Wacko Republicans?
What is it about european culture and more specifically us brits that we are unable to comprehend why republicans are so vehemently opposed to Obama’s healthcare bill?
Having written these people off as uncaring wackos, incapable of kindness to their fellow man, there is no attempt to dig any deeper. No attempt to find out why nearly 50% of congress opposed the bill or why such a huge swathe of America feels so uncomfortable with Obama’s plans. “They’re just crazy bible bashing, creationist red necks.” - that seems to be the final conclusion. I’m not sure that’s true. Why hasn’t this bill been approved decades sooner? “They’re crazy southerners!” just doesn’t cut it for me. Know your enemy - what are their arguments and reasoning? Why would anyone oppose a bill that intends to improve health care for some of the poorest members of American society? Too much Fox news?
Also, given that the new bill effectively forces american insurers to take on new customers. Why aren’t insurance companies actively seeking out this untapped market already? Do poor Americans neglect health insurance because they can’t afford it or because they judge it to be of lesser importance than something else? Is it a lack of desire on the part of the customer or the provider? If its the customer, why mandate them to buy? If its the insurance company, why wouldn’t you want to take on a new customer who’s willing to pay the money? Are middle and upper class Americans willing to pay for the insurance of those who don’t wan’t it?
How free is the American health care market? Why can’t you purchase health insurance in a neighbouring state? Are there health insurance comparison websites? If you’re unhappy with the quality of care you’re receiving, how simple is it to move to another service provider? What prevents insurance policy owners moving to another insurance company if they see that their fellow customers are receiving sub standard care or value for money?
Why is the AMA given a monopoly on licencing medical practitioners? Why should accreditation be left in the hands of a public body like the AMA and FDA? … a slight diversion… If you eat in a Michelin star restaurant, how confident are you that the food will be good or excellent? Would they give a star rating to a bad or mediocre restaurant? Are restaurants or hotels mandated to have external accreditation? Are these accreditation systems such as the AA or Michelin, state funded or privately owned? Why would this system not work if it were applied to healthcare? Is access to another person’s time, effort, medical skills and equipment a human right? Are we entitled to demand it?
But most importantly, why is there such a reluctance to get inside the head of those opposing the bill or ask some of the questions above?
So many questions! So few asking them.
Nope. The British media has made it’s mind up. They know where public sentiment’s at - “We Love The NHS. This should have been done long ago. These republicans are crazy. No more questions, Your Honor.”
“The British media has made it’s mind up. They know where public sentiment’s at - “We Love The NHS. This should have been done long ago. These republicans are crazy. No more questions, Your Honor.”
Err… not quite. The “British media” is in the game of manufacturing this public sentiment.
Go and respond to the UK Lib forums to our demands for more details of your conversion
Even if you support the idea of a universal mandate; you ought to oppose the Democrat bill. There are many ways to achieve Universal Coverage; forcing some of the poorest people in society to purchase expensive and poor value health insurance is not one of them.
I was looking forward to a post on the healthcare bill!
There’s a strong tradition of supporting small government and individual independence in the US, and I think this both contributes to make the country as dynamic and self-sufficient as it is, and also acts as an important ‘check and balance’ against excessive expansion of the state.
On the other hand, some detractors of the bill do simply oppose healthcare for the poorest members of society, if other folks have to pay for it. And that’s just the way it is, and something that far fewer people in the UK or Europe would feel.
”Are middle and upper class Americans willing to pay for the insurance of those who don’t wan’t it? ”
I don’t buy this. Of course everyone would want health insurance if it were free. Why would you want the alternative?
”If you’re unhappy with the quality of care you’re receiving, how simple is it to move to another service provider?”
In practice the series of questions in this paragraph has a complex series of answers. I used to get health insurance with my work, and in a few months I will again. For the few months in between I could’ve continued the work insurance package, but it would’ve cost me $800 a month! I instead found a decent package (albeit with a fairly high deductible) for $110 a month. So one problem is that the amount your work is paying for insurance is often huge, and largely invisible to the employee—it’s not taxed, for example. (Also, there isn’t usually a choice of which provider to go with when your insurance comes through work.) To sum up, it’s often not as free a market as it could be.
Having said that, insurance companies don’t make excessive profits. You could argue (and people do) that they shouldn’t make profits at all. But they certainly make no more than any other business, and probably less than most. So where is all this money going? People say that American healthcare is worse than Europe, and twice as expensive. I don’t buy this.
For a start, it would be interesting to look at e.g. life expectancies (not that that’s the best stat, but people use it) for only people who have had good insurance coverage their whole lives, rather than the whole population. If I’m choosing to live in the UK or US based on quality of healthcare, this would be more meaningful to me personally.
Also, I think there may be a lot of experimental, expensive treatment that appears in the US earlier than elsewhere in the world. This costs a lot of money but people will pay it even if it increases their quality of life even a tiny amount. And fair enough.
Two final points. First, if people in the UK think the bill will eventually lead to the USNHS, it won’t. I think the American mentality is that they take everything else out there in the world, and try and do it better. Which they just might do with healthcare, given time. And second, Republicans argue that public options and socialized healthcare kills higher quality health care for those who can afford it. The ‘death panels’, and so on. But isn’t private healthcare a huge growth industry in the UK? It seems the two can live side-by-side, and universal coverage doesn’t have to mean one size fits all.
Bottom line: my taxes might go up. I hope it’s not too much, but I think it might be worth it.
DavidNcl - It can of course be both ways around; the media can lead the country and the country can lead the media. Newspapers and televisions are in the business of attracting new readers/viewers and readers will generally like to read things that reinforce their own prejusdices so I believe they tend to tow the populist line.
sconzey - I don’t necessarily support a universal mandate. This is my first Socratic post
James! - Wow. Am I that predictable? You just gave my blog a sort of “Dispatches from the front line” feel. It’s really great to get some views from someone who’s had experience on both sides of the Atlantic.
I’ve got an affection for those southern staters (as you clearly have!) and so I was disappointed to see all counter views presented as coming from uncaring or uneducated hicks.
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”Are middle and upper class Americans willing to pay for the insurance of those who don’t wan’t it? ”
I don’t buy this. Of course everyone would want health insurance if it were free. Why would you want the alternative?
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I think there’s some miscomprehension there. I meant… are they willing to pay the insurance of those who didn’t want it when they had to pay for it themselves. The 18.3 million “young invincibles” under 34 years old that are currently uninsured. Would they like to stump up for their healthcare? They’re not poor necessarily, just young and invincible. Assuming a freer market, could these people not be enticed to take out much cheaper insurance for “catastrophic” cover as you did when the costs were passed on directly to yourself?
“but it would’ve cost me $800 a month! I instead found a decent package (albeit with a fairly high deductible) for $110 a month”
Why is that $800/month figure so high? Why would they be willing to pay that figure for something that you clearly didn’t wish to purchase yourself? Someone is paying that $800/month? Who is it? Are your employers mandated to purchase your insurance? Do you have no choice about who your employer picks as a health insurer? That sounds familiar.
Some very interesting comments and I’d like to discuss it further but I must get on with some work for my biggest client - ironically - the NHS!
Odd; low profit margins are usually the sign of a competitive industry. It certainly kills stone dead the idea that the US healthcare market is expensive because the health insurance companies are greedy capitalist bastards.
Megan McArdle over at The Atlantic disputes that whether or not one has health insurance affects one’s life expectancy in the states. It’s certainly true that whilst the US has a lower life expectancy than the UK, there is more variation between different regions of england than between the US and the UK. Furthermore cancer survival rates in the US are better than Europe, and much better than the UK.
And indeed that idea that you hit upon; that we must consider which consumers would choose when faced with the decision between single-payer and free market healthcare actually kills the idea of single payer healthcare stone dead.
For if we argue that consumers ought to be able to choose between living in the UK or US we are arguing against that very element of compulsion so often argued to be a “benefit” of a single-payer system. For socialised collective-insurance systems can exist within a free market, however people argue that only the sick will use them, thus the taxpayers of the whole country must be partially-enslaved to pay for the healthcare of the needy. If we argue for a socialised healthcare system, we argue that you shouldn’t be permitted to make that choice: to live in the US or the UK.
Kev—I just felt this post coming, somehow! And you are welcome for the comments. Let me just add a couple of things related to your reply:
“I’ve got an affection for those southern staters (as you clearly have!) and so I was disappointed to see all counter views presented as coming from uncaring or uneducated hicks. ”
Absolutely, and this picture isn’t at all accurate. I’ve had interesting and productive conversations with lots of (relatively) conservative Southerners , and Palin and the tea partiers don’t representative their views. Unfortunately, they do represent a fair-sized portion of US conservatives (i.e. there are *some* crazy hicks out there)—and they make the most noise.
“I meant… are they willing to pay the insurance of those who didn’t want it when they had to pay for it themselves. The 18.3 million “young invincibles” under 34 years old that are currently uninsured. Would they like to stump up for their healthcare?”
Right, I see. Well, the answer is no, probably not. And you could either say this means people take (and expect others to take) more personal responsibility or care a little bit less about each other. Probably a bit of both.
As for the young invincibles, I’m not sure that is really the mentality. For example, last month was my first month of private insurance, and I wasn’t sure when they would approve me and when my coverage would start (my fault, for looking into it too late, but anyway). Problem is I was due to go skiing for a weekend. It turned out my insurance kicked in in time, but I don’t think I would’ve gone if it hadn’t. Would you? Breaking a leg on the slopes could’ve cost me $1000s of dollars. So I think these young invincibles probably curtail what they do in life til they can get insurance, which suggests it’s not an active choice not to have insurance. At least, if they’re anything like me….
Plus, another problem has been that insurance companies can reject you due to pre-existing conditions. Makes sense as a business practice, but it means a lot of old people struggle to get insured at all. So it’s not all just care-free youngsters who are uninsured.
“Why is that $800/month figure so high? ”
I honestly don’t know for sure. One reason is, I picked a low premium ($110) because I feel somewhat young and invincible. I.e. I have no existing prescriptions, I didn’t expect to see the dentist or doctor much (or at all) in the next few months ($25 a time on my current plan) and was willing to pay up to a $2500 deductible in the unlikely case I really needed serious (i.e. emergency) health-care. The University plan would cover all that, and more. In fact, it is really excellent health-coverage, and seems much better than what I would get on the NHS! But whether it is really worth that much, I don’t know. Also, the Uni might get a deal because they insure so many employees, so maybe that’s not what *they* would pay to the insurance company, it’s just what I would pay to continue it. But the whole thing is somewhat mysterious.
In terms of choice, no, I didn’t have one. Some people have the option to take e.g. half the amount their employer is paying for insurance added to their wages, which is then taxed. People only seem to do this if they get insurance through their spouse.
Sconzey—as I say above, it is really hard to believe that a good health-care plan here in the US isn’t way better than the NHS. But I don’t know what the right stat is to prove that, it’s just anecdotal.
Your bottom line is right—people will pay more taxes to provide a baseline coverage for everyone. But people do pay taxes for this already in the US (I will most likely never use medicare or medicaid) and the same thing happens with e.g. public and private schools—the rich already subsidize the poor through taxes, both in the UK and the US. Enslavement is a strong way to put this, but what’s the alternative plan?
Re: young people — I’m in my early twenties. I could probably afford health insurance. I can’t afford a skiing holiday.
Moreover, if I were to go on a skiing holiday (it wouldn’t be in the UK) and would be covered by my travel insurance.
One of the things I’ve never quite got about the US healthcare system is this fuss about pre-existing conditions. Surely the obvious thing is for the health insurance company to insure you, but exempt things related to your pre-existing condition, or charge a higher premium. Alas, we enter the wonderful world of mandates …
Enslavement is an accurate way to put it. Asserting a claim to a part of the fruits of my labour by virtue of the accident of geography that is my place of birth is partial slavery. It may also be morally justifiable, just as it may also be morally justifiable to steal to feed your family, or morally unjustifiable for a physician to ignore a man in need, but let’s call a spade a spade.
More important — for me — than the issue of whether having health insurance in the US is better than having the NHS in the UK, is whether having health insurance in the US is better than not having health insurance in the US. It’s a question into which disturbingly little research has been done; it is seemingly “obvious” that not having health insurance has a negative effect on mortality, and yet what little research has been done into the issue seems to show that the effect is minimal.
Hi Sconzey
Ha—well my skiing holiday was really a day trip, less than an hour down the road. It cost me around $80, with all my equipment hire and pass. So if you can afford health insurance, you can probably afford that!
I find it unlikely that being without insurance can have a positive effect. Maybe the comparable life expectancy figures are due to things like uninsured folks avoiding skiing trips, or generally living healthier and more abstemious lives—good for them, but having insurance gives you more options, and I’d rather have the options. Plus there are things with insurance that don’t really affect life expectancy, but are nice—I get free glasses or contact lenses, excellent dental care, etc. Unless my old glasses got so out of date that I walk under a bus, or my teeth get some kind of crazy infection, these things aren’t going to save my life. But they are nice to have.
I wouldn’t use the word enslavement, but I’m not going to argue the point.
My thinking is that things will go on in the US in much the same way, still with a huge choice of insurance options (just no longer the choice of having no insurance). The downside as I say is that my taxes will probably go up, but it may not be too much. With further reforms of the way the healthcare system works, perhaps money can even be saved. But you can shoot me down there for being overly optimistic….