6 ms·

Doesn't federally funded healthcare system have problems like lower quality of healthcare, increased government spending, increased chances of corruption and cr

Doesn't federally funded healthcare system have problems like lower quality of healthcare, increased government spending, increased chances of corruption and creating a moral hazard of not working to earn what is consumed ?

Kristine1975 10y ago
No, it doesn't.
Ntrails 10y ago
I'm gonna address these point by point with opinions. lower quality of healthcare Not overall, but arguably yes for people with perfect healthcare plans at the moment. I think that everyone having 90% "rated" healthcare is better than a split of 0%/50%/100% by wealth bracket. Increased government spending Yes. Absolutely - you have to tax people the money that would otherwise go to insurers and spend it as an insurer. Since the US currently spends the highest proportion of GDP on healthcare for incredibly unequal healthcare you can decide for yourself whether even big government could manage to be less efficient. Increased chances of corruption No. Creating a moral hazard of not working to earn what is consumed Sure. It's a problem when there's zero cost involved in healthcare - something many systems struggle with. Often in european countries you'll see some kind of excess/copay so people have a little "skin in the game" before using the system. The UK uses waiting lists and gateway doctors (GPs) to assess need. Rationing of healthcare on a basis of need, rather than wealth seems smarter to me from a population basis. There are many healthcare systems, all have trade offs. Most of the first world is unconvinced that the current American system is optimal
pikzen 10y ago
>lower quality of healthcare On the very top end of healthcare? Maybe, but countries with public healthcare aren't doing too bad on that side either. On average? The quality is insanely higher. Until budget gets cut because some dimwit thought it would be a good idea to stretch their resources thin. >increased government spending Covering everyone costs money, yes. But considering the amount of money that is already being invested by the US govt. into health care and the abysmally poor results it gives, it can't really be worse. >increased chances of corruption Very little. And it solves lobbying, doctors being paid by companies, etc. It's usually a net positive. >creating a moral hazard of not working to earn what is consumed Screw that. People have a right to live decently, even without earning it. That's why we made societies. That's why we keep elders alive, and not immediately send them off to the glue factory as soon as they retire, that's why we keep children and feed them and teach them until they're able to be a useful member of that society. In most sensible systems, their education is largely free too.
zelos 10y ago
The NHS in the UK seems to cost about $3,000/year/person. Admittedly, that probably needs to go up by $500-$1000 to provide a better service, but that seems to be comparable to federal spending in the US already?
- beaconstudios 10y ago
  the level of service that the NHS provides is pretty poor for people with ongoing conditions. They're great for providing emergency treatment but if you require ongoing treatment you will likely get much, much better service from BUPA or another health insurer. One thing the NHS does really well is providing downwards pressure on health insurers' rates though.
  - tracker1 10y ago
    Frankly, what I wish would have happened here would have been to gather up all the federally funded healthcare initiatives and create a government owned, non-profit healthcare corp to cover the same people (va, medicare, medicaid, federal employees, etc). To provide for downward pressure and a baseline for private insurers to compete against... allowing anyone to get a private policy from said corp. Would likely have cost less, reduced redundant agencies and staff, and had a chance at making things better.
    - beaconstudios 10y ago
      I totally agree. I think the conversation around healthcare in the US seems incredibly polarised, to the point where no reasonable middle-ground can be achieved that works for both Democrats and Republicans. The system you've described seems to cover both bases, with coverage for all in times of need but the ability to leverage the market to drive innovation and improved quality. It seems to work well in the UK, for those that can afford BUPA cover.
cmdkeen 10y ago
The UK still allows private healthcare so those who really want to pay extra can do so. In several areas, for instance emergency medicine, there isn't a private offering and others the NHS has the centres of excellence available to all based on need. While our emergency system is often at the point of creaking it at least isn't anywhere close to American levels of having to deal with what should be primary care problems. There's also the massively real hazard of what happens when you have a large proportion of the population who can't access basic healthcare, for instance a greatly increased communicable disease risk. Then there is the economic cost of people unable to work, or work as well, due to potentially treatable medical conditions or bankrupted by medical bills. On a purely economic basis there is a case for universal healthcare.
- ZeroGravitas 10y ago
  "While our emergency system is often at the point of creaking it at least isn't anywhere close to American levels of having to deal with what should be primary care problems." How much of this "creaking" is intentional underfunding or political meddling by politicians looking for a payday from American medical insurance companies when they ruin another nations healthcare is debatable. It's very similar to recent Trump moves of putting people who hate what a government department does in charge of that same government department. Jeremy Hunt the former Health Secretary previously called for the NHS to be replaced with an insurance system. So how can you trust that he's not trying to achieve that goal by crippling the existing system?
  - oldprogrammer2 10y ago
    I can't speak for Trump's motivations, but I've noticed something similar in the corporate world. If a capable executive is particularly critical of an aspect of the business, he may (inadvertently) find himself put in charge of it. It's a method for breaking status quo. And just because this new leader starts as an outsider doesn't mean he stays an outsider after becoming intimate with all the invisible challenges facing that business unit.
    - 10y ago
rjtavares 10y ago
> lower quality of healthcare No. US does not have better health care indicators than other countries with similar development levels. https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... > increased government spending Maybe... But you will spend much less overall on healthcare, so it'll be a net positive for normal working Americans. http://data.worldbank.org/indicator/SH.XPD.PCAP?year_high_desc=true http://data.worldbank.org/indicator/SH.XPD.PCAP?year_high_de... > increased chances of corruption Countries with better healthcare than the US also have less corruption perception. I'm not suggesting public healthcare causes that, but it certainly does not cause the opposite. https://en.wikipedia.org/wiki/Corruption_Perceptions_Index https://en.wikipedia.org/wiki/Corruption_Perceptions_Index > creating a moral hazard of not working to earn what is consumed Moral hazard "occurs when one person takes more risks because someone else bears the cost of those risks". How does this affect healthcare? We know that a lot of diseases have a strong genetic factor, so moral hazard isn't an issue there. Of course, behavior is also an important factor. But working insured Americans are already subject to moral hazard (since they're on a group policy, their disproportionate costs are already supported by others). Medicare and Medicaid recipients are also already subject to moral hazard. So moral hazard will be created for uninsured people and people on an individual policy, for behavior induced health problems. If that's a deal-breaker for you, you should be against federally funded healthcare.
Tomis02 10y ago
Doesn't have to.

Kristine1975 10y ago

No, it doesn't.

Ntrails 10y ago

I'm gonna address these point by point with opinions. lower quality of healthcare Not overall, but arguably yes for people with perfect healthcare plans at the moment. I think that everyone having 90% "rated" healthcare is better than a split of 0%/50%/100% by wealth bracket. Increased government spending Yes. Absolutely - you have to tax people the money that would otherwise go to insurers and spend it as an insurer. Since the US currently spends the highest proportion of GDP on healthcare for incredibly unequal healthcare you can decide for yourself whether even big government could manage to be less efficient. Increased chances of corruption No. Creating a moral hazard of not working to earn what is consumed Sure. It's a problem when there's zero cost involved in healthcare - something many systems struggle with. Often in european countries you'll see some kind of excess/copay so people have a little "skin in the game" before using the system. The UK uses waiting lists and gateway doctors (GPs) to assess need. Rationing of healthcare on a basis of need, rather than wealth seems smarter to me from a population basis. There are many healthcare systems, all have trade offs. Most of the first world is unconvinced that the current American system is optimal

pikzen 10y ago

>lower quality of healthcare On the very top end of healthcare? Maybe, but countries with public healthcare aren't doing too bad on that side either. On average? The quality is insanely higher. Until budget gets cut because some dimwit thought it would be a good idea to stretch their resources thin. >increased government spending Covering everyone costs money, yes. But considering the amount of money that is already being invested by the US govt. into health care and the abysmally poor results it gives, it can't really be worse. >increased chances of corruption Very little. And it solves lobbying, doctors being paid by companies, etc. It's usually a net positive. >creating a moral hazard of not working to earn what is consumed Screw that. People have a right to live decently, even without earning it. That's why we made societies. That's why we keep elders alive, and not immediately send them off to the glue factory as soon as they retire, that's why we keep children and feed them and teach them until they're able to be a useful member of that society. In most sensible systems, their education is largely free too.

zelos 10y ago

The NHS in the UK seems to cost about $3,000/year/person. Admittedly, that probably needs to go up by $500-$1000 to provide a better service, but that seems to be comparable to federal spending in the US already?

beaconstudios 10y ago
the level of service that the NHS provides is pretty poor for people with ongoing conditions. They're great for providing emergency treatment but if you require ongoing treatment you will likely get much, much better service from BUPA or another health insurer. One thing the NHS does really well is providing downwards pressure on health insurers' rates though.
- tracker1 10y ago
  Frankly, what I wish would have happened here would have been to gather up all the federally funded healthcare initiatives and create a government owned, non-profit healthcare corp to cover the same people (va, medicare, medicaid, federal employees, etc). To provide for downward pressure and a baseline for private insurers to compete against... allowing anyone to get a private policy from said corp. Would likely have cost less, reduced redundant agencies and staff, and had a chance at making things better.
  - beaconstudios 10y ago
    I totally agree. I think the conversation around healthcare in the US seems incredibly polarised, to the point where no reasonable middle-ground can be achieved that works for both Democrats and Republicans. The system you've described seems to cover both bases, with coverage for all in times of need but the ability to leverage the market to drive innovation and improved quality. It seems to work well in the UK, for those that can afford BUPA cover.

cmdkeen 10y ago

The UK still allows private healthcare so those who really want to pay extra can do so. In several areas, for instance emergency medicine, there isn't a private offering and others the NHS has the centres of excellence available to all based on need. While our emergency system is often at the point of creaking it at least isn't anywhere close to American levels of having to deal with what should be primary care problems. There's also the massively real hazard of what happens when you have a large proportion of the population who can't access basic healthcare, for instance a greatly increased communicable disease risk. Then there is the economic cost of people unable to work, or work as well, due to potentially treatable medical conditions or bankrupted by medical bills. On a purely economic basis there is a case for universal healthcare.

ZeroGravitas 10y ago
"While our emergency system is often at the point of creaking it at least isn't anywhere close to American levels of having to deal with what should be primary care problems." How much of this "creaking" is intentional underfunding or political meddling by politicians looking for a payday from American medical insurance companies when they ruin another nations healthcare is debatable. It's very similar to recent Trump moves of putting people who hate what a government department does in charge of that same government department. Jeremy Hunt the former Health Secretary previously called for the NHS to be replaced with an insurance system. So how can you trust that he's not trying to achieve that goal by crippling the existing system?
- oldprogrammer2 10y ago
  I can't speak for Trump's motivations, but I've noticed something similar in the corporate world. If a capable executive is particularly critical of an aspect of the business, he may (inadvertently) find himself put in charge of it. It's a method for breaking status quo. And just because this new leader starts as an outsider doesn't mean he stays an outsider after becoming intimate with all the invisible challenges facing that business unit.
  - 10y ago

rjtavares 10y ago

> lower quality of healthcare No. US does not have better health care indicators than other countries with similar development levels. https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare https://en.wikipedia.org/wiki/List_of_countries_by_quality_o... > increased government spending Maybe... But you will spend much less overall on healthcare, so it'll be a net positive for normal working Americans. http://data.worldbank.org/indicator/SH.XPD.PCAP?year_high_desc=true http://data.worldbank.org/indicator/SH.XPD.PCAP?year_high_de... > increased chances of corruption Countries with better healthcare than the US also have less corruption perception. I'm not suggesting public healthcare causes that, but it certainly does not cause the opposite. https://en.wikipedia.org/wiki/Corruption_Perceptions_Index https://en.wikipedia.org/wiki/Corruption_Perceptions_Index > creating a moral hazard of not working to earn what is consumed Moral hazard "occurs when one person takes more risks because someone else bears the cost of those risks". How does this affect healthcare? We know that a lot of diseases have a strong genetic factor, so moral hazard isn't an issue there. Of course, behavior is also an important factor. But working insured Americans are already subject to moral hazard (since they're on a group policy, their disproportionate costs are already supported by others). Medicare and Medicaid recipients are also already subject to moral hazard. So moral hazard will be created for uninsured people and people on an individual policy, for behavior induced health problems. If that's a deal-breaker for you, you should be against federally funded healthcare.

Tomis02 10y ago

Doesn't have to.