5 ms·

Just so we are clear: You're against universal health care?

guylhem 14y ago
In a best case scenario, with educated and understanding people, no political interference, even with our limited technology, it would be a good thing and I'd favor it - especially for diseases which are cheap and easy to treat if caught early. In the real world we live it, it will be bringing our economies on their knees. It's a bad idea. Generally, I am biased against bad ideas.
- purplelobster 14y ago
  Real world data show the opposite of what you're saying. The US spends more on health care than other developed countries with universal healthcare. You must know that, so what point are you trying to make here?
  - guylhem 14y ago
    I know that. In the US, a market economy applied to healthcare limits the demand. Yet a lot of money gets spent uselessly in healthcare- and this happens even in government run programs. People want more of everything, but there are physical limits about what is possible. Even if each person get less per dollar than in other countries, for some reason I don't fully understand there is a high demand of healthcare, and also more distrust of an expert run system (like QALY evaluation in the UK) It's not just an inelastic demand - it is more like a weird moral hazard scenario, or as if healthcare had increasing marginal returns for people utility function. In this situation, replacing the market system by a government program might cost less in the short run - I fully agree - but much much more in the long run if demand is liberated. That's because healthcare is not just like any usual good where you have reducing marginal returns, and it will be made worse especially after it has been "shown" that the endless money supply of the government can provide healthcare to anyone! ("shown" not as a valid proof, but as "noticed" by people who can cast a vote) In the long run, I believe it will end up costing much more by this self perpetrating demand, up to the point it actually damages the economy. A dollar spent on healthcare is not "productive" - healthcare is an investment with a negative interest rate. You can only put more money to try to keep your capital - but in the end you still die (maybe that's the reason for the increasing marginal returns - you need more and more of it). It's bad enough when a country make debts not for investment but for consumption, yet it's much worse to make debts to "invest" in something like healthcare - with a negative interest rate European countries are in for a bad day when they won't be able to patch the system anymore. In France IIRC the social deficit was around 100 billions in 2008 - much more than the government budget - with a 10 billions deficit just for healthcare. Now it's 160 billions in 2012 - http://online.wsj.com/article/BT-CO-20121001-707300.html http://online.wsj.com/article/BT-CO-20121001-707300.html] Almost doubling in 5 years - let's round that to 60 billions per 4 years for a country of 60 millions persons. Let's make some quick calculations. Do you have any reason to think than, in a country with 5 times more people, and spending 16% of its GDP on healthcare instead of 9% in France (not sure about the precise %, but it's around 33% more), all others things being equal it won't create at least a 6051.33 ~ 400 billions deficit in 4 years? (and that's a baseline scenario with an identical efficiency - with the highest cost of healthcare in the US, which can't be slashed in a day, I'd expect something at least like a 1000 trillion/5 years - and that won't be a stimulus, except for increasing demand)
    - lyudmil 14y ago
      I disagree strongly with pretty much all of your points. You acknowledge that the vast majority of the evidence points towards universal healthcare systems being more economically efficient in your first sentence. You then proceed to make an argument that basically asserts the US is a special case and that a universal care system wouldn't "behave" as it does everywhere else and reduce costs, but instead increase them. I see no basis for this assumption and I want to challenge you to demonstrate why you should be granted it. I also want to challenge you on your implied definition of "useful" or "efficient". You say you would favor a universal system if you were to see convincing evidence that it would reduce costs. In your argument, I at least, read an implicit assumption that cost ought to be the deciding factor. I find that point of view detestable. For corporations, whose sole purpose is profits, it makes sense to think of efficiency that way. You and I, however, are people, and shouldn't have values that put resource acquisition higher than human well-being. You're free to disagree, but doing so would convince me that we have very little common basis for dialog. In the last part of your comment you give France as an example of a country that will suffer dire economic repercussions for having run an unsustainable universal healthcare system. I haven't double-checked your references, but I'm happy to grant you, for the sake of argument, that the data is on your side. You've chosen to ignore the vast majority of strong economies with universal healthcare. You've also failed to mention that whatever problems France may have in the future, they pale in comparison to the budgetary problems the US is facing due to the privatized healthcare system it is currently running. References forthcoming should you ask...
      - guylhem 14y ago
        I'm sorry if I seem to be making a special case of the US - what I wanted to say is universal healthcare is not a good idea in general, and even more in the US which is like a worst case for trying to implement it. Universal healthcare reduce individual costs, ie is "more efficient", but raise the demand. Even if it makes each act 50% less expansive, if the demand is 4x more, that'll still be 2x as much in total - it is less efficient on society as a whole, because it's not a productive use for money. My point is not that resource acquisition is the highest goal of human beings, it is just that money spend of such thing can not be put to a better use. It's good to spend money on feeling good (healthcare), as long as the other way the money is spend provide growth. I would favor universal system if I saw convincing evidence that people would not overclaim (ie seek treatment for minor ailments), and if they were respectful of the regulation system which has to exist if they can't self regulate with their own money. I see just the opposite, except maybe for the UK, but I don't have any experience with their system, and I don't know if they run a deficit. Anyway, if there is a special case, it certainly is the UK. Even worse - I've noticed a troubling trend. Apparently "generosity" or "social spending" is correlated with group identification - i.e. people who self categorize as different groups (based on religion, ethnicity - anything) are less likely to favor social spending, maybe because it could favor the other group. I don't have evidence for this - it's just something I noticed when people are debating about social systems. It is troubling, because most of the countries implementing universal healthcare are also running active immigration programs, which helps balance the cost of their social system. But if the trend is real, this countries will voluntary reduce their social spending after the initial period where immigrants footed the bill - leaving them resentful. My hypothesis is that countries where diversity increases (such as countries in the western EU) will reduce their social systems, while countries where diversity plunge (don't know if there is any at the moment - but the province of Quebec in the 1970 is the closest example) will increase their social spending. Please give some references for the US, but from quick calculations adding a trillion of deficit every 5 years looks like a bad idea (and I'm only talking about public healthcare in France- many people pay on top of that private insurance since the public system doesn't fully cover all the costs - money spent to purchase service from such for profit companies should certainly be added if you want to compare healthcare systems)
  - recoil 14y ago
    It's actually worse than that: US government spending on healthcare per-capita actually exceeds per-capita government spending on healthcare in countries like Canada or the United Kingdom that have universal healthcare [1], let alone total spending per-capita across both the private & government sectors. Far from universal healthcare bringing an economy "to its knees", it seems to me that the US system has a far greater chance of doing so. [1] http://www.guardian.co.uk/news/datablog/2012/jun/30/healthcare-spending-world-country http://www.guardian.co.uk/news/datablog/2012/jun/30/healthca...

In a best case scenario, with educated and understanding people, no political interference, even with our limited technology, it would be a good thing and I'd favor it - especially for diseases which are cheap and easy to treat if caught early. In the real world we live it, it will be bringing our economies on their knees. It's a bad idea. Generally, I am biased against bad ideas.

purplelobster 14y ago
Real world data show the opposite of what you're saying. The US spends more on health care than other developed countries with universal healthcare. You must know that, so what point are you trying to make here?
- guylhem 14y ago
  I know that. In the US, a market economy applied to healthcare limits the demand. Yet a lot of money gets spent uselessly in healthcare- and this happens even in government run programs. People want more of everything, but there are physical limits about what is possible. Even if each person get less per dollar than in other countries, for some reason I don't fully understand there is a high demand of healthcare, and also more distrust of an expert run system (like QALY evaluation in the UK) It's not just an inelastic demand - it is more like a weird moral hazard scenario, or as if healthcare had increasing marginal returns for people utility function. In this situation, replacing the market system by a government program might cost less in the short run - I fully agree - but much much more in the long run if demand is liberated. That's because healthcare is not just like any usual good where you have reducing marginal returns, and it will be made worse especially after it has been "shown" that the endless money supply of the government can provide healthcare to anyone! ("shown" not as a valid proof, but as "noticed" by people who can cast a vote) In the long run, I believe it will end up costing much more by this self perpetrating demand, up to the point it actually damages the economy. A dollar spent on healthcare is not "productive" - healthcare is an investment with a negative interest rate. You can only put more money to try to keep your capital - but in the end you still die (maybe that's the reason for the increasing marginal returns - you need more and more of it). It's bad enough when a country make debts not for investment but for consumption, yet it's much worse to make debts to "invest" in something like healthcare - with a negative interest rate European countries are in for a bad day when they won't be able to patch the system anymore. In France IIRC the social deficit was around 100 billions in 2008 - much more than the government budget - with a 10 billions deficit just for healthcare. Now it's 160 billions in 2012 - http://online.wsj.com/article/BT-CO-20121001-707300.html http://online.wsj.com/article/BT-CO-20121001-707300.html] Almost doubling in 5 years - let's round that to 60 billions per 4 years for a country of 60 millions persons. Let's make some quick calculations. Do you have any reason to think than, in a country with 5 times more people, and spending 16% of its GDP on healthcare instead of 9% in France (not sure about the precise %, but it's around 33% more), all others things being equal it won't create at least a 6051.33 ~ 400 billions deficit in 4 years? (and that's a baseline scenario with an identical efficiency - with the highest cost of healthcare in the US, which can't be slashed in a day, I'd expect something at least like a 1000 trillion/5 years - and that won't be a stimulus, except for increasing demand)
  - lyudmil 14y ago
    I disagree strongly with pretty much all of your points. You acknowledge that the vast majority of the evidence points towards universal healthcare systems being more economically efficient in your first sentence. You then proceed to make an argument that basically asserts the US is a special case and that a universal care system wouldn't "behave" as it does everywhere else and reduce costs, but instead increase them. I see no basis for this assumption and I want to challenge you to demonstrate why you should be granted it. I also want to challenge you on your implied definition of "useful" or "efficient". You say you would favor a universal system if you were to see convincing evidence that it would reduce costs. In your argument, I at least, read an implicit assumption that cost ought to be the deciding factor. I find that point of view detestable. For corporations, whose sole purpose is profits, it makes sense to think of efficiency that way. You and I, however, are people, and shouldn't have values that put resource acquisition higher than human well-being. You're free to disagree, but doing so would convince me that we have very little common basis for dialog. In the last part of your comment you give France as an example of a country that will suffer dire economic repercussions for having run an unsustainable universal healthcare system. I haven't double-checked your references, but I'm happy to grant you, for the sake of argument, that the data is on your side. You've chosen to ignore the vast majority of strong economies with universal healthcare. You've also failed to mention that whatever problems France may have in the future, they pale in comparison to the budgetary problems the US is facing due to the privatized healthcare system it is currently running. References forthcoming should you ask...
    - guylhem 14y ago
      I'm sorry if I seem to be making a special case of the US - what I wanted to say is universal healthcare is not a good idea in general, and even more in the US which is like a worst case for trying to implement it. Universal healthcare reduce individual costs, ie is "more efficient", but raise the demand. Even if it makes each act 50% less expansive, if the demand is 4x more, that'll still be 2x as much in total - it is less efficient on society as a whole, because it's not a productive use for money. My point is not that resource acquisition is the highest goal of human beings, it is just that money spend of such thing can not be put to a better use. It's good to spend money on feeling good (healthcare), as long as the other way the money is spend provide growth. I would favor universal system if I saw convincing evidence that people would not overclaim (ie seek treatment for minor ailments), and if they were respectful of the regulation system which has to exist if they can't self regulate with their own money. I see just the opposite, except maybe for the UK, but I don't have any experience with their system, and I don't know if they run a deficit. Anyway, if there is a special case, it certainly is the UK. Even worse - I've noticed a troubling trend. Apparently "generosity" or "social spending" is correlated with group identification - i.e. people who self categorize as different groups (based on religion, ethnicity - anything) are less likely to favor social spending, maybe because it could favor the other group. I don't have evidence for this - it's just something I noticed when people are debating about social systems. It is troubling, because most of the countries implementing universal healthcare are also running active immigration programs, which helps balance the cost of their social system. But if the trend is real, this countries will voluntary reduce their social spending after the initial period where immigrants footed the bill - leaving them resentful. My hypothesis is that countries where diversity increases (such as countries in the western EU) will reduce their social systems, while countries where diversity plunge (don't know if there is any at the moment - but the province of Quebec in the 1970 is the closest example) will increase their social spending. Please give some references for the US, but from quick calculations adding a trillion of deficit every 5 years looks like a bad idea (and I'm only talking about public healthcare in France- many people pay on top of that private insurance since the public system doesn't fully cover all the costs - money spent to purchase service from such for profit companies should certainly be added if you want to compare healthcare systems)
- recoil 14y ago
  It's actually worse than that: US government spending on healthcare per-capita actually exceeds per-capita government spending on healthcare in countries like Canada or the United Kingdom that have universal healthcare [1], let alone total spending per-capita across both the private & government sectors. Far from universal healthcare bringing an economy "to its knees", it seems to me that the US system has a far greater chance of doing so. [1] http://www.guardian.co.uk/news/datablog/2012/jun/30/healthcare-spending-world-country http://www.guardian.co.uk/news/datablog/2012/jun/30/healthca...