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Comment by martythemaniak | Hacker News Reader

I have to say, it is quite bizarre, watching the US health "debate" from up here in Canada.

At the end of the day, it's a philosophical difference. I see people in Sicko, or read any of the thousands upon thousands of horror stories (like the ones in the article) and my stomach turns. I find situations like that downright amoral, so I think having to pay higher taxes for UHC is great value.

OTOH, opponents look at the same people and start to get mad that these people should get "something for nothing", that their tax dollars are used to help people that may have made bad choices.

Call me a pessimist, but I don't think this will turn out well for you guys. Any bill that is passed will be very watered-down and if the republicans get back into power before American UHC gets ingrained in the social fabric, then they'll do their best to kill it or cripple it.

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You're right that there is a philosophical difference, but opponents of Obama's plan are being represented unfairly by those who frame the "debate" in the way in which you just did.

All anecdotal arguments aside, the premise that more government is the only avenue for reform (held by yourself and other "progressives") is why both sides can't seem to agree on anything more than the idea that reform is needed. Around 40% of the American health care system is already managed by the government. The idea that we have a free market health care system that is failing the less fortunate in our country is downright false.

In Obama's current plan, there are plenty of free market solutions to expand coverage and bring down costs that are being ignored and avoided (some due to lobbyists and special interests and others by, IMO, power-hungry politicians with a deeper, anti-capitalist agenda). Furthermore, there are plenty of examples of unintended consequences from prior government policies (with good intentions) that have created some of the problems we have today. Without going into the specifics or giving your last sentence a serious thought, I would just like to say this: Both sides (for the most part) have good intentions so let's not paint each other as evil.

Here's a good place to start to understand the other side: http://online.wsj.com/article/SB1000142405297020360920457431...

Agreed on all of your points other than "power-hungry politicians with a deeper, anti-capitalist agenda". There are some true morons in office in this country, especially most of Congress, but if you can provide me with a single example of an elected official who appears to be truly "anti-capitalist" I'd be shocked.

I've heard Rep. Jan Schakowsky say some things about wanting to destroy the private health insurance industry straight up. Her supporters erupted into a wild applause, too. Disturbs the hell out of me.

Just read the article. The problem is, people are not ready to listen right now to the idea that markets naturally produce the best outcomes. We are trying to get out of a world wide economic collapse that was the result of unregulated markets. At least, that is the general perception. And I must admit, it is my perception as well.

More specifically, if you make a mistake in the market for a new MP3 player, you just have a crappy MP3 player and you're out a couple hundred bucks or so, and you buy a different brand next time. If you make a mistake buying health insurance, and only discover that your policy does not guarantee you the right to continue purchasing insurance at your existing rate when you are diagnosed with an illness, it could result in bankruptcy or even death.

So you understand the hesitancy to trust unregulated market forces when the issue is literally life and death.

I would disagree (and others share this view) that the economic collapse was the result of unregulated markets. It was the result of bad regulation (e.g., the CRA of '95 caused the amount of mortgages issued that were subprime to jump from 1% to 12% by '98 alone) and bad government interference (e.g., low interest rates under Greenspan made money too cheap for too long). Greed was indeed a huge factor, but it came from directions that aren't currently being fingered. Now, I'm not going to defend all private institutions: AIG, for one quick example, had some sketchy things going on that definitely need looking into.

But, for the most part, I am skeptical of any kind of central planning. I believe the federal government should stay out of things like health insurance. If Washington didn't help create the current environment where we rely so much on employer-based health insurance, maybe we would have individual health savings accounts and costs wouldn't have gotten so out of control because individuals would actually care what they were paying. And, in turn, hospitals would actually care what they are charging (i.e., competition).

I mean, just read the Wikipedia page on HSAs to get a feel for how complicated one tiny part of our system is http://en.wikipedia.org/wiki/Health_savings_account. I don't feel comfortable having this system reformed so quickly (especially when these bills aren't being read!). So much of the motives behind the current movement are purely political. I would rather take it slow and have a real, honest look at the problems from both sides.

I think the ultimate obstacle is that we perceive America to be as free market as it gets, but that notion is, in reality, so far from the truth. This belief seems to render any free-market approach to reform as "out-dated" or "pro status quo".

Sorry if I got off-topic. I've been trying to keep my political thoughts off of HN for too long. :)

This is commonly thrown around:

I believe the federal government should stay out of things like health care.

The government's not trying to provide health care. It's trying to provide health insurance, which the private market has shown itself to be incapable of providing for 50 million Americans.

Of course our Congressmen/women aren't going to be performing medical procedures on us (thank God, ha). You know what I meant. I'll edit it for you though. :)

And again, I don't believe you can blame private insurers for that. The government is largely to blame for rising costs.

(BTW throwing that figure around opens up a whole 'nother can of worms, but I'll not go there)

I'm not really sure what you're saying here. But I don't think you can blame government for rising costs. I think it's natural for an advanced society that has already found a cheap way to provide necessities like food to start spending a larger and larger portion of its income on things like health care and education.

There are certainly things the government could do to reduce costs though, like reigning in lawsuits through tort reform. Ironically I think having the government provide insurance for a lot of people will reduce costs as well. The government has way less overhead and doesn't care about making a profit. I know that sounds counter intuitive but think about it from the standpoint of costs to the consumer.

We already have Medicaid and Medicare. I've read so much about their role in the rising costs of health care that I wouldn't even know where to start.

I like Mankiw's thoughts on the public option: http://gregmankiw.blogspot.com/2009/06/whats-point-of-public...

I actually take this back. Obama uses this wording as well, because he is trying to bring down the costs of health care, too. Regulating the insurance industry effects the prices of health care (sometimes negatively). I wish I could explain this better.

For the record, if you want to deal in conjecture and annecdotal evidence there's just as much stacked up against the health care system in canada. I can't tell you how many times I've read of people dying while waiting for a test or surgery. There are even the proven stories of wealthy canadians flying to the U.S. and paying for surgeries privately.

More than anything stories like this (or the ones about Canada) are scare tactics to support a political agenda. The fact still remains, a hospital in the U.S. by law CAN NOT turn away a patient for financial reasons. No one is dying on the street for lack of health care. At the same time Canada generally manages to take care of the great majority of its citizens without killing them by making them wait.

Bottom Line: The U.S. system has problems but so does the system in Canada, the U.K. and elsewhere. What we in the U.S. need to be doing is looking for a third option.

I'm Canadian, and I don't really care very much what people think of our system here in Canada. In my opinion it is great. I think wait times are overstated, in situations where wait times matter. To espouse some personal stories to compare and contrast here, my girlfriends father had some pretty serious colon cancer, from the time it was found it took around a month to get the surgery he needed(including consults and whatnot) and to start treatment. Cost to him and his family 0$.

My uncle lives in Texas, (I love Texas Btw :P ) and he had some serious issues with his spleen. It took him about a month to get his surgery(including consults), he is fine now but still requires continuing monitoring.Cost to him and his family with his insurance coverage ~40K.

I honestly hope that everyone everywhere(not just in the US) gets free and available healthcare.

While there might be some hybrid model in the middle somewhere that may work. I think dealing with a teired model of healthcare will leave people who can only get the public healthcare the shaft.

Average wait times in Canada are worse than the wait times for those Americans who can afford the Best Healthcare Money Can Buy ® - but they actually compare favourably with average wait times in the US (obviously not counting those 47 million Americans who will wait forever for procedures for which they don't have coverage and which they can't afford).

To counter your Texas anecdote... I live in Texas, and my dad was diagnosed with stage 4 metastatic melanoma (extremely low survival rate). The cancer doctors we have in Dallas are some of the best in the world. My dad had insurance and it covered an upwards of $200k. My dad's fine today, and has been cancer-free for 5 years.

The only things that stood out as being broken was the doctors' paranoia of being sued.

You did not mention what your father's out of pocket expenses were. In the Canada example, out of pocket was $0.

I don't know, but it couldn't have been much since my dad makes less than $50k a year. In the Canadian example, you need to figure in taxes.

I don't think your father's income has anything to do with how much he would have had to pay out of pocket. And since I understand you object to the government running things, do you have philosophical objections to the USPS delivering your mail? Or receiving Social Security benefits when the time comes? (These are serious questions, I really would like to know)

My dad's income does have something to do with it because I didn't notice anything change for us financially despite all that he had to go through. Ergo, it couldn't have been that much. I know most doctors don't care how much you make when they bill you. Sorry that I wasn't clear.

I can object to things on a philosophical level and still use them. We become reliant on programs that should have never been created in the first place.

I may pay higher taxes, but I get a lot of "socialized" service. Seems like a decent tradeoff to me.

Responding to below: Taxes are graduated so the largest increase in tax will be to the rich and uber rich, but to them it will be small pickings.

Earned income goes up. Capital gains as far as I know is max 15%. Other tax laws for the really, really rich might change this though.

Hospitals are only required to treat emergencies. Even if you go in for an emergency without health insurance they will bill you directly for it. If you goto a hospital and get diagnosed with cancer they aren't paying for your treatment or the required drugs. If you're lucky they might pay for the initial tests though which are probably 1/100th of the actual cost of the treatments you'll need.

People die with no hope of health care as they don't have the $$. Would you rather be told you have to wait or can't have it at all?

Obama's plan is a third option. The health plan will create a government option to make it available to those who can't afford it.

So it'll be sort of like the postal system. If you want to use Fedex or UPS, you can, if you want uber cheap you can go with USPS, but you don't see Fedex or USPS out of business do you?

We already have Medicaid.

http://gregmankiw.blogspot.com/2009/06/whats-point-of-public...

Responding to comment below: And so many are still without health care! So this will alleviate that. But this will also make it cheaper for large companies like General Motors because they can now switch to the cheaper government plan. It will allow companies like GM to be more globally competitive because european (not all?), japanese auto companies do not have to worry about health care costs.

If the gov plan uses taxpayer money, it doesn't necessarily mean that private insurance will fail. And this is because there will be some who will want the higher quality private insurance. The fact is the richer you are the more you will pay for even modest upgrades. So those who can afford private insurance will still have a reason to go for it. This is evidenced by what TomOfTTB said above who said there are stories of Canadians who fly to the US for health care right? And it's true private insurance will get hit hard by this, but they will probably not all die out. In fact private insurance companies are probably the main driver of the opposition.

In the US, I had to wait 1.5 weeks to see an orthopedist when I sprained both my ankles, with an excellent ($550/mo) PPO insurance plan. In a suburb. Not in a state you'd list in the top 15 for population.

It's a damn good thing I was lucky enough to have the opportunities in life that helped me get a job where not going to work for a month was OK. If I'd had a slightly less flexible situation, I would have been totally over the barrel. You cannot walk with two sprained ankles, but it's not considered a temporary disability either.

Cuz, along with universal healthcare, we're missing worker protection laws too.

On that note, you "hear" about people dying while waiting for surgery in Canada, but where's the evidence?

> OTOH, opponents look at the same people and start to get mad that these people should get "something for nothing", that their tax dollars are used to help people that may have made bad choices.

I don't think the stigma of a lazy person is really associated with not being able to afford health care. I think it's generally understood that even a diligent individual may have a hard time paying for health care in our system. Basically all this plan is proposing is shifting more tax dollars to subsidize health care like we have it subsidizing the post office.

I think there are two primary groups against this: rich people that are financially invested in the current health care system somehow, and middle and sub middle class people who do not believe in people getting "something for nothing"

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