> Medical care is a commodity > No, it's a right.

You cannot have a right to healthcare without taking the right to not work for someone else. You have a right to access healthcare, you dont have a right to force someone to service your health.

And you shouldn't either.

> In the UK, Sweden, Norway, and many other civilized countries, everyone pays into a public pot that is used to provide medical care. Because of this, our workers are much more healthy, and much more able to work without the stress of "what if I get injured during work". They do not have to die of preventable diseases like septicemia, from something silly like duct taping their glass cut because they cannot afford to be treated.

This is medicare. Would you say medicare is economically successful?

> You cannot have a right to healthcare without taking the right to not work for someone else. [...] you dont[sic] have a right to force someone to service your health.

Why is this "right not to work" not enforced across the board? People should be able to just slack off whenever, right?

As far as I can recall, capitalists view people striking as a bad thing, and they invoke private millitaries and various laws to force people to stop striking and work.

So regardless of that, this is a silly idea, what if the fire department decides not to help you? Do they have a right not to work? What about politicians? What would happen if every single politician decided to exercise this right at once?

What about in hospitals? If the only X specialist surgeon available in the world decides to not treat you? And by this I mean, they're willing to treat other people, just not you. What then?

The world that you would like to exist, is, quite frankly, insane. What sane person would decide to let other people die, just because they do not feel like working

> This is medicare. Would you say medicare is economically successful?

Do you think making the working class bankrupt is helping the economy? The very working class that you expect to buy commodities, the working class that, without disposable income to waste on commodities, our economy would crash.

> Why is this "right not to work" not enforced across the board? People should be able to just slack off whenever, right?

It is, and they are. You may end up living on the street if you don't work, but the choice is 100% yours.

> what if the fire department decides not to help you? Do they have a right not to work?

The fire department entered into a contract with their coverage area, bought and paid for in advance by the people they are covering.

> If the only X specialist surgeon available in the world decides to not treat you? And by this I mean, they're willing to treat other people, just not you. What then?

This frequently happens, especially with surgeons.

Your questions indicate to me you have not sincerely considered GP's argument. Your _choosing_ to work is very different from my (or the government) _forcing_ you to work.

> It is, and they are. You may end up living on the street if you don't work, but the choice is 100% yours.

"Be homeless or work" is not a choice. Just like "Give me the money or I'll shoot you" is not a choice.

> The fire department entered into a contract with their coverage area, bought and paid for in advance by the people they are covering.

Just like the surgeons, at the hospital. Now you're finally understanding it.

> This frequently happens, especially with surgeons.

Wow, really? I've never heard of it happening. At least, not within the civilized countries in the EU (As opposed to uncivilized America).

> "Be homeless or work" is not a choice. Just like "Give me the money or I'll shoot you" is not a choice.

Give me healthcare or I will imprison you is your actual proposition, once you shed the intermediary steps.

Freedom is freedom from men, not from nature. We all decay and are victims of our biology, as well as our desires. You are as subject to dying from starvation as of dying from lack of healthcare service if people denied you access to it. The question is not if you have a right to demand those goods, but why the people that are willing to serve you health care for cheap cant get to you.

> Give me healthcare or I will imprison you is your actual proposition

Uh, no? Private healthcare still exists in the UK, alongside the public healthcare industry. People have a choice of which to go into. You seem to have a complete misunderstanding of how this system works...

Why does someone that pay gor his own private care does not have the option to not pay public care. That is the "do it or prison" aspect.

For the same reason that you pay for train maintenance despite probably having a car (At least in places with nationalized trains).

Also are you comparing being homeless (and risking death from disease, and the winter months in the process) to the simple inconvenience of taxes? I'm sorry, I cannot discuss any longer with someone who is willing to consider things so loosely and callously.

> simple inconvenience of taxes

Okay. United Kingdom has 34.4% of tax to GDP ratio. That means that out of 5 working days, almost 2 days are given to the state. I would not consider working 2 days a week for the government a "simple inconvenience".

That analysis of “work days” assumes that 100% of GDP is retained by labor in the absence of taxes.

Its probably even worse if you take a marxist approach to labor.

> This is medicare. Would you say medicare is economically successful?

Good old late stage capitalism.

Because economic success is paramount to all things right? Certainly more important than increasing the quality of life of citizens.

Economic success is why you're not dying of some random disease in a cave and instead typing on a computer that is a part of a worldwide network.

Without economics you can't pay for all the fancy stuff!

You don't understand what I am saying.

In countries with free healthcare, if you only take the department of health budget in isolation it's of course not going to be an "economic success", and I'm just saying that's ok, we shouldn't expect it to be.

Should we expect our armies to be economically successful as well?

Working in healthcare, economic success is much broader than making a profit. Looking at long term cost effectiveness is very common, so I would argue you could say that health care is an economic success.

We are talking about an economic problem. And if you dont care about quality of life, why would you enter a debate about rising cost of healthcare?

> We are talking about an economic problem.

It is a societal problem. This system doesn't have to be economically succesful by itself, so it's not an economic problem first.

> And if you dont care about quality of life, why would you enter a debate about rising cost of healthcare?

Hmmm..What? You probably misunderstood me... I do care about quality of life, and that's why I am shocked by you putting economic success before anything else.

The equivalent of medicare in many european countries is not economically successful and loses money every year. But so what? You balance that from some other budgets, or raise more tax. the point of such a service is not to make money or to break even. The point is to substantially improve the quality of life of citizens by allowing them to seek the care they need.

> You balance that from some other budgets, or raise more tax.

Fun. So if costs are rising, just keep paying more and more, that will solve it!

Providing cost effective healthcare is the best way to treat more people. If you make it more expensive, people will get less service. This is basic microeconomics. As simple as that.

> Providing cost effective healthcare is the best way to treat more people.

*Providing free healthcare is the best way to treat more people.

> If you make it more expensive, people will get less service

All countries with free healthcare also have way tighter regulation on the pharma/medical industry than say, the US, so they can't just go and rise the price of medications whenever they want.

Just to be clear, I'm not saying we should throw money by the windows and not count what we are paying. We should definitely try to optimize the healthcare system so it costs as little as possible, but having a non-profitable healthcare system is not the end of the world, and is definitely better than what is currently in place in the US.

> Providing free healthcare is the best way to treat more people.

Outlandish claim. Venezuela has free healthcare. Argentina has free healthcare. Germany has free healthcare. And in each country, people go private when they can afford it.

> All countries with free healthcare also have way tighter regulation on the pharma/medical industry than say, the US, so they can't just go and rise the price of medications whenever they want.

You got cause and effect mixed up. It is regulation that makes pharma expensive in the us. It is the FDA that doesnt allow german pharma to flood the US, and that puts incredibly onerous costs to the R&D and manufacture of drugs. Thats why it is better for patients in the us to fly to other countries to buy their medication and fly back, in retail smuggling.

> Outlandish claim. Venezuela has free healthcare. Argentina has free healthcare. Germany has free healthcare. And in each country, people go private when they can afford it.

Sure private medicine is often still better than the public service, so what?

The point of free health care is to make sure that people with low income can get treated when they need it without getting crushed by debt.

If you are rich and can afford the best private clinic in town that's good for you. But you weren't the one this system is trying to help in the first place.

That tells you you should give money, not healthcare. Its a very different proposition!

How does bankrupting the system improve quality of life for all?

You assume that having a non profitable healthcare system means bankrupting the entire system. This is false. In France, where the healthcare system is arguably one of the best in the world, it has been losing money since as long as I can remember.

So what? The healthcare system looses money and the government injects money back, either directly from taxes or by some other means. I don't know a single french person that would want to get rid of this system even if that means paying less tax, because this very clearly improve the quality of life of everyone.

Its also important to see what cannot be seen.

Who bears the cost of the most expensive healthcare? And what is the effect of it?

> The healthcare system looses money and the government injects money back, either directly from taxes or by some other means.

The government doesnt have money. Its your money. There's no difference between the government paying it and you paying it, except the government takes a slice along the way. Government is seldom if ever efficient there.

I dont think french people were happy when retirement age was increased, which was to balance the budget. And the spending per capita is amongst the highest in europe. Its not a perfect system.

You are also making assumptions by result. You are saying france has great healthcare because its provided by the government, because it has great healthcare. There are no shortage of examples of countries with socialized medicine and disastrous results, so we must dig deeper to have a model we can compare.

> There's no difference between the government paying it and you paying it, except the government takes a slice along the way.

Ok, so why don't you pay for the roads in front of your house privately?

Because... guess what, with more money, you can achieve more.

> You are saying france has great healthcare because its provided by the government, because it has great healthcare. There are no shortage of examples of countries with socialized medicine and disastrous results, so we must dig deeper to have a model we can compare.

Yes, France has bad results, and it is still better than what is available in the US. The fact that you have to find a worse model to compare to your country just means that you're already failing.

> Because... guess what, with more money, you can achieve more.

Isn't the whole point here that healthcare in the US is spending a lot of money for the results it shows? If money is no problem then this is not a debate.

> Yes, France has bad results, and it is still better than what is available in the US. The fact that you have to find a worse model to compare to your country just means that you're already failing.

I dont think you got my point. The debate on socialized care in the U.S. has to compare what the U.S. would look like with it. If you compare current US with current socialized France, you will make the mistake of saying "socialized medicine is better" on that sample. Add argentina into that mix, and now socialized medicine doesn't work as well. So you need a different model to compare what is successful and what isnt on each instance.

Compare any country with socialized medicine and with a GDP per capita in the same order of magnitude as the US and it's always better. France is not an outlier.

I can compare US medicare, which is socialized health, with other gdp/per capita countries and say the same. Its still very expensive.

Medicare is phenomenally successful given its constraints. It insures more patients, for lower costs, and better care, than any comparably sized private insurer. As the standard for basic care, it can't be beat in the US. Indeed, one of the original Romneybamacare proposals was to make Medicare the baseline health insurer, covering emergencies and major health crises (like cancer), with additional or concierge treatment options to be offered by private insurers.

The only reason why Medicare works is because private insurance subsidizes it. Costs are lower because the federal gov't say "I will pay you $X, even if it costs you $X+$1,000".

Can you give me some more info on this? My understanding is that medicare does less administrative work, and that might have some other consequences like they always pay out or never negotiate down, but how is it subsidized?

Bear in mind the opposite is definitely true as well: older patients are way more expensive than young ones, so their actually healthcare spending per patient has to be higher.

When I say subsidized, I mean informally. Commercial insurance pays much more than the cost of procedures and that makes up for the fact that Medicare sometimes pays less than the cost of the procedure.

In other words, if you were a doctor and you only took Medicare patients, there is a chance that you'd actually be losing money year over year. Of course, it depends on exactly what the doctor is doing as Medicare is more generous with some procedures than others.

Do you have any source for this? I find it generally hard to believe, but i dont know that much about medicare.

But its worse than developed countries healthcare in terms of cost. That has to be an indicative that the private vs public debate is a red herring, something else is making it expensive.

> This is medicare. Would you say medicare is economically successful?

Please explain what you mean by economically successful.

Good value/cost in comparison to other developed nation's public healthcare solutions. Isnt that what the OP is comparing healthcare in the U.S. to?

Medicare is also very expensive, it spends less in administration but also has very high costs in regulation. Medicare has the size of public healthcare in other developed nations, and its still high cost in GDP/capita. So expanding medicare would not solve the cost issue, it will just swipe it under the rug.

Medicare spends less than private insurers; despite the bureaucracy and regulations it's far more efficient than private insurers. Something like 98-99% of every dollar spent on Medicare is spent on treatment vs 85% for private insurers.

One of the reasons that many doctors hate Medicare is the paperwork associated with patients. (This paperwork only exists because of the bad actors who bill Medicare for non-existent health services.) But they stick with it because unlike private insurers, Medicare will pay out for services legitimately performed, which is why nearly every doctor who drops Medicare patients ends up taking them back within 2 or 3 years.

Its still very high per patient, higher than developed countries. And medicare will not necessarily get more efficient as it grows, in fact, the opposite.

Should we remember what the healthcare.gov for obamacare turned out? Billions into a non functional website.

Its true medicare shows some good signs in comparison to private, but it shows some other terrible ones. Lets not forget that healthcare regulation is designed by the same people that run medicare, in a broad sense.

>Everyone has the right to life. I cannot imagine how callous one must be to willingly deprive fellow human beings of that right, purely because it is not how the economic system works. If we have the resources to provide healthcare to everyone, then we should. No matter what the cost.

I disagree on so many levels. First its most of the time the right to comfort (not hurting, being sick 3 days and not a whole week, etc) or the right to live carelessly (thinking about tobacco, obesity and their consequences here), not the right to life. Many people accross the globe don't even have access to our level of care yet they still live. Not everyone is sick either.

I also don't think we should provide to everyone. I don't think that having sick people being able to lead a normal life only thanks to modern medicine, and thus having the possibility of spreading their bad genes, making their descendance dependant on modern medicine, is a very sound choice to make as a species.

As for the public pot, considering that europe's population's getting older, staying longer alive, not being especially healthy (obesity rises too), I don't think that the point where it's not sustainable enough for our societies is very far.