Taking a view against universal insurance:
Anyway, insurance is a terrible way to pay for things. It burdens us with paperwork, invites cheating and, worst of all, creates a moral hazard that distorts incentives. It raises costs by insulating consumers from medicine’s real prices.Suppose you had grocery insurance. With your employer paying 80 percent of the bill, you would fill the cart with lobster and filet mignon. Everything would cost more because supermarkets would stop running sales. Why should they, when their customers barely care about the price?
Suppose everyone had transportation insurance. The roads would be crowded with Mercedes. Why buy a Chevy if your employer pays?
DailyKos with a predictable Democratic rebuttal.
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{ 15 comments }
But this excerpt doesn’t show that Stossel is against universal health insurance, but rather health insurance itself. The flaw in his analogy with the grocery store is that the majority of people can afford to pay for their own groceries, and for those who can’t, there are food stamps. Conversely, the majority of people cannot afford to pay for doctors, medicine, and medical proceedures. Therefore, if we followed Stossel’s logic, only the extremely wealthy would be able to use the healthcare system at all.
This true. The same applies to housing. Without insurance, how many of us could afford to replace our homes in the event of a fire for example.
Health insurance is an essential commodity for most people. Unfortunately, it is merely a vehicle for shared risk, and we will all die, many times in an expensive manner. The fact of the matter is that the increasing demand from an aging population and from a medical standpoint high maintenance population drives up insurance costs. If you won’t afford those costs, then don’t live so long.
Most people have a choice. How about taking some of that housing wealth and diverting to personal health?
This is such a tired old argument. How many people do you know who run over to get colonoscopies and endoscoping and MRIs just bec they don’t have to pay full price. Woo-ee, some fun! We are to the point now that we put off medical care bec the copays and coinsurances and oops, look, your plan has a deductible–all that crap–is too expensive. And that is WITH insurance! I do a health humor website: http://healthsass.blogspot.com. I am Health’s Ass. In reality–we all are.
Yes, the argument Stossel makes is ridiculous. It’s made even more ridiculous by having several easily available cases here in the US to see if there is any truth to it.
The US Military and the VA system both give nearly free care to all their beneficiaries. Are their systems more expensive on a per patient basis than those lives covered by the insurance industry? It would not take long to find out. If there were such data … I can imagine that Stossel and his crowd would sing it from the rooftops.
The VA has the best statistics of any system in the US and (I believe) its per patient costs are at or below the level of the rest of the system.
Given that fact, isn’t any discussion of our current system required to take into account this effective, inexpensive, entirely government-run system that is delivering excellent care?
The VA care is horrible. Try calling to make an appointment, you’ll be told to call back in a week b/c there is no availability. This goes on for months. My VA down here is nasty and run-down. Most of the docs barely speak English.
“The VA has the best statistics of any system in the US and (I believe) its per patient costs are at or below the level of the rest of the system.
Given that fact, isn’t any discussion of our current system required to take into account this effective, inexpensive, entirely government-run system that is delivering excellent care?”
My patients HATE the VA. They see me, then go to the VA to get their medicines. The VA is largely dependent on “volunteer” labor (i.e. residents) and nonphysicians see many patients. This certainly can reduce costs. Why don’t you ask a VET about their preference?
the problem isn’t with the premise behind insurance. It’s the way the triangle of healthcare economics functions between insurers, employers, and providers. 3 people all with difference incentives to care for 1 patient. Emploers want lower cost healthcare. Insurers want higher shareholder returns. Physicians want fair compensation (remember, coloscopy or MRI may cost “$1500″ but no doctor actually ever sees even 40% of that).
Theoretically, a less socialist and mroe market driven market would, I suspect lower costs. With nealry 7 GI people in my 10 miles radius, if they each charged directly for a colonscopy with prices on boards, like minute clinics, the lower price would naturally win over and eventually the patient’s cost would be equal to a small margin above true cost. So teh housing analogy doesn’t work because you know what a replacement house costs… not true with what real healthcare costs.
The more free makret system couldd work for most circumstnace, not all, not the poor but for most. At least in theory.
“The US Military and the VA system both give nearly free care to all their beneficiaries. Are their systems more expensive on a per patient basis than those lives covered by the insurance industry? ” — Evan
Where do you think the “nearly free” services get the funding to pay for them? You’re paying for it, so in a sense the VA system is universal insurance for only a select few paid for by many. Wonder why it’s so cheap?
So … to sum up the counter-arguments you have:
a) Anecdotal evidence that patients hate the VA.
b) The fact that the VA uses residents and FMG’s, as if the rest of the US healthcare system is free of this defect
c) The fact that the VA and military are subsidized by tax payers, ignorning the fact that so is Medicare, Medicaid and about 1/2 of all the care that is given currently in the US.
I hope most of the people posting here have better scientific background than those sorts of arguments would imply.
Come on. The US government already pays for Medicare. It already pays for Medicaid. It uses them as insurance on the private market. Yet the VA population has better statistics and better outcomes than those two systems. This needs to be addressed by anyone who thinks the government needs to have less role in any system that we use to “fix healthcare.”
If your patients who are vets hate the VA, I can line up plenty of patients who aren’t vets who hate their regular doctor too, but that wouldn’t be much of an argument, would it?
BTW, I am a vet.
You cannot generalize the VA system to general healthcare. Any better outcomes could be because vets are used to following orders, unlike the rest of the population. And the mental health care must be so good that many vets are under our bridges panhandling (at least they claim to be vets). I’ll stick to my assertion that my patients see me because they don’t want to go to the VA except for the “free” medications. Maybe those regular patients you know would love their doctors if they had to go to the VA. At least they have A CHOICE.
“Therefore, if we followed Stossel’s logic”
Stossel’s logic rarely stands up to much scrutiny on any topic.
Kevin, if the Dems have it wrong, where’s your option? You’re still heavy on criticism, light on solution.
The anti-stossel argument is unsound.
Yes, nobody will want to get invasive procedures that hurt or cause discomfort.
HOWEVER, if you make healthcare free, then yes many more people will choose to go to their doctors much more often. They wont agree to invasive tests, but they will want more access and they will want more medication.
Old people are especially bad about this. They are convinced that they need to see the doc for eveyr single small item. They dont want a colonoscopy, but they do want to waste doctors time with BS complaints, and that WILL drive up healthcare expenditures dramatically.
“How many people do you know who run over to get colonoscopies and endoscoping and MRIs just bec they don’t have to pay full price.”
You should not lump MRIs in with scoping. Scoping is invasive and causes discomfort. MRI is a totally noninvasive procedure. As long as you arent claustrophobic then MRI is very benign.
Havnet you heard of the massive “consumer driven” demand for full body scanning? You dont think that if this scanning was made free that demand wouldnt skyrocket even more?
Of course it would. Stossel is absolutely right. No, people would not choose to get scoped, but they WILL choose to get expensive noninvasive tests like MRI that run $1500 a pop.
Demand for imaging, doctors visits, prescriptions, and other noninvasive tests/procedures would absolutely skyrocket under a “free” system, just as Stossel says.
I feel like I am pounding my head against a wall.
If the MILITARY SYSTEM is cheaper per patient than the regular US system, then that is pretty much proof that John Stossel is full of crap, as are all of you who are trying to argue that he’s not.
I already think he’s full of crap.
The VA system’s successes suggest that he’s full of crap (you can all view them here):
http://www.rand.org/pubs/research_briefs/RB9100/index1.html
But if there’s really any merit to the argument all you need to do is find out what the US military spends each year per beneficiary who is cared for primarily by the military (Active Duty and their dependents).
Those patients can get free care, medications, and radiological studies and can make an appointment whenever they wish with their providers at no charge.
I’m eager to be proven wrong here with some facts. But keep up the anecdotes, it’s fun to watch people ignore me.
Stossel comes to the correct conclusion, but for the wrong reasons.
The REAL reason to oppose universal health care or mandated coverage is that it is IMMORAL.
As the eminent 20th-century Russian-American philosopher Ayn Rand proved, the individual is an end in himself–he is not subordinate to the state, the collective, “society”, or whatever. Therefore, what priorities he has with his life–including his own health–and what he does with his own money are his concerns, and his only. He has no obligation to provide for others, just like no one else has any obligation to provide for him.
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