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Healthcare for Profit

UncleRogi

Fleet Captain
Fleet Captain
As I watch the American political class wrestle with affordable healthcare, I notice a peculiar
omission that maybe folk here can help me with:

What is a sound moral argument for rationing healthcare by financial prosperity?

:shrug:
 
Can you dumb that down for me? Thinking is hard.

(I'm not being sarcastic - I want to answer your question, but want to be clear on what you mean, and I'm having health issues).
 
Can you dumb that down for me? Thinking is hard.

(I'm not being sarcastic - I want to answer your question, but want to be clear on what you mean, and I'm having health issues).

As I parse it it, he's trying to understand the "healthcare is a privilege, not a right" argument advanced by many American conservatives and libertarians.
 
As I parse it it, he's trying to understand the "healthcare is a privilege, not a right" argument advanced by many American conservatives and libertarians.

I got that as well.

Or to perhaps to put the question another way.

What if any is the moral argument for a profit healthcare system which can leave those without the means to pay without healthcare( as opposed to the Universal Healthcare system used in other countires*).

* Note even in universal Healthcare systems you can have private for profit healthcare. But that's on top of everyone having it regardless of ability to pay

But there really isn't a sound moral argument for a profit system, sure you may have the means to pay today but can you say with 100% certanity that'll be the case tomorrow? or the day after, or the day after that and so on.
 
Ah, OK, thanks.

As someone who lives in a country with UHC, I am eternally grateful. Let's go through my last 2 years.

My son was on dialysis, until he had a transplant late last year. Him and his wife also had two children, and my other has also had a child, and I love my 3 grandkids like nothing else.

I slipped and broke my leg not quite a year and a half ago. Also since then I've had radiation treatment for 2 months for prostate cancer. Oh yeah, and a operation to replace a cataract in my eye. I have not mentioned the various scans (ultrasound, PET, etc) and subsidised medication. I am also not a member of any private health fund, just the government one, which I pay for out of my taxes, as do all Australians. The current levy is 2% of annual income, so in my case a bit over $1300/annum.

So, aside from the levy, what did it cost me? Some of the specialists are in effect private, so it was $80-$200/visit to them, some of which is refundable, sometimes not. Some (subsidised) meds. Some accommodation (private hotel) outside the hospital during my son's op and recovery. Incidentals like fuel. All up, somewhere slightly less than $10K, for one eye op, one kidney transplant, 3 births, and a broken leg. So... I'm getting my money's worth, because there were years and years when I was paying the levy and nothing went wrong, but I didn't mind, because it was, in effect, helping someone else in a bad place.

UHC is about being a community. It's about lifting us all up, rather than leaving some behind because they "cost too much". Right now, we're trying to get a National Disability Insurance Scheme up and running properly, to look after the disabled and handicapped, because some of them, or their families, are paying thousands a quarterin care.

Is it perfect? No. For some reason, dental coverage is not include, and that's bloody expensive, which means a significant share of the population has dental problems.

When I see anything about the US health system, all I see is cruelty and greed. Medicine for profit is a terrible thing to me. Yes, I have no problem with some profit, but when procedures and meds cost tens of thousands of dollars per person, then that crosses into greed.

Think of the whole EpiPen disgrace at the moment.

The people who are trying to change the legislation... are the very people who will never need it. They are multimillionaires. They have no concept of the harm they are doing. None at all. Or even worse, they don't care. They cannot understand what it's like for a lower income earning family, that something might go wrong for them, and they have to either go bankrupt or sell the family home or be in debt for decades, for one procedure. And I've never understood why the employer has to pay for healthcare, but that's a separate thing I guess, part of a salary package or similar.

To be blunt, American Exceptionalism, Objectivism and Manifest Destiny can be boiled down to, "You are gonna cost me money? Imma throw you under a bus now." Yes, it has led to many good things, but the dark underside is, people die, or hurt for years and years.

As they say in the classics, your mileage may vary. For me, it's simply, if the community is healthy, everyone benefits. America has MASSIVE healthcare problems. Australia has them, but nowhere near the same levels.

Do you think the US is better under its current system? Again, no snark, genuinely curious.

(And apologies if it's not clear - again, thinking is hard).
 
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What is a sound moral argument for rationing healthcare by financial prosperity?

First of all, that's not the only basis for distribution in place. Emergency care is by law provided without regard to financial status (although the patients are expected to eventually pay something for it). Ideally, the pooling in insurance would greatly reduce individual costs but for insuring for a system as expensive as health care even the reduced cost by individual insurance will also be significant.

Were patients to not have any connection to the financial costs involved (aside from taxation) they could overuse services, making the costs of the system even larger, and they may also have less incentive to try to earlier prevent health problems.

Additionally, government-run services can and in some cases have been of high cost and low quality in terms of outcomes and the government already continually is in deficit (adding on so much debt the debt ceiling reccurringly needs to be raised) so Americans are particularly skeptical of incurring more costs especially if quality is risked (although the idea is becoming more popular).

When I see anything about the US health system, all I see is cruelty and greed. Medicine for profit is a terrible thing to me. Yes, I have no problem with some profit, but when procedures and meds cost tens of thousands of dollars per person, then that crosses into greed.

That seems like a misinformed view. The profits of health insurance companies are very small compared to the costs of health care overall, the greed involved in getting the profits and the profits themselves are a very minor influence on the total costs, not what causes the expensiveness of the care (they may reduce it by, in wanting profits at all, having an incentive against excessive use), so the private vs. public sector difference isn't about what the costs are just how they should be paid.
 
Also, some health problems are due to genetics or otherwise random chance but many, including some of the most widespread and harmful, are due to individual choices (obesity, smoking, alcohol, STDs, drugs) so society should provide education against harmful choices (and it does so and also prohibits many drugs) but it seems not morally obligatory if not immoral for all of society to through compulsive taxation try to deal with the effects of the choices that some individuals make.
 
We all pay for various services through taxation and we might make little use of some of those services and some might have moral objections to their taxes being used for a particular service.

So is it ok for someone to object on moral reasons against a tax funded health system?

Is it ok for someone to object on moral reason against their taxes being used for military purposes?

How do we view people who hold those view points? Do we hold them to different standards?

You want change then simply have those that make the rules only have access to the healh care that the poorest in soceity can recieve. What are the odds that the system would soon change?

And do you really know what tomorrow will bring, you could loose your job tomorrow and if you have a healthcare package tied to that job what happens. Will your next job have as generous a package?

What about pre-exisiting medical conditions, your children could be born with a genetic condition wouldn't that be a pre-exisiting condiion? Which might be excluded under a for-profit system.
 
I'll start by saying that healthcare should be considered a right and that single-payer healthcare systems are clearly more efficient and over-all create better outcomes for the populaces under such systems. That being said...

The U.S. for profit healthcare system has produced a lot of innovation. We essentially subsidize healthcare improvements (particularly on the pharmaceutical side) for the rest of the world. Yes, the outcomes over-all for the United States do not meet the standards of other wealthy western countries, but our system probably benefited more people over-all when you take into account those worldwide benefits.

In other words, the moral implications of the U.S. for-profit system are incredibly complicated, and there are legitimate reasons why politicians continue to seek out ways to both maintain for-profit while still recognizing healthcare as a right.
 
I was called away, and I thank you folk for such detailed replies.

I'm mostly appalled that the politicians hide behind morality when cutting Healthcare to
subsidize tax cuts for wealthy folk. It is such a hugely complex issue that one simple solution
predicated on profit simply can't be sustainable from a moral viewpoint. But they try.

The logic pretzelse produced are fun to watch, but meanwhile folk are dying. Its a sad
statement on America's seeming priorities.

And now Puerto Rico. Talk about a Healthcare catastrophe, let alone Houston or Florida.

Again, Thanks, folks.
 
We all pay for various services through taxation and we might make little use of some of those services and some might have moral objections to their taxes being used for a particular service.

That's possible. I consider it preferable that programs and services provide some considerable benefit to all the people.

So is it ok for someone to object on moral reasons against a tax funded health system?

Yes, there's a general right to object to what your taxes fund.

Is it ok for someone to object on moral reason against their taxes being used for military purposes?

Yes it is OK and I hope that more people would. Of course that's being done in their name and by their resources and can be unjust to others and also even harmful to us later with retaliation.

How do we view people who hold those view points? Do we hold them to different standards?

I hold them to the same standard, that they've got a right to object including on all moral grounds. Do you hold them to different standards?

What about pre-exisiting medical conditions, your children could be born with a genetic condition wouldn't that be a pre-exisiting condiion? Which might be excluded under a for-profit system.

It makes sense to provide more regulation and/or guarantees of service provision for children and congenital conditions as those conditions wasn't due to the person's choices.

And do you really know what tomorrow will bring, you could loose your job tomorrow and if you have a healthcare package tied to that job what happens.

If healthcare is tied to the government what happens if it defaults on its debt or shuts down?
 
Also, some health problems are due to genetics or otherwise random chance but many, including some of the most widespread and harmful, are due to individual choices (obesity, smoking, alcohol, STDs, drugs) so society should provide education against harmful choices (and it does so and also prohibits many drugs) but it seems not morally obligatory if not immoral for all of society to through compulsive taxation try to deal with the effects of the choices that some individuals make.

Until it's the general 'you'. All people are going to need major Healthcare at some point. It just seems cheaper in the
long run to have an all-inclusive system from the get go. Should we then legislate a moral health code
that then penalizes those who make harmful choices, precludes their treatment?

Who chooses the moral health code? The church? Politicians? Medical proffesionals? Where
would it end? Should children with birth defects be aborted in the name of fiscal responsibility?

That all sounds really ugly.

Just my opinion

Edit: It seems to me that choosing to be a greedy bastard is a 'harmful choice' for
those who do NOT choose to be greedy bastards.
 
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Should we then legislate a moral health code
that then penalizes those who make harmful choices, precludes their treatment?

I don't think we should ban people from getting treatment or services but if the government were a single payer of health care its decision on what to provide would preclude a lot of people from getting access to what it doesn't provide.
I don't want society to ban either treatments or particular people from getting treatment but I don't think it's obscene that the health market, including insurers, does impose a kind of penalty, higher costs, on people who use the system more and thus generate higher overall costs after they've made harmful choices. That seems a reasonable compromise between society either providing care for the results of the choices without any higher individual cost or prohibiting access to care due to the choices.

Who chooses the moral health code? The church? Politicians? Medical proffesionals?

In practice politicians would decide influenced by many groups and at least many individuals would have less choice. There's already a lot of dispute about should taxpayer funding pay for abortions or abortion providers (I believe it is prohibited for federal tax funds to directly pay for abortions but not indirectly by funding abortion providers) and there would be more controversy if the federal government were the single payer of health care services.
 
It seems to me that choosing to be a greedy bastard is a 'harmful choice' for
those who do NOT choose to be greedy bastards.

Do you consider doctors or health insurers greedy bastards? And/or upper- and middle-class taxpayers?
 
If I read this right, the original question is asking "Why is it okay for insurance companies to make a profit selling health care policies?"

Why would it not be okay? It's not immoral for a company to make a profit. People need cars in today's modern society, but few complain about Ford/Chevy/Dodge making money. Indeed, any company that doesn't make a profit won't stay in business very long. Any medium to large company needs investors to keep going, and no one will invest if they don't make a return on their money.

So, the only alternative to for-profit insurance companies is the so-called single-payer system whereby the government takes over all health care plans. As a retired military member, I fall under one of those, and I can tell you it's not all cracked up to be what most people would want. Another thing, as a Libertarian friend of mine likes to remind me, is once the government controls your health care, they control YOU.

I'll admit that Obama-Care did some good, but it also did a lot of bad and/or stupid things. He wanted to limit the profits that a company is allowed to make (see above why that's bad). He tried to force healthy people to buy into insurance plans to help subsidize high-risk plans for unhealthy people. Okay, that bit makes sense, but as we have seen, some (most!) people don't like being forced to do things.

So a friend of mine had a really great but expensive insurance policy. Due to his weight, it included semi-annual orthopedic check-ups with x-rays. Obama-Care said that wasn't legal to include anymore. He was allowed to keep some of the other preventive items covered, but the price of his policy made it a so-call Cadillac policy, so he had to pay a tax penalty. Riddle me this: why does someone get a penalty for being able to afford better insurance coverage to protect themselves against known medical risks???

On the flip side, he and his wife now have to pay extra to be covered for birth control, pregnancy, STDs, and a whole host of other things. They're over sixty years old! When are they ever going to need any of that? But Obama-Care made those items mandatory. So he's covered against herpes but has to pay out-of-pocket for the more-frequent prostate / colon exams his doctors want him to get.

It's one thing for the government to say "This is what we'll cover with Medicaid/Medicare", but it's a whole different thing for the government to tell private insurance what they can and can't cover. I'm okay with the government saying "you must offer to cover these items", but I can't see why a person must buy coverage for things they have zero risk of.
 
As I tried to say, I have no problem with a company making a profit (making a loss is just stupid). I have a very big problem with them making huge profits at the expense (in all senses of the word) of the people that pay for it, crippling them.

As I was trying to say further up, UHC works better for the wider community. Obama tried, in the face of incredibly stiff opposition to bring something better to the American people (tue whether yoiu agree or not).

The likes of Mitch McConnell have no idea why people require UHC. Let them live on the same level of healthcare as a lower income person and see how long that lasts.
 
The thing about Obama-care, and all other congressional bills / laws, is none of them truly target the rising cost of health care. It's not that insurance is so blinking expensive, but how flipping much hospital / doctor bills have gone up. A few years ago, my wife was a passenger in a car accident. A "minor injury" turned into a $6300 ER bill. No x-rays or anything, just popped her kneecap back into place. The driver's car insurance paid for it all, but still ... six grand for a minor injury? I'd hate to see what a trauma would have cost.

A doctor once told me his prices have gone up so much due to malpractice costs. He was sued by a woman for a quarter-inch scar left after he removed a piece of glass from her check (car accident). She won $75,000 from him, of which her lawyer got $25,000 for probably four hours of paperwork. Malpractice insurance paid, of course, isn't this a tiny bit ridiculous? I don't think we'll ever get health care cost in line until we do something with tort reform.

And how about the cost of medications? Again, I have no problem with pharmacies making a reasonable profit, but come on. Have you seen the price of prescription drugs these days?? Now, I don't know if the problem is too much government regulation or not enough, but something isn't working.

Oh, and as to Obama-care trying to make things better: one of the architects of the plan admitted he designed it to fail. He wanted it to fail so we have "no choice" but to go with a government-run single-payer plan. In his view, private health insurance should be illegal.
 
I don't think we should ban people from getting treatment or services but if the government were a single payer of health care its decision on what to provide would preclude a lot of people from getting access to what it doesn't provide.
I don't want society to ban either treatments or particular people from getting treatment but I don't think it's obscene that the health market, including insurers, does impose a kind of penalty, higher costs, on people who use the system more and thus generate higher overall costs after they've made harmful choices. That seems a reasonable compromise between society either providing care for the results of the choices without any higher individual cost or prohibiting access to care due to the choices.



In practice politicians would decide influenced by many groups and at least many individuals would have less choice. There's already a lot of dispute about should taxpayer funding pay for abortions or abortion providers (I believe it is prohibited for federal tax funds to directly pay for abortions but not indirectly by funding abortion providers) and there would be more controversy if the federal government were the single payer of health care services.

Health insurance isn't like motor or home insurance, I don't think many objeect to people paying higher premiums for those that use them more esp motor insurance. But you might be able to live without a car but you likely wouldn't be able to live without your health.
 
@Sgt_G you and I are kind of on the same page. It's the malpractice stuff and the cost of meds that are a large part of the problem, the lawyers and the Glaxo Smith Kliens that are making money off the suffering of others*. That is what needs to be curbed, and that then gets into a whole lot of other issues, mostly law and the "I can sue" mentality. While the doctors, at least later in the piece, are well enough off, they aren't the ones getting the millions or billions that are sucked from the patients and insurance cos each year, it's worth mentioning that interns and doctors in their early years put in insane hours each week trying to care for everyone. It's the leeches that are killing the system, and the leeches are not the people the Republicans say they are.

*and that money is not being paid back into the system, and that's wrong.
 
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