Should the US expand Medicaid to 400% of the Federal Poverty Level

[Socrates92]

Businesses are always making cost-benefit decisions based on territorial issues. I don’t see why evaluating the health-care benefits of given area over another should be any more of a headache than other business-related decisions.

 

[KJW5551]

You get equal misery for all, instead of just misery for some.

Equal misery for all? If we had a Brit, a German, a Frenchman, and an American in the same room and asked them what they thought of their healthcare system, who do you think would be most likely to say they’re miserable?

 

[philipl]

I have mixed feelings on that. Ayn Rand was anti-government on almost everything but she chose Medicare to pay for her surgery.

So, if the government would pay me back all of the SS and medicare money that forced me to pay them, I promise with that money I can afford healthcare payments and a better retirement. Just because I am anti big government doesnt mean I am going to let them steal what they took from me.

 

[Axsenex]

Yes & $77 million have been wasted on golfing trips so I think it’s a better priority.

 

[Augustinian]

The last thing we need is 50 states with 50 disparate health systems;

I disagree. If we do institute a new socialized medicine system, we don’'t know what will work out best- getting different ideas out there to see what works will be a key to optimization. Second, all the states are different- what could work out fine in Mississippi might not work so smooth in Connecticut.

 

[KJW5551]

Except we already have case studies to work off of, namely, the healthcare system of every other OECD country. We don’t need a patchwork of 50 laws to attain affordable healthcare.

Edit: a national health system is no more socialized than a national highway system or national parks service or national defense. But we don’t use the “S word” for those, do we?

 

[Augustinian]

The solution is for us to stop thinking of medical care as “welfare”. There are tons of government services each and every one of us benefits from (highways, libraries, public education, public safety, etc) and we don’t consider that welfare.

If its means-tested, as the OP suggests, its welfare. Those with higher incomes won’t get it.

As far as delivery of services, it will be mostly be done the most economical way available, in clinics- a lot being done by interns and residents who will still need to be trained. Those already on Medicaid aren’t going to be getting the lower tier care while the new Middle Class recipients receive more expensive private office doctors.

 

[boldlygo]

If I’m the American, it wouldn’t be me. I’ve always had excellent healthcare, but I’ve worked, and worked hard for it. To paraphrase St. Paul, “if you don’t work, you don’t eat.” Nothing in life is free, and that includes healthcare.

 

[KJW5551]

Catechism 2288 requires a society to provide health care for its citizens. How it does that is open for legitimate discussion and debate as evidenced by the diversity of opinions in this thread. But make no mistake healthcare is a moral issue, and in my opinion the U.S. lags behind much of the rest of the developed world in providing healthcare for its citizens.

 

[KJW5551]

If I’m the American, it wouldn’t be me. I’ve always had excellent healthcare, but I’ve worked, and worked hard for it. To paraphrase St. Paul, “if you don’t work, you don’t eat.” Nothing in life is free, and that includes healthcare.

Problem with that statement is that there are millions of hard working Americans with poor health coverage or who are a job loss away from being uncovered. Of course there are free riders, there always will be. But most Americans are just as hardworking as you are.

 

[boldlygo]

Of course there are free riders, there always will be

Why??!! If you eliminate the fraud, the load is lightened for everyone else.

[I’m 70 years old, and I still outwork most of the youngsters…]

 

[Socrates92]

Not sure, but we were talking about a federal/national healthcare funding system (ie: exclusively within the States) vs. a State-run one, not a global system, so I’m not sure what this has to do with the question.

 

[Socrates92]

Problem with that statement is that there are millions of hard working Americans with poor health coverage or who are a job loss away from being uncovered. Of course there are free riders, there always will be. But most Americans are just as hardworking as you are.

Of course. The fact that healthcare coverage is generally tied to employment, and strongly incentivized that way by the gov’t is one of the key problems (not the biggest, but definitely a key one) with the American system.

 

[Socrates92]

The solution is for us to stop thinking of medical care as “welfare”. There are tons of government services each and every one of us benefits from (highways, libraries, public education, public safety, etc) and we don’t consider that welfare.

Medical care itself is not welfare. Gov’t healthcare coverage is. As per those other services you mentioned, we might not consider them welfare, but that would be an accurate term. Any time someone benefits from a service at the expense of someone else, I would consider that technically welfare regardless how colloquially unacceptable that may be.

Apart from the questionable assertion that “each and every one of us benefits” (does everyone really benefit from libraries? Judging from the everyday traffic at my branch I’d say no), the benefits are certainly not equal, or even proportionate to the costs. Their is no inherent reason why a bicycle commuter should pay the same for the upkeep of highways as someone that commutes 100km/day in an F150. In that case, all else being equal, the pickup driver is receiving a form of “welfare” from the biker, even if the pickup trucker happens to make 2-5 times as much.

I’d actually question all those you mentioned, except for public safety, as legitimate services of government. Relative to how we would benefit from more competent management within the private sector, it’s probably more accurate to say that each and every one of us is negatively affected by these services. In this way, gov’t healthcare coverage (as distinct from the actual medical care itself) is similar to these other forms of welfare.

 

[QwertyGirl]

If its means-tested, as the OP suggests, its welfare. Those with higher incomes won’t get it.

I would suggest it should be like Medicare, but for all. No means testing necessary.

 

[Socrates92]

Catechism 2288 requires a society to provide health care for its citizens.

CCC 2288:
"Life and physical health are precious gifts entrusted to us by God. We must take reasonable care of them, taking into account the needs of others and the common good.

Concern for the health of its citizens requires that society help in the attainment of living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance."

Society does not equal government. (Although gov’t is a component of society) Free enterprise and charity are equally legitimate parts of society. I read the “social” aspect of CCC 2288 as encompassing all three of these aspects, giving preference to charity and free enterprise before government assistance - as opposed to the “social” in “social programs” as we often think of the term. This is more in line with the Catholic idea of subsidiarity as well as just good economics.

I realise you didn’t actually disagree with anything I just posted. Just thought I’d chime in with my opinion though

 

[QwertyGirl]

(does everyone really benefit from libraries?

Yes. Each and everyone of us benefits from communities having libraries open to the public. This is because it means the general population is more educated. Much of our local library is now accessible
on-line, incidentally. I would not want to live in a country that did not afford its citizens libraries. Sort of the same way I don’t want to live in a country where poor people or middle-class people don’t have access to affordable healthcare. Who wants to live in a country full of sick and diseased people. Even if I’m in perfect health I don’t want to live in those conditions.

 

[Hereiam]

But what about our neighbors in need?

Days gone by, unfortunately.

There used to be a segment of American society known as the “deserving poor” (those who misfortune despite strong work ethic) were economically marginalized…Now the “deserving poor” is only one person, also known as “ME, ME, ME”, and those down and out are down and out because they are substandard.

Many of those who are able to afford healthcare (and other basic survival needs) frankly don’t give a damn about those who can’t, and view any governmental funding to give a boost to those in need as a threat to their “stuff”.

If the Great Depression happened today, rather than a nation coming together and enduring hardship together, we would more likely see violence and unrest.

God help us all!

 

[Socrates92]

Yes. Each and everyone of us benefits from communities having libraries open to the public. This is because it means the general population is more educated.

I would strongly question that assertion.

• First, what portion of the general population actually uses the library? If it’s only 5% (to pull a number out of a hat), then it’s tough to argue that there’s much spillover effect to the rest of society. My hunch is that the percentage is very small, hence my point.
• What are those libraries being used for? Does a 13yr girl checking out a zombie-romance novel really benefit general society? “Educated” is one of those terms that gets thrown around a lot where it doesn’t necessarily apply.
• Even those who are genuinely using libraries to acquire great depths of knowledge aren’t necessarily doing a service to the rest of the society - they’re just bettering themselves for the most part.
• Yes there are definitely some (maybe many? I doubt that though) who do benefit. Those without personal computers and/or those searching for jobs often make use of library resources in a useful manner. But in this aspect, Libraries pretty clearly take on the attributes of welfare - someone is making use of a service without paying for it.
• With public libraries, the fact that the costs are widespread (taxes), while the benefits are very localized (among those who choose to use them - presuming that they do benefit from the choice), makes it very clearly a form of welfare.
• The statement that “each and everyone” benefits is a stretch by any means. I’m sure there are some spillover effects to general society, but is it really enough to justify funding such an institution at public expense? Libraries could also function on a paid membership basis (or rental - or do bookstores already rent books?).

The rest of your response is technically a tangent - we started talking about what benefit is derived from welfare as well as how to define the term. Now you’re talking about affordability, which is a slightly different thing.

Sort of the same way I don’t want to live in a country where poor people or middle-class people don’t have access to affordable healthcare

Healthcare is a lot more bloated with bureaucracy, perverse incentive structures, and cronyism than are public libraries. The unfortunate result is that, yes, it becomes unaffordable for many.

Who wants to live in a country full of sick and diseased people.

Healthcare is one aspect of a nation’s health, just as libraries are one aspect of a nation’s intellectual health. Other aspects - which I think are much more significant - are ordinary healthy habits. Even if it has the best HC system in the world, a nation full of smoking, drug addicted, overeating couch potatoes is going to be less healthy than one with no system in which the people have better habits.

 

[QwertyGirl]

Other aspects - which I think are much more significant - are ordinary healthy habits.

Tell that to someone who has made healthy choices their whole life, and then comes down with a pesky case of cancer. I don’t really have much more to say on the topic if that is your attitude. With regards to your post on the library, the library can help instill a love of reading in very young children. They grow up reading books and being educated. It all goes together.