Kurt Loder on SiCKO

Nick Gillespie | July 2, 2007

If Michael Moore's new doc about health care is a dud, part of the explanation is that it's really not convincing in offering either a diagnosis or a prescription for the American system.

Here's Kurt Loder at MTV giving Sicko a big thumbs down:

What's the problem with government health systems? Moore's movie doesn't ask that question, although it does unintentionally provide an answer. When governments attempt to regulate the balance between a limited supply of health care and an unlimited demand for it they're inevitably forced to ration treatment. This is certainly the situation in Britain. Writing in the Chicago Tribune this week, Helen Evans, a 20-year veteran of the country's National Health Service and now the director of a London-based group called Nurses for Reform, said that nearly 1 million Britons are currently on waiting lists for medical care - and another 200,000 are waiting to get on waiting lists. Evans also says the NHS cancels about 100,000 operations each year because of shortages of various sorts. Last March, the BBC reported on the results of a Healthcare Commission poll of 128,000 NHS workers: two thirds of them said they "would not be happy" to be patients in their own hospitals. James Christopher, the film critic of the Times of London, thinks he knows why. After marveling at Moore's rosy view of the British health care system in "Sicko," Christopher wrote, "What he hasn't done is lie in a corridor all night at the Royal Free [Hospital] watching his severed toe disintegrate in a plastic cup of melted ice. I have." Last month, the Associated Press reported that Gordon Brown - just installed this week as Britain's new prime minister - had promised to inaugurate "sweeping domestic reforms" to, among other things, "improve health care."...

In 2004, French Health Minister Philippe Douste-Blazy told a government commission, "Our health system has gone mad. Profound reforms are urgent." Agence France-Presse recently reported that the French health-care system is running a deficit of $2.7 billion. And in the French presidential election in May, voters in surprising numbers rejected the Socialist candidate, Ségolène Royal, who had promised actually to raise some health benefits, and elected instead the center-right politician Nicolas Sarkozy, who, according to Agence France-Presse again, "plans to move fast to overhaul the economy, with the deficit-ridden health care system a primary target." Possibly Sarkozy should first consult with Michael Moore. After all, the tax-stoked French health care system may be expensive, but at least it's "free."

And that's all before Loder gets around to Moore's strange depiction of Castro's Cuba as tropical paradise. Read the whole review here.

And check out Reason's review online here.

Comments

|7.2.07 @ 7:08PM|#

Great that he doesn't like sicko, but he is an uber-pompous ass. Not only that but the last time I saw him he looked like he stepped out of the grave to take a piss. And that was about ten years ago, when MTV used to play music videos.

Sorry for the OT rant. But I can't stand that dickhole.

Steven|7.2.07 @ 7:13PM|#

Kurt Loder still works for MTV? Isn't he too old to work there?

|7.2.07 @ 7:41PM|#

Haven't seen the movie, but it's interesting that more apparantly includes Medicare horror stories in his anecdotes showing how the US healthcare system is messed up- "There's also a 79-year-old man who has to continue working a menial job because Medicare won't cover the cost of all the medications he needs." Then he goes on and advocates government healthcare for everyone. Huh? If Medicare sucks now, why would it be wonderful when everyone had it?

highnumber|7.2.07 @ 7:42PM|#

He does come across as kind of pompous on TV, but he really is that much smarter than the majority of his co-workers and audience.
Those of us who know, accept the 'tude and sneer at the rest of you with him.

|7.2.07 @ 7:42PM|#

One of my favorite ways to bait those who believe in the government monopoly on health care here in Canada is to wait for them to utter their favorite catch-phrase: "We don't want American-style health care here in Canada."

I promptly respond "Thank god we do have American-style health care here in Canada!"

Of course, this elicits an incredulous "What do you mean?"

To which i answer: "Next time you're in a hospital or doctor's office, take a look at the labels on the equipment and medications. 90% of it was built and developed in the US. Further, anyone who is rich enough can go across the border to the US to avoid the wait list, which cuts down on the number of people waiting here."

[Ron Bailey style disclosure: Unfortunately, I am not rich enough and had to wait 18 months for a simple hernia surgery.]

|7.2.07 @ 7:50PM|#

Aresen brings up a point that I don't see addressed often. Critics of US healthcare point out that Americans pay a lot more for the same healthcare that people in foreign countries get. They argue this as a reason why healthcare in the US is bad. (See e.g. Ezra Klein's article in American Prospect like last month). However, they never address that the high cost of US healthcare drives pharmaceutical companies and other healthcare companies to innovate. I suspect that it isn't a case of merely what the market will bear, rather there would be a lot less investment and less talented personnel going into the field if it weren't so lucrative.

|7.2.07 @ 7:51PM|#

WOW. When did MTV's Kurt "You Can Tell by the Time I Get Three Words Into This 'News' Story That I Am a Pompous Biased Lefty Hosejob" Loder aquire depth and sense? Did he get sick while traveling in the UK or something?

Addendum: I wrote this post in my head before I clicked on "Comments" and saw sage's judgment. I guess he hasn't changed entirely, or maybe he comes across differently in writing vs. on the screen.

bill|7.2.07 @ 7:52PM|#

The "problem" with US health care isn't to little government control it's TOO MUCH.

|7.2.07 @ 8:09PM|#

I mean really. I think he actually died like five years ago and someone has their hand up his ass making him talk - you know, to hold onto those few viewers still alive that think he's worth a shit in the dirt.

highnumber|7.2.07 @ 8:10PM|#

I don't think y'all have ever read Loder. He's got his rock-journo bona fides.

I've always felt bad for him on MTV. He's much smarter than he needs to be for that. On the other hand, I've always respected MTV's decision to have one legit rock journalist and keep him for so long. On the other hand, I wonder how good a paycheck it must be for Loder to keep himself in that ghetto.

I ran out of hands a couple sentences ago, so I'm done.

|7.2.07 @ 8:13PM|#

And how about this when the gub'ment is running the entire health care regime: In the name of public health they make tobacco illegal. And coffee. And potato chips. And chocolate.

I know, it doesn't sound that absurd. But I think if you start pushing the angle that you could go to jail or be denied health care entirely for your lifestyle choices, people might be scared capitalist.

"Sorry sir, I know a broken leg has nothing to do with the fact that you don't have enough fiber in your diet, but rules are rules. Walk it off."

|7.2.07 @ 8:14PM|#

highnumber,

I have the Led Zepplin box set from about 1990, and in the book he wrote a pretty long article. It was actually quite good.

That's my only hand, so I'm done. :)

Grotius|7.2.07 @ 8:22PM|#

highnumber,

You are right. His writing is typically quite good.

|7.2.07 @ 8:41PM|#

""Next time you're in a hospital or doctor's office, take a look at the labels on the equipment and medications. 90% of it was built and developed in the US." Yeah, you know, when I think of the fact that we score lower on most medical and wellness indicators than Canada, it always makes up for it that we made the drugs and equipment that use so much better than we...
"Critics of US healthcare point out that Americans pay a lot more for the same healthcare that people in foreign countries get. They argue this as a reason why healthcare in the US is bad." If you keep reading any critic worth his salt mentions the other crucial premise: that we then do worse on many indicators despite our higher spending. That implies some serious inefficiency (yeah, I paid 100,000 dollars for my car and it breaks down a lot while Jack paid 75,000 for his and it runs smooth. At least I encouraged innovation!) No wonder Iron Man kicked your ass so many times Foom...
"The "problem" with US health care isn't to little government control it's TOO MUCH." Yeah brainchild, that's why other nations with WAY MORE government have less of these problems...Nice deduction...

|7.2.07 @ 8:42PM|#

that THEY use so much better

highnumber|7.2.07 @ 9:00PM|#

Ken,

Do any other factors affect our health apart from medical care?

Have you considered that the innovations you scoff at would not exist if no one paid for them?

Have you read any of the critiques of the US health care system from a libertarian P.O.V.?

Before tossing out sarcastic insults like "brainchild" and assailing other people's deductive skills, you should take a harder look at the facts.

|7.2.07 @ 9:02PM|#

It's a good review, but I couldn't help cringing when he brought up three of the most mendacious/credulous socialist popularizers of the late nineteenth and early twentieth century.


Michael Moore may see himself as working in the tradition of such crusading muckrakers of the last century as Lincoln Steffens, Ida Tarbell and Upton Sinclair - writers whose dedication to exposing corruption and social injustices played a part in sparking much-needed reforms.

Lincoln Steffens was the guy who went to the Soviet Union's show towns and said "I have seen the future, and it works"; Upton Sinclair spread downright lies to advance his socialist agenda. I don't know much about Ida Tarbell, but two out of three probably reflect on the third as well.

|7.2.07 @ 9:10PM|#

"Have you read any of the critiques of the US health care system from a libertarian P.O.V.?" Yes, and they are terrible. For example some of my favorites for sheer lunancy and non-helpfullness:
1. We need health savings account (as if the guy who did not have 60,000 dollars to re-attach his finger would have that if he could save at with a more generous tax deduction)
2. Mandating private health insurance for all-one point is that 50 million can't seem to pay for it now. Besides, this is government intervention at its worst: we won't coerce you to be part of a system you could have a voice in directing through your vote, but we will coerce you to subsidize private companies (socialized costs, privatized profits)

|7.2.07 @ 9:14PM|#

Ken said:

"The "problem" with US health care isn't to little government control it's TOO MUCH." Yeah brainchild, that's why other nations with WAY MORE government have less of these problems...Nice deduction...

So you don't think that four lobbyists from the healt-care industry for every one member of congress means that the government is having a deleterious effect on the system?

I don't know why it is people seem to think that the problems of the US system, with all of its regulations and controls, counts as a strike against the free market. Something about a successful defense resulting only in a change in the indictment, or something like that.

|7.2.07 @ 9:30PM|#

Kurt Loder isn't terrible, but I can't take him seriously after MTV. That's the price you pay for working at such a silly channel. What's next, Robin Byrd replaces Katie Couric?

MattXIV|7.2.07 @ 9:35PM|#

Loder actually makes one of the points that is so often missing from healtcare debates since it doesn't fit neatly into anybody's political world view, namely that every single first-world healtcare system is/has/will experience problematic increases in costs/rationing, regardless of how it is structured.

This seems to be the consequence of three trends. First, all these populations are getting older. Even before retiring, older people still need more medical care and are more likely to experience complications, so as a population ages, you'll see higher costs at lower outcomes. Second, the cost of "standard of care" medicine grows at a faster rate than GDP because medical technology options grow very quickly and the newest technologies are typically more expensive that the older ones (there are some exceptions - laproscopic surgery probably saves money - but most new interventions increase both outcomes and costs). Third, increasing wealth has made it possible for people to induldge in unhealthy but pleasurable lifestyles at higher rates than before - obesity rates and all that jazz. There is pretty much nothing that can be done about the first and the last two are actually side effects of overall positive developments, so there really aren't any politically feasable, let alone actually advisable, policy changes that would address them.

Regarding the US outcomes and money vs other countries, the US definitely gets less per avg dollar spent. But this is totally non-suprising. Mostly privately funded healthcare (the US system) will be funded based on the marginal benefit to outcomes vs cost of the last dollar for each individual, which is rarely the lowest in society, whereas a well-ran single payer system will spend its marginal dollars at the highest marginal benefit overall. These low-marginal return dollars from the relatively wealthy are why the US generally does better at getting newer equipment quicker and treating trauma. Of course you could take the same amount of money and redistribute it and get better outcomes statistics, but it would be the redistibution to people with better marginal outcomes opportunities that does it, not any efficiency of single-payer systems. (Aside: The US gov't-provided safety net healthcare systems are notorious for not making good allocations on the margin, resulting in the poor going to ERs to get routine care, expensive operations being covered but cheap preventative meds not, etc.) One doesn't even need to redistribute with healthcare in mind to achieve this effect.

But outcomes statistics are not ends themselves. What actually happens to individual people will primarily be redistribution, and consequently ones views on gov't-provided universal health care should be shaped by attitudes towards redistribution, not by chasing after efficiencies that are most likely illusory.

|7.2.07 @ 9:37PM|#

Jesus Christ this is not that hard fellas:
YES there is government intrusion into our system, but there is MUCH LESS intrustion into our system than comparable ones and yet we HAVE MORE problems. You can dispute that we have more problems (though most indicators and people's experiences make that difficult), but how system 1 with MORE FREE MARKET and LESS GOVERNMENT has MORE PROBLEMS compared to system 2, 3, 4, etc., that have LESS FREE MARKET and MORE GOVERNMENT with LESS PROBLEMS is evidence of government being the problem defies even the simplest forms of logic that humanity possesses. You guys are like a cult...

|7.2.07 @ 9:45PM|#

Wow. MTV gives a more intelligent and thoughtful review of Sicko than Slate. Slate's Dana Stevens puts in his best shot to surpass Dalia Lithwick as America's dumbest political reporter in his review of Sicko where he states that "The American health-care system is a sick joke and has been for a very long time." No one could disagree with that right? And of course none of Moore's distortions of government run systems are mentioned during the review. It is hard to say someone is acutually more ignorant, dogmatic and narrowminded than Lithwick, but Stevens gives it a good shot.

|7.2.07 @ 9:46PM|#

"and yet we HAVE MORE problems."


Only a moron American liberal who has never actually experienced healthcare in places like Canada and the UK could make such a statement.

|7.2.07 @ 9:49PM|#

1. We need health savings account (as if the guy who did not have 60,000 dollars to re-attach his finger would have that if he could save at with a more generous tax deduction)

Um. HSAs are generally seen as part of a solution that includes catastrophic insurance.

2. Mandating private health insurance for all-one point is that 50 million can't seem to pay for it now.

Um again. Very few libertarians argue for mandated private insurance. For example, Michael Cannon at Cato recently distinguished Cato's position from Heritage's on exactly this point.

Have you got any other example favorite criticisms of a position you apparently don't know?

steveintheknow|7.2.07 @ 9:55PM|#

No ken. Our system has different problems, not more. Understanding that does not require membership to a "cult".

having read your "input" for some time now, you really come off as quite the little-bitch.

|7.2.07 @ 9:57PM|#

Jesus Christ Ken, are you really so stupid that you think that the UK's and Canada's problems result from not enough government intervention? All of the problems associated with those system relate to one problem; you have to ration care someway and we do it through price and they do it through bureaucratic degree. Any moron than defend a system like Canadas where people wait months for Chemotherapy after being diagnosed with Cancer is just beyond the pale. My mother had cancer and was on chemotherapy immediately in the US and she was not rich and she lived an extra year because of it. Had she been a Canadian she would have never recieved treatment because some fucker bureaucrat would have deemed her, as a 68 year old woman who had previously survived cancer, unworthy and she would have died in two months. We got an extra 10 months of her because of our evil American system. Fuck you Ken. No really, Fuck you.

MattXIV|7.2.07 @ 9:58PM|#

Ken,

You're making an argument from correlation, so of course people aren't going to take you seriously. Since you're not comparing against a control (which is impossible in most policy debates), you need to explain the mechanism of action you believe is responsible for the correlation, why other proposed mechanisms are wrong, and how the policy change you envision will facilitate the mechanism.

dru|7.2.07 @ 9:58PM|#

Kurt Loder? Seriously? I'm not a huge Moore fan, but I think you guys are really scraping the bottom of the barrel. Isn't there a more credible objective source out there willing to tear MM apart? Unless Loder's referring to a band called "Socialized Healthcare". Then I might give a damn about his opinion.

dhex|7.2.07 @ 9:59PM|#

"On the other hand, I wonder how good a paycheck it must be for Loder to keep himself in that ghetto."

i would imagine its spectacular.

but yeah he's not a bad writer at all.

|7.2.07 @ 10:01PM|#

Kurt Loder--who knew? Sharp writing and marshaling of facts.

And Lamar, I would probably watch CBS Evening News with Robin Byrd.

|7.2.07 @ 10:05PM|#

Yeah Dru, don't deal with the points he makes, just dismiss him because he works for the wrong network. As I said above, Slate, an allegedly serious outlet, gave a completely stupid and pointless cheerleading review. I don't care if Loder works for the North Korean News Service, he makes good points.

Paul|7.2.07 @ 10:08PM|#

Last March, the BBC reported on the results of a Healthcare Commission poll of 128,000 NHS workers: two thirds of them said they "would not be happy" to be patients in their own hospitals. James Christopher, the film critic of the Times of London, thinks he knows why.

Anecdotal, yes, but there are Canadian nurses, who live in canada, and commute to Seattle to work in our hospitals. Reason given: the Canadian healthcare system sucks air.

|7.2.07 @ 10:09PM|#

Certainly there are other ways/sources/means of discussing health care than through another review of Sicko.

MM is not the authority on the issue.
He is not the one that will craft a policy.

I believe that there are several candidates for president that have healthcare reform packages. What about Reason providing a point by point response to those.

Even the 2nd string (H&R posters, that would be) could ignore Moore's take and aim at the actual policy proposals that are likely to be considered by our government.

Just a thought.

Paul|7.2.07 @ 10:11PM|#

And that's all before Loder gets around to Moore's strange depiction of Castro's Cuba as tropical paradise

The only positive thing I can say about Moore, and people like him, is eventually, people catch on and reject his colossal stupidity.

|7.2.07 @ 10:15PM|#

"Even the 2nd string (H&R posters, that would be) could ignore Moore's take and aim at the actual policy proposals that are likely to be considered by our government."

Well, "reform" is generally policy speak for more government control, which in the case of healthcare would just make things worse. I would rather live with the current system than some system cooked up by Congress in an effort to solve the problem. It is not like they live by the mantra of "first do no harm".

Paul|7.2.07 @ 10:16PM|#

I believe that there are several candidates for president that have healthcare reform packages.

I've seen many of those..."reform" packages. Many of them "reform" us into a system like that of Canada, Britain or France.

Also, do a search on Reason's webpage for "national health" and you'll get a nice dose of articles which cover many of those "reform" packages. Yes, most are the "reforms" we have been presented in the past, but many of them look startlingly like what's being presented again. In my opinion, most "reform" ideas are just recycled old ones. Now, find me a candidate which promises healthcare reforms which reduce the government footprint, erh, stranglehold on our healthcare system now, and I'll be intrigued. Unfortunately, almost every "reform" package I've read about, or heard about somehow suggest a greater governmental role in the healthcare system.

|7.2.07 @ 10:25PM|#

Health care and health insurance were MORE accessible in the USA when the government intervened less. But the AMA didn't like it.

How Government Solved the Health Care Crisis: Medical Insurance that Worked - Until Government "Fixed" It

|7.2.07 @ 10:25PM|#

The old CREEM Magazine always referred to the guy as Kurt "Rear" Loder.

Rhywun|7.2.07 @ 10:31PM|#

Here in the USA, at a private hospital with my family's private insurance, I once sat in the ER for eight hours with a broken arm and wrist, in tears from the pain that the couple aspirin they gave me couln't quell, before a doctor would treat me. So... anecdotes about how awful the care is in Canada or the UK don't particularly sway me. I'm not going to pretend there are any easy answers, and I'm not going to blindly proclaim our system "better"--because clearly (to me) there's a lot wrong with it.

|7.2.07 @ 10:51PM|#

How about this idea Rhywun, sometimes life is hard and no system will be perfect? The issue is not is our system perfect, but rather is our system better than the alternatives?

|7.2.07 @ 11:03PM|#

Poor 'wittle Rhywun,

Aww. You had to wait a whole eight hours to mend your 'wittle bwoken arm?

I suppose we should just wreck the U.S. economy, bring medical research to a halt, and give up more of our liberty so you can get your arm examined a bit faster (assuming it will be examined a bit faster).

Go fuck a goat...

|7.2.07 @ 11:06PM|#

Matt-Actually, I'm arguing that given the apparent correlation over an entire population between the level of government intrusion and quality of care (which seems to be a positive one) it is plain goofy to simply assert that it must be government intrusion that causes low quality of care in a single case. That's like finding that time spent studying is correlated with student achievement, and then, when one kid, say Johnny, has low achievement responding "it must be all that time he spends studying that is keeping his achievement down."
"Jesus Christ Ken, are you really so stupid that you think that the UK's and Canada's problems result from not enough government intervention?" Uhh, if you can read then you can see that I'm arguing that its stupid to think that the US problems can possibly be attributed to the relatively low levels of government intrustion in our system. And sorry about your moms and all, but for every person that gains a year from being able to get treatment in the US system like you describe (curious as to how you just 'know' Canada would not have covered that) there are many Americans whose loved ones are robbed of much more of one year of their lives because they can't get any treatment. I'm sure those people's families would return your advice and tell you to go fuck yourself.
steveintheknow (what a misnomer!)-My reference to a "cult" was in regards to the bizareness of blaming "government" for whatever problems we do have at a higher level when in fact we have much less "government" in our health care than most nations. That kind of bizarre thinking is akin to a real True Believer.
MikeP-Reason recently featured mag and online articles arguing for HSA's and mandated private care. They are ridiculous solutions for the reasons described above, even if coupled with various other proposals. But since you are in the know, how to fix our problems?

|7.2.07 @ 11:07PM|#

I had a motorcycle accident in England and didn't see a doctor for lack of insurance. Friends finally convinced me to go, and the wait for X-rays was about 20 minutes (the hospital was empty and the Dr was from India), total time about one hour. Treatment was a sling. No problems, no hassles, no out of pocket expenses, and I wasn't even a citizen.

But that was about 20 years and it's all different now, from what I hear.

|7.2.07 @ 11:08PM|#

20 years and = ... 20 years ago and ...

|7.2.07 @ 11:14PM|#

Taktix's response shows exactly why the Libertarian view of health care will never be acceptable to the bulk of Americans.

We'd prefer a little more decency and empathy than "So what if you die because you don't have any money to pay for health care, Fuck You!"

|7.2.07 @ 11:26PM|#

> they never address that the high cost
> of US healthcare drives pharmaceutical
> companies and other healthcare companies to
> innovate.

US pharmaceutical companies spend only 11% of their income on R&D. Most of their money is spent on marketing and production.

Does this fact refute your point or am I missing something?

|7.2.07 @ 11:36PM|#

High prices cause pharmaceutical companies to lobby the FDA to do things like reclassify blood sugar levels so that way more people are taking pills. I guess that innovative.

|7.2.07 @ 11:39PM|#

What is the rate of R&D investment in other industries? You can't say "only 11%" with an emphasis on "only" unless they really are very, very low in that respect when compared to other industries.

|7.2.07 @ 11:46PM|#

Look, as I have said on previous threads about this topic, I don't think things are all that simple. Our health care system does quite well at some things, and quite poorly in others. I reiterate that I have yet to see any libertarian solution to the problems of those lacking any coverage and inequality in access of care. In fact, there really can't be. Markets always create inequalities, and that is not always a bad thing (incentives are often good things and some folks that are harder working, smarter, etc. have to be unequally rewarded for those incentives to matter; it also strikes me as just). It's silly to say "more markets" in the face of those problems.
That does not mean that our system does not do some things well (like nonelective surgeries, which can improve the quality of ones life if not save it). And there should be some concern that those of us (like myself) who have fat family coverage will actually lose in a nationalized system. I just think its absurd to see the frothing at every thing Moore claims and the zealotic defense of the market as having no flaws in the health care realm. Bullocks to all that.
I've said it before: is health care something like police protection, where we think everyone deserves a basic equal access of, or is it more like the automobile market, where we are fine with the fact that some guys drive corvettes, others accents, and others nikes...To pretend there are not good arguments to see it as the former strikes me as just being dogmatically silly.

soulrebel|7.2.07 @ 11:57PM|#

the health care industry is a racket, and michael moore is a sensationalist. his movies never offer a debate, only his point of view. that being said, i find his films entertaining and look forward to seeing his next installment of propaganda.

|7.3.07 @ 12:50AM|#

is health care something like police protection, where we think everyone deserves a basic equal access of, or is it more like the automobile market, where we are fine with the fact that some guys drive corvettes, others accents, and others nikes...

...because, after all, it is inherently obvious that the poor get exactly the same police protection as the rich.

|7.3.07 @ 12:56AM|#

John

As can be seen above, I am no ardent defender of the Canadian system, but I think you exaggerate its failings.

There are long wait lists and people do die while waiting for treatment, but the people in the system are compassionate and to their best with the limited resources available to them. Granted, they do some "triage" and try to concentrate there efforts where they will do the most good.

A friend of mine had a "mild" heart attack [if one can define any heart attack as "mild"] five days ago and received prompt and efficient treatment from the moment he arrived at the hospital. His wife, who died several years ago from cancer, received the very best treatment and, when it became hopeless, palliative care throughout her illness.

OTOH, my uncle in California, was essentially allowed to die by Kaiser, who didn't want to spring for the expensive treatments that might have extended his life.

This is anecdotal, of course, and proves nothing.

The major benefit of the US system is that it is continuously produces innovations and advances as the lure of profits drives medical providers to seek new and better ways of treating people. While I am not indifferent to the suffering of those unable to afford the best care, I recognize that such care would not exist were it not for the profit motive that is so despised by supporters of the single payer system here in Canada.

Which brings me to the major problem here in Canada: By Law, I am prohibited from providing for myself by seeking alternative insurance and medical systems.

My worst fear is that, should you in the US adopt our 'single payer' system, the much-despised [by liberals] profit motive that drives medical innovation will cease to function.

Given the unlimited demand for medical services, no system will ever be "perfect" in the sense of providing the maximum possible treatment to all who seek it. There are not enough resources in the world to do that.

However, given the choice between medical care rationed by price and any other system of rationing the resources, I choose the former, for the simple reason that the former will produce more innovation and more benefits for all in the long run.

|7.3.07 @ 1:01AM|#

What's wrong with the trolls on this board? A fairly major "youth media" figure actually comes out pro-market, and people are bitching that he looks old or whatever?
I mean seriously, when was the last time that someone with any kind of youth cred. said anything remotely economically individualistic in a public forum? We usually get Sting wanting taxpayer money to go solve all of Africa's problems, "rock the vote" type deals that are practically Democratic Party advertisements, or rappers that insinuate that the only way to get ahead is by drug dealing, pimping, or otherwise cheating "The System". Is Kurt Loder some kind of musical Dennis Miller? I'm almost surprised MTV let him write that stuff.

|7.3.07 @ 1:06AM|#

I saw the trailer for Sicko in a theater last weekend. One shot scanned down a ranked list of quality of healthcare, and stopped when it showed the US at #37. However, the shot also revealed Cuba at #39. Was I just imagining this?

Paul|7.3.07 @ 1:35AM|#

Here in the USA, at a private hospital with my family's private insurance, I once sat in the ER for eight hours with a broken arm and wrist, in tears from the pain that the couple aspirin they gave me couln't quell, before a doctor would treat me. So... anecdotes about how awful the care is in Canada or the UK don't particularly sway me.

Rhywun, this is arguably because government mandates have changed the role of the ER in this country. You have to wait for eight hours because most big city ER's have become extended social service agencies treating everything from real emergencies on down to letting the drunk homeless guy sleep it off. That takes a up a bed. Period.

When I broke my wrist at age 11, I didn't go to the ER. I went to a family practice doc to treat my break. These days people go to the ER for everything.

My wife (who works in an ER) has seen a sharp increase of people coming to the ER in an ambulance because...wait for it... they had the flu. The fucking flu!!!

We live in an increasingly healthcare oriented society where every pain, every owie, every sniffle must be "fixed". All suffering must be "treated" by the healthcare "system". As long as we keep medicalizing and "healthcarizing" every ailment that occurs in the populace, your ER visit will only get longer.

Oh, guess how long I waited in the Canadian ER when I broke my wrist on a snowboarding trip? Hint: It wasn't any better than your US ER wait.

|7.3.07 @ 1:56AM|#

Ken,

Since you asked how I would suggest fixing the problems with the health care system, I'll offer what I wrote last time I answered...

1. Eliminate the tax bias for employer-provided health insurance.
2. Eliminate physician licensing laws.
3. Eliminate requirements for prescriptions, except for drugs such as reserve antibiotics that involve actual public health concerns.
4. Eliminate Medicare.

That should get rid of most of the state meddling in the market that we can, given the mandate offered. So now to what the government can do, rather than what it can get out of the way of...

5. Provide an adequate government safety net. Do not require that it be as good as the best money can buy. It won't be. Accept it.

|7.3.07 @ 1:59AM|#

I just got a quote for health insurance for both me and my wife for $74 a month.

To me, crisis isn't having to give up Directv to pay for my insurance -- a crisis is not being able to get the treatment I need. Despite our allegedly horrible health care system, my $74 a month will insure that I get my treatment. Now, the deductible would make my life a bit uncomfortable, but a few thousand dollars of discomfort is a better price to pay than sitting in a queue forever. That money is not going to make me very happy if I'm in pain, or worse yet, dead, due to a commie breadline health care system.

entropy|7.3.07 @ 2:13AM|#

Anyone else here hope that Ken gets untreatable dick cancer and is liquidated forthwith?

|7.3.07 @ 2:15AM|#

Single payer health insurance will be here soon. As more and more U.S employers of middle class workers drop health insurance as a benefit, fewer and fewer workers can afford private insurance that subsidizes innovation for the rest of the world. Those U.S. employers who keep providing insurance packages find it more and more difficult to remain competitive with foreign companies that do not have this cost.

Innovation is not going to die because of having single payer insurance in the U.S. Pharmaceutical companies may have to actually develop NEW products rather than spending their research dollars on keeping generic drugs from taking their place, but I don't see that as a downside.

|7.3.07 @ 2:42AM|#

Single payer health insurance will be here soon.

Please oh please, please try at least my suggestions 1 and 5 before doing this.

The problems you cite with employer-provided health insurance are entirely due to the tax favoritism employer-provided plans receive.

And please, rather than single-payer, have n+1-payer health care. I don't care what the government does to provide health care to those it chooses: Don't mandate that everyone must use the government as the provider or payer.

|7.3.07 @ 2:51AM|#

Entropy,

No, I don't. What's wrong with you? Do you have a conscience? Did your mother really screw you up that badly, or are you pathological from birth?

|7.3.07 @ 8:20AM|#

Mmmmmm. I love the smell of vitriol in the morning.

|7.3.07 @ 8:26AM|#

MikeP wrote:
1. Eliminate the tax bias for employer-provided health insurance.
...etc...
4. Eliminate Medicare.

Excellent list. Since we're fantasizing about things that won't happen in the forseeable future, I'd add "Eliminate the idea that people have a 'right' to medical care and/or that people have the right to force others to pay for their medical care."

Rhywun|7.3.07 @ 8:27AM|#

Taktix®,

Fuck you. In case you weren't reading, I didn't advocate any of those things.

Go fuck a goat...

That's charming. Go fuck yourself.

joe|7.3.07 @ 8:28AM|#

I stopped reading after the weak-assed insult to Moore's patriotism.

|7.3.07 @ 8:31AM|#

This is quite a sad list MikeP. Come on...
1. Eliminate the tax bias for employer-provided health insurance. Yes, raise taxes to fix the market. Great libertarian idea.
2. Eliminate physician licensing laws. More quacks working for the insurance companies that provide incentives enough for professionals to deny coverage.
3. Eliminate requirements for prescriptions, except for drugs such as reserve antibiotics that involve actual public health concerns. This one ain't so bad, though a great deal of the public will kill themselves with that freedom.
4. Eliminate Medicare. We have millions of uninsured now, thats part of the problem, So get rid of this safety net (then in number you five you say provide a safety net).
See what I mean that libertarians really can't do much about the problems of undercoverage and noncoverage?

|7.3.07 @ 8:34AM|#

Eliminate the tax bias for employer-provided health insurance. Yes, raise taxes to fix the market
Employers will of course keep offering insurance with benefits packages, they will just be much crappier (higher eductibles, less coverage). Which will make the problem, er, worse...
The honest libertarian answer is "I don't have a duty to pay for your care, now you go die." Of course its inhuman and not politically possible, but hey, its your dogma (libertarianism) we're talking about, not mine, and those drawbacks tend to come with that ideology...Dressing it up in health care savings accounts is like putting perfume on stinky.

|7.3.07 @ 8:41AM|#

@Ken - Eliminate the tax bias for employer-provided health insurance. "Yes, raise taxes to fix the market. Great libertarian idea."

MikeP never said "raise the taxes of employers". He said "eliminate the bias". There are (at least) two ways to accomplish that, and one of them (the one a socialist like yourself would never envision) is to give "me" the SAME tax break that you give "my employer" for buying "me" health insurance. Why shouldn't my purchase of my choice of private health insurance get me the same tax break it gives my employer?

It's simple, Ken.

CB

|7.3.07 @ 8:47AM|#

Ammonium said:

Despite our allegedly horrible health care system, my $74 a month will insure that I get my treatment.

Unless the insurance company denies the treatment.

|7.3.07 @ 9:20AM|#

"Unless the insurance company denies the treatment."

The insurance company can't deny the treatment. They can deny paying for it. Which I think comes back to the original problem.

There is NOT a problem with the American Health Care System. Anyone who can pay can get GREAT health care; unlike in Canada. There are people who cannot pay for their health care. That may be problem.

But there are people who cannot pay for their food. Is that a problem? Of course it is. Should "we" help them pay for it? Perhaps. Should they be guaranteed steak and lobster? Probably not.

There are people who cannot pay for their clothing. Is that a problem? Of course it is. Should "we" help them pay for it? Perhaps. Should they be guaranteed Versace and Hilfiger and Brooks Brothers? Probably not.

There are people who cannot pay for their housing. Is that a problem? Of course it is. Should "we" help them pay for it? Perhaps. Should they be guaranteed a mansion? Probably not.

A person without a dime walks into a hospital and expects Lobster/Polo/Neverland treatment. If they can afford it, they should get it. If not, then they should be satisfied with Yugo/Levi/public housing treatment. After all, they're getting it for free.

CB

|7.3.07 @ 9:26AM|#

When government, insurance companies, hospitals, or anyone else attempts to regulate the balance between a limited supply of health care and an unlimited demand for it they're inevitably forced to ration treatment.

There, fixed that.

|7.3.07 @ 9:26AM|#

Cracker Boy-If it were done this way you are correct that this is not unlibertarian. But as to the socialist crack, you're just not reading my posts, like the one above where I say: "Markets always create inequalities, and that is not always a bad thing (incentives are often good things and some folks that are harder working, smarter, etc. have to be unequally rewarded for those incentives to matter; it also strikes me as just)." Yeah, that's straight up Marx for sure...I do think that socialization is the best way to target under and non-coverage. Moore has this stupid way of saying "These insurance companies deny people coverage and services under existing coverage, but I thought these insurance companies were supposed to help people." Of course not, they are supposed to make money for themselves and shareholders. It's just that some people will always be terrible risks to insure, and some of these people will be not at fault (kids, old folks, mentally ill, or just genetically screwed). So any private solution will fail to meet those problems. Notice my intentionally careful use of the word "those", since socialized medecine may exacerbate or create problems (I noted that above too).
The tendency to respond to nationalizers with the charge "commmies" is ridiculed in the movie btw, so you might want to avoid being a walking stereotype. I imagine you think people who are for libraries or police are socialists since the government pays for them...

|7.3.07 @ 9:29AM|#

Ken,

I will grant that my suggestions 2 and 3 will never happen, but you did ask what the libertarian solution is.

As for Medicare, it is government-paid health insurance for the very wealthiest segment of society. It is beyond revolting that 18 year old minimum wage earners have to pay for millionaires' care, just as it is that they must pay for their Social Security. Furthermore, given the growth of medical costs, Medicare's future financials make Social Security's look like a cakewalk.

On top of that, Medicare through its history has been the largest single driver of health care inflation. It should be phased out as rapidly as possible, with whoever the government chooses to cover being covered by whatever general safety net is devised.

Finally, as Cracker Boy notes, you can end the tax bias by giving the same break to individuals that you give to employers. I doubt you noticed when it was announced a few months ago, but the major part of Bush's modest health care proposal would give individuals the same tax break while capping it for both employers and employees so the government doesn't end up paying for "gold-plated" insurance. That proposal was well received by libertarian health policy wonks.

|7.3.07 @ 9:33AM|#

The current healthcare debate strikes me as being representative of the entire system of capitalism. If you've got money, it's great, and if you don't, it sucks.

|7.3.07 @ 9:38AM|#

If you've got money, it's great, and if you don't, it sucks.

Unless you get uppity and get really sick, then the insurance company will drop your coverage all together; rich or poor.

|7.3.07 @ 9:39AM|#

More anecdotal evidence...

The UK system isn't all it's cracked up to be. A buddy and I were on vacation in England several years ago when I needed emergency services after being mugged. I don't recall much before waking up in a hospital bed, but my wounds were mended to the best of their knowledge at the time. Unfortunately, they failed to diagnose that I had contracted lycanthropy, and as a result, killed several people around London as a werewolf.

Bad call on that one.

|7.3.07 @ 9:46AM|#

@Ken - I've read your posts. That's why I commented.

When I was young, the folks who wanted to take money from people who worked (according to their abilities) and give it to people who didn't (according to their needs) were called socialists. I missed the renaming to Nationalists. Sorry.

I'm not surprised that a "Nationalist" like yourself would fail to consider a tax cut as a possible way to reduce a bias.

CB

|7.3.07 @ 9:49AM|#

"The current healthcare debate strikes me as being representative of the entire system of capitalism. If you've got money, it's great, and if you don't, it sucks."

Thing is, all that stuff that rich people are paying for? It becomes cheaper. There may be a differential between what some people can afford and what others can afford, but that differential exists because more cutting edge stuff is being created all the time.

To recap, it sucks if you are poor when comparing yourself to what someone else could theoretically afford, but it is pretty spectacular if you compare what you can do now to what you could do with the same low amount of money decades ago.

By all means, tweak the insurance incentives and get rid of medicare fraud or whatever to reduce cost in the system, but don't F the whole system up.

|7.3.07 @ 9:54AM|#

It's thanks to free markets that luxuries that used to be available only to the wealthiest of monarchs are now available to everybody.

Take silk stockings for example. Or shoes. Or a balanced, nutritious diet. Chocolate. Warm winter jackets. Glasses. Automobiles. Dirty pictures. Time off to watch a game, several times a week.

|7.3.07 @ 9:56AM|#

Yes, the heavy regulation of insurance, drug development, and the practice of medicine has nothing at all to do with the high cost and relative (to what it could be, anyway) scarcity of medical services and products. Naturally, a system without all that icky capitalistic stuff will work so much better.

Bah. Show me a failed American system that hasn't been corrupted by government's constant interference, and you can talk. It's the socializing of medicine that's the problem today, not the free market. And healthcare isn't exactly inaccessible, either, despite the outcry otherwise. A very large percentage of people without coverage go without by choice. I did in my 20s, for instance.

:-|7.3.07 @ 10:10AM|#

If you've got money, it's great, and if you don't, it sucks.

America's "poor" are considered rich in most parts of the world.

|7.3.07 @ 10:12AM|#

Yeah, and Gary, Indiana's crime rate is considered low in many parts of the world.

So what?

|7.3.07 @ 10:16AM|#

Joe.. what I think :- is saying is... if you're poor in America and don't like it, then move to another country and see how you like it.

The Dan T. solution.

CB
(Joking... I think)

|7.3.07 @ 10:25AM|#

"It's the socializing of medicine that's the problem today, not the free market."
Pro Liberate-I'm going to just assume you came late to the thread (and, therefore are "You're like a child who wanders into the middle of a movie and wants to know...") and just did not read the above discussion, where I point out how moronic it is to say it must be government intrusion which causes our health care problems when WE HAVE LESS INTRUSTION THAN ANY COMPARABLE NATION which in turn have less problems.
MikeP-I wasn't the one who said your policy proposals would never happen. I just said they would not alleviate the problems at issue.
Cracker Boy-as I do not have the html ability to draw pictures for you on this site we'll just have to agree to disagree. Say hi to John Birch and his pals for me.

|7.3.07 @ 10:33AM|#

"WE HAVE LESS INTRUSTION THAN ANY COMPARABLE NATION which in turn have less problems."

If Canada, Great Britain, and France have less problems with their health systems, why are they reforming them? The US is rated #1 in patient satisfaction because we don't have the long waiting lines, we don't have as long a wait in the waiting room and the doctor spends more time with his or her patients. Canadians come to the US to get the medical care they would have to wait too long for in Canada. I would say it's the other countries that have the most problems.

|7.3.07 @ 10:35AM|#

"MikeP-I wasn't the one who said your policy proposals would never happen. I just said they would not alleviate the problems at issue."

Socialized medicine would create a whole host of new problems.

|7.3.07 @ 10:37AM|#

@Ken - you need pictures to explain what "Nationalism" is? Really? Like pretty flowers and rainbows and pie in the sky and stuff? I'm a left brainer. I can handle a description.

Or are you just being joe?

CB

|7.3.07 @ 10:39AM|#

To recap, it sucks if you are poor when comparing yourself to what someone else could theoretically afford, but it is pretty spectacular if you compare what you can do now to what you could do with the same low amount of money decades ago.

We're kind of back to the relative vs. absolute poverty difference. I agree it's a great thing that the poor in America are not suffering from absolute poverty like many in the world are (although this is due to welfare more than anything), but if you're impoverished to the point of not being able to particpate in society I doubt the fact that you have better shoes than poor people did 200 really is going to comfort anybody.

:-|7.3.07 @ 10:41AM|#

No, I'm saying "poor" is a relative term, and that "poor" people go to the emergency room and get "free" medical care all the time in this country. And the rest of us "rich" folks get to pay for it. To sum up: being "poor" in America is preferable to being poor anywhere else on Earth. Socialists and liberalitarians amongst us will note the injustice and indignity of being poor. Tough titties.

|7.3.07 @ 10:45AM|#

"The US is rated #1 in patient satisfaction because we don't have the long waiting lines, we don't have as long a wait in the waiting room and the doctor spends more time with his or her patients."

I would have to see a source citation on this claim before I'd buy it. I have never seen the US ranked 1st on any measure of patient satisfaction.

Still would like to see discussion of the current proposals from people that are likely to craft a policy. MikeP's plan isn't being proposed by any of the candidates that I know of (What's Ron Paul's plan look like?).

|7.3.07 @ 10:45AM|#

"The current healthcare debate strikes me as being representative of the entire system of capitalism. If you've got money, it's great, and if you don't, it sucks."

If you are really poor and really sick, there are charity hospitals that will care for you.

|7.3.07 @ 10:49AM|#

"I agree it's a great thing that the poor in America are not suffering from absolute poverty like many in the world are (although this is due to welfare more than anything)"

If anything, our welfare system has perpetuated poverty. It has destroyed incentives.

|7.3.07 @ 10:50AM|#

"but if you're impoverished to the point of not being able to particpate in society I doubt the fact that you have better shoes than poor people did 200 really is going to comfort anybody."

Don't soft peddle your point by changing to shoes instead of healthcare. What you are saying is that relative healthcare is more significant that absolute healthcare.

Take statins alone. Say you had your way 20 years ago and the system nationalized in a way such that the government rationed care directly, and say the innovative cost of removing the profit incentive from pharma delayed public use of statins by 20 years. Would you take that deal? How many deaths are on your hands? How many lives have you really saved?

highnumber|7.3.07 @ 10:55AM|#

Ken,

Off topic:

Why are you such a smarmy prick?

Seriously.

|7.3.07 @ 11:02AM|#

No, I'm saying "poor" is a relative term, and that "poor" people go to the emergency room and get "free" medical care all the time in this country. And the rest of us "rich" folks get to pay for it.

And as both common sense and comparitive studies of outcomes tell us, that is an incredibly inefficient way to deal with the problem. Catching illnesses early is cheaper than treating them late, and works better.

JasonL,

Statins are very cost-effective, as they save money compared to patients with untreated heart problems having heart attacks. For all the panic about "shutting off the profit motive," a government-run insurance system would still promote such research, as the government would be very interested in seeing such a product come into use.

|7.3.07 @ 11:03AM|#

"I would have to see a source citation on this claim before I'd buy it. I have never seen the US ranked 1st on any measure of patient satisfaction."

It's the same listing that Moore refers to. He points out how the US health care system rates lower than other countries on the overall list. This is because the US is not as cost effective because we don't practice the rationing of other health care systems. On the list of patient satisfaction, the US rates #1, a point that Moore fails to mention. He also failed to mention that Cuba rates lower than the US on the overall list. In other words, Moores documentary is very one-sided and he cherry picks his data.

|7.3.07 @ 11:07AM|#

how moronic it is to say it must be government intrusion which causes our health care problems when WE HAVE LESS INTRUSTION THAN ANY COMPARABLE NATION which in turn have less problems.

Government directly pays for over 50% of the health care expenditures in the US and strongly influences the rest. The actual effects of the intrusion of government in the market is by some metrics far higher that found in a single-payer system. Certainly the government causes health care prices to be higher than they would otherwise be while single-payer systems are specifically geared toward lowering prices.

|7.3.07 @ 11:09AM|#

MikeP-I wasn't the one who said your policy proposals would never happen. I just said they would not alleviate the problems at issue.

I gather from this comment...

See what I mean that libertarians really can't do much about the problems of undercoverage and noncoverage?

...that you think the problems are undercoverage and noncoverage.

If your goal is universal health care, the best way to achieve that goal does not necessarily require everyone has insurance.

Please don't further contribute to the troubles of health care in the US by thinking it does.

|7.3.07 @ 11:28AM|#

"Statins are very cost-effective, as they save money compared to patients with untreated heart problems having heart attacks. For all the panic about "shutting off the profit motive," a government-run insurance system would still promote such research, as the government would be very interested in seeing such a product come into use."

You are a smart guy, joe. I just don't see how you can look around the role of creative destruction and market forces in the development of nearly everything you use every day. Just because the government would like to have a way to reduce their costs doesn't mean those things come about. Is it really an accident that such a huge percent of all development dollars on earth come from the US market and not from the NHS? I mean, they are trying to reduce their costs, right? Shouldn't central health systems be spitting out innovation left and right?

It is easy to look at current innovation, choose only what you like after the fact and say, "See all the money that was wasted? All we needed was these two or three things, and that would be efficient!" You have to know that is too simple of an answer.

I would rather have a system where Ferraris and Audis and BMWs exist than a system where everyone gets a Zil.

|7.3.07 @ 11:37AM|#

"Certainly the government causes health care prices to be higher than they would otherwise be while single-payer systems are specifically geared toward lowering prices."
Are you saying that half assed government instrusion skews prices but that whole-assed government does not (at least to the same extent)? I geuss that is reasonable, but it strikes me as an argument for the total thing.

|7.3.07 @ 11:38AM|#

Rattlesnake,

Thanks.
That's from the WHO http://www.who.int/whr/2000/en/index.html

Here's a different view
http://www.ecosante.org/OCDEENG/65.html

I have no idea which one used more valid methodology...has anyone looked at these?

|7.3.07 @ 11:41AM|#

The interesting thing about Blendon's stuff is that all the countries have about the same patient satisfaction no matter the system. Makes me wonder if patient satisfaction is a sensitive measure.

|7.3.07 @ 11:48AM|#

"Why are you such a smarmy prick?"
Whenever you talk to religious fanatics it becomes frustrating, and the temptation to berate them for their violations of logic and reason, just to hold their dear and simplistic worldviews, is sometimes too strong to resist. Here you have numerous seemingly well read people who will go to crazy lengths, even unneccesary lengths (Moore's film is just not that good and will reach about 1/100th of the market of, say American Idol) to blast what they see as blasphemy. Here are some more examples, sigh:
"Shouldn't central health systems be spitting out innovation left and right?" Actually, a shitload of R&D comes from the government (think universities) and non-profits (like the Howard Hughes Foundation) and often priate companies capitalize (no pun intended) on it. Public sector does ok on innovation, thank you, and sometimes better since long term thinking is often anathema to private corporations (the last issue of Reason had an interview with a libertarian management guru who said this btw).
"Socialized medicine would create a whole host of new problems." Which I plainly said. But will they be worse than than what we got? Ah, there's the rub...
"If Canada, Great Britain, and France have less problems with their health systems, why are they reforming them?" And we are not reforming ours???? A proponent of those systems may note they are better while stipulating they are not perfect.

|7.3.07 @ 11:55AM|#

Statins are very cost-effective, as they save money compared to patients with untreated heart problems having heart attacks. For all the panic about "shutting off the profit motive," a government-run insurance system would still promote such research, as the government would be very interested in seeing such a product come into use.

True, but what nationally funded health care system has gone through the process of researching a drug and bringing it to market? National health care systems are chronically underfunded and they do what all underfunded systems (and people) do - take care of the basics, and scrimp on everything else. It might be nice to have better drugs in the future, but the light bills have to be paid first.

|7.3.07 @ 11:58AM|#

Neu Mejican-Thanks for the post to the WHO study. I glanced at it last night, and thought of posting it, but was just sure that some wingnut, having not read it or understood it, would just post some bullshit from wikipedia or what not to "refute" it. As I've said, I just glanced at it, but the methodology seemed sensible (note, no methodology will ever get, or warrant, 100% agreement that it is 'perfect'), and one would really have to be quite the paranoid bastard to think all those PhD.'s and MD's that did the study were just a left wing cabal. Is WHO totally objective? Of course not, but they have a much better reputation on this than say Cato or Heritage, where the hiring and firing is largely determined by ideological conformity (and they are are pretty up front about this so wingnuts don't b other).
Another good source is: http://www.oecd.org/document/30/0,3343,en_2649_34631_12968734_1_1_1_1,00.html
The OECD is very reputable worldwide (with normal people and researchers of course, not John Birchers). This debate could use a lot more empirically verifiable data and a lot less slogans and anecedotal evidence of course, but part of being a domgatic libertarian is to to have a simple worldview that helps one think they have done all the work necessary to smugly pass judgment on policy matters that have real world effects on people's utility after a 10 minute google search.

highnumber|7.3.07 @ 12:06PM|#

Ken,

Thanks for answering.
I, for one, would appreciate it if you would try to minimize the insults and smart-alecky attitude.
joe is a liberal who very rarely resorts to name-calling here. He presents his points as he sees them. He has thus earned much respect from many other commenters who do not often agree with him.

Thank you.

|7.3.07 @ 12:13PM|#

Ken,

Problems are something that we have fewer of, not less of.

In any case, I think the evidence that our system is inferior to other systems is quite lacking. Sure, parts of our system can be rightly criticized, and the costs for insurance and many services seem to keep increasing at a ridiculous rate, but I don't see how you can blame it on the free market. It simply is not the case that our healthcare system is not permeated by government interference.

"Socialism" in the U.S. is something more regulatory than possessory. Rather than nationalize an industry, we just impose regulations to such a degree that the industry is controlled by government. What's an HMO? Who controls the gateway to new drug development to the extent that it costs billions to bring a new drug to the market? Who has allowed litigation against doctors to run amok? Who is in bed with insurance companies and has created huge barriers to entry for competition? Incidentally, one of the big problems with reforming our system is that a lot of the trouble comes from state regulation.

The severe criticism of socialized medicine within the countries that have it is so great that I can't figure out why you're acting like it is something marginal. Look at what our resident Canadians are saying, for instance. I've heard similar complaints pretty much across the board from Canadians and Brits. Just imagine healthcare services delivered with the commitment and efficiency of the DMV. Oh, yeah.

Another thing: Libertarians aren't "John Birchers". Nor is every study launched by OECD, WHO, etc. without bias. There are very strong political reasons for saying that the system you have is better than the one those nasty Americans have. Otherwise, might not the people say, "Um, why not do things more like they do?"

|7.3.07 @ 12:18PM|#

"Socialized medicine would create a whole host of new problems." Which I plainly said. But will they be worse than than what we got? Ah, there's the rub...

Health care is expensive, and reasonably so when you look at the tremendous amount of work and material that goes into even the most basic blood test. Given that, in the end we have two alternatives:
1) Let pricing determines who gets what level of health care, and some people will fall through the cracks.
2) Implement price controls, and in the subsequent shortages, some people will fall through the cracks.

|7.3.07 @ 12:20PM|#

"single-payer systems are specifically geared toward lowering prices."

By rationing services.

|7.3.07 @ 12:20PM|#

highnumber-I appreciate the comments, and have actually felt I'm being way too combative.
But Joe is certainly not treated with respect around here, as his patriotism and good sense are called into question almost daily...
Perhaps if you preached to thin own, I would subscribe faster...
"It is hard to say someone is acutually more ignorant, dogmatic and narrowminded than Lithwick, but Stevens gives it a good shot." "Fuck you Ken. No really, Fuck you." "Only a moron American liberal who has never actually experienced healthcare in places like Canada and the UK could make such a statement."
John
"Go fuck a goat..." "Poor 'wittle Rhywun,

Aww. You had to wait a whole eight hours to mend your 'wittle bwoken arm?" taktix
" He said "eliminate the bias". There are (at least) two ways to accomplish that, and one of them (the one a socialist like yourself would never envision) is to give "me" the SAME tax break that you give "my employer" for buying "me" health insurance." Cracker Boy

Yet you single me out for being "smarmy?"

"

|7.3.07 @ 12:28PM|#

"Are you saying that half assed government instrusion skews prices but that whole-assed government does not (at least to the same extent)? I geuss that is reasonable, but it strikes me as an argument for the total thing."

If all you care about is cutting costs. But is it a good thing to cut costs by cutting services? That's our biggest complaint about HMO's. National Health Care is nothing but a big HMO.

|7.3.07 @ 12:37PM|#

I gotta call bullshit on the $74 a month for health insurance. $740 is more like it.

highnumber|7.3.07 @ 12:49PM|#

Ken,

I asked that you minimize the smarm, not eliminate it. Sometimes it is called for and sometimes one cannot help oneself. We all have moments. I singled you out because the majority of your comments seemed infected with the smarm and insults.

I disagree about joe's treatment. Certain commenters have problems with him and vice versa, but for the most part he is a respected dissenter.

And there are certain commenters whom I ignore as a matter of course because they add little to the conversation. Some never have anything to add besides snark, and some are always looking for a fight. I will add the standard libertarian disclaimer that you are free to be one of those commenters if you choose.

Have a great holiday, everyone!

USA!

USA!

USA!

USA!

USA!

Let's blow stuff up!
(like in the sky, not in other countries)

|7.3.07 @ 1:41PM|#

"Socialized medicine would create a whole host of new problems." Which I plainly said. But will they be worse than than what we got?"

Yes

Gilbert Martin|7.3.07 @ 3:44PM|#

"Since we're fantasizing about things that won't happen in the forseeable future, I'd add "Eliminate the idea that people have a 'right' to medical care and/or that people have the right to force others to pay for their medical care."

Yes that would be ideal.

The actual state of healthcare hasn't gotten worse than it has been in years past, what has changed is an increase in the "entitlement" mentalilty.

|7.3.07 @ 3:54PM|#

I don't look around it at all, JasonL.

I just don't buy your wholly-naked assertion that there will be no more profit motive if health care providers get paid by the government instead of by insurance companies tha skim a big piece of the pie right off the top.

You completely whiffed, and put all that effort into refuting an argument that no one made. You actually have to read what I write, you know.

|7.3.07 @ 3:58PM|#

Tacos mmmm,

You can pay a whole lotta light bills with the 30% that inefficient HMOs pay in overhead costs.

Rattlesnake Jake,

HMOs exist for the purpose of lowering costs by rationaing care as well.

MattXIV|7.3.07 @ 5:13PM|#

joe,

I believe the 30% number is actually a high outlier that was reported for Cigna Colorado (I can't find the primary source, but most people refering to it that specify where the number is coming from say it was them). I think normal rates are generally in the 12-25% range. It's also important to remember that overhead scales per claim or per member not per dollar spent, so you're going to see a lot of variation based on the membership pools that various payors are working with that might not indicate any actual efficiency difference.

|7.3.07 @ 5:43PM|#

I gotta call bullshit on the $74 a month for health insurance. $740 is more like it.

David,

I don't know where Ammonium lives. I just tried an Urbana, Illinois, address. The lowest quote I got for a 40 year old married couple was $78 per month.

When I dropped the age to 30, I got $49 per month.

If I may ask, where do you buy your high deductible insurance, so I know not to shop there?

|7.3.07 @ 7:56PM|#

MikeP,

WTF is prospectzone.com?

Try a New York address. HDHP rates are just a smidge below regular HMO rates.

Thanks, "community rating."

|7.4.07 @ 12:39AM|#

It is an insurance quote consolidator. I reached it from hsafinder.com, the first hit in my search for insurance quotes. Unfortunately, this particular one doesn't seem to cover the Northeast, and the link for New York sends me to a much less anonymous manually returned quote.

When I tried Chicago, to simulate a large city, it gives only one carrier (Humana) and a rate of $99 for the 30 year old couple and $152 for the 40 year old couple. Still a far cry from your idea of what it would be.

Now, where did you get your $740?

Incidentally, one of the most needed health care reforms is freeing the health insurance market so that companies can compete across state lines. That should help your predicament in New York.

Paul|7.4.07 @ 4:45AM|#

Still would like to see discussion of the current proposals from people that are likely to craft a policy.

Here's one.

Hint: They're proposing more of something, not less of it. Oh, and Great Britain's system is the "model" system, even better than Canada's, which still uses that pesky fee-for-service system.

sam|7.8.07 @ 2:12PM|#

kurt loder doesn't care about poor people