Single Payer Health Care: Livin the Dream!Follow

Ironically it is how the US model works.

Saying I'm sorry your relative died doesn't mean you're apologizing for his death.

Sure is, and if I had the figures right in front of me, I'm pretty sure I could noodle it out.

lack of health insurance kills babies

However, some of those babies were being born from illegal immigrants, so I am sure gbaji and varus don't think this is a problem.

They probably only care about saving "babies" when a young woman wants to have an abortion.

Did you see the bit where I said the average healthcare cost per household in Germany was around $3600? Yeah.

Conservatives want live babies so they can raise them to be dead soldiers.

Yeah. I saw that. I was responding to the NHS figure though, so I'm trying to stick to that comparison. Not ignoring you, but just don't have time to respond to every single case out there either.


I think the bigger issue is that our private insurance costs are higher than they should be because of government intrusion into the industry as it is. As I pointed out earlier in this thread, if we used insurance only for things that actually needed insurance, and allowed people to buy health care directly from private practice doctors (like we used to do prior to the rise of medicare/medicaid and the HMO act), the costs per person would be significantly lower.

The big problem (and trend) with health care in the US is that each step has made things more expensive and pushed us to the next step. When they introduced medicare, it was funded via payroll taxes and limited to retirees. It was basically an extension of social security and not too problematic by itself (aside from the fact that it ended out costing a hell of a lot more than predicted). But with that door opened, there was a push to provide funding for health care for the poor who couldn't afford it. At the time, this was a small percentage of the population, so the expense seemed small as well, so medicaid was created. It was just for those who were not yet retired, but who needed health care and couldn't afford it (there are other conditions and problems as well, but I don't want to get off on a tangent). But this created a cost issue. No one was paying into this directly like for medicare. It was purely a welfare program and the costs also went up dramatically (and more than predicted).

So the response was something which we've come to expect from the left in this country. When you're having a hard time funding something, create a bigger pool from which to fund it. People in the US tend to oppose funding for welfare. But if we put people who are working into the same pools of money, then it's harder for anyone to target just the "freebie" parts of it. That's what the HMO act was about. By forcing companies to offer HMOs to their employees, the government effectively created a large pool of health care money floating around, from which it would be much easier to divert funds needed to cover for shortfalls from medicaid (and even medicare if needed). I'll explain how this works if you want, but I'm trying to keep this short.

This did cover for the shortfall in medicaid. However, it also ballooned the cost for health care because now everyone was funneled through these big health care plans, with insurers paying the bill, and groups of hospitals providing the service. You didn't just go to a local doctor for your health care needs, you had to go into this huge system with its huge overhead. And since nearly all portions of the system interacted with medicare and medicaid, they had to follow a whole set of regulations and restrictions (and the accompanying paperwork). It was no longer a free market and costs went up.

This brings us to the current problem. The costs to buy these huge all-encompassing health insurance plans have gone up so much that most working people can't afford them anymore. It's no longer about actual poor or disabled people who can't work and can't afford to pay for any care at all. Those who can't afford health care increasingly include normal working class people. The same people who could easily afford health care 50 years ago. What happened? They didn't get poorer. The health care got more expensive. This last round of health care reform debate wasn't about covering the poor, but the working people who are too wealthy to qualify for state assistance, but not wealthy enough to pay for the health care insurance.


Here's the source of the problem though: The reason the health care costs are so high is because that money is being pooled into funds which also provide the costs for those who can't afford the health care. So in the process of paying for the poor to get health care, we've priced it out of reach of many working class people. That's a problem. And the solution the Democrats have put forth isn't going to work. The primary method should be familiar if you read those last paragraphs. They are doubling down on the same methodology by simply increasing the size of the pool. That's what the health care mandates are about. Force everyone to pay into the system on the theory that this will make it easier to absorb the health care costs of those who aren't paying enough in to cover what they get.


I just don't see how that's going to work. Even ignoring the unconstitutional aspects of it, why expect a different result than the last time we did this? That's exactly what the HMO act did back in 1973. It used government regulation to get as many people buying insurance for their health care instead of paying for it directly, thus increasing the total pool of money available to cover those who weren't paying enough. But that didn't work. Costs still went up. They will in this case as well. And that's what's "wrong" with the US health care system. We can't just keep doing the same thing and expect different results, yet that's exactly what the recent health care reform act did.

What we need to do is go back to direct payment for health services. Health insurance should be used only for expensive and rare health needs. Do that, and the total cost will drop dramatically for everyone. This does not preclude having programs to help pay those health care costs for the truly needy btw. I just think that the wrong way to do that is to basically hide that cost inside a massive insurance mechanism. We should be honest about what we're doing, and how much it's actually costing us. Because when we aren't, we see cost increases like this without end.

Edited, May 26th 2011 7:00pm by gbaji

Gbaji, I think I've stated before that while I like the NHS, I am aware that it is far from perfect.

I've also given another example of public health insurance that works just as well (it doesn't cover some things the NHS does, but some are much better, like the dental care provided), is highly bureaucratic and still much much cheaper. I don't like the endless filling out of forms (EHIC in Germany: have a lengthy talk with a representative, fill out lots of forms, pay €3 a year. EHIC in the UK: Fill out a 1 page online form, wait a week) and running to different agencies for anything that is elective (mostly planned parenthood kind of stuff). I do like the fact that in some ways it's much more transparent than the NHS (it's not included in taxes) and you can actually choose a company - the forms will have different logos on them and you might have nicer customer service with some of them. And it works. They've gotten rid of some coverage (for example prosthetic teeth coverage is dependent on how often you visit the dentist - you get lovely little stamps to show you've been - and before it was just covered even if you didn't take any care of your teeth), but it's nothing dramatic, and I'm pretty sure there are enough health insurance providers in the US who will cover less.

They're hoping to gain super powers?