Mar 22 2010

The US AHCA.

Category: GeneralDave @ 12:29

Most of Europe (I don’t know about other places) has long been bemused by the fact that a country which aspires to be the greatest in the world doesn’t have something as rudimentary as free, universal healthcare. It’s great to see the US getting there.

The UK’s NHS has its problems but on the whole it’s not bad. The important bit is that anybody in this country who falls ill and needs urgent treatment gets it. Doesn’t matter who they are, what nationality they are, no questions asked. To me that’s civilised; in this 21st C, anything else isn’t. If you’re not entitled to free treatment here, they’ll try & recover the costs – but afterwards. You don’t have the worry of paying to stay alive whilst trying to heal. The NHS gets it wrong at times – wrong or inappropriate treatments and long waiting times are some of the ills that beset it but it’s still infinitely better than the practical alternatives. I have read of people in the US pointing at NICE and calling it something like the “death panel”. All I can say is: go read what it actually does then eat your words! Of course NICE can get it wrong sometimes and it can make decisions which are bad for some individuals. No regulatory mechanism, of any kind, is perfect.

Universal Free Healthcare has to be paid for: Europeans pay far higher taxes than Americans and a lot of that is accounted for by healthcare and other kinds of social welfare. The idea that a free market will (or even can) result in full employment and therefore everyone will be able to afford the basics of civilised life is, to say the least, questionable. I think the US also needs to get away from this “work ethic” thing as the UK rulers kinda did, on the quiet, years ago. I’ll explain why…

Western economies all have much the same basic rule: A public company’s first and overriding duty is to maximise shareholder value. It therefore behoves the directors to minimise costs;if they don’t, they can be sued. One major way to reduce costs, which is generally followed religiously, is to decrease headcount/staff costs. This is done largely by increasing automation and outsourcing to lands where labour is cheaper. This, of course, applies mostly to enterprises which actually make or produce *things* – cars, food, furniture, etc., although it’s being increasingly applied to services as well. The theory is that the workers thus displaced will move into so-called “service industries” (until their jobs are outsourced). Huh! There aren’t enough remaining workers in “real jobs” to support that much service industry and so you end up with permanent, structural unemployment. One way to mitigate this that they’ve used here (and, to a much lesser extent you see it happening in the US) is that they pass laws which create the need for Agencies to oversee the execution of those laws, soaking up some of the excess workforce. In the case of the UK, it’s quite a large proportion.

The net result is that a minority of the population generates the real wealth of the country & their taxes pay to keep much of the rest of the erstwhile working population off the streets doing “makework” jobs. Full employment is a myth that I don’t think will ever be seen again, certainly in the West and this is something that I think our politicians have been lying to us about for years. The permanent structural unemployment I referred to is going to get worse as automation gets cleverer. The whole work ethic thing needs to be rethought; I don’t know what the final numbers will actually be but, as an example: What do we do with the other 90% when 10% of the possible workforce (workforce, not population mind) can produce everything a country needs? The real figures might end up at 80/20 or even 70/30 but I very much doubt they’ll go beyond that.

I think the link between the above & Universal Free Healthcare is fairly obvious but just for a change, I think something good will come of it 🙂

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