"Obamacare saved my life" - Xeni on CNN

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‘Public’ here refers not to the voting public. They are secondary, they only rubber stamp what has become generally acceptable to society at large. “Public” refers to the the public who have been “through” the overtone window.

p.s. Not just in the US. The privatisation of healthcare is happening in England right now, as we write. People are increasingly resigned to having to make copayments to their treatments. Paying for physio, therapy, various diagnostic tests as well as minor surgery out of your pocket has become standard among those who have the necessary disposable income. And don’t kid yourself there has been a concerted effort by the right to push the overtone window on private healthcare wide open in the UK.

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No, i don’t believe that – especially after the year of Brexit and Trump.

Happening it might be, but they are doing it on the sly and there is a constant cry for more NHS money and more NHS treatments; overall the subject is still electoral poison after 7 years of Tory rule, so much so that it’s basically the only topic that a weak Labour leadership can still occasionally leverage. All this in the most “American” of EU states, where voter turnout is pretty low compared to continental average.

To be clear, i’m not arguing that there aren’t forces fighting for privatized medicine all over the world; only that higher voter turnouts usually correlate with a fairer debate on these topics. The lower the turnout, the more moneyed interests can hold sway. This is the same on any subject, but I think it’s very evident about healthcare.

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Ugh! Because they’re spending it all on insurance, obvs!

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As a Brit, I’m obviously very much in favour of a National Health Service which everyone pays into and can be used (mostly) free at the point of service.

However, having spent some time living in countries without an NHS, I’m always puzzled by the extortionate prices of the American system. My current (employer sponsored) insurance in Singapore is bare-bones at best and yet visiting my GP has no co-pay and prescriptions are essentially free. Without insurance, it would cost me USD 20 per visit, including prescriptions.

I broke my finger last year and needed fairly extensive surgery to repair it; the SGD 5,000 (about USD 3,000) it cost was entirely borne by my insurance policy and I had no co-pay. The follow-up appointments cost me SGD 100 or so a time, for x-rays and consultation, which I had to pay out of pocket but which were reimbursed to me in full within a week. More medication than I could ever have taken was included in the price and a more comprehensive insurance plan would have negated the need for me to pay at all.

How exactly does the US justify its soaring cost of healthcare, even under a private system?

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My point was that there were serious attempt to do so prior to the second world war, and that insurance companies evolution are rooted there. And the state attempted to step in during the depression as well (part of their program to stave off communism/stalinism and fascism in the American psyche). Many aspects of our modern life really became set in the postwar era, but many of them are rooted in the interwar period. But yes, the health care system industrialization (as we know it) largely grew up in the postwar era.

I’d suggest the book. it very much gives a good, historical background on the history of health insurance and that it wasn’t always private, for profit corporations covering people.

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My point still being that the origins of modern healthcare insurance in the US were based of socialist principles. So the American psyche is not inherently avert to such ideas.

Except that you have it exactly backwards. Charity is the essence of laissez-faire health, which breaks down when health becomes more technological, and the Usian health system is still trying the fantasy of private, non-social health care in whatever corner of the “health market” they can.

And for some reason you are attempting to make this point in reply to an actual historian. Why?

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Because women aren’t REAL historians, silly! /s

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Because, um, it’s the “best in the world”?!! USA USA USA!

Seriously though, because people with insurance like to know they’re getting a great deal, everything has to look really expensive even though they’re not paying for it so they can then say “whew, imagine if I wasn’t covered!”

If you ask certain members of a paRty, they’ll say it’s because doctors all need expensive liability insurance.

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Every time I watch “Call the Midwife”, I feel very American. Here’s a poor mother with 6 children in a two-bedroom condemned flat, and they say “We’ll get an ambulance and book you into the maternity hospital!” I always expect the mother to gasp that they can’t possibly afford that!

And then I remember England had actual civilized health care in 1950-whatever.

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It’s been going downhill since, mind.

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Er? Californians elect Republicans to state office all the time.

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Welcome to the evidence free zone.

The discussion here is on health insurance in the US.

I linked to Kenneth Arrow’s pivotal paper on Uncertainty and the Welfare Economics of Medical Care 1963. Which is one of the key academic papers that informed healthcare policy under Johnson who pushed through the Medicare Bill in 1965–which is based on a solidarity principle. It is the historical document that is referred to in the context of health insurance and the US of A. It is an important document because it highlights that the issues currently debated in relation to the ACA were very much discussed in the 60s.

I also introduced to the discussion two further key academic papers by Fuchs and Grossman which fundamentally changed the tone of the debate on healthcare in the 70s. Furthermore I pointed out that these texts are helpful in understanding how the public debate on health insurance shifted in the US post WW2 between 1963 and 1972.

To which @anon61221983 responded (and I am paraphrasing): Yes, but I know something about the origins of the Welfare state. To which I said, that is not what I was trying to talk about here. To which you, @andy_hilmer [quote=“andy_hilmer, post:168, topic:93013”] responded
you are attempting to make this point in reply to an actual historian. Why?
[/quote]

Without a clue who or what I am. As it happens I know a bit about the history of Health Economics, which is the field of study that concerns itself with heath insurance. I am very happy to be corrected if @anon61221983’s reading of Arrow’s text is different from mine or if she or you think other texts / authors are more relevant to the discussion. But I do not particularly appreciate the incredibly patronising / lecturing tone of both of your comments.

My instinctive reaction is to withdraw and leave you to your intellectual love in. But on this occasion I decided to go to the trouble and respond.

Because so much is at stake in the world at the moment and because it has to be said.

If this is how you respond to someone who is on your side, who wants to exchange ideas on something that you care about, than god help the person who really disagrees.People on the left really need to come down from their arrogant, self-righteous, know it all, high horse [rant over] and start listening to other people.

How can you have an informed discussion with people when they respond to an argument based on the reading of specific texts, if those people completely ignore those texts and instead insist on pointing out that other excellent academic writing exists on other loosely related subjects. There always are, and everything can be traced back to the Romans (at least). Here we were talking about federal legislation on healthcare insurance and on academic writings which influenced those.

Let’s stick to the subject and if not let’s say so. After all bbs is the home of the enlightening digression–one of the reasons I love it.

Edit because I just saw this and it can’t be ignored: [quote=“Mindysan33, post:169, topic:93013, full:true”]
Because women aren’t REAL historians, silly! /s
[/quote] . Because the arrogance and lack of tolerance it exudes is even worse than I initially assumed. You are saying this to me a f***ing woman whose work includes academic research on Health Economics. And whose only intention was to introduce relevant texts to the discussion. This is the level of the discourse you engage in. And somehow you think your argument is superior to those on the right?

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I’m simply saying that the discussion was embedded in a longer conversation than just the post war period and that Klein speaks to that in her book. With regards to what we’d call “socialized medicine” the Social Security act represents FDRs attempt to deal with health care, though not on as large a scale as the 1965 act. It’s not insignificant and illustrates a continuum of health care. If you think the SSA as part of the new deal is entirely irrelevant to Arrow’s work, then say so. I don’t see how it can be, given that the door to this kind of public-private partnership was opened with the SSA.

I’ve never read this piece you’ve linked to and would be happy to do so and give you my thoughts later.

Sorry you feel I’m being condescending, as that wasn’t my intent.

No, just more humane.

And this is a message board, not an academic conference. If you can’t handle a bit of snark when being a woman on the internet means regularly being talked down to, then I don’t know what to tell you. Sometimes snark is literally the only defense I have against that kind of shit.

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Thanks for the response. @andy_hilmer’s “how dare you” was really the last drop. We need to change the tone of discourse and respect each other in disagreement.

I do wish that Americans would study German history more to see how the infighting on the left facilitated Hitler. Solidarity is the key and it relies on respect.

Edit to respond to last comment:

Which is why: “How dare are you arguing with a historian.” should never be part of the argument.

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Fair enough. I’ll read that article and let you know what I think.

Have a good day!

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Figure out who you are replying to, and about what. My point was that your framing of “socialist” American health care was ahistorical in that the talk in 1948 was about socialized medicine, but it never really happened. Policy issues are one thing, the actual history is another, and your assumption that the policy discussions somehow reflected the history of health care was… exactly wrong.

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I never said that or meant it. Rather that I’m not entirely ignorant on US health care debates/changes, because I’m a historian. I’m not expert, it’s not my field, but my views are built entirely out of opinions about what I think health care should be.

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Keep digging.

Try reading. This is what I actually wrote:

And then I referred to a specific academic text. You might see that I only refer to “socialist principles”. This was my sole use of the term socialist. I did not write “socialist American healthcare” or anything about “socialised medicine”. Because there is nothing socialist about American healthcare, never has been.

I did write about socialist principles and meant the socialist principles of solidarity and risk pooling. Which is the theoretical basis for the much admired German health insurance system. My point was that ir has not always been alien to the US discussion on healthcare–Medicare is the living proof. In retrospect I could have written “solidarity principle” to be more specific. Non the less my point stands and your deliberate misreading of it is frustrating.

And your sweeping evidence free statements on how things really are are infuriating.

I am not assuming anything about how policy discussions reflected the history of healthcare.

Instead, I am arguing and providing textual evidence that the academic discourse on health economics influenced healthcare policy and am suggesting that it is worth revisiting those discussions, because the extent to which the academic debate shaped policy is particularly striking.

We are always complaining about how little influence academic research has on policy. It seems to me that in Health Economics the opposite was the case.

And I do apologies for daring to make an argument on something I have studied. It is certainly reprehensible when someone who is trained as a cultural historian comments on something they have researched.

Maybe you need to start a discussion on bbs codes and specify what qualification entitles commenters to discuss which subject matter. We could than all refer to it and save considerable time by shutting up on most subjects.:grin:

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As i understand it, @nojaboja is there using your

as a jumping off point to criticize @andy_hilmer’s

I would like to note that i know so little about what the three of you are discussing that i have absolutely no opinion on this, just a liking of all of us understanding each other better.

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I know I quoted @andy_hilmer there not you. I hope I made that clear.

This was my impression and the reason I linked to the Arrow text. It is short and poignant the most quoted health economics text–and it is actually an argument against marketisation.

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