7 ms·

Solve both problems (ease of access to eyeware, and screening for eye disease) the Australian way: - One free eye exam each year covered by Medicare (to obtain

Solve both problems (ease of access to eyeware, and screening for eye disease) the Australian way: - One free eye exam each year covered by Medicare (to obtain your latest prescription, and check for all eye disease). - Ability to go into an optical store and buy contact lenses/glasses if you tell them your prescription.

eru 7y ago
About the first: why not just give poor people money, so they can spend it on an eye exam or whatever is more urgent for them? (And for non-poor people we can cut out the middle-men: just let them pay for their eye check out of pocket. Instead of having them pay a levy, have some layers of bureaucracy, and then give it back to them in the form of eye checks. (Note: this is not an argument against medical insurance as insurance against unforeseeable, big events. It's only an argument against indirecting payments for small-ish, routine and predictable items.))
- hannasanarion 7y ago
  Why not both? There's no good reason for healthcare that everybody needs to be locked behind a prohibitive money gate.
  - eru 7y ago
    Doctors and nurses don't work for free. Neither do bakers. So what's the argument that suggests poor people need to be given healthcare, but not bread? I suggest to just give them money, and then they can buy the bread and healthcare they need. (And that's a general principle. However giving goods and services directly does make sense for non-excludable public goods. Eg don't give poor people money to procure national defense. Just provide national defense directly with tax payer money.)
    - tom_mellior 7y ago
      > So what's the argument that suggests poor people need to be given healthcare, but not bread? You (deliberately?) misread the parent's comments. It was not very long, and it centered on the word "both". > I suggest to just give them money, and then they can buy the bread and healthcare they need. Elsewhere you wrote that "unforeseeable, big events" should still be covered by insurance, but I don't think you understand that if people don't have enough money, even getting regular checkups and medication can be pretty "big" from the affected person's perspective. If two people are scraping by on a universal basic income that is enough for basic shelter and food, and one of those people regularly needs checkups or medication for some chronic condition, then you are screwing over one of those people. This isn't about the freedom to choose not to be chronically ill, because there is no such freedom. Neither is it about the freedom to choose not to be treated for chronic medical conditions. There is no such freedom, the word for that "choice" is "torture".
      - eru 7y ago
        > You (deliberately?) misread the parent's comments. It was not very long, and it centered on the word "both". To be more clear: if society spends X dollars per year per poor person on direct financial transfers, and Y dollars per year per poor person on in-kind services, I am suggesting to move to a system of giving the poor person (X+Y) dollars in direct financial transfers. Is that better? About the latter part of your comment: Yes, that is a real problem. There are (at least) two reasonable approaches that leave insurance as insurance: First, you can just give the chronically ill or disabled person more welfare money. Or, second, if you are a purist for equality: enter a very long running insurance contract, before you develop a chronic condition. Because then there's still uncertainty, and uncertain conditions are insurable. In the strictest form, your parents would make the arrangements before conceiving you. BUT: I do gladly concede that for serious enough conditions just handing out medical services might be a reasonable choice. I don't know. But that doesn't say much about routine check-ups for healthy people.
        tom_mellior 7y ago
        Where I live (Austria), everybody (modulo a few exceptions and quirks that shouldn't exist) has state-mandated health insurance. If we go to the doctor, of course the doctor gets paid, but not directly out of our pockets. The system is simple, and it works. I don't understand why you discount this possibility. It's the best model. > enter a very long running insurance contract, before you develop a chronic condition. Because then there's still uncertainty, and uncertain conditions are insurable. In the strictest form, your parents would make the arrangements before conceiving you. I guess this is a complicated way of saying the same thing as I did, except that "your parents" are "the law"?
    - hannasanarion 7y ago
      >I suggest to just give them money, and then they can buy the bread and healthcare they need. I believe you mean "bread OR healthcare".
      - eru 7y ago
        Inclusive-or, sure. To quote myself: if society spends X dollars per year per poor person on direct financial transfers, and Y dollars per year per poor person on in-kind services, I am suggesting to move to a system of giving the poor person (X+Y) dollars in direct financial transfers.
        pinkfoot 7y ago
        Sure, but then you have to refuse to spend an other Z on in-kind services when (X+Y) were spent on other things. And you'll find politicians lack that resolve.
        eru 7y ago
        Yes, political implementation is a different topic. However, this ain't an all or nothing game: You can move some in-kind services to money payment without moving all. Eg it should be possible for politicians to refrain from handing out annual eye exams.
- Thorentis 7y ago
  Private healthcare is almost a scam. It allows providers to charge much higher prices (thus increasing premiums) and makes affordable healthcare even more inaccessable. A Medicare levy, while not ideal, is a fair system. You don't pay it if you don't pay tax, it is proportionate to your income, and it allows a basic level of care for those who need it. Everybody needs eye checks. Poor people get them for free. People earning an income pay for them.
  - eru 7y ago
    > Private healthcare is almost a scam. It allows providers to charge much higher prices (thus increasing premiums) and makes affordable healthcare even more inaccessable. Could you back that up? Are you talking about a specific country, or all manners of private healthcare? As far as I can tell, the least regulated bits of healthcare systems that people pay out of pocket for tend to have done the best in terms of cost control. Eg few if any insurances around the world pays for laser eye surgery. And it's one of the few common healthcare procedures whose costs have dropped massively in recent decades. > A Medicare levy, while not ideal, is a fair system. You don't pay it if you don't pay tax, it is proportionate to your income, and it allows a basic level of care for those who need it. Everybody needs eye checks. Poor people get them for free. People earning an income pay for them. That seems like a good argument in favour of taxing the well-to-do to give the poor money. That's a fine decision for a democracy to make. But I don't see the argument of forcing the poor to spend that money on healthcare instead of letting them decide what's best for themselves. Do you know what they need better than them?
    - Thorentis 7y ago
      I agree that private healthcare can work well, but increasingly I have found that the value it offers compared to the cost is decreasing. YMMV. In terms of letting the poor spend it on what they like, I disagree. You aren't giving them money. You're giving them healthcare. In my opinion, people are not entitled to money. But I do think they are entitled to good health if it can be at all given to them.
      - 7y ago
- ajnin 7y ago
  Forcing poor people to choose between their health and some other need seems extremely cynical to me. Often the poor just can't make that choice, they need food, shelter, clothes first. It's not a real choice when your immediate basic needs are at stake.
  - umvi 7y ago
    And even more cynically, many poor people will prioritize cigarettes and alcohol above food and shelter
    - ramzyo 7y ago
      Do you have a source to back up this assertion - in particular “many poor people?”
      - posixplz 7y ago
        The streets of San Francisco and Seattle.
      - turk73 7y ago
        Yes, far too many experiences with these types of people than I wish to even re-count. Every deadbeat has money for booze but not for feeding their kids or paying the bills.
    - angry_octet 7y ago
      You don't even need to be a cynic -- when you're addicted, the addiction comes first. First, before food, sleep, shelter, family and health. The idea of giving cash is, frankly, asinine. The objective is not to increase the recipients spending power, but to reduce health problems population wide, reducing expensive medical interventions and productivity-draining disability.
  - LyndsySimon 7y ago
    Absolutely no offense intended, but it sounds to me like you want to make that decision for them. That line of thought can be used to justify a huge amount of intrusion into people’s lives.
crooked-v 7y ago
I've done the second, though that was with a non-chain independent glasses shop.
lbutler 7y ago
> - One free eye exam each year covered by Medicare Only if you're over 65! Otherwise its one exam every three years for a standard exam. [1] It's been a while since my last check, but last time I went they did try upselling to some more advanced scan that wasn't covered by medicare. Either way, still think we're doing something right in Australia but having this base coverage for everyone. [1] https://www.humanservices.gov.au/individuals/subjects/whats-covered-medicare/screening-tests-and-scans#a3 https://www.humanservices.gov.au/individuals/subjects/whats-...

eru 7y ago

About the first: why not just give poor people money, so they can spend it on an eye exam or whatever is more urgent for them? (And for non-poor people we can cut out the middle-men: just let them pay for their eye check out of pocket. Instead of having them pay a levy, have some layers of bureaucracy, and then give it back to them in the form of eye checks. (Note: this is not an argument against medical insurance as insurance against unforeseeable, big events. It's only an argument against indirecting payments for small-ish, routine and predictable items.))

hannasanarion 7y ago
Why not both? There's no good reason for healthcare that everybody needs to be locked behind a prohibitive money gate.
- eru 7y ago
  Doctors and nurses don't work for free. Neither do bakers. So what's the argument that suggests poor people need to be given healthcare, but not bread? I suggest to just give them money, and then they can buy the bread and healthcare they need. (And that's a general principle. However giving goods and services directly does make sense for non-excludable public goods. Eg don't give poor people money to procure national defense. Just provide national defense directly with tax payer money.)
  - tom_mellior 7y ago
    > So what's the argument that suggests poor people need to be given healthcare, but not bread? You (deliberately?) misread the parent's comments. It was not very long, and it centered on the word "both". > I suggest to just give them money, and then they can buy the bread and healthcare they need. Elsewhere you wrote that "unforeseeable, big events" should still be covered by insurance, but I don't think you understand that if people don't have enough money, even getting regular checkups and medication can be pretty "big" from the affected person's perspective. If two people are scraping by on a universal basic income that is enough for basic shelter and food, and one of those people regularly needs checkups or medication for some chronic condition, then you are screwing over one of those people. This isn't about the freedom to choose not to be chronically ill, because there is no such freedom. Neither is it about the freedom to choose not to be treated for chronic medical conditions. There is no such freedom, the word for that "choice" is "torture".
    - eru 7y ago
      > You (deliberately?) misread the parent's comments. It was not very long, and it centered on the word "both". To be more clear: if society spends X dollars per year per poor person on direct financial transfers, and Y dollars per year per poor person on in-kind services, I am suggesting to move to a system of giving the poor person (X+Y) dollars in direct financial transfers. Is that better? About the latter part of your comment: Yes, that is a real problem. There are (at least) two reasonable approaches that leave insurance as insurance: First, you can just give the chronically ill or disabled person more welfare money. Or, second, if you are a purist for equality: enter a very long running insurance contract, before you develop a chronic condition. Because then there's still uncertainty, and uncertain conditions are insurable. In the strictest form, your parents would make the arrangements before conceiving you. BUT: I do gladly concede that for serious enough conditions just handing out medical services might be a reasonable choice. I don't know. But that doesn't say much about routine check-ups for healthy people.
      - tom_mellior 7y ago
        Where I live (Austria), everybody (modulo a few exceptions and quirks that shouldn't exist) has state-mandated health insurance. If we go to the doctor, of course the doctor gets paid, but not directly out of our pockets. The system is simple, and it works. I don't understand why you discount this possibility. It's the best model. > enter a very long running insurance contract, before you develop a chronic condition. Because then there's still uncertainty, and uncertain conditions are insurable. In the strictest form, your parents would make the arrangements before conceiving you. I guess this is a complicated way of saying the same thing as I did, except that "your parents" are "the law"?
  - hannasanarion 7y ago
    >I suggest to just give them money, and then they can buy the bread and healthcare they need. I believe you mean "bread OR healthcare".
    - eru 7y ago
      Inclusive-or, sure. To quote myself: if society spends X dollars per year per poor person on direct financial transfers, and Y dollars per year per poor person on in-kind services, I am suggesting to move to a system of giving the poor person (X+Y) dollars in direct financial transfers.
      - pinkfoot 7y ago
        Sure, but then you have to refuse to spend an other Z on in-kind services when (X+Y) were spent on other things. And you'll find politicians lack that resolve.
        eru 7y ago
        Yes, political implementation is a different topic. However, this ain't an all or nothing game: You can move some in-kind services to money payment without moving all. Eg it should be possible for politicians to refrain from handing out annual eye exams.
Thorentis 7y ago
Private healthcare is almost a scam. It allows providers to charge much higher prices (thus increasing premiums) and makes affordable healthcare even more inaccessable. A Medicare levy, while not ideal, is a fair system. You don't pay it if you don't pay tax, it is proportionate to your income, and it allows a basic level of care for those who need it. Everybody needs eye checks. Poor people get them for free. People earning an income pay for them.
- eru 7y ago
  > Private healthcare is almost a scam. It allows providers to charge much higher prices (thus increasing premiums) and makes affordable healthcare even more inaccessable. Could you back that up? Are you talking about a specific country, or all manners of private healthcare? As far as I can tell, the least regulated bits of healthcare systems that people pay out of pocket for tend to have done the best in terms of cost control. Eg few if any insurances around the world pays for laser eye surgery. And it's one of the few common healthcare procedures whose costs have dropped massively in recent decades. > A Medicare levy, while not ideal, is a fair system. You don't pay it if you don't pay tax, it is proportionate to your income, and it allows a basic level of care for those who need it. Everybody needs eye checks. Poor people get them for free. People earning an income pay for them. That seems like a good argument in favour of taxing the well-to-do to give the poor money. That's a fine decision for a democracy to make. But I don't see the argument of forcing the poor to spend that money on healthcare instead of letting them decide what's best for themselves. Do you know what they need better than them?
  - Thorentis 7y ago
    I agree that private healthcare can work well, but increasingly I have found that the value it offers compared to the cost is decreasing. YMMV. In terms of letting the poor spend it on what they like, I disagree. You aren't giving them money. You're giving them healthcare. In my opinion, people are not entitled to money. But I do think they are entitled to good health if it can be at all given to them.
    - 7y ago
ajnin 7y ago
Forcing poor people to choose between their health and some other need seems extremely cynical to me. Often the poor just can't make that choice, they need food, shelter, clothes first. It's not a real choice when your immediate basic needs are at stake.
- umvi 7y ago
  And even more cynically, many poor people will prioritize cigarettes and alcohol above food and shelter
  - ramzyo 7y ago
    Do you have a source to back up this assertion - in particular “many poor people?”
    - posixplz 7y ago
      The streets of San Francisco and Seattle.
    - turk73 7y ago
      Yes, far too many experiences with these types of people than I wish to even re-count. Every deadbeat has money for booze but not for feeding their kids or paying the bills.
  - angry_octet 7y ago
    You don't even need to be a cynic -- when you're addicted, the addiction comes first. First, before food, sleep, shelter, family and health. The idea of giving cash is, frankly, asinine. The objective is not to increase the recipients spending power, but to reduce health problems population wide, reducing expensive medical interventions and productivity-draining disability.
- LyndsySimon 7y ago
  Absolutely no offense intended, but it sounds to me like you want to make that decision for them. That line of thought can be used to justify a huge amount of intrusion into people’s lives.

crooked-v 7y ago

I've done the second, though that was with a non-chain independent glasses shop.

lbutler 7y ago

> - One free eye exam each year covered by Medicare Only if you're over 65! Otherwise its one exam every three years for a standard exam. [1] It's been a while since my last check, but last time I went they did try upselling to some more advanced scan that wasn't covered by medicare. Either way, still think we're doing something right in Australia but having this base coverage for everyone. [1] https://www.humanservices.gov.au/individuals/subjects/whats-covered-medicare/screening-tests-and-scans#a3 https://www.humanservices.gov.au/individuals/subjects/whats-...