[Gothos]

Hello, dear malazites, I have had some (little, truth be told) thought on healthcare system problems, and more precisely: just when did people started considering an instant, 100% failproof life saving operation their basic right, as opposed ot being a priviledge.

Over here in Poland, the national healthcare system has always been on the defensive funds-wise. Plenty facilities don't have the funds to always pay their staff on time; there's not enough doctors and specialists, not enough machines, etc. The fallout is, gigantic queues to get anything done. Record wait times for operations reach 5-7 years.

Which brings me to this: the whole healthcare system is rather young, considering the history of mankind. But already people have started assuming that someone is supposed to bail them out of a life threathening situation. While our ancestors died to diseases and injuries that aren't even considered threathening these days, nobody appreciates that we actually even HAVE the option of getting medical treatment. So instead of being happy when we recieve help, we bitch about having to wait for procedures.
Allright, cool, I understand: everyone wants to live, right? But this is not magic. Medicine is one god damn expensive branch, and assuming that everyone can and will get help on time and without fail is a bit naive, as I see it. Even today, most of the world's population doesn't have access to surgery, therapies, or even something as basic as proper sanitation. The Western World, however, has grown so accustomed to being on the top of the world that we don't even appreciate the fact that something might save our life as opposed to dying in a ditch. No: we demand being saved, and rage if such help fails, or doesn't reach us in time.

So, what would you say? Is public healthcare a basic right that can be demanded, or a priviledge given by humanity's advancement in technology? Do you think people should shift their point of view on the matter?

[Silencer]

People are inherently selfish, and lazy. Welfare states play off this, essentially buying votes by offering people free stuff. The healthcare system is no different.

Everyone wants healthcare. Everyone wants it free/cheap/fast. No-one considers that, aside from the fact that it is prolonging our lifespans and contributing to overpopulation, it's not actually something you are truly entitled to. Yes, there are clauses here and there in all sorts of humanitarian documents detailing the right to life and so on and so forth - all well and good, but you can only take what is provided. Something is only worth what people will pay for it, and there are plenty of people willing to pay more than nothing for life-saving procedures.

Now, to put a bit of a communist spin on this, it is probably fair to say that if you are a contributing member of society you should receive healthcare. Whether or not you should receive expensive, life-saving treatment when you're a druggie, or living off the system, or old enough that you would have been 40 years dead not so long ago, is a different question, from my point of view. Then you get into levels of treatment and such, and it all becomes complicated. Far too complicated, if you ask me. And people don't like complicated, so let's make it simple and just give everyone healthcare for free! Of course, that is a far more complicated process than it at first seems, as opposed to simply getting people to pay a fixed sum for each treatment, in which case the only question is: how much is each treatment/procedure worth? A much better solution, though, apologies to anyone who is poor like me, you miss out.

It's unsolvable without years and years of work. And hard work at that. And people will still be unhappy.

[Aptorian]

Exactly what kind of healthcare are we talking about here?

I'm a Dane, pretty much everyone in Scandinavia are used to not having pay anything for our healthcare (except lots of taxes), so it's not even something I think about as an if/or. Everyone gets healthcare and nobody suffers unduly. That's in my opinion the way it should be.

Generally Danish society is built up so that the poor will never have to remain poor or live a life less happy than the more well to be, your medical bills are paid for you, education is free, there's a big net of social security to take care of the mentally ill and the outsiders. That doesn't mean that there aren't anybody who falls between the cracks, but at least efforts are made to make sure that everyone can live a moderately happy life.

When you as a nation and a people experience an abundance of wealth and success, it would be obscene to not share this wealth, it's a part of that whole humanitarian spirit that the West is so fond of. We can afford to give everyone a new heart, physical therapy, free drugs for their chronic disease, etc. So why shouldn't we? How can you sit in your mansion with your good health and enjoy it in good faith, if you know that a large portion of the population is doing worse, people are dying or suffering from something that could be treated for the cost of a fraction of what you earn every month?

Just out of curiosity, if healthcare shouldn't be free, do you also think the West should stop giving out foreign aid to developing countries or relief after a national disaster like Haiti? If you don't want to help your fellow citizen, then fuck the rest of the world right?

[Gothos]

Don't go comparing a "fellow citizen" (which, in it's own right, is a vast, diverse category) to natural disaster victims. You've got a thing for stupid comparisons today, don't you Apt?

If your country can afford it, then sure, be my guest. Many others don't. From my experiences with the system, I'd rather not pay any taxes and not be eligible for the nationalized healthcare system, and use the money to pay for private service in that division, when I need it. I don't trust the government and national administration to effectively put the money the force out of us to good use. I see "free healthcare" as a misconception - it's far from free, it's being paid for by everyone. Nothing the country provides comes free at all, it all comes from taxes, and taxes are money of the people - yours, mine, the neighbours', you name it. Money redistribution, however, is not the subject of this discussion.

[Silencer]

Clearly, Scandinavia has it better than the rest of the world, with no backlogs like we experience. The couple-of-years wait isn't a joke, even down here in New Zealand. We just don't have enough doctors or facilities to cope with the demand. Sure, our education is free (though an option school 'donation' is kinda-sorta expected, particularly in schools in higher socio-economic areas), and I think that basic health insurance is also provided - don't quote me on that - but that the higher levels of care are mostly off your own back (then again, health insurance isn't hugely expensive over here...most people can afford it).

What I'm against is people who can't be fucked to work getting a free ride through life. If you can't? Sick? Disabled? Fine, I'm down with that. Paying for some layabout who doesn't even *try* to get a job is just not on - paying for them to live with Sky TV, or paying for them to get a life-saving surgery...it makes no difference. And yeah, they had less opportunities, or received less education in their formative years (right...because not turning up to school deliberately to hang with your gang mates isn't the cause of that...), that doesn't mean they can't get a job working on our road systems, or as a janitor, or whatever. Be a rubbish collector ffs. It's just a case of not bothering. Deliberately turning up to an interview drunk so you don't get the job on grounds of untrustworthiness or something is a blatant expression of the desire to not have to work for your keep. Fuck supporting that.

And there is actually a case for stopping giving out aid to developing countries. In many cases it actually hurts the country receiving the aid, let alone the issues associated with a lower death rate due to increased medical care not being matched by a lowered birth rate, resulting in over-population and ever-increasing costs in order to keep the country fed. We can't just let them die, of course, but you have to consider that it is a never-ending cycle due to a constantly increasing population that isn't adjusting to newfound support structures.

As for national disasters, that's a different story again. Didn't do anything to cause it to yourself, and you're not responsible for creating a continuous drain on resources - you're just rebuilding, and once that's over you carry on like you were. No qualms there, relieve away.

[Kanubis]

Silencer, on 26 February 2010 - 10:38 AM, said:

What I'm against is people who can't be fucked to work getting a free ride through life. If you can't? Sick? Disabled? Fine, I'm down with that. Paying for some layabout who doesn't even *try* to get a job is just not on - paying for them to live with Sky TV, or paying for them to get a life-saving surgery...it makes no difference. And yeah, they had less opportunities, or received less education in their formative years (right...because not turning up to school deliberately to hang with your gang mates isn't the cause of that...), that doesn't mean they can't get a job working on our road systems, or as a janitor, or whatever. Be a rubbish collector ffs. It's just a case of not bothering. Deliberately turning up to an interview drunk so you don't get the job on grounds of untrustworthiness or something is a blatant expression of the desire to not have to work for your keep. Fuck supporting that.

I totally agree. I'm a bit of a socialist idealist personally, and I think the most utterly vital thing for any kind of socialism to work is a complete crackdown on abuse of the benefit system (I'm aware of how hard this is to implement, and how it gets more impossible the greater the population base.)

But I also think that a vital step in combating this is to get rid of the pathetic social snobbery against lower-wage jobs. To condemn benefit abuse while acting in a derisory manner towards jobs like garbage collection or burger flipping is utterly hypocritical. People who got a less privledged upbringing and education who take whatever job is within their means will garner as much respect from me as anyone. Socialism, to me, should be about making these jobs valid choices to support yourself and have a fair quality of life. In that regard, I think healthcare should be available to these people.

[Tapper]

Here, healthcare isn't free - everyone legally has to be insured for a basic level of healthcare, however. As such, you can choose to pay X per month and get fully taken care of, or Y, in which case you have to pay for certain services, or have to pay the first 250,- euro of a given treatment.

For example, my own insurance covers only hospitalization and 4 treatments of physiotherapy - additional options may include dentists, etc.

Education up until high school has a basic fee, as well as renting books, around 1500,- a year. For the poorest, there are usually compensation funds, but you have to apply for those, and not many parents want that.

I'd gladly pay more taxes for an entirely free education system, healthcare too.

This post has been edited by Tapper: 26 February 2010 - 10:55 AM

[Morgoth]

Gothos, on 26 February 2010 - 10:34 AM, said:

Don't go comparing a "fellow citizen" (which, in it's own right, is a vast, diverse category) to natural disaster victims. You've got a thing for stupid comparisons today, don't you Apt?

If your country can afford it, then sure, be my guest. Many others don't. From my experiences with the system, I'd rather not pay any taxes and not be eligible for the nationalized healthcare system, and use the money to pay for private service in that division, when I need it. I don't trust the government and national administration to effectively put the money the force out of us to good use. I see "free healthcare" as a misconception - it's far from free, it's being paid for by everyone. Nothing the country provides comes free at all, it all comes from taxes, and taxes are money of the people - yours, mine, the neighbours', you name it. Money redistribution, however, is not the subject of this discussion.

Good luck with that when you develop chronic back pains, or end up in a car accident, or experience heart failure, or have a child born with MS and so on and so forth and on and on.

Thinking that anyone apart from the richest of society can afford the enormous costs associated with serious illness is a joke. Paying taxes for health care means that if it happens to you you'll be taken care of. If it doesn't happen to you you've been lucky and should rather be happy you've at least insured that the unlucky ones are able to live a relatively normal life.

Affordable (or even free) health care for all is not only a right in my opinion, it's also absolutely vital for the long time stability of society.

[Aristai]

There's probably little in the way of 'free' healthcare anywhere in the world. It's largely a question of buying private medical coverage of some sort or potentially being heavily subsidized in taxes. Or sometimes both. But to the point of whether basic medical coverage should be a right and not say, a privilege, really boils down to what kind of society you want to live in. And future generations to live in, ect. Issues of underfunding and lack of qualified people to practise will always abound and it's something that needs to be continually invested in and worked on. For any nation to claim 'first-world' status where significant portions of their population cannot afford proper medical care is both startling and rather sad. There has to be some kind of middle ground. Some way of providing adequate medical treatment that isn't only affordable to certain segments of the population. Otherwise the alternative is somewhat bleak in terms of 'bias' and sadly preferential treatment based largely on bank statments.
Yes some people complain rather loudly concerning wait times without maybe looking at a larger perspective in terms of the rest of the world. Thats true for everything else from voting to court dates. What else is new? In some cases the wait time IS too long, though it's a hard nut to crack both in terms of public spending and issues regarding taxation. Too many people fly to other countries to ply their trade and make a great deal more money doing it, then back at home.

An extreme example might be the podcast I was listening to recently on a train ride. A BBC podcast about the high levels of women dying in Pakistan as a result of complications arising from childbirth. Basicly women trying to give birth on their own or with poorly supplied and trained midwives. They refuse to go near a hospital unless it's an absolute emergency, due to the cost. Unfortunatly it's often too late if they do go, to deal with problems that maybe could have been dealt with at a much earlier date. All due to the cost of using a doctor in a hospital, coupled with their own high levels of systemic poverty. And whatever mitigating circumstances such as poverty breeds lack of education, and lack of education breeds poverty...

It's not about overpopulation or how people used to cope with little or next-to-no medical treatment. They died far younger and in much greater qunatities of what we now consider to be preventable illnesses and situations. Check many developing countries for a nice apt comparision. Hence the reason why large families were so prevelent both in terms of education and mortality.

[Mezla PigDog]

I think access to free healthcare is a fundamental right. Particularly as like Morgoth says, it is vital to long term stability and growth of societies. Otherwise the poor would be even more screwed than they are now and I would be ashamed to live in a country that didn't help them. Additionally, those people who are hit by severe or chronic illness after a long and productive career deserve to be cared for without ruining everything they have worked for. What if someone drags themselves up from a deprived background, has kids who do well and become productive members of society and then falls ill? Should they and the next generation of their family be forced to bankrupt themselves to pay for healthcare? Should the kids ruin their career opportunities by becoming carers? Should everyone just let this grafter die because they are no longer useful? Or should the state help them?

That being said, people definitely expect too much from healthcare. Healthcare is a numbers game. Services adopt strategies for fixing the diseases that affect the most people. If you get something unusual or if you don't respond to the common treatments or drugs, it is just dumb luck really.

[Gothos]

I'm not challenging the idea of public healthcare, even though most of the time so far I got something between jack and shit from it ("A twisted ankle? hah, go lie down for a few days. We won't give you anything to help you get around, though, have fun hopping around! Oh and pay for the visit anyway."). As for bankrupting yourself getting someone to look after you, try and add up just how horrendously much money the state takes from you for that very reason throughout your entire life. I don't know about your countries, where it's probably handled better, but I'd be surprised if, should I fall ill after 50 years of working, I would get 20 cents for every euro spent on taxes back.
I'd rather have the option to take care of my healthcare plan myself rather than being forced to commit to a system that's inherently flawed, widely abused and tragically ineffective. The massive loss due to lack of effectiveness robs both the poor and the rich.

Anyway, what I wanted to challange is people's attitude towards health care (from which I am no exception, to be honest). As I see it, we should feel lucky for even having a chance to access it.

On a different note, healthcare seems to be it's own bane, finance-wise. Help people live longer? You'll have to support them along the way too, costing more and more... For one thing, the inscreasing lifespans should translate into significantly upping the retirement age, but that's another subject.

[Mezla PigDog]

Gothos, on 26 February 2010 - 12:47 PM, said:

As for bankrupting yourself getting someone to look after you, try and add up just how horrendously much money the state takes from you for that very reason throughout your entire life. I don't know about your countries, where it's probably handled better, but I'd be surprised if, should I fall ill after 50 years of working, I would get 20 cents for every euro spent on taxes back.
I'd rather have the option to take care of my healthcare plan myself rather than being forced to commit to a system that's inherently flawed, widely abused and tragically ineffective. The massive loss due to lack of effectiveness robs both the poor and the rich.

I'd rather have a steady drip of taxes feeding into a system that could then plan a national healthcare strategy by knowing what it's income was going to be from year to year. That way they can implement early screening measures for certain diseases that are hugely cost effective in the future. I'm also happy for the majority of my healthcare taxes going to pay for healthcare for the underprivilaged. Saying that, individuals should accept the part they have to play in leading a healthy lifestyle, but again, the stems from background and education.

[Cougar]

We've had free at point of use healthcare since 1945ish and entirely in line with what has been said before, I think it's fundamental to the development of a fairer society. It's part of the recognition that in our system there will always be those who are disadvantaged through no fault of their own and won't be able to pay for healthcare.

In a wider sense, I think it's a symptom of a consensus in British politics which has held for the best part of 70 years despite a slow erosion since the 80s, that we are fundamentally a social democracy. To expand it's about creating a base level of existence and opportunity so that people have the chance to make the best of their lives. Not in that crude sense where you say everyone has the chance to better themselves, but in the sophisticated manner where you level the playing field in so far as is possible without responding to entirely totalitarian controls. Sure it a project we haven't managed, but it's the idea that's important. Even the Tories have struggled to deviate from it, even though they would love to fuck the poor and the non-white with a pointy stick.

Healthcare then is fundamental to this, if you are always too sick to work, you'll stay too sick to work.

Yes people sponge and although I don't pay taxes at the moment, I paid out a lot in the last 5 years of work and by god I payed every penny gladly, yes it frustrates me that there are spongers but I'd rather waste money of lazy twats in the hope that someone poor and hardworking gets a fair crack than eliminate it entirely cos it isn't 100% effective.

[Shinrei]

We've argued this before. This video explains best where I come from on the debate.

[Shinrei]

Apparently no one has watched the video. Anyone care to try to argue the points he makes?

We are already borrowing money to pay for the entitlement programs we have now. We will bankrupt the country in 30 years according to anyone who "is good at math", and "We could eliminate government waste and the entire defense budget and the numbers barely change." This alone should indicate that taxing the rich more won't help even the tiniest bit.

We can feel entitled to our "right" to health care all we want. When we're living in a shithole in 30 years (or less), those of us on this forum will be old and have regrets, while our children will be calling us selfish bastards for not thinking of their future.

I liken this to the global warming debate. The deniers of global warming will continue to do so in the face of the facts of climate change.

Keeping our entitlements and adding to them, is basically the same in economic terms as keeping our oil and resource guzzling society AND ADDING TO IT is in environmental terms.

I too would be proud to pay taxes to give people health care, if I felt it could possibly make a difference.

This post has been edited by Shinrei: 27 February 2010 - 03:12 PM

[Darkwatch]

The problem is how the system is handled. The money needs to be used correctly.
The problem is there is a massive bureaucracy behind National Healthcare, and that means it's a sponge absorbing all the money.
Conversely when I was told how much stitches cost in some parts of the U.S. I damn near fell out of my chair.

If I lived in the U.S. I'd be scared too even scratch myself.
My parents do well, but they don't support me any more. If I got a cut requiring stitches right now in the U.S. I'd have to pack up and go home. The idea is ludicrous.

The reason is, I do work, part-time while going to school, that also costs money. I'm not living off the system, but I have zero room to maneuver financially.
If it weren't for national healthcare I'd have to make damn well sure I never got hurt while being educated, in fact I'd have to almost decide between the two. Or I could have had a need for an operation as a child, guess where the college fund goes. Or I could borrow and launch myself into massive debt that I'll pay back when I'm 60 trying to scrounge up a retirement fund.

I'd rather pay taxes and wait a few hours for services than go to bed at night hoping that I don't get hurt tomorrow.
There will always be moochers in a system, but I'd rather have that than a society where you live in constant fear of injury or need because you may as well die considering how much it will cost.

@Shin, no I have not watched the video.
I will when I get home.

[Adjutant Stormy~]

The provision of services by the government inherently identical to the absolving the populace of the corresonding responsibility. The armed forces: national defense. Police: enforcing of law, and further, laws themselves as absolving the population of the need to self-regulate one's actions.

Now, there are some things that people cannot be relied on to do. The national defense, for example, cannot be consistently attended to by the people, as their industry and livelihoods would be far too disrupted.
But the argument could be made in either direction for nearly everything, which just depends on the degree to which you believe the service is beneficial versus your political / social bent.

In the US, you'll find considerably less support for it, just on average, than in Europe. The question at hand is whose shares responsibility is the health of a person? Is it just their own? Does their family owe them some? Their community? The State? How far does the responsibility go?

IMHO I would expect it to go as far as you'd be willing to give aid yourself. So, certainly you're responsible for yourself. Definitely to your family. Potentially to a member of the community. But probably not to any member of your State.

[Shinrei]

Darkwatch, you bring up the REAL problem of health care in the U.S. IMO. COST.

The video says health care costs are (were as of 2008) rising at twice the level of inflation. Step by step reform that would affect the cost of health care is what is most necessary. It's not so much people in the US are screwed because they don't have insurance, it's because everything you could possibly go to the hospital for is prohibitively expensive if you don't have insurance.

[Adjutant Stormy~]

I think some regulation of healthcare cost is definitely in order. But as to the wholesale provision of care in the States, we have neither the staff nor the cash to do so.

Also, one of the reasons that treatment costs so much without insurance is that the insurance companies actually pay less than you do to the care provider. It's a negotiated rate, as a function of the insurance companies providing a guaranteed payment, rather than the poor joe on the street who may not be able to pay for his appendectomy. It's kind of ironic, because the pricetag is considerably above cost in order to balance the budget for the hundreds of patients that can't pay because the price is inflated. That, and for copious amounts of malpractice insurance.

[Urb]

As for people complaining whenever they feel they don't get the treatment they're entitled to, I see it as a good thing. Complaints help put focus on problems that might not get noticed otherwise, and if some people are complaining more than what is called for, I can just tune them out like I do with most people I don't like. And the road to more cost effective anything (including healthcare) is paved with the implementation of new inovation and technology. If I could do just one thing to my own country, I would force 25% of the population to get a degree in engineering of some kind.

Actually, people don't know what they want to do with their lives before they're 20 years old. Everyone should be educated as potential engineers up to this age. It is the only sensible thing to do :