Friday, July 13, 2007

Another Anecdote Regarding Socialized Medicine

I was talking to my dad's wife today, explaining why I've finally entered the 21st century and gotten a cell phone. We were discussing all the utilities I didn't purchase, such as unlimited long distance, and she started telling me about the long distance plan they have at home.

"We have that internet phone service, and get free long distance. We can call anywhere in the US, England, and Mexico for free. When I have friends over, I ask them if they want to make any long distance calls. They seem shocked, but it's free!"

And that, dear readers, is why I don't want national (or even state) health care.

17 comments:

Eric said...

Did you spring for an iPhone? $600 for the handset plus a minimum $60 a month for the data plan... No problem, right?

Darren said...

No problem for rich kids.

Eric (1 ea) said...

Free.

In the military you'd see kids constantly going on sick call for nit-noid stuff, whereas if they had to pay for it they'd not go. We'd call that "malingering."

Having to pay for stuff sure makes you put your needs vs. wants in order.

But I love how they compare medicine in the U.S. (home to over 300M people) to France or other countries who have half (or less) the population and much higher taxes.

e.g: France: 61M

Darren said...

Yes, it's "free". That's part of the attitude that causes these programs to fail.

allen said...

If all that was wrong with socialized medicine were "the tragedy of the commons" it'd be bad enough. But it also puts the skids on research of every variety, slowing down the pace of innovation and increasing the cost of medical care.

Hell, there's even worse then that but I've ranted about the inherently anti-democratic nature of socialized medicine already.

MikeAT said...

Darren

Congrats on entering the late 20th Century and getting a cell phone.

I know better to ask than "Are you going to enter the 1970s and get cable TV?"

Darren said...

I don't watch much tv anymore. But thank God for DSL!

Ellen K said...

I hardly ever go to the doctor. I know people who take their kids to the doctor for what we used to call "a booboo". Too many people still think that every visit is just the copay and ignore the other pesky costs. The rest of us that never go end up paying for their stupid trips via higher premiums. In the meantime, I can't afford to go to the dentist because what used to cost $75 for xrays and cleaning 10 years ago, now costs twice that based on the assumption that everyone has dental insurance.

Anonymous said...

As a response to the assumed frivolity of doctor's visits if we had universal healthcare, the PPO system of health insurance, in a way, had to address this very problem. Insurance companies were afraid that if we gave people the freedom to choose their own providers, they may choose to go to much more expensive specialty clinicians more often (e.g. a neurologist for a headache), thus causing the insurance companies more money. However, that has not proven true. Though I see the relation you're drawing between your dad's wife's attitudes towards her free long distance and your argument for "free" healthcare, I don't think it's really an apples-to-apples comparison. I'm on the fence about universal healthcare, especially in America, but sitting at home and making free long-distance calls isn't exactly the same as finding a doctor, taking time off from work, driving to the facility, going through the exam, picking up medication, and scheduling any applicable follow-up appointments. And then going to them. I think the sheer inconvenience of it all would help people determine their "wants" versus their "needs" and act accordingly. Yes? No?

Darren said...

Anonymous, I appreciate the way you acknowledge my point, yet disagree with it without attacking me personally--and even provide some backup as to why you think the way you do. Several commenters on here could learn from your fine example.

I don't shy away from disagreement; it's disagreeable people I have issues with!

Now onto your point.

While I acknowledge that there is certainly more effort involved in dealing with health care than there is in making a long distance call, I don't think it can reasonably be argued that people, being told that their (taxpayer-funded) health care is "free", wouldn't avail themselves of it more in the manner of the "tragedy of the commons". It just seems like human nature to me, and insurance companies mitigate that to some extent by having co-payments.

Here's what I don't understand about socialized health care. Survey after survey shows that a large majority of Americans are satisfied with their own health care. The poor and elderly are already covered by Medicare and Medicaid (and Medi-Cal here in California). Who's left?

We also know that there are many people who prefer not to have health insurance, people who could otherwise afford it, because they're young and don't think they need it or they prefer to spend their money elsewhere. I don't see why I should have to pay for their health coverage, and neither do I think it's government's place to tell them they must have insurance.

I just started reading Barry Goldwater's 1960 masterpiece Conscience of a Conservative. I agree with him completely on the topic personal choice, responsibility, and freedom:

"...the Conservative looks upon politics as the art of achieving the maximum amount of freedom for individuals that is consistent with the maintenance of the social order...it is impossible for one man to be free if another is able to deny him the exercise of his freedom." On the next page he said, "the Conservatives first concern will always be: Are we maximizing freedom?"

When we compel people to have health insurance just to live in the state of Massachusetts, we deny them the freedom to spend their money as they see fit. When we limit your choice of health care to that which the government wants to provide, we limit your freedom--while simultaneously raising the cost as I've outlined before.

I guess we can disagree on whether or not people will game the system and thereby cause costs to skyrocket, but I have to believe the weight of evidence is on my side.

j said...

We have universal health care--your analogy is simplistic and innacurate.

Darren said...

j, you added nothing to this thread.

Ellen K said...

I look at the prospect of universal health care much in the same way I look at Social Security. SS when it was started was never meant to be the only resources for retirement. Of course, at the time, 65 was old and few people lived past 70. We used to have ten workers for every retiree, now we have four and by the time I retire it will be down to two. My problem with this is that since everyone has social security deducted, they take the money whether they need it or not, and use it. If health care is simply another payroll deduction, then people will overuse the system, because that is the way we are. And that overuse will cause the cost to skyrocket, times for services to increase and a necessary limiting of what is now common surgery and common procedures. That is why many countries with nationalized medicine also have private insurance. And that doesn't even begin to touch on the issue of HIPPA vs. the need to limit services to American citizens. Without some sort of non-reproducible identity card-such as a biometric card, our system, which is now deluged with people here illegally using public hospitals for common services, will be overwhelmed and then we end up poorer by miles and with a system that may be even less effective than what we now have. Plus, ask around about how medicine operated before HMO's came on the scene. It's been a fiasco since the beginning, yet they were sold to the American public as the salvation of medicine in the US. I don't see where it has worked out that way in terms of payments, cost or efficiency. If I take my kid to the emergency room, and they get admitted, I will get seven different bills-one from the ER, one from the ER doctor, one from the radiologist, one from the lab, one from the hospital, one from the hospitallist and one from my doctor. And that is supposed to be simpler? Do we really need yet another layer of bureacracy to eat up money and provide little in the way of service or efficiency?

Anonymous said...

I do see your point about the freedom to spend one's money as one sees fit, whether that money comes from net wages or has already been taken out by taxes. I guess it comes down to my belief that something is awry with the healthcare in America (despite those that say they are satisfied), but I'm not sure exactly how to go about fixing it.

And your point about "gaming the system" is exactly why I, too, am unsure about universal healthcare. Thanks for your reply.

--Same Anonymous as Above =)

Darren said...

One idea that's been floated, and shot down by several organizations whose ox it would gore, was when Wal*Mart wanted to open small clinics in its stores. Wal*Mart, an entity that has done more to mitigate the effects of being poor than any other organization or government in history, wants to put clinics in their stores. I think the idea was $25 a visit, only slightly more than I pay for a co-payment with my HMO.

That is a market-driven approach to improving health care delivery.

denever said...

>we deny them the freedom to spend their money as they see fit.<

Yes, but to quote another conservative icon, "There's no such thing as a free lunch."

I know people who are gainfully employed but their employers do not provide health insurance and they choose not to buy it themselves. They have the freedom to spend their money as they wish and they don't wish to spend it on something that expensive. They'd rather play the odds, hope for the best, and spend the money on an iPhone, a Prius, and a flat-screen TV.

Then, when they fall ill or are seriously injured, they go to the ER and they are not turned away for lack of insurance.

Because this is done by a certain number of people who can afford insurance but choose not to buy it, my health insurance rates are affected, which limits my freedom to spend my money as I see fit. As long as we have a system of public hospitals and emergency medical care, it will never as simple as saying, "I should be free to choose how I spend my own money and I don't want to spend it on health insurance."

Darren said...

The problem in your story, denever, comes when these people expect "free" care. *That* is where the problem is--that they are allowed to exercise their freedom not to buy health insurance but are immune to the responsibilities that come with that freedom.

I stand by Goldwater on this one.