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Should the Government Provide Free Universal Health Care for All Americans?

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  • Re: Should the Government Provide Free Universal Health Care for All Americans?

    Yes, many are. But we have so much prosperity here that I prefer to focus government health care on the poor rather than trying to throw everyone into the same system. Most Americans would not give up what they have for single payer. Private insurance, if you can afford it, covers so much more. And since most Americans get it through their employer, they don't see the true cost. THat's why Obamacare had to be structured as it was, because Americans would go nuts if they lost their employer coverage because of the government.

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    • Re: Should the Government Provide Free Universal Health Care for All Americans?

      Originally posted by adaher View Post
      Yes, many are. But we have so much prosperity here that I prefer to focus government health care on the poor rather than trying to throw everyone into the same system.
      Right. And the question of what to do about helping the poor, in terms of government policy, has largely been answered. We have numerous safety nets and policies to help those on the bottom rung. If the argument was merely that those safety nets aren't doing enough, we would be talking about how to beef them up. But something else is at work here.

      The way I see it , we have two mostly unrelated concerns with health care:

      Most immediate is the issue is what to do about health care inflation. Health care prices have been increasing at many times the rate of normal inflation for several decades now. If this continues, none of us will be able to afford health care, regardless of who is paying for it.

      The other issue is the practice of socializing health care risk. What began as a hedge against the risk of medical related bankruptcy, has become the primary means of financing everyday health care. The next step, according to some, is to socialize all medical expenses at a national level. To, as you say, 'throw everyone into the same system'.

      I say these two issues are mostly unrelated, but there are a couple of key intersections. First of all, health care inflation clearly colors the debate on socializing health care. The more health care prices go up, the more people yearn to be relieved of the responsibility of paying their own way. Conversely, if health care inflation weren't a problem, if health care prices were going down instead of up, people would be less worried about socializing the costs.

      The second point of intersection is actually where the two concerns come into conflict. Unfortunately, socializing costs also happens to be one of the principal drivers of health care inflation. It's not that hard to understand. In any market, prices will rise to the maximum level people are willing to pay. And when we're not spending our own money, our "will to pay" is virtually unlimited.

      That sets up the political struggle we're seeing now over health care. For those of us who see health care inflation as the biggest problem, the preoccupation with socializing costs seems counterproductive and irrational. It's all the more frustrating because effectively dealing with the inflation problem would minimize the problems the socializers are trying to solve - to the point that they would be easily addressed by existing safety nets.
      Last edited by dblack; 01-14-2012, 10:35 PM.

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      • Re: Should the Government Provide Free Universal Health Care for All Americans?

        One thing that we have to clear up is why there is health care inflation. It's not that the same things are rising in price. It's not true inflation. It's costs, due to new treatments and drugs which are more expensive than the old. An easy way to solve the health care costs problem, if a little draconian, is for government insurance to simply not cover new products until they go off patent and the price drops. Private insurance companies could also use this as a cost control method.

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        • Re: Should the Government Provide Free Universal Health Care for All Americans?

          Originally posted by adaher View Post
          One thing that we have to clear up is why there is health care inflation. It's not that the same things are rising in price. It's not true inflation. It's costs, due to new treatments and drugs which are more expensive than the old. An easy way to solve the health care costs problem, if a little draconian, is for government insurance to simply not cover new products until they go off patent and the price drops. Private insurance companies could also use this as a cost control method.
          Is there some reason you're claiming there's not real inflation? Prices for comparable services have been going up from what I've seen, though I'll admit that's anecdotal. I suspect it's a combination of both real inflation and new treatments - but in both cases rising costs are driven by a lack of demand for lower priced services. If you're insured (and not spending your own money) you'll never have any incentive to look for bargains, or request cheaper old school treatment.

          Are you denying the connection between increases socialization of costs and rising health care prices?
          Last edited by dblack; 01-14-2012, 11:26 PM.

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          • Re: Should the Government Provide Free Universal Health Care for All Americans?

            Originally posted by adaher View Post
            Yes, many are. But we have so much prosperity here that I prefer to focus government health care on the poor rather than trying to throw everyone into the same system.
            I'd be surprised if you really do. I imagine most people who oppose the current social entitlements would throw a fit if I gotten government subsidized health care at that point. After all, I was able bodied (except for the days I was in too much pain to work) and I didn't have children to support. If I'd been receiving any kind of benefit(which I can't since I'm not officially disabled and have no children to support), many on the board would decide I was a lazy no account bum leaching off their hard earned tax money.

            Funny how I'm a hardworking poor person struggling with bad decisions of my youth, but a number of my coworkers (for instance) are lazy no account bums leaching off their hard earned tax money the government sends a little extra money their way to help support their children.

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            • Re: Should the Government Provide Free Universal Health Care for All Americans?

              Originally posted by dblack View Post
              Is there some reason you're claiming there's not real inflation? Prices for comparable services have been going up from what I've seen, though I'll admit that's anecdotal. I suspect it's a combination of both real inflation and new treatments - but in both cases rising costs are driven by a lack of demand for lower priced services. If you're insured (and not spending your own money) you'll never have any incentive to look for bargains, or request cheaper old school treatment.
              Things like doctor fees and hospital beds do go up, but the bulk of health care inflation appears to be new products entering the market, not a rise in prices of the old products.

              Are you denying the connection between increases socialization of costs and rising health care prices?
              Not at all.

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              • Re: Should the Government Provide Free Universal Health Care for All Americans?

                Originally posted by Porras View Post
                I'd be surprised if you really do. I imagine most people who oppose the current social entitlements would throw a fit if I gotten government subsidized health care at that point. After all, I was able bodied (except for the days I was in too much pain to work) and I didn't have children to support. If I'd been receiving any kind of benefit(which I can't since I'm not officially disabled and have no children to support), many on the board would decide I was a lazy no account bum leaching off their hard earned tax money.

                Funny how I'm a hardworking poor person struggling with bad decisions of my youth, but a number of my coworkers (for instance) are lazy no account bums leaching off their hard earned tax money the government sends a little extra money their way to help support their children.
                The majority of entitlements goes to the middle class. If we could cut most of that, we could increase benefits for the poor.

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                • Re: Should the Government Provide Free Universal Health Care for All Americans?

                  Originally posted by adaher View Post
                  The majority of entitlements goes to the middle class. If we could cut most of that, we could increase benefits for the poor.
                  Think about what you're saying...if 'the majority of entitlements goes to the middle class', then we don't really HAVE a middle class, do we? You have hit upon the core concerns of the Occupy Wall Street movement and liberals like myself.

                  There has been the collapse of two radical ideological revolutions in my lifetime...the Bolshevik revolution, and the Reagan revolution. BOTH were huge failures. The Russian people have accepted the truth of their failed ideology. But many in America have not accepted theirs, and have even doubled down on their failed ideology.

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                  • Re: Should the Government Provide Free Universal Health Care for All Americans?

                    Originally posted by Bfgrn View Post
                    Think about what you're saying...if 'the majority of entitlements goes to the middle class', then we don't really HAVE a middle class, do we? You have hit upon the core concerns of the Occupy Wall Street movement and liberals like myself.
                    Social Security and Medicare primarily benefit the middle class. They are only mildly progressive, because what you get is related to how much you made when you were working, in the case of Social Security. There have been proposals to means test Social Security and plug half of the savings into increasing benefits for poor seniors. This has been resisted, of course, because liberals fear turning Social Security into a welfare program. The reason the middle class gets the biggest entitlements is politics.

                    There has been the collapse of two radical ideological revolutions in my lifetime...the Bolshevik revolution, and the Reagan revolution. BOTH were huge failures. The Russian people have accepted the truth of their failed ideology. But many in America have not accepted theirs, and have even doubled down on their failed ideology.
                    That's because no new ideology has arisen to replace the Reagan Revolution. The Reagan Revolution itself replaced the excesses of the liberal ideology. When the left solves the problems inherent in old-style liberalism, they'll have something going. Bill Clinton took a major step in that direction, making government more efficient and getting people off welfare, while reducing crime. Sadly, the left has rejected Clintonism. Maybe 2012 will teach them that they shouldn't have given up on it.

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                    • Re: Should the Government Provide Free Universal Health Care for All Americans?

                      Originally posted by John Drake View Post
                      What serious implications? Assuming the condition doesn't worsen over time then wait time has little import compared to cost, which often determines if there is any treatment of the condition at all.

                      This seems a typical conservative argument, the idea that no treatment at all for most people beats having to wait to see a doctor for those rich few who can afford it, and it seems ridiculous to me.
                      Don't lump me in with conservatives just because today that is the assumption. I've been called liberal as well. (Seriously, I've been called a liberal and conservative in the same day here.) Either way having to label the debate seems to be more important than discussing the issue.

                      It was a realistic question in which I also, in advance, assumed by patient condition may influence the answer. in my opinion a concern worth exploring is the assumption that healthcare for all can be improved even with increased wait times for care. I am not saying it is all one way or the other, but there should be some level of reason when considering the range of healthcare issues to contend with which we are saying would be under government regulation. A consideration should be the system itself being able to handle the level of requests for care. Inevitably that will mean cost, which always seems to make matters worse in terms of government fiscal condition to handle it.

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                      • Re: Should the Government Provide Free Universal Health Care for All Americans?

                        Originally posted by adaher View Post
                        Social Security and Medicare primarily benefit the middle class. They are only mildly progressive, because what you get is related to how much you made when you were working, in the case of Social Security. There have been proposals to means test Social Security and plug half of the savings into increasing benefits for poor seniors. This has been resisted, of course, because liberals fear turning Social Security into a welfare program. The reason the middle class gets the biggest entitlements is politics.
                        Means testing? How many rich people receive social security? It sounds like the typical right wing know nothing solution, like tort reform.


                        On the face of it, it sounds almost progressive. Why should the well-off get the same benefits as everyone else? They don't need them, why shouldn't that money be redistributed to those who need it more?

                        The simplest answer is that it's their money, too. They paid into the system and, in doing so, bought into the same promise as the rest of us. Which gives them the same incentive to support the program as the rest of us. In their 1999 book, Social Security: The Phony Crisis, Dean Baker and Mark Weisbrot address this.

                        The justification for denying benefits to people who have paid taxes into the system is also questionable. We do not deny interest payments to wealthy owners of U.S. Treasury bonds, for example, and it is difficult to see how the payment of Social Security benefits to rich senior citizens is any less appropriate. Indeed, why single out senior citizens as a group for special treatment in this regard? If we think that the rich are getting too much of the economic pie, then they should be taxed more--not just the ones who happen to be over 65.

                        It's important to recognize, though, that there is already a progressive earnings test built into the system, in that higher income retirees pay income tax on a portion of their benefits, and lower-wage earners get a higher return on contributions. In that sense, income fairness exists already in the program.

                        Exchanging that basic fairness for means testing Social Security would take away that "legal, moral, and political right" of all Americans to collect their pensions. It turns Social Security from what is essentially an insurance program into welfare. Which in turn would deeply erode political support for the program. The constituency for any aid program is far less powerful than the constituency for Social Security--the whole of the American workforce, and those with money are the most powerful.

                        There are other, simply practical reasons, to reject the idea of a means test. Primarily, there just aren't enough wealthy seniors to achieve significant savings by reducing their benefits. Use the cut-off level of $250,000 for the definition of wealthy. With roughly two percent of all tax filers in the US claiming that level of income, the percentage of seniors in that bracket is insignificant.

                        In fact, the administrative costs for the Social Security Administration (SSA) in trying to make income determinations, measuring need, and policing the system would be significant--potentially outweighing any savings in benefits.

                        If you make the means testing stringent enough so it applies only to the genuinely well off, it wouldn't hit enough people to matter much. Conversely, if you make the means testing loose enough to matter, it would bite into a lot of ordinary middle class earners, and that's neither fair nor politically feasible.

                        Want some evidence? Well, it turns out that Social Security is already means tested: your benefit level is calculated as 90% of your first $749 in monthly pre-retirement earnings, 32% of earnings up to $4,517, and 15% of your earnings above that. This means that high-income earners get a smaller benefit as a percentage of their income than low earners do.

                        ref. ref.

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                        • Re: Should the Government Provide Free Universal Health Care for All Americans?

                          Originally posted by Rude Boy View Post
                          Yes. A single-payer system would be less expensive and more efficient than the boondoggle we have now, plus everyone would be covered.

                          Single-Payer FAQ | Physicians for a National Health Program
                          You know for a anarchist you sure do want government to give you a lot.

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                          • Re: Should the Government Provide Free Universal Health Care for All Americans?

                            I voted no cause I want good care not Government care.

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                            • Re: Should the Government Provide Free Universal Health Care for All Americans?

                              Problem is, you're going to cut benefits for the rich one way or the other with SS. No one is suggesting raising the payroll tax for working Americans. IN fact, it will be pretty hard to ever return it to 6.2%. That means that either we lift the earnings limit, which means an effective benefit cut for the rich, thus eroding political support, or it gets funded out of general revenues, which means it's no longer a social insurance program, just another welfare program.

                              Either way, the jig is up. Social Security stopped being untouchable some time ago, and it's only going to get more vulnerable as time goes on. While it may not technically be a Ponzi scheme, politically it did rely on the first beneficiaries getting a lot more out than the put in, while later beneficiaries will be forced to pay in more and get less. That will not do much for the political viability of the program.

                              You'd think liberals would have taken better care of their most prized accomplishment.

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                              • Re: Should the Government Provide Free Universal Health Care for All Americans?

                                Originally posted by adaher View Post
                                Problem is, you're going to cut benefits for the rich one way or the other with SS. No one is suggesting raising the payroll tax for working Americans. IN fact, it will be pretty hard to ever return it to 6.2%. That means that either we lift the earnings limit, which means an effective benefit cut for the rich, thus eroding political support, or it gets funded out of general revenues, which means it's no longer a social insurance program, just another welfare program.

                                Either way, the jig is up. Social Security stopped being untouchable some time ago, and it's only going to get more vulnerable as time goes on. While it may not technically be a Ponzi scheme, politically it did rely on the first beneficiaries getting a lot more out than the put in, while later beneficiaries will be forced to pay in more and get less. That will not do much for the political viability of the program.

                                You'd think liberals would have taken better care of their most prized accomplishment.
                                I REALLY hope right wing SOB's run on that shit...I REALLY do. The right has been living in a bubble created by the 2010 elections. But mid term historically have been bad for the party in power. The American people have been watching what's going on in Congress with radical schemes like Paul Ryan's plan to end Medicare, and how teapublicans continue to use insurgency and hostage taking in lieu of compromise. They can clearly see the right's agenda as soon as they gain power in places like Wisconsin, Florida, Ohio, Michigan and New Jersey. Teapublicans are not for less government. They are for a LOT more government dictating and probing into the lives of middle class workers and the poor, and a lot less government for polluters and corporations that swindle the people out of the life savings.

                                In the words of the worst president in our history: "Bring it on!"


                                "Should any political party attempt to abolish social security, unemployment insurance, and eliminate labor laws and farm programs, you would not hear of that party again in our political history."
                                President Dwight D. Eisenhower

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