Better healthcare reform without repealing the inaccurately named "Obamacare"

[ydoaPs]

So, how about we pass a single payer minimum coverage health insurance bill that satisfies all the requirements of the healthcare reform? That way we can have the awesome plan that would have legitimately been able to be called "Obamacare" without repealing the healthcare reform.

[Marat]

In Canada all essential healthcare services are provided by the government without user fees, and that system costs only about 10% of GDP to cover 100% of the population, as opposed to the mixed public-private system in the U.S., which costs about 17% of GDP to cover 86% of the population. Similarly generous healthcare systems in Europe cost about 7% to 9% of GDP, and are cheaper because European physicians cannot automatically practise in the U.S. as Canadian physicians can, which forces up the cost of healthcare in Canada, since physician salaries have to be inflated to keep them from migrating southward.

 

Generous healthcare systems must be affordable, since a devastated United Kingdom at the end of World War II was not only able to introduce a healthcare system for all without user fees, but was also able to provide free dental care and free pharmacare. It is clearly illogical to believe that government-provided healthcare must be too expensive, while private payment of healthcare is not, since government provision of healthcare can control the prices that doctors and drug companies want to charge by the force of law, while private purchasers of healthcare, who have no option but to buy what is offered at the price that it demanded or die (or suffer from untreated disease), are not in a negotiating position to drive prices down by ordinary supply and demand bargaining. Finally, if it is supposed that private healthcare will be cheaper because fewer people will seek medical care for their illnesses, then this does not really save money, since illnesses will only become worse because of delayed or foregone treatment, and a sick person without treatment represents the cost of disease in his inability to work and his suffering, even if he does not represent it in the money his treatment costs, so there is no ultimate saving.

 

But despite the good sense of a public healthcare system, it will never be provided in the U.S., since as Lyndon Johnson's Attorney General, Ramsey Clark, once remarked, the U.S. is not a democracy but a plutocracy. As long as the rich rule American via the campaign financing system, there will be no public healthcare system, not because it doens't make sense, but because it blocks investment and profit-making opportunities for private capital.

[Realitycheck]

I believe it may be possible gradually. Forcing it down Republicans throats makes it hard but demonstrating successes, efficiencies, and goodwill is probably effective. Every jurisdiction has their own thing going on, so it is hard to get everybody on the same boat.

[lemur]

So, how about we pass a single payer minimum coverage health insurance bill that satisfies all the requirements of the healthcare reform? That way we can have the awesome plan that would have legitimately been able to be called "Obamacare" without repealing the healthcare reform.

There was a BBC article a few years ago about how the Cuban health care system is so effective while costing so little. The answer basically came down to mandatory exercise and surprise checkups. As long as people have the freedom and means to destroy their own health with poor diets, exercise, private automotive transit, etc. you can't promise to pay their medical bills. If the US government would follow suit with the EU and raise auto safety standards and driver's license requirements to levels that would restrict driving to a wealth elite who actually have something to lose (financially) in car accidents, I would be more supportive of better universal coverage. As much as I hate the current system of providing services and then billing people into bankruptcy, it does provide a certain incentive to take special care in dangerous activities like driving and work.

Edited May 13, 2011 by lemur

[Marat]

The truly expensive, chronic diseases are those that simply cannot be prevented, since their cause is either not well understood or there is no known method to prevent them. Cystic fibrosis, type 1 diabetes, muscular dystrophy, lupus, multiple sclerosis, a whole range of autoimmune conditions, polycystic and other genetically caused renal diseases, teratomas, about half of all heart disease, about half of all cancers, all cost a fortune to treat and cannot be prevented by any change in lifestyle or medical intervention. Even type 2 diabetes is now emerging in new research as a largely genetically-conditioned, autoimmune condition like type 1 diabetes, and so it is also probably much less preventable than was previously believed.

 

Although there is now a constant drumbeat that prevention is the key to reducing healthcare costs, in fact this is largely a myth promoted by those who don't want a public healthcare system and argue against it on the grounds that since disease is always just the patient's own fault, there is no obligation of society to help the patient. This ideology is reinforced by the fact that healthy people want to feel superior to sick people, whom all societies tend to shun, hate, and fear, and the best way to do this is to pretend that health or sickness is your own fault. Healthy people also like to think that they have some control over their medical fate, so imagining that they have to adopt an unhealthy lifestyle in order for serious illness to have any chance at all to affect them is one way they conjure up a false sense of control. But then suddenly a tall, thin, hyperathletic individual like the tennis star Arthur Ashe suffers a massive heart attack at an early age and everyone tries to ignore the implications.

[lemur]

The truly expensive, chronic diseases are those that simply cannot be prevented, since their cause is either not well understood or there is no known method to prevent them. Cystic fibrosis, type 1 diabetes, muscular dystrophy, lupus, multiple sclerosis, a whole range of autoimmune conditions, polycystic and other genetically caused renal diseases, teratomas, about half of all heart disease, about half of all cancers, all cost a fortune to treat and cannot be prevented by any change in lifestyle or medical intervention. Even type 2 diabetes is now emerging in new research as a largely genetically-conditioned, autoimmune condition like type 1 diabetes, and so it is also probably much less preventable than was previously believed.

 

Although there is now a constant drumbeat that prevention is the key to reducing healthcare costs, in fact this is largely a myth promoted by those who don't want a public healthcare system and argue against it on the grounds that since disease is always just the patient's own fault, there is no obligation of society to help the patient. This ideology is reinforced by the fact that healthy people want to feel superior to sick people, whom all societies tend to shun, hate, and fear, and the best way to do this is to pretend that health or sickness is your own fault. Healthy people also like to think that they have some control over their medical fate, so imagining that they have to adopt an unhealthy lifestyle in order for serious illness to have any chance at all to affect them is one way they conjure up a false sense of control. But then suddenly a tall, thin, hyperathletic individual like the tennis star Arthur Ashe suffers a massive heart attack at an early age and everyone tries to ignore the implications.

1) 'society' doesn't have to take responsibility for taking care of all sickness by paying for it all. Governments could also simply make rules that mandate doctors take care of all sickness within a given "jurisdiction" and if they didn't, they'd lose their license.

 

2) The issue of preventable illness isn't about whether most sickness is preventable or not. It's simply that there are an enormous number of potentially healthy people who live unhealthy lifestyles. There's no reason why people who do make the effort to live healthy should be responsible for people who don't bother. If an ounce of prevention is worth a pound of cure, why should people who prevent have to work more to pay for doctors to crank out cure by the pound?