologize for invoking religion, I don't like using the bible *against* people.  My point is that we are a society.  Is it not for the benefit of the whole that each individual person be given complete and affordable access to health care regardless of their station in life?  Our society, whether we know it or not, is interdependent on each other.   

Americans don't live in a Socialist or Communist country.  Individuals have rights under the US Constitution; "society" has no rights.  And those individual rights should include the ability to opt out of any government-created health care scheme.

I find this stance to be intellectually dishonest unless you are also advocating for repealing EMTALA.

[RetiredAt63]

As for differences between the people, I remember seeing a hockey forum where Canadians were asked if there team couldn't win the Cup, which Canadian team would they want to win. A significant number would rather the Cup not go back to Canada than any other Canadian team win it first. So I get that.

Most Canadians I know tend to hope for a descending series of Canadian teams.  I will root for my team, then a few others, and won't start rooting for any American teams unless the last Canuck team is the Flames.  At that point I usually root for a player (such as Crosby).

/thread diversion

Still diverted - same here, except substitute the Leafs.  ;-)

[RetiredAt63]

I think there is an issue that's being largely overlooked here. Effectively, the US pharma market is subsidizing countries like Australia, the UK, Canada, etc. If the US gets on the UHC bandwagon with some sort of meaningful drug plan, I wouldn't be surprised if drug prices in those countries go up by at least 50-100%.  Actually, to maintain the sort of profit margins these companies currently have, i think the prices in these countries would need to go up almost 300%.

Which boggles my mind really, this is about as clear of an example of "other countries taking advantage of American generosity", shouldn't a drug plan be part of the MAGA platform? lol.

Um, drugs (except those administered in a hospital) are not covered under our health plan.  Hospitals obviously save by buying in bulk.                                                                               

Otherwise we buy our prescriptions at a pharmacy, just like in the US. If we have private insurance our insurance will pay for some % of the cost.  So I fail to see how you are subsidizing us?   

You don't seem to be following how we have described that some things (like prescriptions and dental work and various other things) are not covered by our health care.

[pecunia]

 - KER SNIP -


Um, drugs (except those administered in a hospital) are not covered under our health plan.  Hospitals obviously save by buying in bulk.                                                                               

Otherwise we buy our prescriptions at a pharmacy, just like in the US. If we have private insurance our insurance will pay for some % of the cost.  So I fail to see how you are subsidizing us?   

You don't seem to be following how we have described that some things (like prescriptions and dental work and various other things) are not covered by our health care.
[/quote]


????  OK - I believe you.  However, I remember those busloads of old folks that used to make the trek up to the Great White North to save money on prescriptions.  If drugs are not part of your health plan, then why are they supposedly cheaper in Canada?  I believe Congress even made a silly law that you couldn't import the drugs from Canada.  The rationale was that the health standards couldn't be verified or some such.  I think it was a very weak pseudo argument to protect the American pharmaceutical industry. ????

[DadJokes]

As for differences between the people, I remember seeing a hockey forum where Canadians were asked if there team couldn't win the Cup, which Canadian team would they want to win. A significant number would rather the Cup not go back to Canada than any other Canadian team win it first. So I get that.

Most Canadians I know tend to hope for a descending series of Canadian teams.  I will root for my team, then a few others, and won't start rooting for any American teams unless the last Canuck team is the Flames.  At that point I usually root for a player (such as Crosby).

/thread diversion

Still diverted - same here, except substitute the Leafs.  ;-)

Still diverting, because this is a much more important topic than healthcare (joking of course)- fuck the jets.

[Kris]

- KER SNIP -


Um, drugs (except those administered in a hospital) are not covered under our health plan.  Hospitals obviously save by buying in bulk.                                                                               

Otherwise we buy our prescriptions at a pharmacy, just like in the US. If we have private insurance our insurance will pay for some % of the cost.  So I fail to see how you are subsidizing us?   

You don't seem to be following how we have described that some things (like prescriptions and dental work and various other things) are not covered by our health care.

????  OK - I believe you.  However, I remember those busloads of old folks that used to make the trek up to the Great White North to save money on prescriptions.  If drugs are not part of your health plan, then why are they supposedly cheaper in Canada?  I believe Congress even made a silly law that you couldn't import the drugs from Canada.  The rationale was that the health standards couldn't be verified or some such.  I think it was a very weak pseudo argument to protect the American pharmaceutical industry. ????
[/quote]

In a word, price controls.

https://slate.com/news-and-politics/2000/05/why-do-drugs-cost-less-in-canada.html

[rocketpj]

I think there is an issue that's being largely overlooked here. Effectively, the US pharma market is subsidizing countries like Australia, the UK, Canada, etc. If the US gets on the UHC bandwagon with some sort of meaningful drug plan, I wouldn't be surprised if drug prices in those countries go up by at least 50-100%.  Actually, to maintain the sort of profit margins these companies currently have, i think the prices in these countries would need to go up almost 300%.

Which boggles my mind really, this is about as clear of an example of "other countries taking advantage of American generosity", shouldn't a drug plan be part of the MAGA platform? lol.

Um, drugs (except those administered in a hospital) are not covered under our health plan.  Hospitals obviously save by buying in bulk.                                                                               

Otherwise we buy our prescriptions at a pharmacy, just like in the US. If we have private insurance our insurance will pay for some % of the cost.  So I fail to see how you are subsidizing us?   

You don't seem to be following how we have described that some things (like prescriptions and dental work and various other things) are not covered by our health care.

Every province is different in various ways.  In BC we have the 'Fair Pharmacare' plan, which basically means you are on the hook for the first couple of thousand dollars of drug costs but then the province will step in - for drugs that are on the list.  There are some new drugs that haven't yet made it onto the list, or some other Shkreli drugs that are wildly overpriced.  This does incentivize the province to approve generics, which is fine with me.

Drugs are cheaper here because pharmaceutical companies charge what the market will bear.  In the US you have a non-unified array of bizarre HMOs, Medicaid and private payers where costs are wildly inflated and the companies get away with charging a ton.  In Canada the primary buyer is a single entity that is willing to use a generic if the company is too greedy.

We are not subsidized in any way by the US, it's just that the American system is so screwed that pharma companies get away with outrageous things all the time and you guys think that is normal, or somehow 'capitalism' instead of just plain old corruption.

[RetiredAt63]

 Also for Canadian drug prices:
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.20.3.92

[kei te pai]

In NZ we have Pharmac, the govt national drug buying agency. Approved drugs are heavily subsidised to the patient. Drug prices are negotiated with various drug companies, and sometimes brands of particular funded medications change.
Unsubsidised drugs such as particular cancer drugs can still be purchased in many cases but with no subsidy.
Regular public debate about why isnt this or that drug funded. Regular lobbying by drug companies. But general acceptance that this model works well most of the time for most of the population.
I take a regular routine medication. It costs me $5 every 3 months. If I ever got to $100 in prescription drugs in a year, I would pay nothing more for that year.
I dont understand the preoccupation about " communist or socialist" medicine, why not just assess costs and outcomes objectively?

[anisotropy]

We are not subsidized in any way by the US, it's just that the American system is so screwed that pharma companies get away with outrageous things all the time and you guys think that is normal, or somehow 'capitalism' instead of just plain old corruption.

Yes and No. The bigger picture is quite complicated, on one hand you have articles like this:

Debunking The Pharmaceutical Research ‘Free Rider’ Myth: A response To Yu, Helms, And Bach
https://www.healthaffairs.org/do/10.1377/hblog20170602.060376/full/

But they often neglect nuances such as this:

Reframing the Conversation on Drug Pricing
https://catalyst.nejm.org/reframing-conversation-drug-pricing/

[RetiredAt63]

I dont understand the preoccupation about " communist or socialist" medicine, why not just assess costs and outcomes objectively?

It seems to be an outlook peculiar to some Americans - we are not seeing it on this thread from Europeans or Canadians either. We know it works, we discuss how the details will work, but we don't put much moral judgement into it.  Some things are not covered here because they are not seen as medically necessary (i.e. plastic surgery for "vanity" reasons, compared to plastic surgery for medically necessary reasons) but basically the benefit of a healthy population is seen as worthwhile, just as an educated society is.  Come to think of it, I would guess higher education costs in the countries that have universal health care are also lower than higher education costs in the US.  Different approaches to how a society operates.

[pecunia]

I dont understand the preoccupation about " communist or socialist" medicine, why not just assess costs and outcomes objectively?

Here's the way it was described to me when I was about 12 years old:

    Socialism: You have two cows. The government takes one and gives it to your neighbor.
    Communism: You have two cows. You give them to the government, and the government then gives you some milk.
    Fascism: You have two cows. You give them to the government, and the government then sells you some milk.
    Capitalism: You have two cows. You sell one and buy a bull.
    Nazism: You have two cows. The government takes both and shoots you.

This one is newer:  Russian company: You have two cows. You drink some vodka and count them again. You have five cows. The Russian Mafia shows up and takes however many cows you have.

Besides the jokes, we had great comic books and movies where the bad guy was the "commie."

It was never referred to as brainwashing.  That's what the commies did.  It was (is) education.  It's about learning about American Freedom.  The freedom that must be retained until they pry your gun from your cold dead fingers.

[ixtap]

In NZ we have Pharmac, the govt national drug buying agency. Approved drugs are heavily subsidised to the patient. Drug prices are negotiated with various drug companies, and sometimes brands of particular funded medications change.
Unsubsidised drugs such as particular cancer drugs can still be purchased in many cases but with no subsidy.
Regular public debate about why isnt this or that drug funded. Regular lobbying by drug companies. But general acceptance that this model works well most of the time for most of the population.
I take a regular routine medication. It costs me $5 every 3 months. If I ever got to $100 in prescription drugs in a year, I would pay nothing more for that year.
I dont understand the preoccupation about " communist or socialist" medicine, why not just assess costs and outcomes objectively?

The cost of socialism is FREEDOM!

If you ask how it is more free to have the oligarchs in charge, you are an unAmerican elitist, both for questioning the efficiency of capitalism and using a big word.

If you ask how it considered free market if you can't find out the cost ahead of time and make an informed choice, you are a pinko.

If you ask what is wrong with countries like Sweden or Britain or Germany, you are an idiot who doesn't understand anything and should just move to Venezuela if you are such a commie.

[pecunia]

In NZ we have Pharmac, the govt national drug buying agency. Approved drugs are heavily subsidised to the patient. Drug prices are negotiated with various drug companies, and sometimes brands of particular funded medications change.
Unsubsidised drugs such as particular cancer drugs can still be purchased in many cases but with no subsidy.
Regular public debate about why isnt this or that drug funded. Regular lobbying by drug companies. But general acceptance that this model works well most of the time for most of the population.
I take a regular routine medication. It costs me $5 every 3 months. If I ever got to $100 in prescription drugs in a year, I would pay nothing more for that year.
I dont understand the preoccupation about " communist or socialist" medicine, why not just assess costs and outcomes objectively?

The cost of socialism is FREEDOM!

If you ask how it is more free to have the oligarchs in charge, you are an unAmerican elitist, both for questioning the efficiency of capitalism and using a big word.

If you ask how it considered free market if you can't find out the cost ahead of time and make an informed choice, you are a pinko.

If you ask what is wrong with countries like Sweden or Britain or Germany, you are an idiot who doesn't understand anything and should just move to Venezuela if you are such a commie.

Great patriotic words!  It was written with feeling and not the logic to which the logic are attempting to blind us with.

[carolina822]

I apologize for invoking religion, I don't like using the bible *against* people.  My point is that we are a society.  Is it not for the benefit of the whole that each individual person be given complete and affordable access to health care regardless of their station in life?  Our society, whether we know it or not, is interdependent on each other.   

Americans don't live in a Socialist or Communist country.  Individuals have rights under the US Constitution; "society" has no rights.  And those individual rights should include the ability to opt out of any government-created health care scheme.

I'd be all for that if doctors were also allowed to tell those individuals to fuck off and die unless they paid in full up front before getting sewn up in the ER.

[pecunia]

I apologize for invoking religion, I don't like using the bible *against* people.  My point is that we are a society.  Is it not for the benefit of the whole that each individual person be given complete and affordable access to health care regardless of their station in life?  Our society, whether we know it or not, is interdependent on each other.   

Americans don't live in a Socialist or Communist country.  Individuals have rights under the US Constitution; "society" has no rights.  And those individual rights should include the ability to opt out of any government-created health care scheme.

I'd be all for that if doctors were also allowed to tell those individuals to fuck off and die unless they paid in full up front before getting sewn up in the ER.

Well - The problem with that one is that nobody in the medical business seems to be able to tell you what something costs.  I guess they check if you have good insurance and then charge more.  It looks to be far more lucrative than bank robbery.

[carolina822]

I apologize for invoking religion, I don't like using the bible *against* people.  My point is that we are a society.  Is it not for the benefit of the whole that each individual person be given complete and affordable access to health care regardless of their station in life?  Our society, whether we know it or not, is interdependent on each other.   

Americans don't live in a Socialist or Communist country.  Individuals have rights under the US Constitution; "society" has no rights.  And those individual rights should include the ability to opt out of any government-created health care scheme.

I'd be all for that if doctors were also allowed to tell those individuals to fuck off and die unless they paid in full up front before getting sewn up in the ER.

Well - The problem with that one is that nobody in the medical business seems to be able to tell you what something costs.  I guess they check if you have good insurance and then charge more.  It looks to be far more lucrative than bank robbery.

True, maybe a better solution would be to just ask how much you have, and then do that much of the work before the patient can come up with some more funds. "Sorry, your line of credit only covers taking half your appendix out - but I didn't tack on any extra for making sure it was the bad half!"

People get so worked up over the thought of some bum with no job eating themselves into a large healthcare bill. It's not like those people don't get care under the current system, so I'm not sure why changing who writes the check makes a difference.