Obsessing about other people's health

[cowboy]

Hey cowboy, maybe you don't know, living out in the country as you do, but the challenge of meeting people's needs in dense population centers is not something that happens arbitrarily. It happens by design.

There you go talking down to people again. Of course cities are designed, but they are now designed according to the will of the people (based on the people's ability to elect officials who then select city planners) rather than according to the will of an ideological designer who thinks he is the only person in the world who is intelligent enough to determine what our "needs" are.

My problem with your premise is that I don't like being told what to do. To a large extent, the government already has that power, and I'm unwilling to cede further control of my own decisions. Also, as you so delicately noted, cities and farms are different. Unfortunately, city people have a tendency to create rules for their situation and apply it to mine. That's when I get rankled. Finally, you're a bright guy, and I think a pretty decent fellow, but talking down to the rest of us probably isn't the best way to make a point.

[il Padrino Ute]

There you go talking down to people again. Of course cities are designed, but they are now designed according to the will of the people (based on the people's ability to elect officials who then select city planners) rather than according to the will of an ideological designer who thinks he is the only person in the world who is intelligent enough to determine what our "needs" are.

My problem with your premise is that I don't like being told what to do. To a large extent, the government already has that power, and I'm unwilling to cede further control of my own decisions. Also, as you so delicately noted, cities and farms are different. Unfortunately, city people have a tendency to create rules for their situation and apply it to mine. That's when I get rankled. Finally, you're a bright guy, and I think a pretty decent fellow, but talking down to the rest of us probably isn't the best way to make a point.

Another group of people that bother me are the city folks who want to move to a more rural area, then complain that the farmland smells like farmland, or gripe about their neighbor's barn that blocks the view of something, despite the fact that the neighbor and the barn was there first.

[RobinFinderson]

There you go talking down to people again. Of course cities are designed, but they are now designed according to the will of the people (based on the people's ability to elect officials who then select city planners) rather than according to the will of an ideological designer who thinks he is the only person in the world who is intelligent enough to determine what our "needs" are.

My problem with your premise is that I don't like being told what to do. To a large extent, the government already has that power, and I'm unwilling to cede further control of my own decisions. Also, as you so delicately noted, cities and farms are different. Unfortunately, city people have a tendency to create rules for their situation and apply it to mine. That's when I get rankled. Finally, you're a bright guy, and I think a pretty decent fellow, but talking down to the rest of us probably isn't the best way to make a point.

I was looking forward to a future where we design cities to accommodate a healthy lifestyle. That was the extent of my 'talking down to people.' I didn't suggest a way of getting to that point. I actually think that clean air, clean water, free extensive public transportation, healthy food, free medical care, extensive green spaces, bike paths, less billboard glut, safe neighborhoods, etc. will be a pretty easy sell to the public. If we can design a city with these features, and pull it off for a reasonable price, I bet people would democratically support creating such a place.

[Mormon Red Death]

I was looking forward to a future where we design cities to accommodate a healthy lifestyle. That was the extent of my 'talking down to people.' I didn't suggest a way of getting to that point. I actually think that clean air, clean water, free extensive public transportation, healthy food, free medical care, extensive green spaces, bike paths, less billboard glut, safe neighborhoods, etc. will be a pretty easy sell to the public. If we can design a city with these features, and pull it off for a reasonable price, I bet people would democratically support creating such a place.

What you don't understand is that when you say free health care its not free. The biggest problem with National Health Insurance is that it makes the government able to tell business what they charge for their services. What if we deemed being a Lawyer a "public necessitiy" and Lawyers could only charge what some bureaucrat in DC said they could. What if we did that with any other business?

[RobinFinderson]

What you don't understand is that when you say free health care its not free. The biggest problem with National Health Insurance is that it makes the government able to tell business what they charge for their services. What if we deemed being a Lawyer a "public necessitiy" and Lawyers could only charge what some bureaucrat in DC said they could. What if we did that with any other business?

Actually, I do understand that. Nothing is free. We would pay for health care with tax dollars, which would serve as a massive health insurance policy blind to pre-existing conditions, age, and genetics. It would not be free, but it would probably be cheap (in terms of out-of-pocket to most tax payers).

Not anyone in the U.S. can call him/herself a 'medical doctor.' There are a series of government and professional hoops that must be cleared before such a title is conferred. I single payer system would redefine those hoops. One generation of doctors might be pissed about this, and that single generation of doctors can go practice some other place if they have a problem. Otherwise the profession would attract a new generation of doctors who is fully aware of what they would be getting into.

As far as your attorney example, it seems like a poor choice, since we already have a socialized form of legal representation -- public defenders.

[Mormon Red Death]

Actually, I do understand that. Nothing is free. We would pay for health care with tax dollars, which would serve as a massive health insurance policy blind to pre-existing conditions, age, and genetics. It would not be free, but it would probably be cheap (in terms of out-of-pocket to most tax payers).

Not anyone in the U.S. can call him/herself a 'medical doctor.' There are a series of government and professional hoops that must be cleared before such a title is conferred. I single payer system would redefine those hoops. One generation of doctors might be pissed about this, and that single generation of doctors can go practice some other place if they have a problem. Otherwise the profession would attract a new generation of doctors who is fully aware of what they would be getting into.

As far as your attorney example, it seems like a poor choice, since we already have a socialized form of legal representation -- public defenders.

yes but not all Lawyers HAVE to be public defenders. What you are suggesting would make every doctor and every hospital public.

As you didn't like my analogy how about this? Lets say we as a public decide that architecture and design is a public necessity. All Architects and Designers must be paid at the same rates. How would you feel about that?

[RobinFinderson]

yes but not all Lawyers HAVE to be public defenders. What you are suggesting would make every doctor and every hospital public.

As you didn't like my analogy how about this? Lets say we as a public decide that architecture and design is a public necessity. All Architects and Designers must be paid at the same rates. How would you feel about that?

Who said that all doctors would HAVE to get paid by the public? I'm certainly not advocating that citizens pay for elective cosmetic surgery, and if a doctor wanted to charge a lot more for a particular service, and if some wealthy people opted to pay cash instead of receive the service for free (and avoid the riff raff) then that would be fine as well.

The lawyer example was your poor example, not mine. I actually like it, because it demonstrates how we as a society recognize that modern life creates needs that do not exist in nature, namely the need for legal counsel. For most of the rest of the modern world, health care is also such a need.

As for architects, you may be on to something.

[DU Ute]

Not anyone in the U.S. can call him/herself a 'medical doctor.' There are a series of government and professional hoops that must be cleared before such a title is conferred. I single payer system would redefine those hoops. One generation of doctors might be pissed about this, and that single generation of doctors can go practice some other place if they have a problem. Otherwise the profession would attract a new generation of doctors who is fully aware of what they would be getting into.

Yeah, I'm anxiously awaiting the day when the best and the brightest no longer have the incentive to be doctors.

[CardiacCoug]

In my world, freedom means being allowed to choose how I live, as long as I'm not hurting anyone else. Your world denies me that freedom.

I tend to agree with this.

But the fact remains, if you have a heart attack related to never going to the doctor or you get in a motorcycle accident with no helmet, you are treated with expensive medical care and the taxpayers pay for it.

If taxes pay for it, then government has a right to regulate it -- it is no longer a purely personal decision.

[CardiacCoug]

What you don't understand is that when you say free health care its not free. The biggest problem with National Health Insurance is that it makes the government able to tell business what they charge for their services. What if we deemed being a Lawyer a "public necessitiy" and Lawyers could only charge what some bureaucrat in DC said they could. What if we did that with any other business?

Absolutely.

In what other profession besides medicine do we let the payor (insurance companies, government, etc.) decide how much they will pay for a given service?

I would love to try that with a plumber sometime: "You're charging me 300 bucks? Sorry, I only reimburse $80 for unclogging a drain."

[il Padrino Ute]

I tend to agree with this.

But the fact remains, if you have a heart attack related to never going to the doctor or you get in a motorcycle accident with no helmet, you are treated with expensive medical care and the taxpayers pay for it.

If taxes pay for it, then government has a right to regulate it -- it is no longer a purely personal decision.

That's a great point and I would have no problem if my decisions cost me extra money to be insured, as that would be the consequences of having the freedom to choose.

[SteelBlue]

One of the fundamental problems with most universal healthcare plans is that they have the perverse effect of incentivizing people toward not caring about their own health while becoming obsessive about everyone else's.

That is, since I am no longer responsible for paying for my own health care, I have less incentive to take care of my own health and to be wise in my healthcare spending habits.

However, since I am paying for everyone else's healthcare, I'm more likely to want to control others' choices as they relate to healthcare. Cutting down smoking rates, amount of fat intake, exercise, wearing motorcycle/bike helmets, and on and on. These habits increase health care costs, and so I am more likely to support nanny state intrusions on people's choices.

I'm not buying your argument. You state that becoming obsessive about the health of others is the result of "most universal healthcare plans". Which plans are those? I've lived in 2 European countries that had Universal Healthcare. They have far more smokers there than we have in the states all living without persecution. And that was after decades of universal healthcare. You also state that these things are happening already here in the US, citing smoking as your main example. Well, since we have nothing resembling universal healthcare in the US then it appears your worst fears can come true under our current systems. I fail to see how Universal Healthcare is/will be the cause of the intrusions about which you worry.

[RobinFinderson]

Yeah, I'm anxiously awaiting the day when the best and the brightest no longer have the incentive to be doctors.

The 'best and the brightest,' in my opinion, are not motivated to do good in the world just to get wealthy. In fact I would venture a guess that among the 'best and the brightest' one will find a higher percentage of people who are NOT motivated by greed.

[CardiacCoug]

The 'best and the brightest,' in my opinion, are not motivated to do good in the world just to get wealthy. In fact I would venture a guess that among the 'best and the brightest' one will find a higher percentage of people who are NOT motivated by greed.

This is bullshit.

Medical residents have completed 4 years of post-college education and accumulated an average of $120K in debt when they start their training. Then they earn $40K per year working 80 hrs per week for the next 3+ years. That's $10 per hour if you're calculating at home. I did that for 7 years after medical school.

Ask any financial planner if that is a recipe for becoming wealthy. It's not. Even if you make decent money in your career, that 11 years of making fast-food server money with a college degree is a financial killer.

If you worked that many hours at almost any other endeavor, even driving a truck, you would make more money before the age of 45 than you do in medicine.

[RobinFinderson]

This is bullshit.

Can you tell me what is bullshit? Because from here it looks like I agree.

I argued that the best and the brightest aren't motivated by money. Then you call 'bullshit' and tell me that doctors aren't motivated by money.

So either we agree or you are saying that doctors are NOT 'the best and the brightest.'