Universal Health Care

Current Events Domestic United States Politics
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I believe it was last week when Schwarzenegger proposed his universal health care plan for California. This morning the governor of Pennsylvania, Ed Rendell, announced his “Prescription for Pennsylvania,” which “includes providing subsidized basic health insurance plans, penalizing employers who don’t offer health insurance, restricting how insurers set premiums, rewarding health-care providers who expand their hours of operation and strengthening government oversight of hospitals.”

The article can be found here.

My questions are: was Schwarzenegger the first governor to propose such a plan at the state level? Rendell could have planned this for a while, but he did announce it this week…was he influenced by Schwarzenegger possibly? Do you think other states will follow?

I know PA has suffered from a shortage of doctors for quite a while…one of Rendell’s ideas is to relegate some of the physicians’ responsibilities to other health care workers, like “properly trained nurses, advanced nurse practitioners, midwives, physician assistants, pharmacists, dental hygienists.” I obviously don’t think the government should be interfering in this..but if it insists on doing so, shouldn’t it instead focus on trying to make Pennsylvania a more appealing place to work for MDs and DOs? They are qualified and trained in doing what they do…training other health care workers to perform physicians’ jobs would, I think, require more money than the latter approach.

Thoughts? :wink:

2

I think Massachussets did something recently, with regards to universal health care, but I can’t think of what it was. Personally, if it’s bound to happen, I’d much rather the states do it one by one.

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I obviously don’t think the government should be interfering in this..but if it insists on doing so, shouldn’t it instead focus on trying to make Pennsylvania a more appealing place to work for MDs and DOs?

There is no “if they’re going to violate rights, how best should they do it?” sort of argument. How do you think they would make Penn a more appealing place for MD’s and DO’s other than getting out of the way? Govt causes the shortage…

4

PA’s surgeons went on a one-day strike several years ago to protest the failure of tort reform. PA has a history of antagonism towards health care professionals. I am unsurprised.

-Q

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There is no “if they’re going to violate rights, how best should they do it?” sort of argument. How do you think they would make Penn a more appealing place for MD’s and DO’s other than getting out of the way? Govt causes the shortage…

Sure there is. If our rights are going to be violated by enforcing single-payer health care, then I want that health care to be as efficient and high-quality as humanly possible. I mean, it’s going to be horrid no matter what, but I don’t think it has to be quite as horrid as it is in, say, Canada.

6

Sure there is. If our rights are going to be violated by enforcing single-payer health care, then I want that health care to be as efficient and high-quality as humanly possible. I mean, it’s going to be horrid no matter what, but I don’t think it has to be quite as horrid as it is in, say, Canada.

That’s what I meant. Rendell is going to spend money on health care: that’s really not going to change. But if he’s going to spend it, I’d rather he do it efficiently so that he takes less of my money.

The article does say, however, that he proposes to fund this undertaking by taxing more heavily on cigarettes and things like that. I’m not a smoker, so thankfully he won’t be taxing me more than he already does.

7

Here’s an earlier thread about the Mass. plan.

… if he’s going to spend it, I’d rather he do it efficiently…

Could you concretize what you mean by efficiently? Some people will get more under the new system, compared to what they get before; others will get less, or have to pay more to get the same level. Do you have some ideas as to how one would go about measuring efficiency?

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With something as complicated as health care, I doubt there could be a single measure of efficiency. All we’re saying is that, if they’re gonna do it anyway, the higher quality it is, the better.

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Do you think other states will follow?

I think it is likely. Massachusetts was first, proposed by a Republican Governor, Mitt Romney. Now we have California, Pennsylvania and New York. Republicans are especially effective and deadly at increasing government power, when they decide to do it. They decide to do it when they see it as the “pragmatic” thing to do to forestall Democratic gains (for example, when Bush enacted the prescription drug plan in order to silence Democratic criticism over “high” drug prices). Unfortunately, when a Republican proposes an expansion of government power, he usually gets away with it, because Republican opposition is silenced. I do not think it is a coincidence that the first two states to propose socialized medicine have Republican governors.

Oddly enough, I think the only way the spread of socialized medicine state-by-state will be slowed is after the Democrats have gained more power. That may sound paradoxical, but when that happens the Republicans will once again become the party of opposition. Republicans find it a lot easier to be principled when they are opposing Democratic plans than when they are the party of power.

I know PA has suffered from a shortage of doctors for quite a while…one of Rendell’s ideas is to relegate some of the physicians’ responsibilities to other health care workers, like “properly trained nurses, advanced nurse practitioners, midwives, physician assistants, pharmacists, dental hygienists.” I obviously don’t think the government should be interfering in this..

On the face of it, I think this is a good idea, if it means simply allowing more people to practice medicine. Occupational licensing laws that limit most medical practices to extremely highly trained M.D.'s have the effect of “gold-plating” medicine and pricing it out of reach of many people. If anyone could practice medicine (I mean this, there should be no occupational licensing laws of any kind), medical entrepreneurs would emerge who would offer medicine more cheaply. Cheaper medicine = more widely utilized medical services such as vaccinations.

An example of the type of entrepreneurial approach to medicine I am talking about is being slowly rolled out by Wal-Mart. They are setting up quick in-and-out medical clinics in their stores. For flat, cash fees you can quickly get vaccinations, receive antibiotics for simple infections, etc. Of course, that is a truly free market answer to all of the problems the socialized medicine advocates allege about our current system.

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On the face of it, I think this is a good idea, if it means simply allowing more people to practice medicine. Occupational licensing laws that limit most medical practices to extremely highly trained M.D.'s have the effect of “gold-plating” medicine and pricing it out of reach of many people. If anyone could practice medicine (I mean this, there should be no occupational licensing laws of any kind), medical entrepreneurs would emerge who would offer medicine more cheaply. Cheaper medicine = more widely utilized medical services such as vaccinations.

I too think this would be a positive development. If you have a sore throat, why is it necessary to pay a highly trained and expensive physician to examine you? Of course, it isn’t except that the government forces you to do it. On the other hand, if you have a brain tumor then it makes sense to search out someone with the best medical credentials. Private associations can provide certification programs that establish the qualifications of physicians. This principal applies to all professions (from plumbing to law) that are forced to abide by government licensing schemes.

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With something as complicated as health care, I doubt there could be a single measure of efficiency. All we’re saying is that, if they’re gonna do it anyway, the higher quality it is, the better.

But the primary reason there cannot be a measure is not the complexity of the field as such. The real issue is that a new system may be good for some and worse for others, and there is no way at all (not just too complicated, but no way at all) to add that up.

Any new system should be measured by a different, but admittedly more complex, measure: how close it is to what a free-market would create. So, to take the idea above, I agree with Galileo and Gags that allowing non-MDs to do certain things is good, because – as Galileo notes – occupational licencing laws are the problem, and undoing them is a good thing. Efficiency will result, but it is not a primary.

Let me illustrate this point further. Using efficiency as a primary, someone might suggest limiting the income of surgeons. The idea might be that some may leave the state, but if the restriction is not too absurd, enough will remain. This would probably reduce costs. This would not be a good thing because it would not be the type of cost-reduction a free-market would bring about (unlike the "go to a nurse for a cough thing). So, the result will be some – even if a small – shortage of surgeons. Then, there will be stories of people having optional procedures done while others wait, and the next step will be someone deciding that serious cases --serious by his standard rather than the standard of the patient – should go to the head of the line for surgery. Efficiency is good, but not primary.

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I obviously don’t think the government should be interfering in this..but if it insists on doing so, shouldn’t it instead focus on trying to make Pennsylvania a more appealing place to work for MDs and DOs?

I think what Penn should do is “nationalize”, at the state level, all health care. Force doctors and nurses to work exclusively for the state, in state-run hospitals, which provide their services for “free”. That will really concretize the nature of government-run health care. I would feel compassion for the suffering of the people who were foolish enough to choose to remain in Pennsylvania, but somebody apparently has to be sacrificed to that reality sinks in.

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Exactly, when one advocates doing it as “efficiently” as possible, doesn’t this realy help hide the nature of the beast?

The layman can say, “well, they do a pretty good job of running it, so it must not be that bad”.

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The layman can say, “well, they do a pretty good job of running it, so it must not be that bad”.

And didn’t Mussolini make the trains run on time? Actually, I understand that they didn’t run on time, but assuming they did, isn’t that efficiency a sign of the success of socialism? :worry:

A socialist can always try to make some economic activity look like it is being performed well. For example, Stalin put chandeliers in the subways, the Nazis had massive public works projects to employ the unemployed, etc.

I agree that efficiency is not a primary. The only primary is the result that ensues from a free market. We can talk about that result a priori, but the only way to see what it would look like is to live it. The creativity of entrepreneurs always means that the result is different (and usually better) than one’s expectations going in. On this last point, imagine if Wal-Mart’s plan to put fast, low-cost clinics in its stores was completely unconstrained by licensing laws, Medicare regulations, etc. I would love to see a “McDonald’s of medicine” either as stand-alone clinics or as convenient centers where I could stop in for a check-up in between buying my milk and eggs.

15

Bush Urges Tax to Help Cover the Uninsured

President Bush intends to use the State of the Union address on Tuesday to tackle the rising cost of health care with a one-two punch: tax breaks to help low-income people buy health insurance and tax increases for workers whose health plans cost more than the national average.

16

tax increases for workers whose health plans cost more than the national average.

Wha-wha-whaaaa?!? Thank god for partisan politics.

17

Oh the apple doesn’t fall very far from the tree. The “read my lips” family strikes again:

The plan is a startling move for a president who has repeatedly vowed not to raise taxes. The administration official said that while there would be tax winners and losers under the program, it was revenue neutral and therefore not a tax increase. Yet it is certain to run into opposition from business groups, labor unions and, most of all, the Democrats who now run Capitol Hill.

“It’s a bad policy,” Representative Charles B. Rangel, the New York Democrat who is chairman of the House committee that writes tax legislation, said in an interview Friday night. “We are trying to bring tax relief to the middle class. The president is trying to increase their tax liability. This proposal is inconsistent with what the majority is seeking in the House and the Senate.”

When Charley Rangel is coming at you from the right, there’s a serious problem.

18

President Bush intends to use the State of the Union address on Tuesday to tackle the rising cost of health care with a one-two punch: tax breaks to help low-income people buy health insurance and tax increases for workers whose health plans cost more than the national average.

Republicans are especially effective and deadly at increasing government power, when they decide to do it. They decide to do it when they see it as the “pragmatic” thing to do to forestall Democratic gains… Unfortunately, when a Republican proposes an expansion of government power, he usually gets away with it, because Republican opposition is silenced.

I’m reading Bush’s lips again, and my own! :read:

Actually, it saddens me to see Bush move so quickly to “me-too” with yet another expansion of government power.

This is my summary of political parties today in the United States: Republicans = Democrats + religion = statism. There is no room in that equation for capitalism. No party advocates limited government. In economic matters, they are identical, except that in non-economic matters, Republicans are more bold about injecting religion into government policy.

19

The administration official said that while there would be tax winners and losers under the program, it was revenue neutral and therefore not a tax increase.

Tax “winners” and tax “losers”? Euphemism for “redistribution”.

… but as long as it’s not a net increase, it’s good.

Ah, Republicans… Can always be counted upon to defend capitalism and the American way of life. :read:

20

The more I think about this, the more I want to thank Mimpy for posting it.

I made the case in another thread about the Bush tax cuts that I thought the more fundamental and critical issue with them was not the positive aspect that they were cuts, but the more negative aspect that they were progressive cuts (i.e. they served to shift the tax burden to the rich).

I think this second example shows us very clearly which ideal the conservatives continue to be more consistent with. Tax cuts are out the window, but continued progressivity remains.

That old thread was here.