Ok, I'll bite...
Mostly because I question UHC for philosophical and practical reasons. Mind you, not because I inherently disagree with the idea, but because I don't know that I've ever heard a completely satisfying answer for either concern.

So, philosophically...are we really bound to care for others the way you suggest? Bearing in mind that we're a "secular" country (kinda BS, as we well know), on what grounds should UHC be implemented in a democratic republic? I understand some of the economic argument: it'll save everyone $$ in the long run. So there is a fiscal concern, which then could be turned into a free-market capitalism argument...I guess. But, rationally, what is our obligation to others, religion aside? And just to push a bit further, is there anything in our founding documents that indicates that something like UHC is "the American thing to do"? The point is, you have to be able to convince people that this IS what we're supposed to do. Gotta have some good, political rhetoric behind it, not just an emotional argument.

Now on to the practical. There are examples of national HC for us to learn from, all over the place, yeah? Europe, Canada...etc. But, despite Michael Moore, there are plenty of examples of why and how large-scale HC still falls short. I have family in London with 1st had experience. And although Bernie says we should be more like Finland, there are SIGNIFICANT differences between the US and basically all other places: geographic size, demographic size, gov't structure, wealth, demographic make-up, etc, etc. You can't just model UHC on another country's that is 1/20 the size and made up of highly-educated, culturally homogenous people who happily pay 60% in taxes. I know, oversimplified, but you get the point: HOW can it work here, given that 1) we're not like other places, and 2) other places have their problems with it too?

To be fair: yes, I think we can afford it. We have smart people to figure out how it works. The long term cost benefits (the 0-18 rule = spend it now on kids, don't spend it x10 for emergency room heart attacks) is something that not only makes sense, but could be sold (Tarrant seemingly missed the boat on that one), and yes, even the idea that this is what decent people do isnt the worst reason.

Oh, but what are we going to do when the average life-expectancy starts creeping past 90?

Anyway, just some things to discuss. I dunno how much I buy any of it, but these are the things I think about when people talk about UHC.

 

So, philosophically...are we really bound to care for others the way you suggest?

Yes. We are. That's why we have fire deparments. That's why we have police departments. That's why there is such a thing as "federal disaster relief." That's why there are such things as Unemployment Insurance and Social Security. That's states have National Guards.

You could extend this argument to the military too. Someone against universal health insurance might also argue against "universal national defense." The rich, one might argue could have their own armies. Why should my taxes go to pay for a poor person's national defense?

National Health Care is as important as national defense. After all far more people die in the hospital than on the battlefield.

The list of ways Americans officially care for others in society is long. One could argue that "caring for others" is the essence of what it means to be part of a society.

Plus, from an economic standpoint, we really have nowhere else to go. Health Insurance costs are killing businesses. Our car companies, for example are at a huge disadvantage vis-a-vis their European and Asian competitors because companies in those competing nations don't have to worry about health insurance for their employees and pensioners.

We pay more per capita and get much less. And many people get nothing. The world is laughing at us.

 

Interesting. There difference between fire fighters/police and UHC, however: they are paid for (generally) by the community they protect. Big difference between federal and local control/payment. Moreover, they supposed to be used in emergencies. But, I get your point.

As for car makers...
There is a reason GM has been called a giant HMO that happens to make cars. And its related to why Japan has killed us for so long. And its not simply UHC, its unions. Sorry. Of course, HC is part of what they're after, but the reason we have lagged so far behind for so long is not simply the health care issue. Why is it Nissan and Toyota can build cars in the US and still do well (http://www.nytimes.com/2007/09/04/business/04uaw.html)?

Anyway, I see where you're going with the argument. Not completely disagreeing with the philosophy...but again, its a hard sell in a country that--even if mistakenly--believes in the DYI mentality. You're talking about a completely different worldview. That takes time. Perhaps even a catastrophe. Hopefully tho, just time.

 

Why should I have to pay for the retarded college kids in town to get a free trip to the ER when they ride their skateboards into oncoming traffic; do various acts of idiocy and debauchery; eat crap and drink grain alcohol mixed w/ red bull (great healthy combo) which will lead to cancer and poor immune system, which will make them get sick easier? Among other things...why should I get screwed for leading a healthy lefestyle....should I make poor choices too so I can milk the system??? Why should we lower the bar?

 

What if the same kid on a skateboard gets lucky and avoids getting hurt today...then goes home and sets his apartment on fire? Why should you have you have to pay for the fire department that puts the fire out? Why aren't you complaining about that?

Nobody gets "screwed" because they live a healthy lifestyle, Steve. That's just stupid.

Why should we pay 60K per year to keep criminals in jail, just because of their poor choices?

Why am I getting "screwed" for not being a criminal? I could be "milking" that 60K if I just made worse choices.

****

Serious question, Mr. H: If you saw someone on the street bleeding and unconscious, what would you do?

What would you do? Would you step over the bleeding person and ignore them, or would you call an ambulance? Serious question. What would you do? I'd like to know.

 

Indeed, the Good Samaratin in me would help. But, that is my choice. There's a seriously political/legal difference in me being a good person, and the entire country feeding a health care system. Yes, I see the relationship, but from a political/philosophical perspective, its not the same.

To sort of bail Steve out: have you heard anything about the Netherlands and their health care issues re: decriminalized drugs? Maybe JayV can help out here. But my vague understanding is that the gov't now spends (or had to) a ton of money rehabbing people because they were allowed, legally, to make bad choices re: drugs. Now the state made itself legally responsible to deal with that outcome. My details are lacking, I'm sure and I do hope JayV can shed some light. The point is, UHC "forces" a sort of moral responsibility. That's always going to questionable.

Flip side: seatbelts, smoking laws, drinking laws, etc etc....

 

Yes Jonas- And yet The Netherlands covers everybody, has relaxed drug laws, and still spends less per capita on health care than does the USA.

And it isn't the "good samaratin" in you that would call an ambulance. That's what anyone would do. It's human nature.

There's a seriously political/legal difference in me being a good person, and the entire country feeding a health care system. Yes, I see the relationship, but from a political/philosophical perspective, its not the same.

Yes it is. It's the same. That's why emergency rooms don't turn away the dying, even if they don't have insurance. The difference is that on the larger scale, we can pretend it's different, but it is costing us dearly.

Are we going to drown in health care costs until society crumbles, or are we going to be a decent society and decide that health care is a right of all people. Pretending it isn't a right is exactly why we're in crisis right now. A system that creates profit on the backs of the sick can't go on. We are driving off an economic cliff because people like Steve are jealously guarding their right to divorce morality from policy.

 

Ah, ok...now we're getting somewhere. What, exactly, makes UHC a 'right'? I'm not saying its not, just want to probe this a bit more. What, in our legal system, makes someone else's HC a right that is my responsibility?

For me, that's a hang up: our rights extend as far as another persons'. That is to say, you have the right to say/do whatever you want, as long as that doesn't infringe on my rights, yeah? Well then can't an argument always be made that your right to UHC infringes on my rights via over-extending the tax burden? Or to push it to Steve's argument: your rights to get drunk and crash your car, or eat alot of crap food and become morbidly obese then infringe on my rights as a tax payer because now I'm obliged to take care of you.

I suppose we're arguing semantics to a degree here. If we collectively decide that UHC is a good idea, then we relieve ourselves of the decision-making burden: who deserves UCH, who doesnt.

But I will say again: the argument for UHC cannot--or at least will not be, successfully--one that takes the side of 'its the right thing/human nature thing to do.' At the end of the day, people care about themselves and their family. THAT'S human nature. In fact, I know you to have expressed that exact sentiment. And I don't say that is some inherently bad thing. UHC will come about when people realizes we cannot afford to do anything else. It has to be a economic or security-based argument. (I'm not even kidding about the security thing. Not sure how that would work, but you know how people think/vote).

For every person who thinks we need UHC as good citizens, there is one of not more people who will tell you the same thing Steve did: why should I be made to pay for someone who made bad decisions? And I can tell you from horror stories from a critical-care RN I know, alot of those people are repeat offenders.

The big picture here is this: to do UHC, you need to massive revamp the way the whole system works. Not government. Not economics. Not education. ALL OF IT.

No small task there.

 

A person does not have to right to a free service. If you don't have a home, you do not have the right to steal my money to build a home. Building/buying a home is an expensive service for those that can afford it.

Now, if you need a life saving surgery that costs $60,000, but you cannot afford, should everyone throw a penny to you for it? Maybe. Probably... We are in times where the difference between rich and poor is growing continually. So, we are almost being forced into a socialized form of medicine.

And I am not, nor was I ever implying, that a bleeding man on the street does not deserve medical help. I am just saying that due to the disparity between wealthy and the common man, socialized health services are imminent, even though philosophically, its illogical. Plus anything America consolidates ends up being corrupted. They bring it to the federal level so they can be the racketeers. Do I like the way it is now? No. Do I think the federal government will help? Doubtful.

 

And I am not, nor was I ever implying, that a bleeding man on the street does not deserve medical help.

What do you mean "deserve?" Because if he has no health insurance or money to pay for treatment... why does he deserve help?

Why Steve?

 

Haik you're beating a dead horse. Why don't you instead lobby for free medical care for the horse?

 

You can't answer the question?

Why does someone bleeding to death on the sidewalk "deserve" treatment if they don't have any insurance and they don't have any money?

If they can't pay, why shouldn't we just let him die?

Really. Why?

 

Everyone should be treated humanely. But there's this thing called money in the world. Do you want everyone to act as if money does not exist?

Do you?

 

I am aware of money Steve, but that's not the point.

You are arguing for two contradictory positions.

On the one hand, you are saying that nobody is entitled to medical care.

On the other hand, you are saying that a man with no money and no insurance, who is bleeding to death on the street "deserves" help and should be "treated humanely."

So which is it?

 

Quite the proverbial slippery slope, eh?

Let's just say I will settle on the latter one so that you can calm down...

 

FYI, the 18,000 deaths per year was updated to 22,000 deaths per year.

On the other hand, you might want to do what I finally did. After months of wondering why there wasn't an even higher number of documented deaths among our poorly performing U.S. health care statistics, I found it.

At least 75,000 deaths occur per year in the U.S. because we are at the BOTTOM among 19 countries when it comes to minimizing the number of preventable deaths.

For those who still think that the U.S. has great health care outcomes, they probably think we are best at minimizing preventable deaths. For them the number is 101,000 unnecessary deaths of Americans under age 75 because we are not as good as the top 3 performers.

See all the details by going to http://www.99oh9.org and simply selecting "Real People" on the left.

Bob the Health and Health Care Advocate

P.S. Comment by e-mail to me recently about the 75,000 deaths per year:

... thank you for your amazing website. I just today finally got the CRITICAL education about the term that I have heard for the past several months, and it is an absolute eye-opener.

Once I turned 60 - last year - I began to be ever more acutely aware of how backward the U.S. is with regard to health/medical care. I knew it was definitely not good, but the specifics that you have provided on your website are really maddening! That at least 75,000 deaths each year are preventable is maddening! How DARE those who have been elected to office treat American citizens like this these past many years.

 

Ummm....ok.
Can we get a definition of "preventable deaths"? That's about a vague a term as I've ever heard. And I'm looking at 99oh9.org, and I'm not seeing it. It's not even listed in the "terms and facts section".

Let me see, deaths that can be prevented: lung cancer, liver failure, suicide, drunk driving deaths, drowning in swimming pools, etc., etc...
You know what they all have in common? 1) NOTHING to do with our health care system and 2) all results of free will. Can't so much legislate around that. Now, I will grant the benefit of the doubt and believe that your use of "preventable deaths" includes thinks like pneumonia, heart failure, getting old, etc. But, until you define it, its kinda crap statistic. And crap statistics are good for one thing: defeating the purpose of any argument for which they are used.

Oh, and once again this argument seems to leave out the minor consequence of what happens when we start preventing all those deaths. People living longer, miserable lives. People aren't meant to live forever. Even those under 75. The human animal has far too much much hubris and thinks we can and should defy death.

Kinda makes me think: anti-death penalty people (the religious ones, anyway) argue that we don't have the right to end life: that's God's domain. So, what gives us the right to extend it indefinitely? The US has 360,000,000 people. Do we really want more?

Yes yes yes, its the "right thing to do" to take care of each other. We got Haik's point 15 posts ago. But there are actual, REAL consequences to all this...and no one seems to be taking that into consideration. Big picture, people. Are we REALLY better off trying to make more people live longer? And yes, UHC will have that effect.

So...what say you, UHC supporters?

 

Jonas ... for your question about definitions ...

Many pages at the web site have "Sources" or some equivalent word at the bottom. There you can often find the link to the source report and data. For example, ...

At "Real Lives" you scroll down to "Sources" and then under 75,000 preventable deaths per year you find this ...

"... the researchers considered deaths before age 75 from numerous causes, including heart disease, stroke, certain cancers, diabetes, certain bacterial infections and complications of common surgical procedures.”

And among those links under Sources you will find plenty to read and research.

If you decide to go through more of the web site, please in mind that there are lots of links, either in the main body of a web page or near / at the bottom.

By the way, I suppose this clears up your comment about crap statistics. My volunteer web master expert and I have worked on this web site for over a year. I very often have painstakingly examined the information before including it on the web site ... and sometimes have done deletions or change s when needed. In this particular case of a study done by medical researchers, it's a very definitive term "preventable deaths" because it relates to "preventable diseases" --- and has nothing to do with accidents.

Thanks for asking,

Bob the Health and Health Care Advocate

 

Jonas, for your comments about the REAL consequences of all this ...

Wow, you bring up an excellent point that may be the point that I think of most often as I work full-time and over time on this effort.

The minimizing of preventable deaths actually has nothing to do with what you wrote in your reference to living longer, miserable lives. Quite the 180-degree opposite.

The Health Care for All movement for non-profit single-payer national health insurance is only part of the picture. The ultimate objective is Good Health for All.

When we have a society where we do better at minimizing preventable deaths, we have a society where people are encouraged more to have healthier habits, not just seeing the doctor so that they can get another 5-10 pills to take every day.

When more of us have a higher degree of healthy habits we not only put "years in our lives" but "life in our years." Believe me, it will be the opposite of miserable. The impact of feeling better will manifest itself into other areas of our society, such as treating each other better, having less road rage, etc. etc. etc.

As soon as I can quit this full-time advocacy job by knowing that we all have our national health insurance cards in our hand, I will immediately start doing either paid or volunteer work on the ultimate objective of good health for all. I look forward to helping others live healthier, happier, more productive lives.

More of our deaths (the actual process of dying) will be much shorter, not accompanied by decades of pain and suffering.

Pardon the repetition: happier, healthier lives without decades of pain of suffering. That will be one of the REAL consequences to all of this (using your words) ... and it's one of the biggest motivators for me in my daily work on this effort. People, on average, will not only taking care of each other, but feeling better about themselves and treating each other better. It's a very positively heavy thought.

By the way ... we have 304,376,349 the last time that I looked at a population clock.
http://www.census.gov/main/www/popclock.html

Thanks for commenting about REAL consequences.

Bob the Health and Health Care Advocate

 

To Haik, regarding your comment that "We pay more per capita and get much less. And many people get nothing. The world is laughing at us."

Wow, how true your statements are. Some people would say that they wonder about us. In trying to limit the amount of text, my Peace of Mind web page does not get into everything that I have read and everything that people have told me one-on-one in conversation. People in other countries are truly in awe of our stupidity as a country.

How many times must we shout it: EVERY other industrialized country in the world has Health Care for All with either largely or exclusively NON-PROFIT financing of health care. The most recent country to shift to non-profit financing of health care studied 10-15 other countries and decided to go with SINGLE-PAYER as the BEST choice. And our own country's highly respected Lewin Group has earned a lot of money doing the same kinds of studies from state-to-state across the country ... which is in addition to all of the Government Accounting Office evaluations that reported as early as 1991, and perhaps earlier, that single-payer is what is needed.

We must get educated. We must communicate to our U.S. Representatives. Go to www.99oh9.org and select "Schedule" on the left to take action.

Bob the Health and Health Care Advocate

 

Thanks Bob, Jonas and Steve for a very good discussion.

The most recent country to shift to non-profit financing of health care...

Just curious- Which country was that Bob?

 

Ok Bob, fair enough. Like I said, I was giving you the benefit of the doubt. I was being a bit facetious about the 'miserable lives.' The point I was trying to make--albeit poorly--is that making people live longer, happily or not (which, btw is a pretty lofty and presumptive goal) will add to our population. That's the big picture. That's the long term. So, my concern is, while it sounds all well and good to improve the quality of peoples' lives (what I'm taking to really be the goal for which you're advocating), there is a responsibility to make sure we're not over crowding the planet just because we figure out how to extend life.
Moreover, and this is just for the sake of argument, how we (or you) define "good health" or "good life" is inherently value-laden. There are normative standards you're working with. And normative-based beliefs have this funny way of becoming hegemonic.

I fully agree that a large % among us lead stupidly unhealthy lifestyles. Given our resources, we should be setting the high standards, not the low. But as I said before, we didn't just show up fat and stupid one day. It took most corners of our society and culture decades and decades to get to this point. The work to undo just the health issues are massive. But again, health issues are a symptom of much bigger issues in how we live.

I appreciate your efforts and don't mean to suggest otherwise. We just need to be smart about how we do anything that involves "everybody", and we need to look not at the next step, but the consequences of that next step, and the 10 steps afterward. Now, that sounds like a quick way to be paralyzed by the fear of the unknown, I know. But our natural instinct for the preservation of the species is in part to blame for what got us here....

 

Haik, The country is Taiwan. The following instructions are for how to see videos about United Kingdom, Japan, Germany, Taiwan and Switzerland. The set of videos is called "Sick Around the World."

----- To see my selected "best of the best" videos list, go to Single-Payer Education or go directly to Videos, which has a link to "Sick Around the World" under "Documentaries."

----- If someone is reading this and has a computer that does not run videos, many libraries now have the capability. You can take your own headset set to the library to hear the audio. Some libraries even loan the headset to you.

Bob the Health and Health Care Advocate