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Other Public Options in the USA

tepples (727027) writes | more than 5 years ago

Medicine 10

I've received at least three, now four replies to my current Slashdot signature:

USA already has other public options: public schools and USPS Priority Mail over private schools and UPS 3 Day Select.

I've received at least three, now four replies to my current Slashdot signature:

USA already has other public options: public schools and USPS Priority Mail over private schools and UPS 3 Day Select.

My signature points out that the United States has a history of public and private sectors competing in a given sector. For example, an engineering student in Indiana can go to Rose-Hulman Institute of Technology (private), or she can go to Purdue University (public). An online hobby store can ship packages to customers with United Parcel Service (private), or it can ship them with United States Postal Service (semipublic, funded by an exclusive contract with the US Government for mailing letters).

As of the third quarter of 2009, health insurance for United States residents under age 65 is mostly provided by employers, who make insurance available to their employees. But not all employers are large enough to qualify for group insurance plans, and some employers even restrict employees to part-time hours so that they don't have to offer coverage. Some insurers offer individual plans, but these are known for refusing to cover people with any of several sorts of preexisting conditions. Estimates of the number of documented U.S. residents without health insurance range from 8 million to 47 million.

The legislature of the United States, called the Congress, has recognized that the lack of universal coverage is holding America back compared to other highly-developed countries. Its members have been debating whether to form a public health insurer to compete with private insurers; this hypothetical insurer has been nicknamed "Public Option" or "Obamacare" in the news media. Some more fiscally conservative members of the Congress argue that any public option would distort the market, and people would leave their current plans and end up on Obamacare. Yes, some people will switch from their current insurer to Obamacare, but that's to be expected: people switched from UPS 3-Day Select when USPS introduced flat-rate shipping boxes.

And the so-called "death panel" is actually called iMac.

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Public != federal (1)

tepples (727027) | about 5 years ago | (#29290311)

This post [slashdot.org] appears to confuse a public option in the sense of "managed or funded by a government" with one in the sense of "managed or funded at the federal level of government". I'd like to clarify that I meant the former: K-12 schools are managed and funded primarily at the state and local level.

Re:Public != federal (1)

nedlohs (1335013) | about 5 years ago | (#29290471)

So your whole argument goes down the drain.

The constitution grants the Federal Government the power to run a postal system. Please point to where it gives the Federal Government the powers to run a health system or a school system?

Yes a working public health system is a ridiculous thing not to have in a wealthy society, something like the Australian model of public and private option is better for everyone involved. And the US would be better off with one. But it's not an option at the Federal level, it would need to be at the State level, because the Constitution does not grant that power to the Federal Government.

Of course in reality the constitution is a piece of toilet paper that no one cares about (see Federal interference in education as the obvious example).

There are mechanisms to amend the constitution, if you want a Federally run public health system then that is where you need to start. Unless of course you are in the "the constitution is toilet paper" camp.

Power to collect Taxes for general Welfare (1)

tepples (727027) | about 5 years ago | (#29290929)

Unless of course you are in the "the constitution is toilet paper" camp.

If the Congress's enumerated "power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States" doesn't cover a publicly administered health insurer, then the government has been in this camp since President Johnson signed Medicare into law.

Re:Power to collect Taxes for general Welfare (1)

nedlohs (1335013) | about 5 years ago | (#29293585)

That isn't adding "general welfare" as a end-run around enumerated powers so that anything the government wants to do is fine. It is adding the power to collect taxes, duties, imposts and excises to those two things with a restriction on how they can be used.

So a tax on gasoline with the aim of reducing gasoline usage as opposed to with the aim of raising revenue to fund the government would be unconstitutional (not that anyone cares) at the Federal level.

If you really think that's adding "general welfare" as a new power then you must also think that the government can't spend money it gains from selling assets on "general welfare", right? That's not listed in those revenue items after all.

It would be in the "general welfare" for the government to kill all disabled people and elderly people whop are no longer productiviely contributing to society. Is that OK?

Or is it only things you think are in the "general welfare".

And yes the government has been in that camp since moments after the ink dried on the document.

Re:Public != federal (1)

Sloppy (14984) | about 5 years ago | (#29291229)

I do think it's funny that people are willing (even enthusiastic) to vote for politicians that say, "I will do X," but they are unwilling to amend the constitution to say "Government may/will do X." WTF is up with that?

Re:Public != federal (1)

tepples (727027) | about 5 years ago | (#29291587)

I do think it's funny that people are willing (even enthusiastic) to vote for politicians that say, "I will do X," but they are unwilling to amend the constitution to say "Government may/will do X." WTF is up with that?

A politician needs 51 percent of the people to get elected, sometimes even less in jurisdictions that haven't been completely Duvergerified [wikipedia.org] . An amendment to the U.S. Constitution needs 67 percent of the House, 67 percent of the Senate, and 75 percent of the state legislatures.

Some of the problems... (1)

Darkness404 (1287218) | about 5 years ago | (#29291295)

There are differences between those that you point out. For one, in general the USPS and public schools are inferior to the services offered by private companies. Its not really a matter of life or death if your package is delayed or if little Bobby has a crap high school geometry teacher. But lets say the same standards are held to healthcare, a bad treatment in some cases is going to kill you more than being untreated, any fiscally responsible health care plan wouldn't pay for an expensive doctor when a cheaper one is available, in general, a good specialist who knows his stuff is going to be much more expensive than a general doctor who, although he is a good doctor, might not know as much about skin as a dermatologist, or as much about the heart as a cardiologist, etc. Because those specialists are more expensive people are either going to A) Not go to them B) Insist that the doctor attempts to diagnose and "cure" them even though its way above his level or C) We end up with another disaster like social security.

For another, especially with the current administration the government wants to create jobs, especially for the low-skilled people. An easy way to do that is with the famous government red tape and other crap, lets see, if the government can make people fill out more forms, they can hire more people and tell congress "Give us more money we created XXXX Jobs by doing this!" when all those jobs weren't needed in the first place. Private companies, though they do have paperwork to legally cover their butts, are much better at making things work and making a profit. The government doesn't need to make a profit because they have you and me that they can screw over with taxes.

And lastly, there is simply little reason to have a government option. If we look at places with government options or socialized healthcare, you find startling statistics. The cancer survival rate for Europe (which has in general much more government involvement with healthcare) is much lower than that in the US ( http://www.medscape.com/viewarticle/561737 [medscape.com] ). Do people get in debt over medical bills? Sure, but I'd much rather have $50,000 in medical bills and be relatively healthy than be dead.

Priority Mail doesn't suck (1)

tepples (727027) | about 5 years ago | (#29291511)

For one, in general the USPS and public schools are inferior to the services offered by private companies.

Not necessarily. I've found that especially for smaller packages, Priority Mail is often faster and cheaper than UPS Ground.

The cancer survival rate for Europe (which has in general much more government involvement with healthcare) is much lower than that in the US

But how good is the cancer prevention rate? A fiscally responsible health care plan will pay for 28 grams of prevention before 450 grams of cure.

Is that a pay wall (professionals only) or just a free reg. req. (health consumers welcome)?

I'd much rather have $50,000 in medical bills and be relatively healthy than be dead.

$50,000 in medical bills and you'll end up on welfare, again sucking the government tit.

Re:Priority Mail doesn't suck (1)

nedlohs (1335013) | about 5 years ago | (#29293877)

The US does well at cancer survival rates because it has very good screening programs. If you diagnose early you are much more likely to be alive 5 years later - even if you then didn't do any treatment since you've padded out the population with early stage cases.

This is clearly a good thing, early detection also leads to more successful treatments, it's not all statistical games.

Europe is the wrong place to compare against anyway, your lumping Norway in with the Ukraine.

Yes some public health systems are simply bad. The UK is an obvious example. Others are not. Australia is an obvious example.

What would be interesting is cancer survival rates by country and by income, comparing the US, Australia, Canada and the UK.

I suspect the UK would come last. The US would come first for medium and high income levels. And Canada or Australia would do best for low income levels. Though the simple fact that the US has a prostate cancer screening system that is orders of magnitude better than everywhere else might give them the win everywhere...

But cancer isn't the be all and end of all of health care...

Re:Priority Mail doesn't suck (1)

Darkness404 (1287218) | about 5 years ago | (#29294873)

Not necessarily. I've found that especially for smaller packages, Priority Mail is often faster and cheaper than UPS Ground.

Sometimes, but I have had a lot worse experiences with the USPS being unfriendly compared to Fed-Ex and UPS. It could be somewhat because of the infrequency of non-USPS delivery (I get the mail 6 times a day and a UPS/Fed-Ex package once or twice a week).

Is that a pay wall (professionals only) or just a free reg. req. (health consumers welcome)?

Hm, I don't think it was a pay wall when I accessed it (though it is now for me) However doing another quick Google search comes up with ( http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Study_Compares_U_S__and_European_Survival_Rates.asp [cancer.org] ) and there were other more recent stats but I could never find the primary source (and most were quoted from -very- conservative biased blogs, link to one if you are interested http://mjperry.blogspot.com/2009/08/5-yr-cancer-survival-rates-us-dominates.html [blogspot.com] ).

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