Santa Monica, California, USA
Serenity -- I didn't say civil service jobs were cushy. In fact, I said the opposite. A "civil servant" often trades off equal pay for value of service in the private sector for what seem to be, and probably are, more secure and better health benefits than currently available to most workers in the private sector, where such "benifits," which I would calculate as part of a worker's wage, are often not available at all.
If you really want to follow this through, anyone can hit an insurer's website, state that they are a small business owner, and request a no deductible "group insurance" quote for any number of hypothetical employees. And then you get to gasp.
Now, this doesn't mean that it is impossible for small businesses -- and the definition includes much MUCH larger, but still "small" in government terms organizations than a local Mom and Pop grocery -- to offer such insurance. It does mean, however, that employees have to kick in their share in terms of either paycheck deductions or acceptance of lower wages.
A Universal Health Care system hardly implies "free" health care. It would have to be paid for out of taxes. However, when you multiply the pool of insured to include everyone in the country who pays taxes, the actuarial (accounting term) risk and concommitant costs go down.
Now, it is true that not everyone pays taxes. Trying to stay relevant, I'll leave out children and the infirm, since most of them couldn't pay taxes even if they wanted to, having no income. I suspect someone might reasonably ask why universal health care benefits should be extended to our poor and illegal residents.
The answer still lies in the numbers. Health care ranging from flu shots to major problems is available to anyone through the Emergency Room system. Emergency Room treatment for anyone, legal, illegal, or just broke, is perhaps the single most expensive form of medical assistance available, and nobody, insurers, hospitals, or care providers makes a dime off of it (exagerating for effect here) because the bills never get paid, and people keep getting sick anyway.
So you look, again, to the numbers. Even including people who will never pay their medical bills, when the pool is expanded to include everyone, it's still going to be a hell of a lot cheaper for taxpayers than insurance and medical costs are now. It has to do with dilution of risk. Grossly, its sort of like this: for every ten people who get sick on a given day, 100,000 people don't I'm making these numbers up as an understandable example, but the actual stats are out there. This is where the actuaries come in.
True, idealistic, universal heath care would eliminate all middlemen, including insurers, but I can't see that ever happening in our society, at least not in our lifetimes. Whom might the government hire to manage such a program? The insurance companies, of course, just as the government contracts out many programs, including the logistics of running war ones, to private firms which are in business to make money from our taxes. But maybe that's snarky.
Change of the paradigm could involve a lower overall cost per person. That would be great. May or may not work. Under Universal Health Care, what WOULD change is the part about universal access to healthcare.
Just maybe, if the label were changed to Universal Health Care Access, we might be able to view the notion in a different light and put some changes into motion. I don't think there is anybody locked into the position that "If you can't pay, tough. Drop dead."
Working out the mechanics will not be easy, and the the first steps will probably need to be revised as we go along.
Still, Denmak, Sweden, Norway, Finland, Iceland, Brunei, Qatar, Fiji, Canada, and England have taken decent stabs at it, and a lot of those people don't even speak American.
Where, one might reasonably ask, would those extra tax dollars come from? They would come from not having to pay, in California, for example, $1,400 a month to Blue Cross/Blue Shield for a private, all inclusive no-deductible policy for two adults who happened to have gotten sick somewhere along the line.
Yeah, it's tough stuff, but it doesn't necessarily require a degree in quantum accounting to grasp the concept.
[This message has been edited by oceanvu2 (10-08-2008 10:50 PM).]