In a best case scenario, with educated and understanding people, no political interference, even with our limited technology, it would be a good thing and I'd favor it - especially for diseases which are cheap and easy to treat if caught early.
In the real world we live it, it will be bringing our economies on their knees. It's a bad idea.
Real world data show the opposite of what you're saying. The US spends more on health care than other developed countries with universal healthcare. You must know that, so what point are you trying to make here?
It's actually worse than that: US government spending on healthcare per-capita actually exceeds per-capita government spending on healthcare in countries like Canada or the United Kingdom that have universal healthcare [1], let alone total spending per-capita across both the private & government sectors.
Far from universal healthcare bringing an economy "to its knees", it seems to me that the US system has a far greater chance of doing so.
In the US, a market economy applied to healthcare limits the demand. Yet a lot of money gets spent uselessly in healthcare- and this happens even in government run programs.
People want more of everything, but there are physical limits about what is possible.
Even if each person get less per dollar than in other countries, for some reason I don't fully understand there is a high demand of healthcare, and also more distrust of an expert run system (like QALY evaluation in the UK)
It's not just an inelastic demand - it is more like a weird moral hazard scenario, or as if healthcare had increasing marginal returns for people utility function.
In this situation, replacing the market system by a government program might cost less in the short run - I fully agree - but much much more in the long run if demand is liberated.
That's because healthcare is not just like any usual good where you have reducing marginal returns, and it will be made worse especially after it has been "shown" that the endless money supply of the government can provide healthcare to anyone! ("shown" not as a valid proof, but as "noticed" by people who can cast a vote)
In the long run, I believe it will end up costing much more by this self perpetrating demand, up to the point it actually damages the economy.
A dollar spent on healthcare is not "productive" - healthcare is an investment with a negative interest rate. You can only put more money to try to keep your capital - but in the end you still die (maybe that's the reason for the increasing marginal returns - you need more and more of it).
It's bad enough when a country make debts not for investment but for consumption, yet it's much worse to make debts to "invest" in something like healthcare - with a negative interest rate
European countries are in for a bad day when they won't be able to patch the system anymore. In France IIRC the social deficit was around 100 billions in 2008 - much more than the government budget - with a 10 billions deficit just for healthcare. Now it's 160 billions in 2012 - http://online.wsj.com/article/BT-CO-20121001-707300.html]
Almost doubling in 5 years - let's round that to 60 billions per 4 years for a country of 60 millions persons.
Let's make some quick calculations.
Do you have any reason to think than, in a country with 5 times more people, and spending 16% of its GDP on healthcare instead of 9% in France (not sure about the precise %, but it's around 33% more), all others things being equal it won't create at least a 6051.33 ~ 400 billions deficit in 4 years?
(and that's a baseline scenario with an identical efficiency - with the highest cost of healthcare in the US, which can't be slashed in a day, I'd expect something at least like a 1000 trillion/5 years - and that won't be a stimulus, except for increasing demand)
I disagree strongly with pretty much all of your points.
You acknowledge that the vast majority of the evidence points towards universal healthcare systems being more economically efficient in your first sentence. You then proceed to make an argument that basically asserts the US is a special case and that a universal care system wouldn't "behave" as it does everywhere else and reduce costs, but instead increase them. I see no basis for this assumption and I want to challenge you to demonstrate why you should be granted it.
I also want to challenge you on your implied definition of "useful" or "efficient". You say you would favor a universal system if you were to see convincing evidence that it would reduce costs. In your argument, I at least, read an implicit assumption that cost ought to be the deciding factor. I find that point of view detestable. For corporations, whose sole purpose is profits, it makes sense to think of efficiency that way. You and I, however, are people, and shouldn't have values that put resource acquisition higher than human well-being. You're free to disagree, but doing so would convince me that we have very little common basis for dialog.
In the last part of your comment you give France as an example of a country that will suffer dire economic repercussions for having run an unsustainable universal healthcare system. I haven't double-checked your references, but I'm happy to grant you, for the sake of argument, that the data is on your side. You've chosen to ignore the vast majority of strong economies with universal healthcare. You've also failed to mention that whatever problems France may have in the future, they pale in comparison to the budgetary problems the US is facing due to the privatized healthcare system it is currently running. References forthcoming should you ask...
> the budgetary problems the US is facing due to the privatized healthcare system
Wait, the what?
Did you really just try to pin the blame of US budgetary stupidity on the PRIVATE healthcare system?
So, wars, enormous unfunded liabilities of Social Security, Medicare, Medicaid (both public healthcare systems), and the general welfare state don't dominate the "budgetary problems the US is facing"?
I'm sorry if I seem to be making a special case of the US - what I wanted to say is universal healthcare is not a good idea in general, and even more in the US which is like a worst case for trying to implement it.
Universal healthcare reduce individual costs, ie is "more efficient", but raise the demand. Even if it makes each act 50% less expansive, if the demand is 4x more, that'll still be 2x as much in total - it is less efficient on society as a whole, because it's not a productive use for money.
My point is not that resource acquisition is the highest goal of human beings, it is just that money spend of such thing can not be put to a better use. It's good to spend money on feeling good (healthcare), as long as the other way the money is spend provide growth.
I would favor universal system if I saw convincing evidence that people would not overclaim (ie seek treatment for minor ailments), and if they were respectful of the regulation system which has to exist if they can't self regulate with their own money. I see just the opposite, except maybe for the UK, but I don't have any experience with their system, and I don't know if they run a deficit. Anyway, if there is a special case, it certainly is the UK.
Even worse - I've noticed a troubling trend. Apparently "generosity" or "social spending" is correlated with group identification - i.e. people who self categorize as different groups (based on religion, ethnicity - anything) are less likely to favor social spending, maybe because it could favor the other group. I don't have evidence for this - it's just something I noticed when people are debating about social systems.
It is troubling, because most of the countries implementing universal healthcare are also running active immigration programs, which helps balance the cost of their social system. But if the trend is real, this countries will voluntary reduce their social spending after the initial period where immigrants footed the bill - leaving them resentful.
My hypothesis is that countries where diversity increases (such as countries in the western EU) will reduce their social systems, while countries where diversity plunge (don't know if there is any at the moment - but the province of Quebec in the 1970 is the closest example) will increase their social spending.
Please give some references for the US, but from quick calculations adding a trillion of deficit every 5 years looks like a bad idea (and I'm only talking about public healthcare in France- many people pay on top of that private insurance since the public system doesn't fully cover all the costs - money spent to purchase service from such for profit companies should certainly be added if you want to compare healthcare systems)
NOTE: This is meant as a reply to guylhem's response below.
It is true that the percentage of GDP the US is spending and will be spending in the future is not sustainable, but you're making an argument for universal healthcare. The reason costs are skyrocketing is that you have a privatized system that's (oddly) subsidized by the government. Patent laws give pharmaceutical companies monopolies on different types of drugs, while on the other hand the government is forbidden to negotiate with those companies on the price.
You also have huge overhead (31%) due to the inherent inefficiencies of running this kind of system through the private sector. For example, you need at least two doctors for each transaction - one to diagnose you and prescribe treatment and one working for the insurance company making sure that you actually need that treatment.
As for the argument about demand reduction, I agree that if you had much more demand, even reduced costs may make it unsustainable. However, in the real world that is demonstrably not happening. It simply isn't the case that universal healthcare is more expensive if we consider the evidence.
[temporary monopolies exist to preserve innovation - but let's leave that issue aside]
It might be possible that the overhead will vanish if universal healthcare is implemented. It seems unlikely to me, but a good part of the argument for universal healthcare depends on that.
Yet people just don't vanish or "lie down and die". Those who are making a living from the overheads will certainly want to go on doing that. Universal healthcare will just give them leverage and moral support (think of the patient!) to do it on a scale that will dwarf the gravy train of other government procurement contracts - at the taxpayer expense.
Such as increasing our level of technology so that the next generation will be better off, which is what every generation did until we got the idea that putting a bigger and bigger chuck of the GDP on healthcare each year was a bright idea. Over 10% it is not sustainable. It has to stop growing.
If it was used to develop life changing technologies for the whole human species such as whole brain emulation, space colonization etc- why not. At the moment is it just about making us more comfortable.
A temporary high quality of life indeed, at the expense of the future. Not a bright idea.
You aren't consistent in the point you are trying to make, which lends me to believe you believe in your side beyond reason. People have stated that universal health care has and does work in other countries.
Check out Australia's economy, and it's healthcare system. Admittedly it's scale is tiny in comparison to a U.S and there is a valid discussion of how universal health care scales (i.e is it linear, etc). But evidence already shows it works, so I don't see any point in further trying to convince you.
I don't believe in anything. Maybe universal healthcare will be possible some day, and even a good thing. Presently, in the US, it's a really bad idea.
Australia is the token example of what I said above- the bill for its social system is footed by immigrants, to which some bright bulbs think removing coverage would be another bright idea.
The best solution to reduce costs? Remove all the legal cruft - including medical boards which create monopolies in labor. Leave maybe only the FDA to evaluate drugs. Let the market sort out the rest - ie deregulate.
Australia is the token example of what I said above- the bill for its social system is footed by immigrants, to which some bright bulbs think removing coverage would be another bright idea.
Um... what? I'm Australian and have a pretty good idea of the funding of our healthcare system. Can you please explain in better detail how it mooches off our immigration?
Also, can you please cite some references showing folks that want to remove coverage from immigrants being sensible economists rather than fringe racists?
It seems to me that you're just inventing things out of whole cloth at this point.
I'm not australian so I can't say for sure what's happening down there, but the situation seems very much like France.
In Europe, and especially in France, many people share the belief that immigration is causing problems to the healthcare system. Whether they are economists or fringe racists does not matter if they manage to get enough votes.
I don't know how frequent racism is in Australia when compared to France - after reading about the riots in the press, along with this recent article which featured a poll, showing 83% thought racism was prevalent I thought it was "very much alive". http://www.heraldsun.com.au/news/victoria/racism-very-much-a...
Maybe the press and the polls are inventing things, and my comparison with France is not valid- but since we were talking about Australia, it seemed quite apropos.
EDIT: Volpe, please reread the parent comment. The problem is that western countries with diversity and immigration programs are also the ones with universal healthcare, and that there's a trend of resentment against other groups in these countries (quite related !!) that apparently conflict with the basic idea of social spending, and thus universal healthcare.
I've made my prediction - that countries with low (or no) growth will either reduce (or maintain low) their diversity and increase social spending, or increase diversity while decreasing social spending.
I'll be watching the situation in Europe and North America to see if these predictions happen - using universal healthcare as a proxy to see how social spending evolves.
Australia and Canada could give interesting example since they run active immigration programs and enjoy a decent growth - while still harbouring this kind of resentment. I'd be curious to know if growth can be helpful against this trend, or if the trend is stronger than the benefits of growth and will keep developing.
The article you posted highlights a peculiarity of the Australian racism debate - most of it is countering the idea that there is no racism in Australia, which is nonsense. There is racism here, just as there is racism everywhere. And it's got nothing to do with social spending - the US harbours quite a lot of racism (much more openly than in Aus) and it hates social spending. Australians are so sensitive about the race issue that most will either say there is no racism or that we're the worst in the world, but the truth is that we have problems, but aren't that bad if you actually start comparing to other countries. We certainly have nothing like France's actual laws on books that single out muslims.
But back to the meat of the question, you said this: Australia is the token example of what I said above- the bill for its social system is footed by immigrants. How are the immigrants footing the bill? From what you've said above, they're draining the system, not funding it ('causing problems')
Also, on the while still harbouring this kind of resentment bit -
There is not a country in the world that doesn't have a racism problem nor a population segment that resents foreigners.
France is having some problems that (i think) support my case, and I saw that Australia has some unrelated racism issue, so I concluded that France's healthcare system and Australia's healthcare system are the same.
Do you recall my earlier point about you being 'beyond reason' you are just making wild guesses at things, and cherry picking data to support your factually incorrect stance.
If you truly believe the market is the best way to sort it out, why not let the government compete? Have a single-payer system and let people opt-in. Also, repeal the laws that currently prohibit the government from negotiating drug prices. In a free market, if I'm a major client, I have some leverage to get preferential rates. Then, I'd be all for the market sorting it out. Would you support something like that? My guess is not, which means you aren't really arguing for deregulation, but for a different kind of regulation.
Seriously? You feel confident enough to evaluate the qualifications of the 'doctor' you've just gone to see about the potentially life-threatening bulge on the side of your neck, which he dismisses as just "an enlarged lymph node, no way its Non-Hodgkins lymphoma", which if caught early enough is totally treatable but if you wait too long is fatal? You really feel qualified to do that?
Skipping over the difficulties of implementing universal health care for the moment -- the thing I like best about it is that it drastically simplifies an entire category of "stuff I hate that keeps me up at night".
If "but what happens if I get sick" is no longer a large factor in questions like "should I start this business", people are freer to throw themselves into developing the kind of technology you're talking about.
I've literally spent months of my life dealing with the details of arranging and paying for healthcare for myself and my family -- including time worrying about "but if X happens, how will I pay for it?" It's one of the main stresses in my life, and it very obviously costs me in productivity.
You are quite coherent and this is IMHO the only case where healthcare could be considered an investment - so that it doesn't prevent people from starting a business.
Not sure it is enough by itself to support a universal healthcare ideal, but this a very valid reason - along with easy to treat diseases when they are caught early on.
Right, preventative care, and not just starting businesses -- it stops people from doing all kinds of good things.
Creating art or writing novels, going back to school, moving across the country, working for startups (not just starting them), having kids (or adopting, or taking a leave of absence to help raise kids)... there are lots more things that could go on that list.
Not all of those things equal "more money to the government". Some are "quality of life" sort of things; some add cultural value; etc.. But having a safety net for health issues fixes a lot of problems even for people who won't ever really need it (but can't know that for sure...), and is a sort of economic equalizing factor that I like more than taking more money from rich people and giving it to poor people.
I was trying to figure out what was bugging me about the line I quoted of yours and figured it out - you call a healthcare visit a 'claim' rather than a 'visit' or 'consult' or whatever. I worked in a hospital for four years and never heard of any malingerer referred to as an 'overclaimer'.
>I would favor universal system if I saw convincing evidence that people would not overclaim (ie seek treatment for minor ailments)
The saying "an ounce of prevention is worth a pound of cure" comes from medicine. Many problems are much easier to treat earlier on; by discouraging people from seeking treatment you end up spending more and getting worse results - as happens in the US.
>Anyway, if there is a special case, it certainly is the UK.
Hardly; look at Canada or Australia or France or Germany or Italy or.... The US is a clear outlier among countries with a similar GDP per capita; it's the only one without socialized healthcare, spends far more per capita on healthcare and has a noticeably worse life expectancy. I don't think this is coincidence.
A dollar spent on healthcare is not "productive".
What do you base this statement on?
Well run public healthcare programmmes are exceptionally cost effective. Cancer screening, childhood immunisations, dental, eye and hearing screening for children, free doctors visits for children. These are all things people around me use on a routine basis. They have a real and measurable effect on productivity for us all and do save money.
All these healthcare programmes and many, many more, aren't run for the sake of smiles and happiness. They save dollars, lives and increase productivity.
