Common objections to universal single payer health care and some snappy comebacks

[eridani]

Objection #1

Why should I pay for health care for lazy slobs who never exercise, smoke and eat junk food?

Why should I pay for dental care for snot-nosed kids who drink soda pop all day and whose mothers don’t teach them to brush their teeth?

Snappy comebacks #1

Why should the fire department answer calls from people who let their kids play with matches, have wiring that isn’t up to code, or store dirty rags in their basements?

In early 2007, lack of $80 for extraction of an infected tooth killed a child when the infection spread to his brain. The subsequent unsuccessful attempt to save his life cost $250,000!

Underlying issue for #1

People raise the question of “undeserving” people getting health care because they resent paying for the health care of the elderly, the poor, and public employees when so many of them have limited access to health care themselves.

Why should they tolerate this? The answer is that they shouldn’t. The money that they are paying could and should be used for universal single payer health care that covers everybody—no exceptions.


Objection #2

This is a capitalist country. I don’t want socialized medicine.

The government screws up everything it touches.


Snappy comebacks #2

When did you start thinking that Taiwan wasn’t a capitalist country? They have single payer health care.

Capitalism doesn’t work very well without extensive investment in public goods. Like roads and schools, health care is infrastructure.

The US government successfully financed the Interstate Highway System, the Apollo moon landing, the Internet, the aviation industry and the computer industry.

Health care will mostly be privately delivered, as it is now. The only thing that will change is the funding mechanism.

#2—Why infrastructure needs to be public

One word—Enron

As Enron and Reliant have demonstrated, maximizing profit in the energy industry amounts to large-scale theft. They found that they could make more money by withholding power than by supplying it, so that's what they did, just as insurance companies make more money by denying care than by providing it.

Note that publicly owned utilities in California didn't have any brownouts during the manufactured 'crisis'. Having private health insurance is like hiring someone to tap into your power line between the meter and your house and siphon off as much as they can get by with.


Objection #3

Universal health care means rationing. I don’t want to die while I’m waiting in line.

Snappy comebacks #3

Under the current system, without money you die because you aren’t allowed into the line in the first place.

For those who aren’t old or poor enough, and who aren’t public employees, a very common way to cut into the line is to deliberately commit a crime. This does not happen in any other developed country.

Objection #4

What are you going to do with all the surplus people in the insurance industry? (This is a serious potential problem that we can’t just blow off.)

Snappy comebacks #4

By sheerest coincidence, we are now looking at a very serious shortage of nurses. Retraining a work force that we now pay to tell people “That isn’t covered” to provide actual care is a non-trivial problem, but it’s where we have to go, and better sooner than later.

If the financing of health care is a public good, then public oversight can insure that the claims processing jobs that remain will never be sent out of the country. This is true whether we hire existing insurance companies to do this work or build a separate institutional structure from scratch.

Objection #5

But people are currently satisfied with their health insurance, and an overwhelming majority are satisfied with the cost of their health care.

Snappy comebacks #5

Why in heaven’s name should anyone be surprised by the fact that the 50% of the population that has NO HEALTH CARE EXPENSES AT ALL in any given year are absolutely delighted to be paying nothing for health care?

Unless you’ve been expensively sick, you don’t really know if your health insurance is any good, just as you don’t know if your local fire department is really any good until you have a fire. And if you’re really lucky, you’ll never have to find out.

Objection #6

What we really need is a public/private partnership.

Snappy comebacks #6

What kind of public/private partnership are you talking about?

The kind we have now is that public money is used to take care of sick people, and private insurers take money from healthy people and keep as much of it as they can.

The kind we need is what single payer advocates propose—public funding with (mostly) private delivery.

Objection #7

What do you people have against profits, anyway?

Snappy comebacks #7

Nothing, provided that they go to people who provide actual care and necessary manufactured materials.

Insurance companies freely admit that if the risk pool were to be the entire population, including the sickest, that they can’t make profits. That’s why they insist that they be exempt from insuring the sickest, whose care is then paid for by the government.

If you want health care for everyone, profit-taking should be flat out forbidden to those who admit that they don’t want to spread the risk to everyone.

Objection #8

I don’t want some government bureaucrat choosing my doctor for me.

Snappy comebacks #8

All single payer proposals allow free choice of medical providers, which the private insurance available to most people does not allow. Enough with fragmented provider lists that force you to change doctors every time your circumstances change!

The only “choice” that private insurance offers you is which 50 pages of gobbledegook you want to wade through in order to figure out how they are going to try to avoid paying claims.

The government will just pay the bills with much less administrative hassle and expense, for any provider that you choose.

[Sherman A1]

1. Agreed & Well Said

I am going to bookmark this one to steal later on with your permission....


:toast:

[Oregone]

2. Regarding dental you mention, off topic, not all UHC programs cover it BTW.

My provincial insurance only covers your basic health needs, visits, surgeries, etc. But it allows private supplemental dental insurance to be super cheap (under $20 bucks a month with some providers, which encourages employers to cover it). I realize that everyone thinks its great to have this on day one, but sometimes you gotta start somewhere, and simply allowing people/get an operation to see a doctor instead of die or go into bankruptcy changes a society drastically. When advocating a single-payer system, its good to look around so you aren't arguing for an abstract, and you know exactly what you want it to entail. Just meeting people's raw and basic needs is also another middle ground (that is realistic and put in practice in many parts of the world), which can convince people on the other side that its a viable idea. Its definitely no sweat off my back covering my own dental in a country where the insurance for it is actually affordable.

BTW, I have more choice in medical providers than I would with private insurance in the US. I can go to anyone, anywhere, at anytime (unless its a specialist and I gotta pick up a quick referral).

[eridani]

12. That's one of the things we've learned not to do from Canada

The other thing is to not put health care in the general fund to compete with roads and schools, but in a separate trust fund. Otherwise, regardless of some changes that you probably need, you're doing pretty well.

[grantcart]

3. Objection #2

So you want to dismantle the Center for Disease Control?


One of the most effective Public Health Organizations in the history of mankind it is saving the questioner thousands of dollars and possible loss of life by eliminating most communicable disease from the US.


And it is 100% socialistic in nature. Paid for out of tax revenues all of its services are provided without any concern for cost.
And by concentrating on prevention saves billions in cures.

[eridani]

13. No, nor the VA. Things in the public domain that are working should be left alone n/t

[Mojambo]

4. Nice work. Happy to recommend. n/t

[Kitty Herder]

5. Great big K&R!

:kick:

[Vinca]

6. The people who object have a real "come to Jesus" moment

after they lose their job and healthcare and are diagnosed with a serious disease. (I'm an atheist, but for some reason have always loved the "come to Jesus" reference. LOL.)

[DailyGrind51]

7. Add this 2007 Congressional Report:

http://assets.opencrs.com/rpts/RL34175_20070917.pdf

"The largest dollar difference between the U.S. and the OECD median was in
outpatient care; U.S. spending was $2,668 per person — three-and-a-half times the
OECD median of $727. The U.S. level is almost double that of the second-highest
spender in this category, Sweden ($1,381). However, the high level of U.S.
outpatient spending may be driven partly by methodological issues.
In the United States, it is common for physicians to provide inpatient hospital
care while not being employees of the hospital. For categorizing U.S. spending,
these physician services are considered outpatient services, even though they are
provided in an inpatient setting. The result is that the United States appears to have
a higher proportion of outpatient spending and a lower proportion of inpatient
spending than it otherwise would. Combined, however, outpatient and inpatient
services account for 71% of spending in the United States, compared with 69% of
spending in the median OECD country — quite similar percentages. Even so, total
U.S. health spending per capita is still twice as high as the OECD average. If
independently billing physician costs in the United States could be recategorized as
inpatient spending, it is quite plausible that the United States would rank first in both
outpatient and inpatient spending in Table 4, with proportions of spending in-line
with the other countries. This highlights yet again the care that must be taken when comparing international health expenditure data.26..."

There is much more, especially in the comparison charts!

[ejpoeta]

8. my responses

Objection #1

Why should I pay for health care for lazy slobs who never exercise, smoke and eat junk food?

Why should I pay for dental care for snot-nosed kids who drink soda pop all day and whose mothers don’t teach them to brush their teeth?

actually, we already are. People who don't have insurance end up in the emergency room to get care, and then when they can't pay the bill, it gets spread to the people who can. Plus, those who end up on medicaid we pay for as well. We are already paying for those who can't, but we are paying more, because those without insurance end up waiting until things are bad. they don't do preventative simply because they can't.

Objection #7

What do you people have against profits, anyway?

There's nothing wrong with profits in general, but when those profits can only be made by denying the coverage that people are paying for. does that seem right?

I don’t want some government bureaucrat choosing my doctor for me.
Some bureaucrat that works for the insurance company decides for you already. and they decide what the company is going to pay for too. And they get bonuses for saving the company money by denying your claims. a bureaucrat in washington at least wouldn't have a personal financial stake in whether you get covered or not.

[eridani]

14. Good, I can add those to my slide show n/t

[bertman]

9. Eridani, could you whittle that down so I can get it on a 3x5 index card for my back pocket?

Great post. I'm trying to remember those snappy comebacks for my next family gathering.

[eridani]

15. If I could make one point, it would be that health care should be a public good

What we need to do for a lot of people is to get them out of the mindset that if government is giving away health care, why not iPods? iPods are not public goods, and we have to get them to make a category shift.

I'd suggest thinking of your fire department, and making as many analogies as you can. Start with Objection #1. Another obvious analogy is that most people will never get expensively sick, just as they will never have house fires. Why should we extract as much money as possible from sick people, but not people who have fires? If some low probability devastating thing that likely won't happen to most people, but could happen to anybody occurs, socialize taking care of those things.

Another analogy--for similarly sized towns, the more hospitals they have, the higher hospital costs are. Building more than one cardiac specialty unit in town won't make people have more heart attacks, so all of them must raise prices to cover their capital costs. The same would happen if you had competing for profit fire departments--if they make profits from putting out fires, there is a lot of motivation to start setting more of them.

Etc.

[demodonkey]

10. K & R It seems that some of our greatest fighters for fair elections...

... are coming out for real healthcare.

:patriot:

[eridani]

17. I can only do two issues intensively.

I have to take the lead from others on economics, education, transportation, green jobs, outsourcing, etc. Luckily there are a lot of homegrown experts here on those issues.

[kenfrequed]

11. Good arguments

We need to call and write and repeat all of these points. A lot.

[salguine]

16. What Obama needs to realize, and that every one of his predecessors have failed to grasp,

is that the President who delivers a universal, single-payer national health care system to this country is guaranteed to be ranked among the all-time greatest Presidents, up there with to Lincoln and FDR.

[eridani]

18. Yep. As FDR said "Make me do it."

Log on to http://change.gov/agenda/health_care_agenda/ frequently, and voice your support for single payer health care. As FDR once said to A. Phillip Randolph, "You know, Mr. Randolph, I've heard everything you've said tonight, and I couldn't agree with you more. I agree with everything that you've said, including my capacity to be able to right many of these wrongs and to use my power and the bully pulpit." He said, "But I would ask one thing of you, Mr. Randolph, and that is go out and make me do it."

Sign the John Conyers single payer health care petition by clicking on:
http://johnconyers.com/transition)

Talk to everyone you know, and let's make Obama do it.

[Politicalboi]

19. If Obama hasn't seen

Sicko someone should show it to him. There has got to be a way to do it here.

[Radical Activist]

40. Educating Obama isn't the problem.

The problem is creating a political environment where single payer can actually pass Congress. Contact Obama then contact your Senator and Congressman. Then organize.

[Politicalboi]

20. If Obama hasn't seen

Sicko someone should show it to him. There has got to be a way to do it here.

[Jim Lane]

21. Worth mentioning Medicare in the answers somewhere

Except for Bush's disastrous drug program, Medicare has worked well. The people who have it are generally satisfied. Its administrative costs are a fraction of what's found with the for-profit insurance plans.

It was good framing for Ted Kennedy to call his plan "Medicare for children". That was what he saw as the next step to move to universal health care.

By the way, thanks for noticing the significant problem of the insurance industry's current workforce. I don't think retraining as nurses is the answer, but those folks should certainly get a preference in hiring for jobs administering the new system. I wouldn't object to a preference for other government positions, too.

[Prophet 451]

22. Agreed, but...

I've spent some time talking to right-wingers recently and discovered that their objection isn't really rooted in anything logical. They just have government so much and are so convinced that it will screw everything up that they will not allow a chance for government to do something well.

[eridani]

23. Ask them about the internet, and creating the aviation industry

Some are, of course, so committed ideologically to the destruction of any and all public goods that they are unreachable.

[Prophet 451]

28. Tried all that

What I hate about it is not that some people are so stubborn, it's the fact that they're holding back the rest of us.

[rpannier]

27. Just tell them Government fails miserably when

the people running want it to fail -- DUH-bya

Government works well when competent people are running it

At some point remind them to stop voting for incompetents and gov't will work better

[Prophet 451]

29. I know, I know

I agree entirely. In fact, I live under state-run universal healthcare. It's not perfect (what is?) but it works most of the time.

[eridani]

24. These are part of a slide show I am working on for training health care advocates

If you want a copy, PM me with your email address. Specify whether you want the PowerPoint format or a pdf.

[clear eye]

25. The Most Effective Tax Break Obama Could Give, Would be Single-Payer Health Care

It would help both individuals and businesses enormously, and people who don't have to worry about potential medical bankruptcy, would be likely to spend more on other things. Small businesses would be much more likely to succeed, and larger ones would finally be on an equal footing w/ the rest of the industrialized world. These economic benefits are in addition to the obvious humanitarian effect of universal, progressively funded coverage. So why has Obama appointed as Surgeon-General a noisy, lying opponent of single-payer??

[eridani]

31. Go to change.gov and ask him that, often and vigorously n/t

[rpannier]

26. I use the same comeback

I live in a country with Universal Health Care and have for over a decade and it works really well.

It shuts them up because they realize they're talking to someone who knows and can refute their idiotic talking points

[puebloknot]

30. I got my childhood "socialized" health care in a quonset hut ...

...courtesy of the U.S. Army. All the worried and sick people in this country would be happy to scale down to basics and be able to see a doctor when they need it. Illness cuts through pretense, and all the fancy designer medical facilities can't hold a candle to medical competence laced heavily with compassion.

Yes, we can!

[meow2u3]

32. More Snappy Comebacks (#8)

I don't want some government bureaucrat choosing my doctor for me

I don't want some greedy corporate CEO choosing my doctor for me--and then refusing to honor my insurance when I try to use it!

I don't want to pay through the nose for premiums only to be denied coverage when I get sick.

[eridani]

36. Good. More additions . Thx n/t

[L0oniX]

33. K & R

[nxylas]

34. Too late to rec, alas

If I'd seen it in time, I would have. The only flaw I can see is the "we have socialized fire departments" argument. Many of those who object to universal health care are libertarians who would probably love nothing better than for the fire department to be privatized and run on a for-profit basis (or abolished altogether - Americans are rugged individualists who can put out their own damn fires), so that argument probably won't work on them. But then, trying to have a rational debate with a libertarian is usually a waste of time anyway, so that's not really a criticism. Keep up the good work.

[BlancheSplanchnik]

35. this is what I wish I could come up with *bookmarked*

when I hear rants from the ignorant who are scared and angry but lacking in information (thanks, M$$M).

I'll have to just print up a bunch of copies and hand them out!

[area51]

37. kick. (n/t)

[anonymous171]

38. "I don't want to have wait in line to get treated"

My response: Have you ever been to the Emergency Room before? I've had to wait 2 hours to get my broken nose looked at.

[crispini]

39. Kick. Well done!

And bookmarked.