Welfare in the US

[Phony Moderate]

U.S unemployment figures have historically been low because U.S unemployment figures are even more of a joke than unemployment figures in most 'Western' countries (so a complete joke rather than a relative joke). For what that's worth.

By any standardized model, the US has maintained lower average unemployment numbers over any 10 year period of the last half century than the rest of Europe.

And like he said....

[Wonkish1]

U.S unemployment figures have historically been low because U.S unemployment figures are even more of a joke than unemployment figures in most 'Western' countries (so a complete joke rather than a relative joke). For what that's worth.

By any standardized model, the US has maintained lower average unemployment numbers over any 10 year period of the last half century than the rest of Europe.

And like he said....

So you think the only difference historically in unemployment is the exact method of determining unemployment?

You really think that if the US computed unemployment the exact same way as France or the UK that the US would have the same or higher unemployment historically??

I hope you guys are joking!

[Marston]

@Wonkish1

You really seem to love the expression briefly and succinctly, as you use it in each of your posts...
FYI: It refers to MY question, which I didn't want to expound in more detail. Got it?

Alright, so you want a detailed discussion of healthcare policy?

Not quite. Chiefly, I want to know why so many (not most) Americans have a such violent aversion to something that is not worth discussing at all in every other industrial nation.

Okay, lets start off with the fact that most Americans are fairly content with the current system since most of the premium cost is "payed" by their employer and healthcare cost is payed by an insurance company and they essentially have close to limitless demand of the highest quality drugs, procedures, doctors, etc. they want with little personal expense relative to its cost. They don't want that to change.

Second, many Americans are scared of government imposed cost containment most commonly materialized in conversations about the "waiting lines" in other countries for expensive, but often times life saving expenditures. A fear that is warranted.

Third, they have a fundamental distrust of governments ability to manage a system that is about 1/8 of our entire economy. Given the disasters of government handling many, many things in the past this to makes sense.

Fourth, they believe in competition and government removes that from the system.

Fifth, they don't want the country more "welfarized" than it already is. I.e. they think the country already has enough transfer payments going on why add more.

Sixth, current public debt totals.

First, as to the OP question, I would recommend John Kingdon's quick read: America the Unusual.  It pretty much sums up why American's, as a collective group, are generally adverse to social welfare and economic redistribution programs compared to other western industrialized nation's.

Now, onto this convoluted mess...

You state that most American's are fairly content with the current system. False. For that to be correct, there would have to be some actual sort of 'system' in place. The United States has no one such system. Rather, multiple subsystems have developed, either through market forces or the need to take care of certain population segments. The satisfaction level varies greatly from subsystem to subsystem.


I will admit that most American's (unfortunately) share your view of supporting market solutions as opposed to government intervention in health care financing and delivery. This experiment will fail us sometime in the not-so-distant future when health care spending rises to such a percentage of GDP that we are finally forced to comprehensively overhaul this "system". However, until this point, we're stuck with this quasi-market mess. Only when employee premiums reach a intolerably high rate and Medicare, Medicaid, CHIP, VA, and Military Health crowd out other needed public expenditures in the budget - only then - will something finally get done.

I feel the need to dispel some of your shameless scare tactics in regards to "cost containment" in other nation's that you claim is "warranted".

1) Dude, we already have cost containment measures in place (public and private). No other aspect of health care policy has received more attention during the past 20 years than efforts to contain increases in health care costs. Look at PPS and resource-based relative value scale for price controls in the public sphere. These have existed since the 1970's and haven't reduced beneficiary aggregate satisfaction levels. Unless you have some recent data that I have not been privy to as of yet.

2) The waiting-lines tactic is getting old. Stop cherry-picking data. Thanks.

You also claim that government intervention removes competition. Again, that would imply that there is competition in the first place. Let's not fool ourselves. The healthcare industry in this country is largely monopolized (the insurance side more so than the provider side). I could get into how government can induce competition in health care but this post is already long enough. If you want, I will expand on this in a later post.
..........

Look, I'm tired and irritable right now. So I apologize for being brash and rude and all that. I suppose I cannot fault you for believing common misconceptions but I just see the same lines trumpeted time and time again by the purist free marketers and it gets old, you know? I don't dispute the fact that most American's probably think the same way you do about this issue and so your reasoning on that front still stands. However, I will take issue when you claim these reasons as warranted and factual. Just a warning.










     

[Wonkish1]

First, as to the OP question, I would recommend John Kingdon's quick read: America the Unusual.  It pretty much sums up why American's, as a collective group, are generally adverse to social welfare and economic redistribution programs compared to other western industrialized nation's.

Now, onto this convoluted mess...

You state that most American's are fairly content with the current system. False. For that to be correct, there would have to be some actual sort of 'system' in place. The United States has no one such system. Rather, multiple subsystems have developed, either through market forces or the need to take care of certain population segments. The satisfaction level varies greatly from subsystem to subsystem.


I will admit that most American's (unfortunately) share your view of supporting market solutions as opposed to government intervention in health care financing and delivery. This experiment will fail us sometime in the not-so-distant future when health care spending rises to such a percentage of GDP that we are finally forced to comprehensively overhaul this "system". However, until this point, we're stuck with this quasi-market mess. Only when employee premiums reach a intolerably high rate and Medicare, Medicaid, CHIP, VA, and Military Health crowd out other needed public expenditures in the budget - only then - will something finally get done.

I feel the need to dispel some of your shameless scare tactics in regards to "cost containment" in other nation's that you claim is "warranted".

1) Dude, we already have cost containment measures in place (public and private). No other aspect of health care policy has received more attention during the past 20 years than efforts to contain increases in health care costs. Look at PPS and resource-based relative value scale for price controls in the public sphere. These have existed since the 1970's and haven't reduced beneficiary aggregate satisfaction levels. Unless you have some recent data that I have not been privy to as of yet.

2) The waiting-lines tactic is getting old. Stop cherry-picking data. Thanks.

You also claim that government intervention removes competition. Again, that would imply that there is competition in the first place. Let's not fool ourselves. The healthcare industry in this country is largely monopolized (the insurance side more so than the provider side). I could get into how government can induce competition in health care but this post is already long enough. If you want, I will expand on this in a later post.
..........

Look, I'm tired and irritable right now. So I apologize for being brash and rude and all that. I suppose I cannot fault you for believing common misconceptions but I just see the same lines trumpeted time and time again by the purist free marketers and it gets old, you know? I don't dispute the fact that most American's probably think the same way you do about this issue and so your reasoning on that front still stands. However, I will take issue when you claim these reasons as warranted and factual. Just a warning.

There is actually quite a lot that you have written in here that I don't disagree with. But you are way, way underestimating how much I know about healthcare systems.

I agree that the current system is actually a bunch of sub systems. But I am primarily referring to the sub system of employer "provided" healthcare that most of the public is in. The structure of the system allows for competition really only in quality and not price because of a lack of "skin in the game". This situation of not caring how much cost is bore onto the system when you engage in healthcare spending is unsustainable, but people do like the fact that they have access to almost limitless demand of healthcare services paid for by someone else(until that comes back and bites them with higher premium costs, more co-pays, higher deductibles, etc. transferred from the employer down to them). But if you think that attempts to control costs by removing their near limitless demand of healthcare and ever seeking higher quality will be popular you have another thing coming(the evidence is the public's reaction and almost universal shunning of HMO plans). For those that are in the employer provided healthcare system they are widely content for now and that will remain true until they are furnishing the majority of the cost of the policies themselves. Are you saying you disagree with this?


Point to me where I talked about market solutions. While I do believe that the solutions to this problem will be passing some particular market based solutions none of my post had anything to do with my belief in that. Also please point out where in the last 50 years we have engaged in any meaningful market based solutions(with maybe the exception of the HSA which is a helpful, but only addresses one of many problems in the systems). All I've seen is more and more government solutions to the problems and the system continues to get worse.

I agree with calling this system quasi market, quasi government. I agree that the list of government providers will crowd out other government expenditures.

"Shameless scare tactics" is a joke characterization.

I was referring to peoples attitudes about cost containment measures that seek to limit their limitless demand of healthcare that only develops competition in quality and very little over price. But the scale of cost containment measures in the US vs. universal healthcare systems is not even close. When comparing the two the US has very little cost containment towards accessing expensive healthcare relative to Universal healthcare systems. Average American citizens will not give up their expensive specialists, drugs, and procedures happily. They will be pissed if that starts happening.

The average American voter utilizes "waiting lines" as their common response when they refer to cost containing controls in universal healthcare systems. Again this answer is about what average Americans feel. But if we look at your typical government run Universal healthcare system the way they contain cost is to only budget outlay so much for particular expenditures. So lets say they buy only a couple CAT scans for lets say 1 million people. Well the cost containment comes in the lack of supply sorting out the amount of people that could possibly use the item. Now whether that mismatch of demand vs. supply materializes in gate keepers or waiting lines is a mute point the cost containment occurred by constricting the supply.

I would refer to our country as being in the process of monopolizing 3rd party payment. I wouldn't call it monopolized yet(in the private side of course, it is 100% monopolized in the public). The reason this is occurring is because market forces on our system are trying to get costs under control and they are pushing the carriers together so that the lack of competition will allow for the remaining super carriers to actually facilitate top down cost containment onto the system by rejecting all kinds of expensive procedures or at least getting consumers to share in the costs. The provider side has lots of competition, but since 3rd party payers are still baring the brunt of the costs for any particular healthcare choice the competition is almost all in quality and not in price(as I've said numerous times in this post).

I am curious to hear about your idea for how the government can induce more competition. I always like hearing new ideas.

No apology needed. But I hope you realize you aren't dealing with some average person talking about healthcare who buys "into common misconceptions".

[○∙◄☻¥tπ[╪AV┼cVê└]

I'm sure everyone on this thread is a self-made man who never relied on anyone for anything, be it roads, their rich daddy, or the police.

[Wonkish1]

I'm sure everyone on this thread is a self-made man who never relied on anyone for anything, be it roads, their rich daddy, or the police.

You know it is funny how the average person almost entirely relies on famous politicians/media figures for their talking points. Its like its asking way to much to come up with any originality in them or try to track some down from someone that isn't running for higher office/famous media figure.

[Kevin]

If it hasn't been said before alot of Europeans(and Americans also) don't realize that the US already a comprehensive welfare state(although one lacking universal health care), and it has been one for longer then many European countries.

For instance social security, medicare, medicaid, the standards set by the Dept of Education, and large tracts of nationalized park land, guaranteed minimum wage etc are just a few  examples of how the Federal government contributes towards creating a welfare state. However, let mentioned before the difference between the US and any European nations like the UK or France is that most welfare functions like public housing, welfare, public transportation, state education, from elementary school to college/university etc are provided by the individual state's or local entities like counties or cities, not the Federal Government(although the Feds do provide alot of funding for these programs.

Besides the US in studies has been shown to spend as much on social welfare and other related issues compared to European countries. For example, that's why entitlements makeup the largest single proportion of the Federal budget compared to anything else. Additionally, the hand of the government on whatever level is felt ether way when dealing with these issues.

[courts]

I'm sure everyone on this thread is a self-made man who never relied on anyone for anything, be it roads, their rich daddy, or the police.

Craiglist is useful sometimes. Don't judge.

[Wonkish1]

If it hasn't been said before alot of Europeans(and Americans also) don't realize that the US already a comprehensive welfare state(although one lacking universal health care), and it has been one for longer then many European countries.

For instance social security, medicare, medicaid, the standards set by the Dept of Education, and large tracts of nationalized park land, guaranteed minimum wage etc are just a few  examples of how the Federal government contributes towards creating a welfare state. However, let mentioned before the difference between the US and any European nations like the UK or France is that most welfare functions like public housing, welfare, public transportation, state education, from elementary school to college/university etc are provided by the individual state's or local entities like counties or cities, not the Federal Government(although the Feds do provide alot of funding for these programs.

Besides the US in studies has been shown to spend as much on social welfare and other related issues compared to European countries. For example, that's why entitlements makeup the largest single proportion of the Federal budget compared to anything else. Additionally, the hand of the government on whatever level is felt ether way when dealing with these issues.

In the purest definition of "Universal healthcare" i.e everybody has access to treatment on demand--the US is just as much of a universal healthcare system as the rest of Europe is. If you show up to an emergency room without insurance you don't get turned away because of a  lack of insurance, medicaid, medicare, etc. they have to provide treatment to you.

The notion that there are all of these Americans that don't get treatment when they are in need is an absolute myth.

[Franzl]

What good does that treatment do you if you suffer from something like cancer that can't be treated through a simple ER visit?

Not to mention the simple stupidity of it. Don't think it's possible to create a system that is more inefficient.

[courts]

Not to mention the simple stupidity of it. Don't think it's possible to create a system that is more inefficient.

We find new ways every day.

[Marston]

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We could probably find near universal agreement on the problems afflicting the U.S. health care delivery systems. It's the solutions where we might run into some disagreement, I would wager.

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In that case, I would probably wager that satisfaction varies greatly from plan-to-plan. I would suppose that an individual enrolled in a high deductible catastrophic-coverage only plan would probably have a lower level of satisfaction overall than a individual enrolled in one of those heavily lambasted "Cadillac" plans (assuming that the two individuals cited use the same array of health services). As a whole, I'll agree that many American's over-utilize their health services but I am generally wary of generalizations and the people who make them. Just saying.

I would say, however, that there has been some success controlling costs through cost-sharing (in regards to MCO's, not FFS) while maintaining good access to primary care, preventive serves, and health promotion activities. Despite anecdotes, individual perceptions, and isolated stories propagated by the news media, no comprehensive research to date has clearly demonstrated that HMO's and other MCO's have expended the quality of care delivered. Actually, the quality of care under HMO's has improved over time through early detection and treatment - which is more likely in an HMO. The pressures you cited do not lead to significant changes in physician behavior because under capitation a physician takes full responsibility for a patient's overall care. Also, HMO's and non-HMO's provide roughly equal quality of care as measured by a wide range of conditions, diseases and interventions. At the same time, HMO's lower the use of hospital and other expensive resources. Hence, medical care delivered through HMO's has been cost-effective. Of course, there has been evaluations that have indicated lower access and lower enrollee satisfaction rates for some HMO plans (particularly for-profit). So, it's a mixed bag. I'm just warning against generalizations again. HMO doesn't necessarily equal bad and unpopular. Like so many things in health care, it varies from case to case and from plan to plan.

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It was just an assumption. A pretty apt assumption at that, it seems. As per your request, the HMO Act of 1973 is a prime example. I don't know what you mean by "meaningful" exactly but it cannot be dismissed. It did, after all, kill Ted Kennedy's push for universal health care in the 1970's.

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Relatively speaking, you're right. Compared to some countries, we must look like a libertarian utopia. I just wanted to state the fact that cost-containment practices do exist in the United States.  

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Careful with the generalizations!

It really varies country to country. There aren't many "typical government run universal healthcare systems", I'm afraid. For example, Canada is primarily FFS plan so they contain costs by limiting access for non-medically necessary cases. (Incidentally, these elective cases are where most of your wait-times are seen). Germany, through the Socialized health insurance system, has more of a managed competition approach. The NHS has global budgets. Others have play-or-pay rules, employer mandates, double mandates, high risk pools, etc.

I, myself, am particularly fond of the principles of managed competition. Maybe intrigued is a better word - but that's for another post.

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I don't necessarily disagree with this assessment. In fact, it's probably more true than not.

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Ah, do we have a healthcare professional in our midst? Perhaps someone in a clinical practice profession? Nah. You seem not nearly arrogant enough. Healthcare administration? IT? Public Health?
  


 

[Link]

I wouldn't say that LTCM is the governments fault. I also wouldn't call LTCM a systemic risk. Nor do I think it had to prevented from failing. Option trading has a winner and looser. Systemic risk doesn't come from that.

LTCM was trading a lot more than "options" my friend.  Errr... that was kind of the umm.. problem.

That and some derivatives was where the vast majority their money was being put.

Some derivatives?!  That's like saying Bill Gross trades "some" bonds.  Maybe I'm a bit of a weenie but I would not call $1.25 trillion in interest rate instruments "some derivatives."  I would call that a huge freakin' problem that the Fed needs to look into.

Your fixation on the options portion of LTCM portfolio and your characterizations of a chunk of their operation as "some derivatives"  explains why you seem to think the LTCM was no big deal and that there was no need for government involvement.

So to get back on topic and address the OP's question.  No matter how big the failure of the private sector there are those in America who will say everything is going to be fine and the government doesn't need to get involved.  I know full well there is nothing I'm going to type that will make Wonkish at least consider the possibility that a government brokered orderly unwinding of LTCM was in any way a good idea.  Wonkish will just hand wave and call $12.5 Trillion of market exposure "some derivatives" and say the free market will sort everything out. I respectfully disagree.  And frankly it frightens me that there are people that think this way.

But at that time LTCM wasn't allowed to fail not because it would cause wide scale losses throughout the financial system(that notion is a joke), but that it represented a likely end to a very profitable stream of income--issuing credit to those that were playing the markets.

I would call over a Trillion dollars of trades in a failing company's portfolio a lot of things... a "joke" isn't one of them.

[Wonkish1]

What good does that treatment do you if you suffer from something like cancer that can't be treated through a simple ER visit?

Not to mention the simple stupidity of it. Don't think it's possible to create a system that is more inefficient.

Well in most other Universal Healthcare countries if you have cancer and it takes a turn down any of a number of common roads your screwed!!! And that is for the whole damn population.

[Wonkish1]

I wouldn't say that LTCM is the governments fault. I also wouldn't call LTCM a systemic risk. Nor do I think it had to prevented from failing. Option trading has a winner and looser. Systemic risk doesn't come from that.

LTCM was trading a lot more than "options" my friend.  Errr... that was kind of the umm.. problem.

That and some derivatives was where the vast majority their money was being put.

Some derivatives?!  That's like saying Bill Gross trades "some" bonds.  Maybe I'm a bit of a weenie but I would not call $1.25 trillion in interest rate instruments "some derivatives."  I would call that a huge freakin' problem that the Fed needs to look into.

Your fixation on the options portion of LTCM portfolio and your characterizations of a chunk of their operation as "some derivatives"  explains why you seem to think the LTCM was no big deal and that there was no need for government involvement.

So to get back on topic and address the OP's question.  No matter how big the failure of the private sector there are those in America who will say everything is going to be fine and the government doesn't need to get involved.  I know full well there is nothing I'm going to type that will make Wonkish at least consider the possibility that a government brokered orderly unwinding of LTCM was in any way a good idea.  Wonkish will just hand wave and call $12.5 Trillion of market exposure "some derivatives" and say the free market will sort everything out. I respectfully disagree.  And frankly it frightens me that there are people that think this way.

But at that time LTCM wasn't allowed to fail not because it would cause wide scale losses throughout the financial system(that notion is a joke), but that it represented a likely end to a very profitable stream of income--issuing credit to those that were playing the markets.

I would call over a Trillion dollars of trades in a failing company's portfolio a lot of things... a "joke" isn't one of them.

Hey dumba$$ since you don't know the difference between total notional and net notional I'm not going to sit here and teach you how every class of derivatives work.

Your in over your head and you're making yourself look stupid.

As astonishing as it sounds $1.25 trillion in total notional derivatives is not that much. To give you an idea today Bank of American in all of its parts has more than $100 trillion in total notional derivatives today. That is a lot of total notional(but it still depends on which derivatives we're referring to as well because notional isn't a standardized number over derivatives, and net notional is more important than total).

Allow me to give you an example of a derivative play that has a high notional amount, but its exposure is rather small. Lets say you are a university with a $10 million in variable debt and there is another institution that has $10 million in fixed debt. You both decide that you would rather be the opposite(fixed instead of variable vs. variable instead of fixed) so you engage in an interest rate swap. So as long as the variable rate is lower than the fixed you pay the other guy the spread quarterly and when the fixed debt rate is lower than the other guy pays you the spread quarterly. Essentially both of you just refinanced your debt without going through the process. The total notional on that is $10 million, but that doesn't even come close to meaning that is the amount of capital deployed, leverage incurred, etc. The effect is actually quite small.

The plays that are being talked in the case of LTCM have an even larger disparity between actual exposure and total notional than this and they have even closer countervailing trades put on.

The total notional is highly misleading as to what exposure is because in the vast majority of cases the trade could be put on some other way(selling and buying) that has other disadvantages, but wouldn't carry a number even close to the size of notional value.

In other cases, like CDS the total notional is actually more representative of the actual risk in play because a full scale default actually triggers a payment of the entire notional amount. LTCM wasn't engaging in derivatives like those. They were engaging in derivatives with much, much, much less exposure relative to its notional number and they were putting on countervailing trades so their net notional was low and their net exposure was even lower.

[Link]

I wouldn't say that LTCM is the governments fault. I also wouldn't call LTCM a systemic risk. Nor do I think it had to prevented from failing. Option trading has a winner and looser. Systemic risk doesn't come from that.

LTCM was trading a lot more than "options" my friend.  Errr... that was kind of the umm.. problem.

That and some derivatives was where the vast majority their money was being put.

Some derivatives?!  That's like saying Bill Gross trades "some" bonds.  Maybe I'm a bit of a weenie but I would not call $1.25 trillion in interest rate instruments "some derivatives."  I would call that a huge freakin' problem that the Fed needs to look into.

Your fixation on the options portion of LTCM portfolio and your characterizations of a chunk of their operation as "some derivatives"  explains why you seem to think the LTCM was no big deal and that there was no need for government involvement.

So to get back on topic and address the OP's question.  No matter how big the failure of the private sector there are those in America who will say everything is going to be fine and the government doesn't need to get involved.  I know full well there is nothing I'm going to type that will make Wonkish at least consider the possibility that a government brokered orderly unwinding of LTCM was in any way a good idea.  Wonkish will just hand wave and call $12.5 Trillion of market exposure "some derivatives" and say the free market will sort everything out. I respectfully disagree.  And frankly it frightens me that there are people that think this way.

But at that time LTCM wasn't allowed to fail not because it would cause wide scale losses throughout the financial system(that notion is a joke), but that it represented a likely end to a very profitable stream of income--issuing credit to those that were playing the markets.

I would call over a Trillion dollars of trades in a failing company's portfolio a lot of things... a "joke" isn't one of them.

To give you an idea today Bank of American in all of its parts has more than $100 trillion in total notional derivatives today.

Did you just compare the US' largest bank to a handful of reckless guys in Conneticut unpinning financial grenades?

[Link]

You know if I was someone that made statements like this...

I also wouldn't call LTCM a systemic risk. Nor do I think it had to prevented from failing. Option trading has a winner and looser. Systemic risk doesn't come from that.

I would refrain from making statements like this...

Hey dumba$$

Your in over your head and you're making yourself look stupid.

[Wonkish1]

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We could probably find near universal agreement on the problems afflicting the U.S. health care delivery systems. It's the solutions where we might run into some disagreement, I would wager.

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In that case, I would probably wager that satisfaction varies greatly from plan-to-plan. I would suppose that an individual enrolled in a high deductible catastrophic-coverage only plan would probably have a lower level of satisfaction overall than a individual enrolled in one of those heavily lambasted "Cadillac" plans (assuming that the two individuals cited use the same array of health services). As a whole, I'll agree that many American's over-utilize their health services but I am generally wary of generalizations and the people who make them. Just saying.

I would say, however, that there has been some success controlling costs through cost-sharing (in regards to MCO's, not FFS) while maintaining good access to primary care, preventive serves, and health promotion activities. Despite anecdotes, individual perceptions, and isolated stories propagated by the news media, no comprehensive research to date has clearly demonstrated that HMO's and other MCO's have expended the quality of care delivered. Actually, the quality of care under HMO's has improved over time through early detection and treatment - which is more likely in an HMO. The pressures you cited do not lead to significant changes in physician behavior because under capitation a physician takes full responsibility for a patient's overall care. Also, HMO's and non-HMO's provide roughly equal quality of care as measured by a wide range of conditions, diseases and interventions. At the same time, HMO's lower the use of hospital and other expensive resources. Hence, medical care delivered through HMO's has been cost-effective. Of course, there has been evaluations that have indicated lower access and lower enrollee satisfaction rates for some HMO plans (particularly for-profit). So, it's a mixed bag. I'm just warning against generalizations again. HMO doesn't necessarily equal bad and unpopular. Like so many things in health care, it varies from case to case and from plan to plan.

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It was just an assumption. A pretty apt assumption at that, it seems. As per your request, the HMO Act of 1973 is a prime example. I don't know what you mean by "meaningful" exactly but it cannot be dismissed. It did, after all, kill Ted Kennedy's push for universal health care in the 1970's.

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Relatively speaking, you're right. Compared to some countries, we must look like a libertarian utopia. I just wanted to state the fact that cost-containment practices do exist in the United States.  

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Careful with the generalizations!

It really varies country to country. There aren't many "typical government run universal healthcare systems", I'm afraid. For example, Canada is primarily FFS plan so they contain costs by limiting access for non-medically necessary cases. (Incidentally, these elective cases are where most of your wait-times are seen). Germany, through the Socialized health insurance system, has more of a managed competition approach. The NHS has global budgets. Others have play-or-pay rules, employer mandates, double mandates, high risk pools, etc.

I, myself, am particularly fond of the principles of managed competition. Maybe intrigued is a better word - but that's for another post.

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I don't necessarily disagree with this assessment. In fact, it's probably more true than not.

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Ah, do we have a healthcare professional in our midst? Perhaps someone in a clinical practice profession? Nah. You seem not nearly arrogant enough. Healthcare administration? IT? Public Health?

Well the OPs question asked for generalizations as to why Americans don't want to see a universal healthcare system deployed in the US.

Yeah, but why do people shun HMOs(the private example of universal health systems) because if anything really expensive and bad happens(the reason why you have insurance) there is a good chance they may not cover it or hit(up until recently) a low maximum benefit and be forced into paying anything else yourself. So HMO plans had these maximum benefits that universal healthcare systems effectively deploy through the controlling of the available supply of expensive healthcare and then Obamacare came along and removed some of these limits like lifetime limits and now the plans are starting to and going to continue to explode in cost.

A generalization that points to Americans not liking and shunning HMO plans is not just a random generalization it is a fact. Most Americans will not get caught dead buying an HMO plan myself included because the purpose of insurance isn't to essentially prepay for cheap healthcare and have to worry if things get really expensive. The purpose of insurance is to cover the really expensive risks that come down the road because I haven't and can't budget for them.

I wouldn't call the HMO act of 1973 in anyway a meaningful market based solution.

I of course wouldn't dispute that their are cost containing mechanisms in the US.

That is why I used the term "government run" in the front. Plus when you look at government systems in much of Latin America, Africa, and Asia the vast majority of them are budget outlayed. But at least in most of the cases(unlike Canada, UK, France, etc.) most of the developing world is just outlaying basic low cost healthcare for their government run systems, but the quality is so lacking that as soon as someone gets even a remotely decent income they move to private. So for those countries their government systems are becoming pretty much a welfare system for poor people and should eventually represent lower and lower %s of the population that utilize them.

I will agree that Germany is a HUGE improvement relative to countries like Britain, France, Canada, etc. But I wouldn't necessarily call Germany "government run" nor are you. I call Germany government welfarized competitive insurance since it assesses % of income towards the risk pools.


Nope Finance as you can see by the other posts. But I have a sister who works a healthcare consultant, an Uncle who is a specialist, surgeon, and chief of staff, and another uncle that is in group benefits. I talk with them a lot and study this stuff as a hobby. Healthcare is probably my 2nd most studied political topic behind markets. How about you?

[Wonkish1]

Link you don't even understand how derivatives work and your acting like you have a leg to stand on against someone who does.

Your an absolute joke of a poster!! You talk about things that you don't have a clue about(and you say you have a couple of masters degrees and spent a lot of time in research---BULL$HIT).



And yes Systemic risk doesn't come from transfer payments only institutional risk does. They are different things.

[J. J.]

Actually, it is because it creates a culture of dependance on government, and rich or poor, Americans do not like government interference.

That is different than most European democracies.  In the UK, government is thought to be responsible for the people.  In the US, government is thought to be responsible to the people.

What is one of the objections to people receiving welfare?  "You want to get all in my business," "I have to show you everything," or things along that line.

Conversely, in PA, if you want to run for local, county, or state office, you were required to file a public financial statement.  You had to, in the 1990's, show any gift from a non family member of greater than $500, any source of income of more than $500 (I think that excluded interest).  You didn't have to show the amount.  I've known people that have refused to run for office because they didn't want to include that.

[Link]

and you say you have a couple of masters degrees and spent a lot of time in research---BULL$HIT).

Another obvious lie that is easily debunked.  I never claimed to "have a couple of masters degrees."

[Franzl]

What good does that treatment do you if you suffer from something like cancer that can't be treated through a simple ER visit?

Not to mention the simple stupidity of it. Don't think it's possible to create a system that is more inefficient.

Well in most other Universal Healthcare countries if you have cancer and it takes a turn down any of a number of common roads your screwed!!! And that is for the whole damn population.

Ah yes. As proven by the superior US health numbers and life expectancy. Oh wait.

[Wonkish1]

and you say you have a couple of masters degrees and spent a lot of time in research---BULL$HIT).

Another obvious lie that is easily debunked.  I never claimed to "have a couple of masters degrees."

Oh sorry several "degrees" then drop the masters part.

Link:

You must be logged in to read this quote.

^^^This is bull$hit unless you are actually talking about some University of Phenoix degrees and the international conference was a young socialist group conference held at some Hostel in Athens where the "experts" were people that finished community college.

Link your way to retarded to actually have the history you claim to have.

[Wonkish1]

Ah yes. As proven by the superior US health numbers and life expectancy. Oh wait.

Life expectancy doesn't prove or not prove the ability to get expensive cancer treatment when you get sick in respective countries. If you think that its better have lung cancer in Britain, Canada or France than it is to have an American insurance policy your an idiot!!

[Filuwaúrdjan]

I don't think it is ever good to have cancer.

Anyway, I know from the personal experience of too many of my close relatives that, actually, you do get access to expensive cancer treatment on the NHS. Quite how good depends on the cancer, for obvious reasons. There are also additional socio-cultural issues in the U.K regarding cancer (especially regarding the supposed embarrassment about talking about certain bodily functions; this might sound absurd, but is actually a very serious problem with men, especially older men), and there were some specific problems with cancer care until a couple of decades ago that (for what it's worth) had nothing to do with the structure or funding of the health service (and are no longer an issue).

I also know from rather direct personal experience that you also have access to expensive treatment for other serious illnesses on the NHS.

Certain other points need to be mentioned, I suppose. Firstly, private healthcare in Britain is not what might be assumed; actually it's mostly just the purchasing of a slightly privileged position within the same system as everyone else. Separate rooms, shorter waits for minor operations and so on. Same staff, same care, basically. It's a thing that people get in order to show that they've made it financially, more than anything else. Secondly, the NHS is not a massive cranking, clanking, semi-Stalinist bureaucratic monster, and never has been. It is actually fairly decentralised at an operational level. Whether that is a good thing or not depends on your point of view (personally I would like to see a more centralised service based around major regional hospitals as I think that is actually more effective and would guarantee quicker access to specialist care for everyone).

I also think that calm is a good thing, some of the time. A little more it would certainly be a good idea in this thread. Unlock.