Is withholding health insurance murder?

[bluethread]

The left is seriously making the argument that if the Republican health insurance proposal is enacted into law, then "people will die". Will those people live forever, if the Republican proposal is not enacted into law? Also, is the Republican plan really withholding health insurance, or just adjusting how it is covered?

[WinePusher]

[Replying to post 26 by WinePusher]

"Next, the authors examine three other outcome measures: an index of overall health, a depression index, and a pain indicator. Focusing on whites (to sidestep differences in the racial composition of the two populations and the problem of racial disparities in health outcomes), they find that the two countries score similarly on the overall health index and pain indicator..."

That's pretty damning, isn't it? The two countries have similar scores, if we ignore the Blacks and Hispanics.

Damning of what? This isn't a racial study, it's a healthcare study. The reason why the researchers narrowed their sample to whites only was to account and control for the fact that America is a far more racially diverse country than Canada. Comparing whites in America to whites in Canada would provide a better picture of healthcare in those respective countries because there are an equivalent number of whites in both countries. Comparing American blacks and hispanics to Canadian blacks and hispanics would not provide an accurate picture of healthcare since America has far more blacks and hispanics than does Canada.

Btw, is that the best you could do? You do realize that all you did was cherry pick a small line out of the study and try to use it to make a case against the superiority of American healthcare. But as we can see, it appears you just didn't understand the statistical and sampling control techniques that the authors were using.

Do you agree that the study, along with the general consensus among healthcare economists, completely destroys McCulloch's fake, made up claims about single payer healthcare? Did you read the part that said:

1) Preventive cancer screenings are more common in the United States than in Canada.
2) Controlling for population, the United States has far more MRI's and Cat Scanners than Canada.
3) The likelihood of detecting and successfully treating cancer is far better in the United States than in Canada.
4) The amount of time it takes for patients to see medical specialists is far less in the United States than in Canada. The amount of time Canadians (and Brits) need to wait for treatment is an abomination and an embarrassment for a first world country.
5) Americans are more likely to be satisfied with their healthcare than Canadians are.
6) The Canadian healthcare system is actually less equitable than the American system.
7) American healthcare is far more accessible and available to citizens than the Canadian system.

[JP Cusick]

[Replying to post 26 by WinePusher]

"Next, the authors examine three other outcome measures: an index of overall health, a depression index, and a pain indicator. Focusing on whites (to sidestep differences in the racial composition of the two populations and the problem of racial disparities in health outcomes), they find that the two countries score similarly on the overall health index and pain indicator..."

That's pretty damning, isn't it? The two countries have similar scores, if we ignore the Blacks and Hispanics.

Damning of what? This isn't a racial study, it's a healthcare study.

He already exposed the source as a racist comparison and that is damnation enough.

It hardly makes sense to copy paste the exact same comment as if the racist interior is now going to be ignored.

And of course that is what makes the Canadian health care inferior (as you say horrible) because many powerful Americans do not want any form of universal health care that covers the African American population.

[WinePusher]

He already exposed the source as a racist comparison and that is damnation enough.

Don't you think it'd be wise to not comment on stuff you know nothing about? You clearly don't understand how social science research is conducted, nor do you understand the basics of sampling and statistics. I know, it must be extremely disheartening to have your opinions destroyed and to be proven wrong over and over and over and over and over again. But the facts are facts. Scientific studies have proven you WRONG. Please accept that.

BTW, the NBER is perhaps the most esteemed social science research body in the world.

And of course that is what makes the Canadian health care inferior (as you say horrible) because many powerful Americans do not want any form of universal health care that covers the African American population.

The reason why Canada's single payer system is inferior to America's market based, private system is because of the following:

1) Preventive cancer screenings are more common in the United States than in Canada.
2) Controlling for population, the United States has far more MRI's and Cat Scanners than Canada.
3) The likelihood of detecting and successfully treating cancer is far better in the United States than in Canada.
4) The amount of time it takes for patients to see medical specialists is far less in the United States than in Canada. The amount of time Canadians (and Brits) need to wait for treatment is an abomination and an embarrassment for a first world country.
5) Americans are more likely to be satisfied with their healthcare than Canadians are.
6) The Canadian healthcare system is actually less equitable than the American system.
7) American healthcare is far more accessible and available to citizens than the Canadian system.

You just aren't able to respond to these facts are you?

[Bust Nak]

Damning of what?

Of the inequality between races in America.

The reason why the researchers narrowed their sample to whites only was to account and control for the fact that America is a far more racially diverse country than Canada. Comparing whites in America to whites in Canada would provide a better picture of healthcare in those respective countries because there are an equivalent number of whites in both countries...

That's good for showing America has better health care for those who can afford it, that is not being disputed by me.

Comparing American blacks and hispanics to Canadian blacks and hispanics would not provide an accurate picture of healthcare since America has far more blacks and hispanics than does Canada.

Or you can compare everyone to everyone regardless of race?

Btw, is that the best you could do? You do realize that all you did was cherry pick a small line out of the study and try to use it to make a case against the superiority of American healthcare.

Record will show otherwise, I have not commented on the merit of the American healthcare compared to socialist healthcare.

But as we can see, it appears you just didn't understand the statistical and sampling control techniques that the authors were using.

Come on, the reason was right there in text, I can read you know: I understood that they did it to "sidestep differences in the racial composition of the two populations and the problem of racial disparities in health outcomes."

Do you agree that the study, along with the general consensus among healthcare economists, completely destroys McCulloch's fake, made up claims about single payer healthcare?

No, I don't. I still prefer single payer healthcare.

Did you read the part that said:

1) Preventive cancer screenings are more common in the United States than in Canada.

Yes.

2) Controlling for population, the United States has far more MRI's and Cat Scanners than Canada.

Yes.

3) The likelihood of detecting and successfully treating cancer is far better in the United States than in Canada.

Yes.

4) The amount of time it takes for patients to see medical specialists is far less in the United States than in Canada. The amount of time Canadians (and Brits) need to wait for treatment is an abomination and an embarrassment for a first world country.

Yes.

5) Americans are more likely to be satisfied with their healthcare than Canadians are.

Yes.

6) The Canadian healthcare system is actually less equitable than the American system.

Are you referring to the part where it says the health-income gradient is more prominent in Canada. Wasn't the opening point of that article that health itself, is not the best indicator for health care?

7) American healthcare is far more accessible and available to citizens than the Canadian system.

No, I don't think it says that, unless you are double dipping on the wait time?

Finally, a question: Do you think that Canada could match US's wait time and equipment level, if it spent as much cash per capita as the US does?

[WinePusher]

Damning of what?

Of the inequality between races in America.

Well yea. America is the most racially diverse country in the world, and we do have problems concerning racial inequality.

That's good for showing America has better health care for those who can afford it, that is not being disputed by me.

Well that's the issue isn't it? If you go to the optometrist and you want state of the art eye glasses, then you better be able to afford it. If you go to the orthodontist and you want braces then you better be able to afford it. You aren't entitled to free stuff.

Comparing American blacks and hispanics to Canadian blacks and hispanics would not provide an accurate picture of healthcare since America has far more blacks and hispanics than does Canada.

Or you can compare everyone to everyone regardless of race?

That would skew the data and provide inaccurate results.

But as we can see, it appears you just didn't understand the statistical and sampling control techniques that the authors were using.

Come on, the reason was right there in text, I can read you know: I understood that they did it to "sidestep differences in the racial composition of the two populations and the problem of racial disparities in health outcomes."

I don't think that comment was directed towards you, was it? But hey, if you want to back up JP and argue that the study is racist then go ahead. It would just demonstrate that you are unaware that isolating ethnic groups from one another is common in demographic social science studies.

The point is that racial disparities in healthcare are NOT directly attributable to the quality of the healthcare system itself. There are MANY extraneous factors that affect and contribute to racial disparities. These factors are UNRELATED to the quality of the healthcare system, which is why it is irrelevant to the study.

The Canadian healthcare system is actually less equitable than the American system.

Are you referring to the part where it says the health-income gradient is more prominent in Canada. Wasn't the opening point of that article that health itself, is not the best indicator for health care?

Correct. And the opening point of the article is that the fact that Canada performs better than the US in regards to infant mortality and life expectancy is not important and is not indicative of the quality of the Canadian and American healthcare systems.

American healthcare is far more accessible and available to citizens than the Canadian system.

No, I don't think it says that, unless you are double dipping on the wait time?

To a certain extent I am. For example, I am able to see a primary care physician (a non specialist) at practically any time at any day of the week. I could probably get an appointment tomorrow if I had an infection, I'd get my prescription the same day and I'd probably have my meds by the end of the day. I have friends on medicare who are able to do the same.

The data indicates that this is seemingly impossible in Canada-Britain. Maybe you've had a different experience? I am open to anecdotal evidence.

Finally, a question: Do you think that Canada could match US's wait time and equipment level, if it spent as much cash per capita as the US does?

Well again, that's the point isn't it? The US spends far more than Canada does and as such gets better results. The fake claim, made by people like McCulloch, is that the US spends more on healthcare and gets worse results but as we can see that claim is not true.

[tam]

[Replying to post 35 by WinePusher]

To a certain extent I am. For example, I am able to see a primary care physician (a non specialist) at practically any time at any day of the week. I could probably get an appointment tomorrow if I had an infection, I'd get my prescription the same day and I'd probably have my meds by the end of the day. I have friends on medicare who are able to do the same.

The data indicates that this is seemingly impossible in Canada-Britain. Maybe you've had a different experience? I am open to anecdotal evidence.

Okay then... here is some anecdotal evidence from Canada.

I have a personal primary care physician (actually I have a pair of them, a husband and wife with their own practice). I am sometimes able to get an appointment the same or next day; depending on how pressing the issue. But even with a pressing matter (such as thinking I have an infection), it could be a couple/few days before I get in to see my personal primary care physician.

To get just a general appointment with nothing urgent, that would most likely (not always) take about a week.

It can sometimes depend upon the secretary taking the appointments and guarding the doctor's schedule, lol.

HOWEVER...

I (and everyone else in this country) am certainly able to see "a" primary care physician on the same day, for any reason, at any number of walk-in clinics. Some, maybe even most of these (which I did not know until I was out of the province and needed to see a doctor) take appointments for that day. This saves a person from waiting a few hours after walking in.

If you cannot (or do not) make an appointment, then you may be waiting a while (2-6 hours, six hours being the extreme end; more than that and you might as well have gone to the ER), depending upon how busy it is. But you WILL be seen THAT day.

In all cases (personal physician or random physician at a clinic) you WILL be given your prescription at once (if one is needed), which you can fill that same day.


Prescriptions are not free (unless you have an insurance plan that covers them; most people do; I do not. I do have a family member who got insurance to cover a monthly injection costing $10 000/month. The insurance is $120/month, and this was a pre-existing condition that the inexpensive medication was no longer controlling). But you get them the same day that you see your doctor.

**

And of course anyone can go to the ER for any reason, but hospitals recommend that we go to family physician or walk in clinic for non-emergency things, to cut down on waiting times at the ER.

I went to the ER three times in one week recently for kidney stones. Even at the ER my wait was only about 4 -5 hours, although I have heard of waits up to 12 hours for some people. But it is an ER, and it operates on triage (and if you need to see a specialist at the hospital you might wait these longer times because there are more general practitioners than specialists available).

I still paid nothing out of pocket to be seen; I did not pay for the tests (including the ultrasound that I was booked for and received the very next day); I did not pay for the injection (pain killer and anti-inflammatory) which I could have gone back and gotten more than once, if needed.



This is in general the experience of Canadians (no matter their race), certainly every Canadian that I know.


**

One quick point from the article:

Your article mentioned that more women in the US between the ages of 40-69 (if I am remembering correctly), have had a mammogram. That is not because Canada does not give women between those ages mammograms. Doctors send women to get mammograms, usually beginning at age 40. Whether a woman goes and sees a doctor or chooses to receive a mammogram is a different matter. But it is not because doctors do not send us to get them, and it is not because they are unavailable.



**


Peace to you!

[Bust Nak]

Well yea. America is the most racially diverse country in the world, and we do have problems concerning racial inequality.

Right, and socialised medicine will be one step forward in resolving that inequality.

Well that's the issue isn't it? If you go to the optometrist and you want state of the art eye glasses, then you better be able to afford it. If you go to the orthodontist and you want braces then you better be able to afford it. You aren't entitled to free stuff.

I am/would be entitled to free stuff though, at least free at the point of delivery, with universal health care. Should I not be entitled to free stuff?

That would skew the data and provide inaccurate results.

That would proved another set of data and accurate results, for demonstrating another point - the huge gap between the haves and have nots.

I don't think that comment was directed towards you, was it? But hey, if you want to back up JP and argue that the study is racist then go ahead. It would just demonstrate that you are unaware that isolating ethnic groups from one another is common in demographic social science studies.

The point is that racial disparities in healthcare are NOT directly attributable to the quality of the healthcare system itself. There are MANY extraneous factors that affect and contribute to racial disparities. These factors are UNRELATED to the quality of the healthcare system, which is why it is irrelevant to the study.

It's not unrelated for those who have difficulties paying for it. It is very related for those in the awkward position of being poor but not poor enough for Medicaid, or those with pre-existing conditions.

Correct. And the opening point of the article is that the fact that Canada performs better than the US in regards to infant mortality and life expectancy is not important and is not indicative of the quality of the Canadian and American healthcare systems.

Great. Something we agree on.

To a certain extent I am. For example, I am able to see a primary care physician (a non specialist) at practically any time at any day of the week. I could probably get an appointment tomorrow if I had an infection, I'd get my prescription the same day and I'd probably have my meds by the end of the day. I have friends on medicare who are able to do the same.

The data indicates that this is seemingly impossible in Canada-Britain. Maybe you've had a different experience? I am open to anecdotal evidence.

People I know who have access to universal health care have had a mix of experiences, bad for child birth, good for cancer care. (Which is strange given that child mortality rate was supposed to be better in Canada/Britain, while cancer survival is supposed to be worse.) Appointment wise, from same day to a week depending on the issue, or they can use a walk-in-centre for seeing a doctor same day, if they are prepared to spend the best part of a day in a queue.

Well again, that's the point isn't it? The US spends far more than Canada does and as such gets better results. The fake claim, made by people like McCulloch, is that the US spends more on healthcare and gets worse results but as we can see that claim is not true.

Better results for whom though? The reason I said I still prefer the Canadian system despite longer wait time and fewer CT scans is that no one risk finical ruined or worse if they get sick, especially when one still have the option for private health care since I am relatively well off.

[bluethread]

Well yea. America is the most racially diverse country in the world, and we do have problems concerning racial inequality.

Right, and socialised medicine will be one step forward in resolving that inequality.

No, it would just redistribute the inequality. As Ben Shapiro has pointed out there are three basic economic principles at play, quantity, quality and price. You can control two of them, but not all three.

Well that's the issue isn't it? If you go to the optometrist and you want state of the art eye glasses, then you better be able to afford it. If you go to the orthodontist and you want braces then you better be able to afford it. You aren't entitled to free stuff.

I am/would be entitled to free stuff though, at least free at the point of delivery, with universal health care. Should I not be entitled to free stuff?

There is no such thing as "free stuff". What you are asking for is stuff at no cost to you. You have no right to that, because you can only have that stuff if it is given to you by the person who owns it. If it is given voluntarily that is charity, which is the right of the owner. If it is involuntary, that is theft, a violation of the right of the owner.

That would skew the data and provide inaccurate results.

That would proved another set of data and accurate results, for demonstrating another point - the huge gap between the haves and have nots.

The gap is not relevant. The standard of living of the society as a whole is what matters and that increases when there is competition and innovation.

It's not unrelated for those who have difficulties paying for it. It is very related for those in the awkward position of being poor but not poor enough for Medicaid, or those with pre-existing conditions.

.

That is the problem of seeing healthcare, let alone health insurance as a right. It is not a fault of the market, but a fault of expectations. Regardless of whether there are no government programs or exclusive government financed healthcare, there will always be a segment of society that will receive less healthcare than another segment of society.

People I know who have access to universal health care have had a mix of experiences, bad for child birth, good for cancer care. (Which is strange given that child mortality rate was supposed to be better in Canada/Britain, while cancer survival is supposed to be worse.) Appointment wise, from same day to a week depending on the issue, or they can use a walk-in-centre for seeing a doctor same day, if they are prepared to spend the best part of a day in a queue.

Sounds like improved access is debatable. Though I think access is actually better under a market based system, I'd be willing to call that a draw for arguments sake. What about quality and cost?

Well again, that's the point isn't it? The US spends far more than Canada does and as such gets better results. The fake claim, made by people like McCulloch, is that the US spends more on healthcare and gets worse results but as we can see that claim is not true.

Better results for whom though? The reason I said I still prefer the Canadian system despite longer wait time and fewer CT scans is that no one risk finical ruined or worse if they get sick, especially when one still have the option for private health care since I am relatively well off.

I think you mean immediate financial ruin due to government approved procedures. People can still be ruined by a death of a thousand cuts based on the effects, personal and economic, of taxation and bureaucracy. Also, if one "needs" more than the government is willing to dole out, one can still face financial ruin. The argument rests on generalizing one's current personal comfort onto an entire economy, while faulting open market medical services based on anecdotal extremes.

[Bust Nak]

No, it would just redistribute the inequality. As Ben Shapiro has pointed out there are three basic economic principles at play, quantity, quality and price. You can control two of them, but not all three.

Sure, control price and quantity, let quality find its own balance. No one is suggesting that you can control all three. We are just arguing over which two to control and what level to set them at: You are going for high quality and mid quantity and let the price settle to its natural position; I am arguing for high quantity and mid price and letting quality balance itself out.

There is no such thing as "free stuff". What you are asking for is stuff at no cost to you. You have no right to that, because you can only have that stuff if it is given to you by the person who owns it. If it is given voluntarily that is charity, which is the right of the owner. If it is involuntary, that is theft, a violation of the right of the owner.

When I buy something, I am parting my money voluntarily, and the selling is parting with their goods voluntarily, according to you, we are being charitable, that does not gel with the typical meaning of the word, but that's an argument over semantics. If you want to call that charity then so be it: Socialised medicine is charity.

The gap is not relevant. The standard of living of the society as a whole is what matters and that increases when there is competition and innovation.

That's nice if you are not at the bottom of the bell curve. The standard of living of the society as a whole can take a back seat to minimum standard of living. All the other points are details. The fundamental disagreement is whether we should help the poor, and if we should, do we do so individually or as a society.

That is the problem of seeing healthcare, let alone health insurance as a right. It is not a fault of the market, but a fault of expectations.

The market and expectation doesn't match, that much is true. Whether it is the fault of the market or the expectation, depends on what you own expectation is. I expect more than you, but why shouldn't I expect more?

Regardless of whether there are no government programs or exclusive government financed healthcare, there will always be a segment of society that will receive less healthcare than another segment of society.

And that's fine as long as no segment of society receive no healthcare.

Sounds like improved access is debatable. Though I think access is actually better under a market based system, I'd be willing to call that a draw for arguments sake. What about quality and cost?

Reasonable quality for reasonable cost. It's no secret that the tax is heavier in countries with universal health care.

I think you mean immediate financial ruin due to government approved procedures. People can still be ruined by a death of a thousand cuts based on the effects, personal and economic, of taxation and bureaucracy. Also, if one "needs" more than the government is willing to dole out, one can still face financial ruin. The argument rests on generalizing one's current personal comfort onto an entire economy, while faulting open market medical services based on anecdotal extremes.

Missing half the point - it's not one's current personal comfort, it is the poorest's current comfort, I am covered by BUPA. The other half re: faulting the open market? Well that's the great thing about socialise medicine, it removes the bottom extremes by providing a safety net.

[bluethread]

Sure, control price and quantity, let quality find its own balance. No one is suggesting that you can control all three. We are just arguing over which two to control and what level to set them at: You are going for high quality and mid quantity and let the price settle to its natural position; I am arguing for high quantity and mid price and letting quality balance itself out.

That turns public policy on it's head. The first government controls on medical care was on quality. The FDA was originally established to control the patent drug industry of the 1800's. According to the ACA everybody must have transplant coverage. That is hardly a low quality procedure. Discussions tend to be fluid, with the mix of factors changing based on the needs of the argument. In arguments about regulation, generally the only factor discussed is the one that elicits the greatest emotional response and references to the other factors are characterized as cold and heartless. As for me, I am not calling for any particular mix. I am a believer in informed consent.

There is no such thing as "free stuff". What you are asking for is stuff at no cost to you. You have no right to that, because you can only have that stuff if it is given to you by the person who owns it. If it is given voluntarily that is charity, which is the right of the owner. If it is involuntary, that is theft, a violation of the right of the owner.

When I buy something, I am parting my money voluntarily, and the selling is parting with their goods voluntarily, according to you, we are being charitable, that does not gel with the typical meaning of the word, but that's an argument over semantics. If you want to call that charity then so be it: Socialised medicine is charity.

How much money is one parting with when they gets "free stuff"? If stuff has no cost to you, how is it that you are parting with your money?

The gap is not relevant. The standard of living of the society as a whole is what matters and that increases when there is competition and innovation.

That's nice if you are not at the bottom of the bell curve. The standard of living of the society as a whole can take a back seat to minimum standard of living. All the other points are details. The fundamental disagreement is whether we should help the poor, and if we should, do we do so individually or as a society.

That is a different issue. If the gap between the rich and the poor is 2 when the poor get 10, while the gap between the rich and poor is 10,000 when the poor get 100, which is more helpful to the poor?

That is the problem of seeing healthcare, let alone health insurance as a right. It is not a fault of the market, but a fault of expectations.

The market and expectation doesn't match, that much is true. Whether it is the fault of the market or the expectation, depends on what you own expectation is. I expect more than you, but why shouldn't I expect more?

You can expect whatever you want. However, when one bases the distribution of goods and services on expectations, there is unresolvable conflict, because there is no standard of exchange. One of the primary functions of a market is the establishment of a standard of exchange. Rights can not be granted in cases of unresolvable conflict. For example, property rights can be granted, because the property can be defined and assigned to an individual. Expectation rights can not be granted because expectations are fluid and vary from person to person.

Regardless of whether there are no government programs or exclusive government financed healthcare, there will always be a segment of society that will receive less healthcare than another segment of society.

And that's fine as long as no segment of society receive no healthcare.

So, as long as everyone gets one bandage, that is fine?

Sounds like improved access is debatable. Though I think access is actually better under a market based system, I'd be willing to call that a draw for arguments sake. What about quality and cost?

Reasonable quality for reasonable cost. It's no secret that the tax is heavier in countries with universal health care.

Reasonable to whom, the payer, the recipient, the bureaucrat?

I think you mean immediate financial ruin due to government approved procedures. People can still be ruined by a death of a thousand cuts based on the effects, personal and economic, of taxation and bureaucracy. Also, if one "needs" more than the government is willing to dole out, one can still face financial ruin. The argument rests on generalizing one's current personal comfort onto an entire economy, while faulting open market medical services based on anecdotal extremes.

Missing half the point - it's not one's current personal comfort, it is the poorest's current comfort, I am covered by BUPA. The other half re: faulting the open market? Well that's the great thing about socialise medicine, it removes the bottom extremes by providing a safety net.

So, in your ideal society, society sets policy based on what makes the poorest comfortable in their poverty? The question becomes how socialized medicine removes the extremes. Baby Charlie is a case in point. The extremes still exist, the government just decides who lives and who dies and imposes that decision on the citizenry. In a market economy, that decision is based on the value to the citizenry as indicated through voluntary actions.