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The problem is structural all right: the US could afford to provide universal, single payer (Canadian style) health insurance for what it currently spends on Me

The problem is structural all right: the US could afford to provide universal, single payer (Canadian style) health insurance for what it currently spends on Medicare and Medicaid, given that current per capita public spending on health care is actually a bit higher than the OECD average. If the public sector inefficiencies related to means testing and the private sector inefficiencies related to risk selection, bureaucracy and profit were eliminated, current public spending on health care would be plenty to provide universal, comprehensive coverage based on medical need. The current bizarro-world hybrid system combines the worst aspects of private and health care while still leaving some 50 million Americans uninsured and at least another 50 million with only partial insurance that won't actually cover them in the case of a serious medical emergency.

yummyfajitas 17y ago
You can play all sorts of games with health insurance. But insurance isn't care. This is a point the article makes: On paper, poor patients have great government insurance; their only problem is that they can’t find a doctor. My question, to proponents of "universal" health care is this: how will you make the physical provisions for additional health care to be delivered? I'm not asking about money, just resources (an hour of a doctor's time, a bed in a hospital). If the system is being underused (i.e., doctors going out of business due to lack of patients, empty ERs, etc), that should be easy: just direct the unused capacity to new people. But if the system is currently at capacity or being overused, where will the additional physical capacity to treat 50-100 million new patients come from?
- RyanMcGreal 17y ago
  My question, to opponents of universal health care, is this: How do you explain the fact that universal health care ACTUALLY WORKS in every country that implements it in some form? How do you explain the fact that your simplistic market-based analysis fails to predict the overwhelming success of universal health care at both delivering comprehensive health coverage and at efficiently allocating resources where they're needed?
  - yummyfajitas 17y ago
    You seem to be ducking the question. In any case, I'm not entirely sure what you mean by "actually works". I'll assume "actually works" means "life expectancy in the range of 70-80, no major health disasters." The answer is simple: medicine beyond the essentials (trauma care, birthing, vaccines) doesn't improve health very much. It does almost nothing compared to flush toilets, clean water, refrigeration, vaccines and other benefits of being wealthy. In fact, most variations in medicine can't be shown to have a statistically significant effect on health. So maybe some of those countries do a great job, maybe they don't. It doesn't much matter either way. See this source for a good review of the literature. http://www.cato-unbound.org/2007/09/10/robin-hanson/cut-medicine-in-half/ http://www.cato-unbound.org/2007/09/10/robin-hanson/cut-medi... Now can you answer my question? I'm asking because I'm genuinely curious about the worldview of government health care proponents.

yummyfajitas 17y ago

You can play all sorts of games with health insurance. But insurance isn't care. This is a point the article makes: On paper, poor patients have great government insurance; their only problem is that they can’t find a doctor. My question, to proponents of "universal" health care is this: how will you make the physical provisions for additional health care to be delivered? I'm not asking about money, just resources (an hour of a doctor's time, a bed in a hospital). If the system is being underused (i.e., doctors going out of business due to lack of patients, empty ERs, etc), that should be easy: just direct the unused capacity to new people. But if the system is currently at capacity or being overused, where will the additional physical capacity to treat 50-100 million new patients come from?

RyanMcGreal 17y ago
My question, to opponents of universal health care, is this: How do you explain the fact that universal health care ACTUALLY WORKS in every country that implements it in some form? How do you explain the fact that your simplistic market-based analysis fails to predict the overwhelming success of universal health care at both delivering comprehensive health coverage and at efficiently allocating resources where they're needed?
- yummyfajitas 17y ago
  You seem to be ducking the question. In any case, I'm not entirely sure what you mean by "actually works". I'll assume "actually works" means "life expectancy in the range of 70-80, no major health disasters." The answer is simple: medicine beyond the essentials (trauma care, birthing, vaccines) doesn't improve health very much. It does almost nothing compared to flush toilets, clean water, refrigeration, vaccines and other benefits of being wealthy. In fact, most variations in medicine can't be shown to have a statistically significant effect on health. So maybe some of those countries do a great job, maybe they don't. It doesn't much matter either way. See this source for a good review of the literature. http://www.cato-unbound.org/2007/09/10/robin-hanson/cut-medicine-in-half/ http://www.cato-unbound.org/2007/09/10/robin-hanson/cut-medi... Now can you answer my question? I'm asking because I'm genuinely curious about the worldview of government health care proponents.