8 ms·

I've tried to understand the circumstances preventing socialized medicine in america. I understand there are arguments against socialized medicine, but they mak

I've tried to understand the circumstances preventing socialized medicine in america. I understand there are arguments against socialized medicine, but they make no sense to me on their face (eg. the idea that long wait times would occur, when wait times for USA and wait times for other first world countries with socialized medicine isn't very differe. The idea that socialized medicine would cause less medicine research and advancements, when increasingly medicine advancements are coming from countries with socialized medicine- the US seems to be falling behind in this respect.) Could someone explain to me this phenomenon? I struggle because I do not want to believe the easy, dehumanizing position that 'the people who do not believe what I believe are just too stupid to know I am right'.

will4274 8y ago
Our government is busted. In many cases, it fails to function at all. Thousands of regulations, which are effectively laws, switch back and forth every time the president changes. Both parties blame the other and some independents blame both parties. We have become, as a society, incapable of forming and abiding to compromises. Our healthcare is a shit show, but it's not nearly as much of a shit show as our government, so we're scared of putting one in charge of the other.
- maxxxxx 8y ago
  Medicare works pretty well. Just expand it.
  - mokus 8y ago
    In the formula “just do X”, the problem isn’t so much the “X”, it’s the “do”, for the reasons outlined by the GP comment. In this particular case, the notion that Medicare works at all (let alone well) is a point that about half the country will not concede because it’s one of many a shibboleth that keeps the “sides” at each other’s throats.
    - maxxxxx 8y ago
      "In this particular case, the notion that Medicare works at all (let alone well) is a point that about half the country will not concede because it’s one of many a shibboleth that keeps the “sides” at each other’s throats. " One half will throw a fit no matter what gets done. It would be interesting if Trump suddenly announced support for single payer Medicare for all. Republicans would think it's the best thing ever and Democrats would suddenly be against it... Way too much blind ideology in this country. Before I came here I thought the US is a pragmatic country that gets things done but now I see that leadership can't even agree on a shared perception of reality. When you talk to right wingers or left wingers you don't even recognize that they are in the same country.
      - chillwaves 8y ago
        > Republicans would think it's the best thing ever and Democrats would suddenly be against it... Any evidence of this? Because there is plenty of polling data to show the R camp switching positions based on who is in charge. Never seen it apply the other way. https://www.bostonglobe.com/news/nation/2017/10/25/republicans-change-long-held-opinions-accommodate-trump-polls-show/KD1uhgMw7vM51alvkiJBML/story.html https://www.bostonglobe.com/news/nation/2017/10/25/republica...
      - baddox 8y ago
        > It would be interesting if Trump suddenly announced support for single payer Medicare for all. Republicans would think it's the best thing ever and Democrats would suddenly be against it... I think you’ve got this wrong. I think that in most cases partisanship and hero worship is a lot stronger than support for specific policies. I think you’d find that people wouldn’t change their stated views on single-payer, they’d just reframe the situation so that they can continue to love/hate Trump and blame the other side for everything they don’t like. Look at bump stocks. I know staunch Trump supporters who have bump stocks and strongly oppose almost any form of gun control. Does Trump’s bump stock ban make them like Trump a little less? Perhaps. But it certainly doesn’t change their political affiliation in any measurable way. Same goes for those who oppose Trump. I’m sure they agree that the bump stock ban is nice, but do you think they’re suddenly “coming around” on Trump? I doubt it.
- SolaceQuantum 8y ago
  I agree that the government is busted. But from what I understand, one of the two ruling parties is at least somewhat pro-socialized medicine. I do not understand what needs to be compromised about socialized medicine. I struggle with the idea that fear of the government is greater than the desire for universal medical coverage.
  - baddox 8y ago
    Eh, the two ruling parties have cleverly worked things out so that they never have to actually implement any of the policies they claim to support. They can always just blame the other party for making their policies impossible. Both parties benefit from this system. Look at Obamacare. A lot of Democrats will say that this was a genuine attempt to move toward single-payer, a public option, etc. and that they simply had to make compromises to get what they got passed (a change that undoubtedly helps many people but does so with a regressive tax, and certainly doesn’t simplify anything).
    - infinite8s 8y ago
      It was a compromise. The only way they could get Joe Lieberman's crucial 60th vote was to kill the public option, which he strongly opposed (for what reason who knows).
    - masonic 8y ago
      they simply had to make compromises to get what they got passed For much of that Congress, the Democrat caucus had complete control (with filibuster-proof control of the Senate); they didn't have to "compromise" with a single Republican, hence zero Republican votes.
  - michaelt 8y ago
    Imagine if there were several powerful allied special interest groups that all made a bunch of money from healthcare staying expensive. And they're not just trying to change your mind. They're also working to get the support of the electorate directly. Now imagine some of those groups had absolutely superb PR. Literally making childhood cancer sufferers healthy again. Now imagine, like every industry that wants government influence, they hire your friends into highly paid do-nothing jobs, donate generously when you raise money for your charitable foundation, and so on. Now imagine they're a big employer. And they've got a whole bunch of jobs. Office jobs. Highly paid high-level jobs. Well paid mid-level jobs. Jobs that employ lots of minority groups. Now imagine that the most efficient outcome would be to shut down all the insurance companies and nationalise all the hospitals, but you don't have the political capital to deliver that, it'd make a lot of people very nervous, and you're not even sure it'd be a moral thing to do anyway. So you'll probably have to settle for a middle ground that keeps a lot of the existing middlemen fat and happy. Now imagine, even if your reform is a huge success and goes way better than you have any right to expect, people are still going to die in hospitals, and some people are going to say some of them are your fault. Now imagine turning a blind eye to the problem has been working just fine for the last 20 years. It'd be so easy to just let sleeping dogs lie...
jmalicki 8y ago
What do you mean by socialized medicine? If you mean government required and subsidized, like the systems of France and Germany, which have great healthcare systems, that sounds wonderful. If you mean single-payer healthcare, like Canada and the UK, screw that disaster.
- bigpoo 8y ago
  If you mean disaster as in people not going bankrupt because of medical bills. Or maybe you mean the disaster of there not being upwards of 40,000 deaths a year due to not being able to receive basic health care. ... Oh wait that is all problems they don't have in Canada and the UK but we do have in America.
- SolaceQuantum 8y ago
  What makes single-payer healthcare, like Canada and the UK, a disaster? I'm from Canada and currently live in the US. I don't have many complaints about the canadian healthcare system. I got a suprise bill yesterday in the US healthcare system for routine bloodwork.
  - bitrrrate 8y ago
    I'll second that. Due to a couple of significant illnesses growing up my family would have been bankrupted two times over if we lived in the US. Also, when one of my parents passed after a couples months of hospitalization, emergency room visits and an ambulance ride, they didn't owe a single loonie (Canadian dollar coin) for the care. If it was the US, my bereaved parent would not only owe thousands but they would have to be on guard to verify the accuracy of each bill, negotiate with the provider and then setup a payment plan stretching into infinity. The US healthcare system is another area where capitalism and the 'free market' is failing the consumer. Frankly, when I hear see someone stridently decrying socialized medicine or single-payer healthcare I wonder if their tune would change after their first medically induced bankruptcy or not being able to afford medication that would keep them alive.
  - sys_64738 8y ago
    The NHS in the UK continues to be underfunded to the extent of what it's trying to provide. It takes about 7.5% of the UK's GDP and is continuing to rise. But as I point out it's underfunded to the extent that there are long multi-year waiting lists for things like hip replacement operations.
hathawsh 8y ago
I think people are holding on to the hope that competition in the marketplace will control prices and bring them back to reasonable levels. I know I held on to that hope for a long time, but it's becoming clear that mere competition among insurance providers isn't a strong enough force. Medical prices are so high now that I think people are ready to consider drastic change.
- onething 8y ago
  I wouldn't expect competition among insurance companies to lower prices by very much. Insurance companies are already constrained by law as to how much profit they can make and there is only so much overhead you can remove. In terms of competition, the real problem is the artificially low numbers of health care workers and facilities. The Drs are limited by the low number of medical schools, etc and the number of facilities are limited by requiring Certificates of Need, etc. First remove these barriers to entry and require transparent pricing. Then... maybe competition would result in lower prices.
  - sundaeofshock 8y ago
    You could remove profit entirely from the mix. That would reduce costs pretty significantly.
    - onething 8y ago
      It isn't that simple. >...Seven of the top 10 most profitable hospitals in the United States are nonprofit facilities that each netted more than $150 million from caring for patients in 2013, >...The study’s main purpose was to determine the characteristics of the nation’s most profitable hospitals. They found that facilities that were part of a system were more profitable because they were able to dominate their local market, which gives them greater clout in negotiating higher prices from private insurers. It also means consumers end up paying more if their health-care provider is out of network, Anderson said. https://www.washingtonpost.com/news/to-your-health/wp/2016/05/02/these-hospitals-make-the-most-money-off-patients-and-theyre-mostly-nonprofits/?noredirect=on&utm_term=.360a403876d4 https://www.washingtonpost.com/news/to-your-health/wp/2016/0... Also: >...Nonprofit hospitals have higher profit margins than most for-profit hospitals after accounting for their tax obligations. http://thehealthcareblog.com/blog/2017/04/25/the-fairy-tale-of-a-non-profit-hospital/ http://thehealthcareblog.com/blog/2017/04/25/the-fairy-tale-...
swebs 8y ago
The majority of Americans do support a single payer health plan (though there is a larger divide over Obamacare/Trumpcare for various partisan and non-partisan reasons). Instead of asking why the minority does not, you should probably ask why the government is not fulfilling the will of the people. I'm sure lobbyists from the multi billion dollar healthcare industry have something to do with it.
josho 8y ago
> circumstances preventing socialized medicine in america Honestly I think it has a lot to do with the popularity of Fox News and its bias against any centrist/left policy. Also, keep in mind that the US was for decades fighting a war against communism which branded any socialist idea as evil and even going so far as to overthrow socialist governments. So, there are decades of propaganda that needs to be overcome. In fact I think we have the millennials to thank as they grew up after the cold war and did not experience much of the propaganda that older generations did, so they are more open to policies like universal healthcare. edit: quickly downvoted? If you disagree that's fine, but at least share what you think I've got wrong.
- Asooka 8y ago
  It's a bit ironic that those of us who grew up in actual communism understand the difference between government-planned healthcare and government-funded healthcare better than Americans. Even as the communist regime was being torn apart, I don't remember anyone wanting to take down the health system. It's still chronically underfunded and many people also purchase third-party health insurance in order to have access to better facilities, but the rates never reach even within an order of magnitude of USA's.
  - josho 8y ago
    Yes, that's why I think the word 'propaganda' is fitting, because for a lot of older Americans the 'C' word was bad full stop and didn't merit any further discussion on what parts were bad and what parts may make some sense.
    - malvosenior 8y ago
      Why would we trust the government that just fed us the propaganda you're talking about to run a healthcare system in our interest? > "In fact I think we have the millennials to thank as they grew up after the cold war and did not experience much of the propaganda that older generations did, so they are more open to policies like universal healthcare." So they haven't seen the negative consequences of too much government power and thus are too quick to call for government solutions.
Futurebot 8y ago
The real arguments only rarely get stated by politicians, and it's the reason we don't get other universal services, either. It's ideological. The economic efficiency, competency, or access arguments (government can't do anything right, it's wasteful, etc.) while they do get used (and are certainly believed to various degrees) aren't the core (cultural) reasons. They are a belief that: - society should be dog eat dog, red and tooth and claw, and that the weak and sick should merely die. Not only is that not bad, it's desirable, as the weak and sick bring down the rest and having them disappear strengthens the society / species - the world should be every-man-for-himself, that you should be on your own, and never expect anyone to help you outside of blood relatives, or if you're lucky, charity. - that everything must be "earned," discounting the ideas that it's society itself and all of its trappings (trade rules, police, roads, availability of skilled workers trained with public money, etc.) that's allow said money to be earned in the first place. If you don't earn it you don't deserve it, regardless of what that means for you. - that government should simply not be in the business of providing services, period. It should exist only as a nightwatchman state that protects from "force and fraud" when it applies to domestic policies (empire building and maintenance + policies to further theocracy and political chauvinism are a big divide over spending on the right) - taxation is theft. If one "earns" money, one should be able to keep basically all of it (minus force+fraud taxes, though ancaps don't even want that one.) Now, mind you, this doesn't actually reflect the will of people in the US (recent poll links: https://twitter.com/GunnelsWarren/status/1078510910317174785 https://twitter.com/GunnelsWarren/status/1078510910317174785), but large parts of the right-wing establishment (many of which inhabit the Democratic party, not just the Republican one.) This includes large donors, corporations, and powerful think tanks. One thing that has to be understood about the US, is that since its very founding, it has largely opposed redistribution (the General Welfare clause notwithstanding.) People should remember Madison: "Landholders ought to have a share in the government, to support these invaluable interests, and to balance and check the other. They ought to be so constituted as to protect the minority of the opulent against the majority."
- hathawsh 8y ago
  FYI, these kind of beliefs surface mainly when people engage in groupthink. Few individuals actually believe these things. The vast majority believe in helping each other, but they prefer to help voluntarily rather than forcefully. Helping forcefully is often seen as a loss of freedom. Individuals are often OK with that loss of freedom, even though it hurts. I hope that perspective helps you in your future discussions. :-)
standerman 8y ago
The people that own insurance companies would become less wealthy. The industries (the 6 companies that own the majority of the media industry https://www.morriscreative.com/6-corporations-control-90-of-the-media-in-america/ https://www.morriscreative.com/6-corporations-control-90-of-... ) that rely on the revenue from all the insurance ads would suffer. There's a decent amount of jobs created by all the inefficiency. Overall it's a boost to the US economy, but at the cost of immense suffering from those who are most vulnerable.
- maxxxxx 8y ago
  By that logic you could just impose more busy work on the economy and it would get a boost. Let's say we mandate that every employee needs to have someone that follows them every day and boom, we have doubled up the number of jobs. The money for these inefficiencies has to come from somewhere and that area will suffer.
- eloff 8y ago
  No, inefficiency does not boost the economy. That spending would get allocated more efficiently otherwise which should actually be an overall boost to the economy.
EamonnMR 8y ago
It's almost a religious issue in the US, sort of like gun ownership.
mikestew 8y ago
I've tried to understand the circumstances preventing socialized medicine in america. Just like Dorothy in The Wizard of Oz, the answer was staring you in the face this whole time: "socialized". You say that magic combination of "social" and any of "ist", "ism", "ized", and g-ddamn it, my Granddad didn't fight Mussolini in the war just to the let the socialists take over. I swear to $DEITY that I do not exaggerate that amongst many, the mere utterance is assumed to end the discussion. "Well, that sounds a lot like socialism." "Hmm, when you put it that way, I suppose we have nothing further to discuss." It is literally the reason we didn't get socialized medicine when Truman suggested it in the 1940s, because the AMA stuck the S-word onto it at the start of the Cold War. More annoying is that many of that ilk that I personally know would be hard-pressed to give an even basic, accurate definition of what socialism is (almost guaranteed it'll come out sounding like communism). It's as if someone many years ago said, "anything labelled 'socialism' is bad", and entire nation shrugged its shoulders and said, "okay" without ever looking up what they were on about.
- yakshaving_jgt 8y ago
  > many of that ilk that I personally know would be hard-pressed to give an even basic, accurate definition of what socialism is (almost guaranteed it'll come out sounding like communism) Yeah that might be because “The goal of socialism is communism.”
benmaraschino 8y ago
I honestly don’t get it either. Medicare takes care of some of the sickest and most complex patients—the elderly and those with ESRD—and manages to do it with an administrative overhead of 2%, compared to 17% for private insurers, and appears to be more efficient overall as well.[1] That’s a simple fact. Expanding Medicare to cover all Americans would substantially increase access and drive down costs for everyone, simply by adding younger and healthier individuals to the risk pool. [1]: https://www.healthaffairs.org/do/10.1377/hblog20110920.013390/full/ https://www.healthaffairs.org/do/10.1377/hblog20110920.01339...
AndrewKemendo 8y ago
It's not a rational argument so it can't be understood from that lens.
onething 8y ago
>...(eg. the idea that long wait times would occur, when wait times for USA and wait times for other first world countries with socialized medicine isn't very differe Do you have a citation for that? >...The idea that socialized medicine would cause less medicine research and advancements, when increasingly medicine advancements are coming from countries with socialized medicine- Can you expand on that? What medical advancements are increasingly coming from countries with socialized medicine? The usual argument is simply that since the US doesn't have the price controls on drugs, that companies make a good deal of their profits from the US market.

will4274 8y ago

Our government is busted. In many cases, it fails to function at all. Thousands of regulations, which are effectively laws, switch back and forth every time the president changes. Both parties blame the other and some independents blame both parties. We have become, as a society, incapable of forming and abiding to compromises. Our healthcare is a shit show, but it's not nearly as much of a shit show as our government, so we're scared of putting one in charge of the other.

maxxxxx 8y ago
Medicare works pretty well. Just expand it.
- mokus 8y ago
  In the formula “just do X”, the problem isn’t so much the “X”, it’s the “do”, for the reasons outlined by the GP comment. In this particular case, the notion that Medicare works at all (let alone well) is a point that about half the country will not concede because it’s one of many a shibboleth that keeps the “sides” at each other’s throats.
  - maxxxxx 8y ago
    "In this particular case, the notion that Medicare works at all (let alone well) is a point that about half the country will not concede because it’s one of many a shibboleth that keeps the “sides” at each other’s throats. " One half will throw a fit no matter what gets done. It would be interesting if Trump suddenly announced support for single payer Medicare for all. Republicans would think it's the best thing ever and Democrats would suddenly be against it... Way too much blind ideology in this country. Before I came here I thought the US is a pragmatic country that gets things done but now I see that leadership can't even agree on a shared perception of reality. When you talk to right wingers or left wingers you don't even recognize that they are in the same country.
    - chillwaves 8y ago
      > Republicans would think it's the best thing ever and Democrats would suddenly be against it... Any evidence of this? Because there is plenty of polling data to show the R camp switching positions based on who is in charge. Never seen it apply the other way. https://www.bostonglobe.com/news/nation/2017/10/25/republicans-change-long-held-opinions-accommodate-trump-polls-show/KD1uhgMw7vM51alvkiJBML/story.html https://www.bostonglobe.com/news/nation/2017/10/25/republica...
    - baddox 8y ago
      > It would be interesting if Trump suddenly announced support for single payer Medicare for all. Republicans would think it's the best thing ever and Democrats would suddenly be against it... I think you’ve got this wrong. I think that in most cases partisanship and hero worship is a lot stronger than support for specific policies. I think you’d find that people wouldn’t change their stated views on single-payer, they’d just reframe the situation so that they can continue to love/hate Trump and blame the other side for everything they don’t like. Look at bump stocks. I know staunch Trump supporters who have bump stocks and strongly oppose almost any form of gun control. Does Trump’s bump stock ban make them like Trump a little less? Perhaps. But it certainly doesn’t change their political affiliation in any measurable way. Same goes for those who oppose Trump. I’m sure they agree that the bump stock ban is nice, but do you think they’re suddenly “coming around” on Trump? I doubt it.
SolaceQuantum 8y ago
I agree that the government is busted. But from what I understand, one of the two ruling parties is at least somewhat pro-socialized medicine. I do not understand what needs to be compromised about socialized medicine. I struggle with the idea that fear of the government is greater than the desire for universal medical coverage.
- baddox 8y ago
  Eh, the two ruling parties have cleverly worked things out so that they never have to actually implement any of the policies they claim to support. They can always just blame the other party for making their policies impossible. Both parties benefit from this system. Look at Obamacare. A lot of Democrats will say that this was a genuine attempt to move toward single-payer, a public option, etc. and that they simply had to make compromises to get what they got passed (a change that undoubtedly helps many people but does so with a regressive tax, and certainly doesn’t simplify anything).
  - infinite8s 8y ago
    It was a compromise. The only way they could get Joe Lieberman's crucial 60th vote was to kill the public option, which he strongly opposed (for what reason who knows).
  - masonic 8y ago
    they simply had to make compromises to get what they got passed For much of that Congress, the Democrat caucus had complete control (with filibuster-proof control of the Senate); they didn't have to "compromise" with a single Republican, hence zero Republican votes.
- michaelt 8y ago
  Imagine if there were several powerful allied special interest groups that all made a bunch of money from healthcare staying expensive. And they're not just trying to change your mind. They're also working to get the support of the electorate directly. Now imagine some of those groups had absolutely superb PR. Literally making childhood cancer sufferers healthy again. Now imagine, like every industry that wants government influence, they hire your friends into highly paid do-nothing jobs, donate generously when you raise money for your charitable foundation, and so on. Now imagine they're a big employer. And they've got a whole bunch of jobs. Office jobs. Highly paid high-level jobs. Well paid mid-level jobs. Jobs that employ lots of minority groups. Now imagine that the most efficient outcome would be to shut down all the insurance companies and nationalise all the hospitals, but you don't have the political capital to deliver that, it'd make a lot of people very nervous, and you're not even sure it'd be a moral thing to do anyway. So you'll probably have to settle for a middle ground that keeps a lot of the existing middlemen fat and happy. Now imagine, even if your reform is a huge success and goes way better than you have any right to expect, people are still going to die in hospitals, and some people are going to say some of them are your fault. Now imagine turning a blind eye to the problem has been working just fine for the last 20 years. It'd be so easy to just let sleeping dogs lie...

jmalicki 8y ago

What do you mean by socialized medicine? If you mean government required and subsidized, like the systems of France and Germany, which have great healthcare systems, that sounds wonderful. If you mean single-payer healthcare, like Canada and the UK, screw that disaster.

bigpoo 8y ago
If you mean disaster as in people not going bankrupt because of medical bills. Or maybe you mean the disaster of there not being upwards of 40,000 deaths a year due to not being able to receive basic health care. ... Oh wait that is all problems they don't have in Canada and the UK but we do have in America.
SolaceQuantum 8y ago
What makes single-payer healthcare, like Canada and the UK, a disaster? I'm from Canada and currently live in the US. I don't have many complaints about the canadian healthcare system. I got a suprise bill yesterday in the US healthcare system for routine bloodwork.
- bitrrrate 8y ago
  I'll second that. Due to a couple of significant illnesses growing up my family would have been bankrupted two times over if we lived in the US. Also, when one of my parents passed after a couples months of hospitalization, emergency room visits and an ambulance ride, they didn't owe a single loonie (Canadian dollar coin) for the care. If it was the US, my bereaved parent would not only owe thousands but they would have to be on guard to verify the accuracy of each bill, negotiate with the provider and then setup a payment plan stretching into infinity. The US healthcare system is another area where capitalism and the 'free market' is failing the consumer. Frankly, when I hear see someone stridently decrying socialized medicine or single-payer healthcare I wonder if their tune would change after their first medically induced bankruptcy or not being able to afford medication that would keep them alive.
- sys_64738 8y ago
  The NHS in the UK continues to be underfunded to the extent of what it's trying to provide. It takes about 7.5% of the UK's GDP and is continuing to rise. But as I point out it's underfunded to the extent that there are long multi-year waiting lists for things like hip replacement operations.

hathawsh 8y ago

I think people are holding on to the hope that competition in the marketplace will control prices and bring them back to reasonable levels. I know I held on to that hope for a long time, but it's becoming clear that mere competition among insurance providers isn't a strong enough force. Medical prices are so high now that I think people are ready to consider drastic change.

onething 8y ago
I wouldn't expect competition among insurance companies to lower prices by very much. Insurance companies are already constrained by law as to how much profit they can make and there is only so much overhead you can remove. In terms of competition, the real problem is the artificially low numbers of health care workers and facilities. The Drs are limited by the low number of medical schools, etc and the number of facilities are limited by requiring Certificates of Need, etc. First remove these barriers to entry and require transparent pricing. Then... maybe competition would result in lower prices.
- sundaeofshock 8y ago
  You could remove profit entirely from the mix. That would reduce costs pretty significantly.
  - onething 8y ago
    It isn't that simple. >...Seven of the top 10 most profitable hospitals in the United States are nonprofit facilities that each netted more than $150 million from caring for patients in 2013, >...The study’s main purpose was to determine the characteristics of the nation’s most profitable hospitals. They found that facilities that were part of a system were more profitable because they were able to dominate their local market, which gives them greater clout in negotiating higher prices from private insurers. It also means consumers end up paying more if their health-care provider is out of network, Anderson said. https://www.washingtonpost.com/news/to-your-health/wp/2016/05/02/these-hospitals-make-the-most-money-off-patients-and-theyre-mostly-nonprofits/?noredirect=on&utm_term=.360a403876d4 https://www.washingtonpost.com/news/to-your-health/wp/2016/0... Also: >...Nonprofit hospitals have higher profit margins than most for-profit hospitals after accounting for their tax obligations. http://thehealthcareblog.com/blog/2017/04/25/the-fairy-tale-of-a-non-profit-hospital/ http://thehealthcareblog.com/blog/2017/04/25/the-fairy-tale-...

swebs 8y ago

The majority of Americans do support a single payer health plan (though there is a larger divide over Obamacare/Trumpcare for various partisan and non-partisan reasons). Instead of asking why the minority does not, you should probably ask why the government is not fulfilling the will of the people. I'm sure lobbyists from the multi billion dollar healthcare industry have something to do with it.

josho 8y ago

> circumstances preventing socialized medicine in america Honestly I think it has a lot to do with the popularity of Fox News and its bias against any centrist/left policy. Also, keep in mind that the US was for decades fighting a war against communism which branded any socialist idea as evil and even going so far as to overthrow socialist governments. So, there are decades of propaganda that needs to be overcome. In fact I think we have the millennials to thank as they grew up after the cold war and did not experience much of the propaganda that older generations did, so they are more open to policies like universal healthcare. edit: quickly downvoted? If you disagree that's fine, but at least share what you think I've got wrong.

Asooka 8y ago
It's a bit ironic that those of us who grew up in actual communism understand the difference between government-planned healthcare and government-funded healthcare better than Americans. Even as the communist regime was being torn apart, I don't remember anyone wanting to take down the health system. It's still chronically underfunded and many people also purchase third-party health insurance in order to have access to better facilities, but the rates never reach even within an order of magnitude of USA's.
- josho 8y ago
  Yes, that's why I think the word 'propaganda' is fitting, because for a lot of older Americans the 'C' word was bad full stop and didn't merit any further discussion on what parts were bad and what parts may make some sense.
  - malvosenior 8y ago
    Why would we trust the government that just fed us the propaganda you're talking about to run a healthcare system in our interest? > "In fact I think we have the millennials to thank as they grew up after the cold war and did not experience much of the propaganda that older generations did, so they are more open to policies like universal healthcare." So they haven't seen the negative consequences of too much government power and thus are too quick to call for government solutions.

Futurebot 8y ago

The real arguments only rarely get stated by politicians, and it's the reason we don't get other universal services, either. It's ideological. The economic efficiency, competency, or access arguments (government can't do anything right, it's wasteful, etc.) while they do get used (and are certainly believed to various degrees) aren't the core (cultural) reasons. They are a belief that: - society should be dog eat dog, red and tooth and claw, and that the weak and sick should merely die. Not only is that not bad, it's desirable, as the weak and sick bring down the rest and having them disappear strengthens the society / species - the world should be every-man-for-himself, that you should be on your own, and never expect anyone to help you outside of blood relatives, or if you're lucky, charity. - that everything must be "earned," discounting the ideas that it's society itself and all of its trappings (trade rules, police, roads, availability of skilled workers trained with public money, etc.) that's allow said money to be earned in the first place. If you don't earn it you don't deserve it, regardless of what that means for you. - that government should simply not be in the business of providing services, period. It should exist only as a nightwatchman state that protects from "force and fraud" when it applies to domestic policies (empire building and maintenance + policies to further theocracy and political chauvinism are a big divide over spending on the right) - taxation is theft. If one "earns" money, one should be able to keep basically all of it (minus force+fraud taxes, though ancaps don't even want that one.) Now, mind you, this doesn't actually reflect the will of people in the US (recent poll links: https://twitter.com/GunnelsWarren/status/1078510910317174785 https://twitter.com/GunnelsWarren/status/1078510910317174785), but large parts of the right-wing establishment (many of which inhabit the Democratic party, not just the Republican one.) This includes large donors, corporations, and powerful think tanks. One thing that has to be understood about the US, is that since its very founding, it has largely opposed redistribution (the General Welfare clause notwithstanding.) People should remember Madison: "Landholders ought to have a share in the government, to support these invaluable interests, and to balance and check the other. They ought to be so constituted as to protect the minority of the opulent against the majority."

hathawsh 8y ago
FYI, these kind of beliefs surface mainly when people engage in groupthink. Few individuals actually believe these things. The vast majority believe in helping each other, but they prefer to help voluntarily rather than forcefully. Helping forcefully is often seen as a loss of freedom. Individuals are often OK with that loss of freedom, even though it hurts. I hope that perspective helps you in your future discussions. :-)

standerman 8y ago

The people that own insurance companies would become less wealthy. The industries (the 6 companies that own the majority of the media industry https://www.morriscreative.com/6-corporations-control-90-of-the-media-in-america/ https://www.morriscreative.com/6-corporations-control-90-of-... ) that rely on the revenue from all the insurance ads would suffer. There's a decent amount of jobs created by all the inefficiency. Overall it's a boost to the US economy, but at the cost of immense suffering from those who are most vulnerable.

maxxxxx 8y ago
By that logic you could just impose more busy work on the economy and it would get a boost. Let's say we mandate that every employee needs to have someone that follows them every day and boom, we have doubled up the number of jobs. The money for these inefficiencies has to come from somewhere and that area will suffer.
eloff 8y ago
No, inefficiency does not boost the economy. That spending would get allocated more efficiently otherwise which should actually be an overall boost to the economy.

EamonnMR 8y ago

It's almost a religious issue in the US, sort of like gun ownership.

mikestew 8y ago

I've tried to understand the circumstances preventing socialized medicine in america. Just like Dorothy in The Wizard of Oz, the answer was staring you in the face this whole time: "socialized". You say that magic combination of "social" and any of "ist", "ism", "ized", and g-ddamn it, my Granddad didn't fight Mussolini in the war just to the let the socialists take over. I swear to $DEITY that I do not exaggerate that amongst many, the mere utterance is assumed to end the discussion. "Well, that sounds a lot like socialism." "Hmm, when you put it that way, I suppose we have nothing further to discuss." It is literally the reason we didn't get socialized medicine when Truman suggested it in the 1940s, because the AMA stuck the S-word onto it at the start of the Cold War. More annoying is that many of that ilk that I personally know would be hard-pressed to give an even basic, accurate definition of what socialism is (almost guaranteed it'll come out sounding like communism). It's as if someone many years ago said, "anything labelled 'socialism' is bad", and entire nation shrugged its shoulders and said, "okay" without ever looking up what they were on about.

yakshaving_jgt 8y ago
> many of that ilk that I personally know would be hard-pressed to give an even basic, accurate definition of what socialism is (almost guaranteed it'll come out sounding like communism) Yeah that might be because “The goal of socialism is communism.”

benmaraschino 8y ago

I honestly don’t get it either. Medicare takes care of some of the sickest and most complex patients—the elderly and those with ESRD—and manages to do it with an administrative overhead of 2%, compared to 17% for private insurers, and appears to be more efficient overall as well.[1] That’s a simple fact. Expanding Medicare to cover all Americans would substantially increase access and drive down costs for everyone, simply by adding younger and healthier individuals to the risk pool. [1]: https://www.healthaffairs.org/do/10.1377/hblog20110920.013390/full/ https://www.healthaffairs.org/do/10.1377/hblog20110920.01339...

AndrewKemendo 8y ago

It's not a rational argument so it can't be understood from that lens.

onething 8y ago

>...(eg. the idea that long wait times would occur, when wait times for USA and wait times for other first world countries with socialized medicine isn't very differe Do you have a citation for that? >...The idea that socialized medicine would cause less medicine research and advancements, when increasingly medicine advancements are coming from countries with socialized medicine- Can you expand on that? What medical advancements are increasingly coming from countries with socialized medicine? The usual argument is simply that since the US doesn't have the price controls on drugs, that companies make a good deal of their profits from the US market.