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A few of the comments on the US Elections thread got me wondering about the hostility I've seen towards the idea of a left leaning government in the US. I'm not from the US (obviously from my location) and I consider social welfare, free education and government sponsored healthcare to be really good things. I've had personal experience of all three in a very positive way: My education has been free so far, and has allowed me to pursue my interest in science to PhD level, which given my parents and my own income levels would not have been possible under the US system without me getting heavily into debt, which I would have avoided. My niece was born with a heart condition, and again, our economic background meant my sister couldn't afford private care easily- my niece needed expensive medicine to repair her heart, and my sister is quite young and hadn't the money to pay for it, but the state did. When she needed open heart surgery, she got it, with a good surgeon in a good hospital. There are many flaws with the Irish health system that I won't go into, but mostly they have to do with a drive towards privatisation by a neo-liberal (economically) right wing party who have been in charge of it for too long (Ireland generally has coalition governments. Our current is a mix between centrist Fine Fail, the right wing Progressive Democrats, the left wing Greens and a few independants). And a friend of mine was unemployed after an accident, and was able to get by on social welfare until he could educate himself and get a decent job.

As I understand the american system, it's up to each individual to sort out their own insurance which would pay for the like of my nieces medication and surgery, and to sort out something if they are unable to work (there is some welfare stuff, isn't there? Just not as extensive and cushy as ours) and education has to be payed for but most manage it through loans or perhaps military service. Please, correct me if I'm getting stuff wrong. This seems fine to me- it seems to work alright for a lot of people. I prefer the system I was raised in, but that may be down to familiarity.
What I'm interested in is the hostility I've seen towards the idea of these things being paid for or controlled by the state. Personally, I'm happier knowing the state are controlling public transport and health than a private individual, and don't mind our high taxes (which aren't even that high by european standards) and stuff if they pay for all these things. Seems to me it's simpler than having to negotiate some sort of decent insurance deal, or scanning every job for associated benefits. Just take it out of me pay and let me get on with things would be my attitude.
Why is there an attitude that state control of these things is bad? I'm interested in learning about other points of veiw to my own. (Ie. this thread is not meant to be a challenge or a criticism.)
(And information on attitudes in other places, such as Canada or other European countries is welcome too of course!)

Well, you see, we here in Amuricuh have this thing that you furriners don't.
It's called FREEDON.
You see, the way it is, we're basically a FREE people.

If'n we was to let the Government into our lives to pay for everything and tax us to pay for it, that would be infringing on our God Given Constitutional Rights. Ain't no way We're gonna let the government pay for everything. They might try to take control of those things.


Yes.
There's humor there... Sarcastic humor.

That about sums it up. People who scoff at those notions scream about "big government" and how they'll end up controling every facet of our lives. Conspiracy theorists abound.

Personally, I'm jealous. Your government is paying for you to get your PhD? Free? You don't have to pay the fees back?
Great! Now, I'm thinking about moving to Ireland!

DAMMIT!!!

Stupid Dakka...


Eric

My government paid for my primary education (5-11), and secondary (12-17). Then, dependant on my results in our leaving certificate exams (which are fairly difficult but not too bad) I could get into various university courses. Generally, most people can manage to get into a course somewhere. It mostly requires a good mark in english, irish and maths, and whatever relevant subjects (biology and physics for me), and a third language. Once you're in, the university level stuff is free as long as you don't fail any exams, but they're fairly lienient- if you fail you can choose to repeat the year externally. So you don't get any teaching support, just reading rights in the library, but can resit your exams for free.
I got quite a good result in my undergraduate, and had done a lot of work during summer on research projects and the like, so I managed to net a scholarship which pays my fees for me and pays a modest wage. Without the scolarship, i'd be paying my own fees. But most phd students I know have managed to snag some sort of funding because our government is pumping tonnes of money into graduate education to keep us competitive (our big selling point is that we're well educated and in english speaking in the euro zone).
If I drop out of my phd, I have to pay back the money they gave me, which I reckon is fair enough at this stage. they've invested a lot of money in me.

I'm often envious of the US too, because a lot of the big research happens over there, and the facilities in the top institutes are simply amazing. But on the whole I love living in Ireland. I will be visiting the US sometime soon though.

Big research is well-funded.

College undergrads get their degrees through debt.

I don't know what percentage of undergrads go into debt,
but it seems to be getting worse and worse. There are
people who walk out of their undergraduate degrees with
their education riding on the back of a small mortgage.
Private sponsorship provides ways to alleviate some of
that debt, but it's frightening just how deep people get into
it before they even have a job.

Yeah, to be honest if I had lived in the US I never would have considered university education at the age I entered. I would have gone off to work first, probably in some crappy job (I used to work on the fishing trawlers, then the docks as a porter. Imagine that for ten years...).
Very glad I live here. Though I wouldn't mind a system like they have in Australia too much. Seem fair enough I suppose. The free education thing costs the state a bomb and I often wonder if the teeming hordes of undergraduates really appreciate it enough.

Wait, are you Frank McCourt?

Everyone has their own path to their bliss. Some work
out of choice. Some work out of necessity. I have a hard
time saying what I would have done if I hadn't gone to
college, but I was academically inclined.

Hah! Hardly.My father is a policeman and my mam is a used to run a bed and breakfast. Pretty far from Angela's Ashes in all fairness
You have to respect the American undergraduates. Those that I met were all very hard working and accepting of their debt. I think a large amount of our lot could do with getting some of that attitude.

if this is what we're talking about, there's nothing wrong with debt to pay for school, it's an investment in your future that pays for itself many times over.

You're right. The debt lights a fire under some people to
get with the program and do what they have to do, but
it's such a frightening number to deal with.

Not everyone gets to sleep with Steve Martin to deal with
it (movie reference time)

It's a scary thing for me to contemplate, but if I'd been raised in that system I probably would have been less scared of the debt, and more accepting.
I agree that we should be willing to pay for our educations. but it was nice not to have to!

Healthcare on the other hand I think is something that should be subsidised and available to anyone who needs it to a reasonable standard.

Lack of educational subsidies is one of a myriad of reasons why America is increasingly becoming a class-tiered society. You have to go into debt to get the education; you have to have collateral (in many cases) to cover the debt; you (or your family) have to have money to have bought the collateral in the first place; your family never had the money needed because they couldn't get an education. A nice vicious cycle.

It's very easy for those on the upside to say that everyone should look out for themselves, but not everyone has the opportunities that they, and I myself, had. I was lucky enough to be born into a family that could pay my tuition out of pocket, and pay for my various expenses and insurances, but what about those who just barely can pay the basics? What if they suffer a setback or unexpected expense, like an uninsured injury (which is likely, considering insurance is one of the most unreasonably-priced "services" out there)?

I love living in America, but I hate what some of my fellow Americans are trying to turn it into.

Tacobake wrote:if this is what we're talking about, there's nothing wrong with debt to pay for school, it's an investment in your future that pays for itself many times over.

Not to mention that it's a benefit to you first and foremost. Society benefits only indirectly.

For example a law degree from a top tier school is extremely expensive. Most people who get one do so because they want to make 6 figures practicing on Wall Street. Should society pay the extremely high costs of that degree so that you can earn that high income?

If the degree primarily benefits the individual, as most degrees do, then the individual should bear the burden. (The US has universities that have essentially free tuition for social justice type law degrees - there's on in NYC - so that doesn't enter into the picture).

A lot of the astronomically high debt, both here in Canada and in the US is the students' own fault for living large and spending frivolously. If you go to a State University (most of which are excellent), live at home with your parents and work during the summers and part-time during the school year, you can easily graduate from undergrad with no debt.

If you go to an out of state or private university or don't work while earning your degree, I don't have much sympathy for the fact that you're in debt, especially when you went $50,000 in debt to get a degree in English literature or something.

My total debt at the end of undergrad was $500 because I worked hard to earn and maintain scholarships, lived at home and took the bus instead of owning a car and worked 60 hours a week during the summers and as a TA and RA during the school year. My parent's contribution was limited to food and board. My law school debt is much higher (even with Canadian law school tuition only being 1/3 that of most US schools), but I did it to improve my own income prospects and I'll be able to pay it off myself within a few years.


More generally, society has an obligation to look after members that can't support themselves - the disabled, mentally ill, crippled veterans, etc. There should be a support system in place to look after these people. I don't think its unreasonable to expect people who can to work for a living though.

I agree with you on that stuff. (Well, except it's not really possible to live at home and study in many places in Ireland. Don't laugh, I know we're a tiny island, but our naff road system means it takes a long time to get anywhere.)
Well done for working through undergrad. I was glad I didn't have to.

My wife did that, Asmodai. She did school part-time, lived
at home, and paid for college with a part-time job. She
pretty much had to because her parents were only willing
to provide room and board.

Something happens when people have some means, but
not enough to completely cover what they need. They go
into need(editEBT). My wife had less and made more out of it, but
it took longer.

One could argue that a state school (like hers) is a government
subsidy in and of itself. What I really hate is the stigma
from small liberal arts schools for state schools.

"Staties" was the derogatory term they used for us students.

Heh. Try the stigma attached to attending a university outside the US that isn't oxford or cambridge. "You went WHERE?"
Heh.
Serious respect to people who work their way through college, that's tough going.

So where did you go?

National University of Ireland, Maynooth. A fairly small uni as they go. Noted for the catholic seminary attached to it, and a fairly good engineering and biosciences research base.
It's not so important though.

To get back on topic, what, if anything, is wrong with state subsidised medical care?

The Cost. We already have free health care to an extent in America. Go to an emergency room and regardless of your ability to pay for it, the doctors will do whatever is necessary to keep you alive with no regard to your ability to pay for it. Hospitals know that many of their poorest customers will be unable to pay their bills and this loss is passed onto customers who do pay their bills (either with insurance or subsidized). That's why health care is so expensive.

We do have government provided insurance in this country for the needy, it's called medicare and currently more than 40 million americans are covered by it. Medicaid helps seniors afford medicine. ANd Social Security Disability provides financial assistance to disabled people.

I don't know what the number is, but I would imagine that the cost of buying private insurance is around the same price as the tax increases that would accompany nationwide healthcare. Right now, Social Security, Medicare, and State and Federal tax withholdings only account for 14.7% of my pay checks. How much of your paycheck in Ireland do you take home?

Our healthcare over here is exceptional. Even in Emergency Rooms, which agains is where most of the uninsured primary physicians are, a doctor will be seen in a matter of hours for even the least severe of cases.

The major problem is providing preventative care to the uninsured. This is a really expensive prospect. Current entitlement programs are already on tract to outspend current rates of tax collection in the next 20 years. This means either cutting services or increasing taxes just to pay for government services at the current level their being offered at.

The financial incentives doctors currently have in the U.S., make money, helps keeps the competition for medical school up. This ensures the best brightest get in. Likewise, financial incentives encourge the development of new drugs and other medical devices. National healthcare will come with national regulations and price ceilings that will put a clamp on the current rate of development.

I believe that current medicare programs need to be expanded to include more of the poor, but I definately stop short of saying that national health care should be provided to every american if they are able to get their healthcare from another source.

I had heard of medicaid before but forgotten about it, thanks for the reminder! Tax varies from person to person, but i think my Dad who is on a reasonable wage gave 40-50% of his income in tax.

the federal tax for the richest of americans is in the 30s%.

Medicare is Insurance for poor
Medicaid is Perscription Drug Assistance for Elderly

But if there's a national service available, will employers
even bother to provide competing health care? See: Wal-Mart
(just as one example)

One of the things I see often is the assumption that if your against the government doing something than you must be against it all together, which is not true. For instance if you are against an increased wellfare state you hate the poor. The truth is that many believe in charity and give their time and money but don't want think it is the governments place to enforce charity. Forced charity is no charity at all. Doctors give their time, lawyers do pro bono work, people work at soup kitchens, ect ect. That is not to say that a government should do nothing, but it is a slippery slope. You give a little it will never be enough. Someone will always think it should be more. It is about freedom and freedom from government interference is an important idea. We've strayed so far from our federalist origins it is almost hard to believe that we are the same country at times. States rights are pretty much gone and the federal government calls the shots and the presidency has gained so much more power then ever envisioned and the Supreme Court gave itself the power of Judicial review, which isn't part of it's charter. On the other hand change happens and can be very positive. The rights of Women and minorities are the obvious examples of necessary change that was a problem since the beginning but took many many decades to fulfill.

As far as the people against being for class warfare, it cuts both ways. The people who are pushing for a more socialized system play on class much more often and are the ones that benefit from class divisions much more.

I suppose it comes down to whether you are a Utopian oriented person or a skeptic. You believe that we can tax the hell out of ourselves and that a government with it's hands in everything would somehow break the axiom of absolute power corrupting absolutely and not be corrupt. We'd all be miserable but we'd be equally miserable eh? Even with all that in place you still are going to die and the best you can hope for is that we help each other out if we can and hope for the best. The federal government is not a salve that can make the world a rainbow if it just spends enough money.

I'm old school though, I believe that the government that governs least governs best and it is up to the individuals in a community to help each other, not rely on the government to do so.

Da Boss wrote:I had heard of medicaid before but forgotten about it, thanks for the reminder! Tax varies from person to person, but i think my Dad who is on a reasonable wage gave 40-50% of his income in tax.

My income tax in Ontario is about 31%, but there's also property taxes, a fixed health tax, user fees for most public services (e.g. waste collection, water, sewer), and a 13% sales tax on almost everything aside from food. Gas and alcohol both have taxes that often range from 100%-200%. It's really hard to estimate the precise total going in taxes, but 50% sounds about right.

We have four levels of government (Federal, Provincial, Regional/County, and Municipal) so there's an awful lot of redundant bureaucracy to support.

Good point Asmodia, perhaps basic information should be given out. We have three layers: Federal, State, and County, or Parish if your some backward hick from Louisiana.


To my previous post I meant also to include that one of the changes was that the US Military is spread throughout the globe. I am not saying that we need to return to these earlier times, just that it is quite different now. Change is inevitable and in many cases has been for the better. It is probably more destructive to try and revert change to a mythologized time then it is to allow change to occur naturally.

Oh, there's 21% value added tax on all goods in Ireland bar a few oddities like children's clothes. and services are something like 16% taxed. Alchohol is massively taxed, as is tobacco, but I don't know the numbers. This is on top of the Pay as you earn scheme that has people paying 47% or so. Back in the bad old days we had tax of up to 70%. But it seems to work. yeah, the government is corrupt, but stuff still gets done.

(I haven't checked those figures actually, so take them with a pinch of salt until I have time tomorrow after sleeping and sobering up.)

lifeafter wrote:
Medicare is Insurance for poor
Medicaid is Perscription Drug Assistance for Elderly

Medicaid is a joint Federal and State program which provides care to people with low incomes. It specifically can provide nursing home and long term care, and also may provide medical coverage for children under 18, pregnant women, and people in families with young children

Medicare is a Federal medical coverage program for people in a couple of categories. A) people over 65 who’ve worked enough years (or had a spouse do so), B) People who are considered totally disabled for the purposes of Social Security Disability (And you usually don’t get it immediately), and C) people with End Stage Renal Disease.

Note that Medicare is also divided into several parts:

Part A (the part you automatically get) only covers inpatient hospitalization, has a deductible of about $1000, and has a lifetime maximum number of days. Eventually it can run out.

Part B covers outpatient doctor/hospital care; basically stuff you don’t stay overnight for. You have to pay premiums for this (currently $93.50 per month), and they are steadily rising. This cost also goes up if you don’t sign up within 6 months of first becoming eligible. It also only pays 80% of the Medicare-judged “reasonable and customary” costs, leaving you with the leftover 20% plus anything your doctor charges that’s more than what Medicare considers reasonable and customary. Naturally many/most of the best providers charge more. Though many doctors DO agree to just charge the R&C rates, or can be talked into it by the patient. Part B also doesn’t cover everything. There are lots of things excluded, including all prescription drugs.

Part C is the nickname for private supplemental policies (also called Medigap, as they’re meant to fill the gaps in Medicare) sold by insurance companies to supplement your medicare. There are 10 standard plans (letter coded A through J), with basically identical benefits. Not all of them are sold in every state or by every company. Employers also sometimes have retirement medical plans which act as Part C plans, which are only available to their retirees and dependents thereof.

Part D is the (fairly) new prescription drug benefit. It also doesn’t cover everything.

For a quick reference to Medicare:
http://www.money-zine.com/Financial-Planning/Buying-Insurance/Medicare-Supplemental-Insurance/

Ahtman wrote:I suppose it comes down to whether you are a Utopian oriented person or a skeptic. You believe that we can tax the hell out of ourselves and that a government with it's hands in everything would somehow break the axiom of absolute power corrupting absolutely and not be corrupt. We'd all be miserable but we'd be equally miserable eh? Even with all that in place you still are going to die and the best you can hope for is that we help each other out if we can and hope for the best. The federal government is not a salve that can make the world a rainbow if it just spends enough money.

This is a classic false dichotomy.

The world isn’t divided into just two groups of people or two possible outcomes.

As Canada, the UK, France and most of Scandinavia (as well as other places) have demonstrated, you can get quality care without crushing people under the tax burden.

The US has fantastic specialists, but our general health care and quality of life are not the best in the world. We pay very high prices for care, and a lot of that money goes to the profit of corporate executives, often at the cost of reduced care for people in need.

Part of the function of government is indeed to redistribute some of the burden from people who can’t take care of themselves onto people who can afford more. It’s the price we pay if we don’t want to see our poor, sick, elderly, and disabled dying in the streets. And if we want to avoid a lot of other less dramatic forms of suffering.

There is obviously a lot of real, legitimate disagreement about how much and to what degree we should do this. Obviously no one wants any elderly poor people dying in the streets. But how much medical assistance are we obligated to provide? Is it going too far to use the collective bargaining power of the over 36 million people who are on Medicaid and/or the more than 40 million people on Medicare to get lower prices for prescription drugs? Saving money both for the needy and for the taxpayers who are supporting them? I don’t think so.

Right now our profit-centered model of healthcare results in a great deal of waste and inefficiency, and a lot of very tragic situations where people lose their lives or their livelihoods because they can’t afford the care they need. That, to me, is a problem. That’s not a healthcare system I’m inclined to be proud of.

What statistical comparisons of quality of life and healthcare across different countries seem to show is that a lot of countries which do work along a more socialized model have happier, and healthier populations than we do. IMO, purely on pragmatic grounds, we should be looking at how we can achieve their results, even if we have ideological issues with the means they use.

Mannahin, thank you for clarifying the difference between the two programs for me.

All the countries you mentioned have much higher taxes than the U.S. Instituting a national healthcare plan similar to what those countries have will require a huge increase in the amount of taxes americans will pay.

Government funded healthcare leads to a government regulated health industry. It'll drain the profit margins from the field and decrease both the amount invested in the development of new technologies.

There are too many uninsured in the country right now and a sick population does have implicatoins for the economy. Keeping the uninsured healtheir should translate into a healthier, more productive work force.

We should see how state models such as Massachusetts and California work out before we take the responsibility of healthcare from the free market.