Socialised health care: Why is it scary?

[Sawbones79]

Having read through a number of "libertarian" threads around here, I'm puzzled at the horror an vehemence some posters exhibit towards "socialised", i.e. tax-financed and/or state-managed health care.
Working in a prime example of a health care system that's not only tax financed but also under political control, I have some difficulties understanding the gut-wrenching horror some people seem to feel about providing health care this way. Could anyone kindly explain this viewpoint to me?
(For the record, I'm not in any way opposed to privately financed health care coexisting with a state-run system, which may seem obvious but is actually a rather controversial issue in Sweden).

 

[uk_dave]

From what I can gather (and accusations of straw are likely to follow) the aversion to UHC is that:

1. It makes you pay for it whether or not you want to. Now, of course, you might ask why would anyone not want healthcare, but the point is if everyone gets healthcare then that means some people who don't actually pay any tax also get health care. And that aint fair on those who do pay tax. So, it's better to make it optional then those that can't afford it don't get it (yes yes of course they get some treatment, after all we don't want dead bodies littering the streets, but it has to be on an emergency basis because emergency units aren't at all over stretched with real emergencies, and once you've bandaged them up or given them a shot of something, you can discharge them and basically forget about them. Unless, of course, your financial screening department feels that they should pay something, in which case you send them an over inflated bill (say $250,000) for their stay in hospital and then make them an offer to settle it at $25,000 or they can just go bankrupt and ruin their financial lives for the next few years).

2. Those that currently benefit from private health insurance are going to be aggrieved at the thought of all those years of financial sacrifice being for nothing if you then introduce a UHC system where any Tom, Dick or Manuel can get free healthcare. I mean, they could've bought a boat with that money, or maybe they did buy a boat but felt really guilty about it. Either way, they've sacrificed and the prols haven't so it aint fair!

 

[Sawbones79]

From what I can gather (and accusations of straw are likely to follow) the aversion to UHC is that:

1. It makes you pay for it whether or not you want to. Now, of course, you might ask why would anyone not want healthcare, but the point is if everyone gets healthcare then that means some people who don't actually pay any tax also get health care. And that aint fair on those who do pay tax. So, it's better to make it optional then those that can't afford it don't get it (yes yes of course they get some treatment, after all we don't want dead bodies littering the streets, but it has to be on an emergency basis because emergency units aren't at all over stretched with real emergencies, and once you've bandaged them up or given them a shot of something, you can discharge them and basically forget about them. Unless, of course, your financial screening department feels that they should pay something, in which case you send them an over inflated bill (say $250,000) for their stay in hospital and then make them an offer to settle it at $25,000 or they can just go bankrupt and ruin their financial lives for the next few years).

2. Those that currently benefit from private health insurance are going to be aggrieved at the thought of all those years of financial sacrifice being for nothing if you then introduce a UHC system where any Tom, Dick or Manuel can get free healthcare. I mean, they could've bought a boat with that money, or maybe they did buy a boat but felt really guilty about it. Either way, they've sacrificed and the prols haven't so it aint fair!

I can understand (though not agree with) both those points. However, those patients of mine who also have private health care insurances seem to gain some advantage from them (faster access to non-vital surgery and diagnostics such as MRI springs to mind), and I can't come up with any reasonable objection to this. Having a state-run health care system hardly removes the advantages of also being able to pay for (in my opinion mainly needless) fast-track care, but still makes "free" health care available for those unable to pay.

 

[SezMe]

Generally speaking, those who oppose universal health care are using it as a stalking horse for socialism. They view free market dynamics as the best mechanism for delivering all products and services at an optimum price. Government involvement or intervention is seen as derailing the free market...is seen as the slippery slope to marxism or fascism or communism or whatever the boogie man de jour is.

 

[Alan]

Death panels!

 

[uk_dave]

I can understand (though not agree with) both those points. However, those patients of mine who also have private health care insurances seem to gain some advantage from them (faster access to non-vital surgery and diagnostics such as MRI springs to mind), and I can't come up with any reasonable objection to this. Having a state-run health care system hardly removes the advantages of also being able to pay for (in my opinion mainly needless) fast-track care, but still makes "free" health care available for those unable to pay.

Yes, but you have to visit the US and watch US television to fully appreciate the problem with your scenario.

Tell me, in Sweden do you have TV adverts for actual hospitals? You know, the "Come to our hospital and you'll be treated by the best doctors with the best equipment" type of adverts?

Or drug adverts? The "If you have a twinge in your knee tell your doctor about this super drug drug not suitable for use by humans, may lead to amputation, blindness and incontinence. Cease use if you experience the psychotic murder of a loved one" type?

You see, at the moment the hospitals and drug companies are all powerful because they are able to market themselves direct to the consumer patient. If you have a UHC system, yes you can retain private insurance companies and private hospitals, but for the majority you're going to centralise the treatments and drugs which can be prescribed and that means the drug companies have to deal with a government department rather than an individual practice and the hospitals won't be able to compete on the basis of the comfort of their rooms and whether or not they provide a flat screen tv and a playstation.

And think of all the advertising revenue the poor tv companies will lose!! It'll be worse than the banning of cigarette advertising!

ETA:



NCH hospital adverts

 

[Sawbones79]

Generally speaking, those who oppose universal health care are using it as a stalking horse for socialism. They view free market dynamics as the best mechanism for delivering all products and services at an optimum price. Government involvement or intervention is seen as derailing the free market...is seen as the slippery slope to marxism or fascism or communism or whatever the boogie man de jour is.

Ooops, our cover is blown. I'd better get on the phone with our star infiltrator (code name "Birth Certificate") and get him out of there ASAP.

On a more serious note, I think that there's a point in the free market in general delivering better products faster. I guess it boils down to whether health care can be seen as a consumer product, something I'm not quite sure about.

EDIT: Thanks for those points, uk dave. The direct marketing angle is an interesting one, and hyping up for example a pain killer or new hip replacement directly to the patient is mainly useless in a UHC where standard treatments are chosen in a centralized manner (something I believe to be an ineherently conservative method but profitable in the long run).

 

[Skepticemea]

I see the argument being that if someone can't pay to keep themselves well why should anybody else? It's seems to be financial issue for those against and a moral issue for those for.

 

[lionking]

I must say that it's not an issue in Australia, and any party advocating the abolition of our Medicare would lose badly at the ballot box. I should add that our public health care is not of Rolls Royce standard, and that those who rely on that alone will have to wait quite some time for elective surgery, won't get the doctor of their choice and will have to share a hospital room. There's a small charge for most GP services, and dental isn't covered. The scheme is funded by a 1.5% tax levee on most taxpayers.

A lot of people, including me and my family, "tops up" the public scheme with private insurance, which costs nearly $300 a month for the me, my wife and dependent kids. This covers almost all other costs, private rooms, dental etc. This two tier system seems to work quite well, and all parties here support it.

 

[Darat]

Often can seem to be a case of cutting off their own nose to spite themselves since UHC systems consistently cost less per person than the USA system and provide at least equal if not better outcomes.

 

[Mobyseven]

I must say that it's not an issue in Australia, and any party advocating the abolition of our Medicare would lose badly at the ballot box. I should add that our public health care is not of Rolls Royce standard, and that those who rely on that alone will have to wait quite some time for elective surgery, won't get the doctor of their choice and will have to share a hospital room. There's a small charge for most GP services, and dental isn't covered. The scheme is funded by a 1.5% tax levee on most taxpayers.

A lot of people, including me and my family, "tops up" the public scheme with private insurance, which costs nearly $300 a month for the me, my wife and dependent kids. This covers almost all other costs, private rooms, dental etc. This two tier system seems to work quite well, and all parties here support it.

Another +1 for the Aussie system here.

The fact that I can (essentially*) choose my GP and get in to see him for free is a huge boon.

*Modulo the GP bulk billing -- but plenty do, especially for students.

 

[lionking]

Another +1 for the Aussie system here.

The fact that I can (essentially*) choose my GP and get in to see him for free is a huge boon.

*Modulo the GP bulk billing -- but plenty do, especially for students.

G'day Moby.

You won't be a student forever (or will you?). You might have to get insurance or, gasp, actually pay the gap!

 

[Sawbones79]

I must say that it's not an issue in Australia, and any party advocating the abolition of our Medicare would lose badly at the ballot box. I should add that our public health care is not of Rolls Royce standard, and that those who rely on that alone will have to wait quite some time for elective surgery, won't get the doctor of their choice and will have to share a hospital room. There's a small charge for most GP services, and dental isn't covered. The scheme is funded by a 1.5% tax levee on most taxpayers.

A lot of people, including me and my family, "tops up" the public scheme with private insurance, which costs nearly $300 a month for the me, my wife and dependent kids. This covers almost all other costs, private rooms, dental etc. This two tier system seems to work quite well, and all parties here support it.

Sounds quite similar to here, then. However, those I know of with private insurance mostly seem to get them through their jobs (professional athletes for example).

 

[Mobyseven]

G'day Moby.

You won't be a student forever (or will you?). You might have to get insurance or, gasp, actually pay the gap!

Not forever, but for a while still. And yeah, eventually I'll have to purchase private health insurance for myself -- but not until I finish a PhD most likely.

 

[lionking]

Sounds quite similar to here, then. However, those I know of with private insurance mostly seem to get them through their jobs (professional athletes for example).

Some employers package up health insurance for their staff, but it's fairly rare. Something like 40% of Australians have some sort of private insurance as a top-off.

 

[Kleonaptra]

I've never had to pay to see a GP in outer Sydney. Basic stuff is all free with Medicare. Specialists are what cost me, when the GP has to refer you to someone else.

When I had my baby, my partner and I said, Praise Medicare! She was in Special Care Nursery in an incubator for nearly 3 weeks and I was in hospital for about a week. No way we could have afforded over $1000 a day. If I had private health care the only change would have been a private room for me and a heck of a lot more spent.

 

[lionking]

I've never had to pay to see a GP in outer Sydney. Basic stuff is all free with Medicare. Specialists are what cost me, when the GP has to refer you to someone else.

When I had my baby, my partner and I said, Praise Medicare! She was in Special Care Nursery in an incubator for nearly 3 weeks and I was in hospital for about a week. No way we could have afforded over $1000 a day. If I had private health care the only change would have been a private room for me and a heck of a lot more spent.

Yeah, sometimes it works that way - although bulk billers aren't that thick on the ground where I am.

We had private insurance when we had our seven kids and there were no bills, my wife had her specialist and a private room. We found it good value and reassuring, but situations vary.

 

[JoeMorgue]

Mainly because of the absolute amazing levels of inefficiency our government shows in other services.

Maybe this is just a difference in American culture. I'm not being snarky or sly here, I mean it. Do other countries have some kind of uber-efficient post offices and DMV equivilents that make them more willing to trust their governments to get them a new kidney on time?

But while I'm not outright opposed to socialized health care... yeah I will admit when the topic comes I think of all the hours I've spend quagmired in the beauracracy of our other government provided services and have a sort of cold chill go down my spine. A hospital run like the DMV would be the closest thing I can imagine to pure Hell.

 

[lionking]

Mainly because of the absolute amazing levels of inefficiency our government shows in other services.

Maybe this is just a difference in American culture. I'm not being snarky or sly here, I mean it. Do other countries have some kind of uber-efficient post offices and DMV equivilents that make them more willing to trust their governments to get them a new kidney on time?

But while I'm not outright opposed to socialized health care... yeah I will admit when the topic comes I think of all the hours I've spend quagmired in the beauracracy of our other government provided services and have a sort of cold chill go down my spine. A hospital run like the DMV would be the closest thing I can imagine to pure Hell.

Why should public and private hospitals fundamentally run differently? I could take you to a public and a private day surgery unit here, and I'll bet you couldn't tell the difference.

 

[Darat]

Mainly because of the absolute amazing levels of inefficiency our government shows in other services.

Maybe this is just a difference in American culture. I'm not being snarky or sly here, I mean it. Do other countries have some kind of uber-efficient post offices and DMV equivilents that make them more willing to trust their governments to get them a new kidney on time?

But while I'm not outright opposed to socialized health care... yeah I will admit when the topic comes I think of all the hours I've spend quagmired in the beauracracy of our other government provided services and have a sort of cold chill go down my spine. A hospital run like the DMV would be the closest thing I can imagine to pure Hell.

I can assure you that the UK government can hold its head high in the league of incompetent governments!

But in the UK like in all the other UHCs we leave it up to medically trained people to do kidney transplants not government officials....