[AFNobody]

I'm not sure its fair to argue that universal healthcare is a human right despite the fact it makes economic sense.

Humanity survived just fine without real healthcare and healthcare is not essential to a fair balance of power b/t the government and its citizenry.

Universal healthcare needs to be argued on the economics of the issue because that is the only practical way to make it sustainable. The "feel good" stuff about it being a human right will fail when stress is applied to America and stress is coming. The US, frankly, has peaked and it is all downhill from here.

[intended]

Healthcare is not hard. American healthcare is.

Frankly a single payer system is simpler and faster. But this is an area where American politics and market rhetoric just lead to terrible outcomes.

[candiodari]

In law school we were always taught that there are no rights. Rights, in practice are nothing but duties, and should be looked at like that.

You have no right to "life, liberty and the pursuit of happiness", you have a duty to not interfere with other people's life, liberty or their pursuit of their happiness. But even that is a negative duty. Positive duties, like paying tax, are more like the right to healthcare.

So this should be looked on in similar fashion. Do you have a right to healthcare ? Well, answer the question : do you have the duty to take care of others' health problems, completely irrespective of how it affects you personally (for instance, what if it takes up 90% of your time, while still not doing much more than slightly prolonging a miserable short life for them ?).

These questions are not so simple and knee-jerk statements like "right to healthcare, period" are not helpful and will do nothing but get us into a lot of trouble.

No country has "right to healthcare, period". That does not exist. For the obvious reason that it simply isn't feasible. Providing a named (but finite) list of treatments and medicine free of charge if diagnosed by a licensed physician is the furthest any country goes. In some cases that list is pretty short.

[hestefisk]

http://jeffsachs.org/2017/06/jeffrey-sachs-america-can-save-...

[candiodari]

I must say, I've read through his points on the CNN website, and I find 2 of them very wrong (capitation, and the shifting of money away from trained doctors into untrained "workers" "aided by computers"). Most others ... perhaps, but I can't see them making a large difference except the ones about medicine.

Capitation brings the insurance industry's incentives (ie. only work with healthy people) away from insurance companies and onto doctors. What is a diabetic to do when doctors just directly refuse to treat them directly (or delay, or ...). And before you say it won't happen because of hippocratic oath, we both know this rule will force doctors to do that for 90% of their time.

For such doctors and facilities getting people with longstanding illnesses that are just going to come in time after time after time and need expensive drugs and treatment, like MS patients (multiple sclerose), is going to be financially debilitating. That's not reasonable and absolutely not what we want.

As for replacing doctors with "workers" (presumably he means not even nurses), I feel like shouting at him. Doctor's salaries are high, but don't represent a decent fraction of expenses. You could give everyone in medicine a 100% raise and the cost would be in the low single digit percentages (2-3%). Let's face it, this is not what we need to save on. And if we are to save on it, let's PLEASE do it the right way: by subsidizing the training of more doctors, not by replacing doctors with idots.

What I keep hearing about US medicine is that 2 things are necessary:

1) legal changes limiting legal liability of doctors (doctors pay 5 digits per month in insurance in some places, money that is paid by patients but is definitely not going to better care). Something like the European system where a doctor can only be sued before a judge if he's found by the local ethics/hospital/national medical/... board (staffed with exclusively other doctors) to have gone overboard.

2) limit the cost of medicine and increase choices (e.g. mandatory licensing, importing of generic drugs, or just outright force the use of a generic alternative if available like a lot of European countries are doing)

This is the only point I agree with Mr. Sachs.

and for a bonus (just for bringing sanity into the system):

3) Outlaw any and all advertising for anything medicinal (something like if it requires a prescription, advertising it = jail time)

[whatshisface]

You also have to watch out that asserting positive rights that are sometimes impossible to provide (like healthcare) will confuse people when governments attempt to claim that other, deeper rights are "impossible to give." (For example, they might try to argue that they can't afford to not torture, comparing it to how their impoverished country can't give everyone free internet.)

[komali2]

Why is that? If a country tries to claim it cannot afford not to torture, can't we simply point to all the countries that manage without it, as I do for the healthcare debate?

[dragonwriter]

As anyone who lived through the more recent Bush Administration witnessed nearly daily, people claim “not torturing” is an impossible right to give while denying all positive rights—and acted on that argument—so I fail to see the relationship.

[whatshisface]

Denying every right is the last step of the manuver I'm describing, the first step is to re-define right to mean comfort. Bush-era politics just went straight to step 2 and it didn't work on us.

I suspect that the current UN rights council may be an example of this in action. See: the track record of the members on negative rights, the number of positive rights on their list of rights.

[dragonwriter]

> I'm not sure its fair to argue that universal healthcare is a human right despite the fact it makes economic sense.

“Universal right” is simply that which people feel all people ought to have.

> Humanity survived just fine without real healthcare and healthcare

“Universal healthcare” as a right is simply the right to a certain minimal level which is dependent on technology and resources. The fact that their have in the course of human history been times when no real healthcare by the standards of the early 21st century isn't material to that one way or the other.

> healthcare is not essential to a fair balance of power b/t the government and its citizenry.

That's quite arguably not the case; “government” is an a abstraction than the ultimately boils down to the subset of the citizenry with the most power in allocating resources, and it's quite arguable that that floors for allocation of resources in several domains, including healthcare, are essential for fair balance of power between that subset and the rest of the body of the citizenry.

Further, your implicit argument that a “universal human right” must either be something that prehistoric humans could not survive without or relate to balance of power between people and government is simply a statement of your political values, not a boundary on the what “makes sense” as a universal right.

> Universal healthcare needs to be argued on the economics of the issue because that is the only practical way to make it sustainable.

The actual concrete floor at any given time must be, but then again since every OECD country which guarantees universal healthcare, regardlesa of the details of the system, does it for less total (measured by absolute expenditures, per capita, or per GDP) than the US does spends on healthcare (and some don it for less by all three measures than the US spends in the. smaller public portion of its system alone, let alone the private expenditures), the economics aren't really an issue when you are talking about the US system.