Oops

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]

Comments

[Warren]

In the word of the sage of my generation: "Awesome! Totally awesome!"

[Episiarch]

Maybe he could ask if there were any limeys in the audience and ask the same question. Idiot. Only a douchebag who doesn't ever listen or talk to the people who actually get ground up in the gears of their socialized health care system would pull this stunt. Glad to see him getting self-pwned.

[Naga Sadow]

So his point is shown to be completely stupid but he just goes on with his stupid ramblings?

[Naga Sadow]

Oh, also as Warren has already mentioned in a different form . . .

BURN!!!!!!

[Zeb]

He certainly failed to make the point he wanted to make, but is there any place in the world where most people won't say that they think they have a terrible health care system?

[ChicagoTom]

The real question would be "How many of you would prefer the US system"

I'd like to see how many hands go up at the thought of these Canucks having to pay their own health care out of pocket.

Most of my Canadian friends would not.

[Terry]

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.
This really isn't funny at all. Our nation is going down the fucking drain and all people can do is chuckle or write indignant letters and posts.
What this country needs is another revolution.
If you think your going to stop the feds from grabbing more and more power, and taking away more of your freedom everyday by voting against incumbents, you got your head up your ass because the incumbents have so stacked the election in their favor, it is virtually impossible to vote enough of them out to make a difference.

[pfjob]

In lieu of an intelligent response I will simply say:

"Oh snap!"

[Invisible Finger]

Bad move on my part.

He actually LEARNS something and considers it a bad move.

[some fed]

Lesson:

Americans will probably unequivocally reject Universal Healthcare/Health Insurance once they're stuck with it.

There has to be an easier, cheaper way to persuasively make this argument, or is wanton destruction and suffering the only way most people will ever learn?

[Francis]

Well, you know, he actually may have had his guess right: what I see in discussing the issue with fellow Canadians is that they find their system awfully bad when they talk to other Canadians, but they wouldn't say so when they talk to foreigners...

So, his bet was not that stupid, I believe. And the more I am happy that people actually stood up, and moreover, to a celebrity they may feel intimidated to contradict.

[Atabrat]

He actually LEARNS something and considers it a bad move.

If your intelligence is less than 1 and you square it, you get an even lower number.

[Russ 2000]

Americans will get universal health care the usual way - a bailout of insurance companies.

[Naga Sadow]

some fed,

I believe there is nothing as persuasive to stupid, gullible people as "if we only had the right people in charge". They mean themselves but they rarely expound ont the thought and realize that they mean themselves.

[Kool]

He actually LEARNS feels something awkward at that particular moment and considers it a bad move.

We shall see if he actually learns anything.

[The Extispicator]

As a lawyer, I can see he fell for the most classic questioning error: don't ask the question if you don't already know the answer.

[Warren]

Lesson:
Americans will probably unequivocally reject Universal Healthcare/Health Insurance once they're stuck with it.

I doubt that. Americans will cry for more and more Universal Healthcare/Insurance and it will never once cross their mind that they'd be better spending their own money instead of picking their neighbors pocket. And even less likely they'll notice their neighbor's hand in their pocket. Thought they'll cry for lower taxes too. The rich have plenty of money, they should make everybody healthy, and buy every little girl a pony too.

[GILMORE]

Naga - FWIW, just because people happened to disagree does de facto make his point "stupid" - think of how most people would raise their hands in support of the endless War on Drugs - wrongly? - although, in this particular case his point is in fact pretty stupid sans any audience survey. Im just saying that running against popular sentiment is not the same as being 'proven false/stupid'

your point, otherwise, is noted.

I think this is probably a case of 'the grass is always greener' for people. I mean, first off, most people only care/think about healthcare when sick or like, you know, need to deal with female-maintenance things. The average moe is not a healthcare system guru. When you've got family members who are ill, or accidents happen, there is usually a rude awakening, and most people's feelings are biased towards the negative because of the suffering involved all around, some of which is certainly the fault of the cost and bloated systemic complexities that our multi-payer system has evolved into.

I of course think the gov should get out of the business. but thats unlikely in my lifetime. unwinding medicare will take generations. or maybe sooner... with a massive government financial default. 🙂 cant rule that out given recent moves.

[smacky]

Bad move on my part.

He actually LEARNS something and considers it a bad move.

He hasn't learned anything. He said he made a bad move. It's like a game of chess...he's still advancing the same arguments. He just acknowledged that that was not a well-thought-out tactic. Don't kid yourself. Next time he'll probably know better to plant imposters in the audience posing as Canadians who are happy with their health care.

[Naga Sadow]

Gilmore,

I'm terrible at debating as degrading my opponent is SOP for me. Refer to Warrens last post. He usually states my opinions much more eloquently than me. So to reiterate, he is stupid because he is an economist who adheres to a philosophy that defies economics.

[Matthew]

Ex-exstip-extispicic- Ex-MAN

don't ask the question if you don't already know the answer.

What's telling though, is I'm pretty sure he really believed he did know the answer.

[JW]

I'd like to see how many hands go up at the thought of these Canucks having to pay their own health care out of pocket.

Uh, ChiTom, they already do. Unless you think there is a Canadian health care fairy.

[Gimme Back My DOg]

ChiTom,

All of my Canadian friends prefer the US health care system to the Canadian. Then again, all of my Canadian friends moved from Canada to the US, so it is not exactly a random sample.

[JW]

PAUL KRUGMAN
Bad move on my part.

I would like to copyright the above as slogan of some sort. Heck, it even fits on a t-shirt.

[Atabrat]

Until 2005 when the Canadian Supreme Court struck down a law in Quebec, it was ILLEGAL for Canadians to get private health care for services the public system provided. If the public system is so good, why would they have to prevent you from going outside of it?

[Paul]

Snap!

[Paul]

"Access to a waiting list is not access to health care," wrote Chief Justice Beverly McLachlin for the 4-3 Court last week.

And how many arguments have we (I) had about this one? Next person who inserts "but they have better access" into an argument drops and does 20.

[Paul]

He hasn't learned anything. He said he made a bad move. It's like a game of chess...he's still advancing the same arguments.

Word, Smacky. He's pissed he got caught, he hasn't learned anything.

[TallDave]

lawl

[TomHynes]

Glad to see him getting self-pwned.

It is spelled "pwn3d". I am 55 and even I can spell it.

[Episiarch]

It is spelled "pwn3d". I am 55 and even I can spell it.

Don't tell me how to l33t-speak, old man. K thx.

[Neu Mejican]

All the discussions regarding the Canadian health care system I have had with Canadians start with them complaining about how piss poor it is.

Then they hear stories from Americans about their experiences of how our system fails...the Canadians always roll back their criticism at that point with some version of

"Well shit like that never happens, but it isn't perfect."

[economist]

DOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOM!

[economist]

If you think the Canadian Healthcare system is so fucking great, then move to fucking Canada.
Fuck fuckity fuck fuck fuck.

[40MM]

The difference, of course, is that if those seven people were a random sampling of Americans, one or two of them wouldn't even have health care to complain about.

[Neu Mejican]

Oh, and small sample bias.

Krugman should have stopped when he realized there was only a sample of 7 to choose from...what does it mean if all 7 think the system is terrible? Particularly without the question being something along the lines of "Given this information about the American system, how many think the Canadian system is terrible, or at least as bad as the US system?"

Then he should have talked about something like this...

http://allcountries.org/health/usa_health_care_2008_nyt.html

[Paul]

In a way though, I don't fault Krugman. I'm quite sure be believed that Canadians are overwhelmingly content with their system. Krugman lives in the same echo chamber most of the American media and democratic politicians live in. They've come to believe-- really believe-- that the Canadian system is superior. They believe it through the marrow of their bones. They've been telling themselves and eachother this for so long that they would risk such a public maneuver without ever thinking it might not go in their favor.

All the discussions regarding the Canadian health care system I have had with Canadians start with them complaining about how piss poor it is.

Interesting, I get very few complaints from Americans about the healthcare system. I do get complaints about their particular insurer. And I do hear a lot of complaints about how bad healthcare is for someone else-- usually vague group in some other socio-economic class.

I also know that Europeans have an interesting and wholly wrongheaded view of American healthcare. I remember seeing an independent film a few years ago about a Scottish immigrant who needed an operation and he couldn't afford it. The portrayal of the American "system" and how it worked was so laughably wrong, inaccurate and hopelessly flawed, that I had trouble watching the story through all the counterfactual portrayals.

[Paul]

Oh, and small sample bias.

Krugman should have stopped when he realized there was only a sample of 7 to choose

Neu,

We know this is an anecdotal case with a laughably small sample size. But see my comment above. It's not about the sample size, it's that Krugman so completely believes the hype that he couldn't have ever conceived of such an outcome, small sample size be damned.

[Neu Mejican]

Or he could have pointed to this which shows Canadians being satisfied with their health system at 46% compared to the US at 40%

http://content.healthaffairs.org/cgi/reprint/20/3/10.pdf

[Episiarch]

I also know that Europeans have an interesting and wholly wrongheaded view of American healthcare

Hell yeah. The ex and I got in a few arguments over this, and I ended up getting an earful of totally wrong shit and how Spain at least didn't let her grandmother rot in the street (of course, it let her rot in a hospital room with virtually no care but I didn't bring that up), where here she'd have been fucked. Which is completely false.

[Neu Mejican]

Paul,

I do get complaints about their particular insurer.

So they complain about their own care, but not the system writ large? Is that what you mean?

I find that complaints are directly proportional to the amount of time someone interfaces with the system as a patient or the advocate for a patient. The more you deal with the US health care system, the more critical you are of its inefficiencies.

But that's just my experience.

I also think things are very regionally variable...the difference between care in NYC or Seattle compared to NM or Texas or the difference between Albuquerque and Las Cruces within NM change the picture greatly.

[Naga Sadow]

I don't know Epi. Maybe she's right. Your ex sounds kinda . . . high strung(wink) . . . maybe the grandmother was of similiar character disposition and would have suffered accordingly.

[AlfromAlberta]

I can tell you I am not happy with our healthcare system. Long wait lists, no significant choices, and a severe shortage of Doctors. I have had 5 different GPs in the last 6 years ( all Africans... not that thats a bad thing, they are fine Doctors).

[Naga Sadow]

I'm gonna go ahead and apologize for the above. That was brutal even by my standards. Sorry.

[Episiarch]

Just what are you implying, Naga? Yeah, so I'm a muff diver. What of it?

[Episiarch]

Fuck, you apologized before I could post my joke.

[Naga Sadow]

"That's right. Big whoop! Wanna fight about it!"

Sorry. Was lost in a Family Guy episode in my head. Anyway . . .

What? How did you get the muff diver part from my statement?

[Episiarch]

What? How did you get the muff diver part from my statement?

I didn't; I was trying to confuse you. It worked.

And you needn't have apologized. The harder you can hit me, the better.

[Naga Sadow]

Oh, sorry again. My friend from Denver flew in today and I've already started drinking. Just got the joke.

[libertymike]

Hello everybody! Are we forgetting that the american health care system is dominated by the government already? Are we forgetting that our health care system is can hardly be called a free market system? Are we forgetting how objectively horrible our health care system is-take iatrogenic deaths, for instance?

Look at the percentage of one's income spent on health care pre 1965 and today. Compare the difference. THus, the question begs: has the difference been casued by government or is it just corelative?

[Naga Sadow]

Wow! That's weird. Your joke made sense until you stated it didn't. I lost whatever epiphany enabled me to make that statement.

[Paul]

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.

[Episiarch]

I think I made the same ephemeral connection you did which is what caused me to come up with it in the first place. Or, I just think about that a lot. Could be either.

[Paul]

Las Cruces within NM change the picture greatly.

Dude.... dude

I could tell you stories about General Hospital in LCNM.

[Naga Sadow]

Epi,

Are you drinking too?

[DFD]

It is spelled "pwn3d". I am 55 and even I can spell it.

Both spellings are valid, though pwned is much more common. If you weren't so fucking old, cranky and stuck in your ways you'd appreciate that your way isn't necessarily the only way. 🙂

[Paul]

Uhm, when we start pedantically complaining about the "proper" spelling of l337 speak, we know we have a problem.

And you didn't have to tell us you were 55, we know this by the very fact you're displaying pedantic literalism in the realm of l337 speak.

pwned rotflcopters!!1!!!!!!1!

[Russ 2000]

Epi,

Regarding elderly health care in the US, my grandmother's biggest complaint about her nursing home (aside from the fact that being old and sick sucks anyway) is that nobody would just leave her the fuck alone sometimes.

[Neu Mejican]

I could tell you stories about General Hospital in LCNM.

[Episiarch]

Are you drinking too?

I am now.

Russ, yeah, I know. The point is that there is Medicaid and Medicare and her grandmother would probably have gotten better care here even with no money because in Spain they just didn't give a shit.

[Neu Mejican]

take 2

I could tell you stories about General Hospital in LCNM.

An Aggie then?
Scary place, ain't it.

Our system is flawed. But the suggestion that poor people, the indigent, the underprivleged don't get care is a lie that defies explanation.

Except in the cases where it is true.

Try sitting in the UNM Hospital emergency room sometime and tell me that the poor, indigent, underprivileged get "care."

Or, perhaps, try and find someone a mental health provider in NM if they aren't looking for addiction services, don't have insurance, and don't pose an immediate danger to others.

Funny thing about that is that the state of NM will pay for the service to be provided if you don't have money and even if you do...well...there just ain't anyone available to provide the service if you are outside of Albuquerque.

[johnl]

Sad thing is that Prof. Krugman really is very smart. If he would just think like an economist instead of being so partisan. How can anyone seriously advocate a distribution system where price incentives are completely hidden from the consumers?

[joe]

Canada's health system sucks. It's a creaky, old, mid-20th-century National Health program, like England's.

France has a much better model.

[Neu Mejican]

johnl,

price incentives are completely hidden from the consumers

You mean taxes are invisible and consumers don't connect them with the costs of government services?

[Neu Mejican]

I could tell you stories about General Hospital in LCNM.

I remember when they remodeled Memorial General Hospital, complete with new signage that read

"MGH Hospital"

Yep, Memorial General Hospital Hospital...it ain't brain surgery.

They did have a wonderful ICU at MGH Hospital...unfortunately the most minor emergency might land you there after the emergency room docs were done with ya.

[joe]

Well, NM, those ER doctors are required by law to treat the indigent. As long as their medical situation has reached the emergent level. And then, if they screw up, the ICU is required by law to admit them.

BAM! No problem. Everyone has health care.

Nations of whiners. Get the hell off my lawn!

[Neu Mejican]

joe,

That's not fair cranky old man, only 60% of the nation are whiners...

[Neu Mejican]

Paul,

So what do you call a guy after he goes into Memorial General Hospital for leg surgery?

Not even...

btw, I'm not mad doggin' ya bro.

[Andy Craig]

"You mean taxes are invisible and consumers don't connect them with the costs of government services?"

It's a proven fact that voters don't connect taxes with government "services", and even if they did that still doesn't transmit price information to the individual consumer.

[Neu Mejican]

Andy Craig,

It's a proven fact

By this you mean it is your opinion?

[Neu Mejican]

that still doesn't transmit price information to the individual consumer

So you give the individual consumer an bill that says...your service cost $XXX,XXX. Your taxes covered $XXX,XXX- $Y...Your co-pay is $Y.

How tough is that?
I mean if all you are worried about is information.

[David]

I don't care. I am totally locked out of the US health care system. I am self-employed with preexisting conditions. No insurance company -- none at all -- will ensure me at any cost.

What the fuck am I supposed to do, and why shouldn't I advocate for single payer, national health insurance? It is, literally, my only hope.

[Enough About Palin]

"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.

[johnl]

Neu consumers generally don't have price information or incentives for making decisions about medical goods and services.

For example, I am going to have an extra upper assembly made for my leg. The upper assembly I have provides a lot of support and is great for walking, but it doesn't let me bend my leg enough to ride a bike. The cost for this, to me, is going to be $10 for gas and a couple hours of my time, because my employee benefit package passes on 0% of the cost for these things. Now If this was going to cost me a few thousand dollars, and I don't really have all that much opportunity to ride my bike anyway, I don't know if I would pay for it.

Think about feet. My new foot is AMAZING. It's got two carbon rods that bend independently. The independent bending simulates the action of an ankle. Now this is going to last me for years so I would pay a lot for that even if I was paying. But imagine a kid who goes through a foot a year as he's growing. Does he really need the most expensive foot? A foot that doesn't simulate an ankle is no worse than waring hightops, and if it saves a couple of hundred a year, might be sound. But if someone else is paying for the feet (foots?), why conserve?

[johnl]

David can you try not to be self-employed? At your run-of-the-mill mega-corp, the hiring manager will have incentives to keep salaries down but not healthcare costs. Take advantage of that.

[Andy Craig]

"By this you mean it is your opinion?"

No, by this I mean there exists scientific, sociological evidence of this in the form of polls and studies.

[Mr. Nice Guy]

"What the fuck am I supposed to do, and why shouldn't I advocate for single payer, national health insurance? It is, literally, my only hope."

You should die man, and make room for the more productive. That's the hard core libertarian answer (actually it has something to do with charity taking care of you, blah, blah, blah but I'm saving time).

You know, the Canadians and British get such poor service from their health care sytems that they continue to vote for those who support it and would laugh anyone claiming to abolish it and replace it with a free market system off the stage...Oh wait, snap!

[perilisk]

"I don't care. I am totally locked out of the US health care system. I am self-employed with preexisting conditions. No insurance company -- none at all -- will ensure me at any cost."

Hmmm... Yeah, it's hard to get homeowner's insurance while your house is on fire. It's weird though, I thought doctors still took actual money. It worked for me when I was self-employed and didn't have insurance, you could always give it a shot.

Or did you mean "how can I get other people to pay for my health care?" Well, two options: 1) Singer payer health care. 2) Home invasions. Just pretend you're SWAT.

[perilisk]

@johnl

I completely agree about pass-through. Unless we're talking about the completely indigent or thoroughly unemployable (orphans, whatnot), any single payer system should still pass through at least some small amount as a copay. Even a few hundredths of the cost would make people think twice about what treatment was cost effective and double-check their hospital bills; given that our existing socialized medical systems can't seem to stop fraud, maybe recruiting patients would help.

[Mr. Nice Guy]

"Or did you mean "how can I get other people to pay for my health care?" "

Like I said, the hard core libertarian line is: you should die man, we shouldn't be compelled to help you. Every man for himself unless a voluntary mutual aid society blah, blah, blah...

[perilisk]

"By this you mean it is your opinion?"

Well, it's at least common sense. It's not as though you're getting an itemized bill for the entire US federal budget. Yes, they get an idea of the cost of "government services" as singular block, but not of any particular service. If you asked someone what they were paying for federal highways or drug prohibition or alternative energy subsidies or the war in Iraq or the TSA or the No Child Left Behind Act, etc. etc. they couldn't answer you.

[perilisk]

"Like I said, the hard core libertarian line is: you should die man,"

Are you suggesting that if the guy has guaranteed health care costs that eat up, say, 15% of his monthly income, his only options are "socialized medicine" or "death"? He never said he couldn't afford his care out of pocket, he said he couldn't get insurance. For all you know, it isn't even a life-threatening condition.

Ideally, under a freer and more flexible health care market, he could get insurance, but with the caveat that it would not cover his known healthcare costs. Assuming his pre-existing condition isn't a death sentence, he'd be poor, but covered in the event of something more dangerous and unexpected.

Anyway, the hardcore libertarian line is "healthcare resources will expand (eventually) to meet demand so long as people keep paying what they're worth. But if it ruins you financially, sucks to be you." The socialist line is "healthcare resources are part of a finite state budget and should be allocated where they will be most effective" which to low-priority patients, especially those with time-sensitive issues (say, the elderly or people with chronic incurable ailments) sounds an awful lot like "you should die man".

[alan]

Like I said, the hard core libertarian line is: you should die man, we shouldn't be compelled to help you. Every man for himself unless a voluntary mutual aid society blah, blah, blah...

Or you could advocate for a system so divorced from cost that there is no market efficiency left in it to such a bizarre extent that new technique and technology add to the cost instead of lowering them. Where no medical professionals would find it profitable to service your needs and the needs of others of similar means at a cost you can afford. Sounds kind of like what we have now, doesn't it?

[Mr. Nice Guy]

"Ideally, under a freer and more flexible health care market, he could get insurance, but with the caveat that it would not cover his known healthcare costs."

Which is why, under "less freer" and "less flexible" health care systems this guy would be covered regardless?

So, considering this guy could be any guy after any one check up, why should anyone favor what you're advocating???

[johnl]

Dave, if you want a lot of medical care paid for and you don't want to hold down a regular job, you should marry a girl with a regular job. There are other benefits to that, besides the healthcare.

[jacks 9]

If we go socialist, what will Europe do then??

[CompassionTM]

Compassion(TM), we socialist own it! Only do we truly understand. Line up for your health care, our bureaucrats will know exactly what to do. With the right paper work done by the right people with the right educational backgrounds, and with the right exchange of monies through the taxation of the right class of people, immortality is just a vote a way. Don't let those Libertarians fool you, death is a market failure, and nothing else. Sickness results from greedy capitalist who wont admit to the Mana of the modern state. Look at those ruddy cheek milkmaids in England and Canada, healthy as oxes! Don't you wish you had those benefits? It is free! No worries, Just vote! Some of you may sense a loss of pride and feel that you have become charity cases. With out mental health benefits, you will come to realize that feeling only stems from petit bourgeois false consciousness.

Campassion(TM), we own it! Everything else is just Social Darwinism.

[John C. Randolph]

n. They've come to believe-- really believe-- that the Canadian system is superior.

There was a similar echo chamber a while back that had most of the academics convinced that the soviets knew what they were doing, too. Some of those pinheads still think that Cuba is just fine and dandy.

-jcr

[John C. Randolph]

a severe shortage of Doctors.

Let me guess. Bureaucrats decide how much they get paid?

-jcr

[jonl]

Dave you could even score one for liberty if you married a girl with a regular job who had a problem with the INS, saving her from deportation and you from having to hold down a low paying corporate type job at the same time.

[Lefiti]

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

[Neu Mejican]

Andy Craig,

No, by this I mean there exists scientific, sociological evidence of this in the form of polls and studies.

Really.
Fascinating.
I am swayed by your assertion.
You have supported it so well by claiming that there is proof of some type somewhere gathered by someone in some way all science-ee and stuff...

[Mike Laursen]

If the Democrats succeed in implementing universal health care, over the long run the system will be run by a Republican administration about half the time. And they're going to have very definite ideas about what kind of medical services should and should not be provided for women. I've never met a single Democrat who has ever given a thought to what Republican universal health care would be like.

[Mike Laursen]

Lefiti, why does health care need to be universal? Why not simply help the poor purchase health insurance, and leave the middle class, who can buy their own insurance, out of it?

[Dave W.]

If you think the Canadian Healthcare system is so fucking great, then move to fucking Canada.
Fuck fuckity fuck fuck fuck.

I did and I can report that it was fine. It was also paid for by a regressive tax which made it fairer than the boondoggle gerontogopoly we have in the US.

[VM]

"The bottom line is that Canada is doing something right, even if "the reasons are not totally understood," "

that's a goodie.

well played ghost of DanT. Or is it the ghost of Edweirdooo?

[Mr. Goodbar]

"Like I said, the hard core libertarian line is: you should die man, we shouldn't be compelled to help you. Every man for himself unless a voluntary mutual aid society blah, blah, blah..."

I know what let's do. Let's spend our free time hangin' out on a blog whose political view is different from our own and make hyperbolic snarky slurs about our imagined perspective of the people who regularly post. And if we can only get our other 12 year friends to sign on!

[Mr. Goodbar]

12 year *old.* Too many Skittles today.

[robc]

NM,

I agree asking the question was stupid - the proper test is not to ask people but to look at usage patterns:

What percent of Canadians go to the US for health care services?

What percent of Americans go to Canada for ditto?

The lower number has the better health care.

[Abdul]

France has a much better model.

Actually, she's Italian, and the Prime Minister took her off the market.

[Jordan]

You know, the Canadians and British get such poor service from their health care sytems that they continue to vote for those who support it and would laugh anyone claiming to abolish it and replace it with a free market system off the stage...Oh wait, snap!

Yeah man! And how about that Drug War? That's popular as hell with the voters. And remember slavery? Segregation? Prohibition?

As for Lefiti's article: life expectancy is heavily influenced by factors other than health care. Compare the incidence of obesity, crime rates, etc. Furthermore, if Canada is like most other countries, it counts many births as stillborn that would be counted as live in the U.S.

[Neu Mejican]

robc,

The lower number has the better health care.

I am not sure that is a good metric.

The "why" is important...if Canadians, for instance, are coming to the US for elective procedures it may not be a sign that we have a better system overall, for instance.

[Lefiti]

Libertarianism is a strange combination of free-market fundamentalism and garden-variety nationalism, isn't it? We're the greatest nation on earth, and all that shit.

[robc]

NM,

All health care is elective. 🙂

Yeah, there are adjustments that could be made to the measure (like a distance adjustment due to Canadians being closer to the US than Americans are to Canada) and things like why?, but as a first order measure, it works well.

[joe]

I like the way nailing down the market fetishists on the "David, you're screwed" position brings out a rant about compassion.

Yes, chief, if your response to someone who can't get the health care he needs to stay alive is, "Not my problem," you're lacking compassion. Tell you what: if it makes you feel bad to hear that, I'm frown thoughtfully for a few seconds.

What a horrible accusation, to say that people who are more worried about their taxes rising a little than about other people's lives lack compassion! Where to TEH SOCIALISTS come up with this stuff?

[Mike Laursen]

Libertarianism is a strange combination of free-market fundamentalism and garden-variety nationalism, isn't it?

You really aren't that familiar with the viewpoints of the folks who hang out here, are you? Maybe you should troll at lewrockwell.com.

[R C Dean]

Or he could have pointed to this which shows Canadians being satisfied with their health system at 46% compared to the US at 40%

Sure, but satisfaction is as much a reflection of expectations as it is of performance. This may just mean that Canadians have low standards for their health care system.

[Mr. Nice Guy]

"Yeah man! And how about that Drug War? That's popular as hell with the voters. And remember slavery? Segregation? Prohibition?"

I'm hoping that you see the difference between responding to the charge that the Canadian and English Health Care systems serve the citizenry poorly with the rebuttal: then why is it so popular with the very people it is serving so well and the popularity of slavery, the drug war, etc., at various times.

It's hard to believe the system serves the citenzry so very poorly when that same citizenry treats it as a third rail when it votes. This says nothing about whether its popularity makes it "just" which is what you are confused about.

[joe]

Sure, but satisfaction is as much a reflection of expectations as it is of performance. This may just mean that Canadians have low standards for their health care system.

OK, so we can no longer judge the efficacy of a health care system by patient outcomes, and we can no longer judge the efficacy of a health care system by patient satisfaction.

What does that leave us with?

"Yeah man! And how about that Drug War? That's popular as hell with the voters. And remember slavery? Segregation? Prohibition?" Slavey was universally unpopular among slaves. Segregation was universally unpopular among black people. Prohibition was universally unpopular among drinkers.

The Canadian health care system is MORE POPULAR among patients than ours.

[Jordan]

OK, so we can no longer judge the efficacy of a health care system by patient outcomes, and we can no longer judge the efficacy of a health care system by patient satisfaction.

What does that leave us with?

They're the best we have. Unfortunately, neither is as cut and dry as we might like. That's just how it is.

I'm hoping that you see the difference between responding to the charge that the Canadian and English Health Care systems serve the citizenry poorly with the rebuttal: then why is it so popular with the very people it is serving so well and the popularity of slavery, the drug war, etc., at various times.

Fine, it was a stupid rebuttal. Still, voters make stupid choices all the time. Britain's NHS is the worst healthcare system in Europe. The Swiss healthcare system is much more market-oriented than the NHS (and arguably more so than our system too), but since the British won't vote for it, then the NHS must be better, right?

[Gilbert Martin]

"An impressive array of data shows that Canadians live longer, healthier lives than we do."

Even if it could be definitively proven that that difference is entirely due to the different health care systems (which it can't) that STILL would not prove that the Canadian system is superior.

Whose says those factors are the proper metrics to measure "superiority" by?

The metrics one chooses to measure anyting by are a function ones personal opinions and beliefs.

Who can prove that saving the life or improving the health of X number of people is a higer value outcome than letting them fend for themselves and refraining from interfering with the freedom of everyone else to force them to subsidize those people?

No one on earth - that's who.

[CompassionTM]

Mr. Joe,

Our records show insufficient support from you of our efforts in Canada and England. You will not get the fellow traveler free pass on your usage of the word, 'compassion'. Please forward the 17.5 cent charge (to comply with the per word pay policy of our proudly unionized publication The Guardian).

[ScottInRMH]

Here's my experience with the "free" Canadian Health care system:

Waited 8 months to get arthroscopic surgery to clean out my knee. During that time, my knee degenerated and required a way more complicated operation, leaving me with a semi-working knee that now tells me when the weathers a changing. But hey, didn't cost me anything, if I don't consider all that tax I pay to our government to fund this useless system.

[Brad Wall]

All the Canadians I know - and I live in Canada - are very worried that our health care system is being destroyed and will be replaced by something like the American system. I have heard plenty of complaints about our system but I have never in my life heard a Canadian say s/he would prefer the American system. I am sure a few such people exist but they are a tiny minority.

[Mr. Goodbar]

"What a horrible accusation, to say that people who are more worried about their taxes rising a little than about other people's lives lack compassion!"

Look mom, I found another 12 year old!