1) Private health insurers haven't been able to run anything efficiently as long as I've been alive. My premiums go up by double digit percentages every year because "costs" keep increasing, but at the same time, insurers' profits go up by double digit percentages every year. It seems like this is simply a money transfer to health care executives.
2) The more private companies run our lives (especially something like healthcare), the more they will be able to dictate our choices (what we eat, risky behavior etc). Oh wait... corporations already do dictate what we eat, what sort of medicine we use, where we work, how we communicate, how we move around, what we wear...The only difference between corporate control and government control is that we actually have some say in how the government controls us because at the end of the day we control the government.
3) I haven't seen on person that supports privated health care tell me the downside. I know they exist and we need to know the risks and talk about them openly before we stick with such a horrible system.
But anyways, the downsides to public health care: cafeteria health care (i.e., standardized treatments) which is good for most patients but not for the few who have nonstandard variations of ailments; higher taxes; less personalized care as a consequence of standardized treatments; potentially reduced choice of health care provider(s) (but if the entire system is UHC this may not be the case); potentially longer waits for medical treatment that cannot be handled in a day (i.e., anything that cannot be handled outpatient or by nurses or nurse practitioners).
And the downsides to private health care: all of the above, plus: risk of claim denial for valid claims (though admittedly less of a risk now as a consequence of numerous state and federal laws cracking down on claim denials); double-digit increases in premiums every year despite no corresponding increase in costs (this is actually happening, and has been happening, every year for the past decade); reduced choice of health care providers (which is actually the case now, i.e., in-network vs. out-of-network); ruinous medical bills; unnecessary tests and treatments; private health information being shared with "business partners"; inadequate medical facilities as a result of lack of capital investment due to premiums being redirected to marketing or executive retention.
It turns out the downsides of a private health care system outweigh the downsides of a public health care system, since you have all of the same downsides but the additional downsides that come with a profit-seeking business. And as history has amptly demonstrated, cost-cutting is not one of the benefits of a private health care system (costs are cut in a way that benefits the insurer's profits, but in ways which are detrimental to the insured).
> My premiums go up by double digit percentages every year because "costs" keep increasing, but at the same time, insurers' profits go up by double digit percentages every year.
The raw profit values in dollars? If the costs go up 20%, the premiums go up 20%, and the profits go up 20% all together I'm not going to cry foul. The problem is the fact that costs are going up because of bad management.
> at the end of the day we control the government
You also control which insurance company you use. You have even more power; think about how hard it is to switch countries.
> downsides of a private health care system outweigh the downsides of a public health care system
I agree there, at least when it comes to basic care.
>government control is that we actually have some say in how the government controls us because at the end of the day we control the government.
That was a joke right?
As it is there is a shortage of nurses and doctors. Partly because it costs a lot of money and effort to enter that profession. How many people will be motivated to go that direction if they'll be slaves to government decree? It will take some time, but the effect of government controlled healthcare will be a race to the bottom.
Also, the profit motive is what keeps costs down and service levels high. The less regulated an industry is, the better the service and products are available to consumers who now have choice.
> As it is there is a shortage of nurses and doctors. Partly because it costs a lot of money and effort to enter that profession.
In the not-so-distant-past (less than 10 years ago!) mostly because the AMA tightly controls the influx of new people to the field, in an attempt to make sure that the salaries remain high: http://skeptics.stackexchange.com/questions/4561/does-the-am...
(Although now they are trying, so far unsuccessfully, to reverse it)
> How many people will be motivated to go that direction if they'll be slaves to government decree?
Instead of philosophizing in the void, why don't you look at other countries where, gasp, that is the case? Look at Canada, France, the UK, Israel, Hungary, and any other single payer country. Medical schools still have a 1:10 acceptance ratio, and are usually the hardest or 2nd hardest to get into. There is no "race to the bottom" in countries that had this system for over 50 years.
> Also, the profit motive is what keeps costs down and service levels high.
And yet, the US system is the most expensive system for what it gives (compared to single payer), and what it gives isn't better when you measure e.g. life expectancy. I would say you never actually looked at data if you can say that with a straight face.
> The less regulated an industry is, the better the service and products are available to consumers who now have choice.
I agree about that, but the US healthcare industry is extremely regulated in all the wrong ways. For example, they are exempt from any claim of anticompetitive or antitrust. How do you think that affects choice?
>And yet, the US system is the most expensive system for what it gives...
I was making a generalized comment. As you said, the US healthcare industry is extremely regulated, which is what I believe is the root of the problem we face.
People who want a the government to control health care are pointing at a system with a ton of government interference and saying "Look that isn't working well, we must need more government."
>How do you think that affects choice?
Poorly. But they're exempt because they're also force to take all comers. It's a water fall of faulty logic and regulation.
I'm not defending the current system. I'm advocating a free market system, which isn't anything like what we have right now.
> People who want a the government to control health care
No one wants the government to control healthcare. Many people want the government to run healthcare, and accept that as a result it will be government controlled . You might consider this a distinction without difference, but it paints supporters of public health care in a light they do not deserve. An analogy:
You seem to want my health care to be controlled by people whose own profit is their motive -- in fact, by corporations who are required by law to maximize shareholder profit at the expense of my health.
> "Look that isn't working well, we must need more government."
Most are saying "look, that isn't working well. But e.g. NHS in England is working extremely well. Let's copy that". And after looking at the NHS, it turns out that you need more (and especially, a very different kind) of government involvement.
Can you point to a working example of a system that you believe in? Because if you can't, I think the NHS and government involvement carry a LOT more weight as arguments.
You say that as if socialised medicine is somehow novel and untested? Look at most of the Commonwealth countries, there are no shortage of students applying to study medicine and they still get paid well. Take your blinkers off - or leave them on to be honest, I'm super happy with my socialist healthcare (which I supplement with cheap private cover for faster elective procedures).
> Net consumers are typically very happy in socialist environments, no shock there.
99.9% are net consumers when it comes to healthcare. So you're saying we shouldn't do something that makes everyone happy?
The 0.1% providers should be made happy. Apparently, despite the claims laid by many Americans who argue this, almost every other western country has managed to make those providers happy enough to not all quite en masse and leave everyone without access to healthcare.
> My premiums go up by double digit percentages every year because "costs" keep increasing
Because of government regulation.
> The more private companies run our lives (especially something like healthcare), the more they will be able to dictate our choices (what we eat, risky behavior etc).
Not violently, under the threat of fees or imprisonment.
> The only difference between corporate control and government control is that we actually have some say in how the government controls us because at the end of the day we control the government.
That's not true. The principal difference is that government uses violence to maintain control, while companies almost universally do not (except when they do so by lobbying government). Businesses go out of business all the time, which is a prime example of society exercising control over unpopular businesses, but unpopular governments very rarely cease to exist. I'm not sure how you can justify the claim that society has more control over government, with its vast military and police system and its nationwide campaign of mandatory taxation, than over businesses, which (with very few counterexamples, most of which involve employing government violence) only make money through voluntary transactions where both parties believe they are benefiting.
When you list the downsides of public and private health care, you leave out the primary distinction, which is that with private health care each person gets to choose which (if any) provider and plan to pay for, while with public health care there is no (or less) individual choice.
Now, I won't deny that a "perfect public health care system" sounds ideal, but the problem is that the definition of "perfect" varies from individual to individual. This is not a particularly profound or original idea: any dictatorial control is great for the people who enjoy the choices the dictatorship makes. You can easily apply this to some industry that is mostly privatized, like automobiles. If the perfect vehicle for Bob is a 4 door sedan with great gas mileage because Bob commutes and drives his family around a lot, then a "perfect" system for Bob would probably be one where 4 door sedans were the only automobile produced, and every household paid a set fee and was issued one of these sedans. Bob's costs would almost certainly go down, both from the economy of scale from only manufacturing a single type of car, and from the distributed fees. But that system is really bad for Joe, a farmer who really needs a large pickup truck and will probably have to buy one himself while his government-issued sedan goes to waste. Joe could argue (and I would agree) that even though switching to a privatized automobile industry might cause higher prices for a lot of people (like Bob), the individual choice is the important factor.
"Private health insurers haven't been able to run anything efficiently as long as I've been alive. My premiums go up by double digit percentages every year because "costs" keep increasing, but at the same time, insurers' profits go up by double digit percentages every year. It seems like this is simply a money transfer to health care executives."
If they could compete across state lines, this would be different. You also seem to leave out the government regulations in place, which many times hurts the consumer rather than helps (see: Obama care).
"The more private companies run our lives (especially something like healthcare), the more they will be able to dictate our choices (what we eat, risky behavior etc). Oh wait... corporations already do dictate what we eat, what sort of medicine we use, where we work, how we communicate, how we move around, what we wear...The only difference between corporate control and government control is that we actually have some say in how the government controls us because at the end of the day we control the government."
So you are saying because all of the people here on HN and in the US that want MJ legalized, it's magically legalized? That's not how the government works.
What about the TSA and all of the control they have over us? We have a say..right?..right??
"The only difference between corporate control and government control is that we actually have some say in how the government controls us because at the end of the day we control the government."
The government can send you to prison for not doing what your are told. A corporation can do no such thing. If you don't agree with what a corporation is doing..you can just stop giving them money. Is there an opt-out with taxes? or following the law?
"And the downsides to private health care: all of the above"
With private health care, you have no choice. Yes, there may be private care, but it's so expensive..only the truly wealth can afford it (see: the UK). I still want a choice.
1) Private health insurers haven't been able to run anything efficiently as long as I've been alive. My premiums go up by double digit percentages every year because "costs" keep increasing, but at the same time, insurers' profits go up by double digit percentages every year. It seems like this is simply a money transfer to health care executives.
2) The more private companies run our lives (especially something like healthcare), the more they will be able to dictate our choices (what we eat, risky behavior etc). Oh wait... corporations already do dictate what we eat, what sort of medicine we use, where we work, how we communicate, how we move around, what we wear...The only difference between corporate control and government control is that we actually have some say in how the government controls us because at the end of the day we control the government.
3) I haven't seen on person that supports privated health care tell me the downside. I know they exist and we need to know the risks and talk about them openly before we stick with such a horrible system.
But anyways, the downsides to public health care: cafeteria health care (i.e., standardized treatments) which is good for most patients but not for the few who have nonstandard variations of ailments; higher taxes; less personalized care as a consequence of standardized treatments; potentially reduced choice of health care provider(s) (but if the entire system is UHC this may not be the case); potentially longer waits for medical treatment that cannot be handled in a day (i.e., anything that cannot be handled outpatient or by nurses or nurse practitioners).
And the downsides to private health care: all of the above, plus: risk of claim denial for valid claims (though admittedly less of a risk now as a consequence of numerous state and federal laws cracking down on claim denials); double-digit increases in premiums every year despite no corresponding increase in costs (this is actually happening, and has been happening, every year for the past decade); reduced choice of health care providers (which is actually the case now, i.e., in-network vs. out-of-network); ruinous medical bills; unnecessary tests and treatments; private health information being shared with "business partners"; inadequate medical facilities as a result of lack of capital investment due to premiums being redirected to marketing or executive retention.
It turns out the downsides of a private health care system outweigh the downsides of a public health care system, since you have all of the same downsides but the additional downsides that come with a profit-seeking business. And as history has amptly demonstrated, cost-cutting is not one of the benefits of a private health care system (costs are cut in a way that benefits the insurer's profits, but in ways which are detrimental to the insured).