Saturday, August 22, 2009

Some Thoughts on the American Heath Care Debate

The big issue in American politics right now is health care reform, and a lot of stuff is going on related to this. I want to comment on a few things that have happened.

First, is this little clipAll I can say is "Well done, Sir, well done." The level of hyperbole that has come up at some of these town hall meetings is huge, and some of these people need to just shut up rather than asking questions to score points and fear monger. They should also think before using words like Nazi, especially when asking a gay Jew why they support Nazi policies.

Next is people bringing guns to these meetings. Sure, it can be reassuring to have a gun, it can give you a feeling of power, but are you really that scared of rational debate and your fellow citizens? There have been several cases of people bringing guns along to town hall meetings held by Barack Obama. It's not clear if the people were allowed into the meeting with the guns, but they were definitely allowed into the area outside the venues. And Fox News then goes and puts these people with guns up on TV to show just how crazy some of them are. This also shows a big change from the previous administration. How do you think the Bush government would have reacted to people bringing guns to their events? Given how they reacted to signs and t-shirts, I wouldn't have wanted to find out for myself.

The whole "Death Panel" fiasco is another highlight for those who enjoy seeing stupidity run free. Starting with the woman who writes her own comedy bits, Sarah Palin, who recanted her claims the next day, but had unleashed a beast that just will not die. The relevant piece of the legislation merely allows for people to get reimbursed for talking to their doctor about options for family members who are in a fatal condition. It's just letting you talk to your doctor. No one but you is making the decisions. And in another piece of irony, this piece of the bill that is getting so many Republicans upset was introduced by a Republican. If I were a cynical, suspicious bastard I'd think it was introduced to provoke some outrage.

Finally, there is the reluctance from a great swath of the American people to even consider the idea of making sure everyone has adequate health care as something worth doing. Given the problems of the current system it seems clear that reform is needed, and yet they don't want to do it.

End Post
Writing time: 20 minutes
Time since last post: a week or so
Current media: Leverage


Tinos said...

Everyone wants to make sure everyone has adequate healthcare. A lot of people including myself don't want to use taxation to do it.

Esonlinji said...

Can you suggest a way to ensure everyone has adequate healthcare with using taxation?

For profit health insurance companies face a glaring conflict of interest in that each time the pay for a medical service it is a hit to their bottom line, which leads to all sorts of problems with companies always looking for ways to deny claims.

So a non-profit would seem to be more ideal. The bigger it is, the better efficiencies of scale can be achieved. This would be maximised by having everyone in the one healthcare scheme, and if we're setting up a scheme that everyone's involved in, the government the body to do so, and taxes are a way of funding it that uses existing revenue raising infrastructure.

I think a well set up universal healthcare system run by the government is the best way of ensuring that everyone has access to the healthcare they need.

Tinos said...

Everyone will have healthcare the same way everyone has food. The economy will grow until it is achievable, assuming we keep away from socialism.

Set up your government service and give me the option of not taking part, and don't force me to pay for it in any way.

If for-profit is so bad most people will voluntarily use the government service. I believe you'll find few will though, because the government service won't be as good.

Esonlinji said...

Health care is a lot more expensive than food, and there aren't a lot of options to economise when it comes to health care. If you're hungry and don't have a lot of money, you can skip the steak and chocolates and eat lots of rice and vegetables. If you have cancer you can't cut back on the medicines you take to save money.

In a dual system like you suggest with for profit for most and a government plan for those who can't afford anything else, the government plan is always going to involve taxing someone to pay for it. By definition those covered by it are unable to pay the full cost, so the balance will have to come from society in general. If this isn't paid for from taxes, how will it be paid?

I don't see why you assume a government run service will not be as good as a for profit one. I think the advantages of a government run system outweigh the advantages of a for profit system.

As for your socialism remark, I simply point you to this:

Tinos said...

By definition? I think not. You said private insurance companies don't pay out when they should, while government would. If that's true both rich and poor would use government insurance. This wouldn't happen, because the for-profit services are better.

There's nothing in that link which, if I were an American, I would thank the government for. They would have all been developed without taxation. As for the regulations, I'd be better off without them.

We obviously have very different morals. Person x can't afford treatment. Are we justified in forcing person y to pay for it? I say never. I believe that we should only force people to do no harm, not to do good.

As for the gun thing. If I were an American I'd have done the same thing. Just as if they tried banning cigarettes here in Australia I'd take up smoking. The point is it's standing up to the man.

Esonlinji said...

The thing I said would by definition pay out more than it could take in is a government safety net for those who can not afford private insurance.

It is obvious that if the government provided a good service paid for out of taxes, of course most people would choose that, and that's what I'd like to see.

While universal health care obviously requires everyone to contribute through taxes phrasing it as forcing individual x to pay for individual y is a bit misleading. While making individuals a,b,c,d,... pay for individual y is not really changing the argument, I think society as a whole has a responsibility to ensure that everyone has access to adequate health care, just as society has a responsibility to ensure everyone has access to things like education and law enforcement. Or should those also be run privately (I think I know how you'll respond for schools).

There's also the fact that sometimes doing nothing is doing harm. If you see someone badly hurt on the street, would you just walk by and do nothing? At the very least you would call for an ambulance.

As to the regulations, businesses over the last few centuries have shown a willingness to externalise as many expenses and risks as they can, and to do whatever they can to get as much money as they can. From mines forcing there employees to buy all their supplies at inflated prices from company stores, dangerous working conditions, the formation of monopolies and oligarchies, price fixing, companies that decide it's cheaper to pay for legal settlements than it is to make their products safer and more show that self regulation is unlikely to arise from within. Effective regulations have only come from outside.

There are some things that private industry and the free market can do very well, and those areas they should be left free as doing so is best for society, Computers for example. But there are also things where the free market and private industry do not work, and there we should use alternatives. Health care is one of those things the free market does not do well.

My point about the guns was to highlight a difference between the Bush and Obama administrations. For all the people opposing health care reform's claims that they are not being listened to, they are coming to these meetings and having their say. During the Bush days people were arrested outside his speeches for waving signs and wearing badges supporting the other side. I fear for anyone who showed up with a gun in those days.