Health Care Omerta in the U.K.

It's fine for Brits to talk trash about the National Health Service, but not to Americans.

A few weeks ago, I sat down with Daniel Hannan, the Milton Friedman-loving member of European Parliament representing South East England, to discuss his infamous showdown with Prime Minister Gordon Brown, his opinion of the British National Health Service (NHS), and what the Republicans could learn from the recent successes of Britain's Conservative Party. When I asked Hannan his opinion of Tory party leader David Cameron—who, I argued, “lurched towards the center” in search of popularity—he demonstrated unswerving party loyalty. Cameron, he admonished, was hardly a Tory wet and is more committed to free-market ideas than his old guard Thatcherite critics were willing to admit.

The following day, Hannan repeated his criticisms of the NHS on the Fox News Channel, warning Americans that his country's health system was a "60-year failure" that he "wouldn't wish on anybody." He delivered a stark verdict:

I find it incredible that a free people living in a country dedicated and founded in the cause of independence and freedom can seriously be thinking about adopting such a system in peacetime and massively expanding the role of the state when there's no need.

Had Hannan muttered dark warnings about the British health service's sustainability on the floor of the European Parliament, the Labour Party would surely have made political hay out of it, arguing as they often do that the Tories, if given power, would speedily dismantle the NHS and replace it with a more American-style system. But this was something else entirely. To go to America, to appear on Fox News, and denounce Nye Bevan's "post-war achievement" was too much for both Labourites and squishy Conservatives.



Click above to watch MEP Daniel Hannan discuss his libertarian influences, the NHS, and his YouTube attack on Gordon Brown

The loyal lieutenant, who a day earlier had batted away my criticism of David Cameron's "New Tories," was about to be hurled under the bus by his party leader. "Cameron slaps down NHS 'traitor' MEP who branded health service a failure," read The Daily Mail headline. The BBC reported that Timothy Kirkhope, leader of the Conservatives in the European Parliament, believed Hannan "should be disciplined for his comments about the NHS and said he would be given a 'stern talking to' by the party's chief whip Brussels."

Hannan's opponents in the increasingly unpopular Labour Party seized the opportunity to defend the popular NHS by launching a full-scale attack on the Tory libertarian. Health Secretary Andy Burnham sputtered that criticism of the NHS "is unpatriotic because he is talking in foreign media and not representing, in my view, the views of the vast majority of British people and actually, I think giving an unfair impression of the National Health Service himself, a British representative on foreign media." Those British journalists who gasped when the Dixie Chicks, after excoriating George W. Bush in London, were accused of being patriotism-deficient, have been conspicuously silent when the government of Gordon Brown takes a similar line to Tory "dissent." 

On Channel 4 (which receives some funding from taxpayers), writer and television personality Charlie Brooker barked that Hannan is a "boggle-eyed, slap-headed, unpleasant, revolting, heartless, shit-brained, attention-grabbing, foetid excuse for a prick." British users of Twitter were encouraged to replace their profile photos with a "We Love the NHS" icon, publicly declaring their loyalty to Britain's largest employer. (Indeed, as Hannan explained to Fox News, "most of [the NHS's] 1.4 million [employees] are administrators...the managers outnumber the doctors and nurses. And that is the electoral bloc that makes it almost impossible to get rid of.")

The only reasonable criticism of the rogue MEP came from conservative Mail on Sunday columnist Peter Hitchens, who observed, with appropriate bafflement, that "Hannan is quite principled and really ought to know better than to belong to the Tories at all."

So why the kerfuffle? Where is that stiff upper lip in the face of criticism? The New York Times' indispensable London correspondent Sarah Lyall noted that Britons "complain endlessly" about the NHS, "deplore the system’s waiting lists, its regional disparities in treatment, its infection-breeding hospitals and its top-heavy bureaucracy," but can get "a bit touchy when outsiders are the critics." Professor Karol Sikora, a British critic of the NHS, was denounced by a fellow doctor as "spearheading a right-wing American campaign to denigrate the British National Health Service." 

 
Ah ha! So it isn't the criticism, it's when Americans—especially American "right-wingers"—are the critics. 

Some of the criticism has been erroneous. When Investors Business Daily absurdly claimed that the physicist Stephen Hawking, who suffers from neuromuscular dystrophy, would have been allowed to die if he were a subject of the Queen (he is, in fact, British), Fleet Street's green inkers, from Torquay to Dundee, scoffed at the "increasingly ugly row" over health care that was currently consuming America. Just back from receiving the Presidential Medial of Freedom in Washington, Hawking told journalists the he “wouldn’t be here today if it were not for the NHS." Without the state-funded treatment from the NHS, Hawking said, he "would not have survived.”

The point, though, is not whether those living in the United Kingdom receive competent—or even occasionally outstanding—care in a socialized scheme like the NHS. It is doubtless true that the British health services “saved the life” of Stephen Hawking, just as the drug company that developed synthetic insulin surely saved—or greatly lengthened—mine. The question is not whether a wealthy, Western country with well-trained doctors and nurses is capable of provided decent treatment, but whether government-run systems, which require the rationing of care to limit always-expanding costs, are the most effective way to provide broad health coverage to American citizens.

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  • 24AheadDotCom||

    Fun fact: I once worked with someone who was an extra in her movie. He became a meth head. More recently, she tried to save a farm in So. L.A., but I don't know what happened to her career after that.

    Say, has anyone noticed that Fox and their buddies here have to continually engage in cheap stunts? I mean, now it's Hannah, before then it was the little kid in the Reagan suit, before then it was TedNugent, before then ChuckNorris, and on and on. It's like they have the Showman Gene, an extra Dress-Up Games chromosome, and an Inability to Just MakeAnArgument And ShowHowTheOtherSideIs Wrong Syndrome.

  • anarch||

    "should be disciplined for his comments"

    I think that means something specific in England.

  • ||

    I think that means something specific in England.

    I believe it involves a good spanking, and then something about the oral sex afterwards.

    At least that's how it goes down in Castle Anthrax.

  • dv||

    I'd rather have care rationed on the basis of need rather than on the basis of "whoever can afford it gets it, everyone else can fuck off."

    The NHS, for its flaws, is still better than the American system.

  • ||

    Did Hannan support the "free-market" deal that traded the Pan Am 103 bomber for BP/Exxon Libyan oil contracts?

    John McCain did - his terrorist pal Qadhafi even hosted the lobbyist-loving McCain overnight at his ranch in Libya last week.

    Pitiful - McCain is worth millions and is still taking bribes from terrorists.

  • Rich||

    FTA: "On Channel 4 (which receives some funding from taxpayers), writer and television personality Charlie Brooker barked that Hannan is a 'boggle-eyed, slap-headed, unpleasant, revolting, heartless, shit-brained, attention-grabbing, foetid excuse for a prick.'"

    Will Brooker be "be disciplined for his comments"?

    Watching Hannan in action (e.g., on youtube) is always a delight.

  • Nipplemancer||

    NHS care is rationed not on need but on cost and is a model of inefficiency. The government, all of them not just the U.S., suck at nearly every aspect of their collective jobs. Giving them more control is always a bad idea.
    Our problems are not catastrophic, nor are they unfixable yet. Government intervention has caused more of the problems in our current system, blaming the free market total bullshit.
    If the market were truly free, the costs would go down, profit would go up, and everyone would be happy (except teh poorz).

  • Barry Stocker||

    I think American viewers of the interview with Daniel Hannan should realise that his hero, Enoch Powell, was a leading opponent of non-white immigration into the UK who was sacked from the Conservative Shadow Cabinet (government in waiting) for a speech in which he said that immigration would lead to rivers of blood.

    I would also like to assure American viewers, and everyone else, that not all British and European libertarians and classical liberals are anti-EU. On the continent, excluding the UK, the most pro-market parties are usually pro-EU. FDP in Germany, Venstre in Denmark, VVD in the Netherlands, Radical Party in Italy etc.

    Some Conservative Party classical liberals/libertarians left the Conservative Party in protest at Euro-scepticism, and ended up in the Liberal Democrats. One of them is a prominent member of Liberal Vision http://www.liberal-vision.org/, which is the Classical Liberal/Libertarian group in the Lib Dems, the most pro-EU party in Britain. It's also a party which supported increased rights for local government in the UK, a long time before anyone heard of Hannan or David Cameron. It's hardly a purist Classical Liberal/Libertarian party, but then neither is the Conservative Party, and neither is Hannan.

    Localism is a good thing, but simply imitating everything that can be found in the US system, on the completely bizarre assumption that it all used to be found in Britain is historically absurd, and is wrong for reasons which have nothing to do with Anti-Americanism.

    While there is much to admire in the Founding Fathers, Hannan's view is bizarrely over idealised. I don't think uncritical praise for slave holders, decades after Montesquieu and Smith condemned slavery is very libertarian.

    By the way, Adam Smith thought that removing barriers to trade would naturally lead to Continental 'Empires'. For Smith, an Empire should be a confederacy under a shared representative assembly, so he was arguing for something remarkably like the EU.

    I suggest to everyone that you can't really trust a man who yadda yaddas his way past his intellectual influences, as Hannan does. Remember the episode of Seinfeld which focuses on George's girlfriend who yadda yaddas her way past anything important.

  • ||

    I'd rather have care rationed on the basis of need rather than on the basis of "whoever can afford it gets it, everyone else can fuck off."

    I'd rather not have care rationed at all. By your logic all goods and services are "rationed".

  • ||

    Where can I get "Daniel Hannan is MY President" bumper stickers?

  • Xeones||

    It's like they have the Showman Gene, an extra Dress-Up Games chromosome, and an Inability to Just MakeAnArgument And ShowHowTheOtherSideIs Wrong Syndrome.

    Pot/kettle much? Shut the fuck up, LoneWacko.

  • Tim Cavanaugh||

    Is MEP a post with any actual authority? The UK is still on the pound and as far as I know has not fully "joined" Europe (though I'm not really clear on what that means). So what does a British MEP do?

  • ||

    I'd rather have care rationed on the basis of need rather than on the basis of "whoever can afford it gets it, everyone else can fuck off."

    Dammit swillfredo. You beat me to it.

    Repeat after me: "Just because someone, somewhere, can't afford something, doesn't mean it is 'rationed'."

  • ||

    The UK is still on the pound and as far as I know has not fully "joined" Europe (though I'm not really clear on what that means).

    I believe in this context the verb "joined" is best understood by reference to two dogs engaged in procreation.

  • ||

    The British left have always had an odd mixture of being hyper venomous and completely vacuous when it comes to facts.

    I recall some of the "end of the world" rhetoric when Boris Johnson was showing well in the polls before he was elected Mayor of London.

    I think he has been mayor for a year now....somehow London is still not a smoldering hole.

  • ||

    The UK is doing what it's always done: Making sure that no one country on the continent gets too strong.

  • Barry Stocker||

    The UK is a full member of the European Union, it is not part of the Euro, as is the case for Sweden and Denmark, which like the UK opted out. Membership of the Eurozone is not the same thing as membership of the EU. Some east European members have not completed the criteria to join the EU. At least one non-EU country, Montenegro, has chosen to use the Euro as its legal currency.

  • ||

    I would also like to assure American viewers, and everyone else, that not all British and European libertarians and classical liberals are anti-EU. On the continent, excluding the UK, the most pro-market parties are usually pro-EU. FDP in Germany, Venstre in Denmark, VVD in the Netherlands, Radical Party in Italy etc.

    What the fuck does this have to do with the price of tea in china?

    Are you trying to say that EU representative Daniel Hannan is anti-EU?

    LOL

    More like he is anti-whatever-the-crazy-shit-you-think-the-EU-should-be

  • ||

    The Euro isn't the problem; decimalisation is. The UK hasn't been the same since it mucked about with the pound, shilling, pence, ha'penny system that we all knew and loved and replaced it with a neat and boring decimal monetary scheme.

  • ed||

    I'm rather a fan of Mr. Hannan. Would that we had someone with half his intellect in our own house of common idiots.

    Speaking of idiots, who (if anyone) edited this lede: "To Tory MEP Daniel Hannan, the British National Health Service is, he warns Americans, a "60-year failure" that he "wouldn't wish on anybody."

    Jesus H!

  • robc||

    Pro Lib,

    Dont forget the EU trying to make the Brits drink metric beer.

  • SIV||

    We'll counter your "liter" with a forty.

  • hmm||

    The "o" face picture is kind of unflattering.

    now to read the article.

  • ||

    ProL: You forgot about farthings. And guineas.

  • qwerty||

    This only goes to show that Britain's "conservative party" is no such thing. I invite Daniel Hannan and the last handful of British believers in freedom and Western civilization to come to America. Your country is doomed.

  • Fist of Etiquette||

    The "o" face picture is kind of unflattering.

    More like an "oh, reeeeeeeeeally?" face.

    But that guy does talk real pretty.

    Actually, I admit he is pretty amazing at slicing up his target. In that interview with Glenn Beck (this time wearing a Gestapo uniform, if memory serves), he had some nicer things to say about the Constitution than most American politicians. (Of course, "We the People" ain't standing between Hannan and getting things done.)

  • ||

    This is like saying that if a US congressman goes overseas and says something critical about the US in foreign media, that makes him a traitor.

    Oh wait. That fucking happens ALL THE TIME. And NOBODY CARES.

  • MJ||

    "Hannan was denounced as "unpatriotic" by the Labour Minister of Health"

    Gee, a left-winger attacking someone's patriotism. Who'd a thunk it?

  • ||

    Malto Dextrin,

    I forget nothing! I am fully conversant on pre-decimalisation currency, due to my great book learning.

    Namely, books involving Paddington Bear and Sherlock Holmes.

  • Tony||

    From Gallup:

    On availability of quality local healthcare, the median percentage of satisfied respondents among countries with universal health coverage is 79%, 13 percentage points higher than the median percentage among those without universal coverage (66%). For those that have confidence in their national health system, the difference is again 13 points (73% for those with universal coverage, 60% for those without).

  • Tony||

    I only lived there four months but it's my impression that Britons complain about healthcare as one complains about the weather, because it's there and what are you gonna do run around skipping with praise for the one system you have and that obviously could always be improved on an individual basis?

    It may even have deep problems. But it's not the outlandishly horrific system portrayed by the usual propaganda suspects.

    As the poll above indicates, satisfaction is higher in countries with universal systems.

    Free marketeers don't know if further deregulation and privatization will improve the quality of healthcare in the US just as they don't know it won't lead to further economic drain and revert to a more medieval system than it is. Why not just face reality and see if we can't develop a system that gives the country some of the advantages of other proven systems without some of the disadvantages.

  • B||

    "Pitiful - McCain is worth millions and is still taking bribes from terrorists."

    Pitiful that you are such a dick who likes to make statements he can't back up, at all.

    I would love to see you provide some evidence that McCain is taking bribes from Quadaffi. Yeah, I won't be holding my breath you pitiful little prick.

  • B||

    "I think American viewers of the interview with Daniel Hannan should realise that his hero, Enoch Powell, was a leading opponent of non-white immigration into the UK who was sacked from the Conservative Shadow Cabinet (government in waiting) for a speech in which he said that immigration would lead to rivers of blood."


    And this is relevant to his criticisms of the NHS in what way?


    And isn't it a shame that shrike likes to suck cock down at the local train station? At least that is what I heard anyway.

  • Chad||

    Tony | August 25, 2009, 9:11pm | #
    I only lived there four months but it's my impression that Britons complain about healthcare as one complains about the weather, because it's there and what are you gonna do run around skipping with praise for the one system you have and that obviously could always be improved on an individual basis?

    It may even have deep problems. But it's not the outlandishly horrific system portrayed by the usual propaganda suspects.

    As the poll above indicates, satisfaction is higher in countries with universal systems.

    Free marketeers don't know if further deregulation and privatization will improve the quality of healthcare in the US just as they don't know it won't lead to further economic drain and revert to a more medieval system than it is. Why not just face reality and see if we can't develop a system that gives the country some of the advantages of other proven systems without some of the disadvantages.


    Agreed, Tony. I have lived in both Europe and Japan, and people seemed quite content overall with their health systems. You are right, they complain about it like they complain about the weather.

    In the end, they get similar care and less economic risk at a much lower price. That's all it really boils down to.

  • Slap Maxwell||

    qwerty sez: "This only goes to show that Britain's "conservative party" is no such thing. I invite Daniel Hannan and the last handful of British believers in freedom and Western civilization to come to America. Your country is doomed."

    Uh, wait; so is ours.

  • ransoms147||

    Tony you really can't wait to be an indentured servant can you? Wouldn't it be great if the state provided everything so you could just pay your tithes and be told how to be happy?

  • Rudy||

    Chad,
    You are like school on Sundays.

  • Slap the Enlightened!||

    "I think American viewers of the interview with Daniel Hannan should realise that his hero, Enoch Powell, was a leading opponent of non-white immigration into the UK who was sacked from the Conservative Shadow Cabinet (government in waiting) for a speech in which he said that immigration would lead to rivers of blood."

    All the more reason to like him!

  • Tony||

    13 percent. Thirteen percent you fools! You could be thirteen percent happier, the only price is your very soul. Why not just face facts and open your wallets, you know what's coming and you're going to like it!

  • Chad||

    Agreed. There is less economic risk when people tell you what to do.

  • Amy Ridenour||

    Good article, but you should know that the "postcode lottery" is not something you enter (except by virtue of living in the UK and relying on the NHS), but a popular nickname for the fact that the regional primary care trusts within the NHS have different policies about what they will or will not do or supply.

    Thus, you can live in one town, and a certain cancer drug will be supplied to you, while your neighbor in the next town will not be supplied it, even though you both are "covered" by the NHS, and perhaps all your circumstances except your post (zip) code are the same.

    When it comes to the service you mentioned, IVF, the regional primary care trusts have very different policies. In some areas, IVF is unavailable to women aged 23-39. In others it is available only to women aged 37-39. In half of the trusts, if at least one prospective parent already has a child, IVF is not available under the NHS, but in the other half, it is available. And so forth. That's the "postcode lottery."

  • Mr. Chartreuse||

    Of course in this poll: 83% of citizens in the US were satisfied with the health care they received.

    Another poll, this one from 2006, states that 89% of US citizens were satisfied with the health care they received

  • JV||

    Damn whiners. Complaining about the best healthcare system in the world. Thank god the UK keeps them from talking to Americans! We don't need malcontents spreading sedition to the Colonies. We had that once before! And look what a mess that turned out to be!

    We need a serious debate where people can ask important questions and be assured by their elected representatives that everything will be OK and that the troublemakers will be dealt with.

    Everything will be fine. Just relax and keep walking towards the bright future. Cover your ears and ignore those people over there. We are rounding them up for the camps now.

  • Paul||

    the NHS's famously dense bureaucracy, ever-expanding queues for treatment, and almost non-existent dental care.



    Well, shyea.

  • ||

  • Chad||

    Mr. Chartreuse | August 26, 2009, 12:43am |

    Another poll, this one from 2006, states that 89% of US citizens were satisfied with the health care they received


    In another poll, 11% of Americans were found to have been seriously ill at some point in their life.

  • creech||

    Mr. Hannam can be heard in person at the Campaign for Liberty conference in Valley Forge, PA from Sept.17 to 19th.

  • Mr. Chartreuse||

    In another poll, 11% of Americans were found to have been seriously ill at some point in their life.

    From the second poll I linked to:

    17. (IF SERIOUS ILLNESS, INJURY, OR CHRONIC ILLNESS) How satisfied are you with the medical care that you or your family member received during that time?

    Satisfied NET 90%



    And, so as not to argue in bad faith, the above was asked to those who had health insurance.

  • Sean W. Malone||

    Can we please, PLEASE stop referencing polls on how satisfied or "happy" people are?

    If there's anything that we should have learned from people like Dan Gilbert and others studying happiness and the like - people's relative contentment is in general very static and based on that person's internal baseline way more than it has to do with external factors. Quadriplegics are as happy or happier, on average, with their lives than people who can walk... Yet I wouldn't wish paralysis on everyone else.

    Happiness is no more a measurement of a quality system than is popularity a measurement of the value of Cash for Clunkers.

    Add to that the realization that most people simply don't understand the big picture in most of these cases - and don't bother to think through the long-term consequences of ever more restrictive government policy, and using polling data as any kind of support either way is just silly.

  • ||

    Most of the uninsured in America are probably people like me. I'm only 23 and I go to the doctor about once every 5 years. I am the ideal customer to an insurer, as I would pay constantly but never make use of any services. Why should I pay 200 dollars a month to avoid a 600 dollar cost every 5 years? If I bought insurance, that would lower the cost of premiums for people who made greater use of the system, but I would essentially be subsidizing their healthcare. Insurance by its very nature is socialistic, as people who don't use it much subsidize the care of people who use it too much. The people who use too much healthcare also have no incentive to price shop, screwing people like me over even more. This is why I prefer the Health Savings Account approach. Such an approach would encourage people to shop around for healthcare, and the people like me who never need it could build up quite a savings in the event of a life catastrophe. I suppose that I would need some insurance in the event of a freak accident, but I could get something with a 7500 dollar deductible for a low monthly cost.

  • Chad||

    Mr. Chartreuse | August 26, 2009, 9:52am | #

    And, so as not to argue in bad faith, the above was asked to those who had health insurance.


    If you were at all concerned with good faith, you would realize the distinction between how you feel about the care you received and the quality of the system that paid for it.

  • Chad||

    tkwelge | August 26, 2009, 3:56pm | #

    This is why I prefer the Health Savings Account approach.


    Yep, you will prefer it right about until you either have your first kid or your first serious illness.

    Isn't it strange how people "prefer" whatever puts the most money in their pocket?

    Frankly, I would much rather have the cash than an HSA. I actually have a few grand sitting in one from a former employer, that I haven't touched in years. It SEEMS to be there, but I would much rather just have 2/3 of that amount sitting in my checking account.

  • ||

    @Chad

    I don't think that it is strange at all that people prefer whatever puts most money in their pockets. The people who want obamacare want it entirely because they believe that it will "put more money in their pockets." How is my position any different?

    The problem with the "cash" approach is that many people already have the cash, but they use it on other things, then they want somebody else to pay for their healthcare. The HSA's would show people "this money is for your healthcare" and it wouldn't just be extra cash. This "cash" would come as the result of tax breaks and vouchers meant specifically for healthcare, and individuals using this money for other purposes would amount to government subsidization of other, less need based things. I'm not quite sure what your point is here.

    Once I had my first kid, my tax breaks and vouchers would increase under an HSA system, so I wouldn't really change my opinion. Lifetime emergencies could be handled by catastrophic event insurance that would be relatively cheap with a 7500 or 10000 a year deductible.

    Most proposals for overhauling healthcare would force people like me to buy insurance, even at a time in our lives when we didn't want it, in order to help subsidize the lives of older, usually better, off people.

  • ||

    If you really prefer the cash, then we should just cut taxes overall and we could spend our money on what WE value.

  • ||

    tkwelge - $7500 deductible? I guess you think thats a lot, right? That's 2 nights in hospital under light observation. It doesn't even cover an MRI scan. That's why these kinds of policies are not actually available - its not a conspiracy, its just that your premiums would not be much lower than they are now and the insurers know that.

    To those asking what MEPs do - The answer is nothing. That's why the job attracts self-aggrandizing blowhards like Hannan. You get paid (and get to make fraudulent expenses claims, and take money from lobbyists) for doing nothing, which means you have plenty of time to abuse your country on foreign TV stations. Its roughly equivalent to the congressional representative for Washington DC going on the BBC to announce that social security was a major mistake. Popular? I think not.

    Regarding the NHS versus US healthcare - I've lived under both. I prefer the patient experience in the US - there's less waiting, longer appointments and politer staff. But I had more trust in the NHS to actually administer effective care. The NHS is obsessively cost effective, but it does ultimately produce decent care. In the US the won't blink at ordering a $10k MRI that won't show anything interesting, but a few hundred bucks for a course of anti-fungal treatments? Apparently that need pre-approval. Wierd.

    Its all a question of how you square the circle of ever-rising level of ever more expensive possible care for conditions that were once untreatable (or not worth treating). The Brits chose to do it by providing decent care for everyone and accepting (at least tacitly) that that means heroic levels of care for the very, very ill and treatments for restless leg syndrome may have to fall by the wayside. The Americans chose (if that's the word) to provide endless, extravagent levels of care (so much its detrimental in some cases) for those who are lucky enough to have insurance when they get sick, and nothing (or bankruptcy) for those who aren't. People complain about the British system until they really get sick, at which point they're relieved it works. People like the American system until they really get sick, at which point their insurer finds an excuse to end their coverage.

  • ||

    simonk

    I know that 7500 dollars isn't a lot when you're considering major medical care (that is the whole reason why you'd still need CATASTROPHIC insurance). HSA would be used primarily to cover minor emergencies that don't require hospital stay or MRI's. The only medical care that I really need on a yearly basis is for check ups or setting broken bones and buying medication. HSA could easily cover those every year expenses. The point of the 7500 deductible is to make it so that the insurance company only has to pay money for real emergencies. Every day trips to the doctor and the purchase of medication is something that individuals can be empowered to do. The 7500 dollar number is just an example. With a generous enough HSA benefit, you could probably live with a much higher deductible.

    It's not like a hospital is going to charge you 30,000 dollars up front anyway. They'll usually try to hammer out a payment plan. If I have 5,000 in my HSA and I need 20000 dollars worth of health coverage, I can pay the 5000 grand up front, and the insurance company will only have to pay 12500. I could then make payments toward the remaing 2500 fairly easily by taking money that otherwise would have gone to my HSA and diverting towards the hospital that I still owe. It's not "free" healthcare, but hey, I'm not going to die, and that system inherently encourages individuals to price shop for healthcare making it more competitive.

    In the example you talked about above, you'd be able to deny the MRI, as you don't think that it is worth the cost, and you would be able to utilize the anti fungal treatment, because it's your money.

  • ||

    Chad

    I'll probably wait until i have enough money to have a kid anyway. Having a child is not a subsidized right.

  • ||

    I would applaud somebody for going on foreign tv to announce that social security is a mistake.

  • ||

    The HSA's that I'm talking about would be government subsidized, btw. Even still, it will be much more cheap than obama care and would actually have a built in incentive to comparison shop. It's about trying to good in the LEAST damaging way.

  • ||

    http://answers.yahoo.com/question/index?qid=20081119072419AATONdy

    Here nobody quoted a cost higher than 10000 dollars for giving birth! 7500 dollars would give the insurance company quite a break, and this is a large, once in a lifetime type expense.

    You talk as if everybody is getting hurt everyday and it will always require a 10000 dollar MRI.

  • ||

    http://answers.yahoo.com/question/index?qid=20080610083143AASajOC

    Nobody here said that their MRI cost more than 5500 dollars. That was somebody with insurance and their insurance company probably wasn't price shopping as effectively as an individual would. The prices for such treatments vary wildly. Insurance companies and governments don't comparison shop.

  • ||

    I once heard DR. Drew on loveline say, "The real problem with our healthcare system is the fact that nobody knows how to use it!"

  • Mr. Chartreuse||

    If you were at all concerned with good faith, you would realize the distinction between how you feel about the care you received and the quality of the system that paid for it.

    So when Tony quotes from a poll with, with no link, that measures "satisfaction" with healthcare, you fellate him and say that when people with universal coverage complain about the health care it is the same as complaining about the weather. When I do the same, and post a link, you say I'm not concerned about arguing in good faith.

  • ||

    tkwelge - I basically agree with you than HSAs are the main component of a decent solution to the problem of paying for healthcare. Most of the issues with both the NHS and the private insurance system in the US come about because the actual consumer of care has no incentive to even find out how much it costs. Most people don't even know what their premiums really are. Somehow you have to expose people to the costs of their care or the cost problem and the moral hazard inherent in insurance are just going to get worse, and correspondingly the amount of required care that gets denied or is unavailable will grow.

    But the consequences of really, fully exposing people to the total cost of their healthcare would doom many middle class people who fall sick to death, disability or bankruptcy. In my view that's unconscionable, so there has to be some kind of reliable backup to ensure no-one is deprived of essential care, by which I don't just mean emergency room care, which is ineffective and expensive, but checkups, childhood vaccinations, etc.

    High-deductible catastrophic insurance doesn't really work actuariallu, because the bulk of your insurance premium right now is paying for the possibility of catastrophic short-term care or some kind of chronic long term condition - exactly when you'd use your catastrophic care insurance. Unless you live in a community rating state or are under a large group policy, in which case some of it is paying for the possibility of other people needing that kind of care. Same principle, though. As you've observed, routine care isn't that expensive if you're reasonably fit.

  • ||

    I'm not suggesting fully exposing people to the cost of healthcare. Well, as somebody who makes under 20000 dollars a year, I must say that if you make more than 50000 dollars a year and can't afford your healthcare, then you have nobody to blame but yourself, but I believe in the initial subsidization of HSA to get the ball rolling. I'm not even that reasonably fit, but healthcare would be cheaper if people at least tried to shop around. Insurance doesn't encourage that and neither will the government.

    Personally, once again, as a young poor person, I don't see how you can be 40 and need help paying for decent care. I mean, what have you been doing the last 20 years. I can honestly say, in the 4 job changes that I have made in my life, my income has never decreased. At this rate, I expect to at least be able to take care of myself by the time I'm middle aged.

  • ||

    I'm glad that we can agree on something, though. I just don't think, even from a liberal perspective, that Obama is really bringing the best people and the best minds together to even TRY to hammer out a decent solution. All I see are special interests. Instead of the oil companies under Bush, now we're being ruled by union reps, journalists, and environmental organizations, none of which have my interests in mind.

  • ||

    In the end, they get similar care and less economic risk at a much lower price. That's all it really boils down to.

    No,


    they don't

    Nowhere else has better outcomes and survival rates across the board.

    This is the lie that just won't float because there is just too much information out there, and it's why people are standing up.

    The internet is the enemy of the lying collectivist.. because it exposes the truth.

  • ||

    Having lived in both the US and the UK, I have a pretty good notion of which has the better system right now- the US. The NHS is an ideological solution where one is not helpful. The US system, while better, is hamstrung by some historical anomalies, like the link between employment and insurance; and no shopping for insurance across state lines. These anomalies prevent the operation of the free market.
    Insurance has often seemed to me to be the wrong way to finance healthcare. As everyone knows who has ever had any kind of insurance, if you use it, the insurer wants you gone. You have become a cost to them. The Singaporean model, is simple, cost-effective and humane. Individual have Health Savings accounts which they pay their normal health costs from. They combine this with cheap (because little used) catastrophic illness insurance. For two-thirds of the population, no government bureacracy or revenue is involved at all. For the poorest, the government simply pays the bills, utilising all the same systems everyone else uses. Singapore spends 3.5% of its GDP on health. The UK, 8.4%. And Singapores health outcomes are better than the UK! The US spends about 15% of GDP, but gets much better health outcomes for that extra, especially seniors.
    Thats who I'd copy, if anyone. But could America swallow its pride, copy a tiny city-state in Asia?

  • The Big Fellow||

    This thread is in dire need of a methods lesson.

    1.) Anecdotes are crap. There is nothing to learn from hearing the tales of people who won out in a rationing system, or who feel they were cheated in a price system. It's like trying to decide the speed limit by asked a council made up of accident victims and race car drivers. You get the loudest opinions going back and forth, backed by not a hint of reason.

    2.) Surveys are also crap. Those are just more anecdotes, pilled higher than you can count. Asking people if they like their health care, apart from an extensive background interview and some serious questions as to why (or why not) is meaningless. Consider the extreme example: a man who wants to see US hospitals return to Jim Crow segregation will certainly say that he "isn't satisfied with the present system", and be counted among the presumptive supporters "reform".

    3.) Anecdotes from people who have lived under both systems are just a more interesting form of crap. The only difference here is in the quantity of anecdotes: more than one, less than a survey, not enough to mean anything.

    4.) This is a theoretical issue, and it cannot be settled expect by reference to theory. Either you understand how a price system works, or you don't. Either you grasp the implications of what "cost control" means outside such a price system, and what would be required to enforce it, or you don't…

    Who cares what happened to your college roommate after he went to grad school in Vancouver and broke his leg snowboarding?

  • Limey||

    On Channel 4 (which receives some funding from taxpayers),

    It receives nothing from the taxpayer - it's funded entirely by advertising, although it's still state-owned.

    Andrew Lale is right to mention the Singapore system, which is what Daniel Hannan advocates.

  • abercrombie milano||

    I'm not concerned that Mr. Crumb will go to hell or anything crazy like that! It's just that he, like many types of religionists, seems to take it literally, take it straight...the Bible's books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on...the Bible's books were written by people with very different mindsets

  • tiffany and co||

    you got it!

  • nike shox||

    is good

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