Logic/Philosophy behind American health care

[Velho]

I have a hard time grasping the logic behind the American private-insurance-healthcare. According to Wikipedia 16.7 percent of the population was uninsured in 2009, effectively cutting them off of healthcare. A study in five states in 2001 found that 46.2% of all bankruptcies were related to medical debt, and in 2007 62.1% of bankruptcy filers claimed high medical expenses. At the same time the US spends more money per person on health care than any country in the world, and a greater percentage of income is used for health care of any nation in the UN except for East Timor.

Since those studies the costs and the number of uninsured have increased.

To me it seems like it would be smarter to provide universal health care by making each individual state take care of these responsibilities. I know most libertarians don't want any level of government involved in this, but by looking at the statistics it seems like you are getting screwed by the insurance/medical companies. It's insane that one of the most industrialized nations in the world cannot provide health care for all of its citizens. It's also insane that you let profit wreak havoc on peoples health.

I'm not saying you should get rid of the private sector, since rich folk want to get the feeling that they're getting the best possible treatment. But for the middle class, especially the lower end of the middle class, and the poor, free or almost free health care is extremely important so that they don't have to go to debt or bankrupt if something unexpected happens.

Please explain how the American philosophy on this works, since I've always thought that in a society there are a few basic things which the government has to provide, and one of them is free health care alongside the private sector. Thanks. :)

[MelissaWV]

One of the reasons the costs are so high is the Government's involvement at various points along the line.

Medicare and Medicaid are bloated and awful, and nothing is ever "free." The money comes from somewhere, and whether it's thin air (we just go further into debt) or our pockets, neither prospect appeals to me.

The "profits" that insurance companies make used to come largely from investments. More people are actually using their insurance now, with the rise of catastrophic illnesses and chronic health conditions. Medication is ridiculously expensive, which goes back a great deal to Gov regulation. Insurance is a contract which many don't even read. They don't understand there is a deductible, copay, co-insurance, out of pocket, and maximum benefit. When those benefits run out, they cry foul.

You are not denied emergency care. ER's will not frisk you for an insurance card and refuse to treat you if they don't find one. This idea of the poor dying in the streets because they couldn't get seen is cliche and incorrect. No, I don't think people should be crowding the ER, but it's a stopgap measure at this point.

Lastly, many people have "free" health insurance or close to it... through their employer. Of course, when so many are out of work or working temp positions, benefits are harder to come by. Mandating that the same taxes the Government already takes out each week (even most people that qualify for "EXEMPT" seem to fill out their tax forms to take out taxes every check for some reason) go to paying for one's own "universal" healthcare which, in this country, would be as wretched as the clinic system is currently... why would that be a good idea?

[Velho]

Thanks for the answer. :)


Medicare and Medicaid are bloated and awful, and nothing is ever "free." The money comes from somewhere, and whether it's thin air (we just go further into debt) or our pockets, neither prospect appeals to me.

No of course not, but by taking care of this through taxation and making the states take care of it instead of profit maximizing companies, it would most likely be cheaper.


Medication is ridiculously expensive, which goes back a great deal to Gov regulation.

I do not know about the details of this, but once again this could be done through taxation, throw out regulation that isn't needed and subsidize the cost so that even the poor can afford it.


Insurance is a contract which many don't even read. They don't understand there is a deductible, copay, co-insurance, out of pocket, and maximum benefit. When those benefits run out, they cry foul.

Sounds like an annoying system tbh.


You are not denied emergency care. ER's will not frisk you for an insurance card and refuse to treat you if they don't find one. This idea of the poor dying in the streets because they couldn't get seen is cliche and incorrect.

I understand that people are not left to die, but I've also read that trips to ER can easily leave you in debt so badly that you go bankrupt. I wouldn't want to die because of an emergency, but I sure wouldn't want to lose my income either.


Lastly, many people have "free" health insurance or close to it... through their employer.

That is a good thing, but I'm guessing that you lose this insurance the moment you leave the company, and if you happen to be going trough a hard time in your life/can't find work then you are in a tough spot. Universal health care and employer subsidized health care are able to co-exist.


Of course, when so many are out of work or working temp positions, benefits are harder to come by. Mandating that the same taxes the Government already takes out each week (even most people that qualify for "EXEMPT" seem to fill out their tax forms to take out taxes every check for some reason) go to paying for one's own "universal" healthcare which, in this country, would be as wretched as the clinic system is currently... why would that be a good idea?

I think that this is more about the spending priorities of the government. Maintaining an empire is expensive. I'm sure there are many other expenses that simply shouldn't be there in the first place. I think that it is smarter to invest in your own people instead of bombs, bribes, bases and bailouts.

[Live_Free_Or_Die]

It's pretty simple:

either you own yourself or someone else owns you...
either you have free will or someone else has free will over you...

It's no more complicated than:

is rape, pillage, plunder, theft, and murder wrong?
does it magically become right if a group of people do it?

[Created4]

[QUOTE=Velho;3355644 According to Wikipedia 16.7 percent of the population was uninsured in 2009, effectively cutting them off of healthcare. [/QUOTE]

The problem is in the definition of "healthcare." What you are describing is "medical care," and it assumes that "medical care" equals "health care." For every drug the pharmaceutical companies want to market to you to supposedly provide "health care," there is a natural alternative that is less expensive and in almost all cases more effective. They are found in nature, and cannot be patented and marketed for the insane margins and profits that pharmaceutical companies make. Properly prescribed drugs are the third leading cause of death in the U.S., at over 106,000 deaths per year. When you add deaths from recreational use of prescription drugs and illegal drugs, drugs are easily the leading cause of death in the U.S., easily trumping heart disease and cancer.

As to health insurance, if you take care of your own health and take responsibility for your own health, you don't need it. I am constantly amazed how most people do not understand this basic principle: insurance companies can only survive and earn a profit from insuring healthy people. If you are "insurable" because you are healthy with no pre-existing conditions, why are you giving away your wealth to insurance companies? Keep it and invest it yourself, so that you have your own funds to spend when you need to purchase health services. The entire medical insurance and medical system is built upon fear. My family has not purchased health insurance for over 13 years now, and we use the medical system as little as possible because 99% of the time it offers no cures, only disease management and dependency on their drugs, which we avoid. Insurance will not pay for the real cures, because the FDA has a monopoly on what is considered a "cure" and only allow drugs produced by big pharma to be reimbursed. Forcing me and my family to now support this insane system through my tax dollars so others can participate and make the drug companies richer is a clear violation of my rights as a citizen of the U.S. to choose how to spend my money on REAL health care. People are waking up to the principles of liberty, and Obamacare will fail (as it already has in the courts), as it is unconstitutional to force people to purchase private insurance.

[CaptUSA]

It's insane that one of the most industrialized nations in the world cannot provide health care for all of its citizens... Please explain how the American philosophy on this works, since I've always thought that in a society there are a few basic things which the government has to provide, and one of them is free health care alongside the private sector. Thanks. :)

You do not understand freedom. Our Constitution was set up to defend our liberty - not to provide us with things. That's how America was meant to work.

Now, if you want to talk about the utilitarian aspects of freedom, we can discuss that as well because freedom provides the most utilitarian benefits. But you must start with the understand that if the government provides you with something, they must take something from someone else. You may think that's a good thing, but in the end, it does not benefit society as much as freedom does.

[K466]

Healthcare is totally screwed up here, by government and special interest groups. Free Market healthcare is the answer, this (http://mises.org/daily/4434)is a good article to begin with. After that, there is a lot more to look at here (http://mises.org/daily/3737).

[cameronb]

one needs to merely look back in time - before we had government intervention in the health care / medical care sector, did we have medical care costs that forced people into BK? Absolutely not. Some people confuse the improved technology with the rise in cost, but we have massively improved technology in televisions and stereos and many other advances that have gone DOWN in cost, so it doesn't stand to reason that the increased technology contributes to the cost, it is government intervention where the doctors are accountable to the insurance companies instead of to the individuals. If we roll back red tape and govt intrusion we will see costs driven down and medical care can be affordable WITHOUT insurance. Heck, many people have wised up to the fact that they can get some medical and dental procedures done in latin america with the same technology for pennies on the dollar compared to what they'd pay here. When one understands why that is the case (insurance companies AND government intervention), then it is easier to understand that universal health care is a massive band-aid that will only continue to enrich the insurance companies on the backs of taxpayers.

[acptulsa]

First there was Medicare. Then there was corrpution in Medicare. Then there were laws that said it didn't matter how little paperwork a cash customer required, and how much a Medicare patient required, charging different rates would forevermore be against the law.

'With a free market, you always pay the lowest price. With government, you always pay the highest price.'--Ron Paul

Throw in the fact that insurance companies and pharmaceutical manufacturers have two of the most powerful lobbies in Washington, and it's not hard to see why anyone who ever sees a doctor basically winds up getting a 'rectal probe'...

[Velho]

Thanks for all the replies, you've been very helpful.

[Acala]

Thanks for the answer. :)



No of course not, but by taking care of this through taxation and making the states take care of it instead of profit maximizing companies, it would most likely be cheaper.



I do not know about the details of this, but once again this could be done through taxation, throw out regulation that isn't needed and subsidize the cost so that even the poor can afford it.



Sounds like an annoying system tbh.



I understand that people are not left to die, but I've also read that trips to ER can easily leave you in debt so badly that you go bankrupt. I wouldn't want to die because of an emergency, but I sure wouldn't want to lose my income either.



That is a good thing, but I'm guessing that you lose this insurance the moment you leave the company, and if you happen to be going trough a hard time in your life/can't find work then you are in a tough spot. Universal health care and employer subsidized health care are able to co-exist.



I think that this is more about the spending priorities of the government. Maintaining an empire is expensive. I'm sure there are many other expenses that simply shouldn't be there in the first place. I think that it is smarter to invest in your own people instead of bombs, bribes, bases and bailouts.

So in your view, the problem with healthcare is not ENOUGH government involvement?

Health care is, by far, the most highly regulated, subsidized, constrained, licensed, and tax-manipulated, business in the nation. At every level, government mandates prices, products, services, procedures, employment requirements, record keeping, payment options, and on and on. Competition is stifled, supply is strangled, innovation is prohibited, demand is subsidized, fraud is encouraged, service is reduced, and choice is eliminated. All by government. And the solution from both major political parties is . . . drum roll please . . . MORE government!!!!!

Other posters have addressed the specifics nicely so I won't go over it again. But speaking generally, government destroys everything it touches because it is a tool of force. As a tool of force it is favored by, and almost always eventually controled by, those who wish to use it to take wealth they haven't earned from people who would rather not part with it.

Government NEVER does ANYTHING more efficiently or effectively than people acting voluntarily in a free market. Health care has become unaffordable because of government intervention. The solution is to get government OUT of it entirely at every level. But, you might say, some people will not be able to afford health care. Perhaps. But why is that different than not being able to afford food, clothing, or housing? Why are those less important? Or do you advocate government taking over those industries as well?

If there are some people who ultimately cannot afford the vastly cheaper and better health care offered by a free market, and if those people are unable to rely on their friends and family for help, and if they cannot rely on charity (before government got involved doctors considered it an ethical requirement of their profession to provide free or discounted health care to the indigent), then, yes, they might go without health care. I think it is unlikely, but it is possible. So then you have three choices: 1. dig out your wallet and pay for their care; 2. try to convince others to pay for their care; or 3. accept that life is imperfect.

[TastyWheat]

It's somewhat lengthy, but this is the best criticism of our health care system I've read: How American Health Care Killed My Father (http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/)

In short, the consumer isn't the customer, so the system does a poor job of accomidating the consumer.