Health care - what Republicans don't understand

[fpb]

Comments

[dustthouart]

I'll be leaving for class shortly, but I do want to make one comment, regarding something that has occurred to me. Prescription medications are extremely expensive in the US and reasonable to inexpensive everywhere else, as far as I know. (I know they're cheaper in Mexico, Canada and Taiwan.) Exact same brand and dose may cost a fraction of what it is in the US. In the US, I used insurance and paid a copay of $10 every time I refilled my prescription; in Taiwan, I paid less than $10 out of pocket for the whole thing. (Taiwan has nationalized healthcare, but as a foreign student I had to pay out of pocket, and it was always cheaper than I would have paid WITH INSURANCE in the US

[starshipcat]

The MDeity effect is at least partly responsible for this. Once we start treating doctors like gods, we start expecting godlike performance from them -- and when they fail to deliver, we don't accept that they are just human beings, but instead blame them for not producing a miracle.

Then there is the whole thing of using the courts as slot machine, hoping to get the lawsuit payout so big you'll never have to work again, but that's a whole nother rant for another time.

[elskuligr]

I think you may be confusing two methods through which governments may make health care affordable

[stigandnasty919]

Isn't one of the main reasons why American Health Care is so much more expensive in the USA that in much of the rest of the world is that it is a business? Designed to make money. In Canada and Europe you can cut the cost by whatever the cumulative profit margin is for drug distribution, lab work, medical insurance and hospitals. The total cost is borne by the tax payer and no profit is expected.

I'm not sure if costs for the rest of the world would go up for drugs. I don't think they currently differ much at source, however instead of there being a distribution margin added to the top of the cost, as in the USA, there is a subsidy from taxation, provided in Canada and in the UK. And I think, but stand to be corrected, that the time for which patents for drugs are protected is shorter in the rest of the world than in the USA.

I do think that there is a danger that if the US moved to a social medicine system, that the engine of research, the profits derived from the medical industry, would stall and we would see fewer medical

[elskuligr]

"I do think that there is a danger that if the US moved to a social medicine system, that the engine of research, the profits derived from the medical industry, would stall and we would see fewer medical breakthroughs."

On the contrary: medicine would be paid for by the state, so more people would have access to it, so the companies would be able to sell more instead of limiting their market to people who can afford it with their own means.

Of course if a "social medicine system" meant control of the industry by the state, as in some form of communist economy, you would be right, but that's not what a national health system is about.

[stigandnasty919]

In most european countries and, I believe, in Canada, Cuba etc. the national health systems are controlled by the state. The Health Services are not industries, but services. Canada and the UK and the rest of europe

[cheyinka]

When I was in high school I had half a year of "civics class", which was pretty pathetic (and miserable to endure - I had classmates who would literally howl to prevent anyone from asking or answering questions in class!). The only two lessons I retained about voting was that women weren't always allowed to do so (and it was wonderful that women could vote now) and that one person's vote didn't matter, but we had to all pretend that everyone's vote mattered, otherwise nobody would vote and the government would simply cease to exist. As far as taxation went, well, government was inefficient and politicians were greedy but it was important to pay taxes anyway.

If my experience was anything like representative, I think it explains at least some of the American attitude towards taxes and voting.

[fpb]

We do not expect taxation to be spent efficiently, and we do not imagine that one vote out of forty million (in Italy) or even two hundred thousand (in Luxemburg) will make a huge difference. The point is rather that voting is a feature of the connection of the citizen with the State; it validates the authority of the State, by basing it on explicit popular support, and conversely it shows that the citizen has a definite claim on the State. Which, in turn, means that the citizen has a right to take any politial initiative (within the law) that seems right to him or her. One person never makes a difference, but many times one person makes a party, a movement, or a people.

That being said, it sounds as if you had a teacher with serious personal disappointments.

Re: The low voter turnout

[elegant_bonfire]

I know a few years ago, there were a lot of people who never registered to vote as they didn't want to serve on a jury. (The county used the voter registration rolls to call jurors.)

Now, however, jury duty is pulled from the Secretary of State's records, as they issue driver's licenses, and state ID cards for the eensy minority of non-driving people here. So there's no excuse.

Re: The low voter turnout

[fpb]

I did not think of jury duty, but yes, I would look on it in the same light - as a citizen's duty. (In Italy it is actually quite recent: jurors, called "popular judges", were only introduced in the courts with the Constitution of 1948.)

Re: The low voter turnout

[elegant_bonfire]

I would serve on a jury if I were called. Some people don't want to do it as their job doesn't give them jury duty pay (mine does).

Bit of trivia: The cop slang for a situation where an officer may have to shoot someone who's threatening them--"I'd rather be tried by twelve than carried by six."

Re: The low voter turnout

[fpb]

I also heard a six-shooter called a "jury of six".

[mindstalk]

Nice post.
Regarding voting: most of Europe has some version of proportional representation by now, don't they? That might explain some of it: in much of the US, the marginal difference an individual voter makes seems non-existent. If I'm a Democrat in Hawaii, and I've never voted, there's no point to my starting voting; the state is majority Democratic. Not much point to voting as a new Republican, either. But with PR, a new vote has a small but real marginal addition to the power of its party.

jury duty: a duty, but one potentially rather disruptive to a life, at a random time, for a potentially arbitrarily long time, and for $5 a day. The Athenian jury doubled as a dole; ours isn't sufficient for that.

Regarding types of health systems, an interesting article on path dependence, and why almost no one has as socialized a system as Britain.