Honest Unironic Question about the US Healthcare Reform Debate.

[beccatoria]

Hello US flisters (or others with information). I have a question. I am aware this will probably sound quite dumb, but I assure you this is an honest, unironic request for information because I am confusedI keep seeing the claims - even from like, the "reputable-and-not-crazy" side of the anti-reform people - that public healthcare is bad because

Comments

[pellucid]

I think the best context here is the conservative ideology that is automatically skeptical of the government (too big, too expensive, too inefficient, too controlling, etc.) and in the converse, generally inclined to look favorably on capitalist enterprises (the theory being that the competition in the insurance company marketplace raises the quality of service--as does competition in any marketplace). So there is a fear that any single-payer system, but especially one run by/accountable only to the government, would be inefficient and possibly contribute to some vast conspiracy to turn the United States into a communist country. It's not an ideology I subscribe to (I'm far more likely to support big government and be mistrustful of capitalism, myself!), but it's a pervasive one in much of the US. Lots of intelligent conservatives have well-reasoned arguments for this, but there's also a very high degree of knee-jerk government=BAD going on for many people who haven't bothered to think things through very much

[nicole_anell]

You said that all much better.

[zepooka]

You've pretty much said it with the theory about the competition improving the quality of service... except it never works out as well as it should, because insurance companies are, in the end, companies, that want more money in any way possible. So to get good care, not only do you need a good hospital (because not all hospitals are created equal), you also need to have a level of insurance that will get you whatever medical stuff you need. It's pervasive because capitalism runs the country, and the idea that universal health care might OMG RAISE YOUR TAXES terrifies anybody who already has insurance and is petrified to think that some immigrant or homeless person might live through the night and cost them their new iPhone through tax dollars

[pellucid]

Oh, yes, I completely agree with you. I was just trying to give the conservatives a tiny bit of the benefit of the doubt--sort of as a mental exercise. Mostly they make me want to hit them with very big sticks because I know all too well what it's like to be without health insurance in the US (and to have loved ones with no health insurance AND chronic health issues), and then I moved to the land of milk, honey, and socialized medicine Canada, and there is not enough capslock in the world to emphasize HOW MUCH BETTER IT IS HERE!!!!!!!

[nicole_anell]

Is this just a massive sleight-of-hand they're pulling?
Pretty much. There is *already* a third party (insurance company) getting "in between you and your doctor" as they like to say. They're just stirring up concern about this being a government entity because some people fear and distrust the government above everything.

[beccatoria]

Thanks. As I said above this info really is helping. I'm so used to being a little above the curve in terms of general American Culture knowledge over here in the UK that it was...disconcerting to suddenly come face to face with something I flat out did not "get" on a very basic level. And I'm pretty sure now it that yes, that difference is the ways in which vocal parts of the country bitch about the government. Both hate it and think it's too incompetant to administrate a piss-up in a brewery, but in the UK that's usually met with righteous indignation and an insistance that the other side would do better, while in the US it's met as evidence that they should just leave them the hell alone

[coffeejunkii]

as someone from europe who has grown up with state-sponsored health care, i do not understand this paranoia that many americans seem to have re: the government getting involved in health care. it will not be the end of america as we know it! ugh, so frustrating.

[beccatoria]

No, neither do I! It's kind of why I asked. I'm used to, even when I don't understand on an emotional level or agree at all, at least have some technical understanding of the logic the opposition uses ot reach its conclusions, no matter how horrifying. But this is like...every yes/no question I ask gets answered with "Fish!" It's...disorienting.

[metatxt]

YUP. Not only that, but the public option as proposed really is no different than expanding Medicare as an option for all citizens, rather than universal health care like the NHS. Far as I know, the only two changes this really makes is: access for all citizens + introducing competition in the insurance monopoly. Even though capitalism would assume that the insurance companies compete against each other, the only way they can quickly turn profit (rather than investing in patient health, predicated on longer-term returns) is through increasing denial of care

[beccatoria]

I was at least aware that a "proper" universal healthcare system was not on the cards. :(

I also think that I'm getting a slightly better handle on it now that I'm factoring in the true extent of government distrust. I was thinking of it in UK terms which means, "Damn the government is incompetant and can't run the NHS properly. LET'S GET ONE THAT CAN!" rather than "LET'S PRIVATISE IT ENTIRELY!"

I also <# your comments about how the competition is between the business and the consumer. I already knew I thought it was a terrible way to run healthcare because an insurance company's vested interest is in giving you as little as legally possible; that's the business model of insurance companies, but I'd never seen it converted to that simple - and obvious but somehow easily overlooked - point that it puts the consumer in competition with the busienss.

(((poor americans)))

[greycoupon]

*points to the people more verbose than I*

You forgot that doctors will make more money working at McDonalds.

[beccatoria]

You forgot that doctors will make more money working at McDonalds.

*facepalm* Wow, that's a keeper. I hadn't actually heard that one before. I mean it is true I'm sure doctors make less here, but it's still a really well-paid job and competition to do it is fierce.

That said, I will not deny that actually a fair number of our doctors do come from abroad and part of that is, I think, to do with salary and how it's more in the private sector.

But there are plenty of british doctors who do stay with the NHS and it's hardly an indictment of an entire system. Especially since I think - and I may be wrong here - that it's not so much we're losing british doctors to places like America (thought hat happens too) but that we're losing them to our own private systems?

Which is another whole weird thing about this? People seem to think private healthcare is going to get banned or something? *sigh*