Gov Insurance for All

[NicMouse64]

ok, so your proposal of medicare for all is to eliminate almost everything that medicare currently covers and restrict to only triage level labs? So you propose that we admit to the ED, figure out they need dialysis and then you would cut them off if they can't afford it?

I think that ED coverage should be full service for those who are under serious medical emergencies. Past stabilization if they do not have catastrophic insurance or other means to pay then that is their responsibility. Give the poor a certain amount of responsibility for their actions while also giving a safety net so they do not revolt.... Give them basic primary care and diagnostic testing but catastrophic care needs to be paid for by the consumer whether through cash or a catastrophe plan.

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[762513]

I think that ED coverage should be full service for those who are under serious medical emergencies. Past stabilization if they do not have catastrophic insurance or other means to pay then that is their responsibility. Give the poor a certain amount of responsibility for their actions while also giving a safety net so they do not revolt.... Give them basic primary care and diagnostic testing but catastrophic care needs to be paid for by the consumer whether through cash or a catastrophe plan.

That's the opposite of the healthcare system we currently have. How interesting.

 

[Espressso]

It is interesting that the physicians from Canada and the UK and other European countries seem to think it's all backwards here. The only people who think the "far left" ideas of "medicare for all" are crazy, are a portion of Americans who don't want to see any change, imo.

Obviously medicare for all is a stretch and it's likely close to impossible to accomplish any time soon. But like the $15 min wage debate; propose something bold, and then meet in the middle.

For those against any sort of government-ran healthcare program; may I ask you, what are your suggestions to the current system? Surely, we'd all agree that the current set up is not sustainable, no? If so, then what do we do? Yeah, all of us med students and recent grads facing hundreds of thousands of dollars in medical school debt don't want our paychecks cut, of course not. But step back a little and think about what we, as a country, could be doing differently. You can cite articles about overseas doctors making crap pay, but generally speaking, just about every positive metric of societal function and well-being is higher in these countries. These countries are doing something right. My guess is that is has to do with higher overall taxes, less meaningless spending (wars, military, mainly), and keeping people healthy. Something's clearly off, here, and the idea of revamping the healthcare system, is not that crazy; e.g., the idea of the ACA.

Sure, "medicare for all", probably won't happen during our life time. But something will. Be that more medicaid expansion or something along those lines. I'd like to see more of a targeted approach to pharmaceutical drug prices, focusing on evergreening and IP/patent laws. Put more of a focus on generics and let the "free market" work itself out. Because at our current rate, the "free market" has not worked itself out, by any means. And many many Americans, are paying an expensive price.

 

[Goro]

Keep up the cool heads, SDNers. I like the decorum here!

 

[deleted480308]

I think that ED coverage should be full service for those who are under serious medical emergencies. Past stabilization if they do not have catastrophic insurance or other means to pay then that is their responsibility. Give the poor a certain amount of responsibility for their actions while also giving a safety net so they do not revolt.... Give them basic primary care and diagnostic testing but catastrophic care needs to be paid for by the consumer whether through cash or a catastrophe plan.

so they still get the dialysis and unlimited hospitalizations for anything that they let go long enough to require ED? Yeah, that's no longer basic anymore, you aren't saving money

 

[deleted480308]

It is interesting that the physicians from Canada and the UK and other European countries seem to think it's all backwards here. The only people who think the "far left" ideas of "medicare for all" are crazy, are a portion of Americans who don't want to see any change, imo.

Obviously medicare for all is a stretch and it's likely close to impossible to accomplish any time soon. But like the $15 min wage debate; propose something bold, and then meet in the middle.

For those against any sort of government-ran healthcare program; may I ask you, what are your suggestions to the current system? Surely, we'd all agree that the current set up is not sustainable, no? If so, then what do we do? Yeah, all of us med students and recent grads facing hundreds of thousands of dollars in medical school debt don't want our paychecks cut, of course not. But step back a little and think about what we, as a country, could be doing differently. You can cite articles about overseas doctors making crap pay, but generally speaking, just about every positive metric of societal function and well-being is higher in these countries. These countries are doing something right. My guess is that is has to do with higher overall taxes, less meaningless spending (wars, military, mainly), and keeping people healthy. Something's clearly off, here, and the idea of revamping the healthcare system, is not that crazy; e.g., the idea of the ACA.

Sure, "medicare for all", probably won't happen during our life time. But something will. Be that more medicaid expansion or something along those lines. I'd like to see more of a targeted approach to pharmaceutical drug prices, focusing on evergreening and IP/patent laws. Put more of a focus on generics and let the "free market" work itself out. Because at our current rate, the "free market" has not worked itself out, by any means. And many many Americans, are paying an expensive price.

we don't currently have a free market because of certificate of need laws, professional regulation and emtala, and that was prior to requiring everyone to have health insurance (even if they aren't paying for it) which was a bad idea

I also don't think a minimum wage is a good idea, some labor literally isn't worth $15/hr based on what the employer can monetize off that employee

 

[Espressso]

we don't currently have a free market because of certificate of need laws, professional regulation and emtala, and that was prior to requiring everyone to have health insurance (even if they aren't paying for it) which was a bad idea

I also don't think a minimum wage is a good idea, some labor literally isn't worth $15/hr based on what the employer can monetize off that employee

I can agree to the minimum wage point. Also with increasing automation, most of these jobs will be gone within our lifetime.

But as for the healthcare, it goes back to my original point, surely you don't think the current system is sustainable. What can we logically do about it?

 

[TheRealCookieMonster]

some labor literally isn't worth $15/hr based on what the employer

The point of the minimum wage isn't to reward the producer fairly it's to protect the worker. A "universal wage" or "universal anything" for that matter is usually just laughable. Can you imagine potato pickers making 15$ an hour.

 

[wontonsoup]

The point of the minimum wage isn't to reward the producer fairly it's to protect the worker. A "universal wage" or "universal anything" for that matter is usually just laughable. Can you imagine potato pickers making 15$ an hour.

Anyone working full-time should be paid a living wage. Doesn't matter if they are picking potatoes or doing neurosurgery. If the businesses can't afford it, they should go out of business or find better ways to pick potatoes. For what it's worth, fruit pickers make more than minimum wage as it is, so obviously someone can imagine it.

 

[deleted480308]

I can agree to the minimum wage point. Also with increasing automation, most of these jobs will be gone within our lifetime.

But as for the healthcare, it goes back to my original point, surely you don't think the current system is sustainable. What can we logically do about it?

stop subsidizing everything through govt. Get rid of certificate of need and emtala.

A company won't get away with charging $60k/month for a drug if no one will pay it. People who are liable for their bills will pay more attn to what they are asking for and will start to negotiate down, docs/hospitals/suppliers will need to really demonstrate value to get customer to pay the prices.

Anyone working full-time should be paid a living wage. Doesn't matter if they are picking potatoes or doing neurosurgery. If the businesses can't afford it, they should go out of business or find better ways to pick potatoes. For what it's worth, fruit pickers make more than minimum wage as it is, so obviously someone can imagine it.

nope, that's absurd. Some tasks aren't worth the amount of money it takes to support a family. If you have a family, learn skills valuable enough to fund that

 

[TheRealCookieMonster]

Anyone working full-time should be paid a living wage. Doesn't matter if they are picking potatoes or doing neurosurgery. If the businesses can't afford it, they should go out of business or find better ways to pick potatoes. For what it's worth, fruit pickers make more than minimum wage as it is, so obviously someone can imagine it.

Well fruit is considerably more expensive than potatoes so that kinda makes sense and many fruit pickers don't make minimum wage...
Sorry, I think I just wasn't clear. My attempted point wasn't that potato pickers shouldn't be able to pay for food, it was that universal wage for someone who lives picking potatoes makes no sense. Potato pickers live in areas where the cost of living is well below a $15/hr wage. They don't need $15/hr so forcing them to be paid that makes no sense. But in someone working a hotel cleaning job in San Fransisco may need considerably more than that to survive. Wages shouldn't be job dependent or universal.

 

[deleted480308]

The point of the minimum wage isn't to reward the producer fairly it's to protect the worker. A "universal wage" or "universal anything" for that matter is usually just laughable. Can you imagine potato pickers making 15$ an hour.

clearly someone can imagine it, which is why we have to explain to people how dumb the idea is

 

[TheRealCookieMonster]

nope, that's absurd. Some tasks aren't worth the amount of money it takes to support a family. If you have a family, learn skills valuable enough to fund that

This is not realistic. While I'm all for pulling up the old boot straps and letting people decide what they value we live in imperfect communities and cannot rely on charity or good nature to solve those imperfections. Well... we can, but I guess that comes down to standards.

 

[deleted480308]

This is not realistic. While I'm all for pulling up the old boot straps and letting people decide what they value we live in imperfect communities and cannot rely on charity or good nature to solve those imperfections. Well... we can, but I guess that comes down to standards.

I'm not saying charity solves those problems 100%, I'm saying that someone not solving the problem themself does not create a right to other people's money

 

[wontonsoup]

stop subsidizing everything through govt. Get rid of certificate of need and emtala.

A company won't get away with charging $60k/month for a drug if no one will pay it. People who are liable for their bills will pay more attn to what they are asking for and will start to negotiate down, docs/hospitals/suppliers will need to really demonstrate value to get customer to pay the prices.

nope, that's absurd. Some tasks aren't worth the amount of money it takes to support a family. If you have a family, learn skills valuable enough to fund that

Right, but someone has to do these jobs. And those people should be able to survive. So we have 2 options now, either we subsidize them through government taxation or the businesses bite the bullet and pay them a living wage, at least until automation removes the need for human involvement altogether.

 

[TheRealCookieMonster]

someone not solving the problem themself does not create a right to other people's money

Well I can't disagree with the statement. I just know there are individuals/families and even communities unable to solve problems without external coercion and cooperation. I think for you(others with similar ideals) to convince stop people from throwing money at problems someone or giving handouts you will have to come up with a better solution. Otherwise, you're kinda asking people to stop filling a vacuum. They want the government or employers to give up money because there has yet to be a better system. Even if it seems stupid people are still going to try and fix the issues. The only way to keep them from running you over (literally taking your money) in the process is to take the lead or run away.

 

[NicMouse64]

I'm not saying charity solves those problems 100%, I'm saying that someone not solving the problem themself does not create a right to other people's money

That's assuming there are fundamental rights. Your ideology is built upon the context of a perfect world. Same with communism. Built on the context of a perfect world. Both are great ideas in theory until you get down into the nitty gritty and realize that humans aren't perfect, and those who are struggling will rise up and risk their lives if they have nothing to lose.

 

[TheRealCookieMonster]

Just to be clear the revolution you're talking about isn't happening in this country. The majority have not been that desperate in this country since the depression. And I doubt they ever will again, corporations can keep people fat and happy now. They don't need police dogs and strike breakers. They have cheap 50" TVs and $1extra large sodas for that.

 

[deleted480308]

Right, but someone has to do these jobs. And those people should be able to survive. So we have 2 options now, either we subsidize them through government taxation or the businesses bite the bullet and pay them a living wage, at least until automation removes the need for human involvement altogether.

and if those workers had a skill worth selling at a higher wage they would go to that other option, but when you show up for "x" dollars you are saying that is what your time is worth. There is no reason for the govt to be involved in that negotiation

That's assuming there are fundamental rights. Your ideology is built upon the context of a perfect world. Same with communism. Built on the context of a perfect world. Both are great ideas in theory until you get down into the nitty gritty and realize that humans aren't perfect, and those who are struggling will rise up and risk their lives if they have nothing to lose.

property rights is not an absurd dream. You don't have a right to take people's stuff just because you envision better uses for it

 

[NicMouse64]

and if those workers had a skill worth selling at a higher wage they would go to that other option, but when you show up for "x" dollars you are saying that is what your time is worth. There is no reason for the govt to be involved in that negotiation

property rights is not an absurd dream. You don't have a right to take people's stuff just because you envision better uses for it

You are assuming fundamental human rights. No it's just about power. Rights are something the government has to enforce unfortunately. You only own land because if someone else comes and tries to steal it the government will defend your land with it's guns.

 

[TheRealCookieMonster]

There is no reason for the govt to be involved in that negotiation

The worker literally becomes expendable otherwise. Employers literally have the power to starve people into submission in pure capitalism. This is not sustainable if you care about any "rights".

 

[TheRealCookieMonster]

Welp... I'm out. We're sufficiently off topic enough for me feel the mods watching me.
In honor of the 420th post I made on this thread. Oh and this is relevant because I believe it should be subsidized by government healthcare plans, for applicable conditions of course.

 

[Osminog]

The best economic outcomes can only emerge in a system that allows for voluntary human action — voluntary expression, voluntary association, and voluntary exchange. The best economic outcomes cannot be centrally planned by a collective of well-meaning bureaucrats and Harvard academics; they cannot be wrung from people's checkbooks through acts of coercion; and they cannot be produced through a system of majoritarian rule.

The answer to the economic problems facing our healthcare system is privatization. The government has invested unfathomable amounts of taxpayer money in its effort to micromanage our healthcare system, and the results are well known: distorted prices, cronyism, and health professional shortages. If we want to see an improvement, we have to start allowing the free market — the amalgamation of the voluntary actions of millions of American consumers and producers — to determine the prices of medications, the salaries of healthcare professionals, and the workings of the health insurance industry.

 

[NicMouse64]

The best economic outcomes can only emerge in a system that allows for voluntary human action — voluntary expression, voluntary association, and voluntary exchange. The best economic outcomes cannot be centrally planned by a collective of well-meaning bureaucrats and Harvard academics; they cannot be wrung from people's checkbooks through acts of coercion; and they cannot be produced through a system of majoritarian rule.

The answer to the economic problems facing our healthcare system is privatization. The government has invested unfathomable amounts of taxpayer money in its effort to micromanage our healthcare system, and the results are well known: distorted prices, cronyism, and health professional shortages. If we want to see an improvement, we have to start allowing the free market — the amalgamation of the voluntary actions of millions of American consumers and producers — to determine the prices of medications, the salaries of healthcare professionals, and the workings of the health insurance industry.

Privatization will still require a safety net for those most vulnerable in society. I agree with you--however there needs to be 2 tiers or you will promote an unacceptable level of chaos for those who can't afford healthcare.

 

[Goro]

and if those workers had a skill worth selling at a higher wage they would go to that other option, but when you show up for "x" dollars you are saying that is what your time is worth. There is no reason for the govt to be involved in that negotiation

property rights is not an absurd dream. You don't have a right to take people's stuff just because you envision better uses for it

Actually yes, we do.

Article I, Section 8, Clause 1: The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States.
Sixteenth Amendment to the United States Constitution

This was settled in 1909.

Incomes taxes were also levied during the Civil War.

 

[NicMouse64]

James Madison advocated the ratification of the Constitution in The Federalist and at the Virginia ratifying convention upon a narrow construction of the clause, asserting that spending must be at least tangentially tied to one of the other specifically enumerated powers, such as regulating interstate or foreign commerce, or providing for the military, as the General Welfare Clause is not a specific grant of power, but a statement of purpose qualifying the power to tax

I don't see that anywhere in the constitution. Just because one person said it doesn't mean that is how it is, even if he was one of the founding fathers.

 

[dpmd]

That's assuming there are fundamental rights. Your ideology is built upon the context of a perfect world. Same with communism. Built on the context of a perfect world. Both are great ideas in theory until you get down into the nitty gritty and realize that humans aren't perfect, and those who are struggling will rise up and risk their lives if they have nothing to lose.

Except right now the poor have access to so many programs to help with housing, food, health care, telephones, electricity, etc. You are acting like we need to save some starving destitute folks when the reality is the folks not currently covered are those who simply prioritize their spending on things beside insurance and then get upset when a large expense comes up. You know why they filed bankruptcy? Because they have assets they want to protect from creditors. You can't say they have nothing to lose.

 

[wontonsoup]

Except right now the poor have access to so many programs to help with housing, food, health care, telephones, electricity, etc. You are acting like we need to save some starving destitute folks when the reality is the folks not currently covered are those who simply prioritize their spending on things beside insurance and then get upset when a large expense comes up. You know why they filed bankruptcy? Because they have assets they want to protect from creditors. You can't say they have nothing to lose.

Is your point that the poor aren't poor enough?

 

[dpmd]

Is your point that the poor aren't poor enough?

My point is that there is already a government funded healthcare program for the poor and the ones doing too well to qualify for that or the subsidized insurance plans are not exactly in a nothing to lose position where they are going to violently take from the wealthy.

 

[NicMouse64]

My point is that there is already a government funded healthcare program for the poor and the ones doing too well to qualify for that or the subsidized insurance plans are not exactly in a nothing to lose position where they are going to violently take from the wealthy.

You seem to miss my point--the system we have currently is indeed enough to keep the poor from revolting and violently take from the wealthy. That does not mean that we can not move towards a system where these things will not occur. Go ahead--cut food stamps, get rid of public housing and medicaid. Just warn me before you do because I will want to move to another continent, not because I hate america or it makes me angry, but rather I think the high risk of a violent revolt from the poor would be too high.

 

[wontonsoup]

My point is that there is already a government funded healthcare program for the poor and the ones doing too well to qualify for that or the subsidized insurance plans are not exactly in a nothing to lose position where they are going to violently take from the wealthy.

I apologize for being snarky, but I think that's a pretty low bar to decide our work is done.

@NicMouse64: Personally, I don't really like using the argument that we should fund social programs only to prevent the lower classes from revolting because it is self-limiting in terms of how much aid we should give to the disadvantaged. It's certainly pragmatic but it leaves a bad taste in my mouth and I think we can do much better than the bare minimum. In my view, it's much better to argue that we have an obligation to provide everything needed for life, liberty, and the pursuit of happiness -- which, in my opinion, includes healthcare -- as laid out in our founding document.

 

[atomi]

In my view, it's much better to argue that we have an obligation to provide everything needed for life, liberty, and the pursuit of happiness -- which, in my opinion, includes healthcare -- as laid out in our founding document.

Our founding document is the constitution. The phrase “life liberty and the pursuit of happiness” comes from a different document.

Regardless, liberty is the key point. Americans are free to make their own choices. They are given nothing and prevented nothing. If you want something, you have the freedom to obtain it.

Taking something from others to give it to somebody else is by definition denying liberty to the first individual and precluding the need/drive to obtain it to the second (when you’re a ward of the state, you have no liberty).

Socialism is antithetical to what America is. Period.

 

[NicMouse64]

I apologize for being snarky, but I think that's a pretty low bar to decide our work is done.

@NicMouse64: Personally, I don't really like using the argument that we should fund social programs only to prevent the lower classes from revolting because it is self-limiting in terms of how much aid we should give to the disadvantaged. It's certainly pragmatic but it leaves a bad taste in my mouth and I think we can do much better than the bare minimum. In my view, it's much better to argue that we have an obligation to provide everything needed for life, liberty, and the pursuit of happiness -- which, in my opinion, includes healthcare -- as laid out in our founding document.

If you had asked 18 year old me I would have agreed with you. Then I travelled to some pretty desolate parts of the world and read Guns, Germs, and Steel.

 

[wontonsoup]

Our founding document is the constitution. The phrase “life liberty and the pursuit of happiness” comes from a different document.

Regardless, liberty is the key point. Americans are free to make their own choices. They are given nothing and prevented nothing. If you want something, you have the freedom to obtain it.

Taking something from others to give it to somebody else is by definition denying liberty to the first individual and precluding the need/drive to obtain it to the second.

Socialism is antithetical to what America is. Period.

The Declaration of Independence is the first document the US produced which identified itself as distinct from Britain, I would call that a founding document. There need not be just one.

I disagree that you should have a "drive to obtain" reasonably priced (i.e. won't bankrupt you) healthcare, it should be a given, just like it's a given that if someone is breaking into my house and I dial 911, someone will come help me. And America has a rich history of utilizing socialist ideals. Off the top of my head, the TSA was formed after we decided airline security should be nationalized in the wake of 9/11, the railroads were nationalized in the early 20th century, lotteries were nationalized and used to fund schools in the early 20th century, not to mention all of the worker protections which came directly out of the US socialism movement including the 40 hour work week, OSHA, child labor laws, the entirety of the New Deal. The Cold War caused us to sweep a lot of this under the rug, but it still exists if you dig deep enough.

I don't think the US will ever become fully socialist nor do I think it is a good idea in all cases, but it is clear to me morally that healthcare should not be commodified and subject to unrestrained market forces.

 

[NicMouse64]

Our founding document is the constitution. The phrase “life liberty and the pursuit of happiness” comes from a different document.

Regardless, liberty is the key point. Americans are free to make their own choices. They are given nothing and prevented nothing. If you want something, you have the freedom to obtain it.

Taking something from others to give it to somebody else is by definition denying liberty to the first individual and precluding the need/drive to obtain it to the second (when you’re a ward of the state, you have no liberty).

Socialism is antithetical to what America is. Period.

Socialism has different meanings to different people. Some think roads are socialist--looking at you SB lol. Others think that government ownership of industry is socialist--most on the left would agree there. Problem is some think that the bernie "democratic socialism" is communism. It's not. Taxes are not "taking" from others. It is something you pay so that the government provides you with certain benefits and the rule of law so your neighbors can't rise up and commit unjust acts against you. Where those benefits start and end are up to debate.

 

[puahate]

@wontonsoup Are you familiar with Mark Blyth?

 

[wontonsoup]

Well, you provide that to me and I'll chill in my home you bought me. The food you bought me etc etc. You completely eliminated my incentive to work and provide for my own future. Or do you think I'm better than that, because I'm not. If it's free, it's for me, bro.

Per person, we are the most efficient in terms of production we've ever been in the history of the world and yet we are working longer and longer hours. The irony is that technological progress is only exacerbating this crisis. Historically, society has been able to afford more bs jobs precisely because our robots kept getting better. As our farms and factories grew more efficient, they accounted for a shrinking share of our economy. And the more productive agriculture and manufacturing became, the fewer people they employed. Call it the paradox of progress: the richer we become, the more room we have to waste our time. It’s like Brad Pitt says in Fight Club: too often, we’re “working jobs we hate so we can buy **** we don’t need.” Eventually, and that eventually is coming sooner than you might think, most people will be in this position with the advent of seriously competent automation. It's clear at that point we will have to start providing something like a universal basic income, or the equivalent in terms of shelter, food, etc. I believe in a future where “jobs are for robots and life is for people.”

And if basic income sounds utopian to you, then I’d like to remind you that every milestone of civilization – from the end of slavery to democracy to equal rights for men and women – was once a utopian fantasy too. Or, as Oscar Wilde wrote long ago: “Progress is the realization of utopias.”

 

[wontonsoup]

If you had asked 18 year old me I would have agreed with you. Then I travelled to some pretty desolate parts of the world and read Guns, Germs, and Steel.

I lived in sub-Saharan Africa for a year and read GGS and both of those things only pushed me further to the left. Wait till you read Capital.

@wontonsoup Are you familiar with Mark Blyth?

Can't say that I am.

 

[studentdoct4281]

Medicare for all Will. Not. Work. Period.

It will create bitter doctors who won’t do anything good for their communities anymore (already happening: there used to be such things called churches (st joes, St. Peter’s etc and free clinics that doctors voluntarily ran. Now it’s medicaid etc)

This will also WORSEN national health care because there will be less incentive for citizens to improve their health because why would they? Medicare for all!

 

[puahate]

This will also WORSEN national health care because there will be less incentive for citizens to improve their health because why would they? Medicare for all!

LOL wat.

 

[atomi]

The Declaration of Independence is the first document the US produced which identified itself as distinct from Britain, I would call that a founding document. There need not be just one.

I disagree that you should have a "drive to obtain" reasonably priced (i.e. won't bankrupt you) healthcare, it should be a given, just like it's a given that if someone is breaking into my house and I dial 911, someone will come help me. And America has a rich history of utilizing socialist ideals. Off the top of my head, the TSA was formed after we decided airline security should be nationalized in the wake of 9/11, the railroads were nationalized in the early 20th century, lotteries were nationalized and used to fund schools in the early 20th century, not to mention all of the worker protections which came directly out of the US socialism movement including the 40 hour work week, OSHA, child labor laws, the entirety of the New Deal. The Cold War caused us to sweep a lot of this under the rug, but it still exists if you dig deep enough.

I don't think the US will ever become fully socialist nor do I think it is a good idea in all cases, but it is clear to me morally that healthcare should not be commodified and subject to unrestrained market forces.

Giving you a huge benefit of the doubt that you didn’t get the constitution and Declaration of Independence mixed up, you are confusing critical emergency and safety public services that benefit communities as a whole with healthcare services, the vast majority of which are not life threatening emergent services, that benefit specific individuals.

You cannot put a gun to my head and force me to become a civil servant. I can choose to sell my service and do it pro bono however I want. You cannot commadier my labor and distribute how you see fit. I’ll say it again, physicians are NOT CIVIL SERVANTS. If you think this and want this and are paying $300k to go into medicine, you’ve got some serious cognitive dissonance going on.

But taking a step back, you are using the TSA as a shining example of a government offered socialist-style service? Really? THE TSA?! I want to post the South Park TSA gif so bad right here but am still paranoid about getting permabanned, so I’ll refrain. And actually on that note, bye to this conversation altogether.

 

[wontonsoup]

Giving you a huge benefit of the doubt that you didn’t get the constitution and Declaration of Independence mixed up, you are confusing critical emergency and safety public services that benefit communities as a whole with healthcare services, the vast majority of which are not life threatening emergent services, that benefit specific individuals.

You cannot put a gun to my head and force me to become a civil servant. I can choose to sell my service and do it pro bono however I want. You cannot commadier my labor and distribute how you see fit. I’ll say it again, physicians are NOT CIVIL SERVANTS. If you think this and want this and are paying $300k to go into medicine, you’ve got some serious cognitive dissonance going on.

But taking a step back, you are using the TSA as a shining example of a government offered socialist-style service? Really? THE TSA?! I want to post the South Park TSA gif so bad right here but am still paranoid about getting permabanned, so I’ll refrain. And actually on that note, bye to this conversation altogether.

If you don't like the police example, fine, what about public schools? K-12 education is nationalized but nobody seems to be in hysterics over that. (Betsy Devos doesn't count.)

Nobody said anything about commandeering your labor. That's not the case in Germany or Canada or any number of other countries with socialized medicine.

And I wasn't holding up the TSA as a shining example of socialism, I was making the point that the US has no trouble nationalizing entire industries if it suits it's goals.

 

[wamcp]

It is interesting that the physicians from Canada and the UK and other European countries seem to think it's all backwards here. The only people who think the "far left" ideas of "medicare for all" are crazy, are a portion of Americans who don't want to see any change, imo.

Obviously medicare for all is a stretch and it's likely close to impossible to accomplish any time soon. But like the $15 min wage debate; propose something bold, and then meet in the middle.

For those against any sort of government-ran healthcare program; may I ask you, what are your suggestions to the current system? Surely, we'd all agree that the current set up is not sustainable, no? If so, then what do we do? Yeah, all of us med students and recent grads facing hundreds of thousands of dollars in medical school debt don't want our paychecks cut, of course not. But step back a little and think about what we, as a country, could be doing differently. You can cite articles about overseas doctors making crap pay, but generally speaking, just about every positive metric of societal function and well-being is higher in these countries. These countries are doing something right. My guess is that is has to do with higher overall taxes, less meaningless spending (wars, military, mainly), and keeping people healthy. Something's clearly off, here, and the idea of revamping the healthcare system, is not that crazy; e.g., the idea of the ACA.

Sure, "medicare for all", probably won't happen during our life time. But something will. Be that more medicaid expansion or something along those lines. I'd like to see more of a targeted approach to pharmaceutical drug prices, focusing on evergreening and IP/patent laws. Put more of a focus on generics and let the "free market" work itself out. Because at our current rate, the "free market" has not worked itself out, by any means. And many many Americans, are paying an expensive price.

So, you prefer not to have your physician compensation cut, but you actually are? Why do you want to work for free? If you make 300k in today’s system but only 100k in a new socialist healthcare, you really are gonna be happy about providing 200k worth of free services each year?

After putting yourself in hundreds of thousands in debt, sacrifice your twenties studying nonstop and grueling hours of training, then get thrusted out into practice where everything you do and say carries immense liability...maybe you just have to wait until an attending to change your naive mind.

Also, europe is a horrible example. With America as a hyperpower of course they don’t have to spend as much on their military. In a multipolar world I guarantee you they would be spending multiple times what they do today.
And look at the chronic economic malaise they endure from a failed tax and spend policy, they ARE NOT doing better than America by any major societal means. Did you even pay attention to the recent and ongoing Yellow Vest protests in France? About the common masses angry being taxed too much, NOT too little? Do you see Americans on the street rioting in comparison?

America has an unemployment rate of less than 4% today.
Meanwhile Spain has unemployment rate of 15%. Greece at 19%. France at 9%. 15 of the 28 EU members have unemployment rates of more than 10 percent!
The European debt crisis is a problem they caused themselves from gorging on tax and spend other people’s money that I would not want to replicate here. Innovation/entrepreneurship and the will to work is stifled. People there become dependent on handouts and take and take, rather than contribute to society.

Anyway I just...can’t believe this is the kind of sentiment is coming from medical students. I’ll take myself back to the SDN practicing physicians area.

 

[deleted480308]

You are assuming fundamental human rights. No it's just about power. Rights are something the government has to enforce unfortunately. You only own land because if someone else comes and tries to steal it the government will defend your land with it's guns.

I have guns too. And I’m more than willing to do my own protecting 24x7, the govt is the only reason we don’t do our own protecting because of the false belief that they do it for us. The courts have actually specifically ruled the police do not have a duty to protect you

The worker literally becomes expendable otherwise. Employers literally have the power to starve people into submission in pure capitalism. This is not sustainable if you care about any "rights".

no they don’t because the worker can then go do direct business with others, or the workers can leave en masse and the employer is left with no labr. Both exert pressure on the price negotiation. In fact the govt is one of the main things holding the employee back from having options by all the red tape it takes to start your own company

Actually yes, we do.

Article I, Section 8, Clause 1: The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States.
Sixteenth Amendment to the United States Constitution

This was settled in 1909.

Incomes taxes were also levied during the Civil War.

I’m quite aware of the 16th. That was inappropriate and morally wrong. Much like the wolf documenting their claim to the hen house

I apologize for being snarky, but I think that's a pretty low bar to decide our work is done.

@NicMouse64: Personally, I don't really like using the argument that we should fund social programs only to prevent the lower classes from revolting because it is self-limiting in terms of how much aid we should give to the disadvantaged. It's certainly pragmatic but it leaves a bad taste in my mouth and I think we can do much better than the bare minimum. In my view, it's much better to argue that we have an obligation to provide everything needed for life, liberty, and the pursuit of happiness -- which, in my opinion, includes healthcare -- as laid out in our founding document.

The right to life was to not have your life taken from you, not a guarantee to live at all expense of others. It’s why someone dying of natural causes is not a violation of rights but murdering them is.. i’m a fan of your charitable ideals to provide more to people. It’s why I privately support free clinics, but I don’t get to call myself virtuous by stealing other people’s money for that. Either give your own time/money or stop pretending it’s important. Stealing from others isn’t moral

The Declaration of Independence is the first document the US produced which identified itself as distinct from Britain, I would call that a founding document. There need not be just one.

I disagree that you should have a "drive to obtain" reasonably priced (i.e. won't bankrupt you) healthcare, it should be a given, just like it's a given that if someone is breaking into my house and I dial 911, someone will come help me. And America has a rich history of utilizing socialist ideals. Off the top of my head, the TSA was formed after we decided airline security should be nationalized in the wake of 9/11, the railroads were nationalized in the early 20th century, lotteries were nationalized and used to fund schools in the early 20th century, not to mention all of the worker protections which came directly out of the US socialism movement including the 40 hour work week, OSHA, child labor laws, the entirety of the New Deal. The Cold War caused us to sweep a lot of this under the rug, but it still exists if you dig deep enough.

I don't think the US will ever become fully socialist nor do I think it is a good idea in all cases, but it is clear to me morally that healthcare should not be commodified and subject to unrestrained market forces.

TSA is a mess, please don’t be proud of it
The railroads have also been atrocious financially when you consider amtrak
Those lotteries (at least one state) were just used to shuffle general funds elsewhere and not increase total funding. And that is before we consider the govt rules being the only reason someone else couldn’t have one or each school district couldn’t. Beyond that the crap state of our k-12 education system is so evident it’s a consistent campaign topic. And again the hour restrictions and minimum wage are a bad idea and have absolutely stopped me from giving people work they both wanted and needed in the past

 

[Espressso]

So, you prefer not to have your physician compensation cut, but you actually are? Why do you want to work for free? If you make 300k in today’s system but only 100k in a new socialist healthcare, you really are gonna be happy about providing 200k worth of free services each year?

After putting yourself in hundreds of thousands in debt, sacrifice your twenties studying nonstop and grueling hours of training, then get thrusted out into practice where everything you do and say carries immense liability...maybe you just have to wait until an attending to change your naive mind.

Also, europe is a horrible example. With America as a hyperpower of course they don’t have to spend as much on their military. In a multipolar world I guarantee you they would be spending multiple times what they do today.
And look at the chronic economic malaise they endure from a failed tax and spend policy, they ARE NOT doing better than America by any major societal means. Did you even pay attention to the recent and ongoing Yellow Vest protests in France? About the common masses angry being taxed too much, NOT too little? Do you see Americans on the street rioting in comparison?

America has an unemployment rate of less than 4% today.
Meanwhile Spain has unemployment rate of 15%. Greece at 19%. France at 9%. 15 of the 28 EU members have unemployment rates of more than 10 percent!
The European debt crisis is a problem they caused themselves from gorging on tax and spend other people’s money that I would not want to replicate here. Innovation/entrepreneurship and the will to work is stifled. People there become dependent on handouts and take and take, rather than contribute to society.

Anyway I just...can’t believe this is the kind of sentiment is coming from medical students. I’ll take myself back to the SDN practicing physicians area.

I'm saying it's easier for us to all say we don't want our paychecks cut. But it's harder to step back and think about what might be better, not for us specifically, but for the society as a whole. I never said I want to work for free. Obviously not.

Also, reaching towards the call out of naivety is unnecessary and with all due respect, brings down your argument. We're simply discussing different viewpoints and there's nothing wrong with that. Because someone disagrees with you doesn't warrant calling them naive. But who knows, maybe I'll grow up when I'm an attending.

I don't believe Europe is that horrible of an example. You conveniently cherry-picked a few really bad examples (Greece, who has been suffering from a horrible banking system failure, France, who's refugee burden has exceeded it's capabilities, and Spain, who again, has been going through internal conflicts regarding Catalonia). Your view point of "dependent on hand outs" and "take and take" is not an uncommon American sentiment. So I don't blame you for thinking that way. I'd love to hear your thoughts on UBI for that matter, because I'm sure you're livid about that idea.

Also, I assume you are familiar with how silly unemployment as a metric is. 4% unemployment sounds great, but if there isn't any upward mobility, the jobs are paying below the standard of living, and these workers have virtually no access to higher education, a 4% unemployment rate is basically meaningless. Citing unemployment statistics is like citing GDP for economic status. It's kind of irrelevant. I was speaking more towards metrics such as overall happiness, average vacation/year, homelessness rates, disease rates, education rates, average graduation debt, infant mortality; the list goes on. All of which, America ranks pretty average.

Just going off my personal experience (n=5-6ish), all of my family and friends who practice in the UK, Spain, Germany, and Austria, love it. They take pride on their system, they think it's logical, and more importantly, they're confused about the way the US does it. If Americans choose to travel to other countries for common procedures, it's clear somethings up.

But back to my original comment; if you feel so strongly about anti-"socialist" healthcare. What are your solutions? It's so easy to bash these ideas, but at least people are coming up with them. You can backtrack to calling people naive all you want. But at the end of the day, you (and the entire US republican party), have yet to come up with a fix. This sentiment coming from medical students is not rare and it's not as crazy as you think it is. I suggest you taking a few steps back and maybe trying to think of it from another perspective, rather than falling back and assuming everyone else is naive.

 

[deleted480308]

I'm saying it's easier for us to all say we don't want our paychecks cut. But it's harder to step back and think about what might be better, not for us specifically, but for the society as a whole. I never said I want to work for free. Obviously not.

Also, reaching towards the call out of naivety is unnecessary and with all due respect, brings down your argument. We're simply discussing different viewpoints and there's nothing wrong with that. Because someone disagrees with you doesn't warrant calling them naive. But who knows, maybe I'll grow up when I'm an attending.

I don't believe Europe is that horrible of an example. You conveniently cherry-picked a few really bad examples (Greece, who has been suffering from a horrible banking system failure, France, who's refugee burden has exceeded it's capabilities, and Spain, who again, has been going through internal conflicts regarding Catalonia). Your view point of "dependent on hand outs" and "take and take" is not an uncommon American sentiment. So I don't blame you for thinking that way. I'd love to hear your thoughts on UBI for that matter, because I'm sure you're livid about that idea.

Also, I assume you are familiar with how silly unemployment as a metric is. 4% unemployment sounds great, but if there isn't any upward mobility, the jobs are paying below the standard of living, and these workers have virtually no access to higher education, a 4% unemployment rate is basically meaningless. Citing unemployment statistics is like citing GDP for economic status. It's kind of irrelevant. I was speaking more towards metrics such as overall happiness, average vacation/year, homelessness rates, disease rates, education rates, average graduation debt, infant mortality; the list goes on. All of which, America ranks pretty average.

Just going off my personal experience (n=5-6ish), all of my family and friends who practice in the UK, Spain, Germany, and Austria, love it. They take pride on their system, they think it's logical, and more importantly, they're confused about the way the US does it. If Americans choose to travel to other countries for common procedures, it's clear somethings up.

But back to my original comment; if you feel so strongly about anti-"socialist" healthcare. What are your solutions? It's so easy to bash these ideas, but at least people are coming up with them. You can backtrack to calling people naive all you want. But at the end of the day, you (and the entire US republican party), have yet to come up with a fix. This sentiment coming from medical students is not rare and it's not as crazy as you think it is. I suggest you taking a few steps back and maybe trying to think of it from another perspective, rather than falling back and assuming everyone else is naive.

The proposal has been made, you just don’t like it.

 

[wamcp]

I'm saying it's easier for us to all say we don't want our paychecks cut. But it's harder to step back and think about what might be better, not for us specifically, but for the society as a whole. I never said I want to work for free. Obviously not.

Also, reaching towards the call out of naivety is unnecessary and with all due respect, brings down your argument. We're simply discussing different viewpoints and there's nothing wrong with that. Because someone disagrees with you doesn't warrant calling them naive. But who knows, maybe I'll grow up when I'm an attending.

I don't believe Europe is that horrible of an example. You conveniently cherry-picked a few really bad examples (Greece, who has been suffering from a horrible banking system failure, France, who's refugee burden has exceeded it's capabilities, and Spain, who again, has been going through internal conflicts regarding Catalonia). Your view point of "dependent on hand outs" and "take and take" is not an uncommon American sentiment. So I don't blame you for thinking that way. I'd love to hear your thoughts on UBI for that matter, because I'm sure you're livid about that idea.

Also, I assume you are familiar with how silly unemployment as a metric is. 4% unemployment sounds great, but if there isn't any upward mobility, the jobs are paying below the standard of living, and these workers have virtually no access to higher education, a 4% unemployment rate is basically meaningless. Citing unemployment statistics is like citing GDP for economic status. It's kind of irrelevant. I was speaking more towards metrics such as overall happiness, average vacation/year, homelessness rates, disease rates, education rates, average graduation debt, infant mortality; the list goes on. All of which, America ranks pretty average.

Just going off my personal experience (n=5-6ish), all of my family and friends who practice in the UK, Spain, Germany, and Austria, love it. They take pride on their system, they think it's logical, and more importantly, they're confused about the way the US does it. If Americans choose to travel to other countries for common procedures, it's clear somethings up.

But back to my original comment; if you feel so strongly about anti-"socialist" healthcare. What are your solutions? It's so easy to bash these ideas, but at least people are coming up with them. You can backtrack to calling people naive all you want. But at the end of the day, you (and the entire US republican party), have yet to come up with a fix. This sentiment coming from medical students is not rare and it's not as crazy as you think it is. I suggest you taking a few steps back and maybe trying to think of it from another perspective, rather than falling back and assuming everyone else is naive.

Listen, you are effectively saying you are okay with working for free. Not 100% free, but perhaps 66% free, for example, when I asked if you would be fine doing the same work in today’s system for 200k less income (get paid 100k instead of 300k, because you are ok with the government stiffing you 200k of services reinbursement that you otherwise would have received in today’s current setup).

That’s what it boils down to here. It baffles me that medical students would advocate against their own self interest when you know the huge sacrifices and risks you are taking to become a physician, not to mention the enormous value that you provide to society which should demand fair compensation. And in the current system, fair value really does mean “300k” income, NOT “100k.”

Maybe this is the reason why physician advocacy is so weak?

Teachers go on strike out of self interest all the time asking for ridiculous pension/wage increases even while their doing so will put their school systems in ruinous financial positions (see recent LA strike).
Unions do not hesitate to take and tax and spend other people’s money for their own benefit (see the UAW taxpayer bailout during the financial crisis, or see the unions in chicago refuse to take any pension cuts while the crisis continues to jeppardize the entire city). They all ignore the welfare of the people as a whole.

Physicians need to stand up and do the same. Don’t let ourselves get trampled on by politicians and the masses demanding free this and that. We deserve fair pay even more so than these other non-physician workers who contribute far less to society

 

[alprazoslam]

All I can say is for each handout program a person enrolls in they should lose a freedom that those supporting them have. I’m pretty moderate so I can see both sides but there is more ignorance in the hyper liberals that throw out their economic book knowledge yet have to experience the real world.
But I’ll give you hyper progressives a chance even though my thought process is more like sb247... at least for now.
If you want to increase govt handouts then
You can only get preg and have a baby if you can afford it
You live in govt housing and it has to suck
You eat mandated healthy foods (not coke and taterchips these 500lb foodstamp behemoths almost always buy
You do community service for your free stuff while you look for work
I’d be glad to pay for free childcare for those who cannot afford it to allow them to do the following
No tv, drugs beer cigs etc
If you have some disease that incapacitated you to not be able to legit work then you are exempt


Otherwise we are basically paying people to sit on their a$$ all day like sb247 says.


But in regards to medical care for all I’ll go with the doctor that is actually a doctor here (wamcp) because I tell you what. If people do not have skin in the game they will abuse it and strip us from our hard earned labor. I worked as a nurse prior to med school and the abuse patients put on the system is horrendous and giving the government more power in this will kill physician bargaining power. So if that’s what you want to be a midlevel so at least when you need to climb out of your debt pile you will be able to


So until you have actually lived it don’t comment

 

[GoSpursGo]

This is a good topic, but it's outside the scope of just medical students. In light of that, we're moving the thread to TIH.

 

[managedcarefin]

My point was that Medicare can not negotiate drug prices because of lobbying. If you had Medicare for all, without fixing what’s there, all you end up with is an even juicier target for lobbyists.

Well 70% is 70% federal. In many states where people actually are making 10M+ the top bracket on income tax (state) is already >10%. For example, in New York City it’s 12.6%. So you’re at 82.6% and you want to raise taxes more. Alright, we will make it 87.5% instead of 70%, resulting in slightly over 100% taxation. Great. Couple issues with that.

1: do you think anyone will even take a salary >10M if literally 100.1% is taxed?

2: the amount raised (assuming people continued to negotiate for salaries higher than 10M which provide literally 0 benefit to them at the cost of their employer) is still trivial. All you did is raise taxes slightly more than they would be with 70% marginal tax rates. So instead of 15B you raise 18B (again, you would actually raise 0 dollars as no one is going to demand the company takes a substantial hit financially to pay more taxes - they literally hire an army of people to minimize taxes and a CEO demanding 20M compensation with no actual benefit to him would be fired immediately as he’s costing the company 10M just for fun).

So you still have yet to actually raise virtually any money in the context of Medicare for all.

As for your other proposal of hunting down the rich and seizing 90-99% of their existing wealth...well that’s not going to go well, especially since much of that wealth is overseas. Are we declaring war on Switzerland next? Just curious how far this experiment is going lol.

If the far left was advocating reducing the military budget in favor of social services at least it would pass the smell test. There’s a lot of money to be gained there.





Oh nice, bills introduced. Well, if they actually pass we can revisit this isssue. As it stands it means literally nothing. A lot of the people advocating for X are paid by lobbyists and don’t follow through. See: Obamacare. If you’re taking politicians at their word I’ve got some great oceanfront property in Kansas to sell you.

Wow, and what do food stamps and section 8 housing have in common with Medicaid? Both are income restricted to those that need it most. If you’re making 50k a year you don’t get food stamps for free, and you don’t get insurance for free.

Did you just choose to forget about Medicaid?

Tax rates are progressive....so it's every dollar above 10M is tax at X%...

Why do so many people not know how taxes work?