What is the SDN opinion on Single Payer Health Care?

[Windom Earle]

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This is something I always wondered about. And for many pre-meds, it could be an interview question.

Bernie Sanders’ single payer plan would have costed $ 1.38 trillion a year, but saved 6 trillion over the next decade. We would have a 6.2% payroll tax on everyone, 2.2% health care premium increase/income tax on workers, tax on capital gains tax on people making over 250k, and eliminated deductions for the wealthy, and raised the estate tax in order to pay for it.

According to Professor Gerald Friedman, the US would save 500$ billion in the first year under single payer. (200 billion $ saved from bureaucracy and paperwork, 200$ from monopolistic practices by the drug industry, and 30 billion $ saved from the employer based HC being eliminated).

So it does save money, but people like Ben Shapiro say it would discourage people from going into the medical field (because salaries would decrease + more patients) and that there would be very long wait times for some procedures.

I'm curious to see what @Goro @LizzyM @gonnif and all the other braniacs on SDN think of it. Yay or nay?

 

[Goro]

This is something I always wondered about. And for many pre-meds, it could be an interview question.

Bernie Sanders’ single payer plan would have costed $ 1.38 trillion a year, but saved 6 trillion over the next decade. We would have a 6.2% payroll tax on everyone, 2.2% health care premium increase/income tax on workers, tax on capital gains tax on people making over 250k, and eliminated deductions for the wealthy, and raised the estate tax in order to pay for it.

According to Professor Gerald Friedman, the US would save 500$ billion in the first year under single payer. (200 billion $ saved from bureaucracy and paperwork, 200$ from monopolistic practices by the drug industry, and 30 billion $ saved from the employer based HC being eliminated).

So it does save money, but people like Ben Shapiro say it would discourage people from going into the medical field (because salaries would decrease + more patients) and that there would be very long wait times for some procedures.

I'm curious to see what @Goro @LizzyM @gonnif and all the other braniacs on SDN think of it. Yay or nay?

I'm OK with single payer as long as someone can figure out a way to pay for it. Will the above actually pay for it?

As to waiting times for procedures.....we don't wait enough now? It takes me 1-2 days to see my PCP. A family member had to wait at least a week to get a CAT scan.

Is the Ben Shapiro the conservative activist/writer? if so, hardly someone who's an expert in the field. When you're starting from a mindset that the gov't should e providing health care, there's a conflict of interest in one arguments.

I'd like to see how doctor's salaries would go down by saving money, considering all the factors involved in health care. This is no way my area of expertise, but the following seems to match everything I've read. I'm surprised cost of meds isn't on the list, given the way those thieves at Big Pharma gouge us.

7 Reasons for Rising Health Care Costs

 

[calivianya]

I'd like to add that wait time is only longer for elective procedures.

In a country with single payer, if you get into a major car accident, you still get surgery on the spot - just like you do here. I'm okay with waiting a little longer for a knee replacement if it means everyone in this country can get emergencies handled when they arise without being bankrupted by medical bills.

 

[Windom Earle]

I'm OK with single payer as long as someone can figure out a way to pay for it. Will the above actually pay for it?

As to waiting times for procedures.....we don't wait enough now? It takes me 1-2 days to see my PCP. A family member had to wait at least a week to get a CAT scan.

Is the Ben Shapiro the conservative activist/writer? if so, hardly someone who's an expert in the field. When you're starting from a mindset that the gov't should e providing health care, there's a conflict of interest in one arguments.

I'd like to see how doctor's salaries would go down by saving money, considering all the factors involved in health care. This is no way my area of expertise, but the following seems to match everything I've read. I'm surprised cost of meds isn't on the list, given the way those thieves at Big Pharma gouge us.

7 Reasons for Rising Health Care Costs

The reason that doctors' salaries might go down is because the government would be the ones setting the prices on everything.

I agree with you about the waiting times now. And that would be for elective procedures, if anything. So if anyone wants a boob job, you'll have to wait for Little Timmy to get surgery on his broken arm from Little League first.

Also, Medicare is alot more efficient with their money (97% goes to actual healthcare), whereas with private insurance that number is only 80%. I don't know if that will pay for all of it, but Bernie seems to think so. He has his whole plan laid out in depth.

Btw if anyone is confused Single Payer is also called Medicare for All. We would essentially be bringing the age of eligibility from 65 to 0 overnight under MFA.

 

[AnatomyGrey12]

So yeah like that one time Vermont tried to actually institute single payer? Oh wait their estimated numbers were so much lower than the actual cost that they shut the idea down and concluded it couldn’t work financially. I want to know how it would be paid for, because I certainly am not paying for it.

 

[Windom Earle]

So yeah like that one time Vermont tried to actually institute single payer? Oh wait their estimated numbers were so much lower than the actual cost that they shut the idea down and concluded it couldn’t work financially. I want to know how it would be paid for, because I certainly am not paying for it.

"Writing in the New England Journal of Medicine, Harvard University practice of public health professor John McDonough pointed out that the decision to drop single-payer was as much about politics as finances. While studies showed the taxes would have been high, they also showed that the plan was economically viable (as the Cornell Policy Review also noted). But when Shumlin barely was re-elected in 2014, as McDonough put it, "a clear public mandate for his health care agenda was nowhere in evidence."

Vermont single payer health was not going bankrupt

If we can spend trillions on wars that lead to nothing, it's absolutely possible for our country to give us the healthcare that we deserves.

 

[DaWeasel]

If you want healthcare to work with all the efficiency of the DMV, then I don't know what to tell you

 

[BombsAway]

Imagine what we could accomplish if spent our world-policing budget on human services.

 

[TheWolfOfMainStreet]

As a strict constitutionalist, I don't believe it is the federal government's job to be in the healthcare business period (yes, that includes repealing their current efforts).

At the state level, feel free to institute whatever you want that you can pay for (10th amendment and all that).

[Before someone gives me the "people will die" or "we can save money" lecture, realize that I approach this problem ideologically rather than as a matter of utility. Therefore those arguments won't work for me.]

 

[bananafish94]

The short version of my views is that I favor a public option for all approach. As for SDN, the website as a whole leans pretty far to the right from what I've seen so I would expect more to be opposed than in support of single payer.

 

[Med Ed]

I'm curious to see what @Goro @LizzyM @gonnif and all the other braniacs on SDN think of it. Yay or nay?

Given that this is a pre-allo forum on the interwebs, here is what's going to happen: you will have a smattering of supportive or neutral comments early in the thread, and then a crew of highly vocal anti-single payer posters will arrive, and then it will devolve into a pointless shouting match among individuals who lack substantive health policy backgrounds.

Can't wait!

 

[seren1051]

Welcome to Canada?

We wait a while for non-emergent procedures, provincial government screams out 'this is not sustainable' every once in a while, and physicians (ie. Ontario Medical Associations) fight with provincial government occasionally because contract plan they proposed isn't attractive...but at least it's a universal health care

 

[Matthew9Thirtyfive]

Given that this is a pre-allo forum on the interwebs, here is what's going to happen: you will have a smattering of supportive or neutral comments early in the thread, and then a crew of highly vocal anti-single payer posters will arrive, and then it will devolve into a pointless shouting match among individuals who lack substantive health policy backgrounds.

Can't wait!

I'm not super vocal about it, nor am I particularly opposed to single payer, but I do find interesting @Mad Jack's take on having a universal system with multiple payers in order to keep quality high (I think that was Mad Jack).

 

[Mad Jack]

Single-payer is a very rare thing in the world. Most countries have a mix of payers, even in those nations with universal coverage. I'm a fan of the German model of compulsory insurance on a marketplace that has a mix of for-profit and non-profit options, as well as government coverage for citizens making under a certain amount that is free.

 

[Stumpyman]

People have mentioned the increase in taxes, but let's not forget the loss of jobs. Aside from the millions of people employed by insurance companies, corporations themselves staff many people to work healthcare/insurance-related positions (in corporations it's almost 20% of the workforce). A rapid transition to a single-payer system would be costly in terms of taxes and its potential effect on the economy through many lost jobs. I like the idea of a government-backed public option funded through limiting tax benefits given to private industry (for employer-provided health insurance).

Also, lost jobs are a problem but that happens with most industry-shifts. I don't support Bernie's plan because it's far too rapid of a shift. We would need to figure out a way to transition the many people whose jobs rely on a large insurance system.

 

[de Ribas]

If you want healthcare to work with all the efficiency of the DMV, then I don't know what to tell you

I have been waiting since August 19th for my car title. It's going to be 3 months on Friday. What if patients will have to wait 3 months for their MRI results.

 

[Windom Earle]

45,000 Americans die every year because they don't have access to basic healthcare. That number in Sweden, Canada, and Switzerland is probably 0.

New study finds 45,000 deaths annually linked to lack of health coverage

 

[Matthew9Thirtyfive]

45,000 Americans die every year because they don't have access to basic healthcare. That number in Sweden, Canada, and Switzerland is probably 0.

New study finds 45,000 deaths annually linked to lack of health coverage

Maybe not access, but wait times sure seem to. https://www.fraserinstitute.org/sites/default/files/effect-of-wait-times-on-mortality-in-canada.pdf

 

[Windom Earle]

The short version of my views is that I favor a public option for all approach. As for SDN, the website as a whole leans pretty far to the right from what I've seen so I would expect more to be opposed than in support of single payer.

Interestingly enough, most Americans are in favor of a public option, and have been for quite a few years now. But it still hasn't gotten passed.

 

[begoood95]

If you want healthcare to work with all the efficiency of the DMV, then I don't know what to tell you

Well, when you starve the government of resources of which would make it run more effectively (which is what Conservatives do in order to fulfill the myth of "hur-dur the gov't sux"), then yeah it's going to run inefficiently.

Now, if you actually provide the means and capital with which to run a system (run by the government), then your theory just falls apart.

It's called "Starve the Beast," and it's a wholly dishonest approach to actual solutions to government problems.

 

[NickNaylor]

Single-payer is great in theory, tricky in execution, and as physicians (or will-be physicians) you should view single-payer with a sense of skepticism, because there’s next to zero that you will receive in upside and likely a lot of downside. Sure, some of the bureaucratic stuff might be reduced - prior authorizations, dealing with insurance companies, etc. - but the overall goal of single payer is to “improve quality” and “reduce costs,” as it is with all healthcare systems. For physicians, this will likely mean 1) more bureaucratic oversight of your practice - a.k.a., more crap to click in EMRs documenting that you have discussed or reviewed XYZ and leaving you with ever smaller amounts of time to, you know, practice medicine - and 2) reduction in your salary.

For some people these things might be worth the trade-off of the social goods provided by universal, single-payer coverage, but until you’re actually practicing it’s difficult to appreciate how the above actually impact your life, and it’s easy to place a lot of value on the theoretical benefits of a single-payer system while not being able to appreciate the downsides.

 

[Matthew9Thirtyfive]

Now, if you actually provide the means and capital with which to run a system (run by the government), then your theory just falls apart.

Have you ever worked for the government?

 

[WisNeuro]

Have you ever worked for the government?

In general, when I worked in the VA, my patients received quicker care and I was able to refer out after my evaluations pretty easily and efficiently. At least in the area in which I work (mental health/neuro/rehab) the care was much better than what I see in general on the outside. However, on the provider side, compensation starts to lag, and the entitlement and negativity of many of the patients starts to drag on you. Moving out of the VA I got a sizeable salary increase with similar benefits and a patient population that actually appreciates receiving healthcare. The potential is there, but there are some cracks. I still think that the majority of care in the VA exceeds that of the private world, I just don't think it is a great place to be a provider in certain areas.

 

[Juice313]

I think that a single-payer universal healthcare system could definitely work. While physician's wages may or may not see a slight decrease, in my opinion as a non-physician (for now) this would be worth it in the context of providing more care to more people. It would undoubtedly be a dynamic process for a while in its initial stages as the kinks are worked out, but the bottom line is that it could work.

I did a little research into healthcare systems of other countries a while back and am intrigued by the German system that @Mad Jack mentioned. They have a universal multi-payer system combining statutory and private health insurance, with ~3/4 of the system paid for by the government and ~1/4 privately funded. It's the most restriction-free and consumer-oriented system in Europe (although all are required to have some sort of health insurance), with fairly broad/anti-discriminatory packages. If you make less than 50,000 euros you're automatically enrolled, otherwise you can choose between public insurance (~89% of Germany) or private insurance. What I think it really cool about that your cost for public insurance is based on a certain % of your salary, but you pay half of this and your employer matches your payment and pays for the other half. Coverage includes family members and payments are pay-as-you-go. They manage to have pretty low wait times for appointments/surgeries with an obviously longer wait for elective operations (as expected). Even with all this, they spend much less on healthcare than the good ol' USA.

I don't think I've really heard this system come up much in conversation regarding US healthcare. I think this could very well work here, and that it could be a gentler stepping stone to single-payer care.

 

[Mad Jack]

I think that a single-payer universal healthcare system could definitely work. While physician's wages may or may not see a slight decrease, in my opinion as a non-physician (for now) this would be worth it in the context of providing more care to more people. It would undoubtedly be a dynamic process for a while in its initial stages as the kinks are worked out, but the bottom line is that it could work.

I did a little research into healthcare systems of other countries a while back and am intrigued by the German system that @Mad Jack mentioned. They have a universal multi-payer system combining statutory and private health insurance, with ~3/4 of the system paid for by the government and ~1/4 privately funded. It's the most restriction-free and consumer-oriented system in Europe (although all are required to have some sort of health insurance), with fairly broad/anti-discriminatory packages. If you make less than 50,000 euros you're automatically enrolled, otherwise you can choose between public insurance (~89% of Germany) or private insurance. What I think it really cool about that your cost for public insurance is based on a certain % of your salary, but you pay half of this and your employer matches your payment and pays for the other half. Coverage includes family members and payments are pay-as-you-go. They manage to have pretty low wait times for appointments/surgeries with an obviously longer wait for elective operations (as expected). Even with all this, they spend much less on healthcare than the good ol' USA.

I don't think I've really heard this system come up much in conversation regarding US healthcare. I think this could very well work here, and that it could be a gentler stepping stone to single-payer care.

We don't need a "gentler stepping stone to single payer." The idea that single payer is desirable is without merit. A varied system such as Germany's leads to decent care with decent competition. There are only three nations in the world that have truly single payer health care are Canada, Taiwan, and South Korea. The UK and Scandanavian nations also have systems that are effectively single payer (there are private providers, but they are so limited as to not functionally exist on any level of useful scale). Every other nation in Europe and the rest of the world does not have single payer care. Single payer is NOT EQUAL to universal health care, and it annoys me to no end that these two things are equated when people in our country are talking about health care reform. There are dozens of other models to pick from that are not single payer, it is literally stupid to suggest that it is the de facto best way forward or that it must be the ultimate conclusion of any reform. Americans don't understand the systems of other nations and mistakenly assume they are single payer, and thus that we should be like "the rest of the world" when "the rest of the world" isn't single payer to begin with.

 

[begoood95]

Have you ever worked for the government?

It doesn't matter whether I or you have worked in government. I don't take your experience which I presume you're about to expand upon as evidence contrary to my claims—we all have anecdotes.

On the other hand, we can look to other countries who have any alternative to our system, many of which improve a number of aspects of care that, in the US, we struggle with.

Am I saying we ought to tic-for-tac copy X country's system? No. Am I saying the context within which our healthcare exists is the same as another country's? No.

I am saying that our system is flawed, and I'm saying that people's unwillingness to look at alternatives or to cast aside viable means to improving healthcare in the US is both annoying and unhelpful. We likely, in order to improve our unique situation, must draw from many ideas and implement various aspects of said ideas to achieve our end.

Is anything I said incorrect? Are you willing to disagree with any of my suggestions? Are you going to say that government is simply too ineffective by its very nature such that any government-included solution is ridiculous? Why then do we trust the government with such a large military, if you're willing to answer in the affirmative to my previous question?

Go ahead, I'm interested in your answer.

 

[Mad Jack]

It doesn't matter whether I or you have worked in government. I don't take your experience which I presume you're about to expand upon as evidence contrary to my claims—we all have anecdotes.

On the other hand, we can look to other countries who have any alternative to our system, many of which improve a number of aspects of care that, in the US, we struggle with.

Am I saying we ought to tic-for-tac copy X country's system? No. Am I saying the context within which our healthcare exists is the same as another country's? No.

I am saying that our system is flawed, and I'm saying that people's unwillingness to look at alternatives or to cast aside viable means to improving healthcare in the US is both annoying and unhelpful. We likely, in order to improve our unique situation, must draw from many ideas and implement various aspects of said ideas to achieve our end.

Is anything I said incorrect? Are you willing to disagree with any of my suggestions? Are you going to say that government is simply too ineffective by its very nature such that any government-included solution is ridiculous? Why then do we trust the government with such a large military, if you're willing to answer in the affirmative to my previous question?

Go ahead, I'm interested in your answer.

As can be noted by the trillions of missing cash, we shouldn't trust our government with the military, but we do because we must. There is no other option. In health care there are many, many other options.

 

[Gilakend]

I'm not saying that any idea in here could never work (in theory almost all of them work). However in reality, with our federal governments track record I think you'd have to be crazy support the idea of giving them the additional burden of trying to regulate healthcare.

 

[begoood95]

As can be noted by the trillions of missing cash, we shouldn't trust our government with the military, but we do because we must. There is no other option. In health care there are many, many other options.

No, there are other options, but we allow government control of the military because—in fact—the government can do things well. Except, we've only made it so that we excel in military. We don't do it because we must. We do it because it works. (Btw, not saying I'm currently in agreement with our military's actions and state of affairs—this is only for sake of argument.

In healthcare you're correct; there are many options. Government is one option, and one that in fact has a track record of success in many areas (like Germany!).

 

[DaWeasel]

In healthcare you're correct; there are many options. Government is one option, and one that in fact has a track record of success in many areas (like Germany!).

And Venezuela!

 

[Mad Jack]

No, there are other options, but we allow government control of the military because—in fact—the government can do things well. Except, we've only made it so that we excel in military. We don't do it because we must. We do it because it works. (Btw, not saying I'm currently in agreement with our military's actions and state of affairs—this is only for sake of argument.

In healthcare you're correct; there are many options. Government is one option, and one that in fact has a track record of success in many areas (like Germany!).

No, there is no other option because of international law. It is illegal for a nation to employ private armies, and individuals acting as a part of private armies are considered criminals under international law. In an age of nuclear weapons and weapons of mass destruction, international groups for hire with such firepower were rightly deemed to be worthy of international bans, as the destruction they could provide in exchange for cash is simply too great and no nation could be held accountable for their actions. So no, there is no other option with regard to the government operating our military unless you intend to defy international law and start a third World War over it.

 

[begoood95]

No, there is no other option because of international law. It is illegal for a nation to employ private armies, and individuals acting as a part of private armies are considered criminals under international law. In an age of nuclear weapons and weapons of mass destruction, international groups for hire with such firepower were rightly deemed to be worthy of international bans, as the destruction they could provide in exchange for cash is simply too great and no nation could be held accountable for their actions. So no, there is no other option with regard to the government operating our military unless you intend to defy international law and start a third World War over it.

Cool, now back to healthcare. You fixated on a minutia of my reply, and went on a rant of legality—which is fine and thank you for the information (guess I won't be creating my own private army, darn)—of which has little to do with our thread.

My point was simply to show that the government can indeed be good at things. Moving on now.

 

[Matthew9Thirtyfive]

It doesn't matter whether I or you have worked in government. I don't take your experience which I presume you're about to expand upon as evidence contrary to my claims—we all have anecdotes.

Nope. You have no experience working for the government but somehow think you know how to fix it, so there’s no point in telling you why your statement is wrong. But it is. Or at least it’s an extreme oversimplification.

 

[Mad Jack]

Cool, now back to healthcare. You fixated on a minutia of my reply, and went on a rant of legality—which is fine and thank you for the information (guess I won't be creating my own private army, darn)—of which has little to do with our thread.

My point was simply to show that the government can indeed be good at things. Moving on now.

Your point was, again, misplaced. Our military is enormously wasteful, dude with fraud, and terribly inefficient. Do you know anyone in the military? How about you hop over to the military health care subforum and tell them just how great the military does things. I'll wait.

 

[Matthew9Thirtyfive]

As can be noted by the trillions of missing cash, we shouldn't trust our government with the military, but we do because we must. There is no other option. In health care there are many, many other options.

I wish there was another way. The military would be much more efficient without a lot of the red tape we have to cut through. But there really isn’t another way to do it, and the government certainly isn’t going to get more efficient lol.

 

[Matthew9Thirtyfive]

Your point was, again, misplaced. Our military is enormously wasteful, dude with fraud, and terribly inefficient. Do you know anyone in the military? How about you hop over to the military health care subforum and tell them just how great the military does things. I'll wait.

The opinions of military healthcare on the military forum are obviously incredibly one sided. People who have a decent or good experience aren’t likely to go out of their way to come on here and talk about it, but I know many, many doctors irl that are happy with their military careers despite the inefficiencies.

The military can be really efficient when it wants to be or there is a pressing, urgent need. Outside of that, it can be frustratingly inefficient.

 

[Mad Jack]

The opinions of military healthcare on the military forum are obviously incredibly one sided. People who have a decent or good experience aren’t likely to go out of their way to come on here and talk about it, but I know many, many doctors irl that are happy with their military careers despite the inefficiencies.

The military can be really efficient when it wants to be or there is a pressing, urgent need. Outside of that, it can be frustratingly inefficient.

I know many, many non-physicians in the military that would find any idea of the military being efficient as laughable.

 

[BombsAway]

Nope. You have no experience working for the government but somehow think you know how to fix it, so there’s no point in telling you why your statement is wrong. But it is. Or at least it’s an extreme oversimplification.

Being an enlisted dude handing surgeons their instruments is hardly a worthy soapbox. One need not work for the government to criticise it. This LizzyM of 80 kid is smarter than us and is actually putting forth a legit argument. So is the mad jacker. Let's leave them to it.

 

[Matthew9Thirtyfive]

I know many, many non-physicians in the military that would find any idea of the military being efficient as laughable.

I’ve been in the military for six years almost. I’ve seen SECDEF approve an overhaul contract in a couple hours. It happens when things have to happen now, and really higher ups have an incentive to move. When that is not the case, it can take a while for things to happen. I know people who waited months to get reimbursed for their moves because the disbursing officer wasn’t especially motivated to push it through.

 

[Matthew9Thirtyfive]

Being an enlisted dude handing surgeons their instruments is hardly a worthy soapbox. One need not work for the government to criticise it. This LizzyM of 80 kid is smarter than us and is actually putting forth a legit argument. So is the mad jacker. Let's leave them to it.

I was actually an OR tech and a certified first assistant as a civilian. My military healthcare experience has been as a primary care provider on a ship with minimal physician oversight (as in they reviewed our charts once a month).

Mad Jack’s arguments for multi-payer universal healthcare is great, which is why I tagged him in this thread. You are free to say whatever you want, but when you say something that is either wrong or an extreme oversimplification out of a lack of experience, I will point that out.

 

[BombsAway]

I was actually an OR tech and a certified first assistant as a civilian. My military healthcare experience has been as a primary care provider on a ship with minimal physician oversight (as in they reviewed our charts once a month).

So not in government? lol. So like I said, enlisted dude on a boat is hardly a worthy soapbox. #motrinandcarryon

 

[TheWolfOfMainStreet]

When you're a libertarian watching the big-government Democrats and only-marginally-less-big-government Republicans arguing over healthcare

 

[Matthew9Thirtyfive]

So not in government? lol. So like I said, enlisted dude on a boat is hardly a worthy soapbox. #motrinandcarryon

Reading comprehension. I’ve been in the military (ie, a federal employee) for over five years. The very next sentence describes my military healthcare experience. And your response shows your ignorance. Motrin and carry on is a joke we have because many of our patients come with nondescript symptoms or very minor things that don’t need anything more than some Motrin or Tylenol.

And I’m not on a soapbox. You’re shouting about things with which you have zero experience. So as an enlisted dude who has to navigate the inefficiencies of the government on the daily, I think I am faaaar more qualified to tell you why you’re wrong than you are to tell me why my correction of your statement is inappropriate.

A good rule of thumb is if your only response to an argument is an ad hominem fallacy, your soapbox is probably made of toothpicks.

Carry on.

Edited to fix autocorrect screwup.

 

[AnatomyGrey12]

So not in government? lol. So like I said, enlisted dude on a boat is hardly a worthy soapbox. #motrinandcarryon

Clearly he knows what he is talking about much more than you do.

 

[BombsAway]

Reading comprehension. I’ve been in the military (ie, a federal employee) for over five years. The very next sentence describes my military healthcare experience. And your response shows your ignorance. Motrin and carry on is a joke we have because many of our patients come with nondescript symptoms or very minor things that don’t need anything more than some Motrin or Tylenol.

And I’m not on a soapbox. You’re shouting about things with which you have zero experience. So as an enlisted dude who has to navigate the inefficiencies if the game goverbment, I think I am faaaar more qualified to tell you why you’re wrong than to tell me why my correction of your statement is inappropriate.

A good rule of thumb is if you’re only response to an argument is an ad hominem fallacy, your soapbox is probably made of toothpicks.

Carry on.

My reading comprehension is fantastic. Here, i'll break it down for you.

You responding to gunner: you don't work in government so you couldn't possibly understand
Me to you: enlisted-dude-on-a-boat is a weak argument for understanding health-care policy better than them.
You to me: I'm far more than an enlisted-guy-on-a-boat. As a civilian i was X,Y, and Z!
Me back to you: So you're using your civilian credentials to support your position that you must work in government to criticize it? weak.
You, with rustled jimmies: what? I've been in the military for years, can't you read! As such, I'm super qualified to speak on this issue.

Now, to respond to your latest.

I am not shouting. I'm sorry if you find alternate opinions threatening.
If you're assuming i'm a civilian and that 5 years of service makes you "faaaar" more qualified. What does my 8 years of service make me?
Your last point about ad hominem... exactly! That's what i'm trying to get at. You're trying to undercut gunner's arguments by saying their lack of government service makes their points invalid. I'm saying that's weak as hell.

 

[Matthew9Thirtyfive]

My reading comprehension is fantastic. Here, i'll break it down for you.

Since you seem to be suffering from a serious case of Dunning-Kruger, I’ll break it down for you Barney style.

You responding to gunner: you don't work in government so you couldn't possibly understand

What I actually said is that if you’ve never worked for the government, you wouldn’t understand why it isn’t just the lack of funds or means that makes things inefficient.

Me to you: enlisted-dude-on-a-boat is a weak argument for understanding health-care policy better than them.

You actually made an appeal to authority and an ad hominem fallacy. Also a strawman, since I didn’t actually critique anyone’s heathcare policy arguments. I critiqued a very specific point about government inefficiency.

You to me: I'm far more than an enlisted-guy-on-a-boat. As a civilian i was X,Y, and Z!

Again, reading comprehension. You put my experience on trial through your appeal to authority fallacy. You made an error in describing my experience in your attempt to attack me, and I corrected you.

The point of my expounding on my Navy healthcare experience was to demonstrate that as a primary care provider, I have directly worked within the inefficiencies of military and government healthcare. That was apparently lost on you.

Me back to you: So you're using your civilian credentials to support your position that you must work in government to criticize it? weak.

Yes, this is what you said. It still makes no sense, since in the very same post you quoted, I explained my government healthcare credentials. This is actually what prompted me to tell you to read, as you clearly either didn’t read past the first sentence, or you willfully ignored it in some sort of completely bizarro attempt at discrediting me by pointing out that I worked as a civilian—by quoting a post in which I said I was a military PCP. I’m not sure how else to explain why that’s stupid.

You, with rustled jimmies: what? I've been in the military for years, can't you read! As such, I'm super qualified to speak on this issue.

Again, reading comprehension. I have been in the military for several years. That automatically qualifies me to speak about government inefficiency and to point out incorrect statements by people who don’t have any experience with it. Not sure why this is so hard for you to grasp.

You might want to look up the difference between appeal to authority and an appeal to authority fallacy. They aren’t the same thing.

Now, to respond to your latest.

I am not shouting. I'm sorry if you find alternate opinions threatening.
If you're assuming i'm a civilian and that 5 years of service makes you "faaaar" more qualified. What does my 8 years of service make me?

Your alternate opinion doesn’t threaten me. I have had my opinions changed on here and in real life many times, as I am always willing to listen to reasoned arguments. Every single one of your posts to me have been ad hominem or other logical fallacies. If you stopped focusing on trying to discredit my experience by insulting me and willfully mischaractering my experience, then we could proceed. But you don’t seem to be able to do that.

And if you have 8 years of service, I have no idea how’s you could possibly argue that simply providing funds would streamline things.

Your last point about ad hominem... exactly! That's what i'm trying to get at. You're trying to undercut gunner's arguments by saying their lack of government service makes their points invalid. I'm saying that's weak as hell.

That’s not what an ad hominem is. It’s called appeal to authority, and it is a valid argument. When someone has no experience in something and is speaking from a theoretical point of view, someone with first-hand experience who has evidence to show that the assumption is incorrect is more reliable. That’s why we trust doctors and scientists more than mommy bloggers.

I made a logical argument that his inexperience with the system leaves a blind spot in his thinking. You white knighted for him for some reason.

 

[Lost in Translation]

Gomerblog may be satire but this is closer to the truth than many in pre-allo would feel comfortable admitting: https://www.gomerblog.com/2017/07/first-paycheck-republican/amp/

 

[Matthew9Thirtyfive]

Gomerblog may be satire but this is closer to the truth than many in pre-allo would feel comfortable admitting: https://www.gomerblog.com/2017/07/first-paycheck-republican/amp/

That made me lol.

 

[mydogmolly]

Well, when you starve the government of resources of which would make it run more effectively (which is what Conservatives do in order to fulfill the myth of "hur-dur the gov't sux"), then yeah it's going to run inefficiently.

Now, if you actually provide the means and capital with which to run a system (run by the government), then your theory just falls apart.

It's called "Starve the Beast," and it's a wholly dishonest approach to actual solutions to government problems.

C'mon. Let's be adults, please.

My point was simply to show that the government can indeed be good at things. Moving on now.

Can you name one thing the government does that is better than private sector in terms of quality? Surely there are ethical arguments, as people have mentioned, to be made for certain societal goods that must come from the government because it is the only entity that all citizens have a stake in (we should have a public school system, roads, military, etc); but in terms of quality, the government sucks at literally everything it gets its hands on. I realize you've probably never worked in government, but I think it's silly to say that it "can indeed be good at things" when its track record is downright awful and rife with fraud and waste at just about every level, from school districts to capitol hill.

 

[Med Ed]

I'm not super vocal about it, nor am I particularly opposed to single payer, but I do find interesting @Mad Jack's take on having a universal system with multiple payers in order to keep quality high (I think that was Mad Jack).

It's rather funny, in a way. @Mad Jack is a fan of the German model, which, eleven years ago, was getting excoriated over its mistreatment of physicians. At that time Germany was the SDN poster child for the evils of universal health care.

The math behind single payer isn't very complicated. Reduce the amount of bureaucracy and you can either 1.) have more healthcare for the same expenditure, or 2.) have the same healthcare for less expenditure.

Personally, I favor a two-tier system not unlike Australia's. It's not the most efficient, and it's not the most egalitarian, but I think it's reasonably aligned with our national ethos.