Today's Economy & Trek's Future Economy

[Sci]

This freedom of choice for healthcare carriers is baloney. The rich want to keep the money the government is giving them that is supposed to trickle down to us in the form of jobs and let the rest of us just die.

One day the nice people of the world will rise up and let their voices be known. Only then will Star Trek's Federation be achieved.

Quoted for truth.

 

[indolover]

If the Trek economy is socialist, well who cares? Economics is always value-laden, which is no surprise since it's to a large degree an offshoot of politics (as politics is philosophy it is always is subjective).

I have to say though that the Trek economy makes no sense. There is no stated medium of exchange, but there is still scarcity despite the use of replicators (something has to be used to power them and this supply cannot be limitless).

 

[Paradon]

People like your mother could have been treated with simple preventive treatment before the problems become serious and life threatening. Some simple non-invasive procedures which could fix the problem with not much cost are prohibited by the insurance companies because it cuts into their profits. These safe and effective non-invasive procedures have been around for 100's of years.

While it's certainly true that insurance companies are pulling bullshit like that, I want to make something else eminently clear, here:

There was no money for a doctor's visit. None. Period. Zip. Nada. Nothing. She and I were making just enough to barely survive and nothing more. Even a "cheap" doctor's visit would have been too much.

And that's how it is for many, many Americans.

There seems to be this notion that if we just reduce costs enough, the capitalist medical system model will be okay. And that's just not true. There are too many people who simply can't afford it, even if it's "cheap."

In the days before Medicare and Medicaid, the poor and elderly were admitted to hospitals at the same rate they are now, and received good care. Before those programs came into existence, every physician understood that he or she had a responsibility towards the less fortunate and free medical care was the norm. Hardly anyone is aware of this today, since it doesn’t fit into the typical, by the script story of government rescuing us from a predatory private sector.

 

[Sci]

People like your mother could have been treated with simple preventive treatment before the problems become serious and life threatening. Some simple non-invasive procedures which could fix the problem with not much cost are prohibited by the insurance companies because it cuts into their profits. These safe and effective non-invasive procedures have been around for 100's of years.

While it's certainly true that insurance companies are pulling bullshit like that, I want to make something else eminently clear, here:

There was no money for a doctor's visit. None. Period. Zip. Nada. Nothing. She and I were making just enough to barely survive and nothing more. Even a "cheap" doctor's visit would have been too much.

And that's how it is for many, many Americans.

There seems to be this notion that if we just reduce costs enough, the capitalist medical system model will be okay. And that's just not true. There are too many people who simply can't afford it, even if it's "cheap."

In the days before Medicare and Medicaid, the poor and elderly were admitted to hospitals at the same rate they are now, and received good care. Before those programs came into existence, every physician understood that he or she had a responsibility towards the less fortunate and free medical care was the norm. Hardly anyone is aware of this today, since it doesn’t fit into the typical, by the script story of government rescuing us from a predatory private sector.

Absolute bullshit.

From a doctor who practiced in the years before Medicare and Medicaid:

Most people have never known our country before Medicare and Medicaid, which was enacted 46 years ago. Those of us who were practicing medicine before 1965 knew it well.


About half of older people did not have health insurance. Only unionized or government employees whose employment contracts provided for retirement health insurance were so lucky. But there weren't many such people in small-town Kansas.


Then, just as today, many seniors were living at or below the poverty line...

...If you were among those without insurance, you either delayed care for as long as you could or you asked for charity — never a pleasant task for elderly people who always have taken pride in paying their bills.


Many died from delaying care. For those who finally sought care and were treatable, getting hospital care went something like this:


"Sister Kathleen, I have a woman with large uterine fibroids who is almost bleeding to death each month. Neither she nor anyone in the family has any money. Can you help her?"


Sometimes the sister would suggest we admit the woman next month when the census would be down. Or she would say to admit her Sunday for Monday surgery.


I also could call Carl Lamley, the former administrator at Stormont-Vail Hospital in Topeka, and get the same result.
Both knew that I was not charging these patients a penny. Nor were other doctors in our fine medical community. They took special pride in providing care for anyone who needed it, in contrast to physicians today who will not accept Medicare patients.


Some tax money was involved in the Shawnee County system. The commissioners appropriated limited funds based on an estimated number of poor in the county. Hospitals and pharmacies got the first cut, and any amount left over was for the doctors on a care-point basis. The amounts were so small that we rarely turned in points for payment.


Before Medicaid paid for medical and nursing-home care for the poor, there was a poor farm north of Topeka and there were a very few nursing homes. But most old folks ended up being cared for in the homes of their children, or were out of luck.


There were a few commercial homes. There may have been some affordable good ones, but the ones that stick in my memory were just plain horrible.

In other words, yeah, some doctors tried and did what they could, but the fact of the matter is that charity just doesn't work at the end of the day because there's never enough money. When it comes down to it, you need to have a governmental program to pay for these things, because the government is the only institution capable of marshaling resources on the scale necessary.

 

[Paradon]

Doctors are willing to help those who are in need of medical cares because they're business to help people. It's like you running your own business... YOu can make exceptions and give some of your candies to kids, if you want to... They have moral and ethical obligations to help those that needed help. Plus doctors make plenty of money so they can afford it in situations where someone who can't even afford cheap medical treatment and cheap private insurance. I'm surprise that people are willing to trust the government but not doctors. In other words...they don't trust doctors, who are in business to help people, but completely have fate in some beaurocrats. How many politicians have promise us to make things right but fail to deliver on their promise? I lost count.

Here is a link I found for you: http://www.ronpaul.com/books/the-revolution-a-manifesto/ I definitely recommend it to anyone.

 

[Sci]

Doctors are willing to help those who are in need of medical cares because they're business to help people.

I'm sure some are. But as with any business, if you start providing your free service too often to too many people, you'll run out of money and not be able to afford to keep doing it. That's the basic problem: Too many people in need of free medical care, not enough income from other patients to compensate.

ETA:

It's a lovely fantasy that anyone who needs free medical care can find a doctor willing to provide it. And, yes, sometimes people do get lucky. But in the real world, nice anecdotes don't provide a solution to the actual problem. And in the real world, no, in the overwhelming majority of cases, you can't find free care. You just get fucked.

 

[Paradon]

Sure they can... They just need to screen everyone carefully to prevent someone from taking advantage of doctors. This isn't fantasy. that's the way things were before Medicare and all this government run medical programs. That was before the government screwed everybody over like the way they usually do. I think back then they don't even tax the health care professionals to keep the cost as low as possible in case if some that can't work because of physical or mental disabilities. And I don't think it's morally and ethically to tax people who treat people who get hurt, sick and the disabled...just like we should tax people on food. Besides, there most people aren't disable...there are only a few exceptions. And with spending and tax as low as it can be, there would a lot of money for everyone.

Besides that... I don't think everybody needs a free health care. Some people are able to work and pay for their own medical bills, why should I have to pay for their doctor's bills, when they really make as much as I am or even more. If you really want to, I think the money should only go to people who really need it...like the disabled, who can't work or are limited to only certain jobs. I mean...common...you can't pay $30, $40, $50 to see a doctor? If you can work and healthy, then you should pay for it out of your own pockets.

 

[Sci]

Sure they can... They just need to screen everyone carefully to prevent someone from taking advantage of doctors. This isn't fantasy. that's the way things were before Medicare and all this government run medical programs.

Again, bullshit. Those programs were created because people couldn't afford medical care in the first place.

Only in libertarian fantasyland was everything honkey-doory before Medicare and Medicaid. And meanwhile, even today, those programs are still not enough!

I mean...common...you can't pay $30, $40, $50 to see a doctor?

Yes. It happens. I've been there. With my mother? There was no money. I don't mean in the sense of, "Oh, well, I COULD, but then I couldn't afford such-and-such." I mean, literally, there was nothing left. Period.

You just don't live in the real world if you can't imagine not being able to afford to see a doctor and pay for a prescription. Just like you don't live in the real world if you think the free market could take care of everyone.

 

[Paradon]

I'm saying people that can work should pay for their own doctor's visit. I wasn't talking about your mother and you.

I know a lot of people are afraid, but I don't think the world owes you something just because you think they do. People have to work hard and keep at it to achieve their goal and make this world a better place for themselves and children. Things don't magically work out the way you want just because you want them to...you have try to make it better by working hard and contribute to the economy and society.

Again, I'm sorry for what happened to your mother and you. For cases like this, I think you deserve a free medical services. But for people who aren't disabled...I'm not going to pay out of my paychecks for them. Some of these people probably make a lot more than I do; why should I pay for their cost of treatments.

 

[Nightdiamond]

In the US, if a child needs braces, the parents immediately start worrying about the cost. It happens a lot.

Simple braces, in the US, can break a family's finances.

I don't know how it is in countries with UHC, but if they don't have these types of worries, then it is another argument in its favor.

If the Trek economy is socialist, well who cares? Economics is always value-laden, which is no surprise since it's to a large degree an offshoot of politics (as politics is philosophy it is always is subjective).

I used to think that any culture with replicator tech should be enjoying the same benefits as the Federation. It was completely ridiculous for them not to.

Yet some non Fed cultures chose to maintain unstable economies with poor people, poverty, and crime. They have the same tech that the Federation does. They just don't want to.

After looking over the UHC debate, I think I may have a explanation; Ideology.

Ok so supposedly, UHC makes healthcare, cheaper, less complicated and available to most if not all.

Yet the US, who could implement it, has refused to do it and prefers to deal with huge health costs, and the problems that go with it.

I see a comparison right there.

There are anti - UHC advocates that prefer our current healthcare system.

 

[Sci]

I'm saying people that can work should pay for their own doctor's visit.

Which is, again, a lovely fantasy, but it's just that: A fantasy.

Read just a little bit about the lives of the working poor in America (a good start would be the book Nickel and Dimed: On (Not) Getting By In America by Barbara Ehrenreich) and then tell me with a straight face that "anyone who can work" should pay for their medical care.

Here's a hint: Millions of people can and do work very, very hard, but simply do not make enough money to afford medical care. Period.

I wasn't talking about your mother and you.

Yes, you were. You just didn't realize it, because you have no idea what you're talking about.

I know a lot of people are afraid, but I don't think the world owes you something just because you think they do.

Gosh, I should have told my mother that when she was lying in the hospital, recuperating from emergency surgery after almost dying. "Jeeze, Mom! Don't you know that it's your own fault you couldn't afford medical care? No one owes you anything!"

People have to work hard and keep at it to achieve their goal and make this world a better place for themselves and children. Things don't magically work out the way you want just because you want them to...you have try to make it better by working hard and contribute to the economy and society.

Well, fucking duh. No one's arguing that. We're saying that even if you work hard, the free market often cannot be relied upon to provide you with the services you need.

Again, I'm sorry for what happened to your mother and you. For cases like this, I think you deserve a free medical services. But for people who aren't disabled...

My mother was not disabled. She worked -- and still works -- very hard. She couldn't afford medical care, and it nearly killed her. There is no way around this.

I'm not going to pay out of my paychecks for them. Some of these people probably make a lot more than I do;

Utter bullshit.

why should I pay for their cost of treatments.

Well, for one, because unless you have a magic body that never requires medical treatment or you're literally prepared to say that no one who is unable to pay out of pocket should ever receive any medical care whatsoever, you're paying for them anyway. My mother is a prime example: She certainly couldn't afford to pay for the emergency surgery she had, so guess what? The costs of that surgery were spread out to other patients, driving the cost of other forms of medical care up. If we had single-payer health care in this country, the costs would be lower.

ETA:

I used to think that any culture with replicator tech should be enjoying the same benefits as the Federation. It was completely ridiculous for them not to.

Yet some non Fed cultures chose to maintain unstable economies with poor people, poverty, and crime. They have the same tech that the Federation does. They just don't want to.

After looking over the UHC debate, I think I may have a explanation; Ideology.

Ok so supposedly, UHC makes healthcare, cheaper, less complicated and available to most if not all.

Yet the US, who could implement it, has refused to do it and prefers to deal with huge health costs, and the problems that go with it.

I see a comparison right there.

There are anti - UHC advocates that prefer our current healthcare system.

Too, too true. Never underestimate the appeal of an oppressive socioeconomic system to people who enjoy the benefits of oppressing others.

 

[Paradon]

It's not a fantasy. It's been done before...before medicare and all these government programs. Please, do some research?

And that's kindda fucked up that you called me a heartless asshole...because I was a lot sicker than you mother. I can relate to what your mother went through. I suffered alone and nobody seemed understand what I was going through.

 

[T'Girl]

US health care may be "superior" for the uber-rich, which, surprise!, include many politicians. And it's utter crap for everybody else.

"Crap for everybody else." No.

Better medical care for the rich, yes.
Better medical care for the upper middle class , yes.
Better medical care for the middle middle class, yes.
Better medical care for the lower middle class, yes.

iguana tonante, this is the bulk of the American population.

Once everyone is covered, the government would have the clout to bring discipline into the wild west of health care spending.

End Edit.

The problem with this statement is that if it were true, then the government would be applying this philosophy to the enclosed environment of the medicare/medicaid system. And they're not. If it won't work in a small enclosed system, then it's unlikely that it would work on a larger one.

Sci, I'm sorry for your mother's experience, I do think there needs to be a form of coverage for the truly indigent. But legally compelling large numbers of Americans to abandon the health care of their own choosing, to accomplish this coverage is the wrong way to accomplish the goal.

And I find the part of the plan that would require young people to buy health insurance, knowing ahead if time that they largely won't use it, in order to be able to transfer their payments to others to be disingenuous.

Number of years vary, but every study agrees that the current single payer plan, medicare/medicaid, is heading for insolvency, place 312 million people on a single payer plan and how soon before that goes belly up? Or do we endlessly raise the amount the citizenry pays in every year, or just increase the amount coming from the rich every year, or the amount borrowed every year to keep the system afloat?

The costs of that surgery were spread out to other patients, driving the cost of other forms of medical care up. If we had single-payer health care in this country, the costs would be lower.

But the concept is the same, instead of the costs of that surgery being spread out to other patients, it would be spread over a larger group, but it still being transferred to other people. And what make you think the costs would be lower? If it streamlining the paperwork, let's do that without the single payer. Transferring from private insurance bureaucracy to government bureaucracy? Because the federal government is so efficient?

(Medicare and Medicaid) And meanwhile, even today, those programs are still not enough!

But aren't you advocating basically a larger version of just those programs?

 

[Nightdiamond]

I agree with Paradon, in a sense -- when a doctor opens an office, it is a business he or she is opening. They do want to make money, like anyone else.

The problem may be that the average, hardworking person initially tries to work with the system, in the beginning.

Meaning when they do have need to see a doctor, they look into various medicines, doctors, but sometimes the results are, 'this is how much it is going to cost, and it's a lot'.

So they either pay or don't pay or mortgage something.

It's when they see something like UHC in other places that makes them resentful.

I think the US is an economic superpower, but mostly patterned after the Ferengi, more than the Federation.

Otherwise, UHC would be the rule. not the exception by now. A Federation citizen would definitely say, "Yes (free) healthcare is a right every citizen should have".

If you asked the Ferengi, what would they say? "No! Healthcare is a privilege to those who can pay for it!"

And if you asked about those who can't afford it, they might say, "well, there's some charities or something lying around for those who can't afford it, is this questioning over yet?!!"

 

[Paradon]

I love European people and their cultures...I love European food a lot...in fact I think they are some of the most generous people I've met, but I don't like socialism. [chuckle] I guess we just have to agree to disagree.

 

[CommanderRaytas]

This freedom of choice for healthcare carriers is baloney. The rich want to keep the money the government is giving them that is supposed to trickle down to us in the form of jobs and let the rest of us just die.

One day the nice people of the world will rise up and let their voices be known. Only then will Star Trek's Federation be achieved.

Quoted for truth.

I agree with this.

You know, it's scary when people point at you and call you a communist or socialist because you're a humanitarian....and to many people, "socialist" is not an insult.

Socialism? Huh? Really? Because many of us believe that people should look out for each other and that solidarity is the only way we will ever have a Trek-like utopia? Do you actually think that in the Federation, everyone looks out for themselves and screw those who don't have money? No, everyone works for themselves and the greater good, because see, if we all give a little, we get much more in return.

This kind of "gah you're socialists" mentality reminds me of the Cold War. No offense.

 

[Sean Aaron]

But legally compelling large numbers of Americans to abandon the health care of their own choosing, to accomplish this coverage is the wrong way to accomplish the goal.

And I find the part of the plan that would require young people to buy health insurance, knowing ahead if time that they largely won't use it, in order to be able to transfer their payments to others to be disingenuous.

A "choice" between a few insurance companies with the same set of restrictions and the same profit-over-patient welfare policies isn't much of a choice.

And unless those young people die young they will be using it eventually.

 

[CommanderRaytas]

It pays off the moment you get sick or have an accident, and you don't have to go into horrible debt to stay alive.

 

[Sean Aaron]

Or if you have kids. The antenatal and postnatal care under the NHS was brilliant when my daughter was born and included home visits. We opted for a private recovery room when my wife and daughter were kept for three nights. I was out of pocket less than £100 for that. Innoculations were no charge and there were periodic visits by home care workers to see how we were getting on.

 

[CommanderRaytas]

My mum had eye surgery a few years back and payed nothing at all. If she hadn't got it, she'd basically be blind now.

My sister had knee surgery four years back, and my dad just had surgery for umbilical hernia (which can get really nasty if not treated). They payed nothing, also.

I'm very happy with our system.