Do you support Universal, Single-Payer Health Care?

[The Duke]

As I have said before...

Once government starts paying for health care through taxes, they gain the right to start regulating perhaps health-risky behavior in order to save taxpayer dollars.

Think about it for a while, and that becomes a very scary thought quite quickly.

Not to mention the economic arguments against it (not that the current system isn't equally ****ed up).

Don't they already do exactly this?  Public smoking bans?

[Blue Rectangle]

What benefit is there in the government giving vouchers to the 85% of Americans who can already afford insurance?  Is it similar to the benefits of giving Social Security checks to those who don't need them?

It has a few benefits that I see, the first being it provides a connection between the person paying for health care and the payment for health care.  Right now, people don't have as direct a connection.

It would also provide a lot of those people with more choice than they recieve from their company HMO, so many would recieve a higher standard of care.

Next, because the pool of those buying insurance is not a company's payroll, but a whole country, the risk is spread over a broader population (which is the whole point of insurance to begin with, to spread risk).

It provides security that employer based health insurance doesn't.  You never know when your employer might cut or end your benefits, but as we've all seen the government hardly ever changes your benefits (sometimes this is actually a bad thing).

Finally, for many people who are well off enough to buy insurance but not well off enough to be comfortable with their lot in life, this program would afford them a voucher whose value is larger than their annual budget would allow for health insurance, improving quality of care.

It is true that this would require American's to buy health vouchers for Bill Gates, but then again that seems only fair to me as Bill Gates is going to paying a significant amount of tax to fund the system.  The least we can do is let him in on the thing.

Except for you final point, all those benefits can be achieved without resorting to a massive government program.  There is no reason why companies should pay for health insurance, when they do not pay for auto insurance, homeowner's insurance, etc.  We should consider other, simpler ways to encourage individuals to manage their own health insurance.  HSA and spending accounts, along with their tax and flexibility incentives, are a good start.  Most companies would be happy to be relieved of the burden of providing health insurance.  Workers will be just as happy to not have to rely on their employer for insurance, but this requires a paradigm shift.

It should be noted that the major cause of this linking of employment and health coverage was Nixon's wage controls.  Unable to raise wages to attract and keep talented workers, companies were forced to offer other incentives, including generous health care programs.  Unfortunately, this led to the removal of the consumer-price link that keeps prices under control.  Thus, Nixon's wage controls undermined the other half of his program: price controls.  Health care costs have grown quickly ever since.  It is important to remember that much of the trouble with health care has been fallout from big-government "solutions".

As for your final point, it still does not address why vouchers must be universal.  Why not simply provide vouchers based on need to the 15% who need them, rather than to all of us?  A voucher plan would probably even be a good substitute for Medicare and Medicaid, which have failed because of the lack of consumer choice, which in turn has lead to skyrocketing costs.

[dazzleman]

No, I don't favor universal, single-payer health care.

I think that if government takes over health care, we can expect a similar result to what we got when the federal government stepped into inner city education.

They saw inequality, and resolved it in favor of bringing everybody down to the lowest level.  What we ended up with was a system that was inferior for the poor and lower middle class, and from which the upper middle class and wealthy opt out of by effectively paying for the service twice.

This is what I would expect to happen to health care under federal control.  No thank you.

[The Duke]

What benefit is there in the government giving vouchers to the 85% of Americans who can already afford insurance?  Is it similar to the benefits of giving Social Security checks to those who don't need them?

It has a few benefits that I see, the first being it provides a connection between the person paying for health care and the payment for health care.  Right now, people don't have as direct a connection.

It would also provide a lot of those people with more choice than they recieve from their company HMO, so many would recieve a higher standard of care.

Next, because the pool of those buying insurance is not a company's payroll, but a whole country, the risk is spread over a broader population (which is the whole point of insurance to begin with, to spread risk).

It provides security that employer based health insurance doesn't.  You never know when your employer might cut or end your benefits, but as we've all seen the government hardly ever changes your benefits (sometimes this is actually a bad thing).

Finally, for many people who are well off enough to buy insurance but not well off enough to be comfortable with their lot in life, this program would afford them a voucher whose value is larger than their annual budget would allow for health insurance, improving quality of care.

It is true that this would require American's to buy health vouchers for Bill Gates, but then again that seems only fair to me as Bill Gates is going to paying a significant amount of tax to fund the system.  The least we can do is let him in on the thing.

Except for you final point, all those benefits can be achieved without resorting to a massive government program.  There is no reason why companies should pay for health insurance, when they do not pay for auto insurance, homeowner's insurance, etc.  We should consider other, simpler ways to encourage individuals to manage their own health insurance.  HSA and spending accounts, along with their tax and flexibility incentives, are a good start.  Most companies would be happy to be relieved of the burden of providing health insurance.  Workers will be just as happy to not have to rely on their employer for insurance, but this requires a paradigm shift.

It should be noted that the major cause of this linking of employment and health coverage was Nixon's wage controls.  Unable to raise wages to attract and keep talented workers, companies were forced to offer other incentives, including generous health care programs.  Unfortunately, this led to the removal of the consumer-price link that keeps prices under control.  Thus, Nixon's wage controls undermined the other half of his program: price controls.  Health care costs have grown quickly ever since.  It is important to remember that much of the trouble with health care has been fallout from big-government "solutions".

As for your final point, it still does not address why vouchers must be universal.  Why not simply provide vouchers based on need to the 15% who need them, rather than to all of us?  A voucher plan would probably even be a good substitute for Medicare and Medicaid, which have failed because of the lack of consumer choice, which in turn has lead to skyrocketing costs.

Its undeniable that the shift from consumer to employer centered buying of insurance and the loss of a direct link between paying for and recieving care has caused many of our troubles, and its also undeniable tat the old way was better.  The question I'd raise is, can the old order be re-established in a way that is politically feasable?  I do not believe there is.  Any politican that proposes a program of ending employers based care and a go-your-own-way approach would be eaten alive.  I think my plan is a more politically viable way of re-establishing that critical link.

[Shira]

Like in all other civilized nations, the employer should not pay at all for healthcare. The whole population should be covered by Medicare. The coverage should be on all levels including prescription drugs. With minor variations between countries, this is the situation in Europe, Australia, Japan, Israel and others.

[Bono]

Like in all other civilized nations, the employer should not pay at all for healthcare. The whole population should be covered by Medicare. The coverage should be on all levels including prescription drugs. With minor variations between countries, this is the situation in Europe, Australia, Japan, Israel and others.

I see the US is not a civilized notion.
And btw, most european countires do not have "Medicare", they have state owned, free at the point of use(or a small fee) Hospitals.

[Shira]

Like in all other civilized nations, the employer should not pay at all for healthcare. The whole population should be covered by Medicare. The coverage should be on all levels including prescription drugs. With minor variations between countries, this is the situation in Europe, Australia, Japan, Israel and others.

I see the US is not a civilized notion.
And btw, most european countires do not have "Medicare", they have state owned, free at the point of use(or a small fee) Hospitals.

They do not call it 'Medicare', but practically the whole population is insured without any involvement of the employer. That's how, in my view, it should be here.

[TheresNoMoney]

I think universal, single-payer insurance is a good compromise between state-owned health care and completely free market health care.

[TheresNoMoney]

I'm going to lock the voting.

Thanks to everyone who took part in this discussion. Considering the overall conservative tilt of this forum, the results are pretty good.

[Bono]

Like in all other civilized nations, the employer should not pay at all for healthcare. The whole population should be covered by Medicare. The coverage should be on all levels including prescription drugs. With minor variations between countries, this is the situation in Europe, Australia, Japan, Israel and others.

I see the US is not a civilized notion.
And btw, most european countires do not have "Medicare", they have state owned, free at the point of use(or a small fee) Hospitals.

They do not call it 'Medicare', but practically the whole population is insured without any involvement of the employer. That's how, in my view, it should be here.

No. YOu don't understand the notion.
WE are not insured. We simply have free hospitals. (That actually coast a small fee, but that's besides the point)