In this here post entiteled The Other Side of the Idiot, Sarunas recommended a couple articles about why health care should be universal. Here's my responses to the first one:
1. Dental care isn’t free in Lithuania (thank God: I’d never go to a free dentist). My special lady and I went to the dentist this summer instead of on vacation, the cost being about 750 litai, including two check ups, two cavities, and post-partum periodontal disease. At that price, we went to the best dentist in Vilnius and feel much better now. Was it worth the price, worth scrapping our vacation plans? No doubt.
2. Two idiotic examples. Obviously, nobody who can be golfing wastes time at the hospital. I said people go because they’re bored, not that they go unnecessarily when they have better things to do. Also they go over and over again to various doctors trying to get an excused absence from work; then the government health insurance is supposed to pay them 80% if their wages for their sick leave after the first few days. And Steve? What a fuckin moron. That 750 litai I mentioned made me think twice, but anybody worth the air he breathes will do whatever it takes to pay for critical medical care.
3. “Do you think that people whose genes predispose them to depression or cancer, or whose poverty complicates asthma or diabetes, or who get hit by a drunk driver, or who have to keep their mouths closed because their teeth are rotting ought to bear a greater share of the costs of their health care than those of us who are lucky enough to escape such misfortunes?” Of course I do, because the alternative is slavery. Forcing healthy people to pay the bills of sick people is slavery. Penalizing people who avoid those problems by making them pay for people who didn’t is not only ludicrous, it’s perverse. As sad as it may be that your genes are crappy, forcing other to pay for it is not just sad, it's simply wrong.
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8 comments:
I went to the dentist in Vilnius and she didn't charge me. As far as I'm concerned, dental care IS free in Lithuania.
I'm too lazy to reread the article but from what I remember, one of the main arguments against universal health care is that people will go to the doctor every time they have a minor ache or pain, thus flooding the system and increasing costs for the program. What Gladwell says is actually happening is the opposite: that forcing people to pay high prices, either for insurance or uninsured doctor's visits is causing people to avoid the doctor when they have a legitimate health concern. So either a)the problem goes untreated and becomes more serious, jeopardizing future health, career, relationships, etc. and/or b)the problem becomes serious enough that the person finally seeks medical attention when it is too late to treat it cheaply and quickly. Either way, it costs everyone in the end. And I don't think there are very many people who want to go to the doctor voluntarily. I sure as hell don't: my instinct is to usually tough it out and see if it gets better. But it's good to know that if I in fact do need treatment, I can get it.
You're perfectly happy to pay for quality service like a good dentist, even scrapping your vacation to pay for the visit. But you also have a job and not a particularly serious problem. What if the treatment you needed cost more than the money you had earmarked for your vacation? What if you needed to use your rent money to pay for the treatment? The food money?
I've never had a serious medical issue, but I know people who do. Are you saying that if they can't pay for it then they should just... what? Die?
I'm kind of surprised that you tried to frame your argument (in question 3) in moral terms. I'm not sure what system of morality would possibly condone letting people suffer when one can otherwise prevent it. I think your argument makes more sense in economic terms, but even so I think more beneficial to pay for universal medical coverage. It's easy enough to imagine paying high taxes for hordes of lazy, unemployed people looking to scam hard working folks like us (which happens, but not on the scale I think you're imagining) but in reality there's no economic benefit to any nation when it's workers are unhealthy and therefore absent or unproductive.
rachel, i'm not saying they can, i think i'm saying they have to depend in that case on charity rather than taxes.
bonnie, congradulations.
sarunai, you may not "think there are very many people who want to go to the doctor voluntarily," but like i said The Other Side of the Idiot Coin, I saw the evidence; your instinct (and mine) is not that of everyone. The systems is cluttered enough that doctors assume no one is in serious trouble until you say something.
if i didn't have enough money, i would borrow money. you ask, "if they can't pay for it then they should just... what? Die?" that's not a choice I would make for myself, or anybody else, but it seems to be the choice some people make for themselves, like Steve and every other idiot they mentioned: "i'd rather die than go into debt."
What moral system? A simple free one, really. I like making choices. I always liked buying a date dinner, as long as she appreciated it. If she expected it, I dumped her: I will not be made a slave. I give money when I go to church and give alms to bums sometimes. I choose to do that. As soon as the government steps in and requires me to do that, I resent it. No real moral system requires you to allieve someone's suffering; it would be a contradiction. You can only do a good thing by choice. If you're forced to do it, it's no longer morality that's promting you, and it's no longer impressive from a moral stance. As soon as you take freedom of choice out of a moral system, I don't consider it moral at all anymore.
sarunas said:
"I'm not sure what system of morality would possibly condone letting people suffer when one can otherwise prevent it."
so you are saying that doctors have no choice in whether to provide their services? they have a duty to serve, because the suffering of others is more important than their own concerns?
about a decade or so ago, sweden inadvertently created a 104% tax bracket. that's right, at a certain point if you earned one more dollar you had to pay the state $1.04.
so swedish doctors stopped working about august or september, depending upon their financial success for the year. they had to, to avoid drastic cuts in real income.
i suppose you would say that they had a duty to keep on working, to provide desparately needed medical services to those who had the poor planning to get sick late in the year. maybe you think they should have just not charged for there services once they hit the wall of 104% taxes.
but that probably would have been illegal, plus the swedish government desparately needed the tax money. they really had a moral duty to work and make themselves poorer, didn't they?
will, that system didn't last too long. the government claimed that they never really meant to have a 104% tax bracket, but i think that is a lie.
I'll post a more detailed response this weekend when I get some time, but in the meantime, here's an interesting article from the NY Times:
http://www.nytimes.com/2006/09/27/business/27leonhardt.html?th&emc=th
Okay, so multiple things to address about this issue. First off, it is pretty well established that government intervention in any industry is not economically helpful, except for the cases in which everyone recieves the benefit the good, like national defense. Universal health care does not fit this model because not everyone recieves the benefit of aras' medical treatment.
When A government tries to control an industry there are 2 things that happen. One is that you create scarcity. More people want a good than can get it. I don't know how much this happens in Lietuva but there are certainly many documented cases of medical scarcity in other countries with nationalized healthcare. I read an article in the NY times about a year ago which implied that it is fairly regual for people in great britain to pull out their own teeth using pliers because it can take over a year to get a dentist appointment. I don't remember the specifics, but it did not paint a pretty picture of the situation.
The second situation is creating a black market. Whenever there are more people that want a good than can get it, you create some sort of black market for the good. this doesn't necassarily mean some sort of underground system. In a case like housing in new york, demand is artificially high because of rent control. The result is that often you must pay a key charge of tens of thousands of dollars to first get an apartment, before you start paying the low fee controlled by the government. Also situations where a landlord will purposely rent their apartments to the more affluent people. If you have a 100 people who want an apartment you're not going to give it to a single mom who might not pay the bills.
I don't know if something like this is going on in Lithuania, it certainly was in the soviet union, that if you wanted good medical care, you had to pay the doctor on the side even though treatment was supposed to be free.
I believe it would be more efficient to simply give people money. Have healthcare, and insurance privatized, and then send everybody a health-care check. collect the taxes, and send someone cash that they can spend on healthcare as they see fit. let them spend it on insurance or doctors of their choice, if you want to have universal health care. And if they decide they woudl rather spend the money on booze, that's their choice, and they can face the consequences. The only question in that case would be children, the government would still need to insure them itself, because children can obviously not be intrusted to it themselves.
The supposed economic benefit is that people get their health problems taken care of earlier so it ends up being less costly to treat their conditions, but as far as i know there is little factual information supporting this theory.
I read the article sarunas linked to, and it claimed the reason health care is so expensive now, is simply that it's so good, and that catching things earlier does not in fact reduce costs. 50 years ago health insurance cost roughly 500 dollars a year, in todays money, now it's 11,000. The article claims that the extra 10000 dollars is the price you pay for better health care, which leads to an estimated 10 year increase in life expentancy. And claims that of course it is worth for people to pay 10,000 dollars a year for their entire lives for an extra 10 years. so lets say a person lives to be 80, they start paying for medical insurance at 20, so 60 years, divide that by 2 because it covers wife and husband so you end up spending roughly 300,000 dollars in your life time in medical expenses to live from the years 70 to 80. Not counting the cost of food, lodging, nursing homes, etc.
I believe in fact it is not worth it. Far too much of societies resources are being spent on people who no longer contribute anything to society. Not that old people should have all that medical treatment, of course they shoud. But there are limited resources. Where is that money going to be better spend, what probably amounts to a 100,000 dollars a year to keep a 75 man alive for 1 more year, counting food, medical expenses, nursing home, whatever. Is it more important for that old man to be alive for 1 more year, or to send a kid to college, or to get some better teaching materials in schools, or better teachers. How much of a difference could that money make in the lives of some underprivilleged children. Democracy, at least in the states, and i think everywhere, has a tendency to expend too many resources on teh elderly because they all vote. Every election those are the first issues brought up. Medicare, Perscription drugs, social security.
Sarunas says it's not fair that some people need to choose between food money and medical procedures. The simple fact is that there isn't enough money in the world for everyone to have the type of medical treatment that is now available in the west. Maybe it's just as unfair for people to be having any medical treatments while so many people are dying of hunger. Instead of collecting taxes to pay for medical treatment, maybe western countries should collect those taxes, and then spend them on bringing food to hungry children around the world, that seems more fair and moral to me, than having universal healthcare in the countries that can afford to pay high taxes for their health care.
man this is a long comment
rachel, charity means "a charitable fund, foundation, or institution." the church is the most obvious example. if you don't have the money for an operation, for instance, you go to your church, for instance, and ask for alms, basically. there's plenty of non-sectarian ones too, such as the red cross and united way. the point is, if you want money that's not yours, ask for it from a charity whose entire reason for existing is to give it to you, instead of from me, whose entire reason for existing ccnsists of many noble objectives, but allow me the right to choose them myself.
loky, write this down: while your argument touches upon many truths, you make yourself sound silly when you turn your back on principle: "The simple fact is that there isn't enough money in the world for everyone to have the type of medical treatment that is now available in the west." that doesn't matter in the least. bollocks to who's got how much money. if i had enough money to solve everybody's problems, everybody's in the whole world, that still doesn't mean it's my responsibility.
where'd you pull the roads idea out of, rachel? i never said anything about that. obviously, taxes have to take care of primary roads, that fits in the same catagory as national defense, police, firemen, and the education of minors. everybody needs that, even people who don't drive, cause that's how food gets to the grocery store.
i say primary, though, because alternative routes can be private. there's a private highway now between virginia and washington d.c. the public highway has such bad traffic, that people are willing to pay five times higher tolls to use the private highway that runs the same route that has less traffic. the result is, if you got more money than time, you use up the money. if you got more time, you spend more time. the traffic problem, either way, has become less of a problem, now that there's an alternative, since traffic decreased significantly on the public road. see? everybody wins with private choices.
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