You're right, you don't say it would save the government money. You make the argument that it would save everyone money. No one has any incentive to care about the price of healthcare, currently. Not the suppliers, not the providers, not the insurers. And the consumers simply have no choice.
Something else: It fosters a more competitive work environment, by allowing capable workers to choose the best firms.
It also separates health cost, whose administration is expensive for businesses, from working capabilities of employees. It’s a major problem for small companies.
Finally, anything more than essential coverage could and should still be privatized, and paid for by individuals. Much like today’s life insurance today. e.g., long cancer recovery and care.
Do you have data showing that the gains in competitiveness offset productivity losses from higher unemployment?
>Finally, anything more than essential coverage could and should still be privatized, and paid for by individuals. Much like today’s life insurance today. e.g., long cancer recovery and care.
What is the difference between essential and not essential? I don't think there's a good objective basis for what is and isn't, it just comes down to the costs healthy people are willing to bear, which comes down to feelings again.
The difference between essential and non-essential? Why should I have to make that distinction in a forum?
Both private healthcare AND even medicare do this today, to different degrees.
Largely, routine check-ups and preventive care are covered. Emergency visits and triage care used to be covered (and still should be).
Everything else is quite subjective, and cost is a factor.
More competitiveness necessarily implies more frictional unemployment. You can't have one without the other.
> The difference between essential and non-essential? Why should I have to make that distinction in a forum?
I'm not saying you should, I'm saying an argument that points to universal healthcare as an objective practice requires it.
> to different degrees
Exactly. There isn't an agreed upon objective basis for what qualifies as 'essential'.
Nonsense. You’re thinking about competition for jobs. But I’m talking about competition to hire.
>I'm not saying you should, I'm saying an argument that points to universal healthcare as an objective practice requires it.
You’re asserting that it does. I’m arguing that an argument for it doesn’t require it. That’s one for practitioners and a wider audience to flush out.
> Exactly. There isn't an agreed upon objective basis for what qualifies as 'essential'.
And as before, I’m pointing out that aside from some clear cut cases, it’s not required to be “objective”.
There’s no objective reason why we enjoy various freedoms in the US, other than emotional reasons and desires.
I dunno about that. Most people don't really care if their benefits are any good. And I've never seen a single job listing that went more in depth than "great benefits".
> Finally, anything more than essential coverage could and should still be privatized, and paid for by individuals. Much like today’s life insurance today. e.g., long cancer recovery and care.
Yeah, that's true in most if not all countries with universal healthcare. Of course, as someone else alluded to, it's a difficult distinction to make. I don't care about the mole on my face but a mole might legitimately effect someone else's mental health.
I’m surprised you interpreted what I wrote this way.
What I mean is that some individuals cannot afford to leave their job and take a chance, because of the risk that they will not have any coverage whatsoever.
If you or your family member have a chronic but treatable condition such as diabetes, this a life and death decision.
It makes zero sense to give employers such leverage.
Likewise, employers are less likely to cover individuals that will raise insurance costs.
And also, how does that differ from "some individuals cannot afford to leave their job and take a chance, because of the risk that they will not have any money whatsoever"? Personally I think we could solve both of those problems (and plenty more) with "make employment terms public" (i.e. disclose compensation ranges, benefits & premiums, vacation, and so on).
That's a problem that can be fixed without making the government the sole customer: Make people pay for their own healthcare.
>Not the suppliers, not the providers, not the insurers
That's simply not true. They all have profit motive.
>And the consumers simply have no choice.
That's only true in emergency medicine, which is the minority of care most people receive.
What would you do about emergency medicine in your ideal world though?
People do pay for their own healthcare. That's our current system. Hello?
> That's simply not true. They all have profit motive.
Everyone has profit motive, but when your prices are arbitrary, that doesn't make you care about costs.
> That's only true in emergency medicine, which is the minority of care most people receive.
That's not even CLOSE to factual. Try getting your doctor to tell you how much any complex procedure or care will cost, before the fact, without insurance.
Uninsured, underinsured, or people with high deductibles are much, much more likely to let a health issue linger for much longer than someone who gets free (to them) healthcare. If an issue lingers, getting worse and worse, it may eventually reach the point where it forces them out of the workforce; they stop paying taxes, they stop purchasing commercial goods which drive the economy, they stop buying new cars, etc. (on an individual basis, this is rare, but compounded by 40 million or so people it adds up to a lot of people not performing economic activity who would otherwise be making and spending money)
Free-for-me healthcare is better at providing preventative medicine than out-of-pocket healthcare. Preventative medicine is cheaper in absolute terms over the long term that remedial medicine, even if preventative medicine is much more common that remedial medicine. If remedial medicine removes a person from the work force, that costs the entire GDP a worker.
It is better for all of us -- in purely economic terms -- to have a worker wearing a government issued back brace, taking government issued anti-inflammatory drugs, and participating in government sponsored physical therapy than having a non-worker have back surgery on an insurance plan that spreads the cost among all of that insurer's other customers instead of producing widgets in the factory.
I might not speak for that many people on the left, but I personally support anti-poverty programs as a general rule not because I care about the plight of humanity or whatever, (fuck 'em) but because taxing people and spending those tax dollars on anti-poverty programs improve my overall quality of life more than just letting us keep the money. Every poor person, every homeless person, needs to have tax dollars devoted to them in terms of police and emergency services. Two years ago someone smashed my car's window, stole a $20 backpack with $40 worth of gym clothes, costing me a $500 deductible to replace the window and fix the e-brake. Pretty sure if that asshole had a better education, was given free tradeschool or college they wouldn't have smashed my window.
We, as a society, have decided that we'd rather have a pound of cure than an ounce of prevention. In a dozen ways. And that's fucking stupid.
Ask Bismarck. The first quasi-universal healthcare system wasn’t introduced because Bismarck was so nice; it was to increase productivity and discourage people from voting for the socialists.
Edit: I know that paper straws are a pain to drink through, my question was more: why is banning plastic straws an example of "faith-based science denialism"?
The push to ban plastic straws was nearly entirely based on misinformation or lack of information. Most of the debate was propelled to the highest levels by a 4th grader that literally made the data up[1], but that data was used to prescribe a "science and data driven ban".
Turns out, plastic straws really were never a big problem. Sure, single-use-plastic is a problem in general, but the ban of plastic straws has had nearly zero impact on the environment - or it could be argued it's had a negative impact since companies like Starbucks started using "multi-use" recyclable lids which in reality end up being single-use and are often thrown into the trash instead of recycling bin, and use more plastic material than dozens of straws combined.
The plastic bag ban is the same way too... turns out those reusable cotton tote bags consume way more energy to produce than thin plastic bags, causing dramatic increases in GHG releases, energy consumption, etc[2][3]. We now know plastic bags and straws are not a major contributor (or at all, really) to that massive plastic dump in the Pacific Ocean, which is mostly from fishing vessel waste tossed overboard. Good intentions with poor consequences unfortunately.
It's this sort of "theater" that puts people off...
[1] https://www.nytimes.com/2018/07/19/business/plastic-straws-b...
[2] https://www.nationalgeographic.org/media/sustainable-shoppin...
[3] https://qz.com/1585027/when-it-comes-to-climate-change-cotto...
[4] https://www.nationalgeographic.org/encyclopedia/great-pacifi...
Paper straws break down relatively quickly and can lose suction effectiveness as a result. Reusable metal straws can cause chipped teeth or gum damage if bitten down on by someone with poor fine motor control. No straws at all can leave an individual unable to ingest liquids entirely. Reusable soft plastic straws would be ideal, but the tradeoff is that now we've placed yet an extra burden on an impaired person (or their caretakers) in our society because now they'll need to maintain a supply of clean, reusable straws that they need to transport with them. Disposable plastic straws are "soft" enough to not damage someone's teeth or gums too severely when bitten down on, but are more durable than paper straws to ensure reliable suction over time, and they do not require any upkeep or maintenance for proper hygiene due to their disposable nature.
This quote really stood out to me:
> and they [disposable plastic straws] do not require any upkeep or maintenance for proper hygiene due to their disposable nature.
It's a rather bright example of the problem our global society has put itself into: there's still a need to deal with these items, but that need is no longer on the person using the item; it has been outsourced to the rubbish bin and, thus, to society and the environment at large.
We've done this to ourselves in myriad ways. Expanding public transport is "unfair" to people who have different needs because perhaps some people cannot quickly or easily board transit vehicles, or those trips do not go to the front door of where some people need to go. We cannot eliminate or shrink parking requirements or availability for the same reason.
Politically, we stop at "well, can't do that" without considering "OK, how could we do almost all of that with modifications for people who have other needs?"
We've fallen into the perfect must be the only outcome otherwise why bother. Some of that is genuinely not knowing, but large parts of opposition to the changes we know we need to make--both individually and on the companies and businesses supplying us in environmentally-poor ways--are disingenuously hiding behind those arguments simply to obstruct.
That's frustrating.
> Noninstructional factors explain most of the variance among test scores when schools or districts are compared. A study of math results on the 1992 National Assessment of Educational Progress found that the combination of four such variables (number of parents living at home, parents' educational background, type of community, and poverty rate) accounted for a whopping 89 percent of the differences in state scores
from https://alfiekohn.org/teaching/pdf/Standardized%20Testing%20... if you really want I can dig up the old study.
We need to change education itself so it is not a tool of systemic racism. Which currently, based on that study, it is. In a sense you are right: yes, it does its job if the job is to be the canary in the coal mine. But we did away with canaries in the coal mines and made the mines more secure.
Only if you are deliberately framing these points that way. I'll try to explain how these points can actually be explained as science-driven
> Banning plastic straws
In the US alone, 500M straws were used per day (https://www.nationalgeographic.com/environment/article/news-...). Given that many of these end up in the environment as consumers simply discard the container wherever they are walking, this is a serious reduction in litter.
> asserting that men should compete against women in sports if they identify as women
This one is a really hard debate, however... hormone distribution varies enormously between the two major biological genders so we're already (effectively) selecting athletes with the "best" ratios. Add to that people with intergender bodies (e.g. XY chromosome set but fully presenting as "female", XX chromosomes but have "male" body parts), and it becomes a real mess to define what is a male, what is a female and where a specific individual should be allowed to compete in - even if you're only going by purely biological metrics (hormone levels, appearance of gender-specific body parts). Add to that the "faith-based" stuff aka social gender norms and gender equality/anti-discrimination, and it gets very messy very soon.
tl;dr: for this point, there cannot ever be a "scientific consent" on what's correct and what's wrong. Personally I'd argue for a body-weight differentiation in sports (as it's done in boxing) instead of gender-based, since that way you have at least some common factor that is closely linked with physical strength.
> and eliminating SAT scores
Scoring of almost all kinds has provable issues - and especially in education:
- social background has massive effects on scores: rich parents can afford a lot of things closely linked to higher educational outcome such as private tutors, each child having their own room from a young age, send their children to well-funded public or private schools, or offering a stress-free environment for the child in general whereas poor parents are stuck with whatever the public school system offers, children often not having their own rooms which means they can't effectively learn if their baby sibling is crying in "their" room, and parents passing on their stress (poverty, overcrowding, homelessness, messy divorces, domestic violence) onto their children
- ethnic background: children of minorities have been proven to be discriminated against by teachers even at a young age, not to mention stuff like systemic under-funding of schools in geographic areas where school funding is based on the taxable income of the people living in this area, which is (again) closely linked to ethnic background as a result of segregation and gentrification
- government background: additionally to that, public schools may differ wildly in quality of teaching based on the funding priorities of county and state
- scoring leads to teachers "teaching for the test" aka "bulimia learning" instead of actual long-lasting knowledge transfer. This is something tests aren't primarily at fault for, but nevertheless play an important role
- scoring disproportionally affects students with mental health problems (e.g. test phobia), with dyslexia / dyscalculia and other learning impediments, and also those whose talents are outside of language and math
tl;dr: scoring is deeply flawed as a concept, where especially children from poor backgrounds (no matter if the family or the government is poor) suffer from massive discrimination.
I would have more respect for the right if they just admitted they are ok with people dying in the streets since they just ignore the economic effects of EMTALA.
Are you saying you believe that there are no programs in existence, which are government-run, that are not "shit shows" ?
Of course, there are times when efficiency is not the thing we’re optimizing for. The Space Program is an example of a pretty great government program; there was no profit or benefit to private space travel in the 1950s and 60s so the government had to subsidize it, but now that we are starting to see private business catch up, the best thing to do is get government out of the way. This is not all that different during the Age of Discovery where kings and queens subsidized trans-oceanic travel.
IMHO government should only exist to fix free market deficiencies (Monopolies, unfair competition, fledgling industries, lack of players). Not to take over a market and try to dictate it from the top down. Ultimately the goal should be that all people make enough of a wage to afford healthcare and let the market handle it. And still have a safety net for those who fall through the cracks, but the safety net should never be the goal.
The track record of... Medicare? It's one of the most popular programs in government!
What you've done is just aborb spin. It's true that these people don't trust "The Government" to provide health care, because their thought leaders (and peers like you) keep telling them that. But then they go and enroll in Medicare anyway, and it pays for their care, and because nothing breaks and it's never in the news they don't even think about it.
At some point you'd think the truth would break through, but it just doesn't seem to be happening.
Literally every health care system sucks for someone, it's a complicated problem. But everywhere, both within and outside the US, the systems that work BEST are government-run.
It is also not universally accepted- this is only anecdotal, of course, but I had a doctor tell me he didnt accept it because the rates for some procedures worked out to be below the state's hourly minimum wage.
Perhaps a better example would be the VA- government run hospitals and coverage that is perenially in the news for some new corruption or incompetence scandal, and a very very hit or miss reputation.
Virtually all of the putative working class republicans "opposed to government health care" would be better served by Medicare. Period.
The elderly would get better care if more hospitals and doctors accepted it; there are several ways to achieve this with, I suspect, mixed results.
The social security fund has been “borrowed from” to fund other programs.
The government is clearly in the pocket of big Parma.
The government uses taxpayer money to bail out Wall Street.
The government allocates subsidies based on lobbying groups.
The IRS specifically targeted right wing groups applying for non profit status.
The list goes on and on.
So people on the right are not keen to give that structure more money and power.
It doesn’t matter how successful you may think Medicare is. The power structure and track record of the entity which would manage universal healthcare is abysmal.
I think there is a way to do it which could make the whole program solid and resilient against abuse but the proposals all come from the left who don’t seem particularly interested in resiliency.
What exactly are you talking about? Don’t republicans have a 40+ year strategy of “starve the beast” to purposely make government services worse specifically to build this distrust?
I'm not saying it's a bad idea or a good idea, I'm just saying there is no basis for universal healthcare that doesn't start with 'we need to help people'. Same with social security. Same with many other left wing policies. A lot of the problems around market inefficiency in healthcare are perfectly solvable without helping the poor.
EMTALA already does this and I don’t see a push on the right to repeal EMTALA. Universal healthcare is a more efficient model of what is already happening.
https://www.brookings.edu/research/why-the-2005-social-secur...
It wasn't sold as a push to repeal Social Security, because that polls extremely badly, but that's what it was.
Both sides have appeals to emotion and appeals to logic in their platform. For instance, what basis is there for universal healthcare other than 'we should help each other'? You can't make the argument that it would 'save the government money' to the right, because, in their opinion, the government should be spending any money on it, other than maybe paying for employees' insurance. Every dollar the government spends on it now is just an example of how the government can't do anything right.
I think it's common for people on opposite ends of the spectrum see the other side as 'not grounded in data'. After all, if they saw the reason in the opinions of the other side, they'd be in the middle instead of the end they're on.
All that being said, I think more clarity in government spending would go a long way in creating more/less trust in government's handling of certain operations. Maybe the right sees less inefficiency than they imagined, maybe the left sees more, but we'd at least have some real data to compare.