I found this exchange interesting...
This is from my UHC petition blog
I'm reposting it here because the blog was bumped from the site..
I've been getting around to that in my own blogs which have not stirred much interest.
I have no reason to commit to one method of reform, so far, so I'm keeping an open mind and trying to sift through the chaff coming from all sides for the wheat which might be there so as to have a sound opinion.
Single-payer runs up against the distinction of Uniformity vs. Diversity, in addition to Big Government concerns. It offers reduced overhead but the actual savings are not clear (could be as little as under 10% or as much as over 25%) of current overall costs. Medicare is hardly perfect, and studies have shown that over 90% of insured Americans are reasonably happy with what they have.
I think I understand Obama about "single-payer is nice but 'you caint git thar from here'.
I think single-payer is not reform but revolution, in the USA. As such only violence (virtual, economic, or otherwise) is likely to get it implemented. It might warrant a Constitutional Amendement, depending on which flavor of single-payer is under consideration.
2% employee + 7% payroll tax is 9%. What controls costs to keep those from rising? What rations health care which is current rationed by price of premiums, deductibles, and denials of service? Is is National, Federal, State, or what? Citizens only, or anyone at all?
I'm not sure the problem of moral hazard is that significant, but of course checks and balances are necessary to deal with criminal cheating or frauds. And profit motives are stifled by excess uniformity (while of course excess diversity generates waste and is no guarantee of quality either).
I think single-payer is really socialized medicine with a facade of "it's only social insurance".
Things like that.
Thanks for asking.
Posted by eds
"I think single-payer is really socialized medicine with a facade of "it's only social insurance".
nonsense, single payer is the government collecting the insurance money and paying the doctors without taking a profit for doing so.
It's non-profit insurance.
eds, said something which got my attention up the comment que. It got me thinking about why I support single payer and nothing else.
The gist of the situation for me is that we are a community, a society if you will, and as such we have a responsibility for the well being of everyone and thus the preservation of the community itself. Each of us should contribute what we are able to a pool that pays for the care of all, in the same way our taxes pay for our defense. The current "private" system leaves health care to those who can afford it only. This allows those who can to only take responsibility for themselves. The power of the collective will is felt through democracy itself. The exercise of democracy is being denied through the force of financial power. The health and well being of the community as represented by our taxes is suffering as a result. No private health system or private army can ever represent the will of the community because it has no responsibility to do so.
Posted by Zeno_of_CitiumDo you consider yourself a communist? Your paragraph makes it seem so.
I do agree that "the force of financial power" speaks loudly in DC (and in state capitols), but I have to wonder why consumers (and employers who offer a finite selection of plans) don't speak loudly with their pocketbooks.
It's been suggested that there are cartels operating behind the facade of 1000s of "insurance" companies. Got anything on those?
I've probably spent under $1000 on health care in the past 25years, not counting a car accident for which I negotiated a decent settlement from the insurance company on my own. So I am not in touch with the realities of health care costs except via horror stories and the like. While I have libertarian tendencies, I also have socialist tendencies and consider myself a progressive (and except for fiscal stuff usually a liberal).
I don't believe in the Collective except as 1) a statistical ensemble of individuals and 2) a [usually] muddled notion in people's psyches which can range from a delusion to a basis for lemming-like behavior.
A communists expects to take all property for the use of the community. I do not. I see my views a close to Socialism. I believe that as a community, or society if you will, we all have a shared responsibility to look after the health of everyone in the community. I believe there are certain services that are essential to a functioning community such as access to fresh water, food and energy production which should be treated like communal property and regulated to the benefit of the community. The idea of communal space is not Communist in the ridged sense you describe. Communism in the idealistic form you describe is complete abdication of private property and enterprise. Please, explain to me why it has to be an either or dichotomy. Democracy is shared power and shared responsibility. Democracy is a form of socialism. Capitalism as it is practiced in the US is anti-democratic and leads to autocratic rule.
Posted by Zeno_of_Citium"I don't believe in the Collective except as 1) a statistical ensemble of individuals and 2) a [usually] muddled notion in people's psyches which can range from a delusion to a basis for lemming-like behavior."
It is not necessary to believe in the power of collective will or responsibility. All idealism operates inside a conversation between people. Community in that it exist at all exists in the shared language and concerns of the people. The separateness of the elite is at the root of the disillusion of the community and the root of the current conflict. Democracy has failed because the power of the community's will has been usurped by the power of money and high status. That is the result of unfettered Capitalism.
It depends on the flavor of single-payer. If the government collects taxes and/or pays for services based on need not premium levels, it's not just insurance. Also, the government will of course have huge leverage over all "necessary" medical care and thus be able to dictate to doctors and hospitals, creating a de facto socialized aspect to the system - it will be "free market" at most in name only. This is part of the problem of Big Government and Uniformity, I touched on.
BTW, it might be confusing the other readers the way the blog is presented.
"not Communist in the ridged sense you describe"
rigid? Even so, I don't see how you inferred any particular sense to my brief remark. Are you feeling rigid/ridged?
"Please, explain to me why it has to be an either or dichotomy. "
I have no idea what "it" you mean, since I didn't even begin to imply either-or, in fact I pointed out that I have libertarian and socialist inclinations. ??
"Democracy is a form of socialism."
Oh? Not necessarily in my world.
"Capitalism as it is practiced in the US is anti-democratic and leads to autocratic rule."
That seems to be quite a digression, but clearly arguable.
"we all have a shared responsibility to look after the health of everyone in the community"
Perhaps we disagree as to how much responsibility we have for others. That is, some put a slight emphasis on individual self-responsibility, others put the emphasis on other-responsibility. Zealots make caricatures of an apparent "either-or" nature, which by intent or otherwise tend to drive wedges between us. One might put it this way: Even if I am my brother's keeper, am I to keep an eye on him or by contrast, in effect jail him according to my personal moral opinions?
Thanks for honoring my comments from the other thread by including them here for further discussion.
June 20, 2009 3:34 AM | Reply | Permalink
No you inferred. I did no such thing. You described me as communist, when what I described was clearly not communist.
You are right, you and I clearly disagree on who deserves what in this country, the capitalist or the producer. Clearly the capitalist is taking as much as he can and less is being produced as a result. When you say you don't have responsibility for the well being and health of others that is automatically dividing out yourself.
"Even if I am my brother's keeper, am I to keep an eye on him or by contrast, in effect jail him according to my personal moral opinions?"
jail is not a concern when providing health care, but morality on the other hand is. The statement "am I my brothers keeper" as I understand it does not pertain to watching my brothers actions but to my brother's needs. The community is perfectly able to deal out justice through the collective application of the law as administered through elected government.
June 20, 2009 4:28 AM | Reply | Permalink
"jail is not a concern when providing health care"
But I wrote "in effect jail him". This isn't about putting people in prison but about constraining their behavior via effective moral dictates in law or practice (legislating morality, criminalizing choice, things like that).
"No you inferred. I did no such thing. You described me as communist, when what I described was clearly not communist."
Well... I *asked* because what you had said before did have elements of communistic thought. I didn't actually make a description at that point. But if you put the community before the individual, that sure sounds like a form of communism, esp. if you bring up collective interests.
"You are right, you and I clearly disagree on who deserves what in this country, the capitalist or the producer. Clearly the capitalist is taking as much as he can and less is being produced as a result. When you say you don't have responsibility for the well being and health of others that is automatically dividing out yourself."
fyi -- I find your style harsh and antagonistic. I don't know how you can conclude that "clear" disagreement from what I've written. Have I promoted the excesses of capitalism or poo-poohed the need for doctors to be paid (as producers of health care)??
Now you want to compare capitalist to producer?? That only muddles the producer/consumer picture, and in fact capital is *part* of production. And skimming the cream doesn't mean that less is produced, it means that less is consumed by others. Why do you think it is that people put up with paying too much so much of the time?
When did I say I have no responsibility at all like that?? Please review what I *did* write:
Are you *trying* to drive a wedge between us here?
June 20, 2009 4:58 AM | Reply | Permalink
I would add that even though we disagree, i have enjoyed the exchange... Many thanks.
June 20, 2009 4:32 AM | Reply | Permalink
"not Communist in the ridged sense you describe"
"rigid? Even so, I don't see how you inferred any particular sense to my brief remark. Are you feeling rigid/ridged?"
I meant rigid...
June 20, 2009 4:36 AM | Reply | Permalink
"That only muddles the producer/consumer picture, and in fact capital is *part* of production. "
I disagree. capital is wealth and thus status. the transfer of capital is the transfer of status which also provides the means to control assets. It's separate from the asset or service it is used to obtain.
June 20, 2009 5:29 AM | Reply | Permalink
otherwise barter systems couldn't exist.
June 20, 2009 5:31 AM | Reply | Permalink
Capital goods are different from money and debt, but production is commonly considered as bringing capital and labor together, so how can you disagree that capital is part of production.
Status is something else, social or political. The amount of capital one has or controls, this might qualify as an economic status indicator, but if I lend you money, I'm not lending you my status, I'm giving you cash in exchange for debt (the IOU or stock certificate etc).
I don't get while you're quibbling. Anything else to the rest of the comment?
btw -- Barter doesn't rely on money or debt for purchases, it is a direct trade situation (goods or services) that's the only significant thing. But a barter *system* relies on credit and the equivalent of capital in order to be systematic. If it keeps books, that's just money without tangible currency, for instance.
June 20, 2009 7:01 PM | Reply | Permalink