Wednesday, November 11, 2009

Fire department analogy, a response. Spork in the Eye.

I have a few actual readers and commentators and I check out some of their blogs (they have the good taste to check out mine, so do you for that matter). And well Spork In the Eye had an interesting blog post as to how socialized medicine would be nothing like a socialized fire department but rather more akin to socialized fire insurance (which by the way exists in many areas along with socialized flood insurance and others, but lets ignore that). Since burying a long reply on a distant forum for a post made about half a month ago is a bit off... let me repeat the point here. First it'll give you something to read. Second if Spork cares to reply and I don't happen to make it back to his board there's one here.


Real Universal Health Care IS like the fire department.

Insurance shouldn't enter into the picture and is only there because of a lack of actual fortitude and actual political will to make the system into what the system should be, a real universal health care system. Where the government pays hospitals and doctors for services rendered and there's no payment without services.

Insurance is a business model whereby we mitigate risks (in theory) and pay for services as such. There are actual insurance plans which cover you in the case of illness to get you back to where you were. If you become ill they pay you for lost wages and make sure you don't get hurt. Much like fire insurance will pay for your lost stuff when your house burns down. -- The fire department in this situation really is like real universal health care.

The difference is largely like the fire department before socialization. It was previously the case that fire brigades would put out fires and charge the person helped or loot their property and such. Insurance companies would pay the brigade that put out the fire for those properties with insurance. The system was haphazard and lead to large losses in property rather than a centralized system where fire departments put out fires and it didn't really matter whose stuff was saved.

Further you argue disanalogy due to the idea that the fire departments are localized. This is certainly the case for hospitals and doctors as well. Further it holds true for medicare as such as much of the reimbursement rates and businesses are conducted regionally. Additionally fire departments have very regional operations as well where fire departments are used to fight fires across state boundaries on federal land and as part of a much larger and national effort and presidential and gubernatorial declarations of disaster.

Ultimately any real universal health care plan would require, local, regional, as well as national support.

You aren't reimbursed for your lost health. You aren't paid for getting sick, your doctors are paid for mitigating the situation. And the constitution is established to "promote the general welfare".

There are certain requirements that everybody has and that need to be conducted at above the individual level. We have need for water, housing, health, security, electricity, roads, and a number of other projects and needs that cannot be elsehow conducted on an individual basis. If we do not own these utilities as a people they will end up owning us.

Much of your analysis seems dependent on staying on the obviously failed system we currently endure. Rather than making a clean break towards Medicare for all. Insurance is a terrible way to cover healthcare. Just as it was a terrible way to conduct fire departments prior to the Civil War. Your objection seems to be largely that we shouldn't half-ass this socialism and nationally pay for insurance but rather nationally pay for health-care; I couldn't agree more.


Basically if we half-ass it and using insurance as our model, ofcourse everything will suck. If we somehow did away with the whole thing and paid for the required care of anybody in need of care all of the problems would melt away. There'd be no need to saddle small businesses with the burden of providing insurance, there'd be no need for insurance, the prices would drop, the overhead would drift away, and we'd be able to assemble some more efficient system of regional support. Not every hospital needs an MRI machine. You only need them every once in a while but while everybody is out on their own without any centralization there's going to be more and more lost costs and opportunities, we'll have terrible procedures and unneeded tests, and little help from various. We need a much better system and insurance is never going to build such a system, it's going to build a system of making money by hoping people die.


RedFerret said...

Sounds reasonable - insurance companies are companies after all, they need to make a profit, so the focus is on money making, not health care (But hey, what would I know, the NHS isn't perfect either)


Tatarize said...

How many people go broke paying for the NHS bankrupt and then lose the coverage they had to end up dead? I mean 40k preventable deaths due to lack of coverage a year. And it's not like they are asking to get money if they are found to be ill, just not die due to preventable reasons but often without insurance a lot of people end up coming in several months too late when there's really nothing to do for em.

Spork In the Eye said...

I feel like Steve Martin in "The Jerk" when he gets the phone book and is suddenly famous.

Yeah I replied inline. Internet arguments amongst strong opinions go nowhere -- and I did little more than let it go at that.

And shame on those awful insurance companies with their 3% industry average profit margin! (I guarantee the government won't do it cheaper.)

For what it's worth (off topic of the fire department example): a little reason, a little self responsibility and a high deductible insurance policy goes a long way. It is ridiculously cheap. I paid for it for a 3 year stretch of (self imposed) unemployment.

Oh... and by the way, if you adjust for traffic deaths and murders (which health systems can't really fix) -- the USA has the #1 life expectancy over all those wonderful government health systems. Go figure.