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How to Fix Healthcare |
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- This is not an argument against socialism. It is an argument against all forms of loss-spreading through group
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< | insurance. No developed society attempts to deliver
health care on an individual-risk basis. No health care
economist has ever suggested it can be done. You needed to
explain not only how you got smarter than the rest of humanity, |
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> | insurance.
- It is an argument for individual responsibility, and I believe that a socialized system does not function substantially better than one where insurance companies compete in the open market. One might for example point to the early Jamestown settlement in which exactly that happened which I described.(see below) Though I do admit the point that a certain amount of risk-sharing is inevitable. I was referring to socialism in a more extreme sense. The bottom line is that patients themselves ought to be able to decide how improve their quality of life. Any governmentalized system necessarily has some formula for what treatment is the most efficient improvement of life quality, given that the government has limited resources and an unlimited means of spending it. This will necessarily create dissatisfaction, endless debate and unnecessary overheads which can be avoided through patient choice.
- *No* developed society attempts to deliver health care on an individual-risk basis.
- This whole plan as I have outlined it is based on the Singaporean model of compulsory savings.
- *No* health care economist has ever suggested it can be done.
- Tim Harford did in 'The Undercover Economist', 2007 Random House Paperback, pp123-128. He also writes for the Financial Times.
- You needed to explain not only how you got smarter than the rest of humanity,
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- At the same time, certain procedures ought to be covered by society at large. But this must not extend far enough to negate the incentives set in B.
- Minimize administrative costs. Fighting insurance companies in the courts for treatment and complex coverage schemes should be avoided as far as possible.
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- Nonsense. In the first place, despite the false statement in the last sentence--which you disown at the end but did not correct--taking money from "every working person" does not
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< | create universal coverage. Between the "unemployed" and the |
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> | create universal coverage.
- Correct. Bad phrasing/writing on my part.
- Between the "unemployed" and the
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| | "labor force reserve" (non-disabled adults no longer looking for
work but desiring employment) we now have fifteen million
workers without jobs. Also not working are the 25% of the |
| | including 21 million people below age 5), and the almost
one-sixth of the population above retirement age already
enrolled in the socialized medicine system called Medicare, |
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< | which is overwhelmingly loved by voters. Your "universal |
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> | which is overwhelmingly loved by voters.
- I dealt with the employed people first. Start with the easy part.
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| | coverage" uncovers far more of the population than the 42
million presently without coverage, a fact you never see fit to
disclose. Second, your $1,000 figure is ludicrously incorrect |
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< | as an estimate of "what the average citizen spends per year."
Per capita health care expenditure in the United States was |
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> | as an estimate of "what the average citizen spends per year."
- Not quite 'ludicrously incorrect'. I wrote this piece from memory based on a the aforementioned book, which I have re-ordered from amazon. Given that the topic came up in class, I was eager to put it out there, so I jumped the gun. I now have the book in hand, so here's the numbers (I was off by $500): $1,500 is roughly the cost, in taxes, of both the UK and US health care systems (p126) per person. This could be subtracted easily from taxes and put in the aforementioned account; people who pay less taxes would receive government aid for their account. Again, at page 127, "the typical Singaporean lives to the age of eighty, and the cost of the system (both public and private) is a thousand dollars per person." Around $700 is private, about $300 is public.
- More sources: "Here are some comparisons: Life expectancy at birth in the United States is 78 years; in Singapore, 82 years. The U.S. infant mortality rate is 6.4 deaths per 1,000 live births; in Singapore, just 2.3 deaths per 1,000. But the United States has far more caregivers: 2.6 physicians per 1,000 people, compared with 1.4 physicians in Singapore. The United States has 9.4 nurses per 1,000 people; Singapore, 4.2. And it has six times as many dentists as Singapore and three times as many pharmacists.
The World Health Organization’s most recent full report on global health statistics says the United States spends 15.4 percent of its GDP on healthcare, while Singapore spends just 3.7 percent.
What’s the reason for Singapore’s success? It’s not government spending. The state, using taxes, funds only about one-fourth of Singapore’s total health costs. Individuals and their employers pay for the rest. In fact, the latest figures show that Singapore’s government spends only $381 (all dollars in this article are U.S.) per capita on health—or one-seventh what the U.S. government spends.
Singapore’s system requires individuals to take responsibility for their own health, and for much of their own spending on medical care..."
- Per capita health care expenditure in the United States was
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| | $5,711 in 2007, and according to recent estimates (final numbers
not yet available) substantially higher in 2008. So even
assuming you recoup insurance overhead (which runs at 15% in the |
| | is much less efficient at running comprehensive insurance
schemes than is socialism), the average four-person American
household would need five times more per person than your |
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< | innumerate estimate. Third, you make no actual provision for |
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> | innumerate estimate.
- Well, there is no sources quoted for these numbers either. At this point, it appears that we are arguing about facts in reality as opposed to ways to solve problems arising from the facts. Naturally the former must take precedence to the latter. I would be delighted to look at your sources.
- Third, you make no actual provision for
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| | catastrophic costs, which you absurdly define as "car accidents |
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< | and organ transplants," rather than breast cancer, childbirth |
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> | and organ transplants,"
- Examples, not definitions. I specifically said 'such as'.
- rather than breast cancer, childbirth
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| | complications, appendicitis, infectious disease, and all the
other acute care needs of real people. As for long-term chronic
care, there is no system on earth efficient enough (even the
socialized systems of Finland and Japan, which deliver superior
health care at slightly more than one third of the US per capita
cost) that can manage diabetes or kidney disease for $1,000 per |
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< | year. Yours is basically a scheme for taking care of healthy, |
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> | year.
- I absolutely agree. Which is precisely why such catastrophic costs ought to be borne by the society (call that socialism - in which case we are arguing about the semantics of that word.) The idea that extreme costs, as opposed to preventive costs, are covered by the society at large is central to this plan.
- Yours is basically a scheme for taking care of healthy,
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| | working, rich people--they are not the problem. For the real
problem, you have nothing to offer. |
| | necessary to get correct statistics has been taken. The more
stuff like this you write the lower your grade is going to
get. |
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- That is naturally your prerogative. I should have waited for my sources. I would like to offer one point however: Both in class and on the wiki, we spend a lot of time discussing the flaws of the systems around us, how they do not work, how very little justice is done, how we are all conned. Except for the discussion on whether to change the system from within or without (the lawfirm), there is little concrete debate about the nuts and bolts of how to create something better. Concerning healthcare, the insurance-based market used in the USA seems unsatisfactory, Mr Obama said as much in his recent debate. The British system sweeps away the market almost completely; decisions of what is covered are taken by bureaucrats, there is little patient choice. The system appears to be working well, but has its problems, being costly and creating little to no incentives to live healthily or to contribute much and take little. I proposed a system which might marry the best of both worlds. You obviously don't like it. But I understood the purpose of the wiki to pose, exchange, edit and improve ideas. It was once mentioned in class that the desire to 'break' every new idea ought to be resisted. I also remember a call for creating, as opposed to joining, something new, to build. Guilty as charged.
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- Every person can choose for him- or herself what to do with this money, whether to see an ophthalmologist or dermatologist or dentist or none that year. This is preferable for a number of reasons.
- First, it eliminates the middle man of the insurance company or the government dictating what is and is not covered by the healthcare system. This practically eliminates administration costs and gives power to the people.
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| | Yes, this system relies on a working banking system and lack of hyperinflation. This point of this system is not to fix or explain the banking system but to provide healthcare. |
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- As mentioned above, this is from In Pursuit of Happiness: American Conceptions of Property from the Seventeenth to the Twentieth Century, William B. Scott; Indiana University Press, 1977, page 6 "In America landownership had not always been considered a right. At Jamestown the Virginia Company insisted that all land remain under company ownership as accorded by its royal charter. The Virginia Company required all of its employees to contribute "the fruits of their labor" to the common storehouse. The company distributed food and supplied to each according to his needs. After several years of near starvation the company abandoned its policy of corporate ownership and gave to each settler a three acre garden to support himself. This seemed to work. "For formerly when our people were fed out of the common store and labored jointly in the manuring of the ground and planting corn," noted a visitor, "glad was that man that could slip from his labor, nay, the most honest of them in a general business, would not take so much faithful and true pains, in a week, as now he will do in a day, neither cared they for the increase, presuming that howsoever their harvest prospered, the general store must maintain them, by which means we reaped not so much corn from the labors of 30 men as three men have done for themselves since the private allotment of land."
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| | -- TheodorBruening - 27 Feb 2009 |