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Health care is always "rationed". In the US it's rationed by ability to pay. This is far worse both ethically and practically than any means of rationing it vi

by foldr 7y ago

Health care is always "rationed". In the US it's rationed by ability to pay. This is far worse both ethically and practically than any means of rationing it via a cost/benefit calculation. As far as I know, no presidential candidate is proposing to stop people from buying private medical insurance, so your worries seem entirely unfounded in fact. Even in the UK, you can get private medical insurance if you want to.

dragonwriter 7y ago
> As far as I know, no presidential candidate is proposing to stop people from buying private medical insurance A couple of the variants of Medicare-for-All, including Sanders’, would prohibit normal private health insurance (they would allow private plans for certain non-core benefits, but those aren't what people talking about private medical insurance are mostly talking to about.) I mean, technically, they don't prohibit buying plans, only selling them, but... > Even in the UK, you can get private medical insurance if you want to As far as I know, no Presidential candidate is campaigning on a healthcare plan based even loosely on what the UK currently does.
EdSharkey 7y ago
There is a lot of abstraction in your statements culminating in an attempt to paint me as unethical. I wish we could just talk like friends who happen to disagree on policy. I don't believe a functional health care market where providers must compete on price and quality is as static as the system we have now. The "rationing" you describe that we have today is because we don't have a functional market or insurance system. > As far as I know, no presidential candidate is proposing to stop people from buying private medical insurance, so your worries seem entirely unfounded in fact. Rewatch the debates and listen to the policy statements and their implications, I don't think you're correct.
- foldr 7y ago
  >I wish we could just talk like friends who happen to disagree on policy. I think it's a terrible mistake to treat this as a wonky policy issue rather than an urgent ethical issue. That conception of things is part of the reason that it's been so hard to reform the system. > I don't believe a functional health care market where providers must compete on price and quality is as static as the system we have now. The "rationing" you describe that we have today is because we don't have a functional market or insurance system. I've read through this a couple of times but can't really make any sense of it. As long as people have to pay for their own treatment, people with more money will be able to get better treatment. That's a form of rationing, and it wouldn't go away if the "market" were to get more "efficient". >Rewatch the debates and listen to the policy statements and their implications, I don't think you're correct. If one of the candidates is proposing to ban private health insurance, it should be easy for you to reference a statement to this effect.
  - EdSharkey 7y ago
    > I think it's a terrible mistake to treat this as a wonky policy issue rather than an urgent ethical issue. Your passion is admirable, but no need to insult, friend. I'm not a policy wonk, I just disagree with you. I don't have the same faith in government's ability to deliver services as you do. America is especially bad at delivering services, given our tendency towards crony capitalism and a disengaged public. It is possible to make things worse than they are now with totally well-meaning, but flawed, economic and social policies. > it should be easy for you to reference a statement to this effect. I searched on DDG, got tons of good hits for "debate ban private health insurance" and I picked the first link. The socialists (who aren't looking too hopeless in the polls and actually stand a chance at being the nominee) want to run things soup to nuts, no surprise here. Harris walked it back afterward, Sanders stood his ground and beat her over the head for a lack of conviction. https://www.reuters.com/article/us-usa-election-harris-idUSKCN1TT1X6 https://www.reuters.com/article/us-usa-election-harris-idUSK... > Harris and U.S. Senate colleague Bernie Sanders were the only two candidates to raise their hands during Thursday night’s second Democratic debate when asked, "Who here would abolish their private health insurance in favor of a government-run plan?" > On Wednesday night, U.S. Senator Elizabeth Warren of Massachusetts and New York City Mayor Bill de Blasio were the only two candidates to raise their hands when asked if they would scrap private insurance. Please just watch the debates and don't give anyone a pass. I'm counting on you and others to not pick an unelectable wacko to run against Trump. Full disclosure, I didn't vote for Trump (or Hillary) in 2016.
    - foldr 7y ago
      Ethical disagreements exist. You may not think that this is an urgent ethical issue, but I do. I'm not going to say that your position is ethically acceptable just because it would make you feel better - sorry. You're really selling the US short if you think that it can't implement any one of the multitude of healthcare systems that exist in other first world countries - all of which are superior both in terms of outcomes and in terms of basic decency. This kind of pessimism is just a convenient excuse for doing nothing while people are dying. I believe there will come a time when the right to healthcare is no more up for debate than, say, women's right to vote (no longer a "policy" issue). But, clearly, we're not there yet. You still seem wedded to the idea that the system has to be set up in such a way that a person's access to health care is significantly limited by their wealth. Thus, only certain basic treatments will be "abundant and/or free" even in your ideal conception of how the system should work! And you talk about giving the "maximum possible" number of people in the US access to high quality care - as if this maximum were somehow obviously less than 100%! When you can't get care, it's "rationing". When 15% of the population can't get it because they're too poor, then, well, gee, that's just the market at work I guess. The bottom line here is that Americans still see healthcare as a job perk rather than as a right. That's ethically obscene, but it's still the mainstream point of view, so you're by no means alone. If you are happy with your own personal situation at present, then by all means sit out elections and float pie in the sky market-based schemes as alternatives to actionable policy proposals that would actually make a difference.

by foldr 7y ago

dragonwriter 7y ago

> As far as I know, no presidential candidate is proposing to stop people from buying private medical insurance A couple of the variants of Medicare-for-All, including Sanders’, would prohibit normal private health insurance (they would allow private plans for certain non-core benefits, but those aren't what people talking about private medical insurance are mostly talking to about.) I mean, technically, they don't prohibit buying plans, only selling them, but... > Even in the UK, you can get private medical insurance if you want to As far as I know, no Presidential candidate is campaigning on a healthcare plan based even loosely on what the UK currently does.

EdSharkey 7y ago

There is a lot of abstraction in your statements culminating in an attempt to paint me as unethical. I wish we could just talk like friends who happen to disagree on policy. I don't believe a functional health care market where providers must compete on price and quality is as static as the system we have now. The "rationing" you describe that we have today is because we don't have a functional market or insurance system. > As far as I know, no presidential candidate is proposing to stop people from buying private medical insurance, so your worries seem entirely unfounded in fact. Rewatch the debates and listen to the policy statements and their implications, I don't think you're correct.

foldr 7y ago
>I wish we could just talk like friends who happen to disagree on policy. I think it's a terrible mistake to treat this as a wonky policy issue rather than an urgent ethical issue. That conception of things is part of the reason that it's been so hard to reform the system. > I don't believe a functional health care market where providers must compete on price and quality is as static as the system we have now. The "rationing" you describe that we have today is because we don't have a functional market or insurance system. I've read through this a couple of times but can't really make any sense of it. As long as people have to pay for their own treatment, people with more money will be able to get better treatment. That's a form of rationing, and it wouldn't go away if the "market" were to get more "efficient". >Rewatch the debates and listen to the policy statements and their implications, I don't think you're correct. If one of the candidates is proposing to ban private health insurance, it should be easy for you to reference a statement to this effect.
- EdSharkey 7y ago
  > I think it's a terrible mistake to treat this as a wonky policy issue rather than an urgent ethical issue. Your passion is admirable, but no need to insult, friend. I'm not a policy wonk, I just disagree with you. I don't have the same faith in government's ability to deliver services as you do. America is especially bad at delivering services, given our tendency towards crony capitalism and a disengaged public. It is possible to make things worse than they are now with totally well-meaning, but flawed, economic and social policies. > it should be easy for you to reference a statement to this effect. I searched on DDG, got tons of good hits for "debate ban private health insurance" and I picked the first link. The socialists (who aren't looking too hopeless in the polls and actually stand a chance at being the nominee) want to run things soup to nuts, no surprise here. Harris walked it back afterward, Sanders stood his ground and beat her over the head for a lack of conviction. https://www.reuters.com/article/us-usa-election-harris-idUSKCN1TT1X6 https://www.reuters.com/article/us-usa-election-harris-idUSK... > Harris and U.S. Senate colleague Bernie Sanders were the only two candidates to raise their hands during Thursday night’s second Democratic debate when asked, "Who here would abolish their private health insurance in favor of a government-run plan?" > On Wednesday night, U.S. Senator Elizabeth Warren of Massachusetts and New York City Mayor Bill de Blasio were the only two candidates to raise their hands when asked if they would scrap private insurance. Please just watch the debates and don't give anyone a pass. I'm counting on you and others to not pick an unelectable wacko to run against Trump. Full disclosure, I didn't vote for Trump (or Hillary) in 2016.
  - foldr 7y ago
    Ethical disagreements exist. You may not think that this is an urgent ethical issue, but I do. I'm not going to say that your position is ethically acceptable just because it would make you feel better - sorry. You're really selling the US short if you think that it can't implement any one of the multitude of healthcare systems that exist in other first world countries - all of which are superior both in terms of outcomes and in terms of basic decency. This kind of pessimism is just a convenient excuse for doing nothing while people are dying. I believe there will come a time when the right to healthcare is no more up for debate than, say, women's right to vote (no longer a "policy" issue). But, clearly, we're not there yet. You still seem wedded to the idea that the system has to be set up in such a way that a person's access to health care is significantly limited by their wealth. Thus, only certain basic treatments will be "abundant and/or free" even in your ideal conception of how the system should work! And you talk about giving the "maximum possible" number of people in the US access to high quality care - as if this maximum were somehow obviously less than 100%! When you can't get care, it's "rationing". When 15% of the population can't get it because they're too poor, then, well, gee, that's just the market at work I guess. The bottom line here is that Americans still see healthcare as a job perk rather than as a right. That's ethically obscene, but it's still the mainstream point of view, so you're by no means alone. If you are happy with your own personal situation at present, then by all means sit out elections and float pie in the sky market-based schemes as alternatives to actionable policy proposals that would actually make a difference.