Oops
Radley Balko | September 18, 2008, 4:55pm
During an Intelligence Squared debate on universal health care earlier this week, I think it's fair to say Paul Krugman stumbled a bit:
PAUL KRUGMAN
And private insurance? That’s the thing, I— Actually, can I just —I wanted to ask a question. And—
JOHN DONVAN [MODERATOR]
Please—please do—
PAUL KRUGMAN
—and I wanted to ask, actually two questions, to the audience. First, how many Canadians, would Canadians in the room please raise your hands. [ONE PERSON APPLAUDS, LAUGHTER]
JOHN DONVAN
We have about seven hands going up—
PAUL KRUGMAN
Okay, not as many as I thought. Okay, of those of you who are not on the panel who are Canadians,, how many of you think you have a terrible health care system. [PAUSE] One, two—
JOHN DONVAN
We see—almost all of the same hands going up. [LAUGHTER]
PAUL KRUGMAN
Bad move on my part. [APPLAUSE]
Paul | September 18, 2008, 7:20pm | #
So they complain about their own care, but not the system writ large? Is that what you mean?
No. They complain about their insurer or insurance, not about their care.
Mostly these complaints revolve around cost-- cost of premiums etc. Sometimes they revolve around coverage wich, yes, I know ties into the concept of "access".
However, everyone I have ever known (family and friends) who had serious healthcare issues were taken care of very quickly. Hip replacements, quintuple bypass. Some cases they were taken care of within hours of discovery. Not days or weeks.
I have had care in both countries. Overall, I am satisfied with the care I got in both countries. However, in my anecdotal case, I did run across some of the ironies that exist in nationalized care: The more serious your ailment, the less care you get.
I broke a wrist in Whistler, BC. When I went to the clinic, I was in the waiting room alongside people with the entire gamut of ski injuries: Ligaments, knees, wrists, hands etc. Those with minor hand and wrist injuries (my broken wrist included) were taken care of quickly. When I was finished, people with serious knee injuries were still waiting due to the lack of resources to fix the real serious ailments.
The more you deal with the US health care system, the more critical you are of its inefficiencies.
Probably. Maybe. Depends. The more you deal with anything, the more you recognize its flaws.
Our system is flawed. But the suggestion that poor people, the indigent, the underprivleged don't get care is a lie that defies explanation. The only problem (if one were to even agree that there is one) is that our system is a patchwork of overlapping systems that have to be navigated. The single-payer systems are more straightforward logistically.
This discussion can get deeper.
Enough About Palin | September 18, 2008, 9:21pm | #
"And this schmuck Krugman is a full tenured professor at one of this country's most prestigious colleges and expensive
Colleges which are heavily subsidized by taxpayers.
By the fact that he didn't follow through shows what a piss poor professor he is.
And the next election, doesn't matter who wins, will put assholes like Krugman in charge of health care."
Don't be so sure. What follows is a piece written by william Katz. If you want to scroll past it, that's your prerogative, but it does capture well the sentiments of fly-over country. Most insightful.
From Mr. Katz...
I have no idea who’ll win the presidential election. It is very close, and a single incident or misstep can change the result. Clearly, the convention bounces have faded. Obama seems to be regaining a part of his pre-convention standing, thanks to some folks on Wall Street who give the term “classless society” an entirely new meaning. Oh, and thanks also to the worst, and most embarrassing press bias I’ve seen in my lifetime.
But I do think I know what the election is about. Yes, of course, there are issues, especially economic concerns, and they will cut. But on November 4, this election may well be about culture, which in politics doesn’t mean which singer is invited to the White House or whether the first lady’s hair style is up to date. In politics, culture means instinct, what happens in the gut, which is where a lot of political decisions, and voting decisions, are really sealed. One person has made this race about culture, and her name is Sarah.
It is simply remarkable to watch grown men and women in the media become hysterical about Sarah Palin – the intruder, the outsider, the little woman from a place where none of them would ever live, and where they certainly wouldn’t raise their children. It was equally remarkable to watch David Gergen, a knowledgeable Washington insider, say on CNN that he couldn’t understand the Palin thing. Like the king in the musical, “Camelot,” these highly educated, low-carb-luncheon types seem to wonder, when they see Sarah’s crowds, “What do the simple folk do?”
I’ll tell you a story, told to me by the late Kermit Eby, a University of Chicago professor with a history in the labor movement. It’s about Jimmy Hoffa, when he was president of the Teamsters. Hoffa would visit union halls to rally his members - rough guys, truck drivers mostly. He’d get up in front of them, hop on a chair, impeccably dressed, and start to speak. We’re talking 1950s prices here:
“You see this suit?” Hoffa would ask. “Hickey-Freeman. Three hundred bucks.
“You see these shoes? Florsheim. Twenty-seven-ninety-five.
“You see this watch? Longines. Two hundred bills.”
And those truck drivers would get up and cheer.
Why? Because “one of our own made it.” They liked seeing Jimmy, in his Hickey-Freeman, sitting down with all those management big shots. They liked it that this guy who came from the same streets they did could glance at the same Longines watch that the executives had wrapped around their chubby wrists. “One of our own made it.”
That’s the secret of Sarah Palin. When large numbers of American women, and men, look at her, they see themselves. And they see that a mother, married to a guy who works with his hands, can make it. And they deeply resent those who tear her down and push her out. The journalists trying to destroy Sarah Palin are the same ones who claim to root for “the little people.” Yet, they would never think of associating with them, and they’d be appalled if one of their children married into the Palin family. How does one explain it at the Princeton Club?
I recall a day in 1960 when I was driving through central Illinois with U.S. Senator Paul H. Douglas, for whom I was interning. We entered one of those typical Midwestern towns, and I made a classically dumb, arrogant, University of Chicago undergraduate comment about “the kind of people who live here.” Mr. Douglas, an honored senator, a war hero, a distinguished academic, interrupted my ignorance and admonished me. “Bill,” he said, “never underestimate the wisdom of a small town.” It’s something I’ve always remembered. The citizens of that Illinois town are the ones who, today, are called by the coastal elites “the flyover people.” They are the Sarah Palins - the ones who don’t measure the worth of their lives by their SAT scores or the name of the school on their diploma.
It was about the time I was interning for Mr. Douglas that a British writer and scientist, C.P. Snow, gave his famous lecture about “the two cultures,” the scientific and the humanistic. He complained, rightly or wrongly, that they never spoke to each other. Today, Snow might have written about this country’s two cultures – the one that represents bedrock American values, taught for generations, and the one that represents the “higher,” university-trained culture of the last 45 years. The culture of Sarah Palin versus the culture of Barack Obama.
I’ll tell you another story: CBS used to be known as the Columbia Broadcasting System. In the early days of radio its announcers would step into a booth during station breaks and say to the radio audience, “This is CBS, the Columbia Broadcasting System.” They called it “saying system.” And William S. Paley, who ran CBS, insisted that they wear tuxedos. Now, no one saw them. It was radio. And yet Paley insisted. He explained that it was a formal occasion, that they were entering American homes, that respect had to be shown, and that wearing a tuxedo would remind them how special this was. Tell that story to the “sophisticates” of today’s journalism and they’d laugh at the excess. Tell it to the Sarah Palin people and they’d understand immediately. They’d understand the instinct behind it, the instinct for respect.
It’s the same instinct that made Ronald Reagan put on a jacket every time he entered the Oval Office, because of his respect for what it represented. Compare that to the instinct that allowed Bill Clinton to be photographed in that same office in a track suit.
It is the instinct that made William F. Buckley Jr. say, to considerable approval, that he’d rather be ruled by the first 2,000 people in the Boston phone directory than by the 2,000 members of the Harvard faculty.
It is the instinct that sent Sarah Palin’s son to a recruiting office in wartime, rather than the protest lawn outside an anthropology department.
I share some of the doubts, expressed here at Power Line, about Sarah Palin’s preparedness for high office. What I don’t doubt is her gut instinct. Harry Truman, also rough around the edges, and snickered at by the swells, had that instinct. So, of course, did the much-ridiculed Lincoln, who was called a baboon by his first commanding general. And so of course did FDR, looked down upon by the likes of the columnist, Walter Lippmann.
The Washington and New York elites hate Sarah Palin. They, and especially the feminist “leaders” among them, are like the old factory owners in the pre-union days. They fear that the little people are rising up against them, and they must stop this. They are now the establishment, and like all establishments they protect themselves.
Sarah Palin may or may not be our next vice president. But if she is not, she will be remembered for one great thing – that for a single moment the “flyover people,” those often ignored and sneered at, felt they had a champion, and they felt that one of their own had made it.
They will be back, and if they’re not shown proper respect in this country, they might be a lot angrier next time.
Lefiti | September 19, 2008, 1:26am | #
In Health, Canada Tops US
Our neighbors to the north live longer and pay less for care. The reasons why are being debated, but some cite the gap between rich and poor in the US
by Judy Foreman
Want a health tip? Move to Canada.
An impressive array of data shows that Canadians live longer, healthier lives than we do. What's more, they pay roughly half as much per capita as we do ($2,163 versus $4,887 in 2001) for the privilege.
The summary of the evidence has to be that national health insurance has improved the health of Canadians and is responsible for some of the longer life expectancy.
Dr. Steffie Woolhandler, an associate professor at Harvard Medical School
Exactly why Canadians fare better is the subject of considerable academic debate. Some policy experts say it's Canada's single-payer, universal health coverage system. Some think it's because our neighbors to the north use fewer illegal drugs and shoot each other less often with guns (though they smoke and drink with gusto, albeit somewhat less than Americans).
Still others think Canadians are healthier because their medical system is tilted more toward primary care doctors and less toward specialists. And some believe it's something more fundamental: a smaller gap between rich and poor.
Perhaps it's all of the above. But there's no arguing the basics.
"By all measures, Canadians' health is better," says Dr. Barbara Starfield, a university distinguished professor at Johns Hopkins Medical Institutions. Canadians "do better on a whole variety of health outcomes," she says, including life expectancy at various ages.
According to a World Health Organization report published in 2003, life expectancy at birth in Canada is 79.8 years, versus 77.3 in the U.S. (Japan's is 81.9.)
"There isn't a single measure in which the U.S. excels in the health arena," says Dr. Stephen Bezruchka, a senior lecturer in the School of Public Health at the University of Washington in Seattle. "We spend half of the world's healthcare bill and we are less healthy than all the other rich countries."
"Fifty-five years ago, we were one of the healthiest countries in the world," Bezruchka continues. "What changed? We have increased the gap between rich and poor. Nothing determines the health of a population [more] than the gap between rich and poor."
Gerald Kominski, associate director of the UCLA Center for Health Policy Research, puts the Canadian comparison this way: "Are they richer? No. Are they doing a better job at the lower end of the income distribution? For lower-income individuals, they are doing a better job."
At a meeting last fall of the American Public Health Assn., Dr. Clyde Hertzman, associate director of the Centre for Health Services and Policy Research at the University of British Columbia in Vancouver, analyzed data showing that Canadian women outlive American women by two years and men, by 2 1/2 years.
During the last quarter-century, he says, all income groups in Canada also showed gains in life expectancy. During much the same period in the U.S., death rates widened between America's rich and poor, according to a 2002 study in the International Journal of Epidemiology by American and Australian researchers.
Infant mortality rates also show striking differences between the U.S. and Canada.
To counter the argument that racial differences play a major role, Hertzman compared infant mortality for all Canadians with that for white Americans between 1970 and 1998. The white U.S. infant mortality rate was roughly six deaths per 1,000 babies, compared with slightly more than five for Canadians.
Maternal mortality shows a substantial gap as well. According to the Paris-based Organisation for Economic Co-operation and Development (OECD), a 30-nation think tank, there were 3.4 maternal deaths for every 100,000 births among Canadians, compared with 9.8 deaths per 100,000 Americans.
And more than half of Canadians with severe mental disorders received treatment, compared with little more than a third of Americans, according to the May-June 2003 issue of Health Affairs.
"The summary of the evidence has to be that national health insurance has improved the health of Canadians and is responsible for some of the longer life expectancy," says Dr. Steffie Woolhandler, an associate professor at Harvard Medical School and staunch advocate of a single-payer system.
Of course, some causes of death, such as homicide, wouldn't be much affected by having a single payer system. And the U.S. has "the highest homicide rate of all the rich countries," says Bezruchka.
"Other things might be differences in seat belt usage," adds Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. "We are also disproportionate consumers of illegal drugs, much more than Canada, so it's cultural."
The health of Americans would be better with universal healthcare, he says.
"But there are some things that a single-payer system wouldn't fix — but which would leave one country looking healthier in the statistics."
In some respects, the healthcare system is "the tail on the dog," says Dr. Arnie Epstein, chairman of the department of health policy and medicine at the Harvard School of Public Health.
"It's other aspects of the social fabric of different countries that seem to have a major impact on how long people live," he says.
In the U.S., African Americans and Latinos "face problems of housing, stress and low income, which have nothing to do with a single-payer system." Canada has a large number of Asian immigrants, he says, but they, like Asian immigrants in the U.S., tend to do well on healthcare measures.
The bottom line is that Canada is doing something right, even if "the reasons are not totally understood," says Kominski of UCLA.
Copyright 2004 Los Angeles Times
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