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Why has no nation on Earth ever had a successful private, for-profit, universal health insurance system?
Attention, high school drop-outs! Free debating lessons here:
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Before answering the question above, please read my answer below. If you disagree with my facts and logic, please tell me why I am wrong. Then I will tell you why you are wrong. That is the way grownups do it. If you only want to type a sound bite, go away.
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Profit-making is incompatible with the prevention and cure of sickness. Healing sick people is not a service in the same sense that fixing a car is a service.
The auto-repair industry serves its customers profitably in a free market for several reasons that do not apply to the health care industry:
1. The cost of an auto repair rarely exceeds 50% of the cost of acquiring an equivalent vehicle and is usually less than 5% of that cost.
The patient cannot acquire another body. The cost of an illness may exceed the combined cost of a buying a home and raising a family of university graduates.
2. Garages stay in business by making good decisions and providing good service.
Health care providers stay in business (retain their medical license) by conforming to industry standards. The health care industry (as opposed to the health care INSURANCE industry) does not want customers. They do not have to attract customers. There is no point in advertising for customers. The doctor regrets that the patient needs his help. The patient regrets being a patient.
3. Auto repair is based upon commodities: widely available parts, repair manuals, tools, and mechanics. Costs are well known and prices are regulated by competition
Health care equipment is highly technical and very expensive. Doctors are mostly specialists, often researchers with few students. They sometimes build their own equipment. The customer’s life may depend upon finding the right doctor. If that doctor does not have a contract with the patient’s private insurance company, the claim will be denied. (http://www.creators.com/liberal/froma-harrop/free-...
4. All drivers can afford to drive – until they can’t. If too many drivers can’t afford to drive, some garages may suffer or fail. It’s tough on the ex-drivers and ex-garage owners, but that’s the free market.
Patients must be served whether they can afford to pay or not. If they cannot pay, the cost must be shifted to others.
In particular, children and students cannot afford to pay for their own care. But they must receive the finest possible health care (and education) regardless of the wealth or poverty of their parents.
This requirement is enshrined in our Constitution’s Preamble which vows to “promote the general Welfare and to secure the Blessing of Liberty to ourselves and to our Posterity.” Posterity is our nation’s ONLY product. We MUST do it right. Spending large public funds on the postponement of death for a few very uncomfortable months is an irrational betrayal of our heritage and our national interest.
For the above reasons, universal health care costs can only be met by payments of deductible claims made through an insurance system financed by premiums that are subsidized for the poor. Costs are paid from the insurance pool. For statistical and administrative reasons, the larger the pool, the lower will be the premiums. The risk is spread over a larger population. That is why single-payer policies are the least expensive: everybody is in the same pool. This is a mathematical CERTAINTY.
Breaking the insurance pool into a hundred different pools adds important costs: financing, administrative, advertising, customer selection, claims denial, high executive salaries, and profits. These additional costs (over 25% of the total current cost and over 33% more than the single-payer costs) represent a “tax” paid to private insurance companies by all its customers with no benefit to the consumers.
The usual objection to single-payer is government inefficiency. And reduction of Medicare and Medicaid costs are part of the legislation before Congress. But the Veterans Administration provides excellent care to millions of veterans suffering a wide range of problems at a very reasonable cost compared to private industry.
Government rationing of health care is another objection. But, without exception, every private health care insurance company has a large building with an entire floor or two devoted to a department that does nothing else but ration health care. These claim deniers are answerable only to their highly paid management, not to Congress or to a State Legislature or to the voter. The only recourse to denial of a claim is to file a suit through the court system and pay the lawyer.
There are now insurance solutions approximating single-payer before Congress. They need your support.
General answers:
Success means that, with relatively few exceptions, everyone is served as well as possible within the available resources regardless of previous history or ability to pay. Of course, some will be served better or worse than others. It's the intent that counts.
We have two excellent VA hospitals in the Chicago area. I receive excellent service in my clinic. The brouhaha at Walter Reed was solved by firing a general. There are problems at all hospitals, VA or not.
Most of the VA problems arise from PTSD cases. No civilian hospital has that problem.
I can't believe how many high school drop-outs skipped reading my carefully thought out essay and just dropped a sound bite. That's rude. I begged you guys to go away.
For those who got ripped off at a garage, welcome to the free market. If you were treated that badly in a hospital, you might want to hold off on tort reform.
jwoody88: The USA has a private (not public), for profit, health insurance system. It is neither successful in economic terms nor universal. Many people, including me, have been very well served, whether private or public. I am on Medicare and have no complaints, nor have I ever heard a senior complain. The problem lies with those who are not served.
Texas Tre. The US Army, Navy, and Air Force are models of efficiency. Expensive, yes, but efficient in the sense that they do their best and are held accountable.
That is somewhat like the USSR, which could beat us into space but couldn't make bumaga (that's toilet paper).
The civil service people in our government are excellent. The problem is the guys like Brownie, who did a hekkova job at Katrina. Bush tried to run Iraq with born-again Christians just out of Bob Jones college. He tried to replace federal attorneys from the same source, which is getting Karl Rove into trouble now.
21 Answers
- SeanLv 61 decade agoFavorite Answer
As you say, it is because of the unique situation regarding health care. In the United State between the health insurance industry, the pharmaceutical industry, and the food industry there seems to be three-headed monster that has a goal to keep the populous in ill-health. The result is that we have a health care system that is more reactive to sickness rather than proactive in promoting wellness (which would mean a whole lot less profit for all three of those industries).
And to your answer . . . very well thought out. I am indeed in favor of a sinlge payer VA-like system.
- rrm38Lv 71 decade ago
The answer is simple. Paying less for procedures doesn't make them cost less to provide. The problem does not lie solely in the profit being made by insurance companies. The cost of practicing medicine is incredibly high. Even a single payer non-profit plan will not eliminate that problem. Unless something is done to address cost, rationing will occur at all levels, private and public. I also ask that you speak with a veteran who's had serious health issues and had to rely solely on the VA. I think you'll find that many are not receiving the excellent care that you speak of, nor do Medicaid recipients. Medicare recipients fare a little better, but most of them have supplemental private plans to make up for the gaps in the public coverage.
- M☺lly, RNLv 61 decade ago
As an RN with a BS degree, I believe while Obama's plan is flawed, it's really the only game in town. Either we get health care or we keep going on without it. Illegals get it free. Welfare recipients and poor people get all kinds of care funded by the government now. That won't change with whatever plan goes into effect. Under the law now, all poor children are entitled, children of working families are not if the parents are not covered. Therein lies the rub.
What I want to see is making the Senators, Legislators and Congress get the same coverage as the REST of us. Until that happens, lawmakers will always be held to elite status and way above the rest.
- Tom SLv 61 decade ago
The VA system is quality health care? Have you ever been to a VA hospital? They are dirty, crowded and under serve our Veterans. Ask any Veteran what they think about the VA system.
What service does the Government provide that is self sustaining and efficient? Before you say the post office, please remember that they are currently going bankrupt and are closing branches.
You want to cut a large expense from health care, how about tort reform? many of the procedures performed are done as a medical legal procedure, this is done to protect physicians from unnecessary lawsuits by predatory lawyers. Notice how Obama and the Democrats don't want to talk about Tort reform. I also noticed you didn't mention it either. Can a Veteran sue the VA administration?
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- checkmateLv 61 decade ago
Because you cannot have success and profit both. If the people are paying through the government for their health care, why should anyone make a profit out of them. Actually, now I come to think about it, that creeping selling off of service provision to private comapanies is what's happening here in the UK and what do you know? It's still isn't working. Making a lot of American companies a lot richer as a result, though.
- jwoody88Lv 41 decade ago
I'm sorry, I don't understand your question. A private, for profit, universal health care system? So, do you mean, one private company with a monopoly on health insurance?
To respond to a couple of the previous answers...
The health insurance industry is definitely not service work. The line of thinking that somehow providing health insurance is like providing an education is just wrong. Health care practitioners, on the other hand, ARE doing a service job.
These are totally separate things. The reason someone becomes a doctor is to heal people. But, people don't get a job with a health insurance company because they like to heal people, they do it because they like working in the insurance industry.
There is no way to equate the health care practitioner - health insurer relationship to any other industry.
- Anonymous5 years ago
very interesting arguement so i am supposed to believe that a corporation will scam me on my medical coverage to increase profits but also conclude that if i am insured on a government run no fee at point of service type plan this will not happen to me to meet a budget objective or to move money into a pork barrel project. yes i am now convinced i can trust my government completly ha ha ha ha ha. seriusly i have more trust in the corparation than i ever will in the government high rate of deaths under five as an argument sorry you used that to get child seat laws and to increase interventions in the smoking drinking and drug habits of pregnant women. now is it the health insurance or the mothers habits and accidents you do not get to claim both. liberals do not try to help us conservatives as we are trying to create a system that will not need a public plan.
- TexasTrev38Lv 51 decade ago
I did not drop out from high school. My GPA was 3.75, If you are trying to persuade, then might I suggest not insulting your audience.
On government inefficiency, I guess you missed yet another article all over the news today about how SS recipients are going to receive less next year, with even less in 2011. IF the government can fix either SS or Medicare, then I will be all for considering UHC. But, alas, despite me being a presumed high school drop out, I am not that naive.
edit: Our military is the best in the world in spite of the inefficiencies of the government that funds it.
- LucessaLv 41 decade ago
Good thing you truly weren't addressing HS dropouts or you'd have more auto mechanics responding ;)
You are one of the fortunate ones who has NOT apparently been grossly ripped off by a mechanic's garage. Many, on the other hand, have. My neighborhood garage price gouged me on a muffler which was fixed in April and STILL rattles like there's a pissed off cat inside.
Greed breeds corruption in private industry and govt.
I had to contact my State Atty General regarding my car's auto dealer mechanic. I brought my car in for a faulty belt, which fell off in a parking lot. I had to have the car towed to the dealer to get fixed. THEN I received the recall on that very GM car only to find that since my problem happened BEFORE GM admitted there was a prob and the letter went out my repair bill was not covered.
No mal-practice insurance coverage in the auto repair industry. It's a crap shoot.
- Bamford1000Lv 71 decade ago
There are private hospitals within some universal health care systems and they do make a profit however the concept of universal health care is treatment before profit. It's called humanity.