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I think most people around here know that our healthcare payment structure is totally whack. However, we're not the people who need to know this. Try showing a

I think most people around here know that our healthcare payment structure is totally whack. However, we're not the people who need to know this. Try showing an NPR article about universal healthcare to Joe USA. I guarantee you'll get one or all of the following responses: 1: I don't want my taxes to go up 2: I don't want to pay for illegals to go to the doctor for free 3: My insurance will get worse 4: I like my doctor, I don't want to be forced to go to a worse one 5: I don't want the government deciding when I go to the doctor 6: I don't want to wait six months for a doctor appointment 7: NPR has a liberal agenda Many of my family and extended social circles are quite conservative (in the USA sense) because of how I was brought up. I have heard all of these and more every time the concept of universal healthcare is brought up. Most of the reasoning I hear is not based on facts, but on emotionally misleading arguments from the network of memes and punditry where they get their info. And when they vote, they vote for people who oppose universal healthcare on these fallacious bases. How do you convince someone like this that universal healthcare is better for all of us?

dlo 7y ago
> How do you convince someone like this that universal healthcare is better for all of us? Here is one approach. 1) Enumerate the different options. 2) For each option, enumerate the upsides versus the downsides, which includes cost of implementation and operations, along with their likelihoods. Every option has potential downsides -- are we willing to accept them for the potential upsides? 3) Rank the options by expected utility. Which one comes out on top? Ironically, you may find that universal healthcare is not the top-ranking option or that we have not yet come up with a high-expected-utility option.
- arcticbull 7y ago
  The WHO and OECD did exactly that and disagree. [1] https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000 https://en.wikipedia.org/wiki/World_Health_Organization_rank... [2] https://www.oecd.org/unitedstates/Health-at-a-Glance-2017-Key-Findings-UNITED-STATES.pdf https://www.oecd.org/unitedstates/Health-at-a-Glance-2017-Ke...
  - conanbatt 7y ago
    That's not utility, but health outcomes. What I truly don't get about M4A advocates or believers is why they don't tolerate a public option. Just let the state compete in the open market, and if you like state run , you have your and thats it.
    - arcticbull 7y ago
      Totally fine with it, it’s the MO for many European states, including France. Australia too. The issue for me isn’t puritanical, I don’t need single payer, what I want is everyone’s basic needs met. That said if health outcomes aren’t the utility of a medical system what on Earth is?
      - conanbatt 7y ago
        > That said if health outcomes aren’t the utility of a medical system what on earth is? i.e. You can improve health outcomes and decrease utility by banning tobacco.
        arcticbull 7y ago
        Right, I don’t disagree. I’m still not sure how the utility of the health system isn’t health outcomes. You can make a case that they are interlinked, smoking and health, but that doesn’t really answer my question. If anything, to me, you're making the case that (abuse of) substances such as alcohol, cigarettes and all 'illicit' narcotics should be under the full control of the health system and not the criminal justice system. Similar to how Portugal handles it. FWIW the big issue is that private companies don't want to compete with the state because the goal of the state is to provide quality care, not to maximize profit. None of the private insurers are lobbying for two-tier universal healthcare so they can show off their sheer superiority are they? You'd think if they were actually superior they'd love, or at least be neutral to, the introduction of an inferior competitor. If you're so sure private cover is better why push back against the introduction of a public option at all? Welcome all comers with open arms.
- throwaway34241 7y ago
  Most of the high ranking health care systems would probably be considered "universal healthcare", in that everyone has access to care. Many of them are not single payer though (in the sibling comment's WHO ranking link, France, a multi-payer system, was ranked #1 for "overall system performance"). But I agree generally with this approach. Nearly every developed country has dramatically lower costs for the level of health outcomes, but they do it in a variety of different ways. There are clearly possible affordability improvements (even if we only try to catch-up to where other countries are at). But certain approaches may be more feasible to implement or may have less downside if things don't go perfectly.
sjg007 7y ago
Tell them they already pay for universal healthcare because they already pay Medicare/Medicaid taxes.
- fma 7y ago
  I mean there's people who have are happy with the health insurance through the Affordable Care Act, but wants Obamacare dismantled....
  - redler 7y ago
    Obama said to Trump, during the transition, something to the effect of "I don't care what you call it -- make some tweaks and call it Trumpcare. Take me out of the equation; I don't care. But this is helping millions of people. You can make this a win."
- Gibbon1 7y ago
  Tell them that the US pays MORE in taxes to fund Medicare and Medicaid than other countries spend for Universal. Tell that that with Universal we can let go a whole army of parasites living off the Health Care Industry.
  - estebank 7y ago
    The later argument is not going to get buy in from someone who is in or is related to someone in the health insurance industry, no matter how good it would be for society in general.
- pathseeker 7y ago
  That would be a lie though. Either that or your definition of "universal" doesn't include everyone.
  - cheerlessbog 7y ago
    Unless you mean "you already pay enough to fund a modern universal Healthcare system" which statistically would be true. US govt spending on Healthcare is now per capita than many universal systems.
mgkimsal 7y ago
I hear you, and have similar experiences with some family and some friends/colleagues. You probably also hear people bringing up anecdotes about someone in Canada waiting for 9 months for a hip replacement. Primary difference is that, in many cases, Canadians with enough money can get a procedure done elsewhere (or privately) at their own expense. Wait 9 months, and there's no out of pocket costs to you. US - you may still have to wait months anyway, and you may end up with debt you will carry for years. Almost all of those in that list are fear-based, and fear is a big emotion. I don't know how you get past that, but the 'freedom' factor somehow should be focused on. Freedoms to bring up: * The freedom to move between employers and not have to concern yourself with tying your ability to get specific health service based on an employer's ability (or whim). * The freedom to move geographically and not be concerned that you won't be able to afford access to health services. My own health insurance has a decidedly different monthly premium based on county, and I'd be saving probably $150/month if I lived 3 miles to the south. * The freedom to start your own business (purportedly the backbone of 'US conservative thinking') without worrying about crippling debts. Right now, instead of an elected/representative Congress controlling what services/procedures/medicines you have access to, you have a for-profit private company, with no recourse to change their leadership or focus via election/recall. "Vote with your feet" is basically impossible in this system. "Insurance" is an odd product in this space too, at least for basic health care. Insurance is typically something we might get to reduce our exposure to risk for activities we engage in which are voluntary. Choose to buy a car? Get some insurance to help cover replacement costs, or incidental costs to others you may harm. Buying a house? Or renting? Get insurance to help cover replacement costs of things. You can choose to not buy a car, or a house. No one chooses to be born. Untie anything related to medical care from employment. By what measure is tying someone's ability to access healthcare to the beneficence of their employer remotely morally good? Someone has no employment (through whatever or no fault) and we decide that they are somehow fundamentally unworthy (or perhaps just 'less worthy'?) of access to health services? What never seems to get talked about after "your taxes will go up!!!" is "other things you pay for will go down!". Employer paying $1000/month for your health insurance policy? That expense will go away, and they'll either pay you more with that money or pay more in taxes.
- krupan 7y ago
karlakush 7y ago
You're ignoring by the far biggest downside to state-sponsored healthcare: society now has a strong incentive to ban risky behaviors. If I'm paying for Joe Schmoe's healthcare, why should he be able to give himself liver disease by drinking alcohol or tear his ACL skiing? I don't ski or drink alcohol, so it's no skin off my bone if we ban alcohol and skiing. If you're a minority in a society with universal healthcare, you will have to constantly fight for your rights. The second the rest of society decides your diet or your hobbies are too dangerous, they'll be pushing to ban you from partaking in them. Also for #2, most democrats seem to support giving healthcare to illegals so I don't know why you act like that's a myth. And for #1, it's true for tens of millions of people that they will pay more in universal healthcare than they do currently. This is inherently true of all socialism (make no mistake, universal healthcare is socialist healthcare). If somebody is getting something for free, the money to pay for it is coming out of somebody's else pocket.
- fzeroracer 7y ago
  Your example already occurs, so I don't know why you're conveniently ignoring that fact. Instead, healthcare companies charge more if you're at risk. They're implementing solutions to discourage bad behaviors. Worse, this is all packaged up in various apps designed to take your data and sell them to others to make even more money off of every single person they rip off. Don't even get me started on how the insurance industry abused pre-existing conditions as a catch-all term for denying coverage for things that weren't even a result of life style choices. So how is this different from the horror scenario you bring up?
rossenberg79 7y ago
I don’t believe in universal healthcare, and none of these approaches do much to convince me. I’m in agreement that the current situation is hot garbage, and it’s shitty for a lot of people. However, my insurance now is good enough for me and my family. Sure, it’d be nice if it was cheaper, but whatever. As I get older I find I can’t be bothered to lay awake at night worrying how everyone in the country gets healthcare anymore. I’ve simply accepted that this is the world we’ve been dealt and everyone needs to find their own way to survive. My main concerns are 3,4,5,6. I don’t see them as “fallacious”, I think it’s naive to assume universal healthcare will work exactly as planned with no unforeseen consequences, and I’m generally suspicious of people who do not list the risks along with the benefits.
- kpU8efre7r 7y ago
  I agree. This system is no secret. We all know this is how it works so why do people make poor choices and then later complain about their insurance? With that said, having a massive middle man (private health insurance) to act as bloat and added friction on the economy is bad for everyone. You may not be directly affected but you are definitely affected in other ways that aren't as obvious. I find this sort of thing is common in America. There is always an industry set up as a middle man that needs to get paid.
  - LarryDarrell 7y ago
    "I got mine" "Don't make poor choices" I'm glad this isn't some sort of late stage capitalism drinking game.
    - kpU8efre7r 7y ago
      Thanks for adding to the discussion. I was going to add to my comment but didn't that: This is all an incredibly privileged mindset. Many people don't start on the same level with the same chances, that we do. It's hard to blame poor choices when it's not a choice. But at the end of the day that's a big appeal to emotion. The logical argument, is that the current system is a big honking added step in the system that adds nothing but subtracts a lot and whether or not "you've got yours" you are still affected by those who don't. Poor choices or not it's still in your own interest for the people to your left and right to be covered and get healthcare.
peteradio 7y ago
Don't even try. Trying to convince someone in a straightforward fact based approach only works on someone who comes looking for that information. Bringing it to someone who isn't looking for it causes them to dig in even further, it is not a rational behavior and can't be dealt with rationally either. This is not a dig at these peoples position either, for all I care they are in the right here. People are not Vulcans expected to rationalize every aspect of their lives.
MrBuddyCasino 7y ago
A good first step would be to kill the "single payer" meme. Thats not how it works in the really high performing health systems, which have competing insurance entities. It has been shown that the single-payer system is worse than those. Good and practical systems are always hybrids, not pure.
- cheerlessbog 7y ago
  Evidence? There are certainly high performing single payer systems. The UK system is very popular, had good results and is economical.
  - MrBuddyCasino 7y ago
    The UK would be a weak hybrid "Beveridge Model" system, not single payer. The Scandinavian strong hybrid systems are even better. Just another instance of localism winning over centralisation. https://en.wikipedia.org/wiki/Health_system#International_comparisons https://en.wikipedia.org/wiki/Health_system#International_co...
  - DennisP 7y ago
    The book The Healing of America by T.R. Reid compares the systems of Canada, the UK, France, Germany, and Japan. According to the book, the latter three get among the top results in the world, measured by international organizations on various objective criteria like survival rates after diagnosis of major disease. They have various costs, with Japan being especially low at 5% GDP. All three have competing nonprofit insurance companies, mandates, and price controls. At the time the book was written, they were performing significantly better than the UK and Canada (which were doing better than the U.S.).
ErikVandeWater 7y ago
> How do you convince someone like this that universal healthcare is better for all of us? You have to show that the government is competent enough to create universal healthcare. If people thought the government were more competent in general, they'd be more amicable to having the government choose a doctor for them.
- Scoundreller 7y ago
  Huh? I'm in a public system, and I can change to any doctor I choose if they have space to take me. And choose to show up at any hospital in the country.
  - sokoloff 7y ago
    When I look at government services (where they have a monopoly and often where they have the full force of law to compel me to bend to their whims), I don't immediately think of a smoothly functioning, well-oiled, supportive machine such as I might want for my health care needs. Instead, I think of the DMV, the IRS, our public transportation systems, the FCC, traffic court, etc. I don't love my current healthcare, but I'd rather muddle through 5 additional doctor visits than 1 additional DMV visit.
    - Scoundreller 7y ago
      What's so wrong with your DMV? Anywho, I don't imagine my (public system's) doctor visits being any different than yours. Except less paperwork/billing work.
      - umvi 7y ago
        > What's so wrong with your DMV? Long lines, onerous paperwork, generally unhelpful/not caring govt employees
- EamonnMR 7y ago
  In my experience, sufficiently large corporations can become indistinguishable from government once they achieve total regulatory capture. That's where we are now in the US. If a company could disrupt the way healthcare is paid for, that would be great.
m0zg 7y ago
As Scott Adams said on Twitter the other day, we already have universal healthcare. You can't be denied treatment if you walk into a hospital and require treatment. That is, all the healthcare that covers everybody in the country is already paid for. What we don't have is universal healthcare _insurance_. That said, it's undeniable that NPR has a liberal agenda. They swung so much in that direction in the past few years I stopped listening to them and switched to audio books for my commute. Best switch ever.
- war1025 7y ago
  I think public radio in general leans left of the location's center. Living in a purple / red state, that seems to put it at a pretty happy medium. Also you just need to read between the lines a bit. They do try a lot more to be balanced than many news outlets. I still have no idea why they think "Wait Wait Don't Tell Me" is a show that deserves air time though. Worst radio show I've ever listened to.
- Scoundreller 7y ago
  > You can't be denied treatment if you walk into a hospital and require treatment. You will very likely be denied treatment if your condition is "only" a chronic one. And if you do show up with an acute+chronic condition, your acute condition (heart attack) will be treated, but no mandated follow-up for your chronic one (ongoing high blood pressure). edit: watered down some of the absolute statements, you're all free to try your luck, don't take my advice blah blah.
  - m0zg 7y ago
    As someone with hypertension, it costs something like $10/mo to treat with generic drugs. I know because I had to buy lisinopril out of pocket when I was between jobs. Not a good example. A better example would be something like diabetes, but I don't know if insulin can be denied or not (or whether there are other means for the poor to obtain it), maybe someone can clarify. The larger point is, the "crazy expensive", acute part is already "universal". We just need to mop up the remaining stuff, formalize the arrangement, and call it a day. Adams also makes another point in that this can't happen without downward pricing pressure for drugs and services and there currently isn't much. If you have a fancy insurance plan it doesn't matter to you if something costs $1000 or $10K or $1M - you aren't the one paying. What he suggests is insurance companies should give you a kickback if you find a service for less than a predetermined threshold. You already see this happening in some cases. I believe Trump will create that downward pressure for drugs (as he promised many times during his campaign), but services are going to be an issue for years to come, perhaps until automation takes over.
beautifulfreak 7y ago
Tell them "a stitch in time saves nine." Somehow, that simple saying gets through.
Tsubasachan 7y ago
You don't. If the People want shit healthcare let them have it. And the US will serve as a reminder to us all.
LarryDarrell 7y ago
Start with Left-Wing newsletters. Infiltrate churches. Get some socialists on AM Radio. Start a propaganda Leftist cable network. Create partisan think-tanks. This will be a multi-generational fight. The Right Wing has it figured out. Democrats think they are showing up to a debate club when the other side has been out for blood for the last 50 years. Energize the base, and the moderates will eventually fall in line (just look how small and ineffectual the "Never Trumpers" turned out to be). The base drives things now. You can't just fire up the base and then slap a Romney or Clinton on top and expect to win elections anymore.
- war1025 7y ago
  I appreciate your comment. A common theme I've seen through my politically conscious life (15 years maybe?) is that Democrats think Republicans are stupid, where most Republicans just think Democrats are misguided. Where what you said comes into that is that Democrats think they can win just by nature of Republicans being incompetent. Republicans are out there, like you said, doing the dirty work to win elections and mind/vote-share, because while they disagree with Democrats, they know they can't just rest on their smug sense of superiority.
  - cannonedhamster 7y ago
    Democrats know most Republicans are stupid. Democrats just don't realize most of them are stupid too. Democrats try to play like it's an even playing field where everyone is playing by the same rules and are too afraid to get their hand dirty or be seen as having had to overcome issues in the past. Republicans see character flaws as a bonus just to spite the libtards because Rush told them right. The smart ones in the political sphere are just two sides of the same coin with slightly different opinions on the same issues to anchor what they think should matter in people's minds. I'd politics were rational we'd have significantly different political systems than we have now.
throwaway34241 7y ago
I find it helps to go into the details when trying to sell people on health care reform (I've also had these discussions with conservative family members). First of all "universal healthcare" itself is pretty vague. Most developed countries have universal access to health care for less money but they do it in a lot of different ways, from NHS like systems to multi-payer systems like in France and Germany. So reform could be a lot of things from a public option on insurance exchanges to single-payer with government-run hospitals like some other English-speaking developed countries. Honestly, I feel like people who are worried about second being actually implemented well are not necessarily just ignorant, for example the VA system in the US is structured in a similar way and a lot of people have terrible experiences with it. So at that point I usually acknowledge their concerns and point to other developed country systems that don't have the same single point of failure. When you say "universal healthcare" are you trying to sell them on single payer specifically? I think the argument is stronger by letting go of that and just focusing on the costs and results compared to other countries.
ben_jones 7y ago
Is there a successful example of the US government solving a Universal Healthcare type of problem? Perhaps at a much smaller scale? Maybe some of our military logistics, the space race, etc.? I'm very supportive of universal healthcare but even I doubt in the governments capability to pull it off, we couldn't even pull off healthcare.gov without massive waste. Regardless I will continue to support it even if it means a generational hit to get it right.
- tdeck 7y ago
  Yes, it's called Medicare.
  - conanbatt 7y ago
    Medicare is expensive per capita, and also is not self-sustaining: it needs people paying and not getting benefits to subsist. The entire social security paycheck wouldn't cover the cost of medicare per capita.
- jrockway 7y ago
  The government has successfully solved many large-scale infrastructure problems. Have you ever driven somewhere on a road? Was that road funded by you paying for a "road subscription" or as a benefit from your employer? Probably not. The government built it, and there are a lot of them. I don't see why healthcare is any different. People wanted roads, so we built roads. People want healthcare, so we should build healthcare. It's the same exact thing.
shirakawasuna 7y ago
> How do you convince someone like this that universal healthcare is better for all of us? American conservatism is authoritarian. The only way to reach an authoritarian is to shame them. Because they are family, you shouldn't insult them or anything, but you need them to be on the defensive about those ideas. Go through each one and ask them why they think that, but don't leave it open-ended, make it clear that you're asking why they think that despite all the evidence. Example for response 1: Why do you believe your taxes going up is a problem when you will be paying much less overall? How many dollars are you willing to spend to avoid one dollar in taxes? The clarifying factor where you hold the cards and knowledge, and they don't (and therefore feel shame) is the simple fact that universal, taxpayer-funded healthcare is far cheaper than private healthcare. Because they are authoritarian and this line of thinking disagrees with the authority, there's a very good chance that this will not work, at all. Instead, they will try to change the subject. Don't let them. Patiently guide them back to the question at hand, make them explain how much money they're willing to spend to avoid paying taxes, make them deal with the fact that they will save money. Depending on the person, they will just trudge out or start insulting you. If you're lucky, they might listen a little. It's rare that anyone will change their mind on the spot, let alone an authoritarian conservative, whose entire identity is predicated on believing nonsense given by a chosen authority. But, if you do it enough times, it can start to sink in. Alternatively, if they start insulting you, that's when you have to bring out the less polite shaming, because it's what they respond to. Best of luck.
- Mirioron 7y ago
  >American conservatism is authoritarian. That's funny, I don't see how you got there though. Liberals seem to engage in authoritarian tactics quite often from what I can see. Demands for censorship seems to come from there. >Why do you believe your taxes going up is a problem when you will be paying much less overall? And then they counter with: If people will get better healthcare then somebody will have to pay for it. I like my current healthcare, so I'm going to be the one that has to pay for those other people. Now the onus is on you to prove to them that their costs won't increase. You'll find it very difficult, because those costs probably will increase. >The clarifying factor where you hold the cards and knowledge, and they don't (and therefore feel shame) is the simple fact that universal, taxpayer-funded healthcare is far cheaper than private healthcare. What's your evidence for that? Because if you're going to cite other countries then you also have to keep in mind that they have a completely different structure for healthcare outside of whether the government pays for it or not. The US does more biomedical research than other countries, doctors are paid more, more treatments are available etc. I don't think it's nearly as easy to try to convince someone that universal healthcare is cheaper or better. Also, when you say universal what do you mean? Universal, where everyone gets it or the 'universal' that some (many?) countries do, where you have to be employed and pay over a certain amount of tax to get healthcare or healthcare is predicated on you having mandatory insurance?
ChuckMcM 7y ago
> How do you convince someone like this that universal healthcare is better for all of us? Tell them that the government should get out of the road business, and you should only drive on roads where your employer has paid the toll for you.
- cannonedhamster 7y ago
  You say this like the free market people aren't already doing this. Despite how many bridges collapse they seem to think things are going just fine because the bridges haven't collapsed on the roads they use yet.
conanbatt 7y ago
There are no facts that socialized medicine would be better for the US either. And many of the things you mention are factually correct statements on for example, M4A. When you say "convince" you actually show militancy, not understanding. I get it though, the topic is very complex and people lean very differently. I think the best way to deal with this political will is to do a public option. More choices to the people: if public truly is better, then it will promptly show it in the open market. If its not, then we know socialized solutions will not work.
- CyanBird 7y ago
  > if public truly is better, then it will promptly show it in the open market. And that's exactly what happened, most developed countries have got variants of socialized healthcare Also, market failures happen all the time, it is never a good idea to rely on "Free Market Fanaticism" as that easily leads to catastrophe without oversight
  - conanbatt 7y ago
    > And that's exactly what happened, most developed countries have got variants of socialized healthcare At least by the accounts of the Social Transformation of american medicine, european health systems were pretty much top down, but the AMA was so politically powerful that it was able to fight it effectively.
nicodjimenez 7y ago
Universal catastrophic insurance is a much better idea than universal heath care. Much simpler and cheaper.
- doingmyting 7y ago
  I disagree here. If insurance is optimized to handle catastrophic incidents it'll quickly be underwater for obvious reasons and will potentially contribute to idea that universam health care is terrible. It's orders of magnitude less expensive to treat someone in the early stages of most diseases than when symptoms are catastrophically affecting them.
maxhedrome 7y ago
1. Insurance got more expensive and worse under ACA (slash Obamacare). Fact. 2. I really don’t give a f*#% about paying for other people’s healthcare. 3. The bureaucracy surrounding pharmaceuticals, insurance, and healthcare markup are the majority of the problem. 4. Nobody wants to follow the money and point at exactly where up the chain the margins get retarded. 5. If it were up to me, I’d do something insane like throw the entire Sackler family in prison, drain their entire fortune, and use it to give free healthcare to everyone in America for the next 600 years. 6. I’m an idiot, and it should be plainly obvious why people shouldn’t listen to me.

dlo 7y ago

> How do you convince someone like this that universal healthcare is better for all of us? Here is one approach. 1) Enumerate the different options. 2) For each option, enumerate the upsides versus the downsides, which includes cost of implementation and operations, along with their likelihoods. Every option has potential downsides -- are we willing to accept them for the potential upsides? 3) Rank the options by expected utility. Which one comes out on top? Ironically, you may find that universal healthcare is not the top-ranking option or that we have not yet come up with a high-expected-utility option.

arcticbull 7y ago
The WHO and OECD did exactly that and disagree. [1] https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000 https://en.wikipedia.org/wiki/World_Health_Organization_rank... [2] https://www.oecd.org/unitedstates/Health-at-a-Glance-2017-Key-Findings-UNITED-STATES.pdf https://www.oecd.org/unitedstates/Health-at-a-Glance-2017-Ke...
- conanbatt 7y ago
  That's not utility, but health outcomes. What I truly don't get about M4A advocates or believers is why they don't tolerate a public option. Just let the state compete in the open market, and if you like state run , you have your and thats it.
  - arcticbull 7y ago
    Totally fine with it, it’s the MO for many European states, including France. Australia too. The issue for me isn’t puritanical, I don’t need single payer, what I want is everyone’s basic needs met. That said if health outcomes aren’t the utility of a medical system what on Earth is?
    - conanbatt 7y ago
      > That said if health outcomes aren’t the utility of a medical system what on earth is? i.e. You can improve health outcomes and decrease utility by banning tobacco.
      - arcticbull 7y ago
        Right, I don’t disagree. I’m still not sure how the utility of the health system isn’t health outcomes. You can make a case that they are interlinked, smoking and health, but that doesn’t really answer my question. If anything, to me, you're making the case that (abuse of) substances such as alcohol, cigarettes and all 'illicit' narcotics should be under the full control of the health system and not the criminal justice system. Similar to how Portugal handles it. FWIW the big issue is that private companies don't want to compete with the state because the goal of the state is to provide quality care, not to maximize profit. None of the private insurers are lobbying for two-tier universal healthcare so they can show off their sheer superiority are they? You'd think if they were actually superior they'd love, or at least be neutral to, the introduction of an inferior competitor. If you're so sure private cover is better why push back against the introduction of a public option at all? Welcome all comers with open arms.
throwaway34241 7y ago
Most of the high ranking health care systems would probably be considered "universal healthcare", in that everyone has access to care. Many of them are not single payer though (in the sibling comment's WHO ranking link, France, a multi-payer system, was ranked #1 for "overall system performance"). But I agree generally with this approach. Nearly every developed country has dramatically lower costs for the level of health outcomes, but they do it in a variety of different ways. There are clearly possible affordability improvements (even if we only try to catch-up to where other countries are at). But certain approaches may be more feasible to implement or may have less downside if things don't go perfectly.

sjg007 7y ago

Tell them they already pay for universal healthcare because they already pay Medicare/Medicaid taxes.

fma 7y ago
I mean there's people who have are happy with the health insurance through the Affordable Care Act, but wants Obamacare dismantled....
- redler 7y ago
  Obama said to Trump, during the transition, something to the effect of "I don't care what you call it -- make some tweaks and call it Trumpcare. Take me out of the equation; I don't care. But this is helping millions of people. You can make this a win."
Gibbon1 7y ago
Tell them that the US pays MORE in taxes to fund Medicare and Medicaid than other countries spend for Universal. Tell that that with Universal we can let go a whole army of parasites living off the Health Care Industry.
- estebank 7y ago
  The later argument is not going to get buy in from someone who is in or is related to someone in the health insurance industry, no matter how good it would be for society in general.
pathseeker 7y ago
That would be a lie though. Either that or your definition of "universal" doesn't include everyone.
- cheerlessbog 7y ago
  Unless you mean "you already pay enough to fund a modern universal Healthcare system" which statistically would be true. US govt spending on Healthcare is now per capita than many universal systems.

mgkimsal 7y ago

I hear you, and have similar experiences with some family and some friends/colleagues. You probably also hear people bringing up anecdotes about someone in Canada waiting for 9 months for a hip replacement. Primary difference is that, in many cases, Canadians with enough money can get a procedure done elsewhere (or privately) at their own expense. Wait 9 months, and there's no out of pocket costs to you. US - you may still have to wait months anyway, and you may end up with debt you will carry for years. Almost all of those in that list are fear-based, and fear is a big emotion. I don't know how you get past that, but the 'freedom' factor somehow should be focused on. Freedoms to bring up: * The freedom to move between employers and not have to concern yourself with tying your ability to get specific health service based on an employer's ability (or whim). * The freedom to move geographically and not be concerned that you won't be able to afford access to health services. My own health insurance has a decidedly different monthly premium based on county, and I'd be saving probably $150/month if I lived 3 miles to the south. * The freedom to start your own business (purportedly the backbone of 'US conservative thinking') without worrying about crippling debts. Right now, instead of an elected/representative Congress controlling what services/procedures/medicines you have access to, you have a for-profit private company, with no recourse to change their leadership or focus via election/recall. "Vote with your feet" is basically impossible in this system. "Insurance" is an odd product in this space too, at least for basic health care. Insurance is typically something we might get to reduce our exposure to risk for activities we engage in which are voluntary. Choose to buy a car? Get some insurance to help cover replacement costs, or incidental costs to others you may harm. Buying a house? Or renting? Get insurance to help cover replacement costs of things. You can choose to not buy a car, or a house. No one chooses to be born. Untie anything related to medical care from employment. By what measure is tying someone's ability to access healthcare to the beneficence of their employer remotely morally good? Someone has no employment (through whatever or no fault) and we decide that they are somehow fundamentally unworthy (or perhaps just 'less worthy'?) of access to health services? What never seems to get talked about after "your taxes will go up!!!" is "other things you pay for will go down!". Employer paying $1000/month for your health insurance policy? That expense will go away, and they'll either pay you more with that money or pay more in taxes.

krupan 7y ago

karlakush 7y ago

You're ignoring by the far biggest downside to state-sponsored healthcare: society now has a strong incentive to ban risky behaviors. If I'm paying for Joe Schmoe's healthcare, why should he be able to give himself liver disease by drinking alcohol or tear his ACL skiing? I don't ski or drink alcohol, so it's no skin off my bone if we ban alcohol and skiing. If you're a minority in a society with universal healthcare, you will have to constantly fight for your rights. The second the rest of society decides your diet or your hobbies are too dangerous, they'll be pushing to ban you from partaking in them. Also for #2, most democrats seem to support giving healthcare to illegals so I don't know why you act like that's a myth. And for #1, it's true for tens of millions of people that they will pay more in universal healthcare than they do currently. This is inherently true of all socialism (make no mistake, universal healthcare is socialist healthcare). If somebody is getting something for free, the money to pay for it is coming out of somebody's else pocket.

fzeroracer 7y ago
Your example already occurs, so I don't know why you're conveniently ignoring that fact. Instead, healthcare companies charge more if you're at risk. They're implementing solutions to discourage bad behaviors. Worse, this is all packaged up in various apps designed to take your data and sell them to others to make even more money off of every single person they rip off. Don't even get me started on how the insurance industry abused pre-existing conditions as a catch-all term for denying coverage for things that weren't even a result of life style choices. So how is this different from the horror scenario you bring up?

rossenberg79 7y ago

I don’t believe in universal healthcare, and none of these approaches do much to convince me. I’m in agreement that the current situation is hot garbage, and it’s shitty for a lot of people. However, my insurance now is good enough for me and my family. Sure, it’d be nice if it was cheaper, but whatever. As I get older I find I can’t be bothered to lay awake at night worrying how everyone in the country gets healthcare anymore. I’ve simply accepted that this is the world we’ve been dealt and everyone needs to find their own way to survive. My main concerns are 3,4,5,6. I don’t see them as “fallacious”, I think it’s naive to assume universal healthcare will work exactly as planned with no unforeseen consequences, and I’m generally suspicious of people who do not list the risks along with the benefits.

kpU8efre7r 7y ago
I agree. This system is no secret. We all know this is how it works so why do people make poor choices and then later complain about their insurance? With that said, having a massive middle man (private health insurance) to act as bloat and added friction on the economy is bad for everyone. You may not be directly affected but you are definitely affected in other ways that aren't as obvious. I find this sort of thing is common in America. There is always an industry set up as a middle man that needs to get paid.
- LarryDarrell 7y ago
  "I got mine" "Don't make poor choices" I'm glad this isn't some sort of late stage capitalism drinking game.
  - kpU8efre7r 7y ago
    Thanks for adding to the discussion. I was going to add to my comment but didn't that: This is all an incredibly privileged mindset. Many people don't start on the same level with the same chances, that we do. It's hard to blame poor choices when it's not a choice. But at the end of the day that's a big appeal to emotion. The logical argument, is that the current system is a big honking added step in the system that adds nothing but subtracts a lot and whether or not "you've got yours" you are still affected by those who don't. Poor choices or not it's still in your own interest for the people to your left and right to be covered and get healthcare.

peteradio 7y ago

Don't even try. Trying to convince someone in a straightforward fact based approach only works on someone who comes looking for that information. Bringing it to someone who isn't looking for it causes them to dig in even further, it is not a rational behavior and can't be dealt with rationally either. This is not a dig at these peoples position either, for all I care they are in the right here. People are not Vulcans expected to rationalize every aspect of their lives.

MrBuddyCasino 7y ago

A good first step would be to kill the "single payer" meme. Thats not how it works in the really high performing health systems, which have competing insurance entities. It has been shown that the single-payer system is worse than those. Good and practical systems are always hybrids, not pure.

cheerlessbog 7y ago
Evidence? There are certainly high performing single payer systems. The UK system is very popular, had good results and is economical.
- MrBuddyCasino 7y ago
  The UK would be a weak hybrid "Beveridge Model" system, not single payer. The Scandinavian strong hybrid systems are even better. Just another instance of localism winning over centralisation. https://en.wikipedia.org/wiki/Health_system#International_comparisons https://en.wikipedia.org/wiki/Health_system#International_co...
- DennisP 7y ago
  The book The Healing of America by T.R. Reid compares the systems of Canada, the UK, France, Germany, and Japan. According to the book, the latter three get among the top results in the world, measured by international organizations on various objective criteria like survival rates after diagnosis of major disease. They have various costs, with Japan being especially low at 5% GDP. All three have competing nonprofit insurance companies, mandates, and price controls. At the time the book was written, they were performing significantly better than the UK and Canada (which were doing better than the U.S.).

ErikVandeWater 7y ago

> How do you convince someone like this that universal healthcare is better for all of us? You have to show that the government is competent enough to create universal healthcare. If people thought the government were more competent in general, they'd be more amicable to having the government choose a doctor for them.

Scoundreller 7y ago
Huh? I'm in a public system, and I can change to any doctor I choose if they have space to take me. And choose to show up at any hospital in the country.
- sokoloff 7y ago
  When I look at government services (where they have a monopoly and often where they have the full force of law to compel me to bend to their whims), I don't immediately think of a smoothly functioning, well-oiled, supportive machine such as I might want for my health care needs. Instead, I think of the DMV, the IRS, our public transportation systems, the FCC, traffic court, etc. I don't love my current healthcare, but I'd rather muddle through 5 additional doctor visits than 1 additional DMV visit.
  - Scoundreller 7y ago
    What's so wrong with your DMV? Anywho, I don't imagine my (public system's) doctor visits being any different than yours. Except less paperwork/billing work.
    - umvi 7y ago
      > What's so wrong with your DMV? Long lines, onerous paperwork, generally unhelpful/not caring govt employees
EamonnMR 7y ago
In my experience, sufficiently large corporations can become indistinguishable from government once they achieve total regulatory capture. That's where we are now in the US. If a company could disrupt the way healthcare is paid for, that would be great.

m0zg 7y ago

As Scott Adams said on Twitter the other day, we already have universal healthcare. You can't be denied treatment if you walk into a hospital and require treatment. That is, all the healthcare that covers everybody in the country is already paid for. What we don't have is universal healthcare _insurance_. That said, it's undeniable that NPR has a liberal agenda. They swung so much in that direction in the past few years I stopped listening to them and switched to audio books for my commute. Best switch ever.

war1025 7y ago
I think public radio in general leans left of the location's center. Living in a purple / red state, that seems to put it at a pretty happy medium. Also you just need to read between the lines a bit. They do try a lot more to be balanced than many news outlets. I still have no idea why they think "Wait Wait Don't Tell Me" is a show that deserves air time though. Worst radio show I've ever listened to.
Scoundreller 7y ago
> You can't be denied treatment if you walk into a hospital and require treatment. You will very likely be denied treatment if your condition is "only" a chronic one. And if you do show up with an acute+chronic condition, your acute condition (heart attack) will be treated, but no mandated follow-up for your chronic one (ongoing high blood pressure). edit: watered down some of the absolute statements, you're all free to try your luck, don't take my advice blah blah.
- m0zg 7y ago
  As someone with hypertension, it costs something like $10/mo to treat with generic drugs. I know because I had to buy lisinopril out of pocket when I was between jobs. Not a good example. A better example would be something like diabetes, but I don't know if insulin can be denied or not (or whether there are other means for the poor to obtain it), maybe someone can clarify. The larger point is, the "crazy expensive", acute part is already "universal". We just need to mop up the remaining stuff, formalize the arrangement, and call it a day. Adams also makes another point in that this can't happen without downward pricing pressure for drugs and services and there currently isn't much. If you have a fancy insurance plan it doesn't matter to you if something costs $1000 or $10K or $1M - you aren't the one paying. What he suggests is insurance companies should give you a kickback if you find a service for less than a predetermined threshold. You already see this happening in some cases. I believe Trump will create that downward pressure for drugs (as he promised many times during his campaign), but services are going to be an issue for years to come, perhaps until automation takes over.

beautifulfreak 7y ago

Tell them "a stitch in time saves nine." Somehow, that simple saying gets through.

Tsubasachan 7y ago

You don't. If the People want shit healthcare let them have it. And the US will serve as a reminder to us all.

LarryDarrell 7y ago

Start with Left-Wing newsletters. Infiltrate churches. Get some socialists on AM Radio. Start a propaganda Leftist cable network. Create partisan think-tanks. This will be a multi-generational fight. The Right Wing has it figured out. Democrats think they are showing up to a debate club when the other side has been out for blood for the last 50 years. Energize the base, and the moderates will eventually fall in line (just look how small and ineffectual the "Never Trumpers" turned out to be). The base drives things now. You can't just fire up the base and then slap a Romney or Clinton on top and expect to win elections anymore.

war1025 7y ago
I appreciate your comment. A common theme I've seen through my politically conscious life (15 years maybe?) is that Democrats think Republicans are stupid, where most Republicans just think Democrats are misguided. Where what you said comes into that is that Democrats think they can win just by nature of Republicans being incompetent. Republicans are out there, like you said, doing the dirty work to win elections and mind/vote-share, because while they disagree with Democrats, they know they can't just rest on their smug sense of superiority.
- cannonedhamster 7y ago
  Democrats know most Republicans are stupid. Democrats just don't realize most of them are stupid too. Democrats try to play like it's an even playing field where everyone is playing by the same rules and are too afraid to get their hand dirty or be seen as having had to overcome issues in the past. Republicans see character flaws as a bonus just to spite the libtards because Rush told them right. The smart ones in the political sphere are just two sides of the same coin with slightly different opinions on the same issues to anchor what they think should matter in people's minds. I'd politics were rational we'd have significantly different political systems than we have now.

throwaway34241 7y ago

I find it helps to go into the details when trying to sell people on health care reform (I've also had these discussions with conservative family members). First of all "universal healthcare" itself is pretty vague. Most developed countries have universal access to health care for less money but they do it in a lot of different ways, from NHS like systems to multi-payer systems like in France and Germany. So reform could be a lot of things from a public option on insurance exchanges to single-payer with government-run hospitals like some other English-speaking developed countries. Honestly, I feel like people who are worried about second being actually implemented well are not necessarily just ignorant, for example the VA system in the US is structured in a similar way and a lot of people have terrible experiences with it. So at that point I usually acknowledge their concerns and point to other developed country systems that don't have the same single point of failure. When you say "universal healthcare" are you trying to sell them on single payer specifically? I think the argument is stronger by letting go of that and just focusing on the costs and results compared to other countries.

ben_jones 7y ago

Is there a successful example of the US government solving a Universal Healthcare type of problem? Perhaps at a much smaller scale? Maybe some of our military logistics, the space race, etc.? I'm very supportive of universal healthcare but even I doubt in the governments capability to pull it off, we couldn't even pull off healthcare.gov without massive waste. Regardless I will continue to support it even if it means a generational hit to get it right.

tdeck 7y ago
Yes, it's called Medicare.
- conanbatt 7y ago
  Medicare is expensive per capita, and also is not self-sustaining: it needs people paying and not getting benefits to subsist. The entire social security paycheck wouldn't cover the cost of medicare per capita.
jrockway 7y ago
The government has successfully solved many large-scale infrastructure problems. Have you ever driven somewhere on a road? Was that road funded by you paying for a "road subscription" or as a benefit from your employer? Probably not. The government built it, and there are a lot of them. I don't see why healthcare is any different. People wanted roads, so we built roads. People want healthcare, so we should build healthcare. It's the same exact thing.

shirakawasuna 7y ago

> How do you convince someone like this that universal healthcare is better for all of us? American conservatism is authoritarian. The only way to reach an authoritarian is to shame them. Because they are family, you shouldn't insult them or anything, but you need them to be on the defensive about those ideas. Go through each one and ask them why they think that, but don't leave it open-ended, make it clear that you're asking why they think that despite all the evidence. Example for response 1: Why do you believe your taxes going up is a problem when you will be paying much less overall? How many dollars are you willing to spend to avoid one dollar in taxes? The clarifying factor where you hold the cards and knowledge, and they don't (and therefore feel shame) is the simple fact that universal, taxpayer-funded healthcare is far cheaper than private healthcare. Because they are authoritarian and this line of thinking disagrees with the authority, there's a very good chance that this will not work, at all. Instead, they will try to change the subject. Don't let them. Patiently guide them back to the question at hand, make them explain how much money they're willing to spend to avoid paying taxes, make them deal with the fact that they will save money. Depending on the person, they will just trudge out or start insulting you. If you're lucky, they might listen a little. It's rare that anyone will change their mind on the spot, let alone an authoritarian conservative, whose entire identity is predicated on believing nonsense given by a chosen authority. But, if you do it enough times, it can start to sink in. Alternatively, if they start insulting you, that's when you have to bring out the less polite shaming, because it's what they respond to. Best of luck.

Mirioron 7y ago
>American conservatism is authoritarian. That's funny, I don't see how you got there though. Liberals seem to engage in authoritarian tactics quite often from what I can see. Demands for censorship seems to come from there. >Why do you believe your taxes going up is a problem when you will be paying much less overall? And then they counter with: If people will get better healthcare then somebody will have to pay for it. I like my current healthcare, so I'm going to be the one that has to pay for those other people. Now the onus is on you to prove to them that their costs won't increase. You'll find it very difficult, because those costs probably will increase. >The clarifying factor where you hold the cards and knowledge, and they don't (and therefore feel shame) is the simple fact that universal, taxpayer-funded healthcare is far cheaper than private healthcare. What's your evidence for that? Because if you're going to cite other countries then you also have to keep in mind that they have a completely different structure for healthcare outside of whether the government pays for it or not. The US does more biomedical research than other countries, doctors are paid more, more treatments are available etc. I don't think it's nearly as easy to try to convince someone that universal healthcare is cheaper or better. Also, when you say universal what do you mean? Universal, where everyone gets it or the 'universal' that some (many?) countries do, where you have to be employed and pay over a certain amount of tax to get healthcare or healthcare is predicated on you having mandatory insurance?

ChuckMcM 7y ago

> How do you convince someone like this that universal healthcare is better for all of us? Tell them that the government should get out of the road business, and you should only drive on roads where your employer has paid the toll for you.

cannonedhamster 7y ago
You say this like the free market people aren't already doing this. Despite how many bridges collapse they seem to think things are going just fine because the bridges haven't collapsed on the roads they use yet.

conanbatt 7y ago

There are no facts that socialized medicine would be better for the US either. And many of the things you mention are factually correct statements on for example, M4A. When you say "convince" you actually show militancy, not understanding. I get it though, the topic is very complex and people lean very differently. I think the best way to deal with this political will is to do a public option. More choices to the people: if public truly is better, then it will promptly show it in the open market. If its not, then we know socialized solutions will not work.

CyanBird 7y ago
> if public truly is better, then it will promptly show it in the open market. And that's exactly what happened, most developed countries have got variants of socialized healthcare Also, market failures happen all the time, it is never a good idea to rely on "Free Market Fanaticism" as that easily leads to catastrophe without oversight
- conanbatt 7y ago
  > And that's exactly what happened, most developed countries have got variants of socialized healthcare At least by the accounts of the Social Transformation of american medicine, european health systems were pretty much top down, but the AMA was so politically powerful that it was able to fight it effectively.

nicodjimenez 7y ago

Universal catastrophic insurance is a much better idea than universal heath care. Much simpler and cheaper.

doingmyting 7y ago
I disagree here. If insurance is optimized to handle catastrophic incidents it'll quickly be underwater for obvious reasons and will potentially contribute to idea that universam health care is terrible. It's orders of magnitude less expensive to treat someone in the early stages of most diseases than when symptoms are catastrophically affecting them.

maxhedrome 7y ago

1. Insurance got more expensive and worse under ACA (slash Obamacare). Fact. 2. I really don’t give a f*#% about paying for other people’s healthcare. 3. The bureaucracy surrounding pharmaceuticals, insurance, and healthcare markup are the majority of the problem. 4. Nobody wants to follow the money and point at exactly where up the chain the margins get retarded. 5. If it were up to me, I’d do something insane like throw the entire Sackler family in prison, drain their entire fortune, and use it to give free healthcare to everyone in America for the next 600 years. 6. I’m an idiot, and it should be plainly obvious why people shouldn’t listen to me.