Health Care for Everyone

[Pupik]

Obama has announced his plan to get every american health care coverage. It's brilliant.

Come on, it's a wonderful idea...until you have to fork over the $4,500 co-pay for your yearly physical exam.

 

[Gonz013]

http://www.cnn.com/2007/POLITICS/05/29/obama.health.ap/index.html

👍 I can only hope politicians here use this sort of initiative as an example.

What's wrong with taxing people to provide basic services- that's one of the central roles of a government.

Australia's healthcare used to be practically 100% free (as was tertiary education for that matter).
In fact, Australia used to have people from the US and Europe visit to study how it all worked (efficient and cost effective).
But its all been slowly eroded by econimic fundamentalist driven policies.
Over the last 11 years of having conservative, right wing politicians dominating the government, the once free healthcare and education is now privatized to "promote competition", which in theory should provide people with greater service/ competitive pricing.
Instead, its delivered companies interested in turning ever increasing profits, so it is in fact more expensive- yet we are paying just as much tax as before.

I regard health and education as two of the most fundamental and basic services that should be provided by a government to its citizens- isn't that the whole point of paying taxes in the first place?

 

[Danoff]

👍 I can only hope politicians here use this sort of initiative as an example.

Yea, we can always just throw another tax on the rich. That economic policy will never bite us in the ass.

What's wrong with taxing people to provide basic services- that's one of the central roles of a government.

Nothing. But tax people equally (not one particular portion of society), and tax them as little as possible - because government spending is one of the most inefficient ways to spend money.

Australia's healthcare used to be practically 100% free (as was tertiary education for that matter).
In fact, Australia used to have people from the US and Europe visit to study how it all worked (efficient and cost effective).

Oh, why have I not heard of this? I can tell you that it was not free. Perhaps you didn't pay for it when you used it - but rest assured it was paid for. And when did you run the numbers to determine that it was more cost effective?

But its all been slowly eroded by econimic fundamentalist driven policies.

You mean basic economics.

Over the last 11 years of having conservative, right wing politicians dominating the government, the once free healthcare and education is now privatized to "promote competition", which in theory should provide people with greater service/ competitive pricing.

Works in practice too.

Instead, its delivered companies interested in turning ever increasing profits, so it is in fact more expensive- yet we are paying just as much tax as before.

Blame the government for your tax rates, not the companies looking to offer you a better mousetrap.

I regard health and education as two of the most fundamental and basic services that should be provided by a government to its citizens- isn't that the whole point of paying taxes in the first place?

National defense and rule of law are the most basic services that should be provided by the government. Health and education is your responsibility - and pretty low on the priority scale. I'd say those come after food, shelter, and clothing. Ask yourself, did your food, shelter, or clothing come from the government? No? Then why should your health care and education? Two things that are clearly less critical.

Now ask yourself who provides you with food, shelter, and clothing. You do. And how do you get it? You have private companies lining up to offer you their goods. Next time you go to the grocery store you'll see capitalism at work. Check those prices and tell me they're inflated to line some CEO's wallet. Now tell me what hospitals charge and try to claim (with a straight face) that none of that is wasted on the government bureaucracy.

 

[YSSMAN]

Nope. As the old folks would say, "Not gonna happen."

I do not want a national health care system. Its a system that doesn't offer a end by which the means are justified. Just look at Europe, they are struggling to fund and overburdened health care system with increased taxes, and furthermore, the importation of immigrants to cover these increased costs.

Do you really think it would be any better with the Baby Boomers getting older? Sure, there are plenty of problems with the system we have now, but lets be honest, we still live in the most capable medical system on the planet... Offering the best medical care possible to anyone who can afford it.

Whats wrong with that?

Oh, I remember. People who don't have good jobs can't afford good health care. Oh, and thats my fault because my family and I can... Right, so tax the semi-wealthy and the truly wealthy until they aren't anymore. Take away the driving force behind the economic recovery we have had. Put millions of medical jobs at risk because there is no longer an incentive to becoming a doctor or to inventing a new medication for someone with cancer. Make it so we have three-week waits on MRIs and Cat Scans, instead of the near-instant "you've got a problem, we can help" system we have today.

Yeah, great job Obama. You've got a master plan to drive one of America's greatest industries into the ground. We do health care better than any nation in the world, and yet we suggest that we take it down to a lower level? We've seen how well that worked in the UK and in Germany, hell the rest of the "developed world." And yet, where do the wealthy from those nations come when they need work done on their heart, legs, arms, brain, etc?

Thats right. They come to the United States. Like it or not, this system we have is staying.

 

[ledhed]

*** sigh***


privatize. and kill the lawyers.

 

[Omnis]

http://www.cnn.com/2007/POLITICS/05/29/obama.health.ap/index.html

Obama has announced his plan to get every american health care coverage. It's brilliant. Far from the usual solution that the democrats come up with, his plan is unbelievably carefully thought out, and quite complex. With this kind of outside the box thinking the guy is a shoe-in for the presidency. I honestly can't believe nobody has thought of this solution to the health care problem before. In fact, this solution doesn't just work for health care. It works for all kinds of things that politicians like to promise in order to buy votes.

What's his master plan you ask? What is this ingenious strategy for getting health insurance for every american? What is this brilliant new public policy?

Tax the rich.

Wow... if only more politicians thought like that maybe we could actually cure the problems in this country. Take money from the wealthy and give it to the poor - cures everything. I guess if you eliminate differences in wealth you can eliminate poverty because everyone will have the same amount of money. Russia tried this with great successs. Communism is one of those great ideas that will just keep coming back. We all know at this point that poverty did not exist in communist russia because they made sure that rich people did not exist. That's what I remember thinking when I learned of the bread lines in soviet russia - that everyone there was so increadibly lucky to have a system that eliminated poverty. I'll bet they all had fantastic health care.

Have you ever heard a democrat explain to you when it could possibly be a bad idea to raise taxes on the rich? Have you ever heard any of them acknowledge economics in any way shape or form? Afterall what good would that do? Voters like to hear that things are going to magically get better and it won't cost them a dime.

! The satire is killing me!

 

[Gonz013]

Yea, we can always just throw another tax on the rich. That economic policy will never bite us in the ass.

Nothing. But tax people equally (not one particular portion of society), and tax them as little as possible - because government spending is one of the most inefficient ways to spend money.

👍 I don't dissagree with that principle

Oh, why have I not heard of this? I can tell you that it was not free. Perhaps you didn't pay for it when you used it - but rest assured it was paid for. And when did you run the numbers to determine that it was more cost effective?

Of course I ultimately paid for it, but I paid a lot less, and got a lot more in return.
I didn't come up with the numbers, plenty of studies have been done, and even the ones done by the government themselves show that a government run health system was cheaper and delivered better service.

I'd be happier if everyone paid a little to have only the sick use health care when it is required, because I ultimately pay less.
In the alternative, a 'user pays' model where only those who can afford it pay a lot more for insurance, and those who can't afford it get left out, I don't see how anyone is better off.

You mean basic economics.

Works in practice too.

No, its not 'basic economics' when the right wing politicians conveniently leave out social and environmental factors in economic analysis.
It's idealized economic fundementalism that serves to promote their agenda, rather than reflect true economic realities.

And in this case, it just hasn't worked. It also didn't work when they privatised telecommunications, energy supply and the airport.
They are all more expensive than they used to be, and no, this isn't simply explained by inflation/ indexation.
For instance: It was always in the interest of the government to run telecomms efficiently, it made them more money- it ran at a $100million profit per year- that's $100m less taxes needed. They sold it off for a one-time windfall, and now things are more expensive for everyone, and the money has all been spent.
A country only has so many assets to sell. Once they are gone, that's it. So IF they run well, make an ok profit, provide great service, why sell them off?

When providing what most would consider a fundamental service, a well run government agency with its prime interest in providing a service, rather than profit-making is cheaper and more efficient than a company looking to make a larger and larger profit every financial year.
Obviously, the government agency needs to be run well- so accountability is key in order for this to work, otherwise money just gets wasted.

Blame the government for your tax rates, not the companies looking to offer you a better mousetrap.

I do blame the government. In privatising health care, they should have reduced the taxes so that the money that was supposedly saved was returned, but as usual, this didn't happen.

National defense and rule of law are the most basic services that should be provided by the government. Health and education is your responsibility - and pretty low on the priority scale. I'd say those come after food, shelter, and clothing. Ask yourself, did your food, shelter, or clothing come from the government? No? Then why should your health care and education? Two things that are clearly less critical.

I guess we simply disagree. I consider Health and Education just as important
as defence and rule of law. A healthy, well educated people make a strong country and economy. Everyone ultimately benefits.

What is safety going to do for you if you are too sick to do anything?
What is rule of law good for, if you are unable to read?
You can't separate them so easily, they are interconnected and inter-reliable, bacause they are all vital.
The more education, the less poverty.
The healthier people are, the more they can work.

Now tell me what hospitals charge and try to claim (with a straight face) that none of that is wasted on the government bureaucracy.

I am all for making government agencies accountable (not just at the polls) and reducing bureaucracy. In my line of work, I run into bureaucratic red tape all the time, it's stifling and just gets in everybody's way.

I dislike bureaucracy just as much as privatisation of a nation's vital services and assets.

Capitalism works great in some areas. It promotes competition, innovation, economic growth etc. etc. Without it, my life might not be as good.

But its not necessarily the best solution for every situation.
I don't think that it is the best solution for what most regard vital services, because it creates a situation where the shareholders are more important than the people receiving the vital service. Inevitably, simplistic solutions come into play when innovation and competition are spent/ not enough/ too hard. Its very easy to cut services and raise prices in order to make a higher profit.

We have a 10% tax on goods and services here. I would gladly pay another 1 or 2% if the governement used that money to make health and education free. I think most people would.


This probably belongs on another thread, but...
The problem with capitalism is it's fundamental flaw- it relies explicitly on continual growth.
Anything can only grow so much, before there is nothing left to eat/ room to grow. Unless we just repeat what we did in Iraq- destroy so we can re-build- there's money in that.
But even doing that, our resources are finite, so at some point, capitalism will be unable to cope, and we'll have to find a different way of doing things.

 

[Danoff]

Of course I ultimately paid for it, but I paid a lot less, and got a lot more in return.
I didn't come up with the numbers, plenty of studies have been done, and even the ones done by the government themselves show that a government run health system was cheaper and delivered better service.

Really? The government told you that they did a better job? And you believed them? You didn’t want any kind of independent verification? Because if a company told you that they did a better job you probably wouldn’t trust them.

There are a lot of metrics for “good service”. What many people think is the most important metric is “availability” – that everyone has access to the service. Other people think that having the most up-to-date technology is the most important. Still more think that quality of service, or the fewest number of mistakes, or the fewest number of misdiagnoses is most important. I happen to think that one of the most important metrics in medicine is speed… something that the government is notoriously bad at.

There are also different ways to measure cost. You can measure cost as the percentage of each person’s income that the program required. So if you tax only the wealthiest and you only tax them 0.5% to run your health care system – then your cost is somewhere between 0.5% and 0% averaged over the population. I happen to think that cost should be calculated in terms of total number of dollars spent.

And in this case, it just hasn't worked. It also didn't work when they privatised telecommunications, energy supply and the airport.
They are all more expensive than they used to be, and no, this isn't simply explained by inflation/ indexation.
For instance: It was always in the interest of the government to run telecomms efficiently, it made them more money- it ran at a $100million profit per year- that's $100m less taxes needed. They sold it off for a one-time windfall, and now things are more expensive for everyone, and the money has all been spent.
A country only has so many assets to sell. Once they are gone, that's it. So IF they run well, make an ok profit, provide great service, why sell them off?

It astounds me that you feel you get “great” service from that government. I’ve never in my life been impressed with government service. It’s no secret that having a monopoly on a particular industry (let’s say telecommunications) makes it easy to make money.

A service desired by citizens is not a national asset, it’s a market demand. And no matter how many times you repeat the mantra of government efficiency, government spending is economically speaking one of the least efficient. I don’t know how your telecommunications services were privatized, or any details about your energy supply or airports. What I can tell you is that in the US, most of those services are provided by private companies who have been handed a government mandated monopoly – which is arguably worse than direct government control because you have effectively zero recourse against the policies of the private company. If your telecom or energy services are handled in a similar manner, I’m not surprised you think that the government version was better. But don’t confuse a government mandated monopoly with capitalism.

When providing what most would consider a fundamental service, a well run government agency with its prime interest in providing a service, rather than profit-making is cheaper and more efficient than a company looking to make a larger and larger profit every financial year.
Obviously, the government agency needs to be run well- so accountability is key in order for this to work, otherwise money just gets wasted.

You’re assuming that the goal of making a profit isn’t in line with consumer desires, and that a person without the goal of profit making will allow themselves to better predict consumer needs. This flies in the face of basic economics. Profit making aligns itself with demand naturally. I’d much rather have an organization hoping to make a profit attempt to predict and cater to my needs in order to get me to voluntarily spend money on their product than to have some government official attempt to decipher my needs by ignoring the way I and other consumers like me are spending their money.

To simplify – the search for profit is a much better way to get companies to align their products and services with consumers than the search to maintain office (an office which in many cases isn’t directly voted upon anyway).

I do blame the government. In privatising health care, they should have reduced the taxes so that the money that was supposedly saved was returned, but as usual, this didn't happen.

That’s because government never shrinks. I wonder why you’re in such a hurry to grow it.

I guess we simply disagree. I consider Health and Education just as important
as defence and rule of law. A healthy, well educated people make a strong country and economy. Everyone ultimately benefits.

What is safety going to do for you if you are too sick to do anything?
What is rule of law good for, if you are unable to read?
You can't separate them so easily, they are interconnected and inter-reliable, bacause they are all vital.
The more education, the less poverty.
The healthier people are, the more they can work.

Unhealthy people can work too… just not as well. And education is not a prerequisite for work or enjoying life. Rule of law is still useful to you if you are unable to read. National defense and protection of fundamental human rights are still useful to you if you are sick. [/quote]

This isn’t a matter of opinion. Health and education take a back seat to law, national defense, food, shelter, and clothing (not necessarily in that order). They’re secondary needs.

Capitalism works great in some areas. It promotes competition, innovation, economic growth etc. etc. Without it, my life might not be as good.

But its not necessarily the best solution for every situation.
I don't think that it is the best solution for what most regard vital services, because it creates a situation where the shareholders are more important than the people receiving the vital service. Inevitably, simplistic solutions come into play when innovation and competition are spent/ not enough/ too hard. Its very easy to cut services and raise prices in order to make a higher profit.

No, it is not easy to cut services and raise prices to make a higher profit – or everyone would do so. You clearly do not have a solid understanding of economics. Companies always attempt to maximize profit. In almost no case will a company attempt anything besides profit maximization… even when they make charitable contributions. So why then do they not simply all cut services and raise prices?

There is a simple answer, it is because doing so will not maximize profits. You should know this. If the public schools taught economics I would not be having to explain this to you. Capitalism reduces prices, increases efficiency, and increases quality because it organizes the incentives appropriately. It’s fundamental, undeniable economics. It’s practically mathematic. Is capitalism the right solution in all areas? No. There are many areas where it is wholly inappropriate – but economically speaking, service organizations (like health care) are a perfect place for capitalism.

The most vital product for you is food. It is more critical than health care, education, shelter, clothing, etc. Without it you die in very short order. Yet you do not promote the government taking control of all food supplies. Why? It is THE most vital service. And it is provided to you by companies attempting to maximize their profits.

We have a 10% tax on goods and services here. I would gladly pay another 1 or 2% if the governement used that money to make health and education free. I think most people would.

Then it would not be free. Have you calculated the annual dollar amount associated with a 1 to 2% increase in taxes? Can you tell me right now, without thinking about it, without putting a pen to paper, how many dollars a 2% increase in taxes costs you? You should have this information on the tip of your brain because you should have calculated it in order to make the above statement. You’re making a simple economic statement:

1-2% increase in taxes = fewer dollars than your current health insurance premiums

Do you know that for a fact?

I can tell you for a fact that if it were less, if 1-2% tax did cost the population less than the current health care system, your government could not provide you with health care with only that money.

This probably belongs on another thread, but...
The problem with capitalism is it's fundamental flaw- it relies explicitly on continual growth.

Again, if you took economics you would not say such a silly thing. This is not true, nor will it ever be true. There is nothing inherent in capitalism that relies upon growth. Capitalism creates growth, it does not require it.

Anything can only grow so much, before there is nothing left to eat/ room to grow. Unless we just repeat what we did in Iraq- destroy so we can re-build- there's money in that. But even doing that, our resources are finite, so at some point, capitalism will be unable to cope, and we'll have to find a different way of doing things.

Again you refuse economics. There is NOT money in destroying and rebuilding. Destruction is a net loss. If you do it carefully you can profit more from the new construction than the old, but the simple act of destroying and rebuilding is a net loss and always will be. This is actually a famous economic fallacy known as the “broken window fallacy”. It is a trap that many people who do not understand economics fall into.

BTW – did you really feel it was necessary to bring up Iraq? In this thread? Seriously? There was simply no way you could see to keep it out of the discussion?

 

[Omnis]

Excellent post, Danoff. I'd like to say that Public schools do teach economics (in the states, at least), although not as much as they should, and that it is more than "practically mathematical"; it is a solid science!

I'm looking forward to Gonz's response. That's not to sound sarcastic either, Gonz; I still want to know why, especially after this, you stick to your guns.



...and lol at Iraq.

 

[V1P3R]

I went to the doctors the other day to have my knee checked out. I wasted $35 for him to take all of 3 min. to hand me a pamplit and an anti inflamitory... It's not that I was looking for something worse or that I wasn't happy to pay but ****... give me a ****ing time of day.

Case in point I don't give a **** whether your a genius doctor or "good" at what you do, if your not in it for the "care" then you should quit now. A good doctor that doesn't give a **** is as worthless as a bad doctor that was allow to practice.

 

[Gonz013]

Really? The government told you that they did a better job? And you believed them? You didn’t want any kind of independent verification? Because if a company told you that they did a better job you probably wouldn’t trust them.

Normally, I don't trust politicians as far as I could throw them, and would not piss on them if they were on fire. BUT: In this particular case, yes. The current government wanted the results to show the opposite. Its the same government that introduced the privatization, so it was embarrassed by the result of its (and many other) studies that showed the government had been doing a better job than the private companies.

There are a lot of metrics for “good service”. What many people think is the most important metric is “availability” – that everyone has access to the service. Other people think that having the most up-to-date technology is the most important. Still more think that quality of service, or the fewest number of mistakes, or the fewest number of misdiagnoses is most important. I happen to think that one of the most important metrics in medicine is speed… something that the government is notoriously bad at.

Normally I would agree with you, but in this particular case, it was doing a very good job. A well run government agency is a rarity for sure, but they do exist.
For instance, the postal service in Australia is totally government owned and run. It is incredibly reliable, cheap and efficient. It is constantly innovating and providing better services, despite the huge distances to cover here. I can mail a letter and it will get anywhere in the state within 2 days or less. If I express post, within 24 hours. So it is possible.

There are also different ways to measure cost. You can measure cost as the percentage of each person’s income that the program required. So if you tax only the wealthiest and you only tax them 0.5% to run your health care system – then your cost is somewhere between 0.5% and 0% averaged over the population. I happen to think that cost should be calculated in terms of total number of dollars spent.

I prefer to measure costs per capita. Australia only has 20 million people, so the total amount spent on anything can't be compared to a country like the US for instance.
A per capita cost is more useful, you can compare different systems, you can compare it to average earnings, etc.
A total money spent amount is only a small part of the picture, as it does not indicate if the service is any good, or if the money spent is being used well.
In fact, in the case of the US, the total amount spent only shows how much more expensive it is/ how much money is wasted (refer to WHO data below)

It astounds me that you feel you get “great” service from that government. I’ve never in my life been impressed with government service. It’s no secret that having a monopoly on a particular industry (let’s say telecommunications) makes it easy to make money.

I'm astonished too. Most of the time, government agencies are full of inefficiencies and bureaucracy. In this case though, it was well run, an exemplar that was regarded as one of the best in the world. It is currently being eroded because the people in government are entrusting a vital service to market forces.

A service desired by citizens is not a national asset, it’s a market demand. And no matter how many times you repeat the mantra of government efficiency, government spending is economically speaking one of the least efficient.

This is where we disagree again. I don't consider it a service desired, I consider it a service required.

You’re assuming that the goal of making a profit isn’t in line with consumer desires, and that a person without the goal of profit making will allow themselves to better predict consumer needs. This flies in the face of basic economics. Profit making aligns itself with demand naturally. I’d much rather have an organization hoping to make a profit attempt to predict and cater to my needs in order to get me to voluntarily spend money on their product than to have some government official attempt to decipher my needs by ignoring the way I and other consumers like me are spending their money.

To simplify – the search for profit is a much better way to get companies to align their products and services with consumers than the search to maintain office (an office which in many cases isn’t directly voted upon anyway).

Yeah, I know what you are saying, and like I mentioned, capitalism works great in many areas, but its clearly not working well for health.
My main 'bone to pick' is with people that have a sort of 'faith' in market forces, that the market will take care of it all. This just doesn't happen in reality.
We still need government with vision and leadership to steer us in the right direction, because all too often a country and its citizens require things that don't make a profit, like vital infrastructure. If all infrastructure needed to make a profit, no-one could afford anything. Imagine if all roads were privatized.

Unhealthy people can work too… just not as well. And education is not a prerequisite for work or enjoying life. Rule of law is still useful to you if you are unable to read. National defense and protection of fundamental human rights are still useful to you if you are sick.

This isn’t a matter of opinion. Health and education take a back seat to law, national defense, food, shelter, and clothing (not necessarily in that order). They’re secondary needs.

It IS a matter of opinion. You think differently to what I do. I believe that education and health should be a right, not a privilege.
I believe people that pay their taxes should be entitled to free access to health and education. Why should it only be the wealthy that benefit from these two vital services?
I think its heartless, unnecessary and detrimental to a society to not allow healthcare to people that can't afford it.
Education and health are prime indicators of a person's socio-economic level, and happiness.

Surely you can see how a healthy, educated population is more likely to be happier, wealthier and safer?
Providing healthcare and education to all benefits people, economy, business, everyone. This has been proven time and time again in countries where this is the case.

No, it is not easy to cut services and raise prices to make a higher profit – or everyone would do so. You clearly do not have a solid understanding of economics. Companies always attempt to maximize profit. In almost no case will a company attempt anything besides profit maximization… even when they make charitable contributions. So why then do they not simply all cut services and raise prices?

I guess I'm more cynical when it comes to private companies. I've seen so many companies cut back the quality of their products, like getting stuff made in China to inferior specs, charging the same for their product so that they make a bigger profit. You would expect that people would buy less, but instead, their expectations are lowered - how is that going forward, or beneficial for anyone except the company making the higher profit?

There is a simple answer, it is because doing so will not maximize profits. You should know this. If the public schools taught economics I would not be having to explain this to you. Capitalism reduces prices, increases efficiency, and increases quality because it organizes the incentives appropriately. It’s fundamental, undeniable economics. It’s practically mathematic.

I agree, but only as long as you take into account environmental and social costs. These are typically conveniently left off the 'practically mathematic' calculations you speak of:
What is the cost of NOT providing free access to health and education for all?
How much money is lost on treating illness that could have been easily prevented with a better healthcare system?
How much productivity and revenue is lost from ill health that could be treated quicker by a better healthcare system?
What are the costs of the increased violence and crime from lack of education? (lack of education is the number 1 predictor of poverty and crime)

BTW: I was taught basic economics. I was fortunate in that my teacher's view extended beyond basic theory and numbers on a text book, and looked at how things worked in the real world, not just how they were supposed to work in theory. Blind faith in market forces does nothing to address the inadequacies of any economic model.

Is capitalism the right solution in all areas? No. There are many areas where it is wholly inappropriate – but economically speaking, service organizations (like health care) are a perfect place for capitalism.

If its so good for healthcare, why is it working so poorly?
Why is it such a big political issue? (both here and in US)
By your reasoning, healthcare in the US should be cheaper and better than anywhere else in the world. This is simply not the case:

The US has the most expensive healthcare system in the world, and the offfers one of the least effective services:

People in the US spend more per head of population on health than any other country on earth & yet the US is one of only 2 developed nations in the world that does not offer healthcare to all its citizens.

Clearly, it is not working as well as it should when other developed countries can provide better services at lower costs. That's basic economics too - 'practically mathematical' in fact.
Of the OECD countries:
-US costs for healthcare are the highest of all: more than double the average
-US ranks 26th for infant mortality rates
-US ranks 24th in life expectancy rates
-US ranks last fair in financing of healthcare.
-The US has almost 47 million people not covered by healthcare.
-The only ranking that the US excels in is responsiveness.

The above facts are a bit sad for what is supposed to be the wealthiest & most powerful country on earth.

The US is pretty much the No.1 Capitalist nation, and if relying on market forces is such a good way to deliver healthcare, it should be No. 1 in all areas of health care, shouldn't it?

Going by the data and the facts, (rather than faith in economic theory alone) it is pretty clear that in practice, healthcare would be cheaper in the US if it wasn't just left to market forces.

The most vital product for you is food. It is more critical than health care, education, shelter, clothing, etc. Without it you die in very short order. Yet you do not promote the government taking control of all food supplies. Why? It is THE most vital service. And it is provided to you by companies attempting to maximize their profits.

Actually, the most vital product for human life (any life in fact) is water. You'll die from thirst before you die from hunger. The next is health. Few people die from starvation- they typically die from malnutrition, which is a health issue. The next is shelter, then food. You will die from cold before you starve.

As for food supplies, the US heavily subsidizes agriculture, so in a sense, they are providing food. While the US harps on about free markets, they subsidize and protect parts of their economy that could not compete on the world stage, eg. wheat. So its own rhetoric only applies when its convenient -hypocritical, isn't it?.

But that's beside the point. I'm not advocating that a government supply everything-I'm primarily talking about education and health. Like vital infrastructure, I believe it is too important to leave up to 'market forces'.

Have you calculated the annual dollar amount associated with a 1 to 2% increase in taxes? Can you tell me right now, without thinking about it, without putting a pen to paper, how many dollars a 2% increase in taxes costs you? You should have this information on the tip of your brain because you should have calculated it in order to make the above statement. You’re making a simple economic statement:

1-2% increase in taxes = fewer dollars than your current health insurance premiums

Do you know that for a fact?

Yes it is a fact, and no, I didn't do the calculations, others did. I'm not going to add footnotes and references to my posts, but I wouldn't bother saying it if I didn't think it was true- I wish it wasn't.
Unfortunately, it is the same economically fundamentalist government that introduced the privatization that is still in power. They purposely followed the US model, thinking that capitalist market forces would improve healthcare.
Most people thought it was a good thing to introduce competition & market forces to areas such as health.
We all got some tax breaks, but its not enough to cover the higher costs.
11 years down the road, and people like me are paying more for insurance, and others who can't afford private health are forced to stand in queues to get 'selective' surgery, such as transplants that will save their lives.
Th governement here, much like in the US, is facing a huge backlash at the next election, this being one of many issues where right wing economic fundementalist faith has simply not delivered on its promises.

To give you some idea: I currently pay approx. $90 per month for private health insurance.
Before private healthcare was introduced, I paid less than $400 per year, and most medical treatments were free when you needed them (dental was never covered).

I can tell you for a fact that if it were less, if 1-2% tax did cost the population less than the current health care system, your government could not provide you with health care with only that money.

Well, as you no doubt know, governments don't always make the best decisions.
The medical system is not 100% private (yet). Public health is underfunded, and private health was introduced to boost funding, and provide better service (quicker service, choice of hospitals etc.) to those who could afford it.
The government does not want to introduce an extra 2%, which would cover the costs, as this would amount to an unpopular tax, an admission of failure, and unworkable rewinding of private back to public. We live in a western democracy, so it's not like the government can just repatriate healthcare.

Healthcare is not used by all people all of the time. Its only used by a minority when necessary. If the cost is spread across the whole population, its going to be cheaper for each individual when compared to a system of 'user pays'.

The plain truth of the matter is that the generation before me paid proportionally only slightly higher taxes, yet they got all of their education, (including university) and virtually all their health care costs free.

Now people like me are stuck with a huge bill for university (although I consider myself lucky, as I was at least partially subsidized- this will likely disappear in coming generations).

Entry into universities used to be based on merit, not how much was in your bank account. Now you can practically buy your way in. Standards of entry are lower, because universities desperately require the funding they no longer get.

Just a education should be available to those who earn it, healthcare should be given to those that are sick, not just those who can afford it.

The WHO data clearly shows that market forces providing healthcare has not provided the US with a better health care system. Its given a system that costs US citizens more per person than any other in the world, but lags far behind the best in practically every aspect of healthcare.

http://dll.umaine.edu/ble/U.S. HCweb.pdf

BTW: sorry for the essay, I know its a lot to read, so thanks if you take the time to go through it all.
I'll most likely just shut up about this topic now, unless sufficiently provoked into a response.
I think I have said as much as I need to in order to get my point of view across.
Thanks for the debate Danoff, I may not agree with you on this one, but I can respect that you are at least engaged with political issues, which many people don't bother to take an interest in.

 

[Danoff]

Normally, I don't trust politicians as far as I could throw them, and would not piss on them if they were on fire. BUT: In this particular case, yes. The current government wanted the results to show the opposite. Its the same government that introduced the privatization, so it was embarrassed by the result of its (and many other) studies that showed the government had been doing a better job than the private companies.

There was no one involved in the study that supported government-run health care who wanted to get re-elected? Nobody was left who had a stake? I think I’d want a little more evidence before I turned my back on hundreds of years of proven economic theory.

Normally I would agree with you, but in this particular case, it was doing a very good job. A well run government agency is a rarity for sure, but they do exist. For instance, the postal service in Australia is totally government owned and run. It is incredibly reliable, cheap and efficient. It is constantly innovating and providing better services, despite the huge distances to cover here. I can mail a letter and it will get anywhere in the state within 2 days or less. If I express post, within 24 hours. So it is possible.

Do they have any competition at all? Or do they have a monopoly? Because if it is that latter I can assure you that this kind of service will not lost. Monopolies are quite bad for the consumer – even if they’re government run monopolies. Eventually they will wake up and realize that there is no incentive to do a good job because you have no choice. The US post office has been horrific for many years. Only recently is it making efforts to improve service as it has come under fire from other organizations like FedEx, UPS, or alternatives like online banking.

I prefer to measure costs per capita. Australia only has 20 million people, so the total amount spent on anything can't be compared to a country like the US for instance. A per capita cost is more useful, you can compare different systems, you can compare it to average earnings, etc.
A total money spent amount is only a small part of the picture, as it does not indicate if the service is any good, or if the money spent is being used well.
In fact, in the case of the US, the total amount spent only shows how much more expensive it is/ how much money is wasted (refer to WHO data below)

True, if you’re comparing from country to country – per capita helps. But if you’re comparing Australia to Australia (which is what I was doing) dollars works.

Yeah, I know what you are saying, and like I mentioned, capitalism works great in many areas, but its clearly not working well for health.
My main 'bone to pick' is with people that have a sort of 'faith' in market forces, that the market will take care of it all. This just doesn't happen in reality.
We still need government with vision and leadership to steer us in the right direction, because all too often a country and its citizens require things that don't make a profit, like vital infrastructure. If all infrastructure needed to make a profit, no-one could afford anything. Imagine if all roads were privatized.

Private roads are some of the best roads I’ve driven on. Why is it that when you mention private roads I have this mental image of a wide open, brand new, perfectly maintained, well lit, road with easy to read road signs and near perfect ramp engineering? Because that’s my experience with private roads. Aside from people’s driveways, I’ve never driven on a private road I didn’t like… now public on the otherhand…

It IS a matter of opinion. You think differently to what I do. I believe that education and health should be a right, not a privilege.
I believe people that pay their taxes should be entitled to free access to health and education. Why should it only be the wealthy that benefit from these two vital services?
I think its heartless, unnecessary and detrimental to a society to not allow healthcare to people that can't afford it.
Education and health are prime indicators of a person's socio-economic level, and happiness.

Surely you can see how a healthy, educated population is more likely to be happier, wealthier and safer?
Providing healthcare and education to all benefits people, economy, business, everyone. This has been proven time and time again in countries where this is the case.

To see my point, substitute the word “food” for “education and health” above.

I believe that food should be a right, no a privilege. I believe that people who pay their taxes should be entitled to free access to food. Why should it only be the wealthy that benefit from food? I think it’s heartless, unnecessary and detrimental to society to not allow food to people who can’t affort it. Food is a prime indicator of a person’s socio-economic level, and happiness.

Surely you can see how a feed population is more likely to e happier, wealthier, and safer? Providing food to all benefits people, economy, business, everyone. This has been proven time and time again in countries where this is the case.

But it doesn’t stack up. Food is provided by private companies and it is unbelievably cheap, high quality, readily available, and… totally vital. More on the food analogy below.

I guess I'm more cynical when it comes to private companies. I've seen so many companies cut back the quality of their products, like getting stuff made in China to inferior specs, charging the same for their product so that they make a bigger profit. You would expect that people would buy less, but instead, their expectations are lowered - how is that going forward, or beneficial for anyone except the company making the higher profit?

If they demand doesn’t drop when quality does, it means that the quality was not valued. If the quality was valued, a new market would open up for higher quality goods. In this way, markets become more efficient as wasted efforts are reduced in an effort to remain competitive. I would think that you would know that – having been educated in economics. You don’t seem to be willing to acknowledge the complete and utter dependence of private companies upon consumers. They’re powerless against consumers. They have no option but to provide consumers with exactly what they want – every time. Only the government can usurp consumer demand. Only the government has the power to get paid regardless of the quality of service.

I agree, but only as long as you take into account environmental and social costs. These are typically conveniently left off the 'practically mathematic' calculations you speak of:

What are these “social costs” you speak of? Is that below?

What is the cost of NOT providing free access to health and education for all?

Increased efficiency, decreased cost, higher quality care, and WAY less usage.

How much money is lost on treating illness that could have been easily prevented with a better healthcare system?

That’s an argument against free health care.

How much productivity and revenue is lost from ill health that could be treated quicker by a better healthcare system?

Also an argument against free health care.

What are the costs of the increased violence and crime from lack of education? (lack of education is the number 1 predictor of poverty and crime)

An argument against public schools. Here in the US, we have a pretty horrible public school system – especially in the poorer neighborhoods because our local governments (in their infinite wisdom) have based school revenue on local property values. A system that ensures that the rich kids get a much better education than the poor. What’s worse, no matter how much a poor person is willing to pay to educate their children, they are simply not allowed to do so. The only way a poor person can get their children into a good school is by taking on entirely too much debt by buying a house in a richer neighborhood. That’s the only way to do it via public schools anyway. Private schools are happy to help.

That’s how bad public schools are in America. And all I ever hear is that they need more funding. Why again should we give more funding to an institute that has proven itself to be a bad solution? Beats me. But that’s the nature of government funding. Take money from the government agencies that do well (or the tax payers) and give it to the ones that do poorly – exactly the opposite of a proper incentive structure.

BTW: I was taught basic economics. I was fortunate in that my teacher's view extended beyond basic theory and numbers on a text book, and looked at how things worked in the real world, not just how they were supposed to work in theory. Blind faith in market forces does nothing to address the inadequacies of any economic model.

Agreed. And blind faith in capitalism can get you into a world of trouble. It’s important to recognize where capitalism cannot play a role – or how to frame the problem in such a way that it can. But these areas are limited to conflicts of interest. The military is a prime example. Having a private military would put a private organization in a position to usurp government power, or to simply exert force directly on the populous – a very dangerous proposition. Much more dangerous than having a government-run military. Still, we try to frame the problem so that the government has to act like a corporation. They have to offer soldiers salaries and benefits to entice them to join voluntarily. This was not always the case. The US military used to be based on draftees – and the experience of draftees reflected the military’s lack of incentives. Luckily one of our best economists pointed out to our government that from an economics-based incentive point of view – it would be better to do away with a draft-based military. The result has been astounding.

If its so good for healthcare, why is it working so poorly?

Because nobody has a healthcare system based on capitalism anymore.

Why is it such a big political issue? (both here and in US)
By your reasoning, healthcare in the US should be cheaper and better than anywhere else in the world. This is simply not the case:

The US has the most expensive healthcare system in the world, and the offfers one of the least effective services:

The US healthcare system is not capitalist. It is highly subsidized and government regulated. That being said, the US healthcare system is one of the most advanced and capable systems in the world. We have the world’s best health care technology here – and innovations that the rest of the world leeches from occur right here. Quite simply put, your healthcare system would not be nearly as good if ours were more like yours. Australia (and many other countries) borrow from our innovations… then hold them up and pretend like they’re doing it better than we are.

Now… don’t get all nationalistic on me. Yes, there are certainly medical breakthroughs in Australia. And yes, those breakthroughs certainly end up getting used in the US. And yes, you probably have some really amazing medical research centers and doctors and blah blah blah. But the bottom line is that without the innovation that happens in the US, your healthcare system would be far worse. Don’t try to deny that the US market empowers health care innovation.

People in the US spend more per head of population on health than any other country on earth & yet the US is one of only 2 developed nations in the world that does not offer healthcare to all its citizens.

This means nothing to me. Absolutely nothing. First of all, healthcare is offered to every US citizen (and non-citizens… and even illegal immigrants). But it isn’t offered “free”. Secondly, I don’t care how many people have health insurance. (Try not to confuse insurance with care)

Clearly, it is not working as well as it should when other developed countries can provide better services at lower costs. That's basic economics too - 'practically mathematical' in fact.

Of the OECD countries:
-US costs for healthcare are the highest of all: more than double the average

Cost is high where innovation and technology is at the forefront. Without the US’s heavy cost burden, you’d see much less improvement in health care technology in your country.

-US ranks 26th for infant mortality rates

We have world-class fertility drugs here…. and those fertility drugs increase the risk of multiple births… which increases the risk of premature birth… which drastically increases infant mortality.

-US ranks 24th in life expectancy rates

Blame that on a cushy lifestyle sucking down high fat foods – not the healthcare system.

-US ranks last fair in financing of healthcare.

Don’t care.

-The US has almost 47 million people not covered by healthcare.

Not true. Everyone has access to healthcare. We have 47 million people without health INSURANCE. Does that number count illegal immigrants? Not that I care… because people SHOULD pay for what they use.

BTW – it’s easy to give away free stuff when you live on an island instead of with a huge border right next to an impoverished country allowing poor people to flock to your “free” services.

-The only ranking that the US excels in is responsiveness.

Only the most important ranking.

The above facts are a bit sad for what is supposed to be the wealthiest & most powerful country on earth.

Actually I think they’re great. But let’s get back to the point here…

The US is pretty much the No.1 Capitalist nation, and if relying on market forces is such a good way to deliver healthcare, it should be No. 1 in all areas of health care, shouldn't it?

We are primarily a capitalist nation, but our health care system is far from capitalist. It is heavily government subsidized and highly regulated. Not exactly the proving case you’re looking for.

Actually, the most vital product for human life (any life in fact) is water. You'll die from thirst before you die from hunger. The next is health. Few people die from starvation- they typically die from malnutrition, which is a health issue. The next is shelter, then food. You will die from cold before you starve.

Water = Food
Malnutrition = Not enough Food.

I agree that shelter CAN be more important than food… but not in most situations. Yes, if you live in Oregon and your car gets stuck in a blizzard – shelter can be most important (though if I recall, in that situation they left their shelter in search of food).

Quite simply – food (and water) is the single most important product from human life. Health depends directly upon it. Education is useless without it. This is fact, not opinion.

As for food supplies, the US heavily subsidizes agriculture, so in a sense, they are providing food. While the US harps on about free markets, they subsidize and protect parts of their economy that could not compete on the world stage, eg. wheat. So its own rhetoric only applies when its convenient -hypocritical, isn't it?.

Yes. And I wish they would fix that. Eventually you’re going to get it through your head that the US ignores its own founding principles in many ways – usually to great detriment.

They purposely followed the US model, thinking that capitalist market forces would improve healthcare.

Why would they follow our model? Our model sucks. They should instead try to follow a capitalist model. Something that might actually have a chance of working. Our model currently has the government refusing to pay doctors all while increasing their educational requirements – forcing them out of the market thereby increasing the demand on the few that are left.

What amazes me is that folks like Obama actually LIKE the direction the US health care system is headed and want to send it there even faster.

Th governement here, much like in the US, is facing a huge backlash at the next election, this being one of many issues where right wing economic fundementalist faith has simply not delivered on its promises.

You seem to be under the impression that economics is a religion rather than based largely on mathematics. I assure you you are mistaken.

To give you some idea: I currently pay approx. $90 per month for private health insurance.
Before private healthcare was introduced, I paid less than $400 per year, and most medical treatments were free when you needed them (dental was never covered).

I pay about $400/year (after taxes) – about $33/month. But I can guarantee that a 1% increase in taxes would cost me a whole lot more than the difference between that and the $90 you pay (I just cranked the numbers). Private health insurance costs about $90/month here too. A can tell you for certain that if I’m offered the choice between a 1% tax bump or an increase to $90/month insurance premiums… I’d jump at the $90/month premiums.

The government does not want to introduce an extra 2%, which would cover the costs, as this would amount to an unpopular tax, an admission of failure, and unworkable rewinding of private back to public. We live in a western democracy, so it's not like the government can just repatriate healthcare.

2% is huge. If you think you’re paying a lot now… just wait.

Healthcare is not used by all people all of the time. Its only used by a minority when necessary. If the cost is spread across the whole population, its going to be cheaper for each individual when compared to a system of 'user pays'.

You’re describing insurance. But you’re not correct that it’s cheaper for each individual. That’s not mathematically possible. Spreading the cost over many people does not decrease the cost. If it saves one person money, it costs another person – that’s simple mathematical fact. Insurance works in that way. Some people pay too much, others pay too little – but everyone VOLUNTARILY pays because they want the safety net.

Obama’s plan does not spread the cost over the population (not that I’d be happy with that). It spreads the cost over about 5% of the population while the other 95% don’t pay a dime. That’s just good campaigning right there. You lose 5% of the vote while gaining 95%. If nobody understood the economic impacts of b**h slapping that particular 5% of your population, his plan would succeed in a landslide.

Now people like me are stuck with a huge bill for university (although I consider myself lucky, as I was at least partially subsidized- this will likely disappear in coming generations).

Your cost was likely increased by the amount you were subsidized. Again, economics plays a huge role. People out here are constantly shocked when student loan subsidies are increased and there is an immediate responding increase in tuition. Same thing for housing prices… make home mortgage insurance tax deductible? Home prices go up and nobody is any closer to buying a home.

Entry into universities used to be based on merit, not how much was in your bank account.

Scholarships = merit cased entry. But if you’re willing to pay for teachers to give you special treatment, and you can find teachers willing to offer their services… what’s the problem?

Just a education should be available to those who earn it, healthcare should be given to those that are sick, not just those who can afford it.

Only if you ignore human rights and consider doctors and teachers slaves.

BTW: sorry for the essay, I know its a lot to read, so thanks if you take the time to go through it all.
I'll most likely just shut up about this topic now, unless sufficiently provoked into a response.

I hope I sufficiently provoked a response. The only way you and I are going to learn anything about this subject is by challenging our preconceived notions about the way things work and listening to each other’s viewpoints.

I think I have said as much as I need to in order to get my point of view across.
Thanks for the debate Danoff, I may not agree with you on this one, but I can respect that you are at least engaged with political issues, which many people don't bother to take an interest in.

A quick list of your takes on the situation is not sufficient to spark real thought. In order to actually learn anything from this discussion about our own views or each others we have to lift the hood and get into the dirty details. Otherwise we’ll each mentally counter every point the other one makes and go about our merry way.

 

[Swift]

Wow, I haven't looked at this thread in a while.

Well, I of course agree with Danoff on this. It's radically unfair and just plain stupid to charge people for other's choices. That's my argument right there. You can put up as many arguments as you want to. But when it comes down to it, that's at the heart of "socialized" healthcare insurance. Do you think it's fair that YOU pay for a guys mouth cancer surgery...when he's been chewing tobacco for 20 years? Or pay for someone's high blood pressure drugs when they eat high sodium, high cholesterol foods? You may say yes, but I guarantee if knew the history of these conditions and not just the condition you'd be appalled.

I for one refuse to pay for other people's choices INVOLUNTARILY. I give to charities and things like that all the time. But that is my choice. Not this stupid Robin Hood thing the government seems to be stuck on. Rob from the rich(like it's a crime to be rich) to give to the poor.

As far as healthcare insurance and education being as important as National defense and rule of law...I'm perplexed. How could it be more important for the Federal/National government to provide education then to defend the nation. That's simply not feasible. What is needed to have a country? Sovereignty right? How can a country be sovereign without national defense? It can't, henceforth national defense should always be a higher priority for the federal government then healthcare insurance or education.

And please don't get me started on education. If it wasn't for the government, we could have different types of schools for children that learn in different ways. This would give us a more educated society. Instead, we're stuck with the government telling us what our children should know. Just stupid and wasteful...

 

[Gonz013]

There was no one involved in the study that supported government-run health care who wanted to get re-elected? Nobody was left who had a stake? I think I’d want a little more evidence before I turned my back on hundreds of years of proven economic theory.

The studies, ALL of them, showed that the previous system, before privatisation was better. I'm in no way saying that government run systems are always better. In this case, and when providing vital services, I believe a government controlled/ run system usually delivers better results - this is backed up by the WHO data.
Just because government run agencies have not worked well in the US doean't mean they can't work. There are obviously other factors determining the success/ failure in the case of the US - comparisons with how other countries provide efficient, reliable and economically viable services would be good, but unfortunately, people in the US are often to proud, and boast that whatever they do is the best, regardless of the truth of the matter.

Do they have any competition at all? Or do they have a monopoly? Because if it is that latter I can assure you that this kind of service will not lost. Monopolies are quite bad for the consumer – even if they’re government run monopolies. Eventually they will wake up and realize that there is no incentive to do a good job because you have no choice. The US post office has been horrific for many years. Only recently is it making efforts to improve service as it has come under fire from other organizations like FedEx, UPS, or alternatives like online banking.

Its a monopoly. There is no other competition for mail services. If you want mail/ packages to go across the city/ state/ country, you have to use Australia Post- there is no other choice. There are post offices and post boxes within walking distance of just about anywhere in major cities.
It is a government monopoly that has been working extremely efficiently, cost effectively and reliably for many generations, and is only improving.

It is a good example of how a government agency can run extremely well.

There is FedEx, DHL etc. but these are more expensive, and generally don't offer the same services that Australia Post does. They can't compete.
They only really get used for larger than usual packages that need to go overseas, or if you need something too large for the postal system to handle delivered overnight.

True, if you’re comparing from country to country – per capita helps. But if you’re comparing Australia to Australia (which is what I was doing) dollars works.

It doesn't tell enough of the story though. Its misleading. If you look at dollars spent, it looks great. If you compare it to the lack of services offered, it doesn't look so good anymore.

Private roads are some of the best roads I’ve driven on. Why is it that when you mention private roads I have this mental image of a wide open, brand new, perfectly maintained, well lit, road with easy to read road signs and near perfect ramp engineering? Because that’s my experience with private roads. Aside from people’s driveways, I’ve never driven on a private road I didn’t like… now public on the otherhand…

I think you missed my point. I was saying that governments are charged with providing us with vital services and infrastructure, that in private hands would not be affordable. If every road was private, you couldn't afford to drive anywhere. - But we are straying off topic here.

What are these “social costs” you speak of? Is that below?

That’s an argument against free health care.

Also an argument against free health care.

In my opinion, they are arguments FOR free healthcare, as in my experience, and in the experience of other countries that provide free health care, it results in better and cheaper services.

An argument against public schools. Here in the US, we have a pretty horrible public school system – especially in the poorer neighborhoods because our local governments (in their infinite wisdom) have based school revenue on local property values. A system that ensures that the rich kids get a much better education than the poor. What’s worse, no matter how much a poor person is willing to pay to educate their children, they are simply not allowed to do so. The only way a poor person can get their children into a good school is by taking on entirely too much debt by buying a house in a richer neighborhood. That’s the only way to do it via public schools anyway. Private schools are happy to help.

That's incredible?! I didn't know that!!
That doesn't make any sense. It just invites a vicious cycle to occurr.
No wonder it is so hard to fix!!

It doesn't work like that here.

That’s how bad public schools are in America. And all I ever hear is that they need more funding. Why again should we give more funding to an institute that has proven itself to be a bad solution? Beats me. But that’s the nature of government funding. Take money from the government agencies that do well (or the tax payers) and give it to the ones that do poorly – exactly the opposite of a proper incentive structure.

Public schools here are very good, although they are still underfunded. Exam results between public and private schools are typically very similar.
For some reason, a higher proportion of funding is given to private schools.
Here, the schools are run well, and only require extra money for better facilities and better pay for teachers.

Agreed. And blind faith in capitalism can get you into a world of trouble. It’s important to recognize where capitalism cannot play a role – or how to frame the problem in such a way that it can. But these areas are limited to conflicts of interest. The military is a prime example. Having a private military would put a private organization in a position to usurp government power, or to simply exert force directly on the populous – a very dangerous proposition. Much more dangerous than having a government-run military. Still, we try to frame the problem so that the government has to act like a corporation. They have to offer soldiers salaries and benefits to entice them to join voluntarily. This was not always the case. The US military used to be based on draftees – and the experience of draftees reflected the military’s lack of incentives. Luckily one of our best economists pointed out to our government that from an economics-based incentive point of view – it would be better to do away with a draft-based military. The result has been astounding.

👍 I always worry about economic fundamentalists that seem to cling to economics as if it were a faith. Its been a constant undercurrent of our present government.
👍 We gave up the draft too.

Quite simply put, your healthcare system would not be nearly as good if ours were more like yours. Australia (and many other countries) borrow from our innovations… then hold them up and pretend like they’re doing it better than we are.

You are overplaying the US contribution to world health, and underplaying the rest of the world's.
More than half of US biomedical companies' spending is on marketing, rather than research and development.
The proportion of spending on marketing campaigns has kept increasing over the years. It takes them away from doing the job they are supposed to.
Capitalism invites this sort of inneficiencies. If they didn't have to compete so much, more of the money could be spent of developing new drugs, rather than advertising old ones.

Now… don’t get all nationalistic on me. Yes, there are certainly medical breakthroughs in Australia. And yes, those breakthroughs certainly end up getting used in the US. And yes, you probably have some really amazing medical research centers and doctors and blah blah blah. But the bottom line is that without the innovation that happens in the US, your healthcare system would be far worse. Don’t try to deny that the US market empowers health care innovation.

I'll only get a little nationalistic, and say that the contributions that Australia provides in Medicine are vastly disproportionate to our population. We are punching well above our weight.

This means nothing to me. Absolutely nothing. First of all, healthcare is offered to every US citizen (and non-citizens… and even illegal immigrants). But it isn’t offered “free”. Secondly, I don’t care how many people have health insurance. (Try not to confuse insurance with care).

Don’t care.

I think perhaps that's the problem. You don't seem to give a damn about those less fortunate than you. People aren't poor because of choice, or because they deserve to be poor. They are poor because of their situation.

I don't advocate throwing money at them, but I do think that providing free health and education are two of the best ways of ensuring they have no excuse to get themselves above the situation they are in.

I believe free healthcare and education benefits a nation economically, by allowing people to be free of the burdens of poor health, and by giving people the skills and knowledge to get better jobs, manage businesses and innovate.

Not true. Everyone has access to healthcare. We have 47 million people without health INSURANCE. Does that number count illegal immigrants? Not that I care… because people SHOULD pay for what they use.

It might be available, but only if you can afford it. Ferraris are available to everyone too, but I won't die if I can't afford one.

BTW – it’s easy to give away free stuff when you live on an island instead of with a huge border right next to an impoverished country allowing poor people to flock to your “free” services.

If you look at a map, you will see Indonesia directly to our north. It is one of the most populous islamic country on earth. it has the largest standing army after China, has a lot of poverty, and civil unrest. They are much worse off than people in Mexico. There are thousands of people clammering onto boats trying to reach our shores. Add a massive coastline that is practically impossible to patrol, and you have a recepie for similar immigration problems.

Only the most important ranking.

Actually I think they’re great. But let’s get back to the point here….

I find it astonishing that you would be proud of such poor and damming results. Does your nationalistic pride blind you to the point where you are not willing to admit there is something clearly wrong, and that alternatives should be considered?

Water = Food
Malnutrition = Not enough Food.

Starvation= Not enough food
Malnutrition = Illness

Quite simply – food (and water) is the single most important product from human life. Health depends directly upon it. Education is useless without it. This is fact, not opinion.

I agree, I said that too, but I rank education and healthcare right under food/ shelter/ defence/ law- you shift them into another category altogether.
This is the crucial point where our opinion differs, and why we will never agree.

Yes. And I wish they would fix that. Eventually you’re going to get it through your head that the US ignores its own founding principles in many ways – usually to great detriment.

👍 Agreed.
Apparently, Australia and the US have the most generous free-trade agreement in US's history (according to our news anyway) but the US still protects itself where it can't compete (eg. wheat, beef, cotton etc.)

Why would they follow our model? Our model sucks. ...Our model currently has the government refusing to pay doctors all while increasing their educational requirements – forcing them out of the market thereby increasing the demand on the few that are left.

I wish we wouldn't. Our model is starting to suck too.
It's happening because our Prime Minister is a US ass kisser.
He's best buddies with dubbya.
It looks like he is on his way out though. The decade of right-wing economic fundamentalism has started to show its weaknesses and is backfiring. People have had enough, and the opposition looks set for a landslide win.
But you never know. A week is a long time in politics, and the election is several months away yet.

You seem to be under the impression that economics is a religion rather than based largely on mathematics. I assure you you are mistaken.

I don't disagree.
Some people treat it like it was a religion, entrusting blind faith in the market, while ignoring social and environmental aspects in their calculations- they conveniently get put to one side and labelled 'externalities'.
Much in the same way most people will take some parts of the bible, and ignore others. If an economic model takes all factors and 'externalities' into account, they are much more likely to reflect reality.

But you’re not correct that it’s cheaper for each individual. That’s not mathematically possible. Spreading the cost over many people does not decrease the cost. If it saves one person money, it costs another person – that’s simple mathematical fact. Insurance works in that way. Some people pay too much, others pay too little – but everyone VOLUNTARILY pays because they want the safety net.

Spreading a given cost over many people decreases the cost for each individual, not the overall cost itself. That's my whole point.
It works because everyone pays a little, but very few people use the service.
100% of people pay a little, only 5% use services that cost a lot.
If everyone pays a little, my medical bill can be much smaller if and when I use the service. It also allows people to get minor medical matters dealt with quickly, avoiding them from becoming worse and more expensive.

Prevention is better than cure. And a free medical service provides massive prevention when compared to an expensive one that tends to get used when people get really sick.

It worked in a similar way for education too. Everyone paid a little, but only those who earned it/ wanted a tertiary education used that money.
In my opinion, that's better than a system where the person that uses it, pays for it, bacause there will always be those that deserve an education/ could contribute more with more education, but can't afford it.

Your cost was likely increased by the amount you were subsidized. Again, economics plays a huge role. People out here are constantly shocked when student loan subsidies are increased and there is an immediate responding increase in tuition. Same thing for housing prices… make home mortgage insurance tax deductible? Home prices go up and nobody is any closer to buying a home.

I agree, but my point is that for all the generations before mine, healthcare was free, and education merit based.
It worked well, because no-one was in it for making a profit.
Sufficient funding was given by government, and a great service was provided for those that needed it/ earned it.

So why did it change if it worked so well?

They changed it because the current government has faith in economic fundamentalism, with a right-wing bent.
They though that if they introduced privitization, they could save funding dollars and inneficiencies would be teased out. It works in theory, but brings problems that were unforseen by most people.

Unfortunately, it has resulted in a system that costs more, standards are lowered, and it is not available to those who might use it best.

Australia has always prided itself on the notion of "a fair go" for everyone.

Applying market driven forces to important services only helps to create
a society that is split into 'have' and 'have-nots'.

 

[Swift]

I agree, but my point is that for all the generations before mine, healthcare was free, and education merit based.
It worked well, because no-one was in it for making a profit.
Sufficient funding was given by government, and a great service was provided for those that needed it/ earned it.

So why did it change if it worked so well?

They changed it because the current government has faith in economic fundamentalism, with a right-wing bent.
They though that if they introduced privitization, they could save funding dollars and inneficiencies would be teased out. It works in theory, but brings problems that were unforseen by most people.

Unfortunately, it has resulted in a system that costs more, standards are lowered, and it is not available to those who might use it best.

Australia has always prided itself on the notion of "a fair go" for everyone.

Have you ever had a government job or known someone with one? I used to work for the Dept of the Army for 4 years. Trust me, that is without a doubt one of the most inefficient entities on the earth. I literally spent more time preparing presentations on my progress then I did on trying to make progress. That was due to the fact that there were so many briefings/meetings you didn't really have time to make any real progress. So yeah, it's not a wonder that the military is contracting a lot of work to the private sector now. Go figure...💡

Anyway, anyone and everyone can get emergency care. Just yesterday I had to call 911 for a student that was in severe respiratory distress. The EMT's got here in about 5 minutes and had her in the ambulance in about 15. She's recovering now. They didn't ask to see her insurance card or anything like that. Just made sure she was going to stay alive. As you stated before Gonzo, the response is first rate.

A fair go for everyone is a fine notion. However, it should be a fair go in the way of opportunity. Not an involuntary charity for everyone.

Applying market driven forces to important services only helps to create
a society that is split into 'have' and 'have-nots'.

In a fair market society, how is that a bad thing? Granted, the American system isn't completely fair. Immigrants and minorities get an advantage for some stupid reason. But seriously, why shouldn't those who have earned it get the best food, clothes, housing, education and health care they can buy? To be honest, where I live you NEED a car because public transportation is almost none existent. Should the government subsidize an automotive purchase because of that? Of course not. If I can't afford a car, I should get to a place where it isn't a necessary item to have.

Ok, in a nutshell what I'm saying is that the government has not competition and is run by a bunch of liars, con artists and crooks with a few good people scattered here and there. Why should we trust people that know NOTHING about medicine to let us know what we do and do not need as far as health care is concerned?

 

[Danoff]

The studies, ALL of them, showed that the previous system, before privatisation was better. I'm in no way saying that government run systems are always better. In this case, and when providing vital services, I believe a government controlled/ run system usually delivers better results - this is backed up by the WHO data.

Depends on your metrics.

Government is always inefficient when compared to private. There is no way around it. It is a fundamental constant of the universe and not a matter of opinion. The incentives are not aligned properly with government work to ensure efficiency. My favorite economist breaks down spending into 4 categories.

Spending your money on yourself
Spending your money on someone else
Spending someone else's money on yourself
Spending someone else's money on a third person

The first type is the most efficient economically. You have incentives to maintain value and keep prices low. The second type would be equivalent to giving a gift. It isn't quite as efficient as type 1 because you have less incentive to get value - only to keep costs low. The third type of spending would be the equivalent of taking a corporate-sponsored lunch. You have a strong incentive to boost value (quality) but little incentive to keep costs low. Finally, the last type, is the least efficient method of spending and it is analogous to government spending. In the last category you don't have proper incentive to keep value high or cost low.

Economies should minimize type 4 spending as much as possible and, whenever they can, should promote type 1 spending to ensure efficiency.

There is no way around government inefficiency. They collect money regardless of the product quality - and so they need not keep value high. Any time you're offered services by someone who can extract money from you at the point of a gun (don't believe me? try not paying your taxes), you're going to pay more than you should.

It's basic economics, and it's pretty much undeniable. Monopolies are always bad - particularly so if the one holding the monopoly has the ability to use force to maintain it.

Just because government run agencies have not worked well in the US doean't mean they can't work. There are obviously other factors determining the success/ failure in the case of the US - comparisons with how other countries provide efficient, reliable and economically viable services would be good, but unfortunately, people in the US are often to proud, and boast that whatever they do is the best, regardless of the truth of the matter.

The system in the US is broken and bleeding. I'm not boasting that it is best done in the US. What I'm saying is that fundamentally your notions do not work, and our current experience with it supports that conclusion.

Its a monopoly. There is no other competition for mail services.

Right there you should see the problem. That will be it's downfall. Our mail delivery service has been a monopoly for a long time and at one time it was a source of national pride. Over time it eroded due to the economic principles I touched on earlier. Now it is improving again, but only due to competition.

I think you missed my point. I was saying that governments are charged with providing us with vital services and infrastructure, that in private hands would not be affordable. If every road was private, you couldn't afford to drive anywhere. - But we are straying off topic here.

Taking something that is not affordable in the private sector and making it public does not make it more affordable. It increases the overall cost - but if you force (ie: guns, threat of violence, prison etc.) a portion of your population to bear a disproportionate amount of the cost you can effectively steal money from them to make your own costs lower. That practice is immoral and detrimental economically speaking - but it can seem beneficial to the people who are receiving the fruits of someone else's labor.

Public schools here are very good, although they are still underfunded.

They will always be "underfunded". Nobody thinks that enough money is spent on "the children". How can you put a price on your child's or someone else's child's education? Especially when you're spending someone else's money on it. This is part of the problem with public education or health care. It invites you to make decisions about what other people's health or education is worth and them about you. That leads you to want to make changes to their lifestyle to get value for your money. Public health insurance begs people to whine that others are smoking or eating fatty food and costing a disproportionate amount of money. That leads to laws banning smoking and fatty foods etc.

The only person who can judge how much your health or education is worth is you. Nobody else is qualified to make that decision, and so the funding for those services (that you consume) should be determined by you. Not just for the economic efficiency reasons I laid out earlier, but because it is morally required.

The proportion of spending on marketing campaigns has kept increasing over the years. It takes them away from doing the job they are supposed to.
Capitalism invites this sort of inneficiencies. If they didn't have to compete so much, more of the money could be spent of developing new drugs, rather than advertising old ones.

Informing you about new products or services is not wasted money, and advertising is a key component of competition - the only thing that drives efficiency (assuming you're restricted to moral methods of course).

Advertisement expense is a key part of determining corporate profit. There is a strong incentive to limit advertising costs, just as there is for minimizing research costs and any other costs. Without those incentives inefficiencies occur. And advertising doesn't work unless the product is solid and in high demand.

I think perhaps that's the problem. You don't seem to give a damn about those less fortunate than you. People aren't poor because of choice, or because they deserve to be poor. They are poor because of their situation.

I would suggest that you not go making assumptions about who I do or don't give a damn about. Some people are not poor because they deserve to be poor... some people are poor as a result of other people's poor decisions (or injustice). But once you reach adulthood in this day-and-age, you're responsible for your "situation". What you make of your life is your responsibility and no one else's. To suggest otherwise is to promote injustice.

I advocate private health service and private educational service because I care about everyone having access to a fair, efficient, and high quality system. Private schools are good for the poor (better for them than the rich in the US). Private health service is in everyone's best interest because it keeps prices as low as possible, minimizes inefficiency, and is a just system.

Now the next paragraph may seem hypocritical... but I worded it carefully.

From what I read of your thoughts, you don't seem to care about the rich. You seem to think that it is a bad thing to have more than most people, and that they should be penalized for their success. I find this disturbing. Only one of us is advocating unjust economic policies against a portion of the population.

I believe free healthcare and education benefits a nation economically, by allowing people to be free of the burdens of poor health, and by giving people the skills and knowledge to get better jobs, manage businesses and innovate.

You're advocating healthcare and education... not government-sponsored healthcare or education. Yes, education is good, as is healthcare. I am not advocating that we don't have them, only that they be offered in an equitable manner.

It might be available, but only if you can afford it. Ferraris are available to everyone too, but I won't die if I can't afford one.

You might die if you couldn't afford a gun, should those be free? You could die if you can't afford food, how about that? How about electricity? That could lead to death in the summer or winter.

What if you had a rare disease that required a team of researchers working 6 months on your condition to develop a cure. Are you entitled to that at taxpayer expense? If it costs 10 trillion dollars to provide you with a cure for your disease are you entitled to it? If your heart has stopped and you need a new one, are you entitled to it? Who's heart are you entitled to?

The possibility of death does not entitle you to anything. We are also responsible for keeping ourselves alive. This is especially critical because we're the only people who can determine what our lives are worth.

I find it astonishing that you would be proud of such poor and damming results. Does your nationalistic pride blind you to the point where you are not willing to admit there is something clearly wrong, and that alternatives should be considered?

Which results were the problem? The one that said we don't have 100% coverage? I like that result, I wouldn't want it any other way. The one that said our infant mortality rate was higher? I'm happy to live in a nation where fertility treatments are so prevalent. The one that said that our lifespan isn't as long as others? No, I'm not happy to be living in a country of overeating, smoking, drinking, drug abusing, sedentary people - but that's their choice. I don't see it as a strong referendum against our heath care system.

And how can I not be happy that the US has the best response in the world (that doesn't surprise me btw). That's what I consider the most important part of health care.

Starvation= Not enough food
Malnutrition = Illness

Are you seriously sticking with this? Apparently not... below.

agree, I said that too, but I rank education and healthcare right under food/ shelter/ defence/ law

Glad you changed your mind on that. Now, if healthcare and education are "too important" to leave to private companies, how is it that food and shelter can be left to those devices? Surely all food and shelter should be provided by a government controlled monopoly.

Spreading a given cost over many people decreases the cost for each individual, not the overall cost itself.

That sentence defeats itself. Spreading the cost over many individuals will increase the cost for some, and decrease it for others - but the overall cost remains the same. It is not possible for the overall cost to remain constant, but the individual share of the cost to go down for all. That's mathematically impossible and amounts to simple arithmetic.

Prevention is better than cure. And a free medical service provides massive prevention when compared to an expensive one that tends to get used when people get really sick.

First of all, I'm not a big one for conventional wisdom. You can say "look before you leap" and "the early bird gets the worm" and "better safe than sorry" and "the best things come to those who wait" and contradict yourself all over the place. So "prevention is better than cure" is fairly suspect. But that aside, the phrase is referring to taking care of yourself so that you don't need healthcare in the first place.

I agree that catching illnesses early is important (something the US is apparently quite good at), but having a "free" healthcare system invites abuse and increases usage, inefficiency, and overall demand. Again, simple economics, any time you decrease cost you increase demand. If the cost is zero, demand will be quite high.

bacause there will always be those that deserve an education/ could contribute more with more education, but can't afford it.

An argument in favor of charity - another thing that is best done privately.

It worked well, because no-one was in it for making a profit.

Profit is the most important motivator for productivity. It provides maximum incentive for efficiency, quality, etc. etc. To suggest otherwise is to refute economic theory entirely.

Applying market driven forces to important services only helps to create
a society that is split into 'have' and 'have-nots'.

I'm back to Soviet Russia. Eliminating the rich can give you the illusion of putting everyone in the "have" category, but you really end up with a population of have-nots. Some vindictive people would prefer that if they didn't have everything, nobody should, but I happen to think that it's better to have an economic structure that harnesses basic human greed into productivity, uses competition to promote efficiency and quality, and rewards effort justly.

 

[Omnis]

Applying market driven forces to important services only helps to create a society that is split into 'have' and 'have-nots'.

Applying socialism to important services only helps to create a society that is split into "haves" and "once-hads".

All you are doing is redistributing services and funds, losing efficiency in the delivery of those services in the process-- not to mention destroying any incentive for earning the services in the first place.

Danoff set it straight in his well written post. I still can't believe you take your stance when logic, science, and history are clearly against you.

 

[Gonz013]

Applying socialism to important services only helps to create a society that is split into "haves" and "once-hads".

All you are doing is redistributing services and funds, losing efficiency in the delivery of those services in the process-- not to mention destroying any incentive for earning the services in the first place.

Danoff set it straight in his well written post. I still can't believe you take your stance when logic, science, and history are clearly against you.

When you say "Logic, Science and History" I guess you mean in the US experience? The world is a bigger place, and things get done differently in other places- sometimes they get done better, so why not look at those too?

Experiences worldwide also show that a governement agency/ service can be structured well and that it can run efficiently. I'm happy to admit that this is not usually the case, but it shouldn't dismissed altogether.

I held up Australia Post as an example, and it's actually quite timely. A few economists are trying to spark debate about seling it off at the moment.
They say the government can get about 4 billion for it, providing a windfall for the government.
They are justifying their point of view by saying that Australia Post has never been so profitable and well run, and many parties would be interested in buying it.

In this country, we sell an asset because it's making money and running well.

Already people are crying out against it, because in Australia's experience, once well running institutions are privatised, one of the few ways to make more money is to raise prices. It's happened with energy supply, telecommunications, transport etc.
Australia has a very small population spread out over a large area, so providing services, such as broadband cable or postal services to a remote little town in the middle of nowhere is suddenly not profitable to a privatized service- they're just not interested if its not profitable.
As a result, some people can no longer afford the service they previously could, and they become have-nots.
Sure, the government could step in and subsidize those people, but that will cost a lot more than it would have when they controlled the service.
Where's the fairness/ justice if people are denied important services bacause a company decides it can't make enough profit?

 

[Gonz013]

Depends on your metrics.

Government is always inefficient when compared to private. There is no way around it. It is a fundamental constant of the universe and not a matter of opinion. The incentives are not aligned properly with government work to ensure efficiency.

A fundamental constant of the universe?
??You really can't allow for the possibility of a well run government organisation, that puts in places the incentives required? Is that so impossible to you??
They exist! They're rare, but they exist! Australia Post is just one! (see my post previous to this one regarding debate regarding its possible sale!)

My favorite economist breaks down spending into 4 categories.

Spending your money on yourself
Spending your money on someone else
Spending someone else's money on yourself
Spending someone else's money on a third person

That's all fine, and I'm not going to disagree. Incentives of any sort are intrinsic to performance/ efficiency of any sort of human endevour.
Like I have said before, Capitalism works great because of this, and works great for lots of things, particularly when producing products.
BTW: your 'favorite economist' -is it Paul Samuelson by any chance?

There is no way around government inefficiency.

There is! - Accountability, Transparency, Performance reviews, Requirement to make/ improve profits, requirements to increase services etc. etc.

It's basic economics, and it's pretty much undeniable. Monopolies are always bad - particularly so if the one holding the monopoly has the ability to use force to maintain it.

I'll agree monopolies are bad most of the time, but not always.

[/QUOTE]The system in the US is broken and bleeding. I'm not boasting that it is best done in the US. What I'm saying is that fundamentally your notions do not work, and our current experience with it supports that conclusion. [/QUOTE]

They CAN work in practice. It DOES work in practice. It's worked for Australia Post since 1908! It's worked for the Postal Systems in Europe and Japan too.

Right there you should see the problem. That will be it's downfall. Our mail delivery service has been a monopoly for a long time and at one time it was a source of national pride. Over time it eroded due to the economic principles I touched on earlier. Now it is improving again, but only due to competition.

When will this downfall occur? It's always been a monopoly, and has only kept improving more and more, with a total lack of competition!!

Taking something that is not affordable in the private sector and making it public does not make it more affordable. It increases the overall cost - but if you force (ie: guns, threat of violence, prison etc.) a portion of your population to bear a disproportionate amount of the cost you can effectively steal money from them to make your own costs lower. That practice is immoral and detrimental economically speaking - but it can seem beneficial to the people who are receiving the fruits of someone else's labor.

I agree, but that's not what I'm advocating. I'm saying everyone pay an equal amount, proportional to what they earn, and anyone that needs the service uses it only when they need to.

They will always be "underfunded". Nobody thinks that enough money is spent on "the children". How can you put a price on your child's or someone else's child's education? Especially when you're spending someone else's money on it.

You can put a price on it- it need not be an emotional thing.
Public schools here are just asking for the same funding per student that the private schools get.
It costs whatever it costs to supply and maintain the services and infrastructure, and give teachers a decent pay.
A public school is underfunded if it can't heat a classroom in winter.
A private school is overfunded if it is upgrading a private rifle range with government money.

This is part of the problem with public education or health care. It invites you to make decisions about what other people's health or education is worth and them about you. That leads you to want to make changes to their lifestyle to get value for your money. Public health insurance begs people to whine that others are smoking or eating fatty food and costing a disproportionate amount of money.

Don't worry, the fat smokers will die soon enough.

The only person who can judge how much your health or education is worth is you. Nobody else is qualified to make that decision, and so the funding for those services (that you consume) should be determined by you. Not just for the economic efficiency reasons I laid out earlier, but because it is morally required.

Ok, but what if you decided that your health was valuable, but you simply couldn't afford to pay for it? What if you were sick enough so you couldn't work, and you couldn't afford to pay for the drugs you need to get better?
Value and affordability are not the same thing.

Informing you about new products or services is not wasted money, and advertising is a key component of competition - the only thing that drives efficiency (assuming you're restricted to moral methods of course).

Biomedical companies (not just in the US) are themselves are saying that their advertising spending is getting out of hand, but they feel like they need to keep up with the competition, leading to their R&D suffering.
Instead of concentrating on making better/ new products, they are harping on about how great the old ones are. R&D is expensive and uncertain, and they have to wait for a critical mass of ill people before they R&D a drug just to make sure its profitable- advertising and pushing their drugs to doctors is more cost effective. - So people miss out on potentially life saving drugs that would otherwise be developed, had the advertising budgets been smaller.

Advertisement expense is a key part of determining corporate profit. There is a strong incentive to limit advertising costs, just as there is for minimizing research costs and any other costs. Without those incentives inefficiencies occur. And advertising doesn't work unless the product is solid and in high demand.

Advertising is money that could have been spent doing their actual job. If a particular service is provided by government, all the money that would have gone to advertising and profits can go back into providing the actual service.

I would suggest that you not go making assumptions about who I do or don't give a damn about.

My sincere apologies. I shouldn't have written what I did.

Some people are not poor because they deserve to be poor... some people are poor as a result of other people's poor decisions (or injustice). But once you reach adulthood in this day-and-age, you're responsible for your "situation". What you make of your life is your responsibility and no one else's. To suggest otherwise is to promote injustice.

I agree: Yes, adults should be able to make their own decisions and take responsibilities for their own actions.
BUT- those children can have a much better chance of being better, saner, more capable adults that contribute more to their community and economy by having been given the best chance possible- in part, by providing them with free healthcare and education.

I advocate private health service and private educational service because I care about everyone having access to a fair, efficient, and high quality system. Private schools are good for the poor (better for them than the rich in the US). Private health service is in everyone's best interest because it keeps prices as low as possible, minimizes inefficiency, and is a just system.

It's not 'just' if people are excluded because of how much money they don't have. A well run government sytem keeps prices low as possible because it minimizes spending in advertising and does not need to pay a profit to shareholders.

Now the next paragraph may seem hypocritical... but I worded it carefully.

From what I read of your thoughts, you don't seem to care about the rich. You seem to think that it is a bad thing to have more than most people, and that they should be penalized for their success. I find this disturbing. Only one of us is advocating unjust economic policies against a portion of the population.

I'm all for people becoming as wealthy as they like, just not at the expense of others that would be left behind if services become to expensive for them to afford.
An ideal society should have enough of a safety net, so that if someone finds themselves in a devasted situation, they have a reasonable chance of re-building themselves.
A society that does not offer free health and education to those that need it makes it much harder for someone to further themselves and get out of a bad situation.

You're advocating healthcare and education... not government-sponsored healthcare or education. Yes, education is good, as is healthcare. I am not advocating that we don't have them, only that they be offered in an equitable manner.

I'm arguing for the same thing, but how is it equitable if the service is not able to be accessed by all? It's descrimination based on what you can afford.

Perhaps its only that we want to achive the same end with different means, and we are caught up arguing this, rather than getting to the heart of the matter.
Your experiences in the US clearly show you that a user pays system would be more equitable that what you currently have.
My experiences here show me that privatisation hurts the provision of important services, making them less equitable.

Is it a case of horses for courses?

What if you had a rare disease that required a team of researchers working 6 months on your condition to develop a cure. Are you entitled to that at taxpayer expense? If it costs 10 trillion dollars to provide you with a cure for your disease are you entitled to it?

In a government run system, yes.
If that 10 trillion came from taxpayers, then I would be entitled to get it for free, as I would have already indirectly paid for it.

If your heart has stopped and you need a new one, are you entitled to it? Who's heart are you entitled to?

I'm entitled to the heart of the person that generously donated theirs, just as much as someone else is entitled to my heart if I died in an accident. It's the reason why I'm happy to be an organ donor.
I would want my heart to go to whoever needs it the most, not whoever can afford the surgery.

The possibility of death does not entitle you to anything. We are also responsible for keeping ourselves alive. This is especially critical because we're the only people who can determine what our lives are worth.

The possibility of death entitles me to hope. Hope can be provided by the medical treatments that should be free to whoever needs them.

Which results were the problem?

The ones from the WHO that say you should be doing better in all areas except response.
The infant mortality rates aren't just down to fertility treatments. The great majority of the other developed nations in that WHO report have the same fertility treatments available.

..."prevention is better than cure"... the phrase is referring to taking care of yourself so that you don't need healthcare in the first place.

No, I was reffering to treating an illness early before it develops and gets worse.

I agree that catching illnesses early is important (something the US is apparently quite good at), but having a "free" healthcare system invites abuse and increases usage, inefficiency, and overall demand. Again, simple economics, any time you decrease cost you increase demand. If the cost is zero, demand will be quite high.

No, the US health system is good at responding, not preventing.
Your own doctors complain by saying that the US system is more of a "sickcare" system rather than "healthcare", bacause the US system is great at responding to emergencies, and providing expensive care to diseases and conditions that could have been prevented had they been treated earlier.

but having a "free" healthcare system invites abuse and increases usage, inefficiency, and overall demand. Again, simple economics, any time you decrease cost you increase demand. If the cost is zero, demand will be quite high.

Like you have mentioned yourself, the cost is never zero- you pay through taxes, so abuse is not readily carried out, because people know abusing the system will result in higher taxes. Records are kept on individuals, so doctors can curb the behaviour/ report those that abuse it.
I don't know anyone that likes to go to hospital or the doctor's surgery. People use these services when they need to. Yes, usage would go up, but this allows for earlier treatment and prevention of escalation of conditions/ diseases.
So there may be more people going in for a sore foot/ knee, which on the surface might look wasteful, but there will also be a decrease in people going in for back surgery.

Profit is the most important motivator for productivity. It provides maximum incentive for efficiency, quality, etc. etc.

And you can have incentives in place with a government organisation to promote efficiency - eg. performance reviews for individuals.

To suggest otherwise is to refute economic theory entirely.

There's more than one economic theory, and many variations to each one.

I'm back to Soviet Russia. Eliminating the rich can give you the illusion of putting everyone in the "have" category, but you really end up with a population of have-nots. Some vindictive people would prefer that if they didn't have everything, nobody should, but I happen to think that it's better to have an economic structure that harnesses basic human greed into productivity, uses competition to promote efficiency and quality, and rewards effort justly.

Who mentioned communism? I'm not advocating sharing everything out equally.
I'm only advocating publically funded, freely available services for the most basic and vital services.
There are more motivators than just greed.

 

[Gonz013]

Have you ever had a government job or known someone with one? I used to work for the Dept of the Army for 4 years. Trust me, that is without a doubt one of the most inefficient entities on the earth. I literally spent more time preparing presentations on my progress then I did on trying to make progress. That was due to the fact that there were so many briefings/meetings you didn't really have time to make any real progress. So yeah, it's not a wonder that the military is contracting a lot of work to the private sector now. Go figure...💡

Yes, and it was grossly inefficient.
But that does not lead me to the conclusion that a government run organisation always has to be like this, because I have seen the exact opposite too.

Anyway, anyone and everyone can get emergency care. Just yesterday I had to call 911 for a student that was in severe respiratory distress. The EMT's got here in about 5 minutes and had her in the ambulance in about 15. She's recovering now. They didn't ask to see her insurance card or anything like that. Just made sure she was going to stay alive. As you stated before Gonzo, the response is first rate.

That's great, I hope she's OK.
-Do you think she should have to pay for that?
-Do you think she had a choice with regards to this service she was provided?
-Do you think the service provided was vital? Was it as important as rule of law and defence?
-Do you think you should pay for fire fighters and police officers to provide their service too?

A fair go for everyone is a fine notion. However, it should be a fair go in the way of opportunity. Not an involuntary charity for everyone.

It wouldn't be fair unless everyone contributed, and everyone was able to benefit.
If you miss out because you can't afford- that's not fair.

But seriously, why shouldn't those who have earned it get the best food, clothes, housing, education and health care they can buy?

Nothing wrong with that. But what about good quality health and education for those that can't afford it?
How about a good minimum standard for all, and as many bells and whistles that you want if you can afford them?

To be honest, where I live you NEED a car because public transportation is almost none existent. Should the government subsidize an automotive purchase because of that? Of course not. If I can't afford a car, I should get to a place where it isn't a necessary item to have.

No, but how about some decent, reliable public transportation, so you have the option of not having to buy a car?

Ok, in a nutshell what I'm saying is that the government has not competition and is run by a bunch of liars, con artists and crooks with a few good people scattered here and there.

Agreed. That's why they need to be accountable, and not just every 3 or 4 years.

Why should we trust people that know NOTHING about medicine to let us know what we do and do not need as far as health care is concerned?

Ummm... well, we shouldn't.
The minister for health here is a medical doctor, as well as a politician.

 

[Omnis]

When you say "Logic, Science and History" I guess you mean in the US experience? The world is a bigger place, and things get done differently in other places- sometimes they get done better, so why not look at those too?

Experiences worldwide also show that a governement agency/ service can be structured well and that it can run efficiently. I'm happy to admit that this is not usually the case, but it shouldn't dismissed altogether.

No, I'm talking about the entire world. Sure, an agency can be structured and run well, but, as you said, that's not usually the case (Especially in the U.S. ). You defeated your point. Therefore, why have government involved in such an operation?

A market of monopolistic competition with no government intervention will perform the same operation with more efficiency and more benefit to the consumer. As cost bares down on only the individual (through whichever route it may take to him or her), all forms of falsely-philanthropic policy including universal health care are ultimately ineffective or unnecessary for promoting the well-being of a population. Such policies that many governments have created throughout history have always ended in failure.

 

[Swift]

Yes, and it was grossly inefficient.
But that does not lead me to the conclusion that a government run organisation always has to be like this, because I have seen the exact opposite too.



That's great, I hope she's OK.
-Do you think she should have to pay for that?
-Do you think she had a choice with regards to this service she was provided?
-Do you think the service provided was vital? Was it as important as rule of law and defence?
-Do you think you should pay for fire fighters and police officers to provide their service too?

She is but she's still smoking. How stupid is that?!

To answer your questions.

1. AFTER service is rendered. Yes.
2. Not the first responders but when she got to the hospital, YES
3. Yes it was vital and NO it wasn't as important as law and defense on a NATIONAL scale.
4. We do pay police, firefighters and paramedics already. However, most times they are on a state or local level of authority, not national.

It wouldn't be fair unless everyone contributed, and everyone was able to benefit.
If you miss out because you can't afford- that's not fair.

Sorry bud, but that's socialism/communism. How is it fair to take from the person that earned to give it to the person that didn't earn? Of course, there are a few exceptions to this rule, but 99% of the time that's what you're talking about.

Nothing wrong with that. But what about good quality health and education for those that can't afford it?
How about a good minimum standard for all, and as many bells and whistles that you want if you can afford them?

If you can't afford them you shouldn't have children and should work until you CAN afford them. Why should your life choices be the burden of society at large?

No, but how about some decent, reliable public transportation, so you have the option of not having to buy a car?

That won't be used by the majority of the people because they have cars. So it will be a huge waste of taxpayers money.

Agreed. That's why they need to be accountable, and not just every 3 or 4 years.

That would be nice wouldn't it.

Ummm... well, we shouldn't.
The minister for health here is a medical doctor, as well as a politician.

Same with our surgeon general. But my point is that if politicians are making the laws that govern who can get what care and under what conditions, that's NOT the role of government.

 

[Danoff]

Gonz,

I’ve broken your post into 4 main points to try to consolidate my responses. I’ll summarize them (though I realize that’s dangerous).

A fundamental constant of the universe?
??You really can't allow for the possibility of a well run government organisation, that puts in places the incentives required? Is that so impossible to you??
They exist! They're rare, but they exist! Australia Post is just one! (see my post previous to this one regarding debate regarding its possible sale!)
…Accountability, Transparency, Performance reviews, Requirement to make/ improve profits, requirements to increase services etc. etc.
They CAN work in practice. It DOES work in practice. It's worked for Australia Post since 1908! It's worked for the Postal Systems in Europe and Japan too…. I'll agree monopolies are bad most of the time, but not always.

Summary: Government organizations can be run efficiently if the proper incentives are in place.

I agree, but that's not what I'm advocating. I'm saying everyone pay an equal amount, proportional to what they earn, and anyone that needs the service uses it only when they need to…. I'm all for people becoming as wealthy as they like, just not at the expense of others that would be left behind if services become to expensive for them to afford…. how is it equitable if the service is not able to be accessed by all? It's descrimination based on what you can afford…. It's not 'just' if people are excluded because of how much money they don't have.

Summary: Justice is determined by need and costs should be shared proportionately.

You can put a price on it- it need not be an emotional thing.
Public schools here are just asking for the same funding per student that the private schools get.
It costs whatever it costs to supply and maintain the services and infrastructure, and give teachers a decent pay.
A public school is underfunded if it can't heat a classroom in winter.
A private school is overfunded if it is upgrading a private rifle range with government money…. Ok, but what if you decided that your health was valuable, but you simply couldn't afford to pay for it? What if you were sick enough so you couldn't work, and you couldn't afford to pay for the drugs you need to get better?
Value and affordability are not the same thing…. In a government run system, yes.
If that 10 trillion came from taxpayers, then I would be entitled to get it for free, as I would have already indirectly paid for it…. Like you have mentioned yourself, the cost is never zero- you pay through taxes, so abuse is not readily carried out, because people know abusing the system will result in higher taxes. Records are kept on individuals, so doctors can curb the behaviour/ report those that abuse it.
I don't know anyone that likes to go to hospital or the doctor's surgery.

Summary: Each person is in a position to determine the health and education everyone else should get.

Advertising is money that could have been spent doing their actual job. If a particular service is provided by government, all the money that would have gone to advertising and profits can go back into providing the actual service….. A well run government sytem keeps prices low as possible because it minimizes spending in advertising and does not need to pay a profit to shareholders.

Summary: Advertising and profit makes private corporations as inefficient as government.

Ok, let’s start with the first notion – that government can be structured to be more efficient. You give the example of accountability (like, elections for example) as a way to increase efficiency. You say performance reviews and requirements can help minimize losses.

Voting is a poor substitute for the free market. Many people think much more carefully about purchases that they make than about who they vote for. When people buy a product – especially an important one, they do research, they ask around to determine whether the product is high quality, they’re responsive to feedback and take advertisement with a grain of salt.

But while people often approach voting in a similar way to purchasing a product, research quite is difficult with government policy because of the number of variables. This means that few people choose to investigate. Instead, people attempt to calibrate the promises made by politicians and weigh it against what they think it will cost them. This kind of basis for voting is devastating in the presence of a poorly limited government.

To give a concrete explanation of exactly how this is devastating, allow me to suggest a hypothetical government project upon which candidates might campaign. This project happens to be incredibly similar to one currently proposed in Alaska, so I think it has a good deal of credibility.

Let’s say one of the candidates is proposing a dig project. The scale is massive, 10 billion dollars/year will be spent to offer jobs to the unemployed to dig a hole of biblical proportions. When the hole is properly dug, the project will then employ these people to refill the hole. When the hole is finished being refilled, the process will be restarted.

This project has the major benefit of creating work and eliminating unemployment. These people will now have money to pay for health care, education, food, etc… the work therefore provides them with vital life-necessities that they are so obviously entitled to afford. The only downside here is that it costs 10 billion right? What if we levied that cost on the richest 5% of the population? They could afford it.

Ok, that’s the plan. How does the vote turn out? Remember, people approach voting the way they approach purchases (except so often without the research). So 95% of the population evaluates the promise (universal employment) against the cost to them (nothing). The other 5% sees the cost as high and the benefit as minimal.

Vote passes in a landslide.

Now let’s look from an economic point of view at what we just voted into place – a 10 billion dollar economic drain levied disproportionately onto the citizens most capable (and likely) to use their money to create jobs, products, and economic growth. From an economic point of view it’s $10 billion of pure inefficiency and a step in the wrong direction. It also has the side problem of disproportionately damaging businesses that offer low-paying jobs, as many people will probably be willing to leave those jobs to join the dig – this effect will cause an increase in the number of people participating in the plan, thereby increasing the funding necessary for the plan, thereby increasing the economic burden for following years.

That’s voting. Macro-economic stupidity spawning from a reasonable mirco-economic choice, all made possible by the threat of force. So when you say voting (accountability) increases government efficiency, while it is fundamentally true that voting is better than not voting, the conclusion that it can even begin to compete with market forces misunderstands the fundamentals of voting… and I didn’t even get into the whole one vote represents 500 issues all of which you may not agree with problem.

…and let’s face it. Voting is the ONLY accountability for government (though, not all government is accountable). Performance reviews and requirements to turn a profit are entirely made possible by the act of voting.

Hmmm…. if I write this much about each point I’ll never finish. What’s next?

Justice is determined by need and costs should be shared proportionately.

Justice is not in any way determined by need. Our system of justice is based upon the notion of fundamental human rights and voluntary agreements. A voluntary exchange is obviously not dependent upon need in anyway, it requires consent from both parties – the need of one party does not overrule the consent of the other.

Human rights are also not dependent upon need. Each individual regardless of status or possessions (or religion, or race, or gender, etc.) has the same fundamental rights within the national system of justice. These rights basically amount to freedom from force, a notion that is derived directly from logic (I made a thread about this). Once you attempt to force another human being you forfeit some portion of your rights. That is why it would be impossible to include the right to force another human being to fulfill your “needs”. Even if those needs are health related.

On the notion of proportionality… the idea that a certain percentage of one’s income is worth the same amount of health care, or education, or military, or anything as anyone else’s is fundamentally flawed. 5% of one person’s income is not worth the same as 5% of another’s and so it should not (justly) buy the same product. To suggest otherwise is to suggest that productivity is irrelevant – that the man sitting on the couch all day has earned the same as the man awake at 2am pouring over blueprints. That flies in the face of the concept of fairness.

Each person is in a position to determine the health and education everyone else should get.

You might be willing to live with a scar for $2000. Your neighbor may think that it is worth $2000 to remove the scar. You might think that it is worth putting your family in debt $200k to cure your lung cancer, your neighbor may not agree. Decisions about your health (or education for that matter) must be made by the person who has to bear the consequences. Society might collectively determine that my left ring finger is worth the same as my right, but I know that it is not the case. I know that I use my left far more than my right.

Health is a very personal matter. Different aspects of your physiology mean more to you than those same body parts mean to others, and you are in the best position to determine what they are worth. The man who sits on the couch all day may really hate working. He might be willing to lose a foot to avoid work. The man at work at 2am obviously does not hate working quite so much, and might be willing to pay more (spend more time at work etc.) to save that foot. Those are individual decisions and neither is right or wrong. Just because society comes to a conclusion on what the average foot is worth doesn’t mean that it is the right conclusion for everyone.

Advertising and profit makes private corporations as inefficient as government.

In the US, the government advertises. Even though the army has a monopoly on military service work, they advertise to recruit. Here we advertise government programs like food stamps, highway safety, new post-office policies, and, of course, millions upon millions of dollars are raised and spent campaigning.

Not to mention that we actually have to pay the politicians, and never once do they cut their own pay to reduce the burden on taxpayers.

Corporations on the otherhand will reduce their own pay (profit) to reduce costs, because it will gain them more profit in the future, which they will turn around and re-spend to grow the corporation. Yes, at some point many people get paid obscene amounts of money, but those people are often responsible at that point for having created or maintaining thousands of jobs.

BTW: your 'favorite economist' -is it Paul Samuelson by any chance?

Milton Friedman.

 

[///M-Spec]

Bravo.

Please sir, may I have another?

Folks, there's a reason he wears the badge.


M

 

[Omnis]

Bravo.

Please sir, may I have another?

Folks, there's a reason he wears the badge.


M

Yeah, he does a good job. He's not alone, though.

 

[exigeracer]

I rarely come into the Opinions Forum because every single discussion is constant argument between two beliefs (see post no. 343), but I've got a question for danoff, I just need some quick clarificaiton.

National defense and rule of law are the most basic services that should be provided by the government. Health and education is your responsibility - and pretty low on the priority scale. I'd say those come after food, shelter, and clothing. Ask yourself, did your food, shelter, or clothing come from the government? No? Then why should your health care and education? Two things that are clearly less critical.

So what if you are born in those low-income areas, where you claim the education system is inusufficient? These are the same areas where crime and poverty is high directly because of that poor education, this in turn makes the so-called greatest healthcare system in the world less accessible.

You said that moving to a nicer neighbourhood is not an option. You also dismissed the whole "bad luck" issue when you created this thread. So what do you do if you're born in that area?

 

[Danoff]

So what if you are born in those low-income areas, where you claim the education system is inusufficient? These are the same areas where crime and poverty is high directly because of that poor education, this in turn makes the so-called greatest healthcare system in the world less accessible.

You said that moving to a nicer neighbourhood is not an option. You also dismissed the whole "bad luck" issue when you created this thread. So what do you do if you're born in that area?

Private schools are become much more popular in low income areas than they used to. Some low income communities have experimented with them and had great success.

Similarly, with the changes that I'd suggest to the healthcare system, private health insurance would no longer be so closely related to your company or job - making it more accessible to lower income folks.

In the absence of those changes, with only the government-sponsored healthcare and government-sponsored schools available to the poor, I'd recommend that the child take it upon his or her self to do some extra studying on their own outside of class... and just pray they don't get really sick and need to rely on government medical care.

 

[exigeracer]

and just pray they don't get really sick and need to rely on government medical care.

And if they do get sick and die, tough luck?

 

[Danoff]

And if they do get sick and die, tough luck?

Not quite sure what you're referring to. My statement that you quoted is me saying I wouldn't want to be in the situation to rely on government-sponsored medical care. If they have to rely on it - it isn't tough luck, it's bad policy.

 

[Swift]

Quick questions for the supporters of a national healthcare system. Why should the FEDERAL government get involved with individual's healthcare? How is that even remotely part of the role of the federal government?