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Quality of Life - Thoughts

Greenbeard said:
Over a decade ago, we had exactly this debate.

The House, being the House, said let's set up a national marketplace with financial support to help people without offers of health care coverage at work buy coverage, and we'll make Medicaid a universal coverage program for the poor.

The Senate, being the Senate, said let's set up state-based and state-run marketplaces (with a federal backstop for states not interested in operating and setting policy for their own marketplaces) with financial support to help people without offers of health care coverage at work buy coverage, and we'll make Medicaid a universal coverage program for the poor.

("Conservative" Republicans largely boycotted the conversation).

The Senate won. And the SCOTUS subsequently said fine, but the Medicaid part requires states to opt in to making Medicaid universally available to poor people.

Red ("conservative"?) states largely said 'we're not interested in operating our own state marketplaces, we'll default to the federally-operated option.' The bluest states said 'we'd rather operate our own marketplaces at the state level ourselves, no thank you, federal government.' What a twist! (In Mississippi, the GOP governor and the GOP insurance commissioner feuded over this very question, before the governor won and the state defaulted to the federally-run option). So most red states ended up with federally-operated marketplaces for insurance and many blue states ended up with state-run marketplaces.

Meanwhile, virtually every blue state (and most red states) accepted the option to accept the expansion of Medicaid into a program of universal coverage for the poor. But some of the reddest states held out. But proponents in some deep-red states decided to ask voters at the ballot box and it turns out deep-red voters in Idaho, Missouri, Nebraska, Oklahoma, Utah, and South Dakota all thought Medicaid should be expanded to cover all poor people.

Maybe the moral is that "a conservative approach" to this question is completely meaningless at this point. And we should stop hiding behind labels and abstractions and just do what we think makes sense.

Certainly that approach has improved the quality of life for millions of people over the last 12 years or so with respect to their health care.
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Brilliant post. Thank you.
 
Grand Mal said:
Make it more local then. In Canada the only federal involvement is the requirement that all Canadians have a right to access to health care. It's up to the province's how that is delivered.
You don't have to reinvent the wheel. There's dozens of government health care insurance schemes around the world- pick one that does what you want it to and copy it
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Let's be clear.

This is a general discussion about the quality of life and how people view it.

Healthcare was just an example.
 
HikerGuy83 said:
Let's be clear.

This is a general discussion about the quality of life and how people view it.

Healthcare was just an example.
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Yep, as I tried to point out in post #25. The basic argument seems to be centered around whether the role of government should be to help ensure equality of opportunity or outcome for one’s ‘quality of life’ (socioeconomic status?).

en.wikipedia.org

Socioeconomic status - Wikipedia

en.wikipedia.org en.wikipedia.org
 
soylentgreen said:
So again, it is not a binary decision.

In fact when the two coexist they work far better than just if private insurance was the only access to insurance.
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You seem to have ignored the linked bill entirely. HAND
 
ttwtt78640 said:
You seem to have ignored the linked bill entirely. HAND
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The link has nothing to do with your previous comment of it being only a binary decision. Which it is not.

And you really should not be putting out that the american welfare system is a working alternative. All it does is provide the most limited basic service and then if the patient cannot afford further treatment they just go away and die. . Or end up selling their every possession to afford the medicines.

A universal health care system is far preferable to private insurance. And a mix that actually provides health care service without the fear of not being able top pay for it even with insurance costs is far better.
 
soylentgreen said:
The link has nothing to do with your previous comment of it being only a binary decision. Which it is not.
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BS, that bill (proposed federal law) specifically outlawed any and all private medical care insurance offering ‘competing’ benefits and mandated that all ‘participating medical care care providers’ be either government owned or non-profit. It can’t get much more “binary” than that.

soylentgreen said:
And you really should not be putting out that the american welfare system is a working alternative. All it does is provide the most limited basic service and then if the patient cannot afford further treatment they just go away and die. . Or end up selling their every possession to afford the medicines.

A universal health care system is far preferable to private insurance. And a mix that actually provides health care service without the fear of not being able top pay for it even with insurance costs is far better.
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ttwtt78640 said:
BS, that bill (proposed federal law) specifically outlawed any and all private medical care insurance offering ‘competing’ benefits and mandated that all ‘participating medical care care providers’ be either government owned or non-profit. It can’t get much more “binary” than that.
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Again you seem to be supporting what I have said. Which is that it is never a good idea to look at what the americans are doing in the way of health care unless of course for some strange reason you need to know what is the most dumbest way of doing health care.
 
Not about health care.

Please move on.
 
rickc said:
Quality of life?

Not about Health Care?

Nothing could be further from the truth.
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Health care was an example.

The OP is about quality of life in general.

Granted many metrics include access to health care as a weighting factor.

But that isn't what this thread is about.
 
ttwtt78640 said:
That was precisely my point. It’s hard to argue that paying for (or subsidizing) X is not having any involvement in X.
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ttwwtt78640:

The Canadian Federal Government pays about 22% of the healthcare budgets for each province but it cannot force provinces to do as it says. The Federal Government can set standards of availability (public vs.mprivate healthcare penetration) and make suggestions about how provinces could access more funding for special circunmstances but it cannot and does not try to order the provincial healthcare authorities around. This is because under the rules of the two Canadian constitutions provinces are coordinate and not subordinate to the Federal Government in their constitutionally defined areas of jurisdiction. Healthcare is a provincial jurisdiction.

Cheers and be well.
Evilroddy.
 
ttwtt78640 said:
Yep, but the idea that publicly subsidizing something automagically reduces it’s cost is BS.

For example, the cost of groceries purchased with SNAP funds is no less than that paid by any other grocery buyer. SNAP offers an over $100B/year federal subsidy to ‘grocery providers’ which charge full retail (including profit) price for SNAP grocery purchases.

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ttwwtt78640:

In a private healthcare system there will always be a cluster of premiums to be paid in order to cover profits and in the case of public companies dividends and wth red etc to insurance companies underwrite's fees. In a publicly funded healthcare system every dollar goes to supporting that system even if there is administrative waste along the way. In a private healthcare system, underwriting fees, dividends and profit-taking greatly diminish the flow of money actually making it to the institutions and personnel actually providing the healthcare to those n need. This is further exacerbated by having redundant administrative costs reproduced in many private companies along the healthcare chain, further bleeding the monies actually spent on frontline healthcare. That by-passing of profit-taking and unnecessary reproduction of administrative costs can be a real saving and that is at the root of why American healthcare is so expensive despite being only average in the quality of care it delivers to most (not wealthy) Americans.

Market solutions are sometimes not the best ones in vital sectors with limited resources where people's lives are at stake.

Cheers and be well.
Evilroddy.
 
HikerGuy83 said:
Let's be clear.

This is a general discussion about the quality of life and how people view it.

Healthcare was just an example.
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HikerGuy83:

Thank you for the clarification.

Quality of life is so subjective that I don't think you'll get any well deligated conclusions about it. Rather I think you'll get a more nebulous locus of responses with some correlating points and lots of outliers.

In my case quality of life is a state of mind, not a state of being. For years I worked like a dog teaching high school students with a combination of perfectionist and missionary zeal for the cult of learning. I resisted succumbing to burnout for over thirty years but eventually the long hours (6 days a week and I worked or volunteered during summer breaks) and the fast-paced fluidity of the job made me very ill in my late 50's. It took me two years to recover physically from that damage to body and during that much slower period of my lifetime I thought hard (really for the first time in my life) about who I was and what I wanted. That led me to a complete reshaping of my thoughts about quality of life and allowed me to recalibrate what I knew about my own desires and the channels/pathways towards happiness and contentment.

Much less concern with the material aspirations of life and much greater emphasis on feeding the mind rather than feeding greed, ego or ambition. Today with far less resources at my disposal, I am nonetheless very much more contented with my life (except for a damned cat which plagues me). I am more happy with both less and the prospect of less down the road. I now tutor students in need rather than teaching the best of the best or the toughest of the tough at a break-neck pace and have a much better life for it. However my beloved wife died many years ago and I have no kids, so I need only worry about myself, my aged aunt who lives with me and for whom I am the primary care giver, her aristocratic cat and my wider family. Others' situations will vary.

For me, less has become more and that has been very satisfying to me.

Cheers and be well.
Evilroddy.
 
Evilroddy said:
ttwwtt78640:

In a private healthcare system there will always be a cluster of premiums to be paid in order to cover profits and in the case of public companies dividends and wth red etc to insurance companies underwrite's fees. In a publicly funded healthcare system every dollar goes to supporting that system even if there is administrative waste along the way. In a private healthcare system, underwriting fees, dividends and profit-taking greatly diminish the flow of money actually making it to the institutions and personnel actually providing the healthcare to those n need. This is further exacerbated by having redundant administrative costs reproduced in many private companies along the healthcare chain, further bleeding the monies actually spent on frontline healthcare. That by-passing of profit-taking and unnecessary reproduction of administrative costs can be a real saving and that is at the root of why American healthcare is so expensive despite being only average in the quality of care it delivers to most (not wealthy) Americans.

Market solutions are sometimes not the best ones in vital sectors with limited resources where people's lives are at stake.

Cheers and be well.
Evilroddy.
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Since the OP does not want this thread to focus on healthcare or insurance to fund it (see posts #27, #28 and #37), I will address only the bolded above portion of your post.

Which (other) sectors of the economy (industries?) are “vital with limited resources where people’s lives (or, as the OP put it, ‘the quality of their lives’) are at stake”?

Wouldn’t those ‘quality of life‘ impacting sectors (industries?) include housing, groceries, utilities, transportation and clothing? I, and certainly most folks, spend far more of their (often meager) incomes satisfying (or at least trying to satisfy) those other ‘quality of life’ needs - or do you consider those other sectors (industries?) to mainly (only?) provide wants?
 
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BirdinHand said:
See, the ACA has been a game changer in my family’s quality of life.

If it wasn’t for the ACA, I’d likely have to work as an employee somewhere and maintain working for that employer to have health insurance for my family. And frankly, some employers I’ve worked for have had really bad insurance policies - because that’s what they chose. Even worse would be when they decided to change insurance providers/plans and then that meant I had to change doctors, etc because the new plan would be in a different network.

Now, I simply go online to the NJ Portal annually and renew our coverage (and I always see if there is a different option that’s better for us).

Our health insurance is now under our control. And I haven’t had to be an employee anywhere. I can have my own small business, I can offer consulting services, etc as fits my families schedule and lifestyle - and the worry isn’t there about health insurance.

But, from what I understand, my experience in NJ when it comes to the ACA is completely different than those in other states - because NJ is “all in”. We have numerous providers and tiers available and there are lots of plans to choose from. I’ve heard in other states, that isn’t the case.
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This exact scenario is the strongest reason I support universal health care. It opens up economic mobility and pathways for people to better their lives without fear of being locked into a certain insurance.
 
tacomancer said:
This exact scenario is the strongest reason I support universal health care. It opens up economic mobility and pathways for people to better their lives without fear of being locked into a certain insurance.
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Why limit your desire for (more) income redistribution programs (federal subsidies?) to fund only health care? Why not housing, groceries and utilities? One’s ‘quality of life’ certainly depends on having (at least) those basic needs met on a daily basis.
 
ttwtt78640 said:
Why limit your desire for (more) income redistribution programs (federal subsidies?) to fund only health care? Why not housing, groceries and utilities? One’s ‘quality of life’ certainly depends on having (at least) those basic needs met on a daily basis.
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Health care is one of those things where there is a common case of "pay this amount or die" whereas other markets do not have that factor.
 
tacomancer said:
That's only for momentary stabilization and does not address medical issues where death is the result of degradation over time, such as kidney disease or diabetes which is still subject to the "pay this amount or die" problem.
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Rest assured that your ‘quality of life’ would degrade (rapidly) over (a fairly short) time without housing, groceries or utility services.
 
ttwtt78640 said:
Rest assured that your ‘quality of life’ would degrade (rapidly) over (a fairly short) time without housing, groceries or utility services.
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True and on the low end of the income spectrum, people get help for those things.
 
tacomancer said:
True and on the low end of the income spectrum, people get help for those things.
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OK, but you wanted universal coverage (i.e. no out of pocket expense) - not simply help for some “on the low end of the income spectrum” (wherever that means).
 
ttwtt78640 said:
OK, but you wanted universal coverage (i.e. no out of pocket expense) - not simply help for some “on the low end of the income spectrum” (wherever that means).
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Yup. Two different problems in scope, details, and effect means there would be two different solutions.
 
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