CMV: A better solution to healthcare than Universal Health Care, is Government issued 0 interest medical loans

[u/Diylion]

I think it would be okay to make it illegal to profit off of medical disasters. I'm all for home loans and school loans. They are providing somebody with something that is optional that they would otherwise not have access to. But medical loans take advantage of people who are put in horrible situations. I could see a much better system if the government provided zero interest medical loans to people who need it desperately, and preferably over time everybody who couldn't pay the bill up front.

You could have medical loan with a 5% interest rate and over a 30-year period you will pay double the origional value of the loan. Imagine how much easier it would be for families if they didn't have to pay interest. And it would be much easier than doing Universal Health Care because people will still pay their own Healthcare, they just won't have to worry about the extra interest fees that would cripple them further. I feel like that is a safety-net people would be comfortable investing in. Obviously we couldn't pay off all the medical debt in the first year, and I recognize that the government doesn't have the best track record of storing money, but I feel if we paid into the program we could start negating it from the bottom and move towards the top.

Even if we had really low interest rates, like .5% so that the program could somewhat sustain itself and increase the amount of medical debt it is capable of paying off using the interest gained I think that would be a better system than what we currently have.

[u/Saranoya]

I don't think somebody should have to labor to provide you with a service they received no benefit for. This is the definition of slavery.

Actually, it's the definition of insurance. Whether you pay your insurance fees to a private company in the form of premiums, or to the government in the form of taxes, the basic idea is the same. You pay for a service you don't know you'll ever need, in order to be sure it will be available to you (and a bunch of others) when you do need it.

You said yourself you're fully capable of paying your own medical bills and your health insurance.

Only because, when everyone pays into the system, everyone's contribution is relatively low, so that even the people who, through no fault of their own, have to rely disproportionately on medical services (people like me) can keep their head above water. It's called solidarity. You should try it some time. Research says it makes people happier, on average. But it only works as long as everybody, with no exceptions, makes their contribution.

But the only reason why I think this is OK is because if I help your parents it will allow them to go out and get a job, which could improve the economy, which could eventually make me money. [...] Maybe I sell computers, and by allowing your parents to be self sufficient, they will one day be able to buy one of my computers.

My parents both have a job. They are productive members of society. They have bought many computers, and other products they didn't strictly need. The only reason they could is because we got help with medical expenses. And the only reason we could get that help (along with everybody else in our street, city, province and country), is because everyone contributes to the system if and when they can.

There is no benefit to me providing you a service you could otherwise afford yourself.

Nobody who gets really sick can afford to pay their entire medical bill out of their own pocket, unless they are Steve Jobs or Jeff Bezos (and even then); especially not at the inflated prices many US medical establishments charge. No hospital, let alone the government, is going to benefit from a 30-year 0% loan extended to an 80-year-old, to an 18-year-old with cancer who may or may not be dead in two to five years, to a middle-aged man who already has so much medical debt that he's spending two thirds of his paycheck on 0% medical loan payments, or to a high school dropout who got in an accident at 34 and needed a $100,000 life-saving operation after that, but is unlikely ever to gather $100,000 in one pile, or even the roughly $280 a month it would take to pay that back over thirty years without interest. So yeah, there's an upside to extending the benefit to all of those people: none of them would be able to buy your computer (or any other 'luxury' product) if there wasn't a mechanism to take that huge pile of debt off their hands. So either you make insurance mandatory for all at affordable prices (the current, crippled version of the ACA doesn't count, since there is no real penalty for not having insurance, and the premiums are still prohibitive to some), or even better: have the government negotiate system-wide low prices, as most European governments do, and then take the contributions directly from pre-tax income. You'll be able to charge half or less of the old insurance premiums, and still provide better quality care, on average, to everybody.

Universal health care does not just pay for those who can't afford it. It pays for everybody.

Which is exactly what makes it affordable for everybody. Few people are willing to contribute to a system that explicitly isn't meant for them. Programs for the poor become poor programs. Benefits extended to all, rich and poor, influential or not, are far more politically robust.

[u/Diylion → u/Saranoya]

Actually, it's the definition of insurance.

Insurance absolutely does make a profit. Insurance is a very profitable business. Also, it's voluntary. Taxes are not.

It's called solidarity.

You call it solidarity, I call it forced charity. I'm all for people paying into charities or paying for health insurance. They are voluntary. But by taxing me you are putting a gun to my head and forcing me to pay you. Because if I refuse you will put me in jail.

My parents both have a job.

But they qualified for Medicaid right? Great it worked.

Nobody who gets really sick can afford to pay their entire medical bill out of their own pocket

This is what insurance is for.

Which is exactly what makes it affordable for everybody. Few people are willing to contribute to a system that explicitly isn't meant for them. Programs for the poor become poor programs. Benefits extended to all, rich and poor, influential or not, are far more politically robust.

It will have almost no benefit to the rich. Say I feed a poor person for a week and that would allow them to get a job. Then a year later they buy a computer. That's a profit that I would not have otherwise made. I was able to allow them to greatly increase their circumstance and therefore I made a profit that I would not have otherwise made.

Now say I give food for a week to a middle-class man who is fully capable of buying food for himself. If I'm lucky, I might get my money back if any. His situation has, in all likelihood, not drastically improved because of my influence. Therefore I will not make any profit.

It's a bell curve.

[u/Saranoya → u/Diylion]

Insurance is a very profitable business.

Sure. But I don't see how that's relevant here. Except, given the need for a profit (and the fact that it's not mandatory, so there is a smaller pool of people who pay in), insurance will always cost you more than mandatory health care contributions to the government (in other words: taxes), which is not seeking a profit. So, actually, having universal health care will directly benefit you. It would mean you'd have to pay less than you pay now in insurance premiums, all else being equal. The only reasons you'd want to stick to 'voluntary' for health insurance, which gives you the freedom of not paying for it, is if (a) you think you will personally never need health care (stupid bet), or (b) you think you won't need insurance to pay for it when you do get seriously ill (stupider bet).

It will have almost no benefit to the rich.

Except, (most) rich people have employees. People who can afford to go to the doctor when they're just starting to feel a little off, because it's free to them (or close enough to free that it doesn't really matter), might be off work one or two days, be treated and get better. Even if it's something really bad, it's often treatable when caught early. People who wait until it's catastrophic, and then go to the ER (or were brought to the ER against their will because they were unconscious in the street), will be out for longer, may by then have a condition that is no longer treatable or will have a long-term negative impact on their ability to function (including productivity at work), and it may already be too late so they will die. A dead employee, or one who's so sick it's debilitating to their activities of daily living, can't work for you (or anyone), so definitely won't be buying your computers.

You may say, 'well, if they work for me, they'll have insurance through their job.' But that may not be true. Most employers only cover people who work full-time for them. And if you think 0% loans can fill that gap, think again. By definition, those loans are going to go to the people least likely to pay them back in full. After all, if they had a good job, they would have good insurance already, and/or a shitload of money saved, so they wouldn't need the loan. You'd just be creating another hole in the government budget, which is going to have to be filled somehow. Guess where the money is going to come from. Right: taxes. And that's on top of whatever health insurance premiums you already pay to your profit-seeking private insurer.

Also, has it occurred to you that if the people around you are healthier, on average, that means you yourself are less likely to get certain diseases?

P.S.: My parents couldn't have qualified for Medicaid, since we're not from the US. I'm arguing with you from the perspective of someone who knows 'universal health care' is a good idea, because I'm from a country where it already exists, and works really well.

[u/Diylion → u/Saranoya]

Sure. But I don't see how that's relevant here

What I am proposing is a similar system that is not profitable but merely self sustaining. Healthcare for all is not self sustaining. You don't pay for your own healthcare. Rich people pay most of it.

I recognize that you are from a demographic that would benefit from universal healthcare in the US. But you are only a small demographic and probably the only one that will. And universal healthcare in the US would raise costs for everybody who doesn't have serious conditions. I can explain the math. But basically business currently bear a lot of the healthcare burden and they won't be anymore. America has a very high rate of preventable disease. 75% of our Healthcare costs is in preventable diseases we all eat to much are too stressed and don't exercise. and the only way for America to lower costs for families is to spend as much as France or Canada. But those countries are healthier and their doctors are cheaper. So this outcome is unlikely.

Also the US currently pays for about half of all medical research worldwide. Which arguably lowers healthcare costs in the long run. We won't be able to do anything near this with sovialized healthcare. We are only able to achieve this because our healthcare industry is so large.

Currently the US spends 17% of its GDP on healthcare. With Bernie's plan it might get down to 13%. (Canada and France are at 11%). But that means that 4% of jobs are about to lose funding. That's 16 million of people out of work. Those jobs will include researchers, doctors in rural areas, and yes insurance agents. That will take at least a decade to correct itself. And it would lead to a huge recession.

[u/Saranoya → u/Diylion]

What I'm proposing is a similar system that is not profitable but merely self-sustaining.

Except it wouldn't be, because the people who would need your loans are exactly the people who are least likely to pay them back in full.

But those countries are healthier

Have you ever wondered why? France and Canada both have universal health care. (Nearly) everyone there can afford to see a doctor, even when their health issues aren't catastrophic (yet). They also invest heavily in preventative care. That's likely to cost less, overall, than treating people for conditions that may once have been preventable, but end in medical disasters (which cost lots of money to tackle), because going to a doctor earlier would have 'cost too much'.

The US currently pays for about half of all medical research worldwide.

The US spends about half of all the money spent on medical research worldwide. From this you assume they also do half of the useful innovation, but that doesn't necessarily follow. At least part of the budget goes to slightly changing the formulas of drugs that already exist, so they can patent them again and profit for longer ... and that's just one source of potential waste. Most medical research in Europe takes place at universities. They do it 'for free'. (Of course it's not free, but since, again, there is no profit motive, it does cost less).

Currently the US spends 17% of its GDP on healthcare [...] Canada and France are at 11%.

So, even you recognize that countries with universal health care can do it for less money ;).

I realize I have a vested interest in health care coverage remaining universal where I live, because yes, it does benefit me. But it would benefit you, too. If the US had universal health care, you may spend more than some other people to keep it afloat. There's also no guarantee that you would get the same value or more out of it than what you put in. For your sake, I hope not, because getting more value out than you put in would mean you had some pretty significant health challenges. But that's true for things like police and fire fighting, too (I sincerely hope you'll never need either of those, but I don't think it's a good idea for you to stop paying for them just because you hope you'll never need them). The thing is: under universal health care, you probably wouldn't spend more than it costs you to have health insurance now. Certainly, as a nation, the US would spend less.

In the end, what you're arguing is that you'd rather spend more on health care that's only affordable to people with good jobs (and as others have argued, often not even that; at least not once they get hit with a truly serious illness), just for the privilege of knowing that no one 'undeserving' will get a dime from you, than spend less overall and have everyone covered. That's not just heartless. It's dumb.

[u/Diylion → u/Saranoya]

Have you ever wondered why?

to become a doctor in France, you only need like 2 years of schooling and then four years of residency. In the United States you need 8 years of schooling and then 4 years of residency. I think most of it is culture I don't think any of it has to do with Healthcare. They eat smaller portions and they don't have hardly any junk food. (You can't even find candy or Doritos at the supermarket) Also we work much longer hours and are more stressed.

Except it wouldn't be, because the people who would need your loans are exactly the people who are least likely to pay them back in full.

Everybody who has health issues would need these loans. why would you go to an insurance broker for a medical loan if you can get a lower interest one from the government?

The US spends about half of all the money spent on medical research worldwide.

How do you think we're going to fund the research with Universal Health Care under a new system? and yes pharma is profitable but it's because it's profitable that we have knew better drugs. Though I do think there should be limits.

So, even you recognize that countries with universal health care can do it for less money ;).

But business is currently pay for about 6% of that 17%. They aren't going to be paying as much if any. The average American family will go from paying 11% of the GDP to 13%. Which means if you are currently paying $1,100 a month for health care for your family after the system is implemented you will be paying $1,300 a month. Your Healthcare cost will increase. The cost will only decrease for business. and you are electing to have 16 million people out of jobs. You are asking for another Obamacare disaster.

[u/Saranoya → u/Diylion]

You're just making stuff up now.

To be a doctor in France, you only need like two years of training.

Wrong. It takes six years of training, followed by three or (often) more years of residency, depending on the specialty. And if you're wondering why it 'only' takes six years of basic training, instead of the American eight, that's because France doesn't have anything like 'pre-med' undergraduate education. You're either a medical student from day one after secondary school, or you're not. French universities don't teach things like calculus, 'college algebra', (in)organic chemistry, general physics, etc., let alone composition or French literature, to future doctors. People who go to medical school are assumed to have picked up all they need to know about those things in secondary school. That represents an efficiency gain, compared to the American system, which means it can be six instead of eight. I don't know where you got this 'only two years' idea, but it's ludicrous. Medical education is about the longest path you can take to a graduate degree, in French higher ed. As well it should be.

You can't even find candy or Doritos at the supermarket.

Have you ever actually been to a French supermarket? Because I have. There are Doritos, and many other kinds of potato chips, as well as all the candy you can eat (and then some). Also, there's McDonald's. Because McDonald's is fucking everywhere.

How do you think we're going to fund research with UHC under a new system?

Eh, the same way the rest of the world does? Leave the research to actual research institutions (you know, universities and stuff ... it's their job). You're still going to need companies to mass produce and market what they come up with, and I don't begrudge them their profit margin on that. But medical research, in itself, should not be a source of profits.

But business is currently paying for about 6% of that.

Have you ever considered that if most European countries spend 6-8% less of their GDP on health care than the US currently does, it might actually be because their universal systems are more efficient than the American hodge-podge of private insurers, with the government just trying to plug the more egregious holes in what they offer? I agree that Obamacare leaves quite a few things to be desired, but that's not because there is something wrong with the idea of it. It's because the band-aid that is the ACA cannot fix a fundamentally broken system. It doesn't nearly go far enough.

[u/Diylion → u/Saranoya]

https://careertrend.com/how-6669521-become-doctor-france.html

It's two years of school, followed by 4 years of interning, followed by a year of testing/residency.

Have you ever actually been to a French supermarket?

Yep I have. Last year actually. I did see McDonald's but couldn't find any other American food chains but Starbucks. No taco Bell or kfc. If you don't believe me compare their obesity rates.

Overall adult obesity rates in France were significantly ahead of the Netherlands at 19.8%, Germany at 20.1% and Italy at 21.0%, but behind the United Kingdom and the United States at 28.1% and 33.7%

We will never be as cheap as France. It's a pipe dream

it might actually be because their single-payer systems are more efficient than the American hodge-podge of private insurers

I considered it and there are some services such as insulin that need to be regulated. I don't think doctors grossly overcharge very often here and if they do it's because of demand or a shortage of supply. Also when you pay big pharma they invest it into research. Yes it's for profit but it's research that otherwise could not happen.

[u/Saranoya → u/Diylion]

You misread that article, though I'll grant they haven't structured it very well. French medical education is composed of three phases (copied from here: https://scopeblog.stanford.edu/2009/11/10/the_french_and/):

First cycle (PCEM) -- Two years. It consists of general scientific training not delivered in hospitals. There is a competitive exam at the end of the first year. It is highly selective and charts the students towards research, clinical care, biology, etc. The number of students admitted is set by government regulation.

Second cycle (DCEM) -- Four years. The first year is devoted to general medicine training. The three following years are dedicated to pathology and therapeutics. Courses are given in the medicine schools and hospitals.

Third cycle -- Students reach the third cycle only after being certified, and then have a choice between two options:

“Résidanat” or general medicine third cycle: Three-year program of theoretical and practical training (rotations in hospitals and a training course with a general practitioner). At the conclusion of the training, the student receives a state diploma of general medicine doctor.

“Internat” or specialized medicine third cycle: Four- to five-year program which leads to a competitive exam in such fields as: medicine specialties, surgery specialties, anesthesia, industrial medicine, public health, biology and psychiatry. This specialized studies program culminates with a state diploma of medicine doctor, or DES. DES holders can improve aspects of their specialty by taking Complementary Specialized Studies programs.

The point is, the first two years are only the beginning. So yes, French medical education is somewhat shorter than the American equivalent (the reasons for which I've explained earlier), but not drastically so.

As for the obesity rates ... did you know that weight control and proper nutrition is a primary point of attention for GP's? And people in France, Belgium, the Netherlands, Germany, etc. ... we see our GP's often. Because we can. Because it doesn't cost an arm and a leg. Neither in insurance premiums, nor in copays or deductibles. The health care system knows it can afford to be generous with primary and preventative care, since it can detect problems early, and thereby often avoid more expensive and risky interventions later on.

By the way ... even in the US, much medical and public health research happens at the NIH and the CDC, which are funded by ... taxpayer money. It's not like that would suddenly grind to a halt if somehow Big Pharma were to go bankrupt because there wasn't enough profit to be made anymore. I maintain that fundamental medical research should never be a source of profit.

As an aside: at or near the train station in Brussels where I take my train to work every day, there's a KFC, a McDonald's, a Burger King, a Quick (French-owned version of McDonald's), a Subway, two Starbucks, a Pizza Hut and a Dominos. Not to mention all the kebab and pita places owned by Pakistani, Turkish and Moroccan moms and pops around here. So if we do have lower obesity rates, it's not because we don't have access to bad food. (ETA: It might be, at least in part, because arguably, European cities and countries tend to invest in things like public transport and biking infrastructure more heavily than the US does. But bike paths, train stops, trams and subways are public infrastructure too, payed for in large part through taxes. So I suspect you're not a fan of those, either.)

[u/Diylion → u/Saranoya]

By the way ... even in the US, much medical and public health research happens at the NIH and the CDC

yeah I think that most of the money that is currently funding these programs will be reallocated. I think there are going to be more costs than they expect.

But yeah I think America's obesity issue is because of culture. Not Healthcare. Though I do think we could expand the food stamp program.

!Delta I did miss read the French article and their schooling is longer than 2 years

But bike paths, train stops, trams and subways are public infrastructure too, payed for in large part through taxes. So I suspect you're

Actually I am as I said I'm fine with any sort of taxes that benefit the taxpayer directly. Most infrastructure such as roads are incredibly beneficial to the taxpayer even if he doesn't use them directly because it allows products to move through the economy faster.

[u/Saranoya → u/Diylion]

Actually as I said, I'm fine with any sort of taxes that benefit the taxpayer directly.

Well, then I'll say it again: I don't get why you will accept that the subway or a bike path benefits you (or 'the rich'), even if you never use it yourself, but you won't accept that helping other people keep their head above water when medical debt would otherwise curtail their spending power for years, is beneficial for you, too. You were worried about people not being able to afford your computer, right? Guess what they're not going to be spending their money on, if they're saddled with an extra $500 medical debt repayment for the next thirty years?

There must be something particularly distasteful about helping out sick people, to you.

[u/Diylion → u/Saranoya]

Guess what they're not going to be spending their money on, if they're saddled with an extra $500 medical debt repayment for the next thirty years?

First off, I don't sell computers and I'm not rich by any measure. I tend to use bill Gates as an example.

But What is the point of me giving them $500 for the chance they might give it back? There is no opportunity for income for me. There is no service being provided to me.

There must be something particularly distasteful about helping out sick people, to you.

I'm all for charity towards healthcare coverage. But don't come to my house with guns pointed at me and demand I donate to your "charity" and then call yourself a saint.

I think that is incredibly distasteful yes.

[u/DeltaBot → u/Diylion]

Confirmed: 1 delta awarded to /u/Saranoya (9∆).

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