News America's aversion to socialism ?

[CAC1001]

Universal healthcare need not be socialized medicine remember. France, what we think of as being a literal quasi-socialist country, does not have a socialist healthcare system. Their system is a combination of public, private and not-for-profit entities. Private healthcare in France treats more than 50% of surgeries and more than 60% of cancer cases.

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

 

[Dale]

Government healthcare: Your life and death decided with the compassion of the IRS and the efficiency of the DMV.

 

[apeiron]

Universal healthcare need not be socialized medicine remember. France, what we think of as being a literal quasi-socialist country, does not have a socialist healthcare system. Their system is a combination of public, private and not-for-profit entities. Private healthcare in France treats more than 50% of surgeries and more than 60% of cancer cases.

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

Logic would suggest a mixed model. You don't want everything done by the state (the largest scale) or left to the individual (smallest scale). Instead you want things spread optimally over all possible scales of social organisation (and yes, individual responsibility).

So what that looks like is the state doing what is optimal in terms of scale of economies and critical need (so setting a universal baseline under which it is not sensible to allow its citizenry to fall, then also being responsible for that which the large scale can provide more cheaply). But then not doing the soft stuff, the optional stuff, the frills, the stuff more efficiently contracted out).

So you want public emergency rooms (who else could provide the economies of scale and integration of service). But when it comes to cosmetic surgery or hip replacements, this starts to become the responsibilty of individuals. Or when it is minor stuff, you push it out to GP clinics and even e-medicine.

This is actually what real world health systems are doing. All this talk about state vs individual is missing the point when it pretends that effective societies can only be run on either a totally individual, or totally collectivised basis. To talk like that is a caricature of political or economic debate.

 

[daveb]

Universal healthcare need not be socialized medicine remember.

This is an important point to remember. Although I haven't read the whole thing, AFAIK "Obamacare" is not socialized healthcare (in the idea that you have no choice in doctor, what healthcare you receive, etc.) - it's subsidized healthcare (in that it just requires you to have insurance).

 

[mheslep]

Socialized healthcare does not mean one has zero choice in doctor, though it may be so. This is not the case in the UK's NHS for instance, certainly a case of socialized medicine. Rather it means the doctors, nurses, hospitals work directly for or are controlled by the state. Under Obamacare the state will not write the doctors paychecks, but like energy and telephone utilities it will largely control them, setting salary caps, specifying numbers of specialists and types of treatment programs.

 

[mheslep]

Universal healthcare need not be socialized medicine remember. France, what we think of as being a literal quasi-socialist country, does not have a socialist healthcare system. Their system is a combination of public, private and not-for-profit entities. Private healthcare in France treats more than 50% of surgeries and more than 60% of cancer cases.

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

The publicly run or controlled portion where the government owns the hospitals or determines fees is socialist, just as it is in the US.

 

[WhoWee]

Socialized healthcare does not mean one has zero choice in doctor. This is not the case in the UK's NHS for instance, certainly a case of socialized medicine. Rather it means the doctors, nurses, hospitals work directly for or are controlled by the state. Under Obamacare the state will not write the doctors paychecks, but like energy and telephone utilities it will largely control them, setting salary caps, specifying numbers of specialists and types of treatment programs.

The Medicare reimbursement rates are the standard for the insurance industry.

 

[czelaya]

One factor that tends to be overlooked in health care are the areas of medicine that are the most free market oriented(if this has been already stated please delete).

Lasik surgery is not regulated by insurance companies or the government. When it was first introduced the cost of eye surgery was expensive. However, fierce competition amongst doctors and the lasik industry have driven the cost of the surgery in spite of inflation. Currently lasik surger is cheaper, safer, and has advanced substantionaly.



I'm sure if lasik became an insurance option and subdized by government, the cost of the surgery would sky rocket.

 

[mheslep]

One factor that tends to be overlooked in health care are the areas of medicine that are the most free market oriented(if this has been already stated please delete).

Lasik surgery is not regulated by insurance companies or the government. When it was first introduced the cost of eye surgery was expensive. However, fierce competition amongst doctors and the lasik industry have driven the cost of the surgery in spite of inflation. Currently lasik surger is cheaper, safer, and has advanced substantionaly.

...
I'm sure if lasik became an insurance option and subdized by government, the cost of the surgery would sky rocket.

https://www.physicsforums.com/showpost.php?p=1616468&postcount=116" (no employer tax break, no insurance), where costs have remained almost flat for a decade while regular medical insurance went up ~9% last year alone.

 

[mheslep]

The Medicare reimbursement rates are the standard for the insurance industry.

That argues then that the socialization of medicine in the US extends beyond Medicare.

 

[maine75man]

That argues then that the socialization of medicine in the US extends beyond Medicare.

I'm not sure if it's that. Is anyone aware if that's the result of a legal mandate or just industry standardization.

It's possible that the government bean counters just did the work first. Insurance companies looked at it decided it was good enough, then figured they didn't need to pay people to repeat the same task.

If that's the case it less an issue of government control and more an issue of corporate welfare. With a government agency providing a free service for companies they would otherwise have to pay for in the open market.

 

[mheslep]

I'm not sure if it's that. Is anyone aware if that's the result of a legal mandate or just industry standardization.

It's possible that the government bean counters just did the work first. Insurance companies looked at it decided it was good enough, then figured they didn't need to pay people to repeat the same task.

? How do you know it is not other way around?

If that's the case it less an issue of government control and more an issue of corporate welfare. With a government agency providing a free service for companies they would otherwise have to pay for in the open market.

In a real market not dominated by Medicare/Medicaid, the real price would be set by negotiation by buyer and seller. As it is the purchaser crunches numbers and can "set a price", a fiction.

 

[WhoWee]

? How do you know it is not other way around?

In a real market not dominated by Medicare/Medicaid, the real price would be set by negotiation by buyer and seller. As it is the purchaser crunches numbers and can "set a price", a fiction.

Here's a few links.

https://www.cms.gov/apps/physician-fee-schedule/overview.aspx

http://www.ama-assn.org/ama/pub/phy.../the-medicare-physician-payment-schedule.page

https://www.cms.gov/medicaidrf/

http://www.gehealthcare.com/usen/community/reimbursement/docs/em_reimbursement_info_2011_DOC0941390.pdf

http://www.asha.org/practice/reimbursement/medicare/feeschedule/

 

[maine75man]

I'm not sure if it's that. Is anyone aware if that's the result of a legal mandate or just industry standardization.

It's possible that the government bean counters just did the work first. Insurance companies looked at it decided it was good enough, then figured they didn't need to pay people to repeat the same task.

? How do you know it is not other way around?

What do you mean by the other way around? Which statement do you think could be reversed? I was illustrating one potential conclusion based on the information presented about the private insurance industry using the governments fee schedule. I presented it as a possibility that might be an alternative to your conclusion and even requested information that might illuminate the question further.

If that's the case it less an issue of government control and more an issue of corporate welfare. With a government agency providing a free service for companies they would otherwise have to pay for in the open market.

In a real market not dominated by Medicare/Medicaid, the real price would be set by negotiation by buyer and seller. As it is the purchaser crunches numbers and can "set a price", a fiction.

I think I see what your getting at here. I agree that in a "real market" price is set by a negotiation between buyer and seller. But even if there was no such thing as Medicare/Medicaid wouldn't private insurers still implement a fee schedule of some sort. With insurance companies operating as intermediaries between consumers and providers your already creating something other than a "real market".

 

[mheslep]

... With insurance companies operating as intermediaries between consumers and providers your already creating something other than a "real market".

Agreed. Insurers plus employers as intermediaries due to employer health care tax advantage in the US.

 

[DoggerDan]

Germany also is an example of a universal healthcare system that is not a socialist, top-down system, that consists of combination of public, private, and not-for-profit entities.

And yet their tax rates are still 40%...

 

[Zarqon]

And yet their tax rates are still 40%...

...and as I pointed out before, this number is still not that meaningful.

What matters (from a financial point of view) in the end is how much money you have over after all bills are paid, whether you pay those bills as a part of your tax or independently doesn't matter.

 

[mege]

...and as I pointed out before, this number is still not that meaningful.

What matters (from a financial point of view) in the end is how much money you have over after all bills are paid, whether you pay those bills as a part of your tax or independently doesn't matter.

It is meaningful in the situation regarding Germany and in general.

With Germany - they have about twice the average individual tax rate as the US, but yet many there still have to purchase their own health insurance. So where's the tax-to-service difference?

In general - that 40% taxes that I would pay in Germany is 40% of my income that I don't get to make a choice on. For simplicity's sake (these numbers are all off, but still illustrative), let's say that America's individual tax rate is 20% (exactly half of DE). For the difference: an American spends 20% of their income on a car payment and insurance, where a German gets a car and insurance from the government (the rest of the taxes are spent in the same way). Would you rather have the government-issue car for that 20% of your income or have a choice in what car you get for the 20% of your income? This example is also presuming the utopian situation where the government could obtain, maintain, and provide cars for the same price as an individual in a free market with respect to cars. I would much rather be able to pick out a car myself than have a government issued car - sure I pay the same in the end, but the devil is in the freedom of the details. I get to make a choice about my life, that extra 20% of my labor is at my discression. If I choose to take the bus to work everyday and NOT own a car, what then? I'm still forced, by the (non)virtue of taxation to own a car and not do the most efficient and effective thing for me.

The question with socialism is: what is more important - freedom or equality? Forced equality intrinsically comes at the expense of freedom. Whereas enforced freedom does NOT intrinsically diminish equality.

 

[MarcoD]

The question with socialism is: what is more important - freedom or equality? Forced equality intrinsically comes at the expense of freedom. Whereas enforced freedom does NOT intrinsically diminish equality.

First off, you equate freedom to the amount of 'bling-bling' you own. Why? Second off, if the amount of 'bling-bling' defines freedom, then in a system where wealth is redistributed more evenly, people in general should be more free.

You'll need better reasons than some car example, which has nothing to do with what most people want: freely accessible and cheap public services.

 

[WhoWee]

First off, you equate freedom to the amount of 'bling-bling' you own. Why? Second off, if the amount of 'bling-bling' defines freedom, then in a system where wealth is redistributed more evenly, people in general should be more free.

You'll need better reasons than some car example, which has nothing to do with what most people want: freely accessible and cheap public services.

How does the personal choice of a car equate to "the amount of 'bling-bling' you own"? If I want a 5 door silver hatchback and my neighbor wants a 2 seat red coupe - either hardly 'bling-bling' - the compromise might be we both get a 4 door sedan?

IMO - if a citizen doesn't have a job and doesn't have a means to purchase food, shelter, transportation, or healthcare - then whatever the Government provides should be acceptable and appreciated. On the other hand, the persons paying taxes to make these charity programs available to people that can't help themselves - should be free to spend their remaining money as they decide.

 

[Zarqon]

It is meaningful in the situation regarding Germany and in general.

With Germany - they have about twice the average individual tax rate as the US, but yet many there still have to purchase their own health insurance. So where's the tax-to-service difference?

In general - that 40% taxes that I would pay in Germany is 40% of my income that I don't get to make a choice on. For simplicity's sake (these numbers are all off, but still illustrative), let's say that America's individual tax rate is 20% (exactly half of DE). For the difference: an American spends 20% of their income on a car payment and insurance, where a German gets a car and insurance from the government (the rest of the taxes are spent in the same way). Would you rather have the government-issue car for that 20% of your income or have a choice in what car you get for the 20% of your income? This example is also presuming the utopian situation where the government could obtain, maintain, and provide cars for the same price as an individual in a free market with respect to cars. I would much rather be able to pick out a car myself than have a government issued car - sure I pay the same in the end, but the devil is in the freedom of the details. I get to make a choice about my life, that extra 20% of my labor is at my discression. If I choose to take the bus to work everyday and NOT own a car, what then? I'm still forced, by the (non)virtue of taxation to own a car and not do the most efficient and effective thing for me.

Picking a car is not the same thing as the health insurance case. First of all because it's a very fictional case, since no modern social democratic country forces any type of car on it's citizens, they're always free to buy what the want (and indeed can afford). Secondly because health insurance is simply a matter of risk distribution, and the more people are in on it, meaning when the government makes sure everyone is in on it, the better and more efficient it has the potential to be.

The question with socialism is: what is more important - freedom or equality? Forced equality intrinsically comes at the expense of freedom. Whereas enforced freedom does NOT intrinsically diminish equality.

I don't agree with this assessment. I think that equality is essential to have freedom.

As an example to illustrate it, consider a person born in a poor family, trying to get a good education in a country like the US. Just because there is no law stating he can't attend a university doesn't mean he is equally free to do so as a person born into a rich family. The loss of this persons liberties is now not a principle one, but rather a practical one, although I would argue it is equally important.

(note, I know it is possible to get scholarships etc., but I'm talking about the average. A poor person in the US simply has less opportunities than a rich.)

 

[Zarqon]

How does the personal choice of a car equate to "the amount of 'bling-bling' you own"? If I want a 5 door silver hatchback and my neighbor wants a 2 seat red coupe - either hardly 'bling-bling' - the compromise might be we both get a 4 door sedan?

IMO - if a citizen doesn't have a job and doesn't have a means to purchase food, shelter, transportation, or healthcare - then whatever the Government provides should be acceptable and appreciated. On the other hand, the persons paying taxes to make these charity programs available to people that can't help themselves - should be free to spend their remaining money as they decide.

I agree, and this is also how it works in modern social democratic countries.

 

[mheslep]

If equality of result is essential to have freedom, what shall be done about the musical prodigy, or the mathematical prodigy? After all such children almost certainly are dependent on the inheritance of that talent to a degree from their parents. Shall they be placed in restraints, forced to play bad notes so the tone deaf can keep up?

https://www.youtube.com/watch?v=WJBeuR0xEP8

http://www.finallyequal.com/trailer.html
http://en.wikipedia.org/wiki/Harrison_Bergeron

 

[russ_watters]

I don't agree with this assessment. I think that equality is essential to have freedom.

As an example to illustrate it, consider a person born in a poor family, trying to get a good education in a country like the US. Just because there is no law stating he can't attend a university doesn't mean he is equally free to do so as a person born into a rich family. The loss of this persons liberties is now not a principle one, but rather a practical one, although I would argue it is equally important.

Where can I find those definitions of freedom and equality?

 

[mege]

Picking a car is not the same thing as the health insurance case. First of all because it's a very fictional case, since no modern social democratic country forces any type of car on it's citizens, they're always free to buy what the want (and indeed can afford). Secondly because health insurance is simply a matter of risk distribution, and the more people are in on it, meaning when the government makes sure everyone is in on it, the better and more efficient it has the potential to be.

If everyone had the same car, then parts would be homogenized - the efficiency could still be reduced to the same thing in the example. And it is just that - an example to show the absurdity of controlling one's income.

And how can a system that forces everyone to participate be more efficient? The ACA (or any other mandated health insurance) basically are putting cost-burdens on those with the lowest risk. It's not risk-sharing - it's risk-spreading. In traditional property insurance (the 'mutual' model) - 100 people each with 1% risk of getting flooded out put in 1% of the cost of rebuilding their houses - That's risk sharing. Risk spreading is 100% people with an average of 1% risk (50 with .5% and 50 with 1.5%) of flooding put in 1% of their costs - but the problem is that there are free riders. The 50 with 1.5% risk of flooding are getting a value! They're not actually paying proportional to their risk - this actually encourages them to take more risk. The same is true for health insurance - generally policies are grouped by risk, people are expected to pay according to their risk (determined by age, sex, etc). In a mandated system, where minimum risk expectations are set, you're essentially forcing individuals to over-cover (and allowing others to under-cover, but still get the full benefit). Those that are under-covered (paying less than their proportional risk) aren't going to reduce their risk seeking, while those that are over-covered, to get the full benefit, are going to take more risks. You've just upped the net risk of the whole market by forcing risk-spreading. (this is also why the costs per person WILL go up under the ACA per most models - but the collectivists see this as OK because now everyone is covered)

So again - net freedom is reduced as burdens are added to those with low risk (low burden).

This is not supposed to be freedom from personal responsibility...

I don't agree with this assessment. I think that equality is essential to have freedom.

As an example to illustrate it, consider a person born in a poor family, trying to get a good education in a country like the US. Just because there is no law stating he can't attend a university doesn't mean he is equally free to do so as a person born into a rich family. The loss of this persons liberties is now not a principle one, but rather a practical one, although I would argue it is equally important.

(note, I know it is possible to get scholarships etc., but I'm talking about the average. A poor person in the US simply has less opportunities than a rich.)

I echo russ_watter's question.

First off, you equate freedom to the amount of 'bling-bling' you own. Why? Second off, if the amount of 'bling-bling' defines freedom, then in a system where wealth is redistributed more evenly, people in general should be more free.

You'll need better reasons than some car example, which has nothing to do with what most people want: freely accessible and cheap public services.

I never said that an individual got a better car, infact I gave a situation where an individual would want LESS than the government provided him (although - if that individual wanted to spend 30% of his income and get a better car, he should be able to, but under the government system - he would be left with only 30% of his income because he woudl still be forced to have the government issued vehicle). The same could apply to health insurance: either in a central system or in a mandate the government is reducing choices. An individual could choose to have catastrophic insurance only, but unfortunately - under the ACA for example - that is no longer an option. An individual is forced to have comprehensive personal coverage. The same goes the other way - individuals that are 'over covered' ('Cadillac plans') are now being taxed out of the system, so everything is turned to the middle.

 

[DoggerDan]

...and as I pointed out before, this number is still not that meaningful.

It's quite meaningful to the folks who give nearly half their paycheck to the government.

 

[MarcoD]

David Simon, the creator of TV mega-hit the Wire, riffs on prisons, cities, unions, newspapers, taxation, globalism and the American dream: http://vimeo.com/29805278" .

 

[fleem]

Some humans are more arrogant than others. Positions of power appeal to the arrogant more than do positions of usefulness. In a socialist society the government has more power than industry, and in a free market society industry has more power than government. There will be a proportional excess of arrogant, corrupt people in the positions of power. The people can control government through elections and petitions and they control the free market through supply and demand. The difference is that boycotting is a far more direct and powerful method of voting than that provided by ballots because ballots are always under the control of those in power (the two-party system is one way to maintain that power), and also the people know product quality and their salaries better than they know whether a politician will keep his promises. If the people really wanted to, they could put Haliburton out of business in a heartbeat if the government weren't protecting it, but voting will never put it out of business no matter how much the people want it so. Certainly we need government, if at least to protect the free market through basic laws against murder and theft. But why move even more power from industry to government, where we have less control of it? Think of it this way: if you despise free market because of the monopolies it creates, then consider that the federal government has all the earmarks of a monopoly larger than any other in the free market, but try to boycott it because you feel you aren't getting your money's worth and you'll have men in black at your door with weapons drawn. State sovereignty provides a free market in government (assuming you can move to another state if your state gets too irritating), but federal power stifles that competition.

 

[JDoolin]

Wolf Blitzer: A healthy 30 year old young man, has a good job; makes a good living, but decides, you know what? I'm not going to spend 200 or 300 dollars a month for health insurance, because I'm healthy, I don't need it. But you know, something terrible happens, and all of a sudden he needs it. Who's going to pay for that if he goes into a coma, for example? Who pays for that?

Ron Paul: In a society where you accept welfarism and socialism, he expects the government to take care of him.

WB: But what do you want?

RP: But, what he should do is whatever he wants to do, and assume responsibility for himself. My advice to him would be to have a major medical policy but not be forced...

WB: But he doesn't have that, He needs intensive care, for six months, who pays?

RP: That's what freedom is all about; taking your own risks. (Massive applause) This whole idea that you have to prepare and take care of everybody ...

WB: But congressman, Are you saying that society should just let him die

RP: No.

*Three shouts of "yeah" from audience; two men and one woman*

The relevant point here is not whether there are two or three shouts of yeah, but the spontaneous and enthusiastic applause after the line:

That's what freedom is all about; taking your own risks.

Freedom to eat unregulated food?
Freedom to drink water contaminated by hydraulic fracking?
Freedom to work with asbestos?
Freedom to have no affordable access to healthcare?

Is this a central tenet behind Tea Party; that they are all rugged individualists who wish to take their own chances? Do they not see a benefit in a sort of shared responsibility? Ron Paul began the sentence

"This whole idea that you have to prepare and take care of everybody ... "

I don't know where he was going with this sentence. What was he trying to say; that the whole idea of taking care of everybody is BAD, or is it GOOD? Is the Tea Party platform that we DON'T want to take care of everybody? Exactly who is it that they don't want to take care of?

I want to hear the rest of Ron Paul's sentence. To my knowledge, the liberal view is, YES, we should try to take care of EVERYBODY. We should acknowledge that people are imperfect, and that we should try to take care of them, even if they don't always make the correct decisions for themselves. As a society, we still have a responsibility to them.

As a society and a species, how does humanity want to proceed? We need to make a conscious and collective decision in this. Do we want to continue to evolve in the old-fashioned way, where the strongest and most ruthless survive and the weak and meek perish?

Or aren't we at a turning point in history, where instant communication is the norm, and we have the capacity and technology and resources to really do something different?

People keep complaining about the lack of jobs in America, and all around the world. But I see something different; An Era of Unprecedented Wealth. The problem is that our efficiency has become so great that a job that used to occupy dozens or hundreds can be done by one, or a few. But is that really a problem, or is it wonderful news?

I think we should view the lack of jobs as a Positive; not a negative. We have the resources to DO a lot more jobs. There are a lot of jobs that need to be done, but we don't have any profit-motive to do those jobs. You can only open up so many restaurants and stores before you are just taking business from someone else. You can only have so many farms before you've used up all the land. We still need a lot of things done, but without a government taking the lead and saying "We're going to use tax-money to get these things done" who is going to selflessly do those jobs or pay for those jobs? Nobody is even talking about it. Instead, it's just cut, cut, cut. There's no jobs? We need to reduce discretionary spending? Cut more jobs? WTF?

We're turtling up. We're waiting for the next big idea that will create exponential growth; but what if there is no such "next big idea?" Are we going ever going to realize we already have enough big ideas to take care of each other, and we don't need exponential profit growth?

I've strayed a little ways from Ron Paul's point, but is it the end-all-be-all of freedom, "That's what freedom is all about; taking your own risks?" Maybe that's where you get your joy from, but personally, I don't like risk, and I'd like the freedom NOT TO WORRY about risks. I'd like to know that the right people are in charge, and they are keeping an eye out for me, so that if I screw up, or I don't have enough money to pay for health insurance, or I drink my own tap water, or I go grocery shopping, I don't have to weigh the risks all the time.

And I would like to think that the people who are in charge of my food, my water, my healthcare, etc, are motivated by the public good, i.e. my safety, and not their profit. When I signed up for freedom, I did not know that meant "the freedom to take risks."

I have in mind the freedom in the pursuit of happiness, not the pursuit of safety. I'd like to take the latter for granted.

 

[JDoolin]

There will be a proportional excess of arrogant, corrupt people in the positions of power. The people can control government through elections and petitions and they control the free market through supply and demand.

You are correct, but we should insist on a level of transparency in both government and business such that this corruption would be harder and harder to hide.