Why be against universal healthcare?

[dawny0826]

I'm not stigmatizing anything. I'm just recognizing that a stigma exists.

And I pointed out that a there need not be a stigma at all. People place such attachments willingly.

And I'm certainly not downplaying the good work of people who donate their time at free clinics. What I'm saying is that the way a service is offered changes how people approach it.

It's an unfortunate part of the human condition that people look a gift horse in the mouth, in my opinion.

There's a difference between accepting charity and accepting something that one feels entitled to. I admire both doctors who volunteer their time in free clinics and volunteer firefighters, but I would never feel a reluctance to call a volunteer fire department when I needed it out of some notion that I should call a group of "regular" paid firefighters if I can afford it.

I don't think that people understand how prevelant this attitude reigns in America, particularly amongst the underprivileged and elderly. I've had clients that have brought me to tears with their hatefulness and pride, people that would run you under a bus just to "get" that which they do feel entitled to.

But maybe we should back up. I'm not really clear where your position is coming from:

- do you think that providing universal health care wouldn't affect the rate at which people seek preventative health care?

- do you think that we shouldn't do more to reach out to people who don't seek out free preventative care already?

I want a free market health care system. I am a libertarian.

People can seek preventive health care now.

I think that kind hearted Americans who want to make a difference in their communities should absolutely support organizations that plant seeds that are meaningful to them.

If we want to be free and enjoy the freedoms of a free nation, we each need to assume responsibility for our own welfare. We're not entitled. We're just sometimes arrogant and believe that we are.

 

[dawny0826]

I think it's great that the public is stepping in to try to address such a serious social problem and lack of leadership from your government.

I still think our way is much better. We cover everybody through taxes and don't have to pay extra on top of that through insurance premiums and charitable donations to know everybody, everywhere, is getting the medically necessary health care they need.

We are still charitable, of course, we just don't have to rely on charitable donations for health care. It is an extremely insecure funding model, best not used for matters of universal social need.

Do you not understand that not everyone wants the government interfering with their lives to the same degree? I don't want the government controlling my freaking health care at all. I abhore large government. I don't consider it constitutional. Now, perhaps you better understand where I'm coming from.

I favor a free market with GRASS ROOTS community efforts to solve our nation's problems. There you go. I don't want your health care system. It's great that it works for Canada and other countries but that's not what I want for America.

 

[dawny0826]

Northern Virginia (Fairfax and Arlington county) according to your post has 2 free clinics.

Arlington Free Clinic | Providing high-quality medical care to low-income, uninsured Arlington County adults
The clinic in Arlington only sees residents of Arlington.

https://www.missionlifecenter.org/hopeclinic
The clinic in Fairfax is the other clinic and is a Christian clinic with a mission to share G-ds love and as a non Christian that is problematic.

While giving care on the one hand and having a mission of conversion on the other hand is problematic.

So for poor folks who live in the highly populated Northern Virginia area there are 2 clinics.

This is unacceptable.

I provided a link to ONE network of free clinics - the Virginia Association of Free clinics. This isn't an all-inclusive list and doesn't even include non-profit organizations throughout the Commonwealth that assist with medical-focused needs.

 

[9-10ths_Penguin]

I want a free market health care system. I am a libertarian.

Too bad, because you can't have one. In a laissez-faire system, the health care market is pretty much the opposite of free.

Health care is practically the poster child for market failure. The economies of scale of something like a hospital virtually guarantee oligopolies or monopolies, and I can't think of anything with price elasticities more out of whack than transactions where life and death are literally in the balance.

Libertarian ideals are at cross purposes to truly free market health care. The health care market can be nothing like a free market unless we put major interventions in place.

People can seek preventive health care now.

I think that kind hearted Americans who want to make a difference in their communities should absolutely support organizations that plant seeds that are meaningful to them.

If we want to be free and enjoy the freedoms of a free nation, we each need to assume responsibility for our own welfare. We're not entitled. We're just sometimes arrogant and believe that we are.

So all that stuff earlier about the supposed expense of universal health care was just a red herring, eh? Apparently, it's more that you value your libertarian ideals above the physical well-being of society.

 

[9-10ths_Penguin]

Do you not understand that not everyone wants the government interfering with their lives to the same degree? I don't want the government controlling my freaking health care at all. I abhore large government. I don't consider it constitutional. Now, perhaps you better understand where I'm coming from.

Are you also opposed to a standing army and full-time firefighters?

I favor a free market with GRASS ROOTS community efforts to solve our nation's problems. There you go. I don't want your health care system. It's great that it works for Canada and other countries but that's not what I want for America.

Yes, it works for Canada. For instance, our infant mortality rates are 1.15 deaths per 1,000 live births lower than yours.

At about 4 million births per year in the US, that amounts to about 4,600 extra dead babies per year that didn't need to happen. I hope your libertarian principles are worth them.

 

[dawny0826]

Too bad, because you can't have one. In a laissez-faire system, the health care market is pretty much the opposite of free.

Health care is practically the poster child for market failure. The economies of scale of something like a hospital virtually guarantee oligopolies or monopolies, and I can't think of anything with price elasticities more out of whack than transactions where life and death are literally in the balance.

Libertarian ideals are at cross purposes to truly free market health care. The health care market can be nothing like a free market unless we put major interventions in place.

No ****. Do you think I don't understand this? I want CHANGE. REAL, hard, uncomforable as hell change in America. I want MAJOR interventions.

So all that stuff earlier about the supposed expense of universal health care was just a red herring, eh? Apparently, it's more that you value your libertarian ideals above the physical well-being of society.

If I wanted to be a "socialist", I'd move to your icebox. There's nothing wrong with being a libertarian in a free, society. And disagreeing with universal health care doesn't translate to not caring about the physical well-being of society.

I simply prefer to offer support through other avenues and acknowledge that America's problems don't have to be fixed through our government. We, the people, can solve our own problems.

I believe in non-profit work, charitable giving and humanitarian efforts. I want to touch and feel the programs that I support. I want to work face to face with the people that my money supports.

I sacrifice personally for my community. I am a libertarian. I am not a hyprocrite in terms of what I believe and how I follow through.

 

[dawny0826]

Are you also opposed to a standing army and full-time firefighters?

What the hell kind of question is this?

Yes, it works for Canada. For instance, our infant mortality rates are 1.15 deaths per 1,000 live births lower than yours.

At about 4 million births per year in the US, that amounts to about 4,600 extra dead babies per year that didn't need to happen. I hope your libertarian principles are worth them.

'

This has already been discussed and I don't think you really understand the dynamics that exist within our lower income communities. You're going to peg this on health care when it's a piece to a much large puzzle.

 

[Father Heathen]

Dawny is hardly selfish and uncaring, especially considering that she works for a humanitarian organization and has a lot of experience assisting people in need. Many of whom can be ungrateful for and take for granted the goodwill of others and feel entitled to assistance. Society does need programs as a safety net, but that net shouldn't be made into a hammock. Yes, we should assist those in need (mistakes and misfortune happen), but the purpose should to to set them on the path of recovery and self-reliance rather than to perpetuate a dependency.

 

[9-10ths_Penguin]

What the hell kind of question is this?

It's a question about other examples of "large government".

The mentality that says that firefighting should be a government-provided service is the exact same mentality that says that health care should be a government-provided service. If you understand the one, I would hope that you understand the other.

This has already been discussed and I don't think you really understand the dynamics that exist within our lower income communities. You're going to peg this on health care when it's a piece to a much large puzzle.

Yes, because we don't have low income communities or complex problems in Canada, right?

 

[9-10ths_Penguin]

No ****. Do you think I don't understand this? I want CHANGE. REAL, hard, uncomforable as hell change in America. I want MAJOR interventions.

You do? I thought you said you were a libertarian.

If I wanted to be a "socialist", I'd move to your icebox. There's nothing wrong with being a libertarian in a free, society. And disagreeing with universal health care doesn't translate to not caring about the physical well-being of society.

I simply prefer to offer support through other avenues and acknowledge that America's problems don't have to be fixed through our government. We, the people, can solve our own problems.

In a democratic society, the government is one mechanism by which the people fix their own problems.

I believe in non-profit work, charitable giving and humanitarian efforts. I want to touch and feel the programs that I support. I want to work face to face with the people that my money supports.

I sacrifice personally for my community. I am a libertarian. I am not a hyprocrite in terms of what I believe and how I follow through.

I didn't say you were a hypocrite. All I said was that you value libertarian principles more than the lives that universal health care would save. You've pointed to excuses and catch-phrases for why this should be okay (e.g. "we each need to assume responsibility for our own welfare") and while I disagree with your position, I do think you're sincere.

 

[dawny0826]

It's a question about other examples of "large government".

You've provided poor examples.

The mentality that says that firefighting should be a government-provided service is the exact same mentality that says that health care should be a government-provided service. If you understand the one, I would hope that you understand the other.

No. Our government should protect us. Military, police and firefighters keep us safe. It's excess spending within these areas that's problematic. For the latter two, I don't see much of a problem, here in my community.

Yes, because we don't have low income communities or complex problems in Canada, right?

I'm not saying that you don't. You totally don't get where I'm coming from, though.

 

[dawny0826]

You do? I thought you said you were a libertarian.

That's mean.

In a democratic society, the government is one mechanism by which the people fix their own problems.

Americans need to grow balls too. Just sayin.

I didn't say you were a hypocrite. All I said was that you value libertarian principles more than the lives that universal health care would save. You've pointed to excuses and catch-phrases for why this should be okay (e.g. "we each need to assume responsibility for our own welfare") and while I disagree with your position, I do think you're sincere.

Libertarian principles totally align with community giving and grass-root projects to fix things. I want to see these people obtain quality health care too, just through other avenues.

It doesn't matter that what I believe won't be put into full fruition during my lifetime. I can still practice what I preach on a personal note, which is the most powerful thing that anyone can do.

We do need to assume responsibility for our own welfare. Why do people a problem with this statement? I don't get it. There isn't anything negative attached to it or insinuated by it. If I want to live, I have do certain things to make sure that I sustain. At the end of the day, I can't blame anyone else if I didn't eat.

I don't have to agree with something to be curious about it, to want to learn from others and to understand where others are coming from. A lot of good points have been presented and though I don't agree with them, I admire the forward thinking of a lot of people who have posted on this thread.

 

[9-10ths_Penguin]

No. Our government should protect us. Military, police and firefighters keep us safe. It's excess spending within these areas that's problematic. For the latter two, I don't see much of a problem, here in my community.

"Excess spending"... exactly how much of the military spending in your lifetime do you think has gone towards keeping you safe? And traditionally, paid soldiers have been more of a libertarian bugaboo and been seen as a bigger potential threat to liberty than government-paid doctors have been.

As for police and fire, how are the same concerns not at play there as for health care? As a matter of fact, the first American fire brigades were paid for by insurance companies. If you had a fire insurance policy, you'd get a medallion to nail to the front of your house, and if it wasn't the right one for the fire brigade that arrived first, they'd just let your house burn.

... but still, people were self-reliant, paying for their fire protection themselves (or not, as they chose) and "taking responsibility for their own welfare"... which you said was a good thing, didn't you? But this got replaced with a system that "perpetuated a dependency" on the government.

And for police, what would be wrong with an approach like the American health care system? You could have a Medicaid-style protection for lower income people, with government police in poor areas, but if you make enough, then you have to take responsibility for your own welfare and hire your own security. What would be wrong with that?

I'm not saying that you don't. You totally don't get where I'm coming from, though and you demonize me for wanting to approach complex problems differently.

I'm not demonizing you; I'm just pointing out that what you're suggesting has a cost. Maybe you think that it's worth the cost, but I don't.

 

[9-10ths_Penguin]

That's mean.

I didn't intend it to be mean. I was genuinely confused. In my experience, libertarians are opposed to major interventions in free markets, so when you said that you wanted them, it surprised me. I'm still not sure what to make of that.

 

[9-10ths_Penguin]

We do need to assume responsibility for our own welfare. Why do people a problem with this statement? I don't get it. There isn't anything negative attached to it or insinuated by it. If I want to live, I have do certain things to make sure that I sustain. At the end of the day, I can't blame anyone else if I didn't eat.

Personal responsibility is fine. My problem with this mindset is when it's turned around: "at the end of the day, that guy can't blame anyone else if he didn't eat."

I've never taken EI or welfare myself, and I hope that I never have to. But I would be damned if I'd let anyone dismantle our social safety net... not because I'm lining up some entitlement for myself, but because my sense of responsibility doesn't end at saving my own skin.

I have real problems wrapping my head around the arguments that appeal to "responsibility" while excusing us from being responsible for each other's well-being. I do not equate my own self-interest with responsibility.

 

[Shadow Wolf]

I wonder about you, Rick. Here when people are discussing health care in general your bring up a 90 year old patient with bad knees, and a terminal patient with eye surgery. So what about those who aren't old and who aren't terminal yet need health care? I need a cartilage transplant at the ripe old age of 26, (25 when I was refereed for that surgery) (which is also the surgery for people too young for knee replacement), so what is your excuse when it comes to the normal population, the everyday population, and normal everyday people who aren't like your example of a person with <2 to not even 10 years to live?

 

[Mr Spinkles]

Dawny is hardly selfish and uncaring, especially considering that she works for a humanitarian organization and has a lot of experience assisting people in need. Many of whom can be ungrateful for and take for granted the goodwill of others and feel entitled to assistance. Society does need programs as a safety net, but that net shouldn't be made into a hammock. Yes, we should assist those in need (mistakes and misfortune happen), but the purpose should to to set them on the path of recovery and self-reliance rather than to perpetuate a dependency.

I totally agree. I would only add that a more-private health care system does not increase self-reliance. It actually increases dependency:

(1) Dependency on large employers to provide health insurance, instead of being free to shop around for jobs with smaller employers or even start your own business;

(2) Dependency on last-minute, emergency measures and expensive technology, and expensive new drugs, instead of cheap preventive medicine and good health habits instilled by doctors whose only motivation is to make you healthy and use resources efficiently;

(3) Dependency on money, and charity, to get you out of a jam instead of willingness to follow doctor's orders and help yourself

For example, I have it on good authority that in the U.S., as long as someone is paying for it, an obese patient receiving expensive life-saving care can smuggle Mountain Dews against doctor's orders. As long as someone comes up with the dough, the health industry salespeople will sell you their product, whether it will help you or not, whether it is a waste of money or not. Not so on German National Insurance. If you need the money, the government will help you out but they will cut you off if you are wasting enormous resources due to disobeying doctor's orders.

 

[Mr Spinkles]

It seems that some self-described libertarians are confused about the concept of people taking responsibility for themselves. If I save my money for a rainy day, I'm taking responsibility. If a group of friends and I get together, and we pool our savings, and we agree on a contract by which these funds will go out to one of us in case of some catastrophic misfortune--that is just another way of taking responsibility for ourselves. It's not lazy, or irresponsible. It's not even socialism. It's just smart. **

It's as American as apple pie, totally consistent with the American ideals of personal responsibility, individual liberty, etc. In fact conservative icon Teddy Roosevelt was one of the first to propose public health insurance.

**edit: In fact, it's smart for the same reason Adam Smith realized division of labor is smart (another conservative icon btw). In this case it's division of emergency savings, instead of division of labor, but the principle and the reason why it's more efficient is the same.

 

[Mr Spinkles]

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

Emphasis added. If our Constitution is to be believed, then it follows that one way for "We the People" to take care of ourselves is by promoting "the general Welfare".

Furthermore:

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

This clearly leaves open the possibility that in the future, we will decide that basic health care is a right, just as we decided that women's suffrage is a right. It is a strange allocation of priorities and resources indeed when the same country which guarantees the right to a lawyer does not guarantee the right to a doctor.

 

[Mr Spinkles]

I want a free market health care system. I am a libertarian.

dawny, I admire and respect you for the wonderful charitable work that you do. I also admire that you are open to new ideas about health care. I have spoken to many people about this issue. What I find is that a surprising number of people who consider themselves conservative or libertarian, when you actually get down to specifics, actually favor moving the health care system in a more public direction (this does not mean every doctor is a govt. employee, it could be as simple as having Medicaid for everyone within the context of private health care providers, with the option to buy supplementary private insurance if one wants).

Are you one of these people? Ask yourself what, exactly, you would change about our system. Consider that a 100% free-market health care system is what we had before Medicare. Is that what you would favor? But that didn't work, because it's not profitable to provide health insurance to seniors:

Over the objections of the American Medical Association, Congress approved Medicare by wide bipartisan margins, with President Lyndon Johnson signing the measure in July 1965. Medicare took effect in 1966. At what rate were seniors insured at that time? Kind points to a 2000 government report that said "in 1964, nearly half of all seniors were uninsured, making the elderly among the least likely Americans to have health insurance." We found wide agreement on this point among a half-dozen government and academic reports -- a range from 50 percent to 56 percent uninsured seniors in the early to mid-1960s. One report broke it down further: 54 percent had hospital coverage, and 46 percent had surgical coverage, according to survey statistics cited by the National Health Statistics Reports. It&#8217;s also true virtually all seniors have coverage today.

Even after Medicare, before the Affordable Care Act we still had the most private, most free-market health care system in the world according to World Health Organization data. Is that the sort of free-market system you favor? But that didn't work either, as everyone (including Mitt Romney) acknowledged.

Many conservatives spoke of fixing the free-market health care system we had, instead of expanding public health insurance or government-run hospitals. In fact, contrary to shouting from the Right, that is what the Affordable Care Act (Obamacare) did. The Affordable Care Act is free-market health care 2.0. This point is well-articulated by a former health care executive and fellow at the conservative American Enterprise Institute:

The core drivers of the health care act are market principles formulated by conservative economists, designed to correct structural flaws in our health insurance system &#8212; principles originally embraced by Republicans as a market alternative to the Clinton plan in the early 1990s. The president&#8217;s program extends the current health care system &#8212; mostly employer-based coverage, administered by commercial health insurers, with care delivered by fee-for-service doctors and hospitals &#8212; by removing the biggest obstacles to that system&#8217;s functioning like a competitive marketplace.

Chief among these obstacles are market limitations imposed by the problematic nature of health insurance, which requires that younger, healthier people subsidize older, sicker ones. Because such participation is often expensive and always voluntary, millions have simply opted out, a risky bet emboldened by the 24/7 presence of the heavily subsidized emergency room down the street. The health care law forcibly repatriates these gamblers, along with those who cannot afford to participate in a market that ultimately cross-subsidizes their medical misfortunes anyway, when they get sick and show up in that E.R. And it outlaws discrimination against those who want to participate but cannot because of their medical histories. Put aside the considerable legislative detritus of the act, and its aim is clear: to rationalize a dysfunctional health insurance marketplace.

So now we seem to be discovering that, although it may be an incremental improvement, free-market health care 2.0 doesn't work, either. So we have tried 3 different versions of free-market health care. What fourth version do you propose?

I ask because I have almost literally had this conversation before:

Other guy: "We should expand Medicare so it's available to anyone who needs it."

Me: "You mean like a public option?"

Other guy: "No, not like a public option! Also, insurance shouldn't be tied to employers."

Me: "You mean it should come from government?"

Other guy: "No, it should come from somewhere else! Also, people with pre-existing conditions should not be denied insurance."

Me: "You mean as stipulated in Obamacare?"

Other guy: "No, not like Obamacare! Also, insurance companies should be able to compete across state lines."

Me: "You mean, federal guidelines for insurance should supersede state guidelines?"

Other guy: "No, that would be Big Government! Also, there should be limits to Medicare."

Me: "You mean the federal government should set limits--"

Other guy: "Ahhh! Unelected death panels!"​