I cringe at re-debating the merits and faults of the ACA all over again, we've had several thoughtful discussions on the forum already but it may be unavoidable since it is a key referendum in the pending election. But I think a discussion on principles, the primitive nature of the argument minus the petty score keeping about "talking points" could be in order. Regarding your specific question about the economic decision it comes down to this for me: We have several social programs in place right now. Social Security was started under the New Deal initiative and has expanded and blown out of proportion and is financially untenable. This year was the first year that it paid out more than it took in. If a private company offered the exact same service to people, it would be charged with fraud. We have welfare, medicare and medicaid that were born of the Great Society, they too have grown way beyond the originally promised scope and scale and, combined with Social Security make up the vast majority of our budget that we cannot pay for with the output of our country. Now we are promised a new program under the same guise. If the Fed could cite one credible example of when they had promised an entitlement, proven that it had the desired results and come in on budget, I would totally be open to the idea even though it conflicts with my constitutional ideals. I've said before, this should be done by the states and I have no problem if any state wants to socialize the the healthcare of their citizens. So to me, as good as your question is, it's moot as I don't believe that the Federal Government can deliver the goods, they have absolutely no track record of doing so. Philosophically, I believe the best means by which to elevate everyone, that all the evidence in the world indicates, is to increase the prosperity of people which is achieved by maximizing freedom and choice not increase the amount of decision making among a relatively small and elite few. In a centralized format, power can expand on demand but knowledge and creativity can not. This was sold under the argument that there were 30M+ people without healthcare. But even the CBO states that even after this, the number of uninsured people will be about 22M. So we upend our system for everyone for 8M people? I can also give you first-hand examples of how unexpected consequences are already happening as a result of this that are hurting people. I guess for me it comes down to the simple decision making principle of "show me the proof" that it falls short for me. I've said it before and I'll say it again, if the UK and Canada can make it work, all the best to you. I'm not remotely convinced that we can based on a lot of history. Meanwhile, I look at what companies like Whole Foods does with medical savings accounts for their workforce and see a great way to address the problem but when the CEO touts the success, he's demonized. This country is not having a rational and open discussion about it. If you mention private solutions, you are immediately charged with a lack of human compassion no matter how many people are actually helped by it. All that creativity and choice will be wiped away and I fear a lot of innocent people will suffer as a result. I think we are seeing a lot of this today. Recently, Atlanta GA voted to raise taxes to improve the mass transit system in that city. It was overwhelmingly defeated and the consensus when voters were asked why they voted against it wasn't that they didn't believe the city couldn't benefit from improved mass transit but that they didn't believe that the government would produce what was promised. I think it is indicative of the tone in the US right now.
Thank you. The question arose really from a couple of books I have recently read, Poor Economics (I would recommend this if you have not read it already) and Robert Pestons Who Runs Britain? Although Poor Economics is focused on those who live on less than $1 a day I think the points are applicable to everyone. One of the themes of the book is why do poor people make such bad health and welfare decisions? Why do they not buy chlorine tablets for water when they are readily affordable to them or take up free preventive health care such as childhood immunization or opt for more expensive medicines than they actually need? What particularly struck me is that these are all decisions which are largely taken for us in the Western world and we would probably be just as lax if if were left to the individual. The point at where government intervention and the choice of the individual meet is a fine one and getting the balance right is very difficult. Personally it's something I am finding very difficult to reconcile where I actually stand on the subject. Pestons book spends considerably time looking at the rise of private equity in the UK and the impact it has on the country. He is very much pro-capitalist and pro free market with minimal intervention (with the exception of healthcare interestingly) but he made a very interesting point in regards to taxation and tax avoidance of the super rich. Their fortunes are directly dependent on the benefits of the stable and ordered society (the UK) that they are operating in so they should be paying their fair share of taxes to support it. That might help explain where I'm coming from but the vagaries of the US economy elude em!
In the UK we have a strange obsession (that wouldn't be the case in, say, Germany) that the state must own all the hospitals and employ all the staff. Merely being free at the point of demand isn't enough.
To take a lighter approach, how consequential is Ryan anyway? I mean what is Biden's role and accomplishments? He doesn't even know which state he's in or what century it is.
Eddie, you should know we only make fun of republican veep candidates over here (Quayle, Palin). Biden wouldn't get a negative write-up even if he implied Romney would reintroduce slavery.
That's pretty far out there Risky, It would take something like inferring that Romney gives people cancer to get a rise out the of the public
I personally hope the people of the u.s wake up and realise what and who mitt romney is a right wing idiot for want of better words,if I gave my true opinion of that guy I would be banned from this forum for the use of extreme bad language. A vote for romney is a bad thing for the people of the U.S especially the under priviladged in thier society
This "obsession" is because if we allow private companies to run our healthcare they want to maximise profit margins, rather than the entire income being spent on the healthcare provision.
And now that is a very optimistic view on the state controlled companies . Sure, instead of optimisations and profit in private companies, companies owned by state usually end up with ordering expensive services and leaking the money that way... What i mean ? For example here in my country the army made few procurement requests for cleaning the army bases... with prices agreed at 14-time higher than the price of the cleaning service on the market! Or our state owned railways outsourced a service of keeping the railways clean of tree branches, grass etc - when they did it on their own they paid their own staff 566% less (that is not a typo) than they pay now for the outsourced service. Or welding the tracks ? Their own services were 56% cheaper than the outsourced ones. So you can choose - some profit margin for private companies, or money leaking out of system through overpriced services and/or devices (hey, we need a new XY, manufacturer price is A, but here is this local company which sells it for A+30%, let's support local economy...).
But this is the problem, you are concerned about the amount of cash being spent on healthcare not the healthcare outcomes. If anything was proved by the last governement it was that money is not the only thing the NHS needs.
The NHS is UK is the second most efficient healthcare system in the developed world - which means it is beating private healthcare systems. Whilst what you're saying is on the whole true, and the UK armed forces/railways/roads have exactly the same problems, the NHS has avoided this to that extent. Eh? I'm concerned about any cash spent on health being spent in the most efficient way possible, not lining the pockets of corporations. The last government didn't screw the NHS, this one did. The only massively bad thing done by Labour to health was PFI - yep, bringing in private companies to build hospitals. If you spend £100bn on healthcare, I expect £100bn to spent on healthcare, not £75bn and £25bn on profits.
I would tend to agree with you here however in this case it seems that even the most wasteful public system is much less wasteful than the private sector. You see while the public system do not strive to be as wasteful as it can be the private sector have a incentive to drive up costs for the private consumer as far as they can, and when a 7,3 percent increase is a record low there is something very wrong. Mind you this is during the criticised "Obamacare". Add to this that the private sector again have no incentive to give you the best treatment just the cheapest. This seems to be one of the places where the US really should try to swallow their pride and take a few lessons from europe as it actually may save not only the people but even the state some money.
I've read perhaps 70% of this thread - Mostly Eddie_Dane and his discussion partners. What I've got the impression of so far is, it doesn't really matter which candidate you pick, it's not likely they'll be in it for the voters - And if they are, there's so little they can do in four years it won't matter anyway. If pushed State-side and pressed to vote, I'd vote for Romney. I'm sick to death of the Obama worship of the last four years, and the number of times I've seen his expressionless face on wallpapers.
But the outup is not the amounty of money spent on healthcare, it's the healtcare provided. Of course it's harder to measure non-financials so we just talk about the financials. I've experienced both private and NHS care and while private rooms and edible food are the obvious benefit and both cost money, some of the things I have seen going wrong when I have been on the NHS side are not funding related.
