why are people against socialized medicine?

[disneysteve]

health insurance does not give you healthcare

This is a very important point, and the powers that be are finally starting to realize this. I could give loads of examples, like the insurance company with whom the nearest participating dermatologist is about 70 miles from here. Or the fact that it takes a minimum of 3 months to get an appointment with an endocrinologist under any insurance plan in this area. So having insurance coverage does not guarantee easy and prompt access to care.

The other issue is that there needs to be far greater emphasis on prevention. What we do in this country is disease management, not health care. We wait until someone is sick and then spend boatloads of money to treat them when it would be phenomenally cheaper to prevent the illness in the first place. I've read that 75% of health care spending is to treat chronic, preventable disease and 40% of premature deaths are due to lifestyle choices and preventable diseases.

[Inkstain82]

The U.S. system has some serious issues. I am all for reform.

But I have a few issues with socialized medicine.

ONE - it could end up costing us more in the end. HIGH taxes. As someone said - no one gets a free lunch.

Absolutely. I fully support socialized health care, but anybody who tries to tell you it won't mean raising taxes is lying or delusional. That said, if done right, the cost of health care as a whole for society can go down. I'd rather pay 5% more in taxes and get care than pay 10% of my net income.

TWO - I know WAY too many people in Canada and they are not happy with their healthcare experiences at all. The only good thing they can say about it is that it is "free," but they pay WAY more taxes than I do (back to #1).

I think this is cognitive dissonance. I live close to the border and I support socialized health care. I could pull up a list of people a mile long that love their Canadian system and would never, ever want to live under the American system.

Canadians are just like anyone else: They all disagree on things. I think both sides will find lots of people who agree with them up North.

I read an article a while back that the U.S. system rated about the same as Canada as far as quality. But you know, good luck finding a doctor there in the first place (which is their main issue).

Depends on who does the rankings and what they are ranking.

For high-end care, the U.S. is the undisputed leader.
For ordinary, day to day stuff, the U.S. is middle of the pack.
For breadth of coverage, the U.S. is near the bottom (among comparable countries).

Thirdly, yeah, don't have much faith in the government to make it more efficient.

Funny, I feel the same way about corporate America

[Inkstain82]

MonkeyMama, your post was really insightful, I hadn't even thought about the issue in terms of planned medical visits.

I do have a question that maybe someone can address and help me to understand a bit better. I have been reading in various places that there are less people who are seeking to become full-fledged MDs with the upcoming possible shift toward socialization (as if dealing with managed care isn't nightmare enough). Would it be fair to believe that if we do go to socialized healthcare, then there will be a continuing trend towards less people going into the medical profession to become MDs? Will doctors then be officially considered "government employees"?

It would require positive government action to avoid, yes. You can't expect people to pay hundreds of thousands of dollars in medical tuition for a $30k/year government job.

But there's a problem with the free-market system in this area as well: We have way too many specialists and not nearly enough general practitioners. Canada had the same problem, and through government actions they are bringing the percentage of general practitioners up.

With or without socialized medicine, I firmly believe that government-subsidized medical schools would be one of the most cost-effective options for both bringing up the standard of care and bringing down the costs.

Now as for whether they would be government employees, that would depend on the plan. A lot of what people fearfully call "socialized medicine" isn't that. I can't imagine the U.S. going to an actual socialized medicine plan in the next 20 years, let alone anytime soon.

The most likely endgame is what is called a "single-payer" system. In this system, all the doctors continue working for themselves and hospitals. However, when it is time to bill, there are no insurance companies, only a massive government program.

[tripods68]

Opps...

[tripods68]

The U.S. system has some serious issues. I am all for reform.

But I have a few issues with socialized medicine.

ONE - it could end up costing us more in the end. HIGH taxes. As someone said - no one gets a free lunch.

TWO - I know WAY too many people in Canada and they are not happy with their healthcare experiences at all. The only good thing they can say about it is that it is "free," but they pay WAY more taxes than I do (back to #1).

I read an article a while back that the U.S. system rated about the same as Canada as far as quality. But you know, good luck finding a doctor there in the first place (which is their main issue).

Thirdly, yeah, don't have much faith in the government to make it more efficient.

Your point is well-taken.


The US household spend the highest amongst all industrial nation when it comes to health care spending per household around $7K a year. Yet the US rank 37health care quality behind Morocco as I remember. Yah...that's MOROCCO.

Here's some statistic spent on healtch care as a % of household income (RAND survey).

$20K or Less - 15.5%
$20K - $49K - 7.2%
$50K - $69K - 5.1%
$70K or more - 3.0%

Health Care spending as a % of Income by Age (based 2006 survey RAND)

Under age 35 - 2.7%
Ages 35 - 54 - 3.3%
Ages 55 - 64 - 5.5%
Ages 65 or older - 11.4%

Assuming you have a job with employer that provide health care of course. We consider ourselve lucky. But most Americans cannot afford to buy private insurance coverages or even qualify due to existing health conditions. Most small business owners which make up about 2/3 of this country working population cannot afford health insurance for its employees. That's a problem. We need to provide incentive tax incentives to all business owners.

Majority of working population (about two-third) live under the poverty level if you factor in # of kids per household, credit card debts, personal loans, mortgages, student loans, etc. I haven't even mention illegals aliens and the staggering unemployment in this country 9%. Heck, California alone has 5 million undocumented illegals which by the way the state of have spent 5 billion in insuring. These aren't guys don't even pay taxes yet we spent billions. We have 11.9% in unemployment and a bankrupt state operating in fumes.

The debate should no longer be about socialist medicine. I think we can go behind this arguments and try to solve this problem with real facts and numbers. I voted Republican (McCain and i'm proud to be one) But am for a real Health Care ReFORM.

If we can spend on average $7K yearly on healt care cost, surely we can demand better health care quality without sacrificing "wait time", stiffle competitions without excess taxing.

[feh]

I find it depressing that so many people believe in the Socialism Boogeyman.

[Inkstain82]

I find it depressing that so many people believe in the Socialism Boogeyman.

I really think liberalism and socialism are very emotional, intrinsic qualities.

If the idea of people in bad situations horrifies you, you are a liberal.

If the idea of government control horrifies you, you are a conservative.

[akrogers]

I really think liberalism and socialism are very emotional, intrinsic qualities.

If the idea of people in bad situations horrifies you, you are a liberal.

If the idea of government control horrifies you, you are a conservative.

And if both horrify you, you are a libertarian a la moi

[Inkstain82]

And if both horrify you, you are a libertarian a la moi

Libertarian is a subset of conservatism.

Personally, I'd say that it comes from a fear of reality (in which libertarian ideals are impossible to apply), but then, I'm a government-hugging, lazy, socialistic liberal

[feh]

related article

Not exactly on topic with original post, but was reading this and thought others might find it interesting. It's an analysis of why the public option is having a tough go of it, using hard numbers:

FiveThirtyEight: Politics Done Right: Special Interest Money Means Longer Odds for Public Option

[Goldy1]

Well, what else can I say here? There are so many side topics ie prevention vs disease management, taxes etc.

I was just tihnking about this whole thing lately. I have heard buzz here and there that Obama etc were working on healthcare reform that might include a single payer sstem or SOMETHING.
I have not been following it much b/c I don't like to worry about things.
Then I heard something got shot down in terms of expanding healthcare to low income folks. A quote was that it was going to cover a family of 4 making 30K per year.
If all they are going to do is give more people "medicaid/or whatver the no cost gov healthcare is called" by saying you can make a little more money, what good does that do people who actually work and make more than a little over poverty? I am not for this at all b/c it takes away incentive to earn. I heard a quote about something like if you give man all his basic needs for free, you take away his will to work.
It's a big hairy mess and I guess I will just have to wait and see.

Medicare at 55 sounds great, but it's going broke as it is so I have been expecting it to increase to 70 or 75. lol, and you can plan for it then it changes and it's not there anymore.

anyway there is halp out there. I just found out my local county has a free healthcare program that gives access to dr. visits and rx and urgent care(no hospitalization) and the income requirements are much much more lax than the medicaid type no cost care. This is actually healthcare for people out of private insurance and medicaid anyway apparantly to my surprise.

[Inkstain82]

I am not for this at all b/c it takes away incentive to earn. I heard a quote about something like if you give man all his basic needs for free, you take away his will to work.

Even ignoring the fact that it isn't true (work can be its own reward), it ignores the point.

In a society of well-fed, healthy, well-adjusted individuals, *everybody's* work is more productive and fruitful. The hard-working types actually end up better off in the long run from supporting the (theoretically) non-working types.

[snafu]

There is no 'Free' health care. Everyone is covered and can choose to abuse the system; visit doctors because they crave attention. Canadians complain because the system isn't perfect, doesn't include prescriptions, nor elective procedures like Botox, but no one is denied care, there is no pre-existing condition denial, it is fully portable. Dr. do not need permission to order a medically necessary procedure and are paid, without default, on a fee schedule negotiated and approved by the executive CMA.

Our systems are provincial [state] and while v/similar there are small differences because fees were negotiated and some provinces include procedures that are dispensed in an alternate way. Example: flu shots are covered by Medicare in my province, in others they are free at Clinics offered at shopping centres.

When Medicare was introduced in 1961, modest premiums were charged which quickly became employee benefit, paid by employers. Subsequently provinces rolled those into their sales tax, 1,2,3 cents. My province eliminated premiums two y/o they were $ 48. per month, per family.

Hospitals in Canada are public, not-for-profit, government funded and operated. Patients are unaware of what their stay costs, they are not asked for a dime when they enter nor pay/owe a dime when they leave. There are v/few Private hospitals and they function primarily for elective procedures.

The major issue is hospitals are used as political tools. Government wants to punish a group - they withhold funds; just now they have withdrawn budgeted sums for cataract surgery day beds. It isn't considered life threatening so seniors who have apparently been complaining will have to wait several more weeks for planned, booked day surgery. Of course they can jump the que and pay for it at a private clinic. Hospitals are built to provide jobs or when the economy is booming or to help win an election.
However, anyone needing care for cancer, cardiac, hip/knee replacement and any life threatening problem, goes to the head of the line. For example, when a young mother who would be delivering twins could not be cared for in her small community's hospital, she was medivaced to a near-by American Hospital and we, the taxpayers, picked up the cost of several million dollars for her and babies successful delivery and after care.

Our medical providers are very well trained, we see flocks of them recruited for American Hospitals/Clinics. [I still believe I got better surgical care in a local hospital than my mom did at Mayo Clinic [paid out-of-pocket]. I've worked for the famous Bumrungrad Hospital in Bangkok where the movies stars and celebrities go... they have beautiful decor but medi is about the same]

I tried to check the funding figures but they were evasive. Best I could figure, the federal government pays 32% of the costs of the medicare program, provinces pay 65%, donations/fund raising pays the difference. The federal government increases the tax on gas of which 40 cents per gallon goes to Medicare for distribution [or so the PR suggests].

Yes, we pay much higher income tax, value added tax, and a list of tax that is just too long. In exchange we have a 'Nanny' state, a government that looks after us from cradle to grave. If you saw the benefits handed out to mothers, refugees, immigrants, family reunification, start-up business, environmental commodes, university subsidies, social services, native care, subsidy, care and feeding of homless and so much more...you'd understand why we pay such high taxes. Also we have a gigantic sized country and a tiny population 35 million

[disneysteve]

I heard something got shot down in terms of expanding healthcare to low income folks. A quote was that it was going to cover a family of 4 making 30K per year.

I am not for this at all b/c it takes away incentive to earn.

Even ignoring the fact that it isn't true (work can be its own reward), it ignores the point.

I have patients who are on disability. Many of them could return to gainful employment but if they do, they lose their medical insurance, so they remain on disability. The same thing would happen with expanded Medicaid coverage. That family earning 30K or less gets coverage. If their income climbs to 31K, the coverage disappears. Where is the incentive to move up the ladder in that scenario.

[Inkstain82]

I have patients who are on disability. Many of them could return to gainful employment but if they do, they lose their medical insurance, so they remain on disability. The same thing would happen with expanded Medicaid coverage. That family earning 30K or less gets coverage. If their income climbs to 31K, the coverage disappears. Where is the incentive to move up the ladder in that scenario.

There's a difference between a specific flaw in a specific system and the blanket statement I was responding to.