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Am I the only one in this country bothered by the fact that we don’t have universal health insurance?
Am I the only one bothered by the fact that people keep complaining about the lack of universal health insurance while the national debt is growing so rapidly that we need scientific notational to keep track of it?
John Pieret says
Am I the only one bothered by the fact that some people think that the costs incurred in the unnecessary disease and death of the work force and consuming public doesn’t have a bad effect on the national debt?
I don’t know the answers to any of those questions, but I will tell you I’m not the only one who actually has publicly-funded healthcare who gets enraged by hearing horror story after horror story (especially when the horror stories in questions are happening to my good friends).
Am I the only one bothered by the fact that people ignore the simple principle that trying to fund social programs while trying to support crippling debt is essentially impossible?
Am I the only one bothered by the fact that people are bothered by my ignoring simple principles just because they’re false?
Kristjan Wager says
Yeah for false dilemmas.
The US health care costs are higher per capita than in other countries, they are just paid out of peoples’ own pockets instead of through the taxes, which results in a large portion of the personal bankruptcies in the US.
I don’t think anyone is seiously suggestion funding single payer health care through the existing taxes alone – such a thing would requite a restructure of the payment method, so people would pay through taxes to themselves instead of for temselves (and others) through insurance.
Of course, insurance companies are not interested in such a thing, for economic reasons, and nor are many politicians for ideological (and money-based) money.
Now, it’s perfectly okay to be against single payer health care for ideological reasons, but don’t try to make it sound like it’s for economical reasons, unless you are one of the people living of the current system.
Then add in the cost for the bureaucracy. Then add in the cost for the increased usage of the health systems. Then add in the cost of the interest on the debt that wasn’t paid off.
Holding off on paying interest-bearing debt results in much larger amounts needing to be paid. As with all such debt, the sooner it’s paid off, the better.
Francesco Franco says
Am I the only one in this country bothered by the fact that we don’t have universal health insurance?
Indeed not. That is but one of the reasons I was essentially constrained to move to the south of Italy. It is also one of the reasons I remain here, notwithstanding the fact that I loath living in the middle of nowhere, surrounded by hillybillies and yokels, in a Catholic quasi-theocracy.
Kristjan Wager says
Let’s try again. The US as a whole, uses more money per capita than any other country, and get’s less for it. The current US system is quite heavy on bureaucracy, if you haven’t noticed. Both the bureaucracy inside the hospitals, but certainly also the one in insurance companies and the public sector.
Since the money we are talking about, isn’t used to pay off debt, there is no rationale to add the interest to the costs.
Let me try to explain it again, since I obviously didn’t make it clear last time.
The current US system: the US health system costs X, of which X1 is payed by the insure companies, X2 is payed by private people, and X3 is payed by the public sector.
X1 is payed through a number of monthly instalments – either paid by private people or by companies (quite often a combination of these). This is an administrative heavy way of doing it, with a lot of paperwork by the hospitals, the patients and the insurance companies.
X2 is direct payments from people without insurance costs. This money is often borrowed either from financials companies or from other people. There is often a large amount of paperwork borrowing the money, and on top of that comes the bureaucracy of getting the money, that the hospitals have to go through, especially if the patients can’t pay. The loan costs are often significant for the patiens, and the bankruptcy processes that quite a few go through costs the taxpayers as well.
X3 is the money paid through public systems. Due to the nature of the US health care system, it’s often bureaucratic to get the money, even i you are clearly entitled to it.
A single payer system, means that the already existing tax bureaucracy is used to get the money, and that the hospitals get their money from one place (probably based upon the costs plus a certain overhead).
This is a simplistic view of how finanses work on a national level. The debt the US have, is not payable by dollars as such – instead it’s payable by foreign valuta earned through exports etc. So using more dollars to pay of the debt only works as long as the rest of the world trusts the US dollars.
Just using all the local currency you can get, to pay debt, and ignoring the infrastructure, will derode the trust by other countries.
If the US want to do something serious about the country’s debt, the only way of doing so, is to actually cut import (outflow of money) and increase exports (inflow of money). This is very little to do with a restructure of the US health system, which will not have any impact on import/export as such.
Having said that, making sure that the state budget is balanced is of course also a good idea, so the state doesn’t have to borrow money through state bonds, that are often sold outside the country, or through direct foreign loans (a thing that haven’t happened much yet).
Again, since the restructure of the health system would be paid through a tax increase, that would not be a barrier for a balanced budget.
How about a concrete suggestion right here? Gary has (at least) two bad teeth that have to be dealt with. Does anyone know a good dentist in Gary’s neighborhood who is willing to do a bit of pro bono work? Those teeth are poisoning him on top of his other physical ills (which are even worse than the teeth but not as immediately tractable). It probably wouldn’t hurt if the dentist you chat up is an sf fan.
Or I guess we could argue some more about health insurance and budget deficits.
Oddly enough, other countries find that a national health care system is actually cheaper. The US spends a larger percentage of it’s GDP on health care, and a much larger percentage of its health care on administration.
“Am I the only one bothered by the fact that people ignore the simple principle that trying to fund social programs while trying to support crippling debt is essentially impossible?”
Am I the only one bothered by how stupid and wilfully ignorant the above statement is? What about the GAWDDAMNED WAR AND THE BLOATED DEFENSE BUDGET (NOT TO MENTION THE “SECRET” BUDGET SYPHONED OF BY THE CIA), CORPORATE WELFARE, TAX BREAKS TO RICH ASSHOLES WHO DON’T NEED IT, etc, etc…have a look at THAT chunk of the National budget and ask yourself which one is more responsible for the National debt…f*cking class-blind libertarian twaddle, pardon my french.
Personal and public indebtedness is a weapon of class warfare, pure and simple. Governments borrowing from wealthy creditors whom it should be TAXING instead.
If we, the toiling masses, are going to shoulder the heaviest tax burden, then we ought to have the greatest say in how that $$ is spent. But of course, that’s not how it really works.
Check out Secrets of the Temple: How the Federal Reserve Runs the Country by William Greider, and America: Who Really Pays the Taxes by those two Philadelphia Inquirer investigative reporters. Make sure you have good health insurance before you start reading, as both books are sure to raise your blood pressure.
The US government has a gift for making things inefficient. Systems that rational, civilized countries find to be cheaper are unlikely to be so here.
I saw one of those W.F.Buckley (“Firing Line”) debates on health care back during the early 1990’s. According to the then-Secretary of Health & Human Services, for every dollar spent by Medicare, about 24 cents goes into patient care, which is terrible – except that for every dollar spent on private health insurance, 8 cents goes into patient care. When I think of all those huge buildings (e.g., the Prudential Building) filled with people who have to get paid before insurance companies make a dime of profit, and the huge profits they make, that sounds about right.
That said, I’ll go make a contribute to Gary.
Jon H says
“The US government has a gift for making things inefficient.”
So does US business. Especially US businesses in which increasing the complexity makes it easier to pad the costs, raises the charges, and boost profits.
Furthermore, the way the US healthcare system is set up, any increased efficiencies will probably go to the profit margin, rather than reducing patient costs. in fact, the top priority will be to increase profits, even at the expense of patient care and coverage.
I have to chime in here.
I just saw a talk at my institution that had a couple of heavyweight alumni talking to a bunch of alumni doctors, so I have some real data here. The two alumni were the CEO for a large multinational pharmaceutical company, and the CEO for a regional private health insurance company. Both took very polite, but pointed, shots at each other about the cause of the increased cost in health care. Then came the doctors during the question and answer period. There was much tension in the question and answer period. The CEO of the health insurance company was much more forthcoming (according to his data, 7% of health care costs are administrative costs due to insurance processing… this does not include administrative costs embedded in hospital services, pharmaceutical services, etc). The CEO of the pharmaceutical firm spoke like a politician, never directly answering a question (or if he did, saying things like, “well, that is a problem for the pharmaceutical industry as a whole, but at XXXXX, we don’t do things that way. We are different”).
One comment from that meeting. No one suggested single-payer health insurance. No one suggested any answers, really. Doctors are frustrated, pharmaceutical companies and health insurance companies are pointing fingers at each other, and consumers have no voice.
We in the US like to champion the free market system, but in a free market, the consumer has a choice. This isn’t the way it works in the US. Health insurance for people who are employed is determined by negotiations between the employer and the health insurance company. If you are fortunate to work for a fairly progressive company, you may have several choices. You can’t customize your coverage for your needs, and you can’t say that if you don’t like one company, you’ll take your business elsewhere. The consumer has no direct role in any of the decisions. The policies constantly change, and you get several different answers every time you speak to the insurance providers (we’ve been accused of lying by our insurers… fortunately, we had the documentation to back up our claim). We have a regressive system, where those with the least pay the most (we have fairly good health insurance, which means that we can get prescriptions that cost over $3,000 for three months with a simple $25 copay).
How is this system any better than a single payer system? Yes, it would require a restructuring of the tax structure. But if everyone is playing by the same rules as far as what is allowable, then the bureacracy seemingly should go down. Anyone who says that government just messes things up is clearly not willing to think about tough solutions. Funny, the military is completely centrally controlled by the government, and I haven’t heard any conservatives or libertarians complaining about how the government has fouled up the military… Yes, there may be the occasional $8,000 hammer, but as a whole, is there more/less corruption than there is in the private sector?
Long rant, sorry.
Well, what about solving both problems at once ? Sell your entire country to EU or cannada, or whoever, and use the money to pay all your debt…
Canada probably *would* be better, except of course that they have massive taxes to support their social safety net and don’t have massive debt.
Expecting that we can ever pay off our debt without diverting serious resources into it is just silly, and expecting that these resources can come from merely increasing existing taxes isn’t just unrealistic but likely economically damaging.