Healthcare in the US is a privilege

[forkup]

If you pass socialized medicine, it will be in jeopardy every time someone like Trump is elected. It's stunning how obtuse you're being about this.

I'm not being obtuse. What I am is confused. Since all these remarks show YOU not Trump having a problem with socialized healthcare completely loose from how Trump would abuse a system.

The system is broken, but it has nothing to do with the free market. It's broken because we're over-insured

The free market isn't the problem. The lack of one is the problem.

Those are countries that lean more socialist than the US and I wouldn't want to live in them.

I don't care how much money they save on health care.

Yet here you are saying this.

That's my point. And it simply can't find purchase in your brain. If you pass socialized medicine, it will be in jeopardy every time someone like Trump is elected.

Acknowledging that Trump also doesn't want socialized medicine and therefor you shouldn't do it although here you say this.

Trump has no genuine interest in getting government out of health care. He hasn't even tried. He could have repealed ACA, but he didn't.

Let's just forget the fact that I know he tried in his first term and was only stopped because John McCain wouldn't let him.


If you can't hold an internal consistent position for yourself or give a consistent position of other people. You shouldn't find it weird that people can't follow your logic. Since that logic is... lacking

 

[dblack]

I'm not being obtuse. What I am is confused.

I can see that. I'll try to explain. Again.

The problem with putting important services, like health care, under the control of government is that the government won't always do what you want. This is especially true when the political landscape is volatile and bitterly divided. I'm bringing up Trump and DOGE because it's the perfect example of what I'm talking about.

Let's say Biden had somehow managed to get single payer passed in his term. What do you think would be happening to it now? What sort of destructive things would Trump and Musk be doing to undermine it? With the way our two-party system works (or rather doesn't), if we socialize healthcare, we'll be looking at such a scenario every election. It will become a political football that both parties will use to "scare the seniors" - and everyone else.

Since all these remarks show YOU not Trump having a problem with socialized healthcare completely loose from how Trump would abuse a system.

I'm not sure what this means. But you seem fixated on the idea that I agree with Trump, so let me clear some things up. Trump is not a libertarian. He doesn't care about Constitutionally limited government. He doesn't want to get the government out of health care, despite whatever nonsense might come out of his mouth. He just wants to control health care his way - whatever that might turn out to be.

My political views have evolved somewhat in the last ten years. I've learned a much greater appreciation for consensus and stability. Regardless of your political ideology, it simply does no good to foist major changes on society via a narrow, party-line vote. All that does is leave half the country angry and spoiling for revenge.

The thing I've been trying to get you to consider is how socialized medicine will pan out when it is confronted with the "culture wars". If the government controls healthcare, and conservatives take over, how will that impact the trans community? Don't you think there's a good chance that a conservative leader will do what they can to ensure that taxpayer money isn't supporting their "evil lifestyle choices"? That's just one example, but there's an endless list of ways politicians will use government control of healthcare to manipulate society. Will smokers get health care? Will abortions be covered? Will fat people face a surcharge on their healthcare? What about people who engage in dangerous sports? Will they be covered?

If you can't hold an internal consistent position for yourself or give a consistent position of other people. You shouldn't find it weird that people can't follow your logic. Since that logic is... lacking

My position is internally consistent: it's dangerous to put all our eggs in one (government forced) basket regarding healthcare. It makes health care a political concern rather than a personal decision.

 

[forkup]

My position is internally consistent: it's dangerous to put all our eggs in one (government forced) basket regarding healthcare. It makes health care a political concern rather than a personal decision.

Let me ask you this then. By what mechanism do you figure healthcare would work better under your preferred system?

Just to focus the conversation.

 

[dblack]

Let me ask you this then. By what mechanism do you figure healthcare would work better under your preferred system?

I don't have a preferred "system". I don't think there should be any mandated "system". People should be free to manage their health care however they like.

 

[forkup]

I don't have a preferred "system". I don't think there should be any mandated "system". People should be free to manage their health care however they like.

Isn't that exactly how it is now? What's mandated in the US atm?

 

[dblack]

Isn't that exactly how it is now?

Not at all, no.

What's mandated in the US atm?

Well, health insurance, for one. Thanks to ACA, we're required to buy health insurance from government approved vendors. And the options are limited because the dominant players in the insurance industry have regulated away alternatives. The doctors we are allowed to see are also regulated by the state, regulation controlled almost exclusively by the AMA. In addition, tax policies (by treating health insurance as a tax exempt "benefit") have pushed most of us into dependency on an employer for health insurance.

If you're asking how I'd address the health care situation, if I were the President, the first thing I'd do is work to repeal ACA. It was never anything other than a bailout for the insurance industry. Next, I'd eliminate the tax exemption for employer provided insurance. Then I'd lead an initiative to bust up the state regulatory fiefdoms that insurance companies have created for themselves. But I wouldn't do any of these things via EOs or a slim partisan vote. If I couldn't convincingly make the case for my policies, if there's not at least some consensus, the effort would be pointless.

 

[forkup]

Well, health insurance, for one. Thanks to ACA, we're required to buy health insurance from government approved vendors. And the options are limited because the dominant players in the insurance industry have regulated away alternatives. The doctors we are allowed to see are also regulated by the state, regulation controlled almost exclusively by the AMA. In addition, tax policies (by treating health insurance as a tax exempt "benefit") have push most of us into dependency on an employer for health insurance.

Isn't ACA something you have to enroll in? In fact, the whole mandatory bit was struck down. You didn't know that, or are you just counting on me being ignorant?

What do you suggest you do with the MANY, MANY, MANY people who can't afford to pay for care?

Anecdote time. My brother-in-law was in a hit and run when he was in his late twenties. He had a shattered shoulder. Since he needed surgery, and he wasn't insured (pre-ACA) all the ER did was stabilize the shoulder and put him on his merry way. He's been on disability ever since.

He's just shit out of luck or what?

Very few people get through life without any major health issues. Health issues that take A LOT of money to fix.

If you're asking how I'd address the health care situation, if I were the President, the first thing I'd do is work to repeal ACA. It was never anything other than a bailout for the insurance industry. Next, I'd eliminate the tax exemption for employer provided insurance. Then I'd lead an initiative to bust up the state regulatory fiefdoms that insurance companies have created for themselves. But I wouldn't do any of these things via EOs or a slim partisan vote. If I couldn't convincingly make the case for my policies, if there's not at least some consensus, the effort would be pointless.

So again. You get rid of the ability to afford health insurance now what? What mechanism brings prices down after you done all that?

 

[dblack]

Isn't ACA something you have to enroll in? In fact, the whole mandatory bit was struck down. You didn't know that, or are you just counting on me being ignorant?

I may be assuming your ignorance, but the mandate still exists. Trump just tweaked the penalty, which can easily be put back in place of the insurance companies need it. Most importantly, all the regulations on insurance banning alternatives are still on the books - both at the state level and, since ACA, the national level.

What do you suggest you do with the MANY, MANY, MANY people who can't afford to pay for care?

In the long term, nothing. The entire point is to get people paying for most of their health care, most of the time, out of pocket.

in the short term, we could look at expand the medical safety net for the poor. But it should have aggressive sunset provisions

Anecdote time. My brother-in-law was in a hit and run when he was in his late twenties. He had a shattered shoulder. Since he needed surgery, and he wasn't insured (pre-ACA) all the ER did was stabilize the shoulder and put him on his merry way. He's been on disability ever since.

He's just shit out of luck or what?

Very few people get through life without any major health issues. Health issues that take A LOT of money to fix.

Insurance can be used sanely. As a backstop for unexpected catastrophes, it make sense. But we're trying to use insurance to finance basic health care. That doesn't work.

So again. You get rid of the ability to afford health insurance now what? What mechanism brings prices down after you done all that?

Consumers who demand lower cost health care.

One of Trump's token initiatives on health care is a mandate for "price transparency" in health care. But it's a pointless endeavor because virtually no one cares how much their health care costs. Because virtually no one is paying for their own health care. We've been so fixated on the fantasy that we can get everyone else to pay for our health care that we have a system where the consumers are motivated to blow as much on "covered" services as they can manage. If someone else is picking up the tab, why not get the best?

 

[MarathonMike]

The only country in the world with the bulk of private healthcare is the US. A search, AI says -

While many countries have healthcare systems with both public and private components, the United States is the only OECD country where voluntary health insurance is the main financing and coverage system for most of the population.

Healthcare is the US is a privilege, we enjoy healthcare as a RIGHT in the UK.

View attachment 1093752

How bad is that? Worse than most third world countries. And no, everyone doesn't fly to the US for healthcare, that's a fallacy.

Why is healthcare in the US so bad??

I love it when foreigners try to tell me what my country is like based on watching a few minutes of CNN. I've had fantastic healthcare my entire life, same PCP for 30 years.

 

[BrokeLoser]

Most paycheck to paycheck earners could never save enough for healthcare and retirement and have enough left to afford living. That's a problem. Wages today are woefully inadequate for the vast majority of hard working people to pull it off.

We should fix the problem by having Zincwarrior recruit 50 million desperate thirdworlders to work for slave wages.

 

[Andrew_Jackson_FTW]

The only country in the world with the bulk of private healthcare is the US. A search, AI says -

While many countries have healthcare systems with both public and private components, the United States is the only OECD country where voluntary health insurance is the main financing and coverage system for most of the population.

Healthcare is the US is a privilege, we enjoy healthcare as a RIGHT in the UK.

View attachment 1093752

How bad is that? Worse than most third world countries. And no, everyone doesn't fly to the US for healthcare, that's a fallacy.

Why is healthcare in the US so bad??

I think we have some of the greatest physicians, but a system with too many faults.

 

[Ringo]

FEE-FOR-SERVICE MEDICINE IS A CRIME FROM THE START.
If medicine is paid for, it is a business. If it is a business, it is profit making. Profit can only be made from the sick. So businessmen from medicine will be interested in sick population ....

 

[forkup]

I may be assuming your ignorance, but the mandate still exists.

Does it? Over 24 Million Consumers Selected Affordable Health Coverage in ACA Marketplace for 2025 | CMS

I think more than 24 million people are insured. In fact.

U.S. Uninsured Rate Drops by 26% Since 2019

National Center for Health Statistics

www.cdc.gov

25 million didn't have any insurance, including 2,8 million children. How can that be if health insurance is mandated?

In the long term, nothing. The entire point is to get people paying for most of their health care, most of the time, out of pocket.

Yes, because most people have tens if not hundreds of thousands of dollars laying around.

That's the point. You seem comfortable with the idea that a sizable part of the population won't get any, let alone quality care.

But we're trying to use insurance to finance basic health care. That doesn't work.

It does all over the world. By MAKING everyone have insurance. And by forcing the healthcare providers to actively try to keep it affordable. And what is basic care to you. Is it the stabilizing of the shoulder of my brother-in law? Getting a flu shot? Getting insulin for your diabetes? The surgery required after a heart attack.

What would you like to see covered out of pocket?

Consumers who demand lower cost health care.

That's not how a for profit-system works. I can demand all I want. In the end the producers will charge the maximum price they think they can get away regardless of the consumers wishes.

Let me ask you a question. You have children you said. What would you be willing to pay to keep them free from pain? Free from disease? I'm guessing quite a lot. I'm guessing so much in fact that you'd be willing to forego quite a lot of luxury. The health industry knows this. They don't care if some people can't pay the price they set period. As long as those that can bring in more profit.

This is played out in stuff like insulin prices. It's played out in how the US healthcare industry treats people for certain things compared to the rest of the world.

 

[dblack]

Does it? Over 24 Million Consumers Selected Affordable Health Coverage in ACA Marketplace for 2025 | CMS

I think more than 24 million people are insured. In fact.

U.S. Uninsured Rate Drops by 26% Since 2019

National Center for Health Statistics

www.cdc.gov

25 million didn't have any insurance, including 2,8 million children. How can that be if health insurance is mandated?

Yes, because most people have tens if not hundreds of thousands of dollars laying around.

No, because prices will come down when we're paying for our own health care.

That's the point. You seem comfortable with the idea that a sizable part of the population won't get any, let alone quality care.

No, it will be a difficult transition. But I don't think that people are hapless idiots. We'll figure it out. We won't just wallow in the muck until we starve to death.

It does all over the world. By MAKING everyone have insurance. And by forcing the healthcare providers to actively try to keep it affordable.

LOL - exactly. What you're talking about isn't insurance. It's a social safety net that you have to force people into. Insurance is a hedge against risk that people buy voluntarily.

And what is basic care to you. Is it the stabilizing of the shoulder of my brother-in law? Getting a flu shot? Getting insulin for your diabetes? The surgery required after a heart attack.

That's the question alright. That's why whenever someone tries to claim that basic healthcare is a "right", I always ask "how much health care"?? It's entirely subjective. They never answer.

What would you like to see covered out of pocket?

I'm not sure what "covered out of pocket" is supposed to mean. "Out of pocket" generally means it's NOT covered.

But anyway, the only sane way to use health insurance is as a hedge against unexpected risk. "Catastrophic" insurance. Otherwise, it's just an expensive credit card. Can you imagine if we played this same game with any of our other necessities? What do you think would happen to grocery prices if we tried to feed ourselves with "grocery insurance"? <- here's betting you ignore this question.

That's not how a for profit-system works. I can demand all I want. In the end the producers will charge the maximum price they think they can get away regardless of the consumers wishes.

LOL - no, that's not how a for-profit system works. Take an economics course. Open up a lemonade stand. Charge whatever you think you can get away with. If no one buys your crap, you're out of luck.

Let me ask you a question. You have children you said. What would you be willing to pay to keep them free from pain? Free from disease? I'm guessing quite a lot. I'm guessing so much in fact that you'd be willing to forego quite a lot of luxury. The health industry knows this. They don't care if some people can't pay the price they set period. As long as those that can bring in more profit.

Sigh. You really do need to take an economics course. Or at least think about it a bit. You can set prices as high as you like, but if no one buys your crap, if no one can afford it, you won't make any money. The only way you can generate "sales" for overpriced goods is to enlist the government to get paid, to regulate the market to ban cheaper alternatives, or otherwise tap into the tax funnel. This is what's going on now. This is what needs to change.

 

[dblack]

FEE-FOR-SERVICE MEDICINE IS A CRIME FROM THE START.
If medicine is paid for, it is a business. If it is a business, it is profit making. Profit can only be made from the sick. So businessmen from medicine will be interested in sick population

Now you're talking. We should lock up all the doctors. That'll fix it.

 

[PeterPilot]

I can see that. I'll try to explain. Again.

The problem with putting important services, like health care, under the control of government is that the government won't always do what you want. This is especially true when the political landscape is volatile and bitterly divided. I'm bringing up Trump and DOGE because it's the perfect example of what I'm talking about.

Let's say Biden had somehow managed to get single payer passed in his term. What do you think would be happening to it now? What sort of destructive things would Trump and Musk be doing to undermine it? With the way our two-party system works (or rather doesn't), if we socialize healthcare, we'll be looking at such a scenario every election. It will become a political football that both parties will use to "scare the seniors" - and everyone else.



I'm not sure what this means. But you seem fixated on the idea that I agree with Trump, so let me clear some things up. Trump is not a libertarian. He doesn't care about Constitutionally limited government. He doesn't want to get the government out of health care, despite whatever nonsense might come out of his mouth. He just wants to control health care his way - whatever that might turn out to be.

My political views have evolved somewhat in the last ten years. I've learned a much greater appreciation for consensus and stability. Regardless of your political ideology, it simply does no good to foist major changes on society via a narrow, party-line vote. All that does is leave half the country angry and spoiling for revenge.

The thing I've been trying to get you to consider is how socialized medicine will pan out when it is confronted with the "culture wars". If the government controls healthcare, and conservatives take over, how will that impact the trans community? Don't you think there's a good chance that a conservative leader will do what they can to ensure that taxpayer money isn't supporting their "evil lifestyle choices"? That's just one example, but there's an endless list of ways politicians will use government control of healthcare to manipulate society. Will smokers get health care? Will abortions be covered? Will fat people face a surcharge on their healthcare? What about people who engage in dangerous sports? Will they be covered?


My position is internally consistent: it's dangerous to put all our eggs in one (government forced) basket regarding healthcare. It makes health care a political concern rather than a personal decision.

Do you think the government should be delivering mail as the Constitution specifies, or should private industry do that?

If we taxpayers were not giving all our money to the military industrial complex, could it be possible to deliver universal healthcare instead of perpetual war?

 

[dblack]

Do you think the government should be delivering mail as the Constitution specifies, or should private industry do that?

I think we're at a place where private industry can do that - and largely already does. But it's not a bid deal either way. Why do you ask?

If we taxpayers were not giving all our money to the military industrial complex, could it be possible to deliver universal healthcare instead of perpetual war?

We could "deliver" all kinds of things. We could house and feed everyone in the country. Give them health care, education etc, etc ...

 

[PeterPilot]

I think we're at a place where private industry can do that - and largely already does. But it's not a bid deal either way. Why do you ask?

We could "deliver" all kinds of things. We could house and feed everyone in the country. Give them health care, education etc, etc ...

I asked because I was curious. Thank you for a straight answer.

You probably know that there was a time when USPS did what they called "Postal Banking", and it was a great service for the common man on the street. The Bankers put an end to that in the 60's so they could profit from it. USPS was eventually saddled with all sorts of unrealistic and unfair accounting rules, and those are contributing factors to the sad state of USPS today. Dubya eventually saddled the organization with other burdens, as his buddies in FedEx and UPS attempted to eliminate USPS for their own profits.

Because USPS is a constitutionally mandated service to the people, I favor it. I see the efforts to destroy it over many decades as just one more indicator of the fascist style of government here. Many see it as a form of socialism, government funding something that helps the common man.

 

[dblack]

USPS was eventually saddled with all sorts of unrealistic and unfair accounting rules, and those are contributing factors to the sad state of USPS today. Dubya eventually saddled the organization with other burdens, as his buddies in FedEx and UPS attempted to eliminate USPS for their own profits.

Yep. Private interests lobbying for laws that hamper their competition and give them an edge. That was the story of ACA. The story of so much "well-meaning" legislation that was really just a handout to business interests

I see the efforts to destroy it over many decades as just one more indicator of the fascist style of government here.

Huh? What does that have to do with fascism?

Many see it as a form of socialism, government funding something that helps the common man.

Socialism isn't "government funding something that helps the common man". It's state control of the means of production.

 

[Donald H]

America sshould stay with what they have now, and it will unless the entire system is taken down and it starts fresh. The very wealthy depend on the health care system for a large amount of their profits that make them billionaires. Neither political party is going to ever let that slip away!