Why has there been such antagonism to the idea of Universal Healthcare here?

[Associate Justice PiT]

Basically, because the right-wing in this country is completely in the pocket of the insurance companies and they can manipulate a lot of uneducated and sometimes fanatical people into believing the most ridiculous logic. It borders on insanity.

The entire right-wing is in the pockets of the insurance companies? LMAO

     The entire right-wing (or close to it) in Congress is. That's more or less what matters, since the right-wing relies on them to set policy.

Just about all of Congress is in their pockets.

     Democrats tend to be in the pockets of the trial lawyers moreso, though I must admit that the final outcome of Obamacare seems to suggest that the Democrats love the health insurance industry too.

[LBJ Revivalist]

We really need another FDR or LBJ, badly.
Hell, give us another TR! Or even, dare I say it, Wilson. And I loathe Wilson.

[Landslide Lyndon]

Basically, because the right-wing in this country is completely in the pocket of the insurance companies and they can manipulate a lot of uneducated and sometimes fanatical people into believing the most ridiculous logic. It borders on insanity.

The entire right-wing is in the pockets of the insurance companies? LMAO

     The entire right-wing (or close to it) in Congress is. That's more or less what matters, since the right-wing relies on them to set policy.

Just about all of Congress is in their pockets.

     Democrats tend to be in the pockets of the trial lawyers moreso, though I must admit that the final outcome of Obamacare seems to suggest that the Democrats love the health insurance industry too.

If the Democrats in general were in health insurance industry's pocket then you wouldn't have a majority of them fighting for a public option. The industry needs only a handful of them (Lieberman, Baucus, Lincoln) to undermine anything they don't like.

[Associate Justice PiT]

Basically, because the right-wing in this country is completely in the pocket of the insurance companies and they can manipulate a lot of uneducated and sometimes fanatical people into believing the most ridiculous logic. It borders on insanity.

The entire right-wing is in the pockets of the insurance companies? LMAO

     The entire right-wing (or close to it) in Congress is. That's more or less what matters, since the right-wing relies on them to set policy.

Just about all of Congress is in their pockets.

     Democrats tend to be in the pockets of the trial lawyers moreso, though I must admit that the final outcome of Obamacare seems to suggest that the Democrats love the health insurance industry too.

If the Democrats in general were in health insurance industry's pocket then you wouldn't have a majority of them fighting for a public option. The industry needs only a handful of them (Lieberman, Baucus, Lincoln) to undermine anything they don't like.

     I didn't explicitly agree that all of the Democrats were in the pocket of the health insurance industry. Just that they are not opposed to acting in the interests of the health insurance industry.

[opebo]

This is great: you are rejecting thoughtful analysis and demonizing those who disagree with you because of shallow sentimentality.  Fortunately, you have a lot of company.

How is it 'shallow sentimentality'?  It is life and death - the poors being killed by the rich.  Its not sentimental, it is visceral survival that militates for health care.

[DrScholl]

The entire right-wing is in the pockets of the insurance companies? LMAO

Those in positions of power are and that's what counts. I can't name one right-winger who has actually called the insurance companies on the carpet about their antics.

[President Mitt]

I went to sleep last night, after checking in on the Birchers on Hannity's propaganda show, and I wondered what it's like without health insuarance. I felt sorry for the millions who have to decide between eating bread, and buying insulin for their diabetic daughter. i decided that this country needs Universal Healthcare.

I know the modern day John Birch Society won't like it, but this country needs massive healthcare reform. I know Glenn Beck and Sarah Palin will decry it as Socialism, but it is in the best interests of the country.

Obama has probably killed any chance of Universal Healthcare by his inadequecy. That man has destroyed Liberalism in this country. If only we had LBJ back. I'd gladly trade Obama for him, or FDR, or even Teddy Roosevelt!

[LBJ Revivalist]

I went to sleep last night, after checking in on the Birchers on Hannity's propaganda show, and I wondered what it's like without health insuarance. I felt sorry for the millions who have to decide between eating bread, and buying insulin for their diabetic daughter. i decided that this country needs Universal Healthcare.

I know the modern day John Birch Society won't like it, but this country needs massive healthcare reform. I know Glenn Beck and Sarah Palin will decry it as Socialism, but it is in the best interests of the country.

Obama has probably killed any chance of Universal Healthcare by his inadequecy. That man has destroyed Liberalism in this country. If only we had LBJ back. I'd gladly trade Obama for him, or FDR, or even Teddy Roosevelt!

You know, mimicking me, even down to a former display name of mine, is VERY creepy. Like stalker-ish territory.

[anvi]

Zarn and Cannonia,

I don't reject thoughtful analysis at all.  I said I understand the arguments against universal health care, I didn't say I agree with them.

As far as the constitutional arguments against the current legislation are concerned, I have my own view of the matter, but they will be decided by the courts.  Even if the current approach does not work, as I mentioned, there are other ways to craft a framework for universal health care that would not have to breech any constitutional provisions.  (I can't resist the temptation to point out that the 94 Republican Senate bill that countered Clinton's health care plan had mandates.  So, even Republicans apparently change their own minds about what the Constitution permits and does not permit fairly often.  That's not an idictment of them, by the way; I'm just pointing it out to show that the constitutional issues here are probably much more complex than most of us are led to believe.)

I reject the blanket "anti-government" arguments because, while there certainly are such things as inefficiency and corruption in government, these things also exist in the private market.  And, if the government can take things away, as president Ford so famously quipped, so can the market.  Whether a program is well-crafted or not, or whether the market is performing well in a given industry, depends on the specifics of the case, not on some a priori maxim.  The U.S. government is not doing a good job of dealing with our health care situation now, but neither is the private health insurance industry.

I reject economic arguments because there are plenty of countries with universal health care frameworks that are plenty economically robust (how is the Japanese technological industry doing in the world, or the Swiss banking industry, or the German automotive industry?).  Indeed, I would make precisely the opposite argument, namely that reducing the amount of GDP spent on health care, which universal health care systems help do (they sure don't do all of that work), helps free up economic resources for other sectors.

I reject "anti-innovation" arguments because I have lived in Germany and Japan for extended periods of time, and I found nothing wanting in the treatment I received there when it was needed.  I have spent a good amount of time in Canada too, and anyone who wants to dump all over the scientific research environment in Canada without knowing anything about it ought to visit and look into what a robust field they have made out of developmental biology.  That worry about American medical innovation if we change our insurance coverage system is a paper tiger.

I don't want to go on too long with this, these are just some of the conclusions I've come to.  I am hardly anti-analytical, and I've not only had lots of personal experience with different health care systems, but have read a lot of literature about it, from all perspectives.  But, if you want to accuse me of being sentimental about it, to that I don't mind pleading guilty.  The United States, which has on the one hand arguably the most enviable health care research environment and delivery system of any country, at the same time is stuck on a health insurance coverage system that rations millions and millions of people (as opposed to procedures) out of coverage, and watches some 22,000 of its own citizens die every year for no other reason than they can't get coverage for their illnesses.  22,000 is almost the entirety of the population of my hometown.  To my mind, these latter consequences are cruel and barbaric and fundamentally unjust, and we should as a nation feel morally obligated to fix them.  If you feel differently, then, like I said, you feel differently, and nothing I can say would change that, would it?

p.s.  Thanks much, Torie and Opebo.

[Sam Spade]

Don't most surveys show fairly solid support for the idea of universal healthcare?

Of course.  Then details set in - it's one of those issues in America where its better to just campaign on the idea rather than do anything about it.

I agree with Torie on this issue completely - his solution is the only one that would actually work without continually cutting benefits or reducing R&D (single-payer) or going bankrupt eventually (present system).

[opebo]

I agree with Torie on this issue completely - his solution is the only one that would actually work...

What's the Torie solution?  Do you have a link to were he posted it?

[milhouse24]

Has anyone actually considered how much it would cost to implement Universal Health Care? 

Also, will this be full coverage or will there be things that are left out.  Basic Health Care insurance and services are relatively cheap.  But when you factor in the cost of experimental or non-generic drugs and surgeries the costs skyrocket.  Diseases such as Aids, Diabetes, Cancer and other major surgeries are extremely expensive to treat and obtain drugs.  Our Health Technology has advances in Science have cured us, but the expectations is that we can be cured or treated no matter the cost of the medication. 

There comes a very real and Rational point in time when we have to conduct a self "Death Panel" analysis to determine whether wasting more money on Hospital Bills, surgeries, medication is worth it.  If the tax payers are paying the bill, then there needs to be a rational and cost-effective way to manage the expenditures of health care on individuals, especially the elderly who may want to live a few years longer, but give no financial return for the current economy. 

It may be easy to implement Universal Health care in small European Countries, but it will be far more difficult and inefficient to implement it in an advanced large society like the United States.  As a small business owner, they will pay more taxes to cover the Health Insurance of not just their own small number of employees but the rest of the country. 

Universal Health care is not "FREE" it is paid by every tax payer and small business, but it will create a larger burden and hurdle for small businesses and entrepreneurs to become financially successful in generating revenue, profit, and efficiency. 

Universal Health care can have a stifling effect and stalling effect on Economic Growth and Recovery in the US. 

[WillK]

...
But is it simply a political issue--Have all these Presidents in the past had bad plans, or simply articulated these bold initiatives to the public poorly?

Also, why is Universal Healthcare such a big "No-no" to the Right Wing, at least now and in 1993/1994? Why is that the ''tipping point'' for many of the commentators?
...

I think there is a lack of national solidarity/identity in the US, a byproduct of our cultural diversity and history of racial/ethnic tension.  The result is antipathy toward national programs that provide for those 'other' people.

[Zarn]

...
But is it simply a political issue--Have all these Presidents in the past had bad plans, or simply articulated these bold initiatives to the public poorly?

Also, why is Universal Healthcare such a big "No-no" to the Right Wing, at least now and in 1993/1994? Why is that the ''tipping point'' for many of the commentators?
...

I think there is a lack of national solidarity/identity in the US, a byproduct of our cultural diversity and history of racial/ethnic tension.  The result is antipathy toward national programs that provide for those 'other' people.

Race card? Really?

[opebo]

I think there is a lack of national solidarity/identity in the US, a byproduct of our cultural diversity and history of racial/ethnic tension.  The result is antipathy toward national programs that provide for those 'other' people.

Race card? Really?

Racism is obviously a large factor here, particularly as it contributes to the overall hatred/angst culture which dominates the american polity and reduces support for sensible programs.

[Brittain33]

...
But is it simply a political issue--Have all these Presidents in the past had bad plans, or simply articulated these bold initiatives to the public poorly?

Also, why is Universal Healthcare such a big "No-no" to the Right Wing, at least now and in 1993/1994? Why is that the ''tipping point'' for many of the commentators?
...

I think there is a lack of national solidarity/identity in the US, a byproduct of our cultural diversity and history of racial/ethnic tension.  The result is antipathy toward national programs that provide for those 'other' people.

Race card? Really?

It's uncomfortable to talk about, but yes, a belief that "others" are the ones who benefit from welfare and other benefits is a big source of opposition. Look at the terms Reagan used to describe "welfare queens" and "young bucks" in their Cadillacs in 1980... I understand if you find it uncomfortable because it's not at the root of your beliefs, but it's part of the discourse in America.

(But I have no reason to think it's part of this site.)

[WillK]

...
But is it simply a political issue--Have all these Presidents in the past had bad plans, or simply articulated these bold initiatives to the public poorly?

Also, why is Universal Healthcare such a big "No-no" to the Right Wing, at least now and in 1993/1994? Why is that the ''tipping point'' for many of the commentators?
...

I think there is a lack of national solidarity/identity in the US, a byproduct of our cultural diversity and history of racial/ethnic tension.  The result is antipathy toward national programs that provide for those 'other' people.

Race card? Really?

Yup.   I think that  'birthers' and anti-Heath Care Reform have similar psychological roots.

[Edit:  Though I was thinking of more divisions than just race when I wrote my post. ]

[anvi]

Milhouse,

I drafted a much longer reply earlier, but decided to scrap it in favor of something more concise.

There are different models of universal coverage in the world, not just "single payer," with differing degrees of centralization and taxpayer burden.  I personally am a bigger fan of the Bismarck model of universal coverage (Germany, Japan, Switzerland) than I am of "single payer" (Canada) or the Beveridge model (U.K.).  I don't believe the U.S. will ever adopt any of those systems.  But I do think the differences in the models demonstrate that how much a universal coverage system relies on government centralization and how much it directly costs the taxpayers depends on how it's crafted.  I actually think the way the U.S. government is directly involved in coverage now is quite counterproductive.  It covers way too many people directly (27% of the populous), and while it lowers prices for those it insures, it has no mechanisms to hold down health care costs overall, and so effectively bids up health care prices for everyone else.  Bismarck models insure far fewer people directly, leaving this to private but non-profit insurance companies (which do cover costs of capital but are not publicly traded), but empower government to hold down overall costs for everyone. While that leads, admittedly, to some reduction in quality (many of which are negligible in real treatment), it saves lots of money.

But here is my own personal bottom line.  It surely is the case that a homegrown American universal, or near-universal, coverage system will raise total health care utilization costs and will require various, hopefully rational and hopefully even more transparent, kinds of care-rationing.  But, I would much prefer to ration various kinds of procedures in different circumstances to what we do now, namely ration millions and millions of people entirely out of coverage.  So long as we're going to end up spending 20% or more of our GDP on health care anyway, whether we have universal coverage or not, I would prefer covering as many people as possible. 

[John Dibble]

Aside from the regular arguments, I think at least part of it is that many people are content with the status quo and they'd rather not risk decreasing what they are getting right now by changing it.

I reject "anti-innovation" arguments because I have lived in Germany and Japan for extended periods of time, and I found nothing wanting in the treatment I received there when it was needed.  I have spent a good amount of time in Canada too, and anyone who wants to dump all over the scientific research environment in Canada without knowing anything about it ought to visit and look into what a robust field they have made out of developmental biology.  That worry about American medical innovation if we change our insurance coverage system is a paper tiger.

I think here there is a more to consider here. The medical technology available in one country is not restricted to what is invented there, as the health care systems of Germany, Japan, etc. are free to purchase medical goods and technology from American companies. Depending on how universal care would be implemented here, it could possibly affect the profit margins of the companies that do a lot of research, and if it's negative then that could reduce research from them and that could have global implications. Of course, you could simply offset this by more government funding towards medical research or bigger tax breaks to companies doing medical research. There certainly are a lot of invalid arguments against universal care, but I think this is probably not an entirely empty one.

[anvi]

John,  I see your point of course, and I do think it applies rather evenly internationally in terms of medicines developed in the U.S.  But in Japan, for example, there is a price schedule for procedures that is annually negotiated between the government, providers and citizens, which means that a Japanese physician can only charge so much for an MRI scan.  That makes the purchase of MRI scanners produced in the U.S. prohibitively expensive, so they have to produce their own.  Fortunately, Japan is a technologically innovative country, and companies that sell lots of different kinds of electronics, like Toshiba, also produce lower-cost but still reliable MRI equipment for the Japanese market.  And since other countries in the region, in east and south Asia, also need low-cost medical equipment, the Japanese medical tech products also have good markets there.  Their universal coverage model has not hurt their medical tech industry.

Now in the U.S., pharma gets lots of tax breaks, credits and expensing deals from the government, and medical technology companies will not stop competing, which means they will not stop innovating.  But, just as you and others here quite correctly point out, it all depends on how you craft the coverage system.

[Filuwaúrdjan]

I personally am a bigger fan of the Bismarck model of universal coverage (Germany, Japan, Switzerland) than I am of "single payer" (Canada) or the Beveridge model (U.K.)

It's curious how often Americans commentating on social policy assume that such 'models' exist, as though social policy is largely shaped by imposing and mutually exclusive frameworks that were freely chosen by policy makers at some point in the past. The reality is different; social policy mostly reflects the social and political pressures within society. The concept of models is an abstraction and a fairly unhelpful one; healthcare systems don't differ in Britain and Germany because they have adopted different models, but because in the mid 1940s the conditions existed for a universalist system in Britain (but not anything based on social insurance or means testing), while in the late 1940s the conditions existed for maintaining and developing exist systems of social insurance in Germany (but not for attempting to build a new socialist welfare/health system).

You could never simply import a 'model' from abroad into the U.S because the social and political conditions are so different. Something like the NHS could never work in America so long as Americans are happier answering intrusive personal questions and accepting that it is right that access to quality care is broadly determined by 'the market' than they are with the concept of waiting their turn or being assessed almost entirely on professional grounds.

[phk]

The pink elephant in the room is moral hazard.

[Filuwaúrdjan]

The pink elephant in the room is moral hazard.

You mean that it's only a problem if you're drunk?

[Torie]

Assuming we are not going to artificially truncate drug company profits through price controls, which would of course cannibalize the system and truncate research, the fix on the research side is for drug companies by law to be required to charge US consumers, what they charge monopsonistic government buyers in Europe and Japan, adjusted for the cost efficiencies of volume sales. If we do that, then the prices of drugs will tend to go up in monopsonistic buyer countries, and down in the US, and the US with this fix alone will cease effectively financing most of the drug research for the planet. It is all about price baby, and when you have monopsonistic buyers, the market is flawed, and needs regulation. This is just basic micro-economics. It is just amazing to me that there has not been more chatter about this fix.

I mean, I am clearly not a genius. Why can't others see what I so clearly see?

[opebo]

...This is just basic micro-economics. It is just amazing to me that there has not been more chatter about this fix.

I mean, I am clearly not a genius. Why can't others see what I so clearly see?

People without health care don't care about innovation, Torie, simply because they don't have access even to what exists today, much less the hypothetical profit-driven innovation.  Only rich people care about this pet peeve of yours.

That said, innovation mostly comes from government spending anyway, we just need to end the parasitic 'privatization' of the benefits.