Don't let anyone tell you that universal health care is "not viable", especially in one of the world's wealthiest countries. Such statements are really just political manoeuvrings of a disreputable kind.
In the UK universal health care has been viable since the NHS was founded over half a century ago. There is always controversy over exactly what services are available where, but at least everyone has access to it.
I'm not sure you're considering all sides to the universal healthcare issues. The United States contributes the most money of any country by far toward medical research (close to 10x of what the UK contributes). The benefit derived from that is that countries like the UK get all the benefits of that expenditure without having to make that expenditure. So what you get is a lopsided benefit in non-US countries. This creates free riding.
So what happens is that as other countries free ride the United State's research, the US would have to not only foot hte bill for research and development (of which it is the biggest contribute in the world), but they would also have the bill for the fruits of that research - ie: the actual healthcare services and machines require to deliver those services. The United States doesn't get to pay a single bill and get great universal health care, it effectively pays twice for care while other countries pay once.
The GDP of the US is about 7x the GDP of the UK. So the UK isn't freeloading.
I'm also willing to bet the UK spends their medical research dollars more efficiently. In the States, big Pharma researches ways to make money. Elsewhere, research is done mostly by universities & hospitals, who are more interested in fame than fortune.
Not only is it free riding because the UK isn't spending a proportional amount of their GDP, but it could also be considered free riding because the quantity of research by the UK isn't the same; size notwithstanding.
But you're next line is absolutely baseless. What makes you think the UK spends their research dollars more efficiently? I'd love to hear even a single reason.
While you're thinking, here are some breakdowns of spending:
US: 70.1% of spending is by private industry, 13.6 academic, 12.2 government.
The problem is that we're in debt, and there's no one to pay for it, especially with the costs of healthcare increasing, rather than decreasing, as they should when technology improves.
I agree, but we're printing money and borrowing from everyone willing to lend us money in order to pay for those expenses. I'm not saying they are necessary, but going 2x further into debt isn't a logical solution.
You are making an assumption that an American national health care system necessarily means that the U.S. would spend more money on health care than it currently does. Do you have evidence for this?
The U.S. spends about 16% GDP on health care and this is, by a large margin, the most spent by any rich nation on health care. I think it is hard to argue that a national health care system for the U.S. must inevitably cost more than what is currently spent in the U.S. for health care when every national health care system in the world costs less than what we currently spend.
well nobody says we have to go 2x in debt to pay for healthcare, we just have to stop spending cash on nation building and we'll have enough for ourselves. Of course this probably means less money "defending the border" and keeping the country safe from terrorists, but at least we'll be able to feed ourselves.
We do spend more on healthcare than any other country, it's just that we also have more lawsuits than any other country -- it's what keeps costs high unfortunately. If we weren't allowed to sue doctors, we could probably have cheaper healthcare.
My grandmother died due to improper surgery procedures in canada but we couldn't bring a suit against the doctor. I'm sure if she died in the USA under the same circumstances, we would be able to successfully sue the hospital for negligence.
In rich countries, for the most part, everyone has access to food. Most don't have the means to buy expensive caviar though. In countries with national health care systems everyone has access to basic care. Not all high tech services are available to everyone though.
I think the point is that everyone gets 85% of what they would hope for from a health service, as opposed to a system where only 85% of people have any health service at all.
There's controversy for grey areas, like what kind of aesthetic surgery is to be subsidised. Everyone gets necessary treatment, always, as is normal in a civilised country.
Another interpretation: Prison inmates have an easier life than the poor and free.
Of course, the potential for violence from other inmates is always there, but I suspect that is not a serious problem in most prisons. And the potential for violence from a random citizen in the street is relatively high in poorer areas.
Overall, prison may be a better alternative to severe urban poverty. This may be another reason why the poor are much more likely to face incarceration. Not only does their plight cause them to suffer a lack of alternatives, but the punishment for crime doesn't look so bad to them.
Using data from the U.S. Bureau of Justice Statistics and Census Bureau, I estimate death rates of working-age prisoners and nonprisoners by sex and race. Incarceration was more detrimental to females in comparison to their male counterparts in the period covered by this study. White male prisoners had higher death rates than white males who were not in prison. Black male prisoners, however, consistently exhibited lower death rates than black male nonprisoners did.
Having provided health care in an incarceration setting, I don't think that was the right conclusion to draw. The article notes this man had never been incarcerated before. I imagine that his ignorance of incarcerated life may have been a factor.
I met only a tiny handful of people who told me they preferred life in incarceration to poverty (though, of course, that was not pleasant either).
What I find almost more scary is that instead of anybody in the system using a little common sense and human decency when processing this guy, they right away threw him in jail. Couldn't the police have, when they found him in the bank, seen his situation and tried to resolve things on a human level instead immediately calling down the full force of the system and throwing him in jail and before a judge for what is clearly more of a desperate cry for help than a crime?
A crime is a crime, but we're all people too. Sometimes doing everything precisely by the book isn't what's appropriate, and a little common sense and understanding is called for instead.
I hate the criminalization of everything in America almost as much as I hate our backwards healthcare system.
Edit: unless even the police thought they were doing the humane and common-sense thing by putting him in jail to get health care--in which case I don't know what to do but hang my head.
What you are suggesting is exactly the circumvention of a system designed to take into account mitigating factors (this is why there is a mitigation section of sentencing).
You suggest that the responding officers at the scene of a crime (no matter that yes, this was not a violent crime or one committed with malice) become the judge.
That's an incredibly slippery slope.
And in this case, whats the officer to do? He can't just magically arrange free or reduced cost medical treatment for the man he was just called to arrest for attempting to rob a bank.
Except he won't get medical attention in a city/county jail until he is near comatose.
Maybe in federal prison he would only get the bare necessities and certainly not anything serious to deal with pain.
Plus as a felon you just gave up a whole bunch of rights you took for granted.
It's far from ideal but if he was willing to go this far he should have sought a city with a medical college and teaching hospital. There would still be a bunch of hassle and compromise but it has to be better than being at the mercy of the city/state's apathy while you are locked in a 6x8 cell.
I cannot believe we are nearly three years into the big insurance reform (remember when it was going to be healthcare reform?) and yet the changes are meaningless for most people. I think we need to keep changing "leadership" every election year until the politicians get the point.
This isn't a particularly new idea - the term 'three hots and a cot' goes back a long time. I've heard that a lot of the homeless people here in Boston commit petty crimes to deliberately get caught to escape the cold outdoors during the winter, or to receive dental care (although I should mention that I have not personally confirmed this). This is also mentioned, though without citation, in the Wikipedia article on homelessness: https://secure.wikimedia.org/wikipedia/en/wiki/Homelessness#...
I have heard of that as well. Many have gotten "good" and they know based on their prior convictions, just the type of crime to commit to get into prison for a the winter then get released.
There's a great documentary about this phenomena in Montreal, in winter a bum pretty much can't get arrested, if you do you'll be released almost immediately, but in summer you'll get 3 months for holding a cup out for change.
I'd like to believe that this would be a great protest gesture for the increasingly strained middle and working classes. It would garner a great deal of attention and the narrative is powerful: It is easier to receive medical attention as a prisoner than as a honest hard working blue-collar/service industry worker.
Well, that was dumb. Hospitals will treat people who are unable to pay. The hospital will arrange either lowering your bill or getting a charitable organization to help. When you have absolutely nothing left to lose, there is also always bankruptcy. Since he sold every last thing, that would have been a similar fate.
The people that really get screwed are those who have enough that they don't qualify for assistance, but still have some to lose in bankruptcy. This man could have found many other avenues.
Hospitals will usually only treat uninsured who walk into the emergency room with an immediate life threatening condition.
You cannot for example walk in with cancer and demand treatment.
In the USA you cannot walk into a hospital and ask to see a doctor without insurance or some other way to pay right then, unless you find a private doctor who is willing to negotiate with you on payments (but without credit or being able to prove any income, good luck with that).
Even state assistance programs right now are so badly defunded that they will usually only help people who already have a disability status, being below the poverty level is not enough of a qualifier.
Very related: remember that unemployment numbers are a huge lie because the government doesn't count people who no longer qualify because their time was up. There are a massive number of people in a really bad situation right now.
In fact having SOME income puts you in a worse situation in the USA than having no income. But even no income without a disability right now just makes you part of the crowd and you'll rarely get help.
The thrust of what you are saying is true, but it's not quite as bad as you make it out to be.
Last summer my girlfriend was between jobs. She had a non-life threatening but potentially dangerous condition. She went to the hospital and was treated. During the period of time between jobs she had purchased a temporary health insurance policy. That policy declined to pay for the treatment. The hospital presented us with a couple of options, renegotiate the bill, accept some charity, etc. We chose to fight the insurance company and ultimately had them pay it (because it was a valid claim). But one of our options always hovering around was bankruptcy. Do you want to do that? Of course not. We would have rather cleaned out our savings and maxed out the credit cards before doing that, but it was an option.
So there is an obvious path here, get a temporary policy and use the card to get into the hospital. You will probably get denied by the insurance company for a pre-existing condition, but you can then declare bankruptcy.
Now, that is a pretty terrible way to go about it and speaks of how screwed our system is. But I would say bankruptcy is preferable to prison. And since there is that path available, I would think that this guy is mostly an activist. I think he is making a good point (about how prisoners have a right to healthcare, but not the rest of us), but the problem is that it is too easy to punch a hole in his story. Critics will focus on him instead of the underlying message.
Every health care system must ration care. There are not enough doctors, nurses, drugs, equipment, money, etc. in order to provide everyone with the best possible care in every situation. The question becomes how to best ration care. What is the most equitable way of providing health care to the populace?
I submit that the U.S. has one of the worst methods of rationing health care. It is also the most expensive in terms of cost as a percent of GDP. What has been labeled "Obamacare" in the United States was, for the most part, insurance reform. It will turn a very bad system into a bad system.
Going to prison, despite popular belief, is not a way to get good health care. The idea that prisoners watch cable TV, have great health care, and are well fed in the U.S. is mostly myth. The strategy of robbing a bank to get health care is not a good one.
I don't want to debate this very much, but I felt I should share my opinion/experience:
I'm in Canada. My dad waited 4 months to be contacted, in order to book an appointment for a knee surgery that he drastically needs. After those four months, I flipped and asked a friend for a favor.
I also thought I had an ear problem. I waited 6 months before someone called me to book an appointment to get it checked out.
When I went to the emergency room with a 41 degree (C) fever, I waited 4 hours before someone gave me acetaminophen and told me to wait longer.
Yes, with universal health care, I'm able to gain access to all of this. Yet, how effective is it? I'm sure everyone has a different experience, but there are many people who have had similar experiences to me.
As a senior in college under my parent's military health insurance plan, I had to wait three months to get knee reconstruction surgery.
As a working adult under my company's private health insurance plan, I had a severe ear problem - the earliest I could get an appointment was a month, at which point the doctor thought it might be a tumor, but the earliest I could get an MRI was another two months later (luckily someone who had a midnight appointment canceled a couple of weeks later. I got a phone call at 10pm telling me that if I could get to the hospital by midnight they would fit me in, and they did. Thankfully the MRI was negative).
I've been to the emergency room several times for myself and others. The minimum wait was 3 hours, the maximum was closer to 8.
In several of healthcare experiences, I've been directly billed for services that should have been covered by the healthcare provider, leading to a couple of months of fighting with the hospital and the provider (complete with account turned over to collections, etc).
IOW, your experience with universal health care service seems similar to mine under privately sponsored programs, only you didn't have to worry about having to pay for the services.
I have a relatively good PPO plan through my US employer. I pay out $300 a month in insurance fees, and in addition I presume my employer pays out a couple times that. But, it still takes me a couple of months to get in for a doctor's visit and $30 for a 7 minute visit. You're not alone. Sure, I always have the $75 hospital option, but the hospitals largely are specialized for ER trauma.
The economics of health care is all backwards. It's an economics problem.
Why are you going to your family doctor's office for a quick visit? Whenever I need something simple - check for strep throat, ear ache, potential broken bone - I find a nearby clinic, and they usually see me within a few hours.
In Dallas it was even easier - CareNow had a web check-in form, so they'd call you 30 minutes before your time and you show up and usually wait no more than 10 minutes before a doctor pokes and prods you.
My own experience as an American in London was euphoric. After abandoning a flight home do to illness, I checked into a hotel and asked the concierge to recommend a medical center. What a surprise when she said she would call a doctor to my room. Even better, the doctor provided me with medication on the spot. Still better, I wasn't charged.
I am unsure of how your healthcare system works. Is it possible to pay for more timely service from a private hospital or private doctor?
If it is possible but not feasible because of cost, then an American, speaking practically, experiences the same thing. Not enough money to pay for medical service. However there is an important difference.
An American must pay something out of pocket. The financial burden may lead to bankruptcy and ultimately no medical care at all. I've noticed that you did not raise concerns about bankruptcy but instead your concern was over slow medical service.
You cannot pay to "jump the queue" in Canada if the health care procedure is covered by public health insurance which includes most things you'd expect a doctor to do or prescribe.
You can only pay to jump the queue by leaving the country, such as going to the United States or India for medical treatment.
It's different in new Zealand. If you don't like the waiting list you can have private insuanace or pay yourself for a private hospital. We did this when my wife had a melanoma. Waiting list was 3 months (non urgent) so we went private. It cost $4000 (operating room, surgeon, nurses etc).
Here is how to get medical treatment in Canada, you move to a major city with a teaching hospital, for instance, Vancouver/UBC.
Look at the various medical boards and find out who is on those boards, when you get referred to a specialist insist on finding someone either on the board or connected to the board. Get those people to put you on the list, and constantly complain to them, they will get you moved up.
My personal experience is with my friend who wanted a nose job because his nose had been broken a few times, he happened to get a connected doctor and had a nose job within a week, his doctor relayed the aforementioned. My other experience is with heart surgery, my mother-in-law was having heart complications, in the suburbs they sent her home with nitro, and told her to come back in a week for some test. She lives in a retirement community so they have poor resources and lots of people needing those resources, especially for heart failure. She was still having pains so I insisted we take her to VGH, at VGH they took it very seriously, we got there about 11 PM and by 4 AM on a Saturday they had done a triple bypass with a surgeon who needed to be called in.
Morale of the story, in Canada you need to be near well funded hospitals with out a lot of old people around, or have connections. If you have a lot of people drawing on a limited resource you'll have to wait a long time in line.
That has nothing to do with Universal Healthcare, and has everything to do with the fact that there are not enough doctors. Which is unrelated to Universal Healthcare -- just look at a country like Austria, which has very good social insurance, and absolutely tons of doctors.
Here, the education to become a doctor is free, and there are lots of (free) childcare services available to average people. So a person need only have enough money to survive, and need not pay for school or babysitting above the age of about 3, and graduate a medical doctor without debt.
That is how my mother-in-law, who grew up rather poor, became a neurologist after she had her unplanned baby (my husband).
Beyond that we (North American) have rules betters suited for an abundance of medial personnel, rather than a shortage: You need a regular doctor visit to renew benign drugs like Ventolin or Insulin, we have nurses cleaning up vomit instead of janitors, and licensed dental hygienists are not allowed to clean teeth unless they have a dentist on site [1]. Which would be fine, if we had doctor, nurse and dentists to spare, but they seem like comparatively easy things to fix if there's a shortage.
And following this, remember what we read about here in Michigan about a school superintendent asking our governor to turn the city's schools into penitentiaries.
If we spent half as much on our children or on public health care than we do on the massive prison population we have in this country, I bet we would still be #1 in the world in nigh everything. The American mindset of "here and now, what's the 'future'?" is going to destroy us.
The NHS in the UK was designed to be a healthcare system free at the point of delivery. It has become such a part of British life that I would say it is now part of British culture. However, it has grown into something that cannot be sustained in the long term and now people cannot imagine ever paying for healthcare. I am now living in the US and have very good insurance and have access to far superior facilities when I was in the UK, but if I had to choose between the 2 systems I would choose the NHS every time. Access to basic healthcare should not be a privilege, but a right. I know the costs may seem prohibitive, but how can anyone justify not providing it whilst spending billions on defense? Surely spending money to save lives is better than spending money to take them.
You drastically overestimate the quality of the "medical care" inmates receive. Just last month, for example, the SCOTUS held that California must reduce its prison population by 33,000 inmates because of the inability to provide them adequate medical care. In fact, in its ruling, it said the system produced, "needless suffering and death."[1]
Americans are woefully under- or misinformed about the state of the U.S. prison system. Going to prison is hardly, "medical security." In fact, according to some sources, it accelerates the aging process, thereby increasing the need for the very medical services that, by their absence, aid along this accelerated aging process.[2]
Hyperbole such as that found in the parent post is not only totally useless, it actually does harm to both sides of the argument.
I don't believe universal health care is a viable long term solution. However, this is a man who put 20 years of work and taxes into the system and never got to use what he put in.
Alternatively, someone who has never had a job in his life and who doesn't mind living off the system enjoys the full benefits that this man paid for. Health care, food, and housing.
It's quite viable in my country, The Netherlands. Sure we pay high taxes, but we aren't left on the street like dogs when life fucks us over. There are other disadvantages to our system of course, like the parasitic behavior you described.
The Netherlands also didn't have the HUGE healthcare cartel to contend with when their system was implemented. In the US, insurance has allowed healthcare providers to charge enormous fees because they knew it would be covered. US healthcare is among the most expensive in the world, and it's not because of superior quality. Now that many people would like to change this, it's almost too late.
To clarify: I didn't mean to say that I have a strong ethical preference for universal health care. [0] What I wanted to say, is that for some things, e.g. emergency care, most societies will have rules to require universality. And if we go from there, paying for prevention often comes cheaper than waiting for the emergencies.
[0] I might have one, but it's doesn't matter for the argument. I'm also in favour of independent `death panels', that apply cost-benefit analysis to decide where to spend finite resources of society-provided universal health care.
Personally I think that universal health care is undesirable for ethical reasons. How are we supposed to evolve if we don't let our species' least capable members get weeded out by natural selection?
There's nothing "ethical" about allowing folks who can't pay for their own health care to get it at someone else's expense.
Personally I think that universal health care is undesirable for ethical reasons. How are we supposed to evolve if we don't let our species' least capable members get weeded out by natural selection?
I'm a big Nietzsche fan, but that my friend, is fucking disgusting.
You're equating the value of a person with their ability to game our society's system of making money. By your logic, we should be rushing to ensure that lottery winners in trailer parks are provided the best medical care while starving PhD students are left to die.
Natural selection is has done great things for life on our planet but it doesn't apply here.
If an individual has otherwise flourished in a society to the point where they can afford to have other members of a society provide them those services, then they are (despite medical appearances) apparently fairly well adapted.
The issues arise when they are not using their money to give themselves these advantages. (Perhaps it is inherited money, or perhaps it is provided by the society itself).
Believe it or not, we actually spend more government money on healthcare than most countries where universal care is offered [1]. And still have all these uninsured.
That's without even including the absurd amounts of private money. Just the government layouts, which don't cover close to everyone. Let that sink in.
Disclaimer: I believe the "healthcare system" in America is flawed and should be changed.
However, this is a man who put 20 years of work and taxes into the system and never got to use what he put in.
Let's think about this for a minute. When you say "put 20 years of work ... into the system" what do you mean? Was he not adequately compensated for the work he did? Is free healthcare in perpetuity assumed to be part of compensation for work that you do? Should it be?
As far as taxes, the article says he "looked into filing for disability. He applied for early Social Security." but only qualified for food stamps. I find that portion of the article to be either misleading or not complete - it doesn't say whether he actually applied for disability, or say anything about applying for the food stamps. The earliest you're eligible to receive SS benefits is age 62, so I'm not sure why (or how) a 59 year old would apply for early benefits.
Regardless, the "system" is indeed broken. However, I don't think the path to fixing it includes emotion-filled appeals about how many years of work someone has "put into the system".
If tax is for anything it ought to be to help the less fortune in society. Once you start discriminating on who is the most deserving of basic medical society you have to start questioning the society you live in.
The state funding some basic form of healthcare for all is civilizing, and has other benefits. Healthcare is not an incentive to do well: it does not work as an incentive at all. Those who want better healthcare pay for it even in countries where there is a basic provision.
It's perfectly possible for state healthcare provision to co-exist with private healthcare providers too.
I think the big reason universal health care isn't viable in the US is because of the system we already have in place. Big insurance and high-cost health care are firmly entrenched, and it would take an act of god to change this without upsetting the entire economic apple cart. I'm not really sure what the answer is at this point, but I agree with you when you say it's not a viable long term solution.
Firstly, you're addressing a different question than everyone else (even though I agree it's the right question), because you're talking about political viability whereas most people get stuck arguing about economic viability.
Second, there are a whole bunch of pieces to the system that keeps this in place. Relationships between lobbyists and government. Campaign financing regulations. Gerrymandering. SCOTUS interpretation of the commerce clause. If you started fixing a few pieces like those ... one at a time over decades ... you could change a lot of things.
Universal, socialized healthcare is here now, in the US. It exists fully and completely.
The middle class ignores free clinics and medicare facilities unless they become destitute or desperate.
The infrastructure is here, now. This overt dissonance will end eventually, and the US will catch up to the standard quality of life other first world nations enjoy. I hope it happens in my lifetime.
Are you talking about Medicare or Medicaid (ie, single-payer insurance) or Veteran's Administration (ie, government-run healthcare)?
Both are fiscally solid for decades, and yet are under attack by those who would profit from their demise.
Not only are we not getting closer to universal health care (or even insurance) but recent news indicates there is majority political support (note: not the majority of public) for some form of medicare/medicaid reduction.
Canada has been borrowing money for healthcare for a few years. A 30% increase in cost is slated for the next 5 years. I have NO idea how it's going to be paid for.
Um, no -- Canada has been borrowing to offset a shortfall in general revenue for years. We were under an austerity program when we needed to be, but rather than going back to normal business when the deficit crisis passed, we inexplicably decided to lower taxes and return to a deficit condition. Health care isn't the problem; the idea that we can get services (of any kind -- health care isn't all that the government provides) without paying for them is.
I'm not asking for any services. They're being shoved down my throat, whether I like it or not. I'd gladly pay for alternative providers if I had the ability.
If people don't want higher taxes, then reduce services. It's simple, but not politically viable.
Don't say that you should raise taxes just because there is a revenue shortfall. That only encourages the bastards.
Edit: It's not inexplicable to lower taxes. The average tax rate in Canada is 40% including all taxes. That is insane.
On-Topic: Anything that good hackers would find interesting. That includes more than hacking and startups. If you had to reduce it to a sentence, the answer might be: anything that gratifies one's intellectual curiosity.
Off-Topic: Most stories about politics, or crime, or sports, unless they're evidence of some interesting new phenomenon.
Please avoid introducing classic flamewar topics unless you have something genuinely new to say about them.
Would you not describe someone willfully and knowingly committing a felony, simply because it's the best alternative he can see to obtain the health care he needs as an "interesting new phenomenon"? (NB: I'm not saying it is the best alternative; just that it's clearly the best one this guy thought was available to him.)
In the UK universal health care has been viable since the NHS was founded over half a century ago. There is always controversy over exactly what services are available where, but at least everyone has access to it.