SB 107-02: Hospitals Act (Rejected)

[WD]

Hospitals Act  

1. All hospitals, clinics, hospice facilities, and nursing homes within the boundaries and under the legal jurisdiction of the Republic of Atlasia shall become property of the Republic of Atlasia effective January 1, 2022.
    1a. The owners of said properties shall be fairly compensated under all relevant law concerning the purchase of said properties.
2. All persons currently employed in the facilities mentioned in Section 1 shall become employees of the Republic of Atlasia effective January 1, 2022.
    2a. Employees covered by this Act shall elect a works council tasked with the day to day operations of the firm in question.
3. $1,000,000,000,000 will be allocated toward the construction of new hospitals, clinics, hospice facilities, and nursing homes over a period of five years, effective January 1, 2022.
4. Upon the passage of this legislation, no privately owned hospital, clinic, hospice facility, or nursing home may be built or opened in the Republic of Atlasia or in any area subject to its jurisdiction.
5. The AtlasCare program shall end on January 1, 2022.
6. Effective January 1, 2022, private hospital companies, insurance agencies, hospice care companies, and nursing home companies shall be placed under public ownership.
    5a. The owners of said properties shall be fairly compensated for any losses incurred as a result of said purchase of facilities.

Sponsor: Ishan

The gentleman from Northern Ireland is recognized.

[Continential]

The issue that I would be considered a far-left winger on is healthcare, and I believe that healthcare is a human right which shouldn't be used for the intent of making profit and shouldn't be considered an industry.

Here's an amendment to the Act.

Hospitals Act

1. All hospitals, clinics, hospice facilities, and nursing homes within the boundaries and under the legal jurisdiction of the Republic of Atlasia shall become property of the Republic of Atlasia effective January 1, 20223.
    1a. The owners of said properties shall be fairly compensated under all relevant law concerning the purchase of said properties.
2. All persons currently employed in the facilities mentioned in Section 1 shall become employees of the Republic of Atlasia effective January 1, 20223.
    2a. Employees covered by this Act shall elect a works council tasked with the day to day operations of the firm in question.
3. $1,000,000,000,000 will be allocated toward the construction of new hospitals, clinics, hospice facilities, and nursing homes over a period of five years, effective January 1, 20223.
4. Upon the passage of this legislation, no privately owned hospital, clinic, hospice facility, or nursing home may be built or opened in the Republic of Atlasia or in any area subject to its jurisdiction.
5. The AtlasCare program shall end on January 1, 20223.
6. Effective January 1, 20223, private hospital companies, insurance agencies, hospice care companies, and nursing home companies shall be placed under public ownership.
    5a. The owners of said properties shall be fairly compensated for any losses incurred as a result of said purchase of facilities.

[Schiff for Senate]

The issue that I would be considered a far-left winger on is healthcare, and I believe that healthcare is a human right which shouldn't be used for the intent of making profit and shouldn't be considered an industry.

Yes, this bill doesn't seem bad in theory, and I'd be open to supporting it, though it would depend on specifics. The particular amendment you just offered seems fairly reasonable.

[WD]

24 hours to object to the amendment

[S019]

I am not going to support this. As I said in the other thread, I am mostly a capitalist, and I only support nationalization in extreme circumstances to deal with urgent crises. The current AtlasCare system works fine and a competitively priced public option will compete just fine with private plans. Anyways, very few national health system ban private hospitals to begin with, this is just a nonstarter for so many reasons.

[Joseph Cao]

The amendment is fine. I've yet to see an argument that taking a sledgehammer to the system will be the panacea people claim it is, however, especially when people have squared the legislative circle to make AtlasCare work for every category of Atlasian citizen.

[Schiff for Senate]

I might support this.

[The world will shine with light in our nightmare]

I certainly don't plan on ending AtlasCare. The healthcare system we have in place now is a successful one that was carefully drawn out and negotiated by multiple people in both parties. We have only been expanding AtlasCare since the original law passed to cover more services, and regions can even set AtlasCare as the sole provider if they so desire.

[Schiff for Senate]

I might support this.

In truth, I had not considered all aspects of this debate when I made this remark. One constituent PM'd me with a paragraph detailing reasons to oppose this, and one particular point in particular has convinced me this bill is something I should oppose - I hadn't considered it until then, but abolishing all private hospitals would result in even those who can afford superior medial treatment (so they can get better care, avoid waiting for very long, etcetra) do not have an option to do it. Were an amendment added to address this issue, I would consider supporting this bill, but as it currently stands, I am leaning towards opposing it.

[West_Midlander]

I might support this.

In truth, I had not considered all aspects of this debate when I made this remark. One constituent PM'd me with a paragraph detailing reasons to oppose this, and one particular point in particular has convinced me this bill is something I should oppose - I hadn't considered it until then, but abolishing all private hospitals would result in even those who can afford superior medial treatment (so they can get better care, avoid waiting for very long, etcetra) do not have an option to do it. Were an amendment added to address this issue, I would consider supporting this bill, but as it currently stands, I am leaning towards opposing it.

Thank you for bringing up this point, CR. I was undecided on the bill but I will oppose it because government typically does a bad job of providing even essential services. Leaving any industry especially something as vital as healthcare wholly up to the government is a bad idea.

As part of the American Dream, people who have fought all their lives to better themselves and their families should be able to pay for premium healthcare. I do believe that there should be free or low-cost care available to low-income people, the disabled, seniors, and children of low-income people, though.

[Schiff for Senate]

To be clear - I would support this bill if at least one of two things happened:

a.) a broad majority of respondents to the poll I made indicate they support this bill
b.) an amendment was added to this bill allowing for SOME private hospitals to exist and for the wealthy to seek medical treatment there if they can afford it and want to do so

My office may draw up an amendment regarding the latter in a few days, while the former is ongoing.

[Senator-elect Spark]

Wouldn't this bill have the effect of nationalizing the health care sector? I'm all for keeping Atlasians healthy of course, but I think there's a better way of going about this such as doing the public option, and expanding coverage to as many citizens as possible.

[Continential]

To be clear - I would support this bill if at least one of two things happened:

a.) a broad majority of respondents to the poll I made indicate they support this bill
b.) an amendment was added to this bill allowing for SOME private hospitals to exist and for the wealthy to seek medical treatment there if they can afford it and want to do so

My office may draw up an amendment regarding the latter in a few days, while the former is ongoing.

Why should the wealthy be the ones who get better healthcare while the masses gets normal healthcare? I support a healthcare system that makes sure that all Atlasian citizens have the same quality of healthcare regardless of their income, and I would be willing to expand the amount allocated towards building new healthcare facilities and I'll introduce an amendment that'll allocate money to renovate/modernize existing healthcare facilities to improve the quality of those facilities.

[WD]

I might support this.

In truth, I had not considered all aspects of this debate when I made this remark. One constituent PM'd me with a paragraph detailing reasons to oppose this, and one particular point in particular has convinced me this bill is something I should oppose - I hadn't considered it until then, but abolishing all private hospitals would result in even those who can afford superior medial treatment (so they can get better care, avoid waiting for very long, etcetra) do not have an option to do it. Were an amendment added to address this issue, I would consider supporting this bill, but as it currently stands, I am leaning towards opposing it.

There is no evidence that private healthcare is superior to public healthcare. That is a falsehood. Overall, I agree with the sponsor that healthcare should not be an avenue for profit generation and I support this bill.

[S019]

Private hospitals do offer better quality of care in nations where both are offered, perhaps this is because less people use them, but this point is not really up for debate.

[Southern Senator North Carolina Yankee]

The main problem with the American health care system (IRL) is that the incentives all point towards and inflationary posture.

1. Everyone gets emergency care but not preventative care.
2. Yes it is overwhelmingly private sector, but with many multitude of competing programs that subsidize the industry as a side effect of helping a targetted group.
3. Alongside of this subsidization, there is no attempt at leveraging lower prices because of the disparate nature of the government programs and the fractional nature of the health care system, means no one is in a position to sort of level the playing field
4. Massive amounts of special interest money flows into Congress and the allure of the potential lobbying careers for Congress, staff and executive personnel means they are literally greasing the wheels of post public office careers where millions of dollars will be made in the future by selling out the public interest now.

However, in game:
1. Atlascare covers preventative care and the subsidies and such work to reduce this mal-incentive.
2. The government programs have been consolidated into Atlascare, giving it massively more leverage than the Medicare program in real life.
3. The equivalent of "Medicare negotiating lower drug prices" not only exists for the larger Atlascare and has for going on five years now, but such has also been cross applied to hospitals, producers of medical supplies/equipment and etc.
4. We don't have that kind of corruption here.

The end result is that most of the incentives here point away from health care inflation while not leaving people to die in the streets and ensuring greater access to health care, in part because so much work has been done to reign in the costs.

I credit President Scott for his work as such on ensuring the application and enhancement of these provisions in the area of drugs beyond what the original bill even had.

[Southern Senator North Carolina Yankee]

Beyond the practical effects of the Atlascare program as detailed in my previous post, I would draw attention to this issue from an area of game mechanics as this is a policy area, where within certain limits, regional agency has been preserved for the sake of game play, including a number of market place regulations as well as to regulate the kind of delivery modes available.

Atlascare deals primarily with paying for health care, as in you go to someone and pay them to cover your expenses aspect of health care. The space occupied IRL by insurers, medicare, etc. The regulations within the larger bill deal with setting up how that relationship works, helping people who need it to afford it and as stated previously, the presence of various structures, and policies whereby "coverage" aspect of health care can have a substantial impact on the "delivery", ie the realm of hospitals, clinics, etc etc.

The presumption being that if the regions wanted to experiment with different models would thus have a degree of freedom in terms of how they could structure their regulations and thus allow them to structure a different setup. It gets back to a concern that pertains to centralist approaches, that if you completely "resolve" a situation without no room for maneuver down the line, you have shut down that as a "playable" option for those lower entities and that is a consequence here that needs to be considered.

[Southern Senator North Carolina Yankee]

The point about profit, we have a number of areas where profit is not only allowed but expected in terms of the production of necessities of life. Food, clothing, entertainment (I would consider it a necessity), alcohol for some. Anyway the point being is we don't feel the need for the government to start manufacturing canned beans because of how much money Pepsi Co makes.

We even decided a long time ago that the most efficient way to help fight hunger was to give people aid on a card (yes this was done through a more complex process some time ago), that they then take and use to buy groceries from a privately owned supermarket or big box store, where they buy food products manufactured by private industry. In fact it is the right, during the Trump administration IRL, that made the argument in favor of a "socialist scheme" distributing beans and rice to people Soviet Style as a way to remove the ability to "waste" food stamps on "luxury foods" or whatever the hell they claimed. As some will recall, I spoke out about this ridiculous proposal at the time.

So process that, we give people food stamps on a card, which are then used to buy goods in a privately owned super market, which is selling privately produced food items, most all of which (baring a few co-ops) is operating on the for profit model.

If it works for food, why does health care have to be nationalized "because people shouldn't profit off a persons health". The whole reason why health care is different and it is regarded as different is because of the inflationary mal incentives IRL, the resulting insane prices that it produces and get this "the corruption induced" government policies that allow it to happen.

That is the only reason why there is such an appetite for nationalization and single payer in the United States IRL today because of the influence of the anglosphere and the fact that industry induced gov't corruption makes any alternative unfeasible. However, if the past year has served as any guide in such matters, those same dynamics will stop the anglosphere centralist approach from happening just as much as it stands in the way of a German or Swiss model. I have long contended that the latter is a better fit for America IRL based on its history and traditions etc, etc. I have never bought into the argument that the Anglosphere approach is "more practical" because of the corruption, which obviously isn't any less induced to bribe away the possibility of then it would be such a regulated multi-payer system.

I don't support monopolies, be they government or private and I think the creation of a government monopoly here in the quest to solve an IRL problem or appease certain ideological sensibilities, is only going to create more problems then it fixes, especially when failing to account for the differences in game, relative to the situation IRL.

 

[Continential]

Reserved for post I'll make later today after school.

[WD]

The issue that I would be considered a far-left winger on is healthcare, and I believe that healthcare is a human right which shouldn't be used for the intent of making profit and shouldn't be considered an industry.

Here's an amendment to the Act.

Hospitals Act

1. All hospitals, clinics, hospice facilities, and nursing homes within the boundaries and under the legal jurisdiction of the Republic of Atlasia shall become property of the Republic of Atlasia effective January 1, 20223.
    1a. The owners of said properties shall be fairly compensated under all relevant law concerning the purchase of said properties.
2. All persons currently employed in the facilities mentioned in Section 1 shall become employees of the Republic of Atlasia effective January 1, 20223.
    2a. Employees covered by this Act shall elect a works council tasked with the day to day operations of the firm in question.
3. $1,000,000,000,000 will be allocated toward the construction of new hospitals, clinics, hospice facilities, and nursing homes over a period of five years, effective January 1, 20223.
4. Upon the passage of this legislation, no privately owned hospital, clinic, hospice facility, or nursing home may be built or opened in the Republic of Atlasia or in any area subject to its jurisdiction.
5. The AtlasCare program shall end on January 1, 20223.
6. Effective January 1, 20223, private hospital companies, insurance agencies, hospice care companies, and nursing home companies shall be placed under public ownership.
    5a. The owners of said properties shall be fairly compensated for any losses incurred as a result of said purchase of facilities.

Amendment is adopted.

[Former President tack50]

Iirc this is modeled after an old TNF bill right? I remember considering something like this back when Inwas more active lol

In any case the bill is a bit too extreme even by my standards (where "Medicare for all" would be a compromise and a right wing policy). However yes, hospitals should be mostly in public hands. This is an issue I 1000% support

[Schiff for Senate]

To be clear - I would support this bill if at least one of two things happened:

a.) a broad majority of respondents to the poll I made indicate they support this bill
b.) an amendment was added to this bill allowing for SOME private hospitals to exist and for the wealthy to seek medical treatment there if they can afford it and want to do so

My office may draw up an amendment regarding the latter in a few days, while the former is ongoing.

Why should the wealthy be the ones who get better healthcare while the masses gets normal healthcare? I support a healthcare system that makes sure that all Atlasian citizens have the same quality of healthcare regardless of their income, and I would be willing to expand the amount allocated towards building new healthcare facilities and I'll introduce an amendment that'll allocate money to renovate/modernize existing healthcare facilities to improve the quality of those facilities.

Then it appears this is where our views on this subject diverge. I believe everyone should have access to healthcare, but I don't necessarily believe everyone needs to have equal access, especially if that access is quite frankly inferior and drags down those who can afford better. I definitely support those who don't have access to healthcare to get healthcare, but I don't think there's any need to force the wealthy to that same level of healthcare if they can afford superior healthcare and want it (and are willing to pay for it). This bill would be unfair to those people under the veil of equality. Everyone should have access to healthcare, but that shouldn't mean that some people are forced into having worse healthcare than they'd otherwise have - seems inferior. I am considering adding an amendment to address this; alternatively, if you want to, you could do it. If the amendment passed (I'd support it), then I would likely back this bill, but without an amendment to protect the wealthy and allow them to retain superior healthcare, I doubt this bill will be getting my vote (on a related note, I am tracking the results from my poll - the people are split about evenly, and I will thus vote my conscience on this bill).

[Schiff for Senate]

I might support this.

In truth, I had not considered all aspects of this debate when I made this remark. One constituent PM'd me with a paragraph detailing reasons to oppose this, and one particular point in particular has convinced me this bill is something I should oppose - I hadn't considered it until then, but abolishing all private hospitals would result in even those who can afford superior medial treatment (so they can get better care, avoid waiting for very long, etcetra) do not have an option to do it. Were an amendment added to address this issue, I would consider supporting this bill, but as it currently stands, I am leaning towards opposing it.

There is no evidence that private healthcare is superior to public healthcare. That is a falsehood. Overall, I agree with the sponsor that healthcare should not be an avenue for profit generation and I support this bill.

Unless we plan on creating a very expansive government healthcare program, which I would oppose, no, this simply isn't true. Private industry will always offer better services than the government with regards to healthcare if cost is no object, and if for the wealthy cost is of no object and they are willing to pay a lot of money for better healthcare, I don't see why they need to be forced to settle for - what would inevitibly be inferior - government healthcare.

[WD]

To be clear - I would support this bill if at least one of two things happened:

a.) a broad majority of respondents to the poll I made indicate they support this bill
b.) an amendment was added to this bill allowing for SOME private hospitals to exist and for the wealthy to seek medical treatment there if they can afford it and want to do so

My office may draw up an amendment regarding the latter in a few days, while the former is ongoing.

Why should the wealthy be the ones who get better healthcare while the masses gets normal healthcare? I support a healthcare system that makes sure that all Atlasian citizens have the same quality of healthcare regardless of their income, and I would be willing to expand the amount allocated towards building new healthcare facilities and I'll introduce an amendment that'll allocate money to renovate/modernize existing healthcare facilities to improve the quality of those facilities.

Then it appears this is where our views on this subject diverge. I believe everyone should have access to healthcare, but I don't necessarily believe everyone needs to have equal access, especially if that access is quite frankly inferior and drags down those who can afford better. I definitely support those who don't have access to healthcare to get healthcare, but I don't think there's any need to force the wealthy to that same level of healthcare if they can afford superior healthcare and want it (and are willing to pay for it). This bill would be unfair to those people under the veil of equality. Everyone should have access to healthcare, but that shouldn't mean that some people are forced into having worse healthcare than they'd otherwise have - seems inferior. I am considering adding an amendment to address this; alternatively, if you want to, you could do it. If the amendment passed (I'd support it), then I would likely back this bill, but without an amendment to protect the wealthy and allow them to retain superior healthcare, I doubt this bill will be getting my vote (on a related note, I am tracking the results from my poll - the people are split about evenly, and I will thus vote my conscience on this bill).

But why? I, for one, do not believe you are entitled to better healthcare just because you are financially well off. And you talk about “protecting” the wealthy; why do those who are the most well off need “protection”. This viewpoint of wanting to protect to interests of the wealthy above all else is quite classist, if you ask me. A just society prioritizes and gives to those who are vulnerable and in need.

[Schiff for Senate]

To be clear - I would support this bill if at least one of two things happened:

a.) a broad majority of respondents to the poll I made indicate they support this bill
b.) an amendment was added to this bill allowing for SOME private hospitals to exist and for the wealthy to seek medical treatment there if they can afford it and want to do so

My office may draw up an amendment regarding the latter in a few days, while the former is ongoing.

Why should the wealthy be the ones who get better healthcare while the masses gets normal healthcare? I support a healthcare system that makes sure that all Atlasian citizens have the same quality of healthcare regardless of their income, and I would be willing to expand the amount allocated towards building new healthcare facilities and I'll introduce an amendment that'll allocate money to renovate/modernize existing healthcare facilities to improve the quality of those facilities.

Then it appears this is where our views on this subject diverge. I believe everyone should have access to healthcare, but I don't necessarily believe everyone needs to have equal access, especially if that access is quite frankly inferior and drags down those who can afford better. I definitely support those who don't have access to healthcare to get healthcare, but I don't think there's any need to force the wealthy to that same level of healthcare if they can afford superior healthcare and want it (and are willing to pay for it). This bill would be unfair to those people under the veil of equality. Everyone should have access to healthcare, but that shouldn't mean that some people are forced into having worse healthcare than they'd otherwise have - seems inferior. I am considering adding an amendment to address this; alternatively, if you want to, you could do it. If the amendment passed (I'd support it), then I would likely back this bill, but without an amendment to protect the wealthy and allow them to retain superior healthcare, I doubt this bill will be getting my vote (on a related note, I am tracking the results from my poll - the people are split about evenly, and I will thus vote my conscience on this bill).

But why? I, for one, do not believe you are entitled to better healthcare just because you are financially well off. And you talk about “protecting” the wealthy; why do those who are the most well off need “protection”. This viewpoint of wanting to protect to interests of the wealthy above all else is quite classist, if you ask me. A just society prioritizes and gives to those who are vulnerable and in need.

Everyone is entitled to healthcare. I agree with that statement. But there are then three ways about it:

1.) Everyone is forced into the same, low-to-low-medium-quality government healthcare.
2.) Everyone is forced into the same, high-medium-to-high-quality government healthcare.
3.) Those who cannot afford it are given access to government healthcare, but those who can afford it have the option to opt out and get private medical treatment they pay for themselves.

I believe the second and third options would be theoretically just, though I'd much prefer the third and question the practicality of the second. What's very possibly being proposed here is the first of these, and that I cannot in good conscience support. So I intend on introducing an amendment to change this, and if the amendment passes, I will vote for the bill.