
Universal health care: will people finally get it? - kickthemout
The only good thing that can come out of this COVID-19 situation is that people will understand the importance of universal health care here in the US.<p>Scenario 1: I get laid off, I lose insurance for me and my family, I have to figure out how to find a new coverage, maybe COBRA, pay for it out of my pocket, and eventually try finding a new job. Ah, in case I get the virus and I’ll need to be hospitalized good luck paying the bill...<p>Scenario 2: I get laid off, I can focus on finding a new job without extra expenses. I get the virus, I go to the hospital and get treated, no bills.<p>This seems a no brainer to me. Am I missing something?<p>Disclaimer: European living in the US
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takk309
I agree with you. This will change the election narrative a lot. Pre-covid,
the major issues were looking to be gun control, taxes, and health care. Now
it will be just health care and recovering the economy.

In my opinion, universal health care will do more to help the economy than any
stimulus package ever could. If people aren't spending so much on healthcare,
they will spend it elsewhere. That being said, we will still pay, just through
taxes instead of direct costs. Hopefully the system will be made more
efficient so that costs decrease from what they are now.

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eyko
I'm not sure how the USA is going to fund universal health (one that's
actually unversal and free like we have here in Europe) care without first
having a discussion on taxes. I can't say I'm qualified to have an opinion on
it but regardless what the budget in the USA is, the cost of public healthcare
all of a sudden could very well be unsustainable without having a federal
level tax policy similar to other countries with public heatlh care.
Furthermore, the USA as a whole does not have a very healthy population, which
means free health care could cause a surge in appointments and treatments. I
think it's something that they will have to do sooner or later but the first
years (or decade?) would be a test to overcome, and cultural changes would
need to kick in before it starts running smoothly.

~~~
erentz
Currently there is a private tax that people and companies pay: the insurance
premium. All Medicare for all proposals have funding plans that include higher
taxes or new taxes that essentially pick up this premium in other areas. At
least some require that this insurance premium is carried over into salaries
ISTR since it’s currently a benefit and should go to your salary.

~~~
luckylion
> Currently there is a private tax that people and companies pay: the
> insurance premium.

We do that in Germany too. On top of (much) higher income taxes, (much) higher
sales tax and plenty of extra taxes on products. Health insurance is "free" as
in "you pay ~7% of your income and your employer matches it".

There's no such thing as a free lunch or free healthcare.

~~~
throw0101a
And what are the deductibles and co-pays? What are the bankruptcy rates and
how many of them are because of medical bills?

Plenty of Americans "have insurance", but if you go (or are taken via an
ambulance) to the 'wrong hospital' you're not covered. Even if you go to the
correct hospital, but are treated by the 'wrong doctor' you also may not be
covered:

* [https://www.usatoday.com/story/opinion/2019/09/23/out-of-net...](https://www.usatoday.com/story/opinion/2019/09/23/out-of-network-doctors-surprise-medical-bill-scam-editorials-debates/2378662001/)

Do a search for "out of network hospital" or "out of network doctor". So yes,
the health coverage in Germany is certainly not "free", but you're actually
covered. Just because you pay your premiums in the US does not necessarily
mean much.

~~~
luckylion
> And what are the deductibles and co-pays? What are the bankruptcy rates and
> how many of them are because of medical bills?

Depends on your insurance, but obviously lower than in the US. I don't know
what US-insurance companies usually cover, public health care in Germany is
so-so, e.g. if you need glasses, they won't pay, so you've have to pay for
those yourself.

The US system certainly has plenty of issues, and I'm not saying that European
systems aren't superior, I'm just saying that we pay _much_ more. This
obviously has a smaller effect in low-income people as their healthcare,
social benefits etc will be subsidized by others, but if you're working in a
high-skill profession, you'll take home _a lot_ less of your paycheck than in
the US.

Unless the high earners in the US are fine with significantly reducing their
net income, I don't think you'll find a lot of support.

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toomuchtodo
I say this as someone who has maxed out his FEC contributions to Senator
Sanders, and have also contributed heavily to a PAC that supports Medicare For
All:

Based on primary returns, the electorate is still selfish and not willing to
support a candidate who supports Medicare For All. The situation must
deteriorate much further before the path to universal healthcare becomes
unavoidable.

Based on exit polls, it’s clear the 65+ cohort is who is holding this up
(although the 30-44 age cohort is culpable to a lesser extent, at least in the
Dem primary).

Disclaimer: I received a few more years with my Mom than I otherwise would
have because of the ACA. Universal healthcare is my hill to die on, most
especially for my kids.

~~~
martythemaniak
Sanderite Medicare for All is a subset of Universal Healthcare. Please stop
pretending they see the same thing.

~~~
Benjmhart
No, push for the most aggressive plan possible. This is the one moment in
history you might just get what you want. If you start in the middle they'll
argue you down to nothing. Hold firm and tell. Don't ask.

~~~
martythemaniak
The Sanderite strategy was to insist that there is only one way to do things,
which was his way, and everybody else must simply fall in line. It didn't work
last time, it didn't work this time.

~~~
toomuchtodo
It works if something happens to enough of the electorate opposing it (about
5k people over 55 die each day, the older you are the more moderate or
conservative you skew [vs progressive] per Pew Research). This ignores death
spikes from black swan events (COVID-19); they bring about change more
rapidly. “Progress occurs one funeral at a time”, apologies to Max Planck.

Just as interracial marriage, womens’ voting rights, the legalization of
abortion, same sex marriage, and the slow sweep of marijuana legalization and
prison reform come eventually, this too will arrive. We’re just arguing the
timeline, which is frankly insane we’re willing to wait so long to save the
lives of so many of our fellow citizens.

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Waterluvian
I think there's a lot of good things that can come out of this. Not just
healthcare concerns.

It feels like covid might be able to push public opinion on many matters
beyond the local minima.

"I've never seen a sky so blue."

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lcall
In tandem with my other comments elsewhere on this page, I suggest a scenario
0: Use Dave Ramsey's advice (or other similar), and among other preparations
have a sufficient savings account (and avoid debt and keep your costs low) so
that if you lose your job or other circumstances require, you can sign up for
medical insurance which you pay for. Hopefully also you have good family
and/or church ties where you help others and they help you, freely, and have
built these up over time. While diligently looking for work (even
flex/temporary), you maintain these ties and they help you if necessary. I
have written extensively at my web site.

Having outside entities manage our lives by force, because of our individual
failure to live a prepared, wise lifestyle, causes us to lose freedoms we won
in the 1770s. But it is not to late to begin now, and encourage others. There
is so much good that we can do, if we are not victims of the advertising
industry but instead think, have a direction, worthwhile goals, and humility
while we patiently try. It is really worthwhile.

Edit: there are also other very good preparations one can make besides
financial, such as basic emergency supplies and long-term food storage (wheat
& beans keep well and can keep one alive), rotation, etc, without necessarily
digging a bomb shelter. These and being without debt yield peacefulness.
Again, more at my web site (no ads):
[https://lukecall.net](https://lukecall.net) send questions freely via the
address at the footer.

edit: ps: if downvoting, an explanation could help.

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austincheney
No. It has nothing to do with politics. It is a labor and economics problem
that I don’t see the pandemic solving for. Few people in the US who can easily
afford health care are willing to advocate for universal health care at their
own expense simply because it’s too expensive. This is a problem with health
care in the US specifically.

Health care in the US is excessively expensive due to intentional market
inefficiencies. There is a lot of research on this. Simply speaking the
industry employs too many people. Consider the number of people employed due
to medical insurance, medical equipment industry, pharmaceutical industry,
medical administration experts, regulation, and so forth. Unless you are
willing to kill a large segment of commercial medicine and put many people out
of work this industry will remain expensive, and so long as it remains this
expensive a universal medical service simply isn’t going to happen.

In the meantime the closest thing to universal medicine in the US is the VA.

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allengeorge
No.

We’ll see the same reaction that people had when witnessing extreme weather
events: focus on the immediate problem, and refuse to engage with larger
issues on the basis that “it’s too political”. For extreme weather events
citizens and authorities showed an aversion to discussing “Is it climate
change?”, and “How should we deal with climate change?”, etc.

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lcall
If states want to try this kind of thing, I am supportive, because they can
learn from each other as laboratories of democracy. But the US federal
government is the wrong organization to attempt it. Having them do it causes a
loss of the freedoms we won in the 1770's: freedom from control by faraway
people running our personal lives (and badly).

I believe we are obligated to help each other (accountable before God), but
not by force, nor by doing it in a way that the elected minority decides,
because we lose freedoms that way (via taking more our incomes from us, taking
and controlling the results of our work). Better to have freedom to do it even
better, privately, or as communities, families, states, etc., when & how we so
choose. States can decide otherwise, but no fed gov involvement. That is why
we have the constitution that we do -- it is important.

~~~
lcall
Why a downvote with no explanation?

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treyfitty
No. Before I get dismissed as a cynic, it’s not hard to see that the rich and
powerful have better resources to protect their interest (by design). Despite
our stark realizations that our utter disregard for a collective mentality
would have provided immense benefits in hindsight, our country is deeply
rooted in individuals. The narrative will quickly change back to the
individual level and individualism will not cede. All this will be nothing
more akin to a moment of silence at a baseball game. Great moments of
togetherness will be forgotten, but those homeruns will exalt players to
heros.

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throwawaypa123
Scenario 3: You keep your job and have a mild case.

Never underestimate people's idealogical beliefs even under strain.

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pezo1919
I think it's time to realize health is a common interest and not the interest
of individuals only.

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throw0101a
> _Am I missing something?_

"Freedom."

Edit: seriously, a lot of objection to this is that it's "socialism" (for some
definition of the word/concept), and we all know that socialism is bad. "Just
look at what happened in the USSR!"

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pizza234
> This seems a no brainer to me. Am I missing something?

Yes; you're making a judgment based on an exceptional situation (considered a
once in a century occurrence).

Note that this a general consideration, independent from the the debate
universal health care or not.

~~~
naasking
> Yes; you're making a judgment based on an exceptional situation (considered
> a once in a century occurrence)

It's not. We've had at least 4 outbreaks in the past 20 years, and it's only
going to get _worse_ because our economies and supply chains are more
interconnected than ever, and people are more mobile than ever.

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reddog
What I get from the testing kit rollout is that the government is massively
incompetent and I shudder at the thought of them getting their hands on
anything to do with my healthcare.

Make the federal government work and then we can talk.

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dleslie
There is far too much money being made in private medical services and
insurance to be able dissuade enough American politicians against the private
insurance model.

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erentz
You’re right in that it is a no brainer and has been for some time: 68,000
people die each year in the US due to lack of healthcare. On top of that it
will save the US about $500 billion per year. So it’s right for both moral and
fiscal reasons.

But from the perspective of your average politician they just want to get re-
elected, and maybe make some extra cash through grift along the way. To do
that they get financed by lobbyists that include business interests which are
against this. Some that are against it for direct reasons (they’re a health
company) some for less direct reasons (they’re a big US business and they like
the control employer based health care gives them over their workers).

So few politicians are pushing it. And they don’t have to because in our
system so long as they other side doesn’t push it either, they can just give a
bunch of weak excuses and it never happens.

Will this pandemic change that? Hard to say. The current Dem front runner has
said quite literally that he would veto it. Even if all the hard work was done
to get it through the house and senate, all he had to do was sign it into law,
he would veto it. So you know where the Dem leadership stand on this, solidly
with their donors and against giving people healthcare.

And so far in terms of response we have seen that instead of direct and simple
solutions they are focused on creating complicated and means tested solutions
that leave out significant chunks of the population including the most
vulnerable. (And overall acting incredible slowly given the seriousness of the
situation.) So I don’t think if it happens it’ll happen easily.

On the other hand, if Trumps opinion ratings go down and he decides he wants
to be remember he may have a crazy brain fart and spurt out an order to give
everyone healthcare in this pandemic. It would still be unlikely to happen
because the Rep leadership would try to complicate it just as they did the
plan to give everyone checks.

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lordnacho
The more extreme this virus gets, the more it is in the interest of the
candidates to annonuce their support for it. I can just see Trump going for it
and spinning a story about how he always wanted that. And what would people
say? Go against it?

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zackmorris
Edit: after I submitted this, I saw that the thread got flagged. Should I
delete this or leave it?

Giving a political answer since the topic is political.

COVID-19 is the first major crisis caused by laissez faire/free
market/libertarian capitalism that the US has experienced. We had ample time
since SARS in 2003 to be working on a vaccine, but right-leaning politicians
have cut federal medical research funding since the 2000s (when I began seeing
the connections between tech and politics). See this National Institutes of
Health funding graph (NIH in green):

[https://www.aaas.org/sites/default/files/2019-06/Disc-1.jpg](https://www.aaas.org/sites/default/files/2019-06/Disc-1.jpg)

Background:

[https://www.americanprogress.org/issues/economy/reports/2014...](https://www.americanprogress.org/issues/economy/reports/2014/03/25/86369/erosion-
of-funding-for-the-national-institutes-of-health-threatens-u-s-leadership-in-
biomedical-research/)

Here is an article from 2010 on using zinc against coronavirus, when I first
realized just how long it's been around:

[https://journals.plos.org/plospathogens/article?id=10.1371/j...](https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176)

So a great deal has been known about the virus for quite some time. But we
didn't commit the federal funding to properly address it, because we didn't
feel it was a priority, because it didn't affect us directly yet. I watched
the same thing as a child when the powers that be actively worked to undermine
AIDS research in the 80s because it didn't strike the members of happily
married nuclear families.

Before we have the conversation about socializing the vulnerable sectors of
our economy, I think we need to get to the heart of why we are so divided
politically.

To me, it began when Ronald Reagan said "The nine most terrifying words in the
English language are: I'm from the Government, and I'm here to help." That
framed subsequent discussions as being between the people and the government,
as two separate entities. But the US was founded on We the People. We're the
government of the People, by the People, for the People.

Personally, I vote to start breaking down that distinction. I want to see our
tax dollars at work again, solving real problems. Not going to pork barrel
programs and unaudited black holes in the military industrial complex, and now
the pharmaceutical industrial complex. We don't need twelve remedies for
diseases of affluence like hair loss. We need hard research done by
universities again, to find cures, with real money available immediately to
free researchers from spending the entirety of their careers groveling for
funds.

The way I see it, the glorification and defense of pure capitalism is
misguided. Capitalism is a process, like evolution. It's the default position
that groups of people and economies fall back to, like barter. It's a very
efficient method for distributing goods and services. But unfettered
capitalism eventually leads to crony capitalism, late-stage capitalism,
monopoly and oligarchy.

An alternative is humanism. In a situation like this one, where we have to
choose between eliminating 2% of our population or losing money in our
economy, I would hope that we choose human lives over capital.

I'm aware of the benefits of a good work ethic, doing a hard day's work etc.
We don't need to debate the basics of capitalism vs socialism, or point
fingers that someone is lazy or getting a free lunch. I'm talking about the
meta-level debate about the purpose of the US government and whether we should
serve the public again or double down on catering to a small handful of
wealthy oligarchs.

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grayed-down
I do believe you're missing quite a lot. As western societies become
increasingly feminized, many in these societies expect to be cared for and
nurtured in much the same way they were by their mothers. Their governments
then take on the role as their Other Mother.

The problem with our Other Mother providing health care is that options and
competencies will become severely limited due to centralized decision making
and lack of incentives for qualified individuals to become physicians, or even
to continue practicing medicine.

I believe the individual should share in some of the financial and logistical
burdens of their own healthcare. Do I think our Other Mother has a role in
providing healthcare? Certainly, but way in the back of the process in support
of extreme and extremely chronic cases like transplants, severe injury
recovery, advanced diabetes and some others.

~~~
xtracto
The tale of "capitalism / free market is good for providing options and
competition" has been debunked time and time again. Look at telcos or nowadays
cable providers. Yeah there are several , but they conspire to setup
geographic micro monopolies. Same with airlines and computing (Microsoft in
the past, Google in the present, apple as well)

That is fine for goods and services that are not essential... but for health?
It is a terrible idea now, as it was for firefighting 200 years ago.

