Thursday, August 13, 2009

How to provide universal healthcare

Part II of "Why conservatives hate Democracy" will commence as soon as I get time to finish pulling the statistics together. In the meantime, let's get back to healthcare.

There are five proven ways to provide healthcare to all the citizens of a nation. Conservatives are against all of them:

  1. Socialized medicine like in Britain and Scandinavia, where all hospitals and clinics are government-owned and all doctors are government employees (American example: VA and military healthcare systems): Republicans are against it, of course.
  2. Single-payer government-owned insurers with private providers, like Canada or Taiwan (American example: TriCare for military retirees/dependents): Against it, of course.
  3. Hybrid single/multi-payer government major medical and private supplemental insurance, like France (American example: Medicare): Against it, of course. (At least for non-prunes -- they're afraid of the prunes if they dare try to eliminate Medicare).
  4. Employer mandates like in Germany requiring employers to provide insurance, with government insurance payment assistance for the unemployed, and insurers required to must-issue and provide a minimum amount of coverage: Against it, of course.
  5. Individual mandates like in Switzerland requiring individuals to purchase insurance, with government insurance payment assistance for the unemployed and those who cannot afford it, and insurers required to must-issue and provide a minimum amount of coverage: Against it, of course.
That's it. Those five ways, or hybrid mixes thereof, are the only proven ways anywhere on this planet for insuring that all the citizens of a nation have access to healthcare when they need it. And Republican conservatives are against each and every one of them, even the most modest ones involving employer or individual mandates that retain a private health insurance industry.

So what do conservatives propose? Well:

  1. "Let them eat cake." Otherwise stated as, "healthcare is a privilege, not a right." But life is the most fundamental right, without which all other rights are worthless. If you're dead because you did not get healthcare when you needed it, WTF good is the right to bear arms? Dead people can't bear arms, they're DEAD! This is a non-starter from both a moral point of view due to the dead bodies that result and from a political point of view in a democracy. But then, we already knew conservatives hated democracy and have no problems creating as many dead bodies as necessary in pursuit of their agenda of profiting from the labors of others via all means possible.
  2. Unicorns and cotton candy trees: a "free market" healthcare system which is guaranteed to not cover the oldest / sickest individuals because they aren't profitable to insure, thus resulting in dead bodies. We already have up to 22,000 people per year killed due to lack of health insurance, any move towards even more "free market" would result in even more dead bodies. But once again, conservatives have no problem with murdering people, as long as they just set up the policies that lead to the deaths rather than pull the actual trigger. They, like, get fucking woodies from the notion of dead people, as long as there's profit involved. Remember, for a conservative, if there's profit involved it is by definition "good", and if something hurts profits, it is by definition "evil". A conservative denotes "good" and "evil" by how much profit can be made doing it, not by any morality that you might recognize by reading the Bible or any other holy book.
In short: What conservatives propose is a lot of dead bodies. Which is not surprising, since "a lot of dead bodies" is their answer for any societal question, whether said question is illegal immigration, dealing with terrorists, or whatever. And they see absolutely no problem with that (see #1, "Let them eat cake"). From a moral point of view it is completely immoral, but conservatives view the right to make a profit as more important than the right to life. Unless we're talking about fetuses, but that's another issue.

-- Badtux the Healthcare Penguin


  1. There is the story about the fundamentalist who told his flock water will flow uphill if you pray hard enough. Someone later objected that the statement was not true; he had tried it and water had continued to flow downhill. The pastor/minister/con artist said that only proves my statement - you were not praying hard enough.

    So it is for the 'free market' health care advocates. They admit to any fault that you finally prove, but then calim it only proves -= THE MARKETS ARE NOT FREE ENOUGH!!

    As you have pointed out til your beak is weary - no where on the planet does the health care system that they advocate work unless you define 'work' as profit the insurance companies.

    Many thanks for your insight.

  2. It is possible to design a universal coverage health care system with incentives to increase quality of care and control costs:

  3. Neal, that's a hybrid plan, a mix of the socialist salaried doctor model and the singlepayer model. There's nothing particularly novel about it, the Mayo Clinic and Kaiser-Permanente already work in a similar manner except that they're paid by employers rather than by the government. The main problem with the HMO model that you propose is that it doesn't work in sparsely-populated areas. There is one doctor in Moose Jaw, Montana. The other problem is that salaried doctors tend to retire on the job -- we need at least some incentive for those doctors to see an acceptable number of patients otherwise they will see as few as they can get away with seeing.

    There's nothing inherent in a single-payer model that prevents capping physician reimbursements at expenses past a certain point. The doctor in Moose Jaw turns in a spreadsheet of expenses plus number of patients who've visited his office in the past month, the payer gives him his expenses plus a salary scaled by number of patients (to keep him from retiring on the job) capped at a certain amount, and there we go. And we tax at 100% any profit he makes from any other medical-related enterprises so he can't do profit-sharing from a hospital or medical testing company to game the system by prescribing unnecessary tests or hospitalizations.

    For that matter, there's nothing in a multi-payer system that prevents this kind of cost control, we'd just need an intermediary claims processing level to handle the cap. What is lacking right now is political will. And that political will is going to remain lacking until the situation reaches crisis point, because politicians need two things to get elected -- votes, and money. And they don't want to alienate either of them, sigh.

    - Badtux the Healthcare Penguin

  4. It would seem the problem is not that we need affordable care for all . The problem seems to more be one of perception . People percieve National Health Care to be scary , even tho the VA and Medicare work . The real problem seems to be convincing people to go against the Anti Care advertising (screamers&deathers) and demand what is good for all of us . How can we let big money take away such and important thing as National Healthcare ?
    Hey didn't we go to the moon a couple times ? You'd think this would be easy . Whatever happened to convincing politicians that could move whole sections of the country forward at one time ?
    a tired of the debate ; w3ski



Ground rules: Comments that consist solely of insults, fact-free talking points, are off-topic, or simply spam the same argument over and over will be deleted. The penguin is the only one allowed to be an ass here. All viewpoints, however, are welcomed, even if I disagree vehemently with you.

WARNING: You are entitled to create your own arguments, but you are NOT entitled to create your own facts. If you spew scientific denialism, or insist that the sky is purple, or otherwise insist that your made-up universe of pink unicorns and cotton candy trees is "real", well -- expect the banhammer.

Note: Only a member of this blog may post a comment.