Very nasty moral quandry, all around. My own opinion can kinda be summed up as "axe the healthcare once it gets to the point it costs more than the staff administering it, especially if patient is below retirement age and willingly unemployed". And to those who think that a life can't have a monetary value put on it, you sure as hell can pin a pricetag on keeping someone alive and make very good estimates about how much progress can be made by putting that wealth in other places. Especially when a person's got multiple independent medical conditions, thus meaning their one extremely costly to prolong life is directly consuming resources able to prolong the lives of several others.
Citatation please. Literally every nation with universal healthcare spends less than the full-private US per person, AND has better outcomes.Actually, universal healthcare has been proven economically, statistically and mathematically incapable of causing overall healthcare costs to go down. Single-payer systems for general treatment that operate as close to at-cost as possible without taking risks of not being able to pay doctors or afford medicines (similar to how the pre-privatization London Underground was run) do cause healthcare costs to be lower than open market healthcare on a case-by-case basis (though I blame this on a lack of regulation, the amount of price-gouging in healthcare is insane), but ultimately cause the amount of money in it to balloon because the number of cases skyrocket after a few decades.
The reason for this lands it firmly in "utilitarians are poring over everything to figure it out and arguing over moral value judgements at all times" territory. Because the reason for the cost of universal healthcare inflates massively is because people live longer and have fewer deaths while young, and those extra people add up. 30 years after it gets set up, you have much of an entire extra generation back to pay for healthcare for, and that costs a lot. A 30% increase in the population of 90 year olds costs a vast sum to care for, and where the argument against it starts to show up is that paying for this may well not be viable, because (most of) those people aren't working, so they're nothing but a net negative, economically.
"Wealth or lives" problems like this are one of the biggest issues to philosophy, particularly utilitarian ethics, because you actually have to decide the monetary worth of a life. When you dig deep enough, you can start to find some reasons to let people die due to poor health care involving population carrying capacities and per-capita resource usage that are more a matter of environmental impact and scarcity than monetary value, but even then, you still have to come back to how much economic weight a non-contributing (in this case retired) life has, because you need to decide how much economic damage a life can cause before you have to give up on it.
Very nasty moral quandry, all around. My own opinion can kinda be summed up as "axe the healthcare once it gets to the point it costs more than the staff administering it, especially if patient is below retirement age and willingly unemployed". And to those who think that a life can't have a monetary value put on it, you sure as hell can pin a pricetag on keeping someone alive and make very good estimates about how much progress can be made by putting that wealth in other places. Especially when a person's got multiple independent medical conditions, thus meaning their one extremely costly to prolong life is directly consuming resources able to prolong the lives of several others.
Yes, but the overall costs of healthcare rise dramatically, especially a few decades after implementation, because everyone's getting it and they're making use of more healthcare per-person. The British public healthcare system has, without fail, always risen in cost every single year since it came into existence. Those higher life expectancies and lower early life death rates mean there's a lot more old people around to take extremely expensive care with late-life conditions. This causes huge amounts of economic damage, because life expectancy rising to 90 years old from 80 with an unchanged retirement age of 60 is a huge increase in the proportion of the population that's a pure economic negative.Citatation please. Literally every nation with universal healthcare spends less than the full-private US per person, AND has better outcomes.
CITATION PLEASE. You did not provide one, you just kept spouting talking points. Try again.Yes, but the overall costs of healthcare rise dramatically, especially a few decades after implementation, because everyone's getting it and they're making use of more healthcare per-person. The British public healthcare system has, without fail, always risen in cost every single year since it came into existence. Those higher life expectancies and lower early life death rates mean there's a lot more old people around to take extremely expensive care with late-life conditions. This causes huge amounts of economic damage, because life expectancy rising to 90 years old from 80 with an unchanged retirement age of 60 is a huge increase in the proportion of the population that's a pure economic negative.
You're complaining that I glossed over the lower per capita cost, when I literally said that it's a lower cost on a case-by-case basis, but ends up costing more due to more cases. And I blamed it on a lack of regulations allowing healthcare to be covered in utterly insane price gouging, because... That's the only thing that really fits, given how very nearly every single other thing involving capitalist systems and socialist systems in comparison tends to work out. Even with energy resources, one of the things that governments across the Western world typically get a stranglehold on in some form, directly government-offered tends to have higher operating costs than corporate, the corporate just charges more above cost.
Heck, most of the medical research is done in the countries where there's extremely expensive healthcare. Because that research costs money, and governments have a nasty habit of hating to fund research with uncertain development value, while the health insurance and pharmaceutical companies want to treat as many conditions as possible so they can price-gouge everyone for as long as possible. This is the core of why more economically liberal systems have always advanced faster than comparable social systems with less economic liberty. Because someone, somewhere, will get it in their head that they can make money off of something and work towards it. The fewer barriers in the way of that, the more often it happens, and the more chances you get for real progress. The key the maximizing the benefit of Capitalism is then making sure that the wealthy aren't using that wealth to erect more barriers.
Here's an article from The Atlantic about how end-of-life care is an absolutely massive proportion of healthcare spending and the economic issues caused by that. By adopting universal healthcare, you immediately need to start planning out all this treatment qualification, because in the US, it's nearly a fifth of the GDP at current rates. And universal healthcare without those qualifiers like the UK has means everyone gets these treatments, without exception, and that costs vast sums of money. Combined with the US's existing state of health being much worse, due in part to a refusal to use healthcare services because of the cost, and that refusal won't change overnight. The consumption habits responsible for most of the rest aren't likely to change for any reason connected to universal healthcare.CITATION PLEASE. You did not provide one, you just kept spouting talking points. Try again.
...You fail at reading comprehension, apparently, because the last two paragraphs, and the citations I provided, make it quite clear that rich old people (it doesn't actually matter that they're white, just that they're rich and old) are the problem. Them dying off or retiring means that a large amount of tax revenue, a vital thing to make single-payer work, is going to vanish. Expanding the corporate tax rate is ultimately the only way to make it work, politically, and even then... Well, Republicans repeal. And, contrary to Democrat propaganda, they're not all Rich Old White Men. The most problematic individuals are actually in their 40s and 50s, they still easily have another two or three decades in them, and there's a nontrivial amount of minority senetors (though yes, Democrats have it better off. Both are still disproportionately composed of the uppermost classes, as well as whites and men). Them existing makes the necessary tax revenue foundation of single-payer unstable.Gotcha, make sure only white people are allowed to be old
I did admit my mistakes. Right here:And still no citation that universal healthcare is more expensive. Please concede at this time that it is cheaper, just like all the experts say it is unless you have an actual relevant citation to provide.
I then went into things that make for decent arguments against it for the US, in particular, that have to do with a number of factors being absolutely horrible for setting up a form of single-payer that actually works, because it's a system that has pretty hefty requirements. As described in the Atlantic article I linked, the only way the UK manages to get to its quite high cost effectiveness is by having a bureaucracy that decides on what healthcare is acceptable. You need quite a lot of expertise funneled into that system, and it needs to be rather well managed. Otherwise you end up with the nation being incapable of paying for it.So in conclusion, I appear to have mixed up my arguments or made inferences/conjectures from incomplete data. I think its because I started from a random dive into the world of end of life healthcare and keeping the elderly alive and expanded that backwards without looking up any of the population statistics involved.
Yes, but the overall costs of healthcare rise dramatically, especially a few decades after implementation, because everyone's getting it and they're making use of more healthcare per-person. The British public healthcare system has, without fail, always risen in cost every single year since it came into existence.
Dude stop. Hes bieng far more reasonable, articulate, and willing to do the research than any other anti medicare for all person ive ever seen so you can atleast respond with your own well thought out responses instead of taking childish potshots at him.Do you work for Raytheon, @Morphile ?
He's being disrespectful to the other members who are asking him for the things you claim exist but do not.Dude stop. Hes bieng far more reasonable, articulate, and willing to do the research than any other anti medicare for all person ive ever seen so you can atleast respond with your own well thought out responses instead of taking childish potshots at him.
What's a missile-spamming defense contractor have to do with healthcare?Do you work for Raytheon, @Morphile ?
...Dude. I admitted I was wrong, twice, in posts after that one. Explicitly saying that the overall costs can be lower, with good management. As shown with Switzerland, the savings can actually be relatively small, and my argument for total cost going up is very much a problem to overcome, and US politics make it extremely difficult to make sure that management is able to deal with it, especially in combination with the problem of paying for it. You need to halve costs with doubled treatments for it to break even. You need massive savings to cover the huge increase in coverage that the US would have with universal healthcare.No, the overall costs are lower, significantly, that's the point.
How so? If you're referring to citations supporting a resistance to Universal Healthcare in the US... Well, I've pointed at a decent amount of evidence showing that there's a lot of money that has to come from somewhere to pay for universal healthcare, and pointed out that there's a problem of the wealthiest demographic in the US closing in on death of old age. Which, due to how the US handles income tax, means a sizable amount of tax revenue goes up in smoke. Hell, the UK doesn't actually have universal healthcare, they withhold treatments all the time based on the cost effectiveness. And this leads to a per-capita spending nearly half that of the US, because you have the advantages of single-payer, but then deny expensive, low-impact treatments.He's being disrespectful to the other members who are asking him for the things you claim exist but do not.
How is it mental gymnastics to accept that I am wrong on a fact (that universal healthcare will increase the total cost), but point out that there's still real problems to overcome? How the fuck do you think the United States is going to pay for hundreds of billions added to its yearly budget (for reference, the federal budget was 3.8 trillion in 2015. California alone would push that up to 4 trillion. Given current private healthcare spending, 700 billion would be after massive savings. As in more than halved costs)? How the fuck do you think whatever is done to pay for it will last in any meaningful way with how Republicans have acted in the past? Can you genuinely trust the Democrats to not racialize the shit out of it like so much other welfare, or utterly fuck the budget by doing actual universal healthcare?Twist, twist, turn, pull, shift...I've seen these type of mental gymnastics before and they don't work on me.
How is it mental gymnastics to accept that I am wrong on a fact (that universal healthcare will increase the total cost), but point out that there's still real problems to overcome? How the fuck do you think the United States is going to pay for hundreds of billions added to its yearly budget (for reference, the federal budget was 3.8 trillion in 2015. California alone would push that up to 4 trillion. Given current private healthcare spending, 700 billion would be after massive savings. As in more than halved costs)? How the fuck do you think whatever is done to pay for it will last in any meaningful way with how Republicans have acted in the past? Can you genuinely trust the Democrats to not racialize the shit out of it like so much other welfare, or utterly fuck the budget by doing actual universal healthcare?
You still need to pay for it, and the US has a horrible track record of budget balance because the Democrats give no fucks about the magnitude of their spending and the Republicans give no fucks about the funding issues of tax cuts.
The military spending is because the US has gotten stuck in the situation of keeping the peace for trade, though it could be cut down because we've got no need of the large land forces we have. Nothing's shown up that shows it vaguely necessary to have tens of thousands of tanks, but we just keep making tanks instead of something more useful, like extra naval forces and aircraft that actually work in the combat situations we keep getting into. The focus of the spending is grotesquely inefficient because ever since the Cold War ended, we stopped having any need for mass deployment capabilities, because there's been no combat where a large mass of troops and tanks is actually helpful. It's all urban combat against terrorists.Well we're not remotely near the historic tax level high and have a lot of money busy with less important stuff (like, military spending most obviously, we're at one of our highest non-war levels for no real reason), you'd think we were pushed to the edge the way you're talking about...
Kinda that, the way Democrats tend to go about it tends to be covered in profiling, causing it to be vastly disproportionate in favor of minorities. Because of the heavy correlation. This has utterly fucked the lives of poor urban whites, because the welfare offices are extremely anal about white people proving they qualify (which nothing short of tax and medical records will do) while blacks who just look poor get far fewer questions asked. Could just be an issue with urban bureaucrats, honestly.Well, unless by 'racialize' you mean 'make sure it targets poor minority areas too.'
...Going to need a citation on that, though the succeeding statement about tax cuts is exactly what I was referring to with US politics not being friendly to it, because any tax increases that the Democrats use to pay for it would get axed by Republicans, followed by sabotage of the system so they can gloat that single-payer totally doesn't work. The best we're likely to get is a state-based health insurance company that acts just about exactly like the current ones, but with the goal being to actually provide coverage, rather than profits. Which would let some of the funding be handled by insurance premiums and such, rather than having everything stuck with taxes.Oh, fun fact, the Democrats actually have a good record with paying for their stuff. The deficit was decreasing under Obama, if it wasn't for the financial crash we'd likely be in the green well before the end of his term, and of course the debt actually went down under Clinton
...It's just racism, and it's probably more a problem with the bureaucrats than the politicians. Granted, the Democrat politicians have spent the last few decades supporting policies that are specifically intended to benefit some ethnicities more than others, rather than direct and general anti-poverty measures, but I pin that more on the fact that they're politicians and thus looking to garner votes. It's actually not that I think their discriminating against white people, as much as it is they're discriminating in favor of minorities. Which is, ya know, still racist, and still unacceptable in any meritocratic system. Not all racism is oppression, oddly enough, it can just mean that one group is promoted above others. Which does not mean those not receiving the privileges are oppressed.Ah, at last, we get to the real problem: reverse racism
Meritocracy is a myth. The only way to actually have anything resembling one is to take all children from their parents at birth and have them raised by the state. And even that STILL doesn't account for effects of parental health and nutrition pre-birth....It's just racism, and it's probably more a problem with the bureaucrats than the politicians. Granted, the Democrat politicians have spent the last few decades supporting policies that are specifically intended to benefit some ethnicities more than others, rather than direct and general anti-poverty measures, but I pin that more on the fact that they're politicians and thus looking to garner votes. It's actually not that I think their discriminating against white people, as much as it is they're discriminating in favor of minorities. Which is, ya know, still racist, and still unacceptable in any meritocratic system. Not all racism is oppression, oddly enough, it can just mean that one group is promoted above others. Which does not mean those not receiving the privileges are oppressed.
Denial of privileges isn't oppression, and most Western welfare systems are very much a form of privilege. It's only oppression if one group is explicitly denied something granted in general terms. Very technically speaking, the limited suffrage wasn't oppression as it was originally described as a specific privilege of land-owning male citizens. Can't remember if "white" was one of the qualifiers or not off the top of my head. Of course, these days, it's generally considered a baseline right of democracies to vote, rather than a specific privilege to some particular class. Though this post-dates the US, and the US actually still enumerates voting as a specific privilege instead of a general right of the citizens.
And do note that this is me explaining why I don't consider the denial of welfare to poor whites to be a form of oppression, not an attempt at re-defining oppression to excuse the horrible things people have done throughout history. I do still consider it abhorrent, but not by definition a form of oppression. Because I have complex views that involve not needing buzzwords to see things as bad, they can be bad independently of any buzzwords. Or at least the typical ones.
Actually yes it does. To those of us who actually value life, liberty and the pursuit of happiness, not to mention equity and equality, it is.Not all racism is oppression, oddly enough, it can just mean that one group is promoted above others. Which does not mean those not receiving the privileges are oppressed..
...Meritocracy is defined by giving power and wealth based on merit. It doesn't necessitate any control on an individual's capacity for merit beyond maybe giving a level playing field in educational infrastructure. A meritocratic system can function perfectly fine with a bloody eusocial species, let alone the relatively-narrow-in-potential modern human species, because the only thing that is required to be a meritocracy is that progression be defined by performance.Meritocracy is a myth. The only way to actually have anything resembling one is to take all children from their parents at birth and have them raised by the state. And even that STILL doesn't account for effects of parental health and nutrition pre-birth.
No, it doesn't, at least by the definition of oppression I work with. It's discrimination, but oppression, to me, means that general rights are being specifically withheld. As such, the situation of specific privileges that are generally withheld would not qualify under the definition of oppression. The latter is still a bad state, but the exact term "oppression" doesn't apply, because the term, to me, means that there is active detriment, rather than unequal privilege. I'm a bit of an ass with definitions. It's a large chunk of the reason I viscerally despise the progressive left, because they constantly redefine or ignore definitions of words to suit their purposes.Actually yes it does. To those of us who actually value life, liberty and the pursuit of happiness, not to mention equity and equality, it is.