[von Wrangell]

Originally Posted by Dr Reducto

So how would a high tax rate (needed to pay for healthcare), and limiting personal choice help that social mobility?

The current tax rate for me is about 28%. I don't consider that to be a high tax rate. And I get payed more than the average wage on Iceland. I still get free health care.

Also, I have a question about how socialized medicine works. I assume that since doctors are forbidden from keeping private practice (the way it works in all the socialized medicine countires I have heard of), they will be forced to take a government wage. That's a sucker's deal, because in America, if you aren't coming from a wealthy family, you are looking at 300k in loans when you graduate medical school. So what about that? How are they going to pay those loans off without the prevailing wage for doctors as of now? Or will the government pay for medical school for perspective doctors? Or maybe they will allow doctors to remain in private practice? although I doubt it because all the best doctors will remain private and command even higher prices, and people obsessed with everyone being equal will complain.

They can have a private practice but all the money and prioritation still go through the government. Meaning patients can decide what doctor they can go to but still not pay anything (or at least very little) for getting what they consider the best care.

Since we have no private schools here we don't pay a cent for being in school. The only loans people take here when it comes to school are loans to skip having to work with school. And those loans are as generous as possible for the person taking that loan. Basically as low rates as possible or 1% and you simply pay them back by paying 3.75% of your monthly wage for several years. Nothing that really hurts. This ensures that everyone can be a doctor without having to come from a wealthy family.

And doctors around here are in the top 20% of yearly income. So they don't have to worry about money.

There are a lot of things to consider. I personally think medical care should remain private, and that the government should abandon the medical monopoly and allow people to freely purchase prescription drugs and allow for lay people to do much more in the way of basic medical care to bring prices down by making the supply of medical labor much larger.

What should those lay people do?

[Busemann]

Originally Posted by Dr Reducto

Also, I have a question about how socialized medicine works. I assume that since doctors are forbidden from keeping private practice (the way it works in all the socialized medicine countires I have heard of), they will be forced to take a government wage. That's a sucker's deal, because in America, if you aren't coming from a wealthy family, you are looking at 300k in loans when you graduate medical school. So what about that? How are they going to pay those loans off without the prevailing wage for doctors as of now? Or will the government pay for medical school for perspective doctors? Or maybe they will allow doctors to remain in private practice? although I doubt it because all the best doctors will remain private and command even higher prices, and people obsessed with everyone being equal will complain.

Medical school, here in Norway at least, is completely free. Some choose to practice privately, but the average government wage for hospital doctors is just over $100,000 plus overtime, which usually amounts to an additional $20,000. Specialists make considerably more of course.

[BRussell]

Check out this table:


The US doesn't have better health outcomes, and in fact has worse (life expectancy, infant mortality). The US doesn't have "more access," at least in terms of physicians and nurses and hospital beds per capita.

But the US does spend a helluva lot more on health care than other countries. Over twice as much. Again, our government spends as much per capita as countries that actually have universal insurance. It's insanity.

At some point, you have to wonder if the reason we have such an expensive system is at least partially due to our lack of universal coverage. Part of it, I'm sure, is our costs - how much our physicians are paid, how much drug companies and med tech companies charge us for their wares. But the inefficiency in our private, splintered system is massive. If everyone was simply covered in a straightforward manner, I bet we would spend less than we do now.

[BRussell]

Originally Posted by tie

Perhaps, but this is a different argument, and more complex and difficult to prove. You keep on mentioning GM, but I don't think GM is a good example. I'd say GM is a special case, brought down by the incompetence of its management (which I'm sure has been well-compensated). Let it go bankrupt. And if GM can't afford its health benefits, then why can the whole country afford the same health benefits? It can't.

Generally, I think this "economic efficiency" argument is a red herring, since so many of its proponents also argue that health care is a fundamental "right." Overall, if you hope that national health care will cover more people, then it will also cost more and likely reduce US competitiveness (not that health care doesn't have benefits...). If national health care covers the same or fewer people, then it will cost about the same, with minor efficiency savings from lack of duplication and minor losses of efficiency from government bureaucracy.

In my view, GM is just a symbol of the company that provides good health benefits to its employees. Perhaps in the case of GM, it's just a crappy company and should go bankrupt. But clearly there's a general incentive in our system to be like Walmart rather than GM. Everyday in the WSJ you read about some company cutting its employees' benefits and receiving praise from analysts and getting a rise in its stock price.

We have a perverse system in which most Americans' health insurance is covered by employers, but employers have a disincentive to cover us. If we continue along this path, either we're going to burden our employers excessively, or we're going to end up with ever fewer people covered. Furthermore, we're going to end up with pressure for employers to only hire healthy people, or make up excuses to fire people who get sick. It's just irrational.

[Dr Reducto]

Originally Posted by von Wrangell

They can have a private practice but all the money and prioritation still go through the government. Meaning patients can decide what doctor they can go to but still not pay anything (or at least very little) for getting what they consider the best care.

Do you believe that doctors should be able to opt-out of the system if they choose?

Since we have no private schools here we don't pay a cent for being in school. The only loans people take here when it comes to school are loans to skip having to work with school. And those loans are as generous as possible for the person taking that loan. Basically as low rates as possible or 1% and you simply pay them back by paying 3.75% of your monthly wage for several years. Nothing that really hurts. This ensures that everyone can be a doctor without having to come from a wealthy family.

Aren't school systems like that "streamed" though? As in, if you aren't smart, say goodbye to college?

What should those lay people do?

This is really a tangential issue, but a lot of basic emergency room visits are just stuff like stitches and other minor injuries that aren't all that difficult to diagnose and fix. If we allowed nurses to handle stuff like that, with a doctor coming in at a supervisory role, it would definitely cut waiting lines at hospitals.

[von Wrangell]

Originally Posted by Dr Reducto

Do you believe that doctors should be able to opt-out of the system if they choose?

No. You become a doctor to work for your society. Not to make money. If you want to make money choose another profession.

Aren't school systems like that "streamed" though? As in, if you aren't smart, say goodbye to college?

It's supposed to be like that but unfortunately school is seldom based on intelligence and is more based on how much you can remember for exams. But in the perfect world schools should be "streamed". You shouldn't get higher education if you aren't above average in intelligence. Meaning your chances of getting an education should be based on you intelligence (or rather ability to learn) rather than on how wealthy your parents are. But if you are meaning that there is some sort of cut off (not everyone gets into school) that's not the case around here. Everyone can get into any level of our school system as long as he/she has finished the level before that.

This is really a tangential issue, but a lot of basic emergency room visits are just stuff like stitches and other minor injuries that aren't all that difficult to diagnose and fix. If we allowed nurses to handle stuff like that, with a doctor coming in at a supervisory role, it would definitely cut waiting lines at hospitals.

It's done in that way around here.

[Dr Reducto]

Originally Posted by von Wrangell

No. You become a doctor to work for your society. Not to make money. If you want to make money choose another profession.

So with that sort of environment, do the best doctors leave the country to make much more money, the same way the rich will come to America/South America so they dont have to wait for procedures?

[von Wrangell]

Originally Posted by Dr Reducto

So with that sort of environment, do the best doctors leave the country to make much more money, the same way the rich will come to America/South America so they dont have to wait for procedures?

Hasn't happened here. Nor do the rich go to the Americas to get procedures.

[von Wrangell]

You all went awfully silent.

[Busemann]

Originally Posted by von Wrangell

You all went awfully silent.

That's what happens when real smackdowns occur

[Dakar]

Originally Posted by von Wrangell

No. You become a doctor to work for your society. Not to make money. If you want to make money choose another profession.

I've got to say this is statement I agree with most.

[Dr Reducto]

I have a question as to how you can consider healthcare a "right".

I consider rights to be something that can exist outside of government, and are natural born. They are something that the government honors, as opposed to grants.

For example: If there is no government, I still have the right to free speech, the right to bear arms, etc. The government doesn't have to grant me these rights for me to excercise them.

As for "free" healthcare, this is more of something you view as a responsibility of government, rather than a right. Absent a government, no one will give you healthcare for free. Essentially, it's about as much of a right as the right to welfare. It's not a right.....you simply deem it as a responsibility of government.

If I am going to get medical care, I want the best care I can get, and am willing to work for it. If I want to pay a doctor to talk to me today about a treatment, and book an MRI for tomorrow, and do a biopsy and not have to wait a long time for lab results, I should be allowed to pay for the level of care I want. I am a very "free market" type of person, and know that it's not the most equitable way to distribute a limited resource, but I prefer being able to work hard in order to reap the benefits of that hard work.

Edit:
And as for the statement "You shuldn't become a doctor for money", it's my choice if I want to go to medical school for 4 years and go through a grueling residence for money. What if people said about your job "You should do it for the good of society, not for money"? San Francisco's mayor said Wi-Fi is a basic human right....does this mean that IT people should do their work for the good of eliminating the digital divide? What about lawyers? Should lawyers become lawyers just so they can do pro bono work for people who can't afford a decent rate?

I feel that if you want to become a doctor (or any profession) for money, it is your right to do so.. I personally feel it's a dumb idea to do it for money (because of the intensely hard program), but people should be free to do it

[Nicko]

Originally Posted by Dr Reducto

I have a question as to how you can consider healthcare a "right".

I consider rights to be something that can exist outside of government, and are natural born. They are something that the government honors, as opposed to grants.

I think the simple answer is that it comes down to different countries setting different standards. Some countries think its a right, while others don't. Maybe there will be a time when all countries consider it a right, and it will be.

[Nicko]

Originally Posted by von Wrangell

No. You become a doctor to work for your society. Not to make money. If you want to make money choose another profession.

Just gotta add that I completely disagree with this. If someone is really good at something (doesn't matter what field they are in) they should be able to get paid what their work is worth and what the market will bare. If that means $100 or $600 a day (or whatever), so be it.