After posting the piece about Nurses traveling to Germany and reading the feedback. I would like to open up a debate on this BB about "Universal Health Care" or "Single Payor Systems"
In doing this I hope to learn more about each side of the issue. I do not want to turn this into a heated horrific debate that ends in belittling one another as some other charged topics have ended, but a genuine debate about the Pros and Cons of proposed "Universal Health Care or Single Payor systems" I believe we can all agree to debate and we can all learn things we might not otherwise have the time to research.
I am going to begin by placing an article that discusses the cons of Universal Health Care with some statistics, and if anyone is willing please come in and try to debate some of the key points this brings up. With stats not hyped up words or hot air. I am truly interested in seeing the different sides of this issue. This effects us all, and in order to make an informed decision we need to see "all" sides of the issue. Thanks in advance for participating.
Michele
I am going to have to post the article in several pieces because the bulletin board only will allow 3000 characters.So see the next posts.
YOU are aware Elkpark, that I have said in previous comments that I do support helping care for severely disabled and elderly. YOU also must be aware of the misrepresentation of the high number of uninsured and who that group represents, correct?
They report to you the high number of uninsured in the US and it is accepted without question. That "uninsured statistic in California represents 30-year-old single men that have an earned income of $50,000.00 per year. Is that who we should provide free single-payer universal government run healthcare to?
I also support medicaid reform. Or, do you think that we should pay for section 8 housing, SSI of $530.00 per month, and free medical/dental to alcoholics and drug addicts, whom by the 7th of each month have squandered their $530.00 on drugs or alcohol?
Medicaid in the US needs to be reformed.
Kitkat
I would agree that Medicaid needs to be reformed, for many reasons. But as far as your comment about the single men making $50,000 in California--well, if we had a single payer system, do you think that these men would get it for free? That everyone else in the nation would be supporting their healthcare needs, and these men wouldn't contribute a dime?
No, their taxes, just like anyone else's, would be paid towards the system. And these 30 year old men, who would be paying for a single payer system through their tax money, are the ones least likely to use the system. Yes, these young men are statistically the least likely to utilize the health care system. Their money would be paying to help the disabled, the elderly, prenatal care, cancer patients, and everyone else. So perhaps they would be the ones who should be resentful of a single payer system.
I am not arguing in favor of a single payer system per se, but just with your logic. It is very flawed, about who deserves health care and who doesn't. And as far as the alcoholics and drug addicts who get Medicaid, perhaps it would be helpful if we actually had facilities to help these people get rid of their addictions. We don't. The facilities in the nation are far and few between, and unable to accomodate all of those who are eligible for "free" medical care.
Unless you have a lot of money to check yourself into a private rehab place. And even if you have insurance, it often doesn't pay for anything related to mental health or addiction.
Some one asked me the other day if health care was important to Australians and my answer was
YES!!!!
Elections are won and lost here on health care issues. We have a free health care service - not ideal - not perfect but about 100,1000 kilometers ahead of where the USA is.
We have a mixed system where you can either be uninsured and trust to the public hospital system or take out health insurance and go to a private hospital - your choice. To keep the young in private health insurance we have "life-time cover" where the longer you are with the company the cheaper the cover is.
We do have difficulty retaining people in private health insurance even with this and a government rebate on private insurance - why? well basically because private companies like to save money and that means that the patient has to pay and pay and pay.
Now to address some of your other issues
Research - if you want to know how active we are in research check out how many discoveries have "made in Australia" stamped on the bottom:D
check out this site and remember this is just ONE research facility within Australia - do a search on "health" on that site and see what comes up.
Public health - from what I can gather we have more public health well the best word is "attention". When the government is footing the bill for people in hospital then it makes sense to stop people form getting ill in the first place. We even legislate to ensure compliance. We were the first to bring in seat belt laws - now you NEVER see anyone driving without a belt on.
Our government owns and funds the ABC and it runs whole programs on health issues.
At the dawn of the American welfare state, in his 1935 State of the Union message, President Franklin D. Roosevelt (1938: 19-20) proposed social security, unemployment insurance, and (what was then called) aid to dependent children to help the deserving poor, but he added an ominous warning:
The lessons of history, confirmed by evidence immediately before me, show conclusively that continued dependence on relief induces a spiritual and moral disintegration fundamentally destructive to the national fiber. To dole out relief in this way is to administer a narcotic, a subtle destroyer of the human spirit. It is inimical to the dictates of sound policy. It is a violation of the traditions of America.
More than 60 years later, it should be clear that the narcotic of "continued dependence on relief" is less subtle and more destructive than Roosevelt feared.
Summary
Welfare is both a consequence and a cause of several conditions best described as social pathologies. These conditions include dependency, poverty, out-of-wedlock births, nonemployment, abortion, and violent crime. The basic hypothesis of this study is that welfare dependency and the other pathologies are jointly determined and are derivative of a common set of other conditions.
Differences in the levels of these conditions among the states provide a basis for estimating the specific effects of welfare benefits, the relations among the social pathologies, and the extent to which the pathologies are based on a common set of root causes.
Analysis of the state data for 1992 yields the following estimates of the effects of an increase in Aid to Families with Dependent Children (AFDC) benefits by 1 percent of the average personal income in the state: the number of AFDC recipients would increase by about 3 percent; the number of people in poverty would increase by about 0.8 percent; the number of births to single mothers would increase by about 2.1 percent; the number of adults who are not employed would increase by about 0.5 percent; the number of abortions would increase by about 1.2 percent; and the violent crime rate would increase by about 1.1 percent.
The social pathologies associated with the current welfare system no longer seem acceptable, not so much because of their fiscal costs but because of their malign effects. An important question addressed in this study is the extent to which these pathologies are dependent on conditions that could be changed by government policy.
Social Pathologies
For this study, the six conditions are described as social pathologies, not because they are necessarily illegal or immoral in an individual case but because the level of these conditions is broadly considered as undesirable. There is less consensus, however, about the relative undesirability of these conditions. An increase in welfare dependency, for example. may be considered desirable if it reduces one or more of the other conditions. As it turns out, however, an increase in AFDC benefits increases all of the six pathologies that are the focus of this study.
Welfare Dependency
In 1992, 5.4 percent of the national population were dependent on cash benefits from AFDC, with a range from 2.0 percent in Idaho to 10.8 percent in the District of Columbia. This program is jointly financed by the federal and state governments and is administered by the states subject to numerous federal guidelines. All AFDC recipients are also eligible for food stamps and medicaid, and many also receive benefits from special food programs, utility assistance, and housing assistance.
An additional 2.6 percent of the population receive cash benefits from other federal and state programs, for a total of 8 percent who are dependent on cash benefits. A broader 9.9 percent of the population receive food stamps, and 11.9 percent are covered by medicaid. A more complex study would be necessary to estimate the causes and consequences of the broader set of means-tested programs. For this study, the level of welfare dependency is defined as the percent of the population that receive cash benefits from the AFDC program.
Poverty
A total of 14.5 percent of the population have money income below the official poverty line, with a range from 7.6 percent in Delaware to 24.5 percent in Mississippi. The national poverty rate is now about the same as when the War on Poverty was instituted 30 years ago, despite the expenditure of over $5 trillion (at 1993 prices) for means-tested public assistance programs in the intervening years and a 75 percent increase in average real income. More means-tested benefits may or may not have contributed to the incidence of poverty but they have clearly not reduced it.
Any definition of poverty, of course, is somewhat arbitrary, depending on what types of income are included. The government estimates national poverty rates for 15 different aggregations of income, taxes, and transfers, with a range from 10.4 percent based on all after-tax income and transfers to a high of 22.6 percent based only on pre-tax money income. For this study, the level of poverty is defined as the percent of the population with pre-tax money income and cash transfers below the official poverty line, the only such data available by state.
Out-of-Wedlock Births
Out-of-Wedlock births are the most rapidly increasing social pathology. On a national basis (in 1991), 29.2 percent of births were to single mothers, with a range from 14.3 percent in Utah to 65.9 percent in the District of Columbia. Since 1960, the illegitimacy rate has increased from 2.3 percent to 22 percent for whites and from 21.4 percent to 68 percent for blacks. A substantial part of the current generation of inner city young people has grown up without a father, a contributor to the increase in violent crime and the decline in school performance as well as to some of the pathologies addressed in this study.
Nonemployment
The percent of the adult population that is not employed has been declining for many years and, compared to many other nations, is unusually low. For lack of a better word, I will define this condition with the inelegant word nonemployment, because the word unemployment has usually been used to describe those not working but seeking work. Formally, the nonemployment rate is the percent of the civilian noninstitutional population age 16 and over that is not employed. On a national basis the nonemployment rate is 38.6 percent with a range from 31.1 percent in Nebraska to 51.7 percent in West Virginia.
Abortion
Abortion is the most contentious issue in contemporary American politics, primarily because the polar positions have dominated the debate. The "pro-choice" advocates consider any restriction on abortion as a violation of a woman's rights. The "pro-life" advocates consider any abortion as murder. No study of the causes and consequences of abortion would reconcile these positions. Most Americans, however, appear to favor legal and social rules that would make abortion legal, safe, and rare. For the most part, abortion is legal and safe but it is not rare. On a national basis there are 379 abortions per 1,000 live births (somewhat lower than the prior peak of 436 in 1983), with a range from 74 in Wyoming to 1,104 in the District of Columbia. For the broad group of Americans who regard most abortions as undesirable but not a crime, abortion is appropriately described as a pathology and an understanding of the conditions that explain the large variation in abortion rates can be valuable to aid their judgment on this contentious issue.
Violent Crime
Violent crime may be the most serious social pathology in the United States. The reported violent crime rate has increased substantially for several decades and is much higher than in other nations. And the number of violent crimes estimated from victimization surveys is much higher than the number reported to and by the police. On a national basis, there were 758 reported violent crimes per 100,000 residents, with a range from 83 in North Dakota to 2,833 in the District of Columbia.
Root Causes of the Culture of Poverty
One objective of this study is to identify the extent to which the six social pathologies are the consequence of a common set of root causes. The conditions examined included the level of welfare benefits in each state, a measure of general economic conditions, the racial and ethnic composition, and several social and cultural indicators.
Welfare Benefits
The one variable that best reflects the welfare policy in a state is the level of AFDC benefits per recipient household. State governments also set eligibility standards subject to federal guidelines, but differences in these standards are not easily measurable. For this study, welfare benefits are defined as the annual AFDC benefits per recipient household as a percent of the pretax personal income per capita in the state. On a national basis such benefits are 23 percent of personal income per capita, with a range from 10.4 percent in Mississippi to 40.8 percent in Alaska.
Total welfare benefits per recipient household, one should recognize, are much higher than the direct cash benefits from AFDC. The total benefits for those households from AFDC, food stamps, and medicaid only range from 50 to 100 percent of personal income per capita. And the total benefits for those AFDC recipients who also receive housing assistance, utility assistance and specialized food programs range from 90 to 125 percent of personal income per capita. These estimates of total benefits provide a better sense of why welfare has become a trap for so many women. For reasons that are not clear, however, the several measures of social pathology that are the focus of this study are more closely related to the narrow cash benefits from AFDC than to the broader measures of total welfare benefits, maybe because many AFDC recipients value cash benefits more than noncash benefits or are not eligible for the broader set of benefits.
Economic Conditions
General economic conditions in a state are represented by the pretax personal income per capita. On a national basis average personal income is $20,105, with a range from $14,082 in Mississippi to $27,909 in the District of Columbia.
Race and Ethnicity
The racial and ethnic composition in a state is represented by the percent black and the percent Hispanic. Blacks are 12.4 percent of the national population, with a range from 0.3 percent in Montana to 65.0 percent in the District of Columbia. Hispanics are 9.5 percent of the national population, with a range from 0.4 percent in West Virginia to 38.2 percent in New Mexico. These two groups are combined in a percent minority measure when preliminary tests indicate that their effects are not statistically different.
Social and Cultural Indicators
Social and cultural conditions in a state are represented by four indicators: church membership, educational level, percent metropolitan, and average temperature. The distinctive attribute of each of these indicators is that they reflect individual choices of whether to join a church, continue education, and where to live.
Church membership is measured as the sum of the percent of the resident population who are Christian adherents (1990) plus the percent who are Jews. By this measure, 55 percent of the national population are church members, with a range from 32.6 percent in Alaska to 80 percent in Utah.
The educational level in a state is measured as the percent of the resident population age 25 and over with a high school or higher education (1990). On a national basis 75.2 percent are educated at this level, with a range from 64.3 in Mississippi to 86.6 percent in Alaska.
The metropolitan population is measured as the percent of the population resident in metropolitan areas. On a national basis 79.7 percent of the population are residents in a metropolitan area, with a range from 24 percent in Montana to 100 percent in the District of Columbia.
The average daily low temperature measure used in this study is roughly proportional to the distance from North Dakota. This variable, which is significant only in the welfare dependency regression, reflects some combination of the tighter welfare eligibility standards in the southern states and the social and cultural differences among regions that are correlated with temperature. Whatever the balance of these effects, including this measure is important to increase the precision by which the effects of other conditions is estimated.
Methodology
The patterns of pathology are estimated by least-squares regression techniques. For each of the six pathologies, two types of relations are estimated: The first relation includes one or more other jointly determined pathologies and a subset of the root causes; this relation is estimated by a weighted two-stage (TS) regression where the whole set of root causes is used as instrumental variables. The first relation provides estimates of the relation among the several pathologies and the partial effects of specific root causes given the level of the other included pathologies. The second relation includes only a set of root causes; the relation is estimated by a weighted least squares (LS) regression. The second relation provides estimates of the total effect of specific root causes that operate both directly on the specific pathology and indirectly through their effect on other related pathologies. All variables in both relations are weighted by the resident population of each state. This increases the relative effects of conditions in the largest states and makes the estimates correspond more closely to the effects of national conditions. Only those variables that are statistically significant at a 95 percent level or more are included in either of the relations; as it turns out, most of the included variable are significant at a much higher level.
Patterns of Social Pathology
The patterns of social pathology are summarized in Tables 1, 2, and 3. First, some general advice on reading these tables. The top tier of coefficients in each table are estimates of the percent change in the focus pathology from a 1 percent increase in some other condition. For example, in Table 1, a 1 percent increase in the poverty population in a state increases welfare dependency (the number of AFDC recipients) by about 0.6 percent. The lower tier of coefficients (except for temperature) are estimates of the percent change in the focus pathology from a 1 percentage point increase in some other condition. For example, in Table 1, a 1 percentage point increase in the population living in a metropolitan area increases the AFDC population by about 1.3 percent. The coefficients on the temperature variable are estimates of the effect of a 1 degree (Fahrenheit) increase in the average daily low temperature. The numbers in parentheses are the standard errors. If the estimate of the coefficient is unbiased, there is a 95 percent probability that the true (unknown) level of the coefficient is within two standard errors of the estimate. The R2 is the percent of the weighted and unweighted variance of the focus pathology among the states that is explained by each relation.
Welfare Dependency
The patterns of welfare dependency summarized by the first two columns of Table 1 support the following conclusions:
1. Welfare dependency is strongly related to poverty. Specifically, a 1 percent increase in the poverty population in a state increases the population of AFDC recipients by about 0.6 percent.
2. An increase in AFDC benefits by 1 percent of personal income, about $17 a month in 1992, would increase the dependent population in a state by about 2.2 percent given the number of the poor and by about 3.0 percent including the effect on poverty. Some part of this increase may be induced immigration from other states, so the proportionate effects of a uniform national increase may not be as high.
3. Economic conditions and the minority population affect welfare dependency only through their effects on the poverty rate. A 1 percent increase in average personal income reduces dependency by about 1.0 percent. A 1 percentage point increase in the minority population increases the dependent population by about 0.7 percent.
Table 1
Welfare and Poverty
Welfare
Dependency
Poverty
TS LS TS LS
Effect of a 1 Percent Increase
Dependency .27
(.06)
Poverty .63
(.17)
Income -1.04 -.72 -.81
(.29) (.17) (.18)
Effect of a 1 Percentage Point Increase
Benefits 2.18 2.96 .75
(.23) (.26) (.21)
Church -.69 .41 .36
(.15) (.12) (.15)
Education -3.92 -4.25 -1.76
(.88) (.87) (.68)
Metropolitan 1.05 1.31 -.40
(.17) (.31) (.18)
Minority .70 1.38 1.14
.31 (.14) (.15)
Temperature -2.11 -2.15
(.36) (.50)
R2
weighted .99 .99 .99 .99
unweighted .39 .21 .64 .67
4. Given the number of the poor, welfare dependency declines with an increase in church membership. A 1 percentage point increase in church membership reduces the dependent population by about 0.7 percent. A 1 percentage point increase in the population completing high school reduces the dependent population by about 4 percent. And a 1 degree (Fahrenheit) increase in average temperature is associated with a 2.1 percent decrease in the dependent population. This temperature effect probably reflects the tighter welfare eligibility standards in the southern states.
5. Urbanization increases dependency. A 1 percentage point increase in the population residing in metropolitan areas increases the dependent population by about 1.3 percent.
Most of these findings are expected, in direction if not in magnitude. Welfare dependency is primarily determined by the level of welfare benefits and the conditions that affect the poverty rate. One important finding is that an increase in the minority population does not increase dependency except to the extent that it increases the poverty rate. In other words, poor minorities are no more likely to be dependent on welfare than are poor whites. One puzzling finding is the positive effect of urbanization on dependency, given that urbanization (as also shown on Table 1) has a negative effect on the poverty rate; the urban poor are apparently more likely to be dependent on welfare than are the rural poor.
Poverty
The patterns of poverty summarized by the last two columns of Table 1 support the following conclusions:
1. Poverty is also related to dependency. A 1 percent increase in the dependent population increases the poor population in a state by about 0.3 percent. An increase in AFDC benefits by 1 percent of average personal income increases the number of poor residents of a state by nearly 0.8 percent.
2. Poverty declines with an increase in average income and education. A 1 percent increase in average personal income reduces the poor population in a state by about 0.8 percent. A 1 percentage point increase in the population with high school or higher education reduces the poor population by about 1.8 percent.
3. The size of the poor population in a state is strongly related to the size of the black and Hispanic population. A 1 percentage point increase in the percent minority increases the poor population by about 1.1 percent.
4. For reasons that are not obvious, a 1 percentage point increase in church membership appears to increase poverty by about 0.4 percent.
Again, most of these findings are expected. Poverty is primarily determined by the level of AFDC benefits, general economic conditions, education, and the percent minority. The major puzzle is the positive effect of church membership on poverty, compared to its negative effect on welfare dependency.
Out-of-Wedlock Births
The patterns of out-of-wedlock births summarized by the first two columns on Table 2 support the following conclusions:
1. Out-of-wedlock births are strongly related to welfare dependency. A 1 percent increase in the welfare dependent population in a state increases the number of births to single mothers by about 0.5 percent.
2. Illegitimacy is also related to nonemployment. A 1 percent increase in the nonemployed population increases the births to single mothers by about 0.9 percent.
3. The level of welfare benefits, in turn, indirectly increases illegitimacy through the effects on the size of the dependent population and on the number of the nonemployed. An increase in AFDC benefits by 1 percent of average income increases the number of births to single mothers by about 2.1 percent.
4. Out-of-Wedlock births decline with an increase in church membership. A 1 percentage point increase in church membership reduces the number of illegitimate births by about 0.4 percent.
5. In this case, the effects of the two large minority groups are very different. A 1 percentage point in crease in the black population increases the number of illegitimate births by about 2.3 percent. In contrast, a 1 percentage point increase in the Hispanic population reduces the number of illegitimate births by about 0.5 percent.
Nonemployment
The patterns of nonemployment summarized by the last two columns of Table 2 support the following conclusions:
1. Welfare dependency reduces employment. A 1 percent increase in the dependent population increases the number who are not employed by about 0.1 percent.
2. An increase in welfare benefits reduces employment by increasing the number of welfare dependents. An increase in AFDC benefits by 1 percent of average income increases the number who are not employed by about 0.5.
3. Education has a strong effect on employment. A 1 percentage point increase in the population with high school or higher education reduces the number who are not employed by about 2 percent.
4. Employment is also related to the relative size of the metropolitan and Hispanic populations. A 1 percentage point increase in the metropolitan population increases the number who are not employed by about 0.5 percent. A 1 percentage point increase in the Hispanic population reduces the number who are not employed by about 0.4 percent.
Abortion
The patterns of abortion summarized by the first two columns of Table 3 support the following conclusions:
1. Abortion is strongly related to nonemployment. A 1 percent increase in the adult population not working increases the number of abortions by about 1.7 percent.
2. An increase in AFDC benefits by 1 percent of average income would indirectly increase the number of abortions by about 1.2 percent by increasing the nonworking population.
3. A 1 percent increase in average income increases the number of abortions by about 1 percent.
4. Education, like income, contributes to abortion. A 1 percentage point increase in the population with educa- tion at the high school level or higher, for a given number of nonemployed, increases the number of abortions by about 3.6 percent.
5. The effects of the two large minority groups are somewhat different. A 1 percentage point increase in the black population increases the number of abortions by about 1.8 percent, whereas a 1 percentage point increase in the Hispanic population increases abortions by about 0.8 percent.
The pattern of abortions is not consistent with the usual patterns of the culture of poverty. The number of abortions increases with nonemployment and the percent minority, but it also increases with education and income. Maybe the most surprising finding is another blank space: the number of abortions appears to be independent of church membership.
Violent Crime
The patterns of violent crime summarized by the last two columns of Table 3 support the following conclusions:
1. The level of violent crime is strongly related to welfare dependency. A 1 percent increase in the welfare dependent population increases the violent crime rate by about 0.6 percent.
2. An increase in welfare benefits indirectly increases the violent crime rate by increasing the number of welfare dependents. An increase in AFDC benefits by 1 percent of average income increases the violent crime rate by about 1.1 percent.
3. The level of violent crime is also related to the composition of the population, reflecting both a direct effect and an indirect effect operating through the level of the welfare dependent popula- tion. A 1 percentage point increase in the metro- politan population increases the violent crime rate by about 1.3 percent. A 1 percentage point increase in the black population increases the violent crime rate by about 3.8 percent, and a 1 percentage point increase in the Hispanic population increases the violent crime rate by about 1.9
Patterns Across Pathologies
A comparison of the effects of the eight root causes across the six pathologies is useful to identify the conditions that most consistently contribute to or defend against these pathologies.
The level of AFDC benefits relative to the average personal income in each state is the one condition that increases each of the six focus pathologies, with effects ranging from a weak effect on nonemployment to disturbingly strong effects on welfare dependency and illegitimacy.
The next most consistent correlate of these conditions is the percent of the population that is black, a root cause for five of the pathologies other than nonemployment. The percent Hispanic contributes to welfare dependency, poverty, abortion, and violent crime but reduces illegitimacy and nonemployment.
The most consistent defenses against these pathologies are education and higher average income. A higher percent of the population with high school or higher education reduces dependency, poverty, and nonemployment. Higher average income reduces dependency, poverty, and violent crime. Both higher education and income, however, increase abortion.
The effects of the other conditions examined are more mixed. Church membership reduces welfare dependency and illegitimacy but appears to increase poverty. A higher percent of the population of a state that is resident in metropolitan areas increases dependency, nonemployment, and violent crime but reduces poverty. The contrary effects of church membership and the metropolitan population on welfare dependency and poverty are probably the most puzzling results of this study.
The Good Samaritan's Dilemma
For the most part, the political support for welfare reflects a generous motive to help those who are poor, single, and with children. Welfare would provoke little controversy and benefits would probably be higher if these conditions were substantially accidental or temporary--the result, for example, of the death, disability, or temporary unemployment of the major contributor to a family's income. That is why welfare was first promoted as a widow's allowance. That is why President Clinton supports welfare as a safety net but not as a way of life. The moral dilemma, of course, is that welfare, like the most forms of social insurance, increases the number of people with the insured condition. This study, for example, estimates that an increase in AFDC benefits per household by 1 percent of average income would increase the number of welfare dependents by about 3.0 percent and the number of births to single mothers by about 2.1 percent.
There is no obvious resolution of this age-old dilemma, and I claim no special moral insight. The patterns of pathology associated with the current welfare system, however, no longer seem acceptable, not so much because of their fiscal cost but because of their malign effects. The welfare legislation that Congress recently approved will give the state governments a greater incentive and opportunity to experiment with different approaches to welfare. The effects of this major welfare reform are difficult to predict, because state governments will have more flexibility to set benefit rates and eligibility conditions and there are many types of exemptions from the remaining federal mandates. The most important change is probably the substitution of lump-sum payments to the states for the current system of matching grants; this will increase the marginal cost to state taxpayers from the current 20 to 50 percent of AFDC benefits to 100 percent.
This study suggests that the state governments may be best advised to focus welfare on the innocent--widows, the genetically or accidently disabled, and children--and to set firm time limits on the welfare eligibility of others. Education and a strong general economic climate appear to be the most effective policy-responsive conditions to reduce the remaining pathologies. A blind compassion may be admirable but a knowledgeable compassion is twice blest.
"... But Charlie Company came armed not only with gifts and dollars - on their road show they also had a US army doctor, travelling in a state-of-the-art mobile medical clinic.
He was offering on-the-spot (free) health care to any villager who wanted it.
The aim of all of this is to win the hearts and minds of suspicious Iraqis, to persuade them the Americans are here as friends and helpers, not just as an army of occupation. "
There is something missing from some people's financial analysis of universal healthcare ( or any other service or business). This point is usually missed more by the right. I am not trying to have a democrat vs republican thing happen here, but it strikes me that these lapses in understanding on the part of many conservatives is what causes concern for democrats. It has been mentioned at least a couple of times on this thread that having businesses pay more for healthcare ( such as in California) causes severe job loss and pay cuts. I realize that this would be the thus far realistic expectation, but shouldn't that change? God forbid the CEOs that make up to 200 times the amount of money of the lowest paid worker take a pay cut to compensate for the increase cost to the business (like they do in certain asian countries)! It is a lie and a logical fallacy to tell us that job loss and pay cuts is the natural effect of increasing cost to business--thats just how the greedy sleazy CEOs and upper managment CHOOSES to do it! Yes--it makes more sense for the heads of companies to lay people off than to forgoe purchasing new $500,000 catamarans this year! I guess if you want healthcare, there is going to be hell to pay for it.
There is one more point I'd like to make--to answer a question that was posed earlier on a different universal healthcare thread. I'm paraphrasing, but the question asked why someone who makes alot of money (and who 'apparently' worked hard for it) be forced to fork it over through some social program to someone in need. Well, I don't know about forcing, but the reason could be because some people may need help ( and I don't mean people who aren't willing to help themselves).I can't understand why this reason escapes some people--especially when some of these people are nurses! Humans are not like other animals --I love animals, but they ARE NOT human. Bye the way, if anyone actually meets a sentient turkey (you know one that can think, plan ahead, ponder its own death like humans do), please let me know. And no-- I am not a turkey. Humans are the dominant species for several reasons, the biggest one being because we are part of a civilization. The reason a civilization works so well and the reason people even choose to be part of a civilization is because of the protection it affords and its ability to help those in need. Why even be part of a civilization unless your willing to help others (or take advantage of them)? Thanx for reading.
Los Angeles' supermarket workers now on strike, as well as those employed by the city's transit system and in the Sheriff's office, deserve the full support of all working people and their organizations. The attempts to cutback their health benefits are a crude assault on them and their families. It is a cruel rebuke to thousands of workers who have remained on their jobs serving the public in part because they have had a compact with their employers that has left them free of the pain and anxiety being experienced by the millions of people across the nation who are either uninsured or underinsured. Employers complain about the high cost of healthcare insurance, however, supermarket profits have climbed 91 percent over the past five years. That's 10 times greater than the rate of increase in their contribution to employee healthcare coverage.
The reality of the current strike, repeated in highly contentious collective bargaining across the country, has brought into sharp relief the basic issue of how healthcare is financed and delivered in our country. It's a problem the solution of which can hardly be put off any longer.
What we are witnessing is "the life and death struggle of the employer-based healthcare system," said the leader of a Los Angeles union local involved in the grocery workers strike. True. And, it raises an important question. Is the healthcare insurance system that ties coverage to employment - and requires that working people continually battle to save it in bargaining with employers who would reduce or eliminate it - really worth saving? It is also the question hanging over the much heralded new law in California requiring employers provide some level of coverage. As long as nothing is done to control the prices set by the profit-driven healthcare insurance companies and the multinational pharmaceutical corporations, healthcare cost will continue to soar. So too will the number of people without any health coverage. Over 2002, the number of people without health insurance increased 2.4 million bringing the total to 43.6 million.
According the U.S. Department of Labor, the proportion of private-sector workers covered by employer-sponsored healthcare plans fell from 63 percent during 1992-93 to 45 percent in 2003 and employers still providing coverage are shifting costs to employees. Of those who were insured, most were in plans that required employee contributions and over the past decade those premium payments have risen nearly 75 percent.
Meanwhile, the cost of the employees' contribution to employer-sponsored healthcare is rising far faster than their wages. That growing gap is causing many to forfeit healthcare coverage and that in turn has become a major factor in the continual increase in the number of uninsured. In many cases workers are being pressured to bargain away wage increases and other benefits in order to remain insured.
The strikes over healthcare - and there will be more - are only the latest illustration that we are experiencing a healthcare crisis. As the prices charged for delivering healthcare continue to rise, there will be no remedy to the situation unless decisive measures are taken. The best answer lies in abandoning the employer-sponsored health insurance paradigm altogether. The alternative is government-sponsored health insurance on the "single payer" model with guarantees of a single standard of patient care. Healthcare has emerged as a central question in the current Presidential election campaign. With public attention focused on the issue, it is a good time for unions and others to press forward the campaign for a comprehensive, universal healthcare system.
Should the help offered be forced onto people via taxes and tax increases? The problem with liberals many times is that they feel everybody is needing and deserving of help and other peoples' earned income. Taxes initially were to provide for the common defense of this nation and to provide for commonly used community goods and services. To tax a person, take their money, and give it to another person who is not working is redistribution of wealth. Again, I ask (as the libertarian, not the Republican) should the help that you and maybe many other's want to provide be forced onto people via tax deductions?
The preamble to our constitution says the provide for the common defense (our military), and to promote the general welfare of the people. It does not say to provide for the general welfare of the people.
I think too that we are great in this country about stating that we all want to protect our liberties. We have the ACLU start law suits over protecting those supposed liberties. However, what about the liberties of the taxpayer to "truth in taxation"? What about the civil liberties of the taxpayer? What liberty and justice do they have when their money is used in ways that they do not approve of e.g. abortion and many other issues.
Another common thing that I hear people say namely Democrats and liberals is why not give tax breaks to the poor? I have an answer for that. Poor people do not pay into income taxes. In fact, via child tax credits, and the Earned Income Credit many of my single mother girlfriends get MORE money back after filing their taxes, than they paid in, to the tune of $1,200.00 more! They also get child care subsidies, free school lunches for their children, and many other taxpayer subsidized freebies.
I must say this in defense of single-moms. If men were forced by threat of prison to pay for absolutely HALF of all the children that they create care and life for 18 years, then many single mom's would not be in the situations that they are in. However, is that the taxpayers responsibility when poeple's own personal choices put them into certain situations? If we want to allow people to make all the choices that they want to, shouldn't we also expect them to be personally responsible for those choices?
Minnesota DFL Senators Push Government-Health-Care-For-All Plan
(St. Paul, Minnesota) - If several DFL senators get their way, Minnesota residents will receive their health care according to government guidelines and government budgets, says the Citizens' Council on Health Care (CCHC).
The Minnesota Senate Health and Family Security Committee held an informational hearing today at the Minnesota State Capitol on two DFL bills that would require universal coverage in Minnesota. SF 339 by Senator Leo Foley (D-Coon Rapids) would establish a universal health care system. SF 979 by Senator John Marty (D-Roseville) would require the state health department to design a universal system and put it into place by 2010.
Not Consumer Driven
"Single-payer is the antithesis of consumer-directed health care. This is essentially 'care by committee,'" said Twila Brase, president of CCHC.
"If universal coverage becomes law, government committees will dictate what kind of care is available, how many dollars will be spent on it, and what age, lifestyle and other factors will limit patient access to services," she added.
Orchestrated Hearing
Although the senate committee's public announcement of the hearing said there would only be a discussion of the proposed legislation, the agenda contained a list testifiers - all well-prepared supporters of the bills.
"This was an orchestrated promotion of single payer. There was no announcement that testimony would be taken and no real attempt to get or hear testimony on both sides of the issue," said Brase.
No Solution to Rising Costs
"One of the main reasons we have a problem with health care costs is the false sense of entitlement. Universal coverage will expand entitlement and further remove consumers from the true cost of health care, " says Brase.
Brase also says government programs are also prime targets for fraud. She points to the $106.9 billion in improper Medicare payments that have been made between 1996 and 2002. In addition, the federal government recently identified $167 million in fraudulent power wheelchair claims.
No Right to Pay for Care
Brase notes that the bill prohibits purchase of private health insurance. In addition, it says, "There shall be no co-payments, deductibles, or other out-of-pocket payments by individuals for services."
"If this bill passes it's time to pack up and move to another state. Doctors won't be able to accept private payment, patients won't be able to pay cash for care denied, and citizens may not even be able to buy a private insurance policy to receive care in another state," Brase warns.
kitkat, like most conservatives, you are missing one thing in your arguments. We already pay for people who CHOOSE to not contribute to healthcare. Systems that force people to pay into them, universal or single payer or whatever, don't eliminate personal responsibility. They ensure it. Right now, I could go to an emergency room with no insurance and no intention of paying for my care and the hospital has to treat me. Who do you think winds up paying for it? It's my fellow citizens who are responsible enough and able to pay for insurance and medical care.
I understand that argument. I also see it's flaws.
So, then the 30 year old man that makes $50,000 per year, but makes the decision to NOT purchase any healthcare should be forced and government mandated to purchase government run and sponsered healthcare?
Where is his freedom of choice? Where are his civil liberties to choose to NOT be forced into buying into healthcare?
After we answer the above question my next inquiry will be this:
If in effect what you are saying is that we pay anyway, then what difference does it make how we pay it? What is the difference between paying it with higher healthcare premiums, or paying it with government run Healthcare?
The question is then of ethics. If that 30 year old man chooses not to purchase healthcare, and then gets sick, seeks care and does not pay for his servies, that is his ethical responsibilty, not yours and not mine. He should be held accountable and resonsible. Keep his tax returns until it's paid (as they do child support deserters). What do we call it, Fergus when people take things and recieve things and then don't pay for it, or as you said, "Have NO INTENTIONS of paying for it."
At least, with our current system, people don't enter queues and wait. My HMO allows me to see any MD as a clinic appointment without seeing my GP first and then getting a referral and then waiting to see a specialist.
Why should all of our care suffer with a single payer system because we decide we should all get "equitable" care. In single payer systems, that are government run, you are no longer the customer. They do not have to satisfy your needs. They do not have to provide good care. You and I should be grateful for that care and humble and not complain or disagree with care. You lose the relationship with your doctor, and become subservient to the government. That is a high price to pay.
All in all, I am coming to the conclusion that single payer, government run healthcare is not the answer. I'd rather keep my HMO. It seems the lesser of two evils.
roxannekkb
327 Posts
I would agree that Medicaid needs to be reformed, for many reasons. But as far as your comment about the single men making $50,000 in California--well, if we had a single payer system, do you think that these men would get it for free? That everyone else in the nation would be supporting their healthcare needs, and these men wouldn't contribute a dime?
No, their taxes, just like anyone else's, would be paid towards the system. And these 30 year old men, who would be paying for a single payer system through their tax money, are the ones least likely to use the system. Yes, these young men are statistically the least likely to utilize the health care system. Their money would be paying to help the disabled, the elderly, prenatal care, cancer patients, and everyone else. So perhaps they would be the ones who should be resentful of a single payer system.
I am not arguing in favor of a single payer system per se, but just with your logic. It is very flawed, about who deserves health care and who doesn't. And as far as the alcoholics and drug addicts who get Medicaid, perhaps it would be helpful if we actually had facilities to help these people get rid of their addictions. We don't. The facilities in the nation are far and few between, and unable to accomodate all of those who are eligible for "free" medical care.
Unless you have a lot of money to check yourself into a private rehab place. And even if you have insurance, it often doesn't pay for anything related to mental health or addiction.