When Has Nationalizing An Industry Ever Worked For The People? Ever? (1 Viewer)

[rockaction]

I'm asking this about health care and single-payer insurance. 

Seems like a rabbit hole disaster. 

 

[Juxtatarot]

Firefighting? 

 

[rockaction]

I'd just like to remind you that in an oil rich nation like Venezuela, they're fleeing in boats for other coasts.  

 

[rockaction]

Firefighting? 

I don't think public safety and governance falls under the rubric of industry, but that's okay. 

We could have private firefighters, and people have argued for it.  

 

[roadkill1292]

How does Canada, England and most of western Europe manage it without it being a "disaster?" I don't like the insinuation that we're not capable of doing things these lesser nations manage quite well. We're the USA. We're awesome (when we want to be).

 

[rockaction]

How does Canada, England and most of western Europe manage it without it being a "disaster?" I don't like the insinuation that we're not capable of doing things these lesser nations manage quite well. We're the USA. We're awesome (when we want to be).

One could argue this. Others could argue that, in part, they free ride off of our free market system with respect to access to equipment and drugs, much like the state of defense in Europe. 

I'd argue that depressed wages leads to worse health care, and earlier deaths if all things were constant. 

 

[roadkill1292]

One could argue this. Others could argue that, in part, they free ride off of our free market system with respect to access to equipment and drugs, much like the state of defense in Europe. 

I'd argue that depressed wages leads to worse health care, and earlier deaths if all things were constant. 

I don't buy the argument that there won't be innovation without our crappy free market system. There's also the risk that spending 40% or so more than everyone else for universal health care will eventually be a burden that we can't afford (the same thing goes for defense). A rational health care system is like public education and Social Security, it makes the whole nation greater in the long run.

 

[Cjw_55106]

How does Canada, England and most of western Europe manage it without it being a "disaster?" I don't like the insinuation that we're not capable of doing things these lesser nations manage quite well. We're the USA. We're awesome (when we want to be).

Im not arguing whether or not it can be done, but we are about 10 times more populated than Canada and maybe 6 times bigger than England. Size matters. 

 

[roadkill1292]

Im not arguing whether or not it can be done, but we are about 10 times more populated than Canada and maybe 6 times bigger than England. Size matters. 

How?

 

[Ministry of Pain]

How does Canada, England and most of western Europe manage it without it being a "disaster?" I don't like the insinuation that we're not capable of doing things these lesser nations manage quite well. We're the USA. We're awesome (when we want to be).

Why is Canada and England the Gold Standard you measure everything against? You don't live in those countries and a lot of people cry foul. You might have heard of Brexit? Go ahead and be snarky and attack me when I am just pointing out how ridiculous your arguments are on a consistent basis and ongoing due to your very flawed Mt Rushmore. 

But I want to clearly say that like everyone you are entitled to your opinion and that is exactly what it is. In your mind Canada and England and a lot of Europe is a euphoria compared to here. You love to hammer down on the United States and it's citizens as if you are on a higher level than most. It makes one feel better about themselves. 

Carry on

 

[Gachi]

America got healthcare wrong. Health insurance companies shouldn't exist. It should have been Medicare for all from the beginning with private supplemental coverage like they do in France. 

However, we're in too deep at this point. Ain't no going back. All we can do at this point is try to expand private insurance, which is what the ACA did (or tried to). The issue is health insurance companies are terrible and don't have people's health as a priority. 

 

[The Commish]

I don't buy the argument that there won't be innovation without our crappy free market system. There's also the risk that spending 40% or so more than everyone else for universal health care will eventually be a burden that we can't afford (the same thing goes for defense). A rational health care system is like public education and Social Security, it makes the whole nation greater in the long run.

Agree with you and for those who are staunchly entrenched in the opinion that there won't be innovation, I recommend reading  "The Entrepreneurial State" written by Mariana Mazzucato  I started it during Christmas break and haven't finished it, but it makes one give pause to the notion that innovation disappears in a single payer sort of system.

 

[Doug B]

I don't think public safety and governance falls under the rubric of industry, but that's okay. 

IMHO, healthcare easily falls under "public safety".

 

[Gachi]

Do health insurance companies give out research money/grants? I thought medical research was purely government-funded.

If so, I wonder how many medical breakthroughs have been a result of a private insurance company funding the research. 

 

[roadkill1292]

Why is Canada and England the Gold Standard you measure everything against? You don't live in those countries and a lot of people cry foul. You might have heard of Brexit? Go ahead and be snarky and attack me when I am just pointing out how ridiculous your arguments are on a consistent basis and ongoing due to your very flawed Mt Rushmore. 

But I want to clearly say that like everyone you are entitled to your opinion and that is exactly what it is. In your mind Canada and England and a lot of Europe is a euphoria compared to here. You love to hammer down on the United States and it's citizens as if you are on a higher level than most. It makes one feel better about themselves. 

Carry on

I'm going to extend you the undeserved courtesy of a serious answer. It's not a ridiculous argument to make that single payer nations spend significantly less and have generally better health outcomes than we do. It is not in our best national interests to ignore the success and popularity of those systems, even if we ultimately don't choose to copy them in most aspects.

Regardless of where we might be on somebody's list of best nations, I want us to be even better.

Not everything is about you, MOP.

 

[Da Guru]

How does Canada, England and most of western Europe manage it without it being a "disaster?" I don't like the insinuation that we're not capable of doing things these lesser nations manage quite well. We're the USA. We're awesome (when we want to be).

Since I live 40 minutes from Canada and do work for the auto companies I know many Canadians. Have not heard many good comments about their system. Many come to Michigan for elective surgeries they have to wait a long period of time for.   A man I knew was in tremendous hip pain and needed replacement.  Was told it would be a 14-18 month wait so he had it done here. Of course you have to have the $$$.

 

[Hawks64]

One could argue this. Others could argue that, in part, they free ride off of our free market system with respect to access to equipment and drugs, much like the state of defense in Europe. 

I'd argue that depressed wages leads to worse health care, and earlier deaths if all things were constant. 

According to the WHO the US isn't even top 20 in healthcare in the world.

 

[pantagrapher]

Medicare works pretty damn well.

 

[Jackstraw]

Why is Canada and England the Gold Standard you measure everything against? You don't live in those countries and a lot of people cry foul. You might have heard of Brexit? Go ahead and be snarky and attack me when I am just pointing out how ridiculous your arguments are on a consistent basis and ongoing due to your very flawed Mt Rushmore. 

But I want to clearly say that like everyone you are entitled to your opinion and that is exactly what it is. In your mind Canada and England and a lot of Europe is a euphoria compared to here. You love to hammer down on the United States and it's citizens as if you are on a higher level than most. It makes one feel better about themselves. 

Carry on

Because they have better heath outcomes? Because they deliver services at much lower costs? 

 

[Gachi]

Since I live 40 minutes from Canada and do work for the auto companies I know many Canadians. Have not heard many good comments about their system. Many come to Michigan for elective surgeries they have to wait a long period of time for.   A man I knew was in tremendous hip pain and needed replacement.  Was told it would be a 14-18 month wait so he had it done here. Of course you have to have the $$$.

I don't think that has to do with single payer. Maybe there's a shortage of orthopedic surgeons in Canada. They only have a handful of medical schools there. 

Medicare works pretty damn well.

Medicare sets a lot of regulations that doctors hate. And the reimbursement is not very much.

 

[toshiba]

Since I live 40 minutes from Canada and do work for the auto companies I know many Canadians. Have not heard many good comments about their system. Many come to Michigan for elective surgeries they have to wait a long period of time for.   A man I knew was in tremendous hip pain and needed replacement.  Was told it would be a 14-18 month wait so he had it done here. Of course you have to have the $$$.

Living 5 minutes from Canada, I hear great stories.  Yes there are waits sometimes, but my mother had to wait 8 weeks to get cancer removed here in the US back in 2002.  I am sure everywhere has stories and I hear mostly great ones from Canadians.

 

[The Commish]

Medicare sets a lot of regulations that doctors hate. And the reimbursement is not very much.

These aren't necessarily negatives to the system as a whole, however, I do question how successful our Medicare programs would be if the  pharma companies didn't have the safety net of our "private sector" to fall back on when making up the profits they miss out on because of their Medicare agreement with the government.

 

[Henry Ford]

Firefighters

Police

Military

Energy production/utilities (many places have private, many public)

Sewers

Water distribution

Public transportation

Roadway/public infrastructure construction

 

[Henry Ford]

Basically, any time you can say "the government sets up the basic framework and allows private actors to work within that framework to use the government provided resources to make profit" it's a situation that could work out pretty well.  When the government takes full vertical control of an industry, it all is terrible.  If doctors had to work as direct employees for the government, for example.  As opposed to insurance provided by the government.  

 

[jonessed]

Medicare works pretty damn well.

It also runs at an unsustainable cost.

 

[Henry Ford]

It also runs at an unsustainable cost.

While it's true that revenues or expenditures for Medicare hospital insurance are projected to need adjustment in 15 years, there is no question that outpatient and medication costs are perfectly controlled and sustainable at current levels.

 

[The Z Machine]

Nationalizing has worked out well in certain instances in delivering more services to more people (think train / transport systems).  These systems aren't the most profitable though.

NYC had competing, private subway systems when they were first built.  That didn't work well.  I think it's pretty obvious that the NYC subway system delivers a high level of service to many many people.  A private, for-profit system would probably not have the reach or operation frequency that the current public one does.

 

[jonessed]

Firefighters

Police

Military

Energy production/utilities (many cities have private, many public)

Sewers

Water distribution

Public transportation

Roadway/public infrastructure construction

How did we get to where local public services like firefighters, police, sewers, etc. are considered nationalized services?  They are all local.  Universal healthcare would be nationalized, the military is nationalized, SS is nationalized.  Most of what is on your list is not nationalized.

 

[Henry Ford]

How did we get to where local public services like firefighters, police, sewers, etc. are considered nationalized services?  They are all local.  Universal healthcare would be nationalized, the military is nationalized, SS is nationalized.  Most of what is on your list is not nationalized.

Sorry, was the question "when has nationalizing an industry in the U.S. ever worked for the people?" Maybe I misread.

 

[jonessed]

While it's true that revenues or expenditures for Medicare hospital insurance are projected to need adjustment in 15 years, there is no question that outpatient and medication costs are perfectly controlled and sustainable at current levels.

Because the private sector pays out the nose to make up the difference.  A universal healthcare system would have to completely rebuild how healthcare is delivered.  Universal healthcare as an expansion of Medicare is a pipe dream.  It would never be affordable.

 

[Henry Ford]

Because the private sector pays out the nose to make up the difference.  A universal healthcare system would have to completely rebuild how healthcare is delivered.  Universal healthcare as an expansion of Medicare is a pipe dream.  It would never be affordable.

Insurance companies make great money on Medicare policies.  Even the ones bailing on the ACA are begging for more Medicare folks.

 

[Henry Ford]

Wait, I misunderstood.  You're saying non-Medicare people pay out the nose to make up the difference. 

Im not sure that's true, especially given that private insurance (especially w/r/t Medicare Part D) pays a similar if not the same rate in many/most cases.

 

[jonessed]

Sorry, was the question "when has nationalizing an industry in the U.S. ever worked for the people?" Maybe I misread.

Ah.  Perhaps some examples would be good.

 

[fightingillini]

Medicare works pretty damn well.

From an administrative sense, yes.  From a fiscal sense, no way.

 

[jonessed]

Wait, I misunderstood.  You're saying non-Medicare people pay out the nose to make up the difference. 

Im not sure that's true, especially given that private insurance (especially w/r/t Medicare Part D) pays a similar if not the same rate in many/most cases.

Yes.  Medicare reimbursements for outpatient procedures are lower than what private insurers pay.  That's why so many fewer doctors except Medicare patients.

 

[fightingillini]

 It's not a ridiculous argument to make that single payer nations spend significantly less and have generally better health outcomes than we do.

Agree with the spending piece.  But how do you measure your better health outcomes statement?

 

[Henry Ford]

Ah.  Perhaps some examples would be good.

The Police of Denmark seem to be quite efficient and popular. That's a fully nationalized police force.  Limited industry versions like the Royal Canadian Mounted Police, U.S. Marshalls, etc are pretty good at their jobs.

 

[Henry Ford]

Yes.  Medicare reimbursements for outpatient procedures are lower than what private insurers pay.  That's why so many fewer doctors except Medicare patients.

That's not actually across the board true, and with Medicare Advantage plans administered by private insurance companies, it's not at all hard to find a doctor.  

 

[jonessed]

That's not actually across the board true, and with Medicare Advantage plans administered by private insurance companies, it's not at all hard to find a doctor.  

It is in the Bay Area (and CA in general).  This might vary quite a bit by locale. 

 

[kface]

Living 5 minutes from Canada, I hear great stories.  Yes there are waits sometimes, but my mother had to wait 8 weeks to get cancer removed here in the US back in 2002.  I am sure everywhere has stories and I hear mostly great ones from Canadians.

I am from Canada and when my brother got cancer the system was an absolute thing of beauty.  Specialist care in under a couple of days and wonderful care throughout.  It did nothing but warm my heart for how well the system worked for him

 

[kface]

Agree with the spending piece.  But how do you measure your better health outcomes statement?

http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective

Pretty much the last in everything...while spending twice as much

 

[The Z Machine]

As was said when Obamacare was being debated before passage: The US is doing healthcare wrong, almost any way you slice it.

 

[Brony]

I don't get why so many Americans assume that if there is a national health care program, then you are prescribed who does your surgery and always gives you a 10 month waiting time.  It doesn't work like this in most successful models (in other countries).  Most have a separate non-mandatory secondary insurance market. If you're wealthy and don't want to mingle with the commoners, you can buy private insurance and FastPass to the front of the line or see other specialties that accept this secondary insurance.

I've spent several years doing comparisons of health systems and the U.S. model sucks (for patients).  Essentially the same quality and outcomes at double the price.  So much waste here that could be better managed with single payer.

 

[matttyl]

Yes.  Medicare reimbursements for outpatient procedures are lower than what private insurers pay.  That's why so many fewer doctors except Medicare patients.

That's not really true, though.  It was just over 90% of doctors in the country that accepted Medicare in 2012.  That was likely a "high water mark", though - as additional cuts to Medicare have likely lead to more opting out.  Also, just because a doctor "accepts Medicare" doesn't mean that they are taking on additional patients who have it. 

Now, Medicaid is a different question.

 

[Henry Ford]

It is in the Bay Area (and CA in general).  This might vary quite a bit by locale. 

That's true.  Really expensive places to live probably have a huge disparity.

 

[NutterButter]

Isn't it true the medicare is going to be a financial mess in the not too distant future?  If that's our example of single payer, how is that a good one?

 

[Henry Ford]

Isn't it true the medicare is going to be a financial mess in the not too distant future?  If that's our example of single payer, how is that a good one?

Yes/no.  Medicare hospital insurance will be 100% fine for the next 12-15 years with no action. It will then gradually ramp down from having 85% of what's needed to pay claims to 2040, when it will have 79%.  Then back up it goes slowly.

But that's assuming nothing is done to fix it - and Obamacare (for instance) added 11 years to that life.  The gap could be closed with a .35% (not 35%, 35/100 of a percent) payroll tax.

Outpatient and prescription coverage are 100% solvent.

 

[NutterButter]

Yes/no.  Medicare hospital insurance will be 100% fine for the next 12-15 years with no action. It will then gradually ramp down from having 85% of what's needed to pay claims to 2040, when it will have 79%.  Then back up it goes slowly.

But that's assuming nothing is done to fix it - and Obamacare (for instance) added 11 years to that life.  The gap could be closed with a .35% (not 35%, 35/100 of a percent) payroll tax.

Outpatient and prescription coverage are 100% solvent.

Can you explain to me what the ACA did to add those 11 years?

 

[Henry Ford]

Can you explain to me what the ACA did to add those 11 years?

Primarily Enforcement mechanisms for Medicare fraud, and changed the payment mechanisms to disincentivize duplicative procedures and care when not effective.  

 

[Ditka Butkus]

Need to put controls on malpractice suits and create an environment for lower insurance rates...Our country is way to litigious...Maybe I'm wrong....How do we match up with others in that regards?