Morkenlar wrote:

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Anyone else have ideas on what would/could convince you to change position on this issue?

In a discussion at work, I warmed up to the idea of public healthcare in the sense that it was another service the community provided for the sake of the community. There is a firestation on ever other block and no one thinks a thing about it. Why not in addition to schools, police station, fire stations, etc, there were health clinics found in very city for use by the locals? Isn't basic community services a core purpose for government? The problem with that view, to me, is that government does not focus on only this core purpose - it want to be involved and spend money on everything under the sun. I cannot support healthcare if it's just another spending program the government starts in order to get more taxes. I would support universal healthcare if the government cut its nanny programs and fluff spending to only live as a maintenance function for the basic community services.

vizco wrote:

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Everything said about medical care could be said about food or housing as well, and yet government has not taken over either of those segments of the economy. Instead we provide a safety net (Food Stamps and various Housing programs, respectively) for those in need.

Why is health care different? (In fact, we already have Medicaid, which provides government-paid health care to the poorest, and Medicare which provides it to the elderly.

Few would argue that we shouldn't provide health care to the needy; the question is, why should the government essentially take over the whole industry to do that?

Because many people view healthcare as essentially a community service. Fire departments exist as a purely protective service for society. It's such a communal activity that we assume government to provide it. Schools are the say way; no one rants and raves about government taking over schools. Healthcare can be viewed in that same way, in that it's not individual-focused. Note that I am not saying that it IS that way, only that it can be viewed in that way.

Much of our marketplace assumes that goods and services are for-profit items. You want to buy a car? We expect selection and availability to be based on profit-driven market. The fire station down the street has no concept of profit and the firemen do go into the profession for profit-incentive reasons. Healthcare may be one of those things that should not be profit-driven but community oriented. If a principal of a high school or a general in the army does not care about annual returns of investment, why should a hospital administrator? That is sort of the change in thinking some people have gone through. In that sense, insurance companies really have no position in the industry because they exist solely to manage access, not provide care. How go about that big market change? Some people see government as the proper tool.

Why not houses and food? Those are really individual-focused and not community focused in that the products are chosen and comsumed by the individual. A hospital is about services; no one goes out to buy a MRI machine to use for his test and then keeps it in his garage next to the old treadmill. A large hospital infrastructure must exist to provide services, not goods. Providing point services is not as functional as providing foodstamps or rent-controlled housing.

A large part of the answer to your questions is "efficiency". Food is easy to provide for individuals through point services, but healthcare is much more efficient as an organizationally controlled industry. Don't confuse "best" with "most efficient", but many people still feel that community healthcare is most efficient.