Obamacare

Obama's Health Care Quackery

Countries with universal health coverage are economically worse off than the U.S.

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True to the advice of his chief of staff to never let a good crisis go waste, President Barack Obama is using the current economic crisis to sell a top item on the liberal wish-list: universal health care. "You can't fix the economy," he has repeatedly said, "without fixing health care."

But the president needs to take a big chill pill before committing America to a huge new entitlement: One is hard pressed to find any evidence from abroad showing that universal coverage has grown the major industrialized economies more than ours in the past—or shielded them more than us from the global slump now.

At the president's behest, Democrats are exploring ways to ramrod a health care reform bill through Congress this fall by using procedural shenanigans to avoid a Republican filibuster. In his budget, Obama has already proposed an additional $634 billion—nearly three-quarters of a trillion dollars—in health care spending over the next few years. If he gets his way, this money will be the first installment toward a government insurance plan that will compete with private plans to allegedly put affordable coverage within everyone's grasp.

But whatever else universal coverage might bring, there is no evidence that it will bring economic nirvana. If anything, contrary to what the president suggests, the correlation runs the other way for countries with universal coverage such as Canada, England, France, Germany, and Japan. On nearly every economic front, their performance has been worse than America's—even, surprisingly, in controlling health care costs.

Contrary to popular perception, even though America is at the epicenter of the financial crisis, it has suffered less than its industrialized peers in terms of economic growth. According to the latest International Monetary Fund figures two weeks ago, the U.S. economy actually grew 1.1 percent last year even as Japan's shrank by 0.6 percent. France and England's both grew 0.7 percent, and Canada's only 0.5 percent—or less than half of America's. Only Germany did slightly better at 1.3 percent.

What's more, despite all the gloom and doom about the American economy, IMF expects its gross domestic product to shrink 2.8 percent this year compared to anywhere between 3 percent (France) to 6.2 percent (Japan) for these other economies. (Figures from the U.S. since the IMF projections suggest that the U.S. economy contracted more than expected in the first quarter of this year but it is not yet clear how the other countries performed.)

Not only is America hurting relatively less now, its economic performance in the prior 18 years—from 1990 to 2007—has also been visibly better than everybody else's. Calculations based on Department of Agriculture data show that America's GDP grew at an average annual rate of 3 percent during this period. By contrast, Canada's grew 2.88 percent; England's 2.3 percent; France's 1.92 percent; Japan's 1.74 percent and Germany's 1.59 percent.

Besides experiencing lower growth rates than America in the past, with the exception of Japan, these countries have also experienced chronically higher unemployment rates. Setting aside last year, between 1997-2007 America's peak unemployment rate was below its peers by anywhere from 1 percent (Canada) to 5.7 percent (France). Japan has always had an unusually low unemployment rate, never hitting over 5.3 percent partly because of its policy of guaranteed employment in urban areas that forces workers to share jobs to keep more people employed.

All of this has made Americans much wealthier than all these countries, given that Americans' per capita income in 2006, adjusted for purchasing parity, was about $6,000 more than the next country, England.

But are these countries fiscally stronger? Not by a mile. European countries started reining in their soaring deficits in the years prior to the downturn, thanks to the European Union's requirement that these levels not rise above 3 percent of GDP. But that meant that they had to either dismantle their social spending programs—including universal health insurance—a politically difficult task, or maintain their sky-high taxes. For the most part, they have chosen the latter.

The upshot is that whereas America's 2007 taxation rate was 28.3 percent of GDP, Canada's was 33.3 percent; Germany's 36.2 percent; England's 36.6 percent and France's 43.6 percent. Japan's taxation level of about 28 percent is at par with the United States'—but only at the price of a government debt that totaled a jaw-dropping 170 percent of GDP last year, nearly three times that of America's. Such taxation rates have left these countries limited room to respond to crises, which is why European countries roundly dismissed Obama's calls to increase stimulus spending right now.

The trillions of dollars that this administration is spending to stimulate the economy might be a complete waste of money. But such wastage is a luxury that America can afford because of its relatively lower tax-and-spend burden.

The one remaining economic argument for universal health insurance in the United States is that it will help rein in medical costs. The rap against America is that it spends over 15 percent of its GDP on health care—more than any other industrialized country—and yet leaves upwards of 45 million people uninsured. If it had universal coverage, the theory goes, uninsured folks would get care sooner—not wait till they have a medical emergency—saving the system a ton of money.

It is a nice theory, but there is no evidence that it is true. Although America's per capita health care spending soared in the 1980s, a 2007 study by Kaiser Family Foundation found that it slowed considerably in subsequent years. Indeed, between 1990 and 2003, the rate of growth of America's per capita spending was 3.6 percent, only a little bit higher than France, Germany and Japan's—but significantly lower than England's 4.2 percent. That's striking given that England engages in the most aggressive rationing known to the free world, routinely delaying care to patients unless they are critically ill.

However, Canada, which too indirectly rations care for many specialized treatments by putting patients in queues, has succeeded in limiting per capita spending to 2.4 percent. At best, then, universal coverage has a mixed record in controlling health care spending increases, even after resorting to rationing.

All in all, there is no major industrialized economy with universal coverage that has performed as well—let alone better—than the United States in the last decade. Universal coverage might not be the cause of their inferior performance. But the crucial point is that there is zero evidence that it has put them on a more solid footing. Before applying this exotic therapy to America, Obama needs to offer more than mere hunches that it will work. He needs to offer actual evidence.

Over to you, Mr. President.

Shikha Dalmia is a senior analyst at Reason Foundation. This article originally appeared at Forbes.com.

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  1. If President Teleprompter had “inherited” a booming economy he’d be claiming that “fixing” healthcare is essential to maintaining our high standard of living.

  2. If you’re the government (or the president) you can’t fix the economy…. or health care. You can only make them worse.

  3. “One is hard pressed to find any evidence from abroad showing that universal coverage has grown the major industrialized economies more than ours in the past-or shielded them more than us from the global slump now.”

    Don’t go tryin’ to get all fuckin’ logical on us here now! That shit just don’t fly.

    Examining available evidence to form a conclusion…you sicken me!! You’re just not hopeful enough.

  4. The main problem with health care is the third-party-payer problem, which single payer socialized medicine can only solve with rationing. A true free market is the real solution, but there’s no way we are going to that without the equally draconian measure of practically banning everything except catastrophic coverage.

    Even with the insane taxes that would have to support socialized medicine, I’d still probably pay less in medical costs a year than I do now. I am so sick it is rational for me to want to go on the dole. My principles are still strong enough to make me balk.

  5. Reason’s front page spells “quackery” as “quakery.” The article turned out far differently than I expected.

  6. Heh heh. You can’t fix the economy without fixing typos.

  7. I think we need to euthanize NutraSweet. For the common good, of course.

  8. “I think we need to euthanize NutraSweet. For the common good, of course.”

    No way!

    He’s like the Beautiful Bobby to your Sweet Stan. Reason wouldn’t be the same without him.

  9. We must not question Lord Obama as he is protecting us from the evil banker Apophis.

    Dissent will not be tolerated and will be met by his press corps of loyal staff-weapon-wielding Jaffa.

    We must strive to work as hard as possible in his green-energy naquada mines.

  10. Sug, have you considered that universal health care* paradise that is the Great White North? There, if you’re lucky, you’ll get sick enough to avoid some of the worse waitlists. Inch closer to death, and your next 3 ER visits will earn you a shiny new car!

    *UHC, for when we have the inevitable Graft vs. Host-esque benefit.

  11. He’s like the Beautiful Bobby to your Sweet Stan. Reason wouldn’t be the same without him.

    More like Kaufman and Lawler. But who is who?

  12. A true free market is the real solution, but there’s no way we are going to that without the equally draconian measure of practically banning everything except catastrophic coverage.

    There is no need to ban more generous insurance coverage. What is needed is to eliminate the tax bias that makes health care provided as an employee benefit cheaper than health care paid for from the employee salary.

  13. If President Teleprompter had “inherited” a booming economy he’d be claiming that “fixing” healthcare is essential to maintaining our high standard of living.

    Just like how conservatives claim that it’s always the right time for tax cuts, whether the economy is up, down, or anywhere in between.

    Sugarfree is right on one key point: we will never have a free market system. Therefore, it is irrelevant whether such a system would work or not. Our choices are a single-payer system or the hybrid monstrosity that we have now. The correct choice is obvious. Our current system is expensive, burdensome, confusing, and does not adequately protect people – even those with “good” insurance.

  14. Maybe you can switch off week to week?

    And I was going to say the Tommy Rogers to your Bobby Fulton but that was too obscure. In any event, +1 to catching the reference.

  15. Our current system is expensive, burdensome, confusing, and does not adequately protect people – even those with “good” insurance.

    Exactly Chad! The solution is to have a system that protects no one. Then at least we’re all equal, right?

  16. Dagny,

    The best doctor I ever had was a Canadian that fled from that gray regime. He was a really nice guy and actually cared if you were in pain or uncomfortable. He looted all the samples closets in the hospital for me to try new drugs rather than buy a month’s worth that didn’t work. He gave out painkillers freely (but not insanely so.) He knew I was paying out of pocket and kept my visits to a minimum and would refill scripts with a phone call, rather than another visit.

    O Canada, like hot actresses for The CW, send us the doctors you neglect so woefully…

  17. To make a fair comparison, you need to count Americans’ private health insurance premiums as if they were taxes. Money out of your paycheck is money out of your paycheck, whether it goes to Uncle Sam or Blue Cross.

  18. Chad read “Harrison Bergeron” and thought Diana Moon Glampers was the hero of the piece.

  19. Japan’s taxation level of about 28 percent is at par with the United States’-but only at the price of a government debt that totaled a jaw-dropping 170 percent of GDP last year, nearly three times that of America’s.

    But we are working hard to catch up. Go America! Go!

  20. “…and another thing, Vonnegut! I’m gonna stop payment on the check! … Fuck me? Hey, Kurt, can you read lips? Fuck you! Next time I’ll call Robert Ludlum!”

  21. So, what Obama and the Democrats really want is to implement a Schadenfreude Program, where poor people can enjoy the suffering of the less poor. In other words, let’s make sure everyone has crappy healthcare!

    The idea that there are just tens of millions of people with no access to healthcare is loony. The statistics generally ignore young people who don’t think they need coverage (like college students) and the like. No to mention that some people simply opt to spend their money foolishly. Why not nationalized food?

  22. Sug, in my town in Canada, there was a hot doctor at the walk-in clinic who’d hand out birth control to high-schoolers like that shit was candy. For the sake of the sexually active girls who came after me, I hope he hasn’t fled yet!

  23. Why not nationalized food?

    Why does anyone need more than 1800 calories a day? Anything more than that is just greedy.

  24. . . .and bad for Gaea. Concentration camp diet for the environment!

  25. who’d hand out birth control to high-schoolers like that shit was candy.

    Hmm… candy…

    Besides, Canada has it right: Why should doctors make more than a car mechanic or a high school teacher?

    And when the doctors all work for the government think of the cost savings when malpractice falls under sovereign immunity!

  26. Not malpractice, man, eugenics!

  27. sexually active girls

    This phrase has too many syllables. “Cum dumpsters” is way more elegant.

  28. Good doctors earning more than crappy ones? Some people buying more Kraft Dinner than others? No, no, no. In Obama’s America, all of our tapeworms will be equally underfed.

  29. sexually active girls

    They are the best among us, Warty. Have some respect.

  30. This article is definitely correct about universal healthcare’s economic impact, but when presented to liberals it’s an unconvincing argument against UH.

    The desire for UH is born out of either the personal experience of not being able to get or pity and guilt from hearing about people who can’t get the desired level of care. They say, “the economy be damned if we have to let people suffer!”

    A better argument would be to show that even in countries that do have UH there are as many or more people who do not get the care they desire (liberals will say “need”. The difference is subtle.) So essentially you’re destroying some amount of economic growth for no benefit in return.

    Another, more complicated (and therefore less effective) argument is to point out that the loss in growth caused by UH over the long term results in an ever increasing per capita income gap between the countries. The result is that after a certain period of time, the increase in the standard of living, even among the poorest of the poor results in their ability to afford better health care than their neighbors who’ve had UH for the entire period. In other words a given level of UH now delays a better level of UH in the future.

  31. Dennis: Wait a second. You guys called me creepy for liking young chicks.

    Charlie: Yeah, but eighteen’s legal, bro. This isn’t a morality contest.

  32. Warty has evidently taken a page from the Episiarch school of seduction. Hey, it worked on LiLo.

  33. slutmonkey | May 7, 2009, 1:02pm | #

    This article is definitely correct about universal healthcare’s economic impact, but when presented to liberals it’s an unconvincing argument against UH.

    Because any argument with a sample size of one is unconvincing. How about I counter with a sample size of three – Luxembourg, Norway, and Singapore – all of which have national health care systems AND higher per-capita GDP than the US.

    I guess I win the argument, right?

    Of course, in reality, the affect of various health care systems on the macro-economy is small enough that it will be more than offset by the thousand other things that affect gdp. Unless you take dozens nations and randomly assign them to “universal health care” and “mostly private health care” systems, and then measure the outcomes, your data is just pure garbage. Single-nation anecdotes are meaningless and any honest person would admit this.

  34. The Episiarch school is just a nickname. The real name for the school is the stun gun and duct tape school of sweet love.

  35. Warty, don’t forget the Rohypnol, Blind Drunk, and If You Don’t Have Sex With Me I Won’t Love You schools.

  36. All are superior to the You’re Ugly And Fat But I’m Drunk Enough To Not Care school. That place sucks.

  37. Let the government cover catastrophic coverage and childhood immunizations, etc.

    Get rid of the chains that keep insurance tied to employers.

    Force insurance companies to accept those with pre-existing conditions in order to get access to the rest.

  38. Chad: No disagreement here. UH WILL lower GDP because of increased tax burden, but whether the amount of reduction is meaningful is up for debate. Macro economics is not a field that easily lends itself to empirical study–there are too many variables.

    I should be clear that I’m pointing out what you would NEED to show to be convincing, rather than what you CAN show. Having not researched this topic myself I wouldn’t actually present the arguments I suggested as being based in fact. They are more hypothesis at this point.

  39. Singapore has a national health care systems AND higher per-capita GDP than the US.

    Singapore is smaller than the small “city” that I live in here in Iowa. Whereas the popuplation is about the same as the whole state of Iowa.

    It just happens to be one of the largest and busiest sea ports in the world due to its physical location along a bunch of key east-west trade routes.

    There is so much money coming in to the city/state they are importing labor to clean the streets and dirt to make the island bigger.

    It is absolutely impossible to make a meaningful comparison between the economy of Singapore and any given state in the US let alone the entirety of the US.

  40. By the way it cost $10K just to get a permission slip to buy a car in Singapore — the car itself runs 30-40% more retail than one does here in the US.

  41. slutmonkey | May 7, 2009, 1:34pm | #

    Chad: No disagreement here. UH WILL lower GDP because of increased tax burden, but whether the amount of reduction is meaningful is up for debate. Macro economics is not a field that easily lends itself to empirical study–there are too many variables.

    It’s not hard to put numbers to it. The dead-weight loss associated with income and payroll taxes is about 20%, so the roughly 5% of GDP tax increase required to provide full health care for everyone would likely lower overal GDP by 1% directly. That’s hardly a problematic price to pay.

    The problem with libertarian and conservative thought about taxes is that they confuse the idea that taxes are bad for the economy (true) with the idea that taxes are VERY bad for the economy, which is false. In essense, the government removes six dollars from the economy for every five it brings in. While this is a steep premium to pay, many many things are worth the 20% premium.

  42. Is it me? Obama grows more and more inarticulate by the day. Not unusual though for Ivy grads to be so unable to complete a sentence without filler such as “emmm… ahh…you know….eh…eh…ahh….ahhh…”

    In fact, in my life’s experiences, all things being equal, an ivy grad is more apt to communicate with lots of filler language than one who is not an ivy grad.

  43. By the way it cost $10K just to get a permission slip to buy a car in Singapore — the car itself runs 30-40% more retail than one does here in the US.

    Of course, you don’t NEED the car in Singapore in the first place. Price? Zero.

    I spent as much on all my transportation needs while living in Japan as I spend on maintenance and gasoline alone here in the states….never mind insurance and car payments.

  44. The important thing to focus on is overall costs to the economy. Whether health care is paid for directly through taxes, or indirectly through premiums, the costs still must be paid. Attempts to focus just on the tax burden hides the fact that we are already paying the difference as premiums.

    I’m not a big fan of single payer, but then again our current system is pretty screwed up as well. Finally of course we do have universal coverage now, just the coverage is usually of the most expensive kind, ER care.

    Follows is an early paper on I did on the topic

  45. Sir, I read your article on Obama’s healthcare plan, and I agree that his plan alone won’t deal with the costs. I believe, there are two components to managing costs. The first is to reduce the cost of services provided (like Obama’s plan does), and the second is to reduce the amount of services demanded (supplied). Long term solution’s must control the growing costs of healthcare and keep it to a manageable percentage of GDP

    Currently there are several promising avenues for reducing the cost of the services provided. One great example is clinics where a nurse/physicians assistant diagnoses and treats most of the everyday stuff for which people commonly seek treatment. Of course a physician is on staff for consultation, and to handle conditions that actually need a doctor’s treatment. Another example is letting pharmacists write prescriptions. In most cases it’s simply not necessary to pay for another doctor visit to take care of routine treatment. Steps like these can let doctors concentrate on the types of conditions that require their medical expertise, and let the routine cases be handled by others. This will reduce the overall costs of medical care, and also result in speedier service. Finally, we need to induce more incentives for cost reduction into the profession, but more on that in a moment.

    The second challenge to reduce costs is to reduce the amount of healthcare services demanded without reducing the quality of health. The keys to this are healthier lifestyles and better preventative care. The old maxim that an “ounce of prevention is better than a pound of cure” is doubly apt for the healthcare system. The healthcare system should provide a direct link between the costs of unhealthy living, and lifestyle choices. While still giving people the freedom to make unhealthful decisions if they so want. The best way to do this would be to return the savings from choosing a healthy lifestyle to those that do it, while letting the people that choose not to pay for their own decisions.

    When designing such a system we should acknowledge some facts about how healthcare is provided. The first is that we already have universal healthcare we just provide it in an extremely inefficient manner. We make those without insurance go to the emergency room when younger (which is very expensive), and then after not providing adequate preventive care for years, we put everyone on Medicare and pay for everything. Thus missing many years of opportunities to provide cheaper preventive care, and promote healthier living in return for much higher bills later. Thus the proposition that we can keep healthcare costs down in the short term by having uninsured just leads to higher long term costs and financial ruin.

    Therefore, I propose a single payer system to provide health insurance for all (insurance not actual medical services). The system would collect enough in taxes to provide for healthcare to all, but then provide a monthly rebate system to reimburse those people who were living a healthy lifestyle and thus reducing system costs. For example, if it costs $2400 a year to insure a person living a healthy lifestyle, and $4800 to insure a person who is unhealthy, then if a person “chose” to be “fit” and live a healthy lifestyle they would get a $200 check each month. If they chose not to, then that would be ok too. Individuals would be examined once or twice a year to see if they were healthy, and living up to their part of the bargain. Criteria for being fit could be determined by a panel of medical experts and could include criteria like being a healthy weight, being a non smoker, evidence of regular exercise etc. People would not be required to be a health nut, but would have to be living a healthy lifestyle with a balanced diet and regular exercise. Basically all the things that doctors always tell you to do, but that so few actually do.

    For some the extra money would not be worth it. They could continue to live their lives as they see fit, without placing the burden of their unhealthy choices on the rest of us. I do think many families though would take advantage of this program thus lowering overall healthcare costs and freeing up income for savings, investing, or other consumers items. And because we are currently spending so much on healthcare even a 10% reduction in costs due to healthier living would save the nation over $200 billion a year now, and much more in the future when Medicare etc will be trying to bankrupt our country.

    In addition a single payer system would provide cost savings by simplified billing and reduced overhead. Doctor’s offices and hospitals would only have 1 payer to deal with and would no longer need to maintain large collections and billings departments. Thus allowing providers to focus on care. Costs could be further reduced by calculating a median price for services (cost + a certain percent for profit). Providers that could meet or beat that price would make extra profit. Those that could not would go out of business. Over time as efficiencies increased the median would naturally lower thus continually encouraging cost savings.

    Other side benefits to a single payer system would include more entrepreneurialism because people would no longer have to worry about health insurance when starting their own business. And employers could focus on providing goods and services instead of trying to manage their healthcare costs.

    Once again we are not talking about socialized medicine, but socialized insurance. Which is basically the case now but it’s just run very inefficiently. This new system would preserve people’s choices while lowering the overall healthcare costs to the economy. It would put long term solutions in place that would prevent our nation’s unfunded healthcare liabilities from bankrupting us, and also result in a higher quality of life for us currently. The economics of the matter are clear. Our current system is massively inefficient. It deals with healthcare issues in the most expensive way, and does not reward good decision making on individuals. It’s time for a change.

  46. Of course, you don’t NEED the car in Singapore in the first place. Price? Zero.

    Sure you do. Or at least the customer support engineer that drives us around when we’re there needs one.

    I imagine that the imported labor walks around and uses the mass transit, but it appears that the natives all drive really nice cars (the government essentially bans all cars more than 10 years old through prohibitive taxation).

  47. Force insurance companies to accept those with pre-existing conditions in order to get access to the rest.

    Oh, capital plan, old chap. And when insurance companies shut down because they have to cover some junkie’s high-cost HAART treatment to the tune of 15,000 per year (plus another 50K in hospitalization costs), what are you going to do then?

    That, of course, is only one example.

  48. You know, there are bridges and causeways connecting Singapore to Malaysia, which are only like a mile apart. I imagine that the bridges are used for cars.

  49. It a very simple argument Chad. I like my insurance. You (and other UHC proponents) have no moral or legal right to prohibit me from buying my insurance or to force me to pay for other people insurance.

    Outcomes-based analysis that shows society may have a net gain if we strip away our individual rights to life, liberty, and the pursuit of happiness are just another form of evil.

  50. You know, there are bridges and causeways connecting Singapore to Malaysia, which are only like a mile apart.

    And those bridges are traversed by an endless stream of dump trucks hauling in Malaysian dirt to make Singapore bigger.

  51. Krone – first part of your plan that wants to let other professionals other than doctors do some of the work?

    A+

    This part of the plan?

    Individuals would be examined once or twice a year to see if they were healthy, and living up to their part of the bargain. Criteria for being fit could be determined by a panel of medical experts

    Um…F—

    In absolutely no, way shape or form will I live in a nation where I have to go in front of panel to demonstrate my fitness. Fuck that.

  52. Is Kroneborge joking, or just an asshole? Either way, he’s an asshole.

  53. TAO-

    You already do.

  54. Canadian sexually active young women are not cum dumpsters. Chav is.

  55. “You can’t fix centrally plan the economy,” President Barack Obama has repeatedly said, “without fixing centrally planning health care.”

    Centrally planned. I mean fixed…

  56. LM – um, no I do not.

  57. “But the crucial point is that there is zero evidence that it has put them on a more solid footing. Before applying this exotic therapy to America, Obama needs to offer more than mere hunches that it will work. He needs to offer actual evidence. ”

    Don’t we wish that were the case

  58. Even though I am a PhD scientist, my employer did not appreciate my work enough to give me a raise big enough to close the equality gap. So I quit my job to pursue my dream of being a street mime. Now none of my neighbors are willing to pool their money to pay for my health insurance.

  59. So you’re making an argument by quoting a Kaiser Foundation Lobby group?

    What riles me so is the blatant “I don’t really want to see what others are doing, I’ll just assume” attitude on BOTH sides. All this proves is how blinded by their own dogma both sides are.

    The right, and neo-libertarians, ASSUME a federally-managed program. Britain has this, Canada does not. You also ASSUME that a government agency will be set up to manage care for all. Canada has this in a sort-of way, and Germany does not have this at all. All health care in Germany, universal grade, or not, is run by private corporations or non-profit entities.

    In no other G8 country do workers face the prospect of being laid off just after finding out their wife is pregnant, their COBRA running out after six months, and paying for the birth of their child with their house. Or cancer. Or try moving out of your insurer’s coverage area with a disabled child. It’s retarded, simple as that.

    Don’t come back with the “healthcare is free for the poor, just don’t pay.” It might be, but if your middle-class existence suddenly finds itself in the middle of a serious disease and coverage canceled, you have LONG way to fall before you’re a street bum with free healthcare and a sub 200 credit score.

    The WTO won’t rule in the USA’s favor that the business subsidy of universal health care be revoked throughout the rest of the world, so might as well do something simple, that works.

  60. TAO-

    Um, yes you do. You are in law school. In order for you to ever practice law, and earn a living therefrom, you have to:

    1. graduate from an American Bar Association approved law school

    2. pass your state’s bar examination which includes passing the so-called multi-state bar examination.

    3. you have to prove your “fintness” to practice law with your state’s board of bar examiners.

    You want to do some reading on the third point? Check out In Re Anastaplo 366 US 82. Please read that case. If for no other reason, you will read one of the best dissents in Supreme Court history.

    My point is that you are already having to prove your “fitness” to a panel.

  61. uh, yes, but the equivalence isn’t there. Dragging the entire citizenry before Dr. Mengele and Co. is a different animal from going to the supreme court.

  62. Jaydub, there are many flaws in the current system which are driving the cost of health care through the roof. These flaws have been listed at great length with libertarian solutions for eliminating those flaws in many past threads on this forum. None of those solutions involve government intervention into the system.

    Don’t make the mistake that because we oppose the imposition of a universal solution by the federal government that we actually like or defend the current system.

  63. First and foremost, fuck the AMA and the federal government. I want to see Walmart and Target duking it out for my health care dollars.

  64. What about comparing levels of income inequality? That, to me, is more a measure of economic health than growth, GDP, per capita income, or any other metric that, by the way, doesn’t account for whether Americans have more or less equal access to health care. Unemployment also matters less when the unemployed have access to services that keep them healthy and off the streets.

    Since I see healthcare as a right no different from police or fire protection, the measure of the success of our country’s system should be whether it’s universal and functional, not whether it grows the economy, though I don’t think this article showed a causal relationship between levels of economic growth and access to universal healthcare. It seems self-evident to me that equitable access to healthcare lessens the burden of health problems on the state.

  65. umm, the fitness exame is competly optional, if you don’t want to go, don’t go.

    If you do want to go, you can go, then be eligble for a prebate.

    I would prefer a different system, but this is the only one I could come up with that aknowledges the current facts.

    That we are already paying for everyone’s care, and that there is no current link right now between lifestyle decions and costs.

    I really don’t care if someone wants to be an obese smoker, or sit around smoking crack all day. The problem is when we are forced to pay for their healthcare (or ER care).

    I would also be totally content with an op-out. Sign a sworn statement to a judge that you will not take any medical care you can’t pay for out of pocket, and you can totally opt-out.

    The idea being to give people as maximum choice, while also aknowledging the current reality.

  66. Since I see healthcare as a right no different from police or fire protection,

    You are wrong. Next point?

  67. TAO-

    Please read the case. George Anastaplo had to “prove” his fitness to practice law in the state of Illinois. He refused to answer a question regarding his political affiliations.
    He was dragged before Dr. Mengele and Co.

    Now that I think about it, mcuh of the citizenry was dragged before Dr. Mengele and Co. in order to prove their “fitness” during the red scare days.

    TAO, i tell it like I see it-this ain’t no desert island hypothetical (not that I don’t enjoy them-you and MNG have made them into an art form).

  68. Tony-

    The Supreme Court has already ruled, more than once, that the individual does not have a right to police or fire protection.

  69. That, to me, is more a measure of economic health than growth, GDP, per capita income, or any other metric that, by the way, doesn’t account for whether Americans have more or less equal access to health care.

    Access to healthcare, especially ‘equal access’ (which doesn’t exist, ESPECIALLY in nationalized systems) is not the ultimate goal. This is something that doesn’t seem to sink in. I, as dictator of Egalitarian Land can decree that all citizens shall henceforth have 100% access to healthcare.

    Now what? Access to what? Somewhere the rubber meets the road. This is why Canada sends so many patients to the U.S. Canada doesn’t have the facilities to cover all their healthcare needs. If you grant 100 million people 100% access to fifteen NICU’s, someone’s gonna end up in a very long waiting line.

    Sure, you got access, you just don’t actually have care.

  70. Kroneborge-

    No mention of state licensure of health care providers, particularly MDs, regarding costs? This is a flaw that I notice with almost all analysis of the health care situation.

  71. “if your middle-class existence suddenly finds itself in the middle of a serious disease and coverage canceled”

    Jaydub, can you give us a percentage of insured people of which this happens to? All in all, I prefer a system of private insurance over a national health care plan. National health care plans cause overusage of the system and therefore high taxes which stagnate the economy with chronically high unemployment and rationing to cut down on those high costs caused by the overusage of the system. Also, to cut down on costs, research and development is cut back. Why do you think more new medicines come from the US? If we go to a national health system, who’s going to be creating all the needed new medicines and technology?

  72. Okay I misspoke. Not a right per se, but a practical social good that functions best when it’s universal. I don’t see how anyone can defend a poor child not having access to adequate healthcare simply because she is poor.

  73. How is fire protection a right? It used to be provided privately by insurance companies.

  74. Kroneborge-

    I now they exist, but there are not too many examples of “obese smokers.” They can run together, but not often.

  75. I really don’t care if someone wants to be an obese smoker, or sit around smoking crack all day. The problem is when we are forced to pay for their healthcare (or ER care).

    So…therefore…you propose single-payer, forced healthcare.

    Genius, kiddo.

    I would also be totally content with an op-out. Sign a sworn statement to a judge that you will not take any medical care you can’t pay for out of pocket, and you can totally opt-out.

    People can already opt-out of having health insurance! Why take the extra step? And the opt-out thing will last right up until the media gets a story about a kid with leukemia and the parents opted out the family.

  76. Tony-

    Just as a poor DC kid should be able to access the same educational opportunities as Obama’s two girls?

  77. I don’t see how anyone can defend a poor child not having access to adequate healthcare simply because she is poor.

    If we’re making this Hyperemotional Twaddle Day, I don’t see how anybody can defend forcing my fixed-income grandparents to pay for a child for whom they are not responsible.

  78. If you want to encourage people to have more children when they cannot afford them, by all means, promise the kids “free” schooling from Pre-K through College, “Free” Healthy Meals for Life and “Free” Health Care.

    Shit, I’m gonna go get a kid right now. Sounds like I don’t have to do anything to take care of him.

  79. It’s really not the children that are expensive though, it’s the elderly.

    So the real question is at what level does a society cut off aid? That’s the problem with healthcare, is it’s got both a moral and an economic component.

    On the one hand, if the resources are available to save someones life shouldn’t that life be saved? But on the other hand, resources are limted as well. Should we spend 10k to extend somone’s life by a year, what about 100k or 1m?

    I think that’s why it’s important to get people to ration their own care as much as possible. One such method is the co-pay. You need to put some costs on the care so people don’t take Johnny to the hospital every time he gets the sniffles.

    Also as noted I think it’s important to restore the link between lifestyle chocies, and healthcare costs. To control total system costs.

  80. THE URKOBOLD BELIEVES THAT ORAL SEX IS A RIGHT. WHAT HAS THE GOVERNMENT DONE TO ENSURE UNIVERSAL ACCESS TO THE MOUTHS OF YOUNG, NUBILE, LARGE-BREASTED WOMEN? AS THE URKOBOLD DICTATES THESE WORDS, THERE ARE MEN OF ALL AGES DENIED THE PLEASURES OF THE CUNNING TONGUE. WHAT KIND OF SICK SOCIETY IS THIS?

  81. . . . but a practical social good that functions best when it’s universal.

    Wrong again.

    There is no such thing as a “social good”.

    We are a nation of free people, each person with certain unalienable rights of life, liberty, and the pursuit of happiness.

    There is no entity called “society” that has any rights. Which is why all outcomes-based arguments that “society” will benefit from this or that action is pure evil.

  82. I think that’s why it’s important to get people to ration their own care as much as possible.

    BINGO! And the way people ration their own care based on what they can afford?

    Everyone say it with me now: FREE MARKETS!

    So the real question is at what level does a society cut off aid? That’s the problem with healthcare, is it’s got both a moral and an economic component.

    If elderly people want to spend fantastic sums of money on healthcare to keep themselves alive, that’s their business. It should be noted that those End-Of-Life expenditures have a “trickle down” effect in terms of techniques and technologies.

    Krone, the problem is you’re talking about this as if this is a “we” problem. “we” have to get “them” (the elderly, or whomever) to not use so much of “our” resources.

    The easiest way to solve a collective action problem is to make it an individual action problem.

  83. “I don’t see how anyone can defend a poor child not having access to adequate healthcare simply because she is poor.”

    She can get it now under CHIPS. We don’t need univeral health care for that.

  84. Careful, your Lord Master Trollness. If Oral Sex is a Universal Right, I think that men are going to find themselves impounded into giving rather than having women available for receiving.

    And do you want to take the risk that it’s your turn with Hlllary Clinton? Not me, Your Ur-Trollness, not me.

  85. TAO-

    IMO, Black’s dissent in Anastaplo ranks as one of the ten best in Supreme Court history.

  86. You can see by the crude, bullying remarks of so many posters to this column what kind of world you seem to want promote.

    Cruelty, violence, and self-destructive hatred.

    An ignoble audience for an ignoble argument.

  87. Just as a poor DC kid should be able to access the same educational opportunities as Obama’s two girls?

    Yes as long as we’re not using tax dollars to subsidize religious schools.

  88. I don’t see how people sleep at night having invoked the weakest sector of society in such a nakedly socialistic and outrageously cynical and opportunistic fashion.

    I mean, fuck off and die, Tony.

  89. TAO-

    Let’s everybody say it: FREE MARKETS!

    Let’s everbody say it: FREE MARKETS APPLIED!

    No need to have the state license lawyers.
    No need to have the state license doctors.

  90. Once again we are not talking about socialized medicine, but socialized insurance.

    No difference, in practice. The government sets all kinds of requirements on the business and practice of medicine as a condition of accessing Medicare and Medicaid.

    He who has the gold, makes the rules.

  91. “THERE ARE MEN OF ALL AGES DENIED THE PLEASURES OF THE CUNNING TONGUE. WHAT KIND OF SICK SOCIETY IS THIS?”

    We ugly fuckers shouldn’t be denied a good blow job from a beutiful woman. The government should step in and do something about this. And if we don’t have enough money to go to a prostitute, then the tax payers should pay for it. We have a universal right to blow jobs from beautiful women.

  92. TAO

    The problem is that the Supreme court has said that people can’t be turned away for care. This makes it a collective problem. And even though economically there are some very good arguments for getting rid of that, I really don’t think it will ever happen.

    Thus based on the fact that everyone has to get treatment, the question becomes what’s the most efficient way to do so.

    IMHO, I think the method I’ve outlined is probably the best I’ve heard so far.

    If someone can come up with a better one to control TOTAL costs (taxes and insurance) while also promoting the maximum amount of indivudual liberty I would be very much intersted in it.

  93. There is no such thing as a “social good”.

    We are a nation of free people, each person with certain unalienable rights of life, liberty, and the pursuit of happiness.

    There is no entity called “society” that has any rights. Which is why all outcomes-based arguments that “society” will benefit from this or that action is pure evil.

    I guess we defend society differently, since obviously there exist collectives of people, which is all I’m referring to.

    If my neighbor’s house catches fire, that is not just his problem; it could easily become my problem, even if he started the fire deliberately. That’s why societies evolved to make firefighting protecting a collective service. My freedom not to have my house burn down is enhanced by my neighbor having the same access to that service as I do, regardless of whether he can afford it. I think the case can be made that the same logic applies to health care. If it’s a matter of whether an individual can afford access, inevitably people who can’t will be sicker over the long-term, affecting not just my insurance costs but the various burdens the state takes on dealing with lower health metrics. That’s the practical argument; the moral argument is even easier. Maybe you deserve to have a bigger house if you’re wealthier. Fine. Do you deserve to be healthier?

  94. “And do you want to take the risk that it’s your turn with Hlllary Clinton? Not me, Your Ur-Trollness, not me.”

    You don’t have to worry about that. She’ll only be giving blow jobs to women.

  95. defend = define*

  96. Tom in Vermont-

    You mean you also support the elimination of all public sector police and military organiztions? After all, they are about cruelty and violence and hatred.

  97. “I guess we defend society differently, since obviously there exist collectives of people, which is all I’m referring to.”

    We are all individuals with individual rights. There is no such thing as a collective right.

  98. THE ANGRY OPTIMIST, YOU FOOL, CAN YOU COMPREHEND NOTHING? THE URKOBOLD CLEARLY SAID “YOUNG, NUBILE, LARGE-BREASTED WOMEN.” TO THE EXTENT THAT THE U.S. CANNOT SUPPLY ITS OWN FELLATIATORS AND CUNNINGLICKERS (ALL YOUNG, NUBILE, LARGE-BREASTED WOMEN, OF COURSE), IT CAN OUTSOURCE SUCH FUNCTIONS OR LAUNCH A MANHATTAN PROJECT TO CLONE THEM.

    NATURALLY, THE URKOBOLD ADVOCATES THIS ONLY OUT OF ALTRUISM, FOR HE DOES NOT NEED THE GOVERNMENT’S HELP, HAVING (1) THE WEIBSKOBOLD, (2) THE TROLLINESS TO ATTRACT OTHER SOURCES OF PLEASURE AS NEEDED, AND (3) LOTS OF MONEY TO HIRE HIGH-QUALITY PROFESSIONAL ASSISTANCE.

  99. Maybe you deserve to have a bigger house if you’re wealthier. Fine. Do you deserve to be healthier?

    If your answer to this is “no”, Tony, you’re going to have a hard time explaining why we shouldn’t just send 50% of our income to Africa to improve their healthcare.

    I mean, “we’re” a wealthy nation. “They” have poor nations. QED.

  100. We are all individuals with individual rights. There is no such thing as a collective right.

    Never said there was. I just said insofar as fire protection is a right, so should be health care. If it’s not a right, that’s fine with me. Call it whatever you want. I’m not interested in semantics.

  101. Kronebarge-

    Then respond to my point about licensure and the effort on the part of allopathic interests and the state to deny folks the opportunity to employ non-allopathic treatment modalities. This is often done by harassing health care practitioners who do not practice the allopathic method.

    Licensure has a tremendous effect on cost. If health care were truly a free market, doctors would not be able to command $180.00 five minute office visits.

  102. Tony, we already have medical care for the poor, it’s called Medicaid. A big problem I have is that many of those 45 million uninsured can afford insurance, but they choose not to get it because they would rather spend their money on other things. Obama’s plan would force us to pay taxes to pay for the insurance of these people. That ain’t right.

  103. Love the comments about ‘reason’, ‘logic’ and ‘evidence’ from apparent Repugs. Where were all of you over the past catastrophic 8 years when the neo-cons were “creating their own reality”, when Dr. Bill-follow-the-balloon-Frist was conducting his video diagnosis of T. Schiavo and when over half of your Presidential candidates raised their hands when asked if they did not believe in the theory of evolution? You tea baggers are down to 21% membership and falling fast!

  104. URKOBOLD-

    I prefer small breasted woman with long sinewy legs.

  105. If your answer to this is “no”, Tony, you’re going to have a hard time explaining why we shouldn’t just send 50% of our income to Africa to improve their healthcare.

    I mean, “we’re” a wealthy nation. “They” have poor nations. QED.

    Well we can’t feasibly subsidize the health care of everyone on the planet. Maybe when we have a planet-wide government with everyone contributing, but for now I’m only talking about what should happens within the borders of our country. That’s not to say that it may not be in our interest for Africans to be healthier. It almost certainly is. So any aid is a good thing to a point.

  106. DH-

    We are not in Lawrence, KS.

  107. LIBERTYMIKE, YOU ARE FLAWED! THE GOVERNMENT WILL DECIDE WHAT SORT OF SERVICE YOU WILL RECEIVE. WHAT ARE YOU, SOME SORT OF BOURGEOIS, CAPITALIST PIG?

  108. nope, Tony, not buying it. It doesn’t matter if we can “feasibly” fund it, it’s a fact that it’s an injustice that our wealthier selves are healthier than their poorer selves.

    Why arbitrarily draw the line at our country?

  109. LM – you like ’em taller than you? Because that would make us some kind of twin.

  110. I think there is some basis for licensure, but that it is also used to stifle compeitition.

    Also, even if you got rid of licensing mandatory licensing requirments, people would often still seak them out becuase they like that extra bit of certainity.

    As a CPA myself, I know that those 3 letters give people some assurances that I’ve met a cetain minimum standard. But that’s ALL it means.

    Anyway, I think a lot of the stuff they reserve for doctors could be done by nurses etc, and then only refer to doctors as needed.

    Also, I think MD’s often disdain other things like chiropracty etc that have definitly proven benefical to people.

  111. “Never said there was. I just said insofar as fire protection is a right, so should be health care.”

    Fire protection, police protection, and health care are services, not rights. Fire protection and police protection are normally provided by local governments. As a minarchist, that’s alright with me. That works out alright as far as I’m concerned. But health care is best provided for by the private sector. The rationing and low spending on research and development in countries with national health care proves that.

  112. Tony, we already have medical care for the poor, it’s called Medicaid. A big problem I have is that many of those 45 million uninsured can afford insurance, but they choose not to get it because they would rather spend their money on other things. Obama’s plan would force us to pay taxes to pay for the insurance of these people. That ain’t right.

    If the system is working right Medicaid should only go to those who can’t afford it. Stereotypes about what poor people are like don’t persuade me.

    At any rate we’re already subsidizing their health care in this case, so I don’t get your point about Obama’s plan. The problem in today’s reality isn’t necessarily the destitute and the elderly who can get socialized health care already. It’s people who can probably afford insurance but whose insurance doesn’t actually cover their medical needs. Lots of middle class people go bankrupt because of health care costs. The statistics are staggering and nobody who appreciates them can defend keeping the system the way it is.


  113. Why arbitrarily draw the line at our country?

    Um because people in other countries don’t participate in the system by paying the taxes to our treasury.

  114. I just said insofar as fire protection is a right, so should be health care.

    You said that I might care if my neighbor’s house catches fire, because it could spread to my house. So, therefore, I might have an interest in cooperative solution to fire protection.

    In a crowded environment, it might be in my best interest to ensure that my neighbor doesn’t accidentally burn my house down when I not there to protect it myself. So maybe I should buy fire protection service — so be it. Why do I need to rely on a government agency? That is one solution, not the only solution.

    But I actually live out in the country. If my neighbor burns his house down, it won’t affect mine. Now, I’m a risk averse kind of guy, so I’m willing to pay a private company to come put out the fire at my house if it catches fire. That’s no reason for me to force my neighbor to buy the same protection from the same enterprise I choose or to buy protection at all.

    If it’s not a right, that’s fine with me.

    That’s a start.

    Call it whatever you want. I’m not interested in semantics.

    Dude, semantics matter — they really do.

  115. So the real question is at what level does a society cut off aid?

    Private systems don’t. Only nationalized systems “cut off aid”.

  116. “…paying for the birth of their child with their house. Or cancer.”

    AHAHAHA You can pay for childbirth with cancer??? GENIUS!

  117. TAO-

    Bingo. It has always been that way for me. I can not explain it. It just is. That is why I have grown to buy the position that gays are born gay. I have always been attracted to very tall women. I had a sixth grade english teacher who was about 40 at the time and she was about 5’10, without heels, and leggy. She would wear high heels and panty hose and she had great legs. WOW! She probably weighed about 120 or so-but she had some great calf muscles. You know what, how about a little name dropping? This teacher is the daughter of Rachael Carson (Silent Spring)

  118. What about comparing levels of income inequality? That, to me, is more a measure of economic health than growth, GDP, per capita income, or any other metric that, by the way, doesn’t account for whether Americans have more or less equal access to health care.

    Tony, so you are saying better everyone is in mud hut poverty than some be fantastically rich and others merely rich compared to the majority of humans who have ever lived? Most people in the world can only dream of living as well as the poorest in America. Clean water, electricity, plentiful food,….

  119. TAO-

    Let’s say you, me and MNG are stranded on a desert island with two real tall, leggy babes. Problem is that both gals “belong” to MNG.

    What do we do? HINT: My non-coercion principles might give way…..

  120. Well we can’t feasibly subsidize the health care of everyone on the planet.

    We probably can’t feasibly subsidize the healthcare of everyone in the country. Take Canada, for instance…

  121. kinnath,

    You’re focusing too much on the specifics of the example. If someone who hasn’t bought fire service protection has his house catch fire, it’s potentially a problem not just for him or his next door neighbor but for the entire neighborhood or neighboring rural fields, forests, what have you. It threatens people collectively to let a house smolder. Fire protection is just another form of social insurance. We all buy in so that our individual risk (and everyone else’s) from fire is minimized. Nobody’s freedom is threatened; it is in fact greatly enhanced by this form of insurance being universally applied. Fire is rarely an individual problem. It spreads. All this is to say I think the argument can be made that poor health is just as much a collective problem.

  122. Well, your freedom is effected any time taxes are levied to pay for something. Your freedom to spend your money as you wish.

    That being said, that’s kind of the deal with the devil for getting a government that provides services, you don’t always get what you want. But that’s a deal most people are willing to make.

  123. Kroneborge,

    The freedom to spend your pittance in wealth that you pay to provide for fire service is a much more trivial freedom than the freedom not to die in a massive fire. Yes there’s give and take with regard to specific liberties. That’s called living in a civilization.

  124. “kinnath | May 7, 2009, 2:43pm | #
    Jaydub, there are many flaws in the current system which are driving the cost of health care through the roof. These flaws have been listed at great length with libertarian solutions for eliminating those flaws in many past threads on this forum. None of those solutions involve government intervention into the system.

    Don’t make the mistake that because we oppose the imposition of a universal solution by the federal government that we actually like or defend the current system.”

    IMO This is the heart of the libertarian argument & it’s system of values. We put personal freedom and personal liberty highest on our priority list–to us government should exist ONLY to prevent other people from taking that freedom away.

    Our general desires for smaller government, fewer regulations and lower taxes is a result of that belief rather than a means to any social or economic result.

    Most libertarians think that it will also work as well or better than the status quo as a means to goals like equality, a higher standard of living, healthcare and the like, but don’t forget that these are arguments meant to enlist the support of people who have these results as goals rather than people whose goal is freedom.

  125. ***Sorry for the interruption***

    And in other good HBO news, Peter Dinklage has signed on to star in the pilot for “Game of Thrones.” The pilot, to be directed by Tom McCarthy (who worked with Dinklage in The Station Agent), is based on a series of George R.R. Martin books (the Song of Fire and Ice series)

    You may now return to your regularly scheduled program, already in progress.

  126. Fire protection is just another form of social insurance.

    You brought up the specific case.

    And you keep repeating the general case of “social this” and “social that”.

    I argure that your are wrong on both the specific and the general case.

    It is true, that we are “social” animals and we tend to form packs. You are also correct that we some times “choose” to collaborate with others in our pack.

    Your specific problem is that you follow this to the point that all collaboration must be governed by the super-pack called the United States of America.

    Libertarians argue that:

    1) We’re all grown-ups and should talk care of ourselves.

    2) If we choose to collaborate, it should be through private agreements between like-minded individuals.

    3) Occasionally, we need to collaborate on such big jobs that we form LOCAL governments.

    4) On far rarer occasions, we need to collaborate through STATE governments.

    5) On the rarest of occaisions, we need to collaborate through the FEDERAL government.

    Progressives, almost always, start with the goal that the feds should govern and finance almost all collaborative efforts. And this is almost always based upon some outcomes-based analysis that “society” will benefit if everybody does things the same fucking way.

  127. Um because people in other countries don’t participate in the system by paying the taxes to our treasury.

    So, only people who pay taxes would be entitled to the government health care?

    What about immigrants? Are you going to require everyone to carry around a “Proof Of Citizenship” Card so people who *haven’t* paid taxes *don’t* get the healthcare?

  128. Yes there’s give and take with regard to specific liberties. That’s called living in a civilization.

    Civilization has always flourished when people are free to persue their own set of goals rather than “society” dictating a common set of goals.

  129. woot on the Fire and Ice series being made into a show. I just hope they don’t destroy it like they did with “The Sword of Truth” series

  130. Tony | May 7, 2009, 2:47pm | #

    What about comparing levels of income inequality? That, to me, is more a measure of economic health than growth, GDP, per capita income, or any other metric that, by the way, doesn’t account for whether Americans have more or less equal access to health care. Unemployment also matters less when the unemployed have access to services that keep them healthy and off the streets.

    Agreed, Tony. GDP is a terrible measure of things, and merely by using it as a standard, we have created massive distortions in our political and economic systems. Not all GDP growth is good. Indeed, most GDP “growth” that the US experienced between the 2001 recession and the 2008 crash turned out to be a lot of fat and very little meat. One can easily create phoney GDP “growth” by borrowing lots of money externally and spending it locally. Nowhere in the GDP calculation is the fact that we are now in debt up to our eyeballs figured in. Nor is resource depletion figured in as well. And let’s not even get started on the discussion of how much of our GDP “growth” turned out to be phantom bank and real estate profits. Whoops…

    Using “income inequality” statistics can also lead to distortions, but no more than GDP itself. We need to quit focusing on “growth” and focus on making people happier.

  131. There have been a number of efforts to replace GDP with something a bit more meaninful. GDP as it currently is buyes into the whole broken window fallacy.

    That being said, usually the best way to make people happy, is to keep government out of the way as much as possible, and just keep things a level playing field. Level as an equal oppotunity, not necessairly equal outcome.

  132. You fools, A Song of Ice and Fire is being written by Dave Benioff, writer of such stellar accomplishments as the new Wolverine movie and Troy. Though he is banging Amanda Peet. Regardless, resolve yourself to disappointment now.

  133. Tony, so you are saying better everyone is in mud hut poverty than some be fantastically rich and others merely rich compared to the majority of humans who have ever lived? Most people in the world can only dream of living as well as the poorest in America. Clean water, electricity, plentiful food,….

    Actually, that isn’t as far from the truth as you think. Once people are out of the “mud huts” and are living basic developed-world lifestyles, increasing income barely affects happiness. What DOES increase happiness is being richer than your neighbors, which is obviously zero-sum.

    Imagine three countries with three citizens each, with the following incomes

    Poor Country – $1000 $1000 $1000
    Middle Country – $12000 $12000 $12000
    Rich Country – $30000 $30000 $100000

    What studies have shown is that while the people in the poor country would likely be fairly unhappy due to their difficult lives, the people in the middle country would likely be as happy or even happier than the people in the rich country. Beyond about $8000 GDP, more wealth simply brings little additional happiness. However, being poorer than your neighbors tends to make you unhappy, and being richer makes you happier. The “rich” country in this example would actually have lots of envy-related unhappiness.

    Additionally, a number of studies have asked questions along the lines of “Would you rather make $75000 in a country where everyone else made $100000, or $60000 in a country where everyone else made $50000?”. The responses are usually fairly equally split.

    So yes, the evidence points out that decreasing inequality does make people happier – enough so that some overall reduction in income is worth sacrificing in order to obtain greater equality.

  134. Level as an equal oppotunity, not necessairly equal outcome.

    Equal opportunity does not guarentee equal outcomes.

    Equal rights does not guarentee equal opportunity.

  135. So yes, the evidence points out that decreasing inequality does make people happier

    So what. The right to pursue happiness doesn’t mean you’ll actually catch it. Under no circumstances should the government be in the business of making people happy.

  136. do cvidanye gents

    time to dodge the rain drops outside

  137. Chad, if you’re going to cite to “studies”, maybe it’d be best if you actually, y’know, provided them?

    Of course, since results are “split” when it comes to the crab-bucket effect, that split doesn’t exactly lend any strength to your position.

  138. Although if happiness once you are above a certain income level is principally decided by your position in society, and positional goods relative to others, then is most of society doomed to unhappiness?

    Or is that unappines largly due to constant advetising saying you need to buy this thing to be happy.

    Not that having things is bad, but basing your happiness on positional goods probably is to at least some extent. And it’s really bad if you use it as a basis to redsitrubute wealth.

  139. Chad: We need to quit focusing on “growth” and focus on making people happier.

    The two are not completely separate if you agree that growth = more per capita wealth, but the point is that increasing freedom by reducing the things that government is “responsible for” increases BOTH.

  140. focus on making people happier.

    LOL. By what standard? What is possibly going to make every single person happier?

  141. I think the liberal stance is about ensuring that people have access to the level of basic needs beyond which Chad’s comparative happiness calculation applies.

  142. Of course the problem is that a lot of people won’t do any work if you provide them with their basic needs.

    I personally don’t mind providing a help up, but so often it just turns into a hand out.

  143. Kroneborge,

    Poor people don’t have it better off than “hard working” rich people no matter how you spin it. And a lot of people who are paid very little work a lot harder by any standard than a lot of people who have a lot of wealth. Can we be rid of these Reagan campaign talking points/racist stereotypes finally? I mean it’s 2009. Income inequality is at Gilded Age levels despite productivity increasing and it’s no accident.

  144. It’s unfortunate, but “basic needs” aka “basic rights” is not well defined. Liberals often say it includes things like healthcare, food, and a job. Conservatives argue that it includes laws enforcing morality and “protecting children”. Libertarians define it more narrowly to only include: life, liberty and the pursuit of happiness.

  145. Income inequality is at Gilded Age levels despite productivity increasing and it’s no accident.

    Please tell us why income inequality is a bad thing.

  146. I’ve known more than a couple of people that were perfectly happy to be “poor” if that meant not having to have a job, and the rest of their needs being met.

    IMO, that’s unacceptable. If you are going to get government assistance you should at least do something like pick up trash on the highway or something.

  147. Oh, and realizing that welfare can have a corosive effect on work ethics doesn’t make you a racist.

  148. It’s unfortunate, but “basic needs” aka “basic rights” is not well defined. Liberals often say it includes things like healthcare, food, and a job. Conservatives argue that it includes laws enforcing morality and “protecting children”. Libertarians define it more narrowly to only include: life, liberty and the pursuit of happiness.

    I think this is a good point. My interpretation of “pursuit of happiness” is just what I articulated: providing some level of an equal playing field so that that pursuit is possible for all people. The specifics are certainly open for debate, and this country has debated and will continue to debate them.

  149. Please tell us why income inequality is a bad thing.

    It’s not. But the level we are at today is grotesque by historical standards; it’s bad because it stagnates economic growth and represents exactly the type of two-class system this country was founded to repudiate. It means two sets of laws for the two classes (which we seem to have). It means the noble pursuit of wealth libertarians champion is practically impossible for anyone not already wealthy.

  150. Oh, and realizing that welfare can have a corosive effect on work ethics doesn’t make you a racist.

    This claim requires some form of evidence. It doesn’t make you a racist; perfectly nonracist people have articulated this presumption for many years. What they don’t realize is that this rhetoric originates in race-baiting Republican campaign rhetoric from the 80s–back then everyone knew they were talking about “those people.”

  151. It means two sets of laws for the two classes (which we seem to have). It means the noble pursuit of wealth libertarians champion is practically impossible for anyone not already wealthy.

    Welcome to the law of unintended consequences. You asked for an activist big government, and you got it.

  152. “Everyone knew…”

    [citation needed]

  153. Your argument has a logical fallacy in it. Namely since some person somewhere said something, and that person was bad, or had bad motives, that the argument itself is not valid.

  154. Inequality of income/wealth is a bad measure. All of the wealthy people who don’t work very hard either provide a service that is highly desired (as in the case of celebrities and gossip) or had an ancestor who passed their wealth to them. This is not unfair. They’re just working smarter.

    “Equal Opportunity” is also a bad thing to argue about because people have a hard time separating “his parents are rich and can provide him with a better start”–which is perfectly fair–from “the government won’t let _____ do or own ______” which is completely arbitrary and unfair.

    If you’re worried about the poor, a better measure would be the rate of increase of quality of life for the poor as compared to the rate of increase in quality of other poor people. There’s no need to compared anyone to the wealthy. When you do it’s clear that the more free a country is, the faster this “minimum” QOL improves.

    It’s the rate of improvement that matters, not the current levels. That is how to determine what is superior.

  155. Once UHC takes effect, it won’t be long before the government deems it their responsibility to ensure that people are as healthy as possible in order to contain the costs of the system. It will lead to less freedom in your personal lifestyle choices. You like bacon-wrapped hot dogs and chocolate shakes? Well, it’s off to re-education fat camp with you! Ironically, this is happening in Japan, where there is no obesity epidemic:

    http://www.nytimes.com/2008/06/13/world/asia/13fat.html?_r=1&no_interstitial

  156. Teve: hahaha That link is awesome! (in a totally scary awful way)

  157. The author of this article doesn’t have a clue as to what he is talking about. Have you been to Europe lately? I have been going my entire life, and the European standard of living is much higher than the average American citizen. I just got back from Germany and France last month. Everyone gets two weeks Easter vacation paid. My friend just had a baby in Germany and she gets one year paid maternity leave, and if she chooses to stay home with the baby, she can get her job back after three years. Her husband also gets two months paid maternity leave. On the otherhand, my friend in Arizona just had a baby and she is on maternity leave for only three months. But guess what she gets? The company she works for (a big credit card company) called to tell her that when she comes back to work in July that she will be laid off, but first she has to train the people from India that will be taking over her job! Only in America can this travesty occur! There are no social safety nets in place in America. In Germany, you don’t loose your house if you get sick or are laid off. We pay high taxes, but we don’t get anything for paying those taxes. At least in Europe you have a high standard of living, even if you get laid off, you don’t have to give up your standard of living. Do me a favor and go to Europe, then you’ll see for yourself how Americans live (bottom of the barrel) compared to the way Europeans live (life at its best).

  158. Tony,
    What metric would you chooose to use to determine what level of income equality is acceptable?

    How do you define “Too Wealthy” or “Too Poor”?

  159. “Imagine three countries with three citizens each, with the following incomes

    Poor Country – $1000 $1000 $1000
    Middle Country – $12000 $12000 $12000
    Rich Country – $30000 $30000 $100000

    What studies have shown is that while the people in the poor country would likely be fairly unhappy due to their difficult lives, the people in the middle country would likely be as happy or even happier than the people in the rich country. Beyond about $8000 GDP, more wealth simply brings little additional happiness. However, being poorer than your neighbors tends to make you unhappy, and being richer makes you happier. The “rich” country in this example would actually have lots of envy-related unhappiness.”

    You see, this is just too fucking depressing to me. Contemplating this very true assessment of the modern human situation inevitably leads to despair. What hope is there for us when we are that fucking pathetic?

    It’s ignorance, really. Pettiness borne of historicsl ignorance of just how fucking miserable human life can be.

    When Carthage fell to Rome, ALL of the men were killed. ALL of the women and children were enslaved. The land was sown with fucking salt so nothing would grow there.

    And people are unhappy, not because of anything they lack, but because other people have more? It’s not enough that they can be clean and sanitary, and can get all of the food they need, and read all of the books that they can get for free at the library and just generally do whatever the fuck they want to do with their free time?

    And by the way, just what the fuck is this ‘happiness’ shit that is being demanded? Would the people suffering from “envy-related unhappiness” be even less happy if they ended up as a galley slave in a Roman war ship, or perhaps working in the silver mines at Laurium? What if the went to some such hell for a few days and then came back to their life of freedom and cleanliness, where even the poorest people are fat?

  160. The Angry Optimist | May 7, 2009, 4:33pm | #

    Chad, if you’re going to cite to “studies”, maybe it’d be best if you actually, y’know, provided them?

    How hard is it to type “happiness measurement” into google? There are plenty of good books on the subject as well. I would start with the works of Arthur Brooks.

    Diane Kubel | May 7, 2009, 5:44pm

    I’ve lived in the US, Japan, and western Europe. I found the standard of living was similar in all three…and that you are absolutely correct that its worse to be poor in America than in the other two. It is also better to be rich. Any difference in the average is so small that it is trivial, and mostly used to purchase cheap Chinese crap that doesn’t make us happier anyway.

  161. Diane:
    Time off is a cultural thing–NOT a direct measure quality of life. Some people prefer more time off, while others prefer more money, and don’t be mistaken it IS a trade off between time and money, whether it’s “paid” time off or not.

    The more time off each person in the company takes, the less that company can produce. This means that there is less total profit per person coming into the company–less for everyone to share. Few people want to work 24/7, but no company can afford to let all their workers not work at all, so you have to agree on a balance. In the US we tend to agree on more work than Europe which is why we are more productive.

    One reason that maturnity leave in particular is such a sticky issue is that GENERALLY women tend to prefer more (and more flexible) time off, while men would rather work more and have more money.

    Outsourcing to India is a whole nother can of worms, but I don’t feel like taking the time to explain it simply ATM.

  162. Publius:
    It’s unfortunate that not every adult is a mature adult. Anyone with ideas on how to solve THAT problem needs to step the fuck up.

  163. Dear Slutmonkey,

    Time off is a measure of quality of life! Who wants to work all the time? Europeans get paid just as much as Americans do and even more so, and on top of it they get a lot of paid vacation. It works in Germany, and Germany is the worlds third largest economy. Maybe they are fourth now behind China, I’m not sure. Have you ever been to Europe? They think Americans are lazy and wouldn’t agree at all that Americans work harder and are more productive. Americans work longer hours, but Germans are more productive in a shorter span of time. They also get to take lots of time off while Americans are still working and working for less, in a lot of cases. Quality of life means getting to keep what you have worked for your whole life! Europeans understand this. Americans don’t. Obviously, its the new American Dream to loose your home if you become ill or laid off. Do me a favor and to to Europe. You’ll see first hand how well off Europeans live compared to Americans. My dad’s friend in Germany told me about a program he saw on T.V. in Germany about how people live in Detroit. He couldn’t believe the shanties that people live in. That just doesn’ exist in Western Europe.

  164. That just doesn’ exist in Western Europe.

    Haha. Do me a favor and take a midnight stroll through the immigrant ghettos in Europe where unemployment persistently runs several times that of the national average.

  165. It might not be the American dream to lose the home when they get laid off, But then again why should I have to pay off my neighbors home just because he got laid off?

    And if quality of life means getting to keep what you earned why are you then asking me to give it to someone else?

  166. Diane
    Uh.. actually Germany is not third and the USA is still numero uno:
    In other good news, the U.S. ranks first among the G8 nations in quality of life according to another recent study by JPC-SED. This Quality of Life indicator takes into account the average life span, healthcare system, productivity numbers, higher education levels and gross domestic product in each country.
    http://www.gaebler.com/Productivity-and-Vacation-Comparisons-by-Country.htm

    I think you are confusing quality of life with Quality Of Life. The average personal quality of life is not the same as the average Quality Of Life because an individual’s quality of life depends on his or her preferences. If some oddball prefers wearing loincloths and hunting to city life, and wearing a loincloth and hunting is what he does, then his quality of life is high. If EVERYONE wears a loincloth and hunts then their Quality Of Life is low.

    You prefer more time off. Most Americans prefer more money. Your personal quality of life might be higher in Europe, but Quality Of Life is higher in the USA. It’s a cultural preference vs an individual’s preference.

    My capitalization method of differentiating these terms is probably not strictly canon, but hopefully it makes sense.

    Also, If quality of life means “Getting to keep what you’ve worked for your whole life” I would still argue the US has better QOL than W.Europe because our taxes are lower–we keep more.

  167. The problem with healthcare is that it’s starting to work. That is, we’re getting to the point where if you pay more and more money, you can actually improve your health, lifespan, and quality of life significantly.

    And this is precisely what’s making the current system of medical insurance obsolete: it was based on the idea that some people would occasionally get really sick in ways that could be fixed at a huge cost, but that most people would be “healthy” most of the time even while paying into the risk pool.

    Nowadays, nearly EVERYONE is “sick” relative to what they COULD obtain if they only spent a few more healthcare dollars. The pressure to spend ever more is enormous, especially because people’s sense of a “right” to healthcare was born in an age when that right wasn’t anywhere near as effective or expensive relative to, hell, GDP.

  168. Great observation Drew.

  169. right on Drew.

  170. From the article:
    “Before applying this exotic therapy to America, Obama needs to offer more than mere hunches that it will work. He needs to offer actual evidence.

    No, he doesn’t, actually. He has more than enough votes in his rubber stamp Congress to make it happen without any form of debate.

    Bend over and grab your ankles America, Big Business is about to dump their legally binding contractual obligations regarding providing health care to their employees all onto the little guy. This is the reason they spend so much to buy Congressmen.

    The value of the health insurance benefit will be erased from your salary, business will pocket the money they save by dropping health insurance, you won’t get a dime of the savings. But your taxes will skyrocket to pay for the new UHC, so now you can take a big slice off what’s left of your take home pay.

    And to top it all off, not only do you lose value/hour of work, not only do you lose income to more slavery, uh, sorry, taxation, you also get the added benefit of having a doctor’s office that is just like the DMV!

    Happy days! America is saved!

    (yeah, that was sarcasm)

  171. Jordan, Kroneborge and Slutmonkey,

    Every country has rich and poor people, but the U.S. has 35 million living in poverty. That’s 10 percent of the population. Every country will always have rich and poor people, but not every country has a strong middle class. A strong middle class is what made America strong both economically and politically stable. I don’t look at statistics or models, I believe what I see with my own eyes, and I see that the standard of living for Americans has been drastically reduced during the past 30 years.

    Either we are one country or we are not. No, I don’t like my tax dollars being spent irresponsibly, but there do need to be social safety nets in place for people that get sick or are laid off or are in an accident and have to go on disability. Aren’t you seeing that this economic crisis has affected all of us? You shouldn’t have to pay for your neighbors home, but what if its on fire, should the fire department let the fire spread to your house? No. Safety nets are in place so that economic downturn doesn’t run rampid and hurt all of us. I don’t like paying taxes, but its a necessary evil to pay for roads, bridges, schools, transporation hubs, all of which are in total disrepair in this country. We pay all these taxes, but what are we getting for our taxes? In Europe, at least you get something for your taxes. Healthcare, education, social services if you are laid off.

    As for vacations, Americans are always crying about the fact that they work to much and don’t get enough time off, so don’t tell me they wouldn’t want six weeks vacation. Europeans, in Germany at least, you get vacation and you get paid. I don’t think any American would argue with getting paid to take six weeks off.

    Slums exist in every country, but if we are numero uno, then why do we have 35 million Americans living in poverty, and growing. Don’t you think that’s 35 million too many?

  172. Slutmonkey,

    Germany is the fourth largest economy behind China, which is what I said. The U.S. is no longer numero uno, they are second behind the E.U. In ten years, China is poised to take over as the world’s largest economy. By that time, the U.S. will be number fifty. Americans need to wake up and realize that other countries make up this planet we live on and stop sleeping like they have for the past thirty years plus.

  173. Our current health care system in the US is broken. It costs twice as much per person as any other health care system in the world and it provides worse results than most socialized systems. We have a lower life expectancy and higher infant mortality. The Left comes up with a solution and the Right says “NO”. The GOP is a party destined for extinction. Good riddance.

  174. Dalmia writes: Not only is America hurting relatively less now, its economic performance in the prior 18 years-from 1990 to 2007-has also been visibly better than everybody else’s. Calculations based on Department of Agriculture data show that America’s GDP grew at an average annual rate of 3 percent during this period. By contrast, Canada’s grew 2.88 percent; England’s 2.3 percent; France’s 1.92 percent; Japan’s 1.74 percent and Germany’s 1.59 percent.

    Comparing rates of GDP growth without taking population expansion into consideration is dumb, or disingenuous. All things being equal, a country with a faster growing population will have a faster growing economy. GDP growth unadjusted for population tells us nothing about economic performance, and even less about whether living standards are rising. I’m utterly SHOCKED that a libertarian would use dodgy statistics in support of a claim! (also, I strongly suspect the numbers for America would look even worse if we use, say, 1995 as a starting point instead of 1990, for the earlier date cherrypicked by the author — again, shockingly! — will tend to downplay the success of economic reforms undertaken in much of the rich world in the 1990s).

    When you look at per capita GDP growth, it’s clear that the advantage the US used to often enjoy over many of its rich world competitors is either eroding, or has vanished completely. And when you combine this trend with America’s far greater income inequality and widespread poverty, it’s obvious that average living standards in the US have fallen below much of Europe and Canada. Moreover, social mobility in the US is now below that of nearly all of the rich world, too. Far from being associated with a superior economic model, America’s dysfunctional, bloated, corporatist approach to healthcare is a sign of a tired and increasingly ineffective approach to raising living standards. Hopefully the country’s new political leadership will arrest this decline.

  175. Diane:

    You apparently didn’t follow my link, but
    since you “don’t look at statistics or models”, I won’t waste time showing you more stats proving my assertions, but I will answer your other points:

    We do get many things from our taxes–obviously EU countries “get more” but they also pay more. I also know that individuals and private charities will spend the same money more efficiently and more effectively than the government. As was mentioned earlier: Libertarians AGREE that the current system is broken. All the things you list can be done–and can be done better–if done privately. The libertarian solutions to these problems are outlined elsewhere.

    Is 35 million too many? You are saying yes, but I would say no. Why? You’re not arguing a question of principle, you’re arguing over what number should be used for acceptable.

    Again, my point is NOT that there will always be poor people. My point is that freedom is more important than eliminating poverty. Freedom is more important than health care. From what I’ve seen facts are against you when it comes to the EU vs the US, but even IF you were right, freedom is more important.

    Like Benjamin Franklin wrote, “They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety.”

  176. The purpose of universal healthcare is not to “grow” the economy–such growth has, in the past 20 or so years, accrued mainly to those who are already wealthy.

    An uninsured person faced with bankruptcy because of a medical bill he cannot pay is not benefited by overall economic growth, because he does not participate in it.

    Every person I have ever talked to who has lived in Denmark or the UK where healthcare is virtually free has nothing but good to say about it, and that will be the case once it’s enacted here.

    You people all go worship at the altar of economic growth, I will support Mr. Obama’s effort to bring universal health coverage.
    If this be socialism, let us make the most of it.

  177. My point is that freedom is more important than eliminating poverty. Freedom is more important than health care.

    The problem is your warped concept of freedom. Taxes are a very minor intrusion into our freedom. If my taxes were to go up 5% of my income tomorrow (and they should), how would I be less “free”. Well, I suppose I would have to wait another six months for the LCD-TV or something like that.

    But that same 5% tax increase could pay for a universal health care system (freeing me from all sorts of hassles and worries about my private insurance) and a robust public transportation system (freeing me from needing as many cars for my family, or freeing me from needing to take my grandma to the doctor’s office because she could go by herself, etc).

    It is precisely the ultra-limited conception of freedom that most libertarians have that separates them from the center of politics. Most people do not believe that economic and political freedom is the only freedom that matters. Nobody is against freedom…but many are against such limited thinking about it.

  178. Please don’t patronize people about healthcare.
    The biggest problem is that the insurance industry has gotten in the way of the doctor-patient relationship and resulted in healthcare systems hiring MBAs and MHAs who know NOTHING about either medicine or healthcare delivery. These people are also bureaucrats making 100K a piece.
    You need to talk to patients and doctors in other countries. In emergencies patients receive excellent care, have more access to primary care physicians, and can afford to my their prescription drugs. Amazing that they do this for less than 16% of their GDP and have better health outcomes, leading the US in many categories.
    The time has come to reform the healthcare system. It is too bad those on the right cannot realize that medicine should never have become another big business.
    Written by a physician!

  179. “But that same 5% tax increase could pay for a universal health care system (freeing me from all sorts of hassles and worries about my private insurance) and a robust public transportation system (freeing me from needing as many cars for my family, or freeing me from needing to take my grandma to the doctor’s office because she could go by herself, etc).”

    Your grandma must not be very good at working the system. My mother gets to all of her medical appointments using taxpayer funded medical transportation that picks her up, helps her in and out of the house and hospital and brings her home.

    And for fucks sake, we get it, you like the government taking your money and spending it for you. It makes you feel safe. We don’t. It doesn’t make us feel safe. It pisses us off.

    And if we are so fucking marginal, why do so many left wing trolls keep coming to this site to tell us how marginal we are? You guys have won. You have control of the government. The great re-distribution has begun. Why not let us marginal people have our marginal conversations about our marginal beliefs in peace?

  180. Shikha is trying to prove Pres. Obama wrong by creating a straw argument. Obama never said that fixing the healthcare will fix the economy. He merely said that it is an essential part. Obama’s reasoning does not say that you will have a wonderful economy if you just fix the health care system.

    Next time, I suggest that the author pays close attention to what she is trying to disprove. This one reads like very tortured logic…kind of novice.

  181. And for fucks sake, we get it, you like the government taking your money and spending it for you. It makes you feel safe. We don’t. It doesn’t make us feel safe. It pisses us off.

    It’s not about feeling “safe”. It is about the government purchasing things which private markets are incapable of providing. Few of us need more of the crap that we are spending privately with our marginal income.

    And yes, I like to come here and annoy the heck out of you guys.

  182. If my taxes were to go up 5% of my income tomorrow (and they should)…

    The Treasury accepts donations. What’s stopping you?

  183. I always get to the party late.

    It is about the government purchasing things which private markets are incapable of providing.

    Impossible. There is nothing markets can’t provide. It will just cost you.

    Few of us need more of the crap that we are spending privately with our marginal income.

    So says you. But that’s it, isn’t it? You want to everyone to live their life the way you want them to.

    And yes, I like to come here and annoy the heck out of you guys.

    Not so much annoying as amusing, that you guys actually believe the stuff you spew out. Just because DR met a couple healthy young people that haven’t been screwed over by the system (s)he thinks there aren’t people that NICE has told to fuck off rather than pay for medicine that will only extend their live a few years. Just because Diane visited a nice neighborhood in Europe she thinks that all people are better off there. But then she only wants to believe what she dreams up, not facts. The US system is screwed up, the biggest problem being the crooks who are doctors and hospital admins that keep upping their prices on private insurers to make up for the difference between what the gov pays in medicare and what they want and such. The fact still remains that the US has the highest rate of survival for any disease of all countries. We also have the highest availability of and greatest access to modern and advanced techniques and equipment, like MRIs and CAT scans, etc.
    The problem with your socialist solution is that a single third-party payor system does nothing to keep prices down. This is why even France is trying to push people into HMOs, because costs are spiraling out of control. Only a free market can keep costs down. Competition breeds innovation. Companies must keep their prices down to attract customers. If we are to provide assistance to those who can’t afford it, it should be some sort of direct payment for a private plan. We must also allow the individual to be the consumer and take the health insurance decision away from employers. Of course this will raise wages, since employers already count insurance as part of the compensation and if there is a possibility some company will do it all mut do it to attract quality employees. I know there isn’t much as far a specifics here, but there is a char limit and it’s late and I don’t know if anyone will even read this.

  184. If I claim the right to appropriate 5% of your income for what I see as essential for society, what’s to stop me from claiming all of it? Is your life’s effort mine to spend?

  185. Unless Obama’s plan has changed since his campaign (not at all unlikely) he has never proposed taking us off private insurance. The government insurance plan he offered during his campaign is similar to any plan you’d get from an employer: you select from a number of different private insurance companies who give the employer, or in this case the government, preferred rates and/or special coverage packages. While I worked for the government I was insured under Blue Cross/Blue Shield for instance, only I payed about 1/2 of what I’d pay if I got direct individual coverage (that’s including the contribution on the government’s side).

    This is not socialized medicine in the sense of the countries compared in the article. It’s more comparable to Singapore’s system. Obviously it is still in violation of core libertarian principles, but if you’re going to have a debate it is more useful to compare apples to apples.

  186. @sugar: Oh, I don’t understand the logic that drives you to conclude that we’d have to ban all but catastrophic coverage in a single-payer system. There is a root reason why I cannot obtain such coverage voluntarily but I don’t think it has to do with the demand side of things; something is broken on the supply side, and I’m willing to bet it’s regulatory in nature.

    I think our biggest preventable health issues are on the way to fixing themselves through social change, and more than likely cannot be adequately addressed by professional medicine anyway. The current system is likely to collapse under its own (literal, in this case) weight. The question is whether the government will step in and lock the broken system in place with our tax money or step out of the way and have the courage to see what rises from the ashes. So far that kind of courage is in short supply, but maybe our taste as a nation for political cowardice will sour before it’s too late. We’ll see.

  187. mr simple | May 8, 2009, 1:26am | #

    I always get to the party late.

    It is about the government purchasing things which private markets are incapable of providing.

    Impossible. There is nothing markets can’t provide. It will just cost you.

    Ahh, the libertarian vision of us all sitting in our bunkers on a pile of gold and surrounded by lots and lots of shotguns. See, we don’t need no @#$@# gub’ment! We can do it ourselves!

    There is no meaningful distinction between “incapable” and “incapable at any remotely reasonable cost”.

    So says you. But that’s it, isn’t it? You want to everyone to live their life the way you want them to.

    Few Americans are buying “needs” with their last dollars. That is a simple fact, as can be discerned from the mountain of data about the high percentage of “poor” people who own cars, tvs, air conditioners and Nikes. People poor enough to actually be buying food, clothes or shelter with their last dollar would not have their taxes raised under any reasonable plan, or at least would get refunds larger than the additional taxes.

  188. “There is no entity called “society” that has any rights. Which is why all outcomes-based arguments that “society” will benefit from this or that action is pure evil.”

    Indeed so.

    “Society” is nothing more than a term for a collection of individuals. It is not an entity that is accountable for anything or that anyone is accountable to.

  189. Justen,

    @sugar: Oh, I don’t understand the logic that drives you to conclude that we’d have to ban all but catastrophic coverage in a single-payer system.

    The problem lies with the fact that health insurance is not insurance at all.

    Take auto insurance. What does it cover? You hitting something, you hitting someone, someone hitting you who can’t or won’t pay, theft, vandalism, and a few other things. The common thread is all coverage is linked to either someone doing something to you, or (for a higher premium) you doing something (most likely non-deliberately.)

    What does it not cover (and some far out plan or place that does this has nothing to do with disproving my point)? Oil changes, new tires, tire rotation, a worn-out clutch, alternator, engine, a faulty window seal, car washes, new brakes, etc. In other words, routine maintenance.

    Health “insurance” covers routine maintenance, in fact a lot of plans affect every economic interaction with health costs so completely that you never bear or even know the full cost of anything you have done.

    This is the third-party-payer problem. If you don’t bear the direct costs of routine stuff, if someone else is paying, you don’t care how much it costs. In the absence of competition, costs rise. And health expenses become something that no one can pay out of pocket.

    Single-payer can do nothing to solve the third-party-payer problem except by rationing. The standard line is that single-payer can hold costs down, but HMOs are supposed to do that already and don’t. And as for the removal of the profit-motive being the key, I refer back to $400 Pentagon toilet seats. If you can’t get stuff cheaper, you just buy less of it. So either we ration or taxes spiral out of control.

    If people only had true health insurance, coverage for things that are statistically probable and not known future expense (home insurance doesn’t pay for your house to get painted,) then competition would be injected back into the market. People wouldn’t pay, or would shop around for better deals. When they got hit by a bus, or came down with cancer… then insurance would kick in.

    Socialized medicine and its slightly better twin, “single-payer” insurance, would work only under one set of conditions: The complete revocation of demonstrated human behavior. The citizens would have to ignore the economic incentives to ignore health costs and refuse any unnecessary or too costly treatment. Doctors would have to accept lower pay for differing skill and education levels to counteract the lack of competition. The bureaucrats in charge would have to be ethically perfect and have perfect moral judgment. The political cronies up the ladder to Congress would have to be unimpeachable ethically and have complete knowledge of the unintended consequences of their policies. In other words, the “if the right people were in charge” fallacy writ very large over a huge portion of our economy.

    It can’t remember… in this argument, which ones get called utopians all the time as an insult?

  190. It is about the government purchasing things which private markets are incapable of providing. Few of us need more of the crap that we are spending privately with our marginal income.

    What an arrogant prick.

    You don’t get to decide what we need or what we want and then tax us to make sure the government gives us what you think is right.

    Go fuck yourself.

  191. Shikha’s piece is proof that the Private Health Insurance Lobby is reaching the bottom of the barrel of scribblin’ ho’s who will flack for the most expensive health care system on the planet…

    Why do people continue to buy into the fiction that providing a private sector profit margin to the bill paying function is an expression of our “individual liberties”?

  192. “Why do people continue to buy into the fiction that providing a private sector profit margin to the bill paying function is an expression of our “individual liberties”?”

    Why do you think anyone here is likely to buy into the strawman argument you’ve concocted?

    No one claims that the current health care system with all the government mandates and government created cost shifting is a manifestation of individual freedom.

    Making it even less free with even more government involvement will certainly not be doing anything to advance any “individual liberties”

  193. “What an arrogant prick. :”

    Eh, he’s a liberal.

    Par for the course.

  194. kinnath:

    Don’t make the mistake that because we oppose the imposition of a universal solution by the federal government that we actually like or defend the current system.

    I sure as hell don’t. I read what you wrote. Between telling each other to f off there isn’t anything new here, and not even Wal-Mart competing for your healthcare dollar (I sure as heck would not be at the mercy of their customer service around where I live) will fix the issues I outlined.

    You know as well as I that most markets in the USA are anything but free. They’re less regulated, but not free. Healthcare is one of the worst ones, because it’s regulated almost like guns: a random patchwork of contradictory regulations from various levels of government, elected and otherwise.

    Again:

    In no other G8 country do workers face the prospect of being laid off just after finding out their wife is pregnant, their COBRA running out after six months, and paying for the birth of their child with their house. Or cancer. Or try moving out of your insurer’s coverage area with a disabled child. It’s retarded, simple as that.

    Don’t come back with the “healthcare is free for the poor, just don’t pay.” It might be, but if your middle-class existence suddenly finds itself in the middle of a serious disease and coverage canceled, you have LONG way to fall before you’re a street bum with free healthcare and a sub 200 credit score.

    Answer this with a free(er) market solution. I am all ears.

    “Fuck off and die” isn’t a valid answer, either to me, to the “system,” or to the hypothetical victim. Calling me a liberal isn’t the right answer, either, both in terms of applicability or a solution.

  195. Mr. Simple,

    I’ve been traveling to Europe my entire life and I’m 38 years old. When I travel, I always travel as a local and I never stay in hotels, especially American hotels. So don’t tell me I’ve haven’t been in Europe’s poorest neighborhoods. Even the poorest people over there have access to healthcare. That is the point. I have family there and I speak to the locals and my family about government and politics and how things are in Germany and Western Europe in general. Poor people in this country are a hell of a lot worse of than poor people in Western Europe. I grew up in inner-city Chicago. Why don’t you come visit the South Side or the West Side of Chicago? Those types of neighborhoods and living conditions don’t exist in Western Europe.

  196. You don’t get to decide what we need or what we want and then tax us to make sure the government gives us what you think is right.

    But people get to decide for themselves via the democratic process. And most people just don’t see paying taxes as the biggest burden they face.

    Possibly because the people doing the most whining about taxes are the people manipulating the system the most in their favor.

  197. Slutmonkey,

    If you are living in poverty, you are not free! Money gives you freedom.

  198. “But people get to decide for themselves via the democratic process.”

    Nope – that is a contradiction in terms.

    Voting to force somebody else to be subjected to somehthing you want is not “deciding for themselves” – it is deciding for everybody else.

  199. So what form of government would you suggest, Gilbert?

  200. In no other G8 country do workers face the prospect of being laid off just after finding out their wife is pregnant, their COBRA running out after six months, and paying for the birth of their child with their house. Or cancer. Or try moving out of your insurer’s coverage area with a disabled child. It’s retarded, simple as that.

    .
    .
    .

    Answer this with a free(er) market solution. I am all ears.

    First you have to prove that it’s my problem to worry about.

    Why should I care whether or not a poor mother living in a major city has health insurance?

    Why should I care whether or not a poor family in appilachia has health insurance?

    Why should I care whether or not a middle-class dude in the LA basin has health insurance?

    See the whole question of UHC is moot if you can’t prove that I have some legal responsibility to provide those people with health insurance.

    Yes, it is very sad when bad things happen to nice people. But reducing sadness in society is not a legal justification to force people to take care of other people against their will.

  201. The way to have good and safe government is not to trust it all to one, but to divide it among the many, distributing to everyone exactly the functions in which he is competent …

    – To let the National Government be entrusted with the defense of the nation, and its foreign and federal relations …
    – The State Governments with the Civil Rights, Laws, Police and administration of what concerns the State generally.
    – The Counties with the local concerns, and each ward direct the interests within itself.

    It is by dividing and subdividing these Republics from the great national one down through all its subordinations until it ends in the administration of everyman’s farm by himself, by placing under everyone what his own eye may superintend, that all will be done for the best.

  202. “So what form of government would you suggest, Gilbert?”

    I suggest abiding by the one we are actually supposed to have now – A Constitutional Republic.

    Where the only things that can be decided democratically are those that fall within the boudaries of the limited government powers delegated to the federal government as specified by the 10th Amendment.

    Everything else is up to individual, voluntary choice.

    Creating a mandatory participation socialized medicine scheme does not fall within the paramters of any ennumerated power delegated to the federal government by the Constitution and healthcare is most certainly NOT a “right” (there are no affirmative rights.

    So under the legitimate system we are supposed to have, healthcare is just another consmuer commodity that is the responsibility of the individual to deal with.

  203. kinnath:


    First you have to prove that it’s my problem to worry about.

    Why should I care whether or not a poor mother living in a major city has health insurance?

    Why should I care whether or not a poor family in appilachia has health insurance?

    Why should I care whether or not a middle-class dude in the LA basin has health insurance?

    See the whole question of UHC is moot if you can’t prove that I have some legal responsibility to provide those people with health insurance.

    Yes, it is very sad when bad things happen to nice people. But reducing sadness in society is not a legal justification to force people to take care of other people against their will.

    So you’re saying fuck ’em.

    If you’re willing to risk everything you worked for to series of events beyond your control, that’s up to you.

    Truth is, it could become your problem. Even if your and your loved ones’ health stays perfect and accident-free throughout your lifetime, poverty breeds disenchantment and crime. I am sure you also have solutions for that (shoot the crooks, get a gun, etc.), but would you want to have to cap a home invader if you didn’t have to? Do you like having to see your insurance agent every time your window in your car gets smashed in for parking change?

    The point is that it causes other costs to the society you live in. You’re not advocating libertarianism here, you’re advocating ‘fuck everyone’ until, like most people eventually, you need something. Or you’re independently wealthy, in which case the sniveling proletariat doesn’t matter anyways.

    Libertarianism isn’t about no government. It’s about minimal government. “Minimal” is a point we can all argue, but it’s definitely more than “none.” In my mind, ground rules are still okay, like as a condition of running an insurance company you need to offer a plan with no preconditions (say at a percentage of pre-tax income), which is what the German system is like (although being German, there are a zillion rules in the fine print, which I am not a fan of). If you don’t like it, don’t become a medical insurer with greater than some amount of revenue.

    You admonished me on assumptions, yet you assume that you must be a member of a “socialized” system, and that you must pay for others (sounds like all insurance to me). The Canadian system does not force membership in a medical services plan (not in BC or Alberta, anyways). You’re stupid if you don’t join up given what it offers, but you can get private insurance, or none at all, if you want. The German system says that if you’re employed full time you must have insurance, period. Again, if you can find a private plan you like better, go for it.

  204. So you’re saying fuck ’em.

    That’s not what actually I said.

    I said you need to prove I have a legal responsibility to see that those people have insurance before you can demand that I pay taxes to make it happen.

    I didn’t bother to read the rest of your post.

  205. kinnath | May 8, 2009, 9:06am | #

    What an arrogant prick. You don’t get to decide what we need or what we want and then tax us to make sure the government gives us what you think is right. Go fuck yourself.

    It doesn’t take a lot of arrogance to feel superior to the morons that invested trillions in SUVs, McMansions, credit default swaps, train-your-replacement outsourcing, and oodles and oodles of cheap Chinese crap, now does it?

    The government could decide what to spend the money on by having a blind monkey draw potential projects out of a hat, and still completely whoop what the “free market” mananged to come up with. Not surprisingly, the “free market” chose “screw the world, I got mine” short-term consumption.

  206. It doesn’t take a lot of arrogance to feel superior to the morons that invested trillions in SUVs, McMansions, credit default swaps, train-your-replacement outsourcing, and oodles and oodles of cheap Chinese crap, now does it?

    A jealous, arrogant prick.

    The government could decide what to spend the money on by having a blind monkey draw potential projects out of a hat, and still completely whoop what the “free market” mananged to come up with.

    In your worthless opinion.


  207. That’s not what actually I said.

    I said you need to prove I have a legal responsibility to see that those people have insurance before you can demand that I pay taxes to make it happen.

    It is what you said. You have no legal responsibility to do anything but pay taxes on income and property in (most of) this country, so that’s a straw man argument.

    The rest of my text stated you did not necessarily need to pay taxes to make sure others had coverage. This being said, your taxes are already paying for the health care of hundreds of thousands of people, so whether you should or want to is moot; you are already.

    Remember medicare and medicaid? The difference between the prices an uninsured person who could pay and what the government rate table pays for a service is listed (and accounted for, of course) as “charity” by medical companies. Thankfully they don’t do it for corporate (ahem, private insurance) rates. Services provided for those with nothing to collect, are also reimbursed, at a percentage, by government, which is your tax money. Look up “medically indigent” in the regs.


    I didn’t bother to read the rest of your post.

    That says loads about your mentality. Ignoring it won’t make it go away.

  208. “So you’re saying fuck ’em.”

    Nope – refraining from subsidizing somebody else doesn’t count as “fucking ’em” They have no inherent right to any assistance to begin with.

    The only thing that count’s as “fucking ’em” is activily doing something to harm someone.

  209. “Libertarianism isn’t about no government. It’s about minimal government. “Minimal” is a point we can all argue, but it’s definitely more than “none.”

    Well lets see, we didn’t have any government healthcare mandates or government healthcare programs in the year 1800 or 1850 or 1900. I’m pretty sure the government was actually in existence in each of those years and all the ones in between.

    If the government refrains from getting further involved in healthcare now or even if it got completely out of altogether, it wouldn’t count as us having “no government” any more today than it did before it ever got involved in it to begin with.

  210. The rest of my text stated you did not necessarily need to pay taxes to make sure others had coverage.

    Every government mandate is a “tax”. Sometimes the government collects the tax directly (on income or property). Sometimes the government levies an unfunded mandate on a business. The business must cover the cost of the mandate the only way possible — by raising prices. This is a hidden tax. This is the politicians favorite tool, because it doesn’t show up on the government books.

    This being said, your taxes are already paying for the health care of hundreds of thousands of people, so whether you should or want to is moot; you are already.

    Right. I get a chunk of my payroll taken out to cover FICA. It doesn’t matter if it’s right or wrong, I’m used to it so I should just shut up.

  211. It doesn’t take a lot of arrogance to feel superior to the morons that invested trillions in SUVs, McMansions, credit default swaps, train-your-replacement outsourcing, and oodles and oodles of cheap Chinese crap, now does it?

    The government could decide what to spend the money on by having a blind monkey draw potential projects out of a hat, and still completely whoop what the “free market” mananged to come up with. Not surprisingly, the “free market” chose “screw the world, I got mine” short-term consumption.

    Chad provides a nice summary of the liberal philosopy: Free people make bad choices; therefore, the government should make the choices instead.

    Great, except the government is run by “people” who have the same propensity to make bad decisions as the general population. However, when these people make a bad decision, we all pay for it with no recourse.

  212. Remember medicare and medicaid? The difference between the prices an uninsured person who could pay and what the government rate table pays for a service is listed (and accounted for, of course) as “charity” by medical companies.

    When medical providers accept less in compensation from the government than the cost of providing a service, the medical provider shifts the delta cost to the rest of us that have private insurance. Either that or they stop taking medicare/medicaid patients (which is already happening).

    It doesn’t “cost” less to treat medicare/medicaid patients. The “price” is set below “cost” by the government.

  213. That says loads about your mentality. Ignoring it won’t make it go away.

    Since your first point was wrong, any following rebuttal was moot.

  214. “It doesn’t “cost” less to treat medicare/medicaid patients. The “price” is set below “cost” by the government.”

    Yes and increasing numbers of doctors are opting to refuse to accept medicare patients because of that fact and all the paperwork headaches involved. And of course that means increased lack of actual access to care by the medicare recepients. Another cost imposition.


  215. Chad provides a nice summary of the liberal philosopy: Free people make bad choices; therefore, the government should make the choices instead.

    If most people weren’t dumb, would libertarianism work? That’s a nice isoteric debate. But it also is set in a fantasy world.
    Here in reality, most people are simply incapable of making the types of decisions that a truly functional libertarianism would require. For example, I saw a study the other day that found that less than 20% of adults could calculate simple compound interest, which implies that at least 80% of people are incapable of sorting through all the exotic mortgages that were dangled in front of their face.

  216. Here in reality, most people are simply incapable of making the types of decisions that a truly functional libertarianism would require.

    And people call me an elitist prick.

    You want to treat the population as a herd of sheep to be tended.

  217. “Here in reality, most people are simply incapable of making the types of decisions that a truly functional libertarianism would require.”

    Libertarianism doesn’t require any particular qualitiative level of decision making on anyone’s part (which is a matter of opinion anyway) . All it requires is the freedom of the individual to make the decisions for himself.

    No other particular outcome is necessary.


  218. Right. I get a chunk of my payroll taken out to cover FICA. It doesn’t matter if it’s right or wrong, I’m used to it so I should just shut up.

    I never said you should accept it and shut up. If it’s being paid already, it’s fair to ask if it can be spent better, or needs to be spent at all.

  219. Gilbert,

    In that environment, we quickly get to a point where everyone’s self-interested decisions (rational or not) start to conflict. Nobody lives in a sealed-off bubble. Societies evolve, and in the modern civilized world (outside of the U.S.) health care is a universal right. It’s possible and evidently likely that for-profit health care will never be universal or even optimal. Drug companies don’t have an incentive to cure people; they are more incentivized by market principles to only invest in remedies that don’t cure people. Given that people can and do organize themselves to provide certain services collectively, what is the moral problem with having a goal first (i.e., universal healthcare), and organizing either the government or the market or both to provide it?


  220. “So you’re saying fuck ’em.”

    Nope – refraining from subsidizing somebody else doesn’t count as “fucking ’em” They have no inherent right to any assistance to begin with.

    The only thing that count’s as “fucking ’em” is activily doing something to harm someone.

    Fine. Let them suffer in their bad luck, and if their kids grow up to be violent home invaders, you hope that they won’t prey on you, and that their victims have good health coverage. Fair enough, that’s worked well the world over.

    Point is, you’re connected to your neighbors, so live with that. You don’t have to help, and government has no business mandating that you should. You can choose to be a prick, and get even more pissed off when that neighbor won’t help you jump your car in the dead of winter. Just don’t bitch you’re now getting to feel the shit end of the stick.

    Or, heaven help you, you get cancer, and your “lifetime limit” (read your insurance fine print!) runs out. I don’t wish this on anybody, but clearly, you’ve been fortunate enough, because after a couple of years like that, your tone would be decidedly different.

    Insurance as a business is just that. A business for profit, as much as possible. If that price comes at a cost, where do you draw the line? What if your insurance company won’t honor your contract? Sue them? If they can pay to keep you on a legal treadmill long enough to go broke? What now? Won’t happen you say, of course, and fairness be damned.

    You’re right, “fairness” isn’t a human right. Life, liberty, and the pursuit of happiness is, but only if you’re lucky and/or well insured?

  221. So who fucked you over jaydub to make you so bitter?


  222. When medical providers accept less in compensation from the government than the cost of providing a service, the medical provider shifts the delta cost to the rest of us that have private insurance. Either that or they stop taking medicare/medicaid patients (which is already happening).

    It doesn’t “cost” less to treat medicare/medicaid patients. The “price” is set below “cost” by the government.

    Most hospitals take Blue Cross even though they pay less than medicare/medicaid for some services. True, it may be easier to get paid, but it’s still net 90 paid in over 180 days. Both the private companies and medicare/medicaid are massive, massive bureaucracies, and government has the power to change only one.

    Oddly, the uninsured that are able to pay pay more than either, even if it’s cash up front. I know, I know, their problem – if they’re bleeding out after a traffic accident, they have time to decide who has the best prices or fair pricing schedules. Yep. Gotcha. Not your problem.

    You get the best prices in health care, or have been fortunate not to need this stuff?

  223. You’re right, “fairness” isn’t a human right. Life, liberty, and the pursuit of happiness is, . . .

    You were right up to this point.

  224. “I saw a study the other day that found that less than 20% of adults could calculate simple compound interest, which implies that at least 80% of people are incapable of sorting through all the exotic mortgages that were dangled in front of their face.”

    And they sure as hell cannot understand their 45 page health insurance policy. They have no idea that the meaning of the exclusions for treatments deemed “not medically necessary” or “experimental” will be unilaterally determined by the insurance company on an ad hoc basis.

    On a broader level, it is no surprise that the gap between rich and poor is growing. The majority of the people are stupid, and they are easy prey for the cunning.

  225. “Fine. Let them suffer in their bad luck, and if their kids grow up to be violent home invaders, you hope that they won’t prey on you, and that their victims have good health coverage.”

    Ha!

    Spare the creakly old liberal theory about poverty being the root cause of crime.

    Just like every other liberal theory about anything, it’s never been proven to be true.

  226. “Point is, you’re connected to your neighbors, so live with that. You don’t have to help, and government has no business mandating that you should. You can choose to be a prick, and get even more pissed off when that neighbor won’t help you jump your car in the dead of winter. Just don’t bitch you’re now getting to feel the shit end of the stick.”

    The fact that I oppose government mandates has nothing to do with whether I choose to help my neighbor do something or not.

  227. I’m not sure I understand the reasoning, but the point seems to be that the inefficiency of the US health care system is what boosts the US economy. The spending on health care in other nations was
    – Canada spent 9.8% of GDP (2005)
    – Finland spent 7.5% of GDP (2005)
    – France spent 11.2% of GDP (2005)
    – Germany spent 10.7% of GDP (2005)
    – Japan spent 8.2% of GDP (2005)
    – the Netherlands spent 9.2% of GDP (2005)
    – Sweden spent 9.2% of GDP (2005)
    – the United Kingdom spent 8.2% of GDP (2005)

    And the source reports:
    – the United States spent 15.2% of GDP (2005)

    So, the US GDP is nearly 7.5% larger than Finland because the US spends an excess 7.5% of GDP on health care than if the US used the more efficient Finish system. But the US should be only 4% larger in GDP than France because its health care is the second most inefficient and has thus already bloated their health care costs to boost their economy.

    I wonder, shouldn’t we likewise seek to involve the US government into the auto industry is the same way to make it more inefficient to boost the economy? How about requiring all employers to recognize unions and encourage them to be really conservative in their adoption of new job methods, new technology, etc.

  228. “You’re right, “fairness” isn’t a human right.”

    And what constitutes “fairness” is in the eye of the beholder.

    You haven’t accomplished anything that proves your particular opinion on what constitutes “fairness” is in any way superior to mine.

  229. The propaganda war against UHC will play on the fear that government bureaucrats will intercede in the health care decisions of doctors and patients and that the bureaucrats will deny lifesaving procedures.

    Will that work? Aren’t people smart enough to realize that health insurance companies intercede in decisions between doctors and patients everyday and that insurance company clerks routinely deny people lifesaving procedures by claiming that a particular treatment is “not medically necessary” or is “experimental”? (And that’s if they cannot rescind the policy entirely by hiring an investigator to pore over the insured’s health history in an effort to find some malady he or she didn’t disclose on his or her application–like acne, depression or a yeast infection).

    Will government insurance be any better? At least the government bureaucrat won’t be enticed to turn down my claim because he will be rewarded with a year end bonus for doing so. I don’t want his self-interest to play a role in this particular decision. Do you?


  230. Now what? Access to what? Somewhere the rubber meets the road. This is why Canada sends so many patients to the U.S. Canada doesn’t have the facilities to cover all their healthcare needs. If you grant 100 million people 100% access to fifteen NICU’s, someone’s gonna end up in a very long waiting line.

    For one, Canada does not have a national system per se. It’s handled by the provinces, and meeting a standard of care is required to get access to federal money for provinces that don’t have the plan or tax revenue to cover those expenses. Kind of like those disagreeable federal highway dollars down here.

    Some provinces send patients to US hospitals for elective, not life saving, surgeries because they can negotiate a better deal with those US hospitals as a private payer than it would cost to do so within their system. Free markets, after all. If you’re not eligible to enter the United States for some reason, you get the elective surgery in your province. “Elective” means you could not convince your doctor that you’d die if you didn’t have it. Sure, you can find extreme oversights in any system, but that’s 99% of the cases.

    You make it sound like Canadian ambulances regularly drive across the border, full of injured Canadians from recent traffic accidents that cannot be taken care of.

  231. This post from someone else on another board sums up our present problem well IMO:

    1. Work hard for decades — putting away as much as you can.

    2. Pay for the best health insurance your employer(s) offer. Year after year. The premiums keep going up but so what? You may need it someday.

    3. Get diagnosed with cancer.

    4. Boy you’re sure glad you have good private health insurance. Fight with the insurance company every step of the way to get the treatment you and your doctor think you need. But the accountants that are in the loop are always sure there is a cheaper option available and they want you to take it. After a lot of fighting you get through chemo. The doctor’s office has a full time person on board that does nothing but argue with the insurance companies and hopefully free up enough of the doctor’s time to practice medicine. BUT AT LEAST THEY AREN’T GOVERNMENT BUREAUCRATS.

    5. Your present employer goes out of business. Nothing you can do about it the economy sucks. COBRA isn’t available in this case. The insurance company dumps you — and no insurance company will take you on at any price even if you get a new employer. The reason is your cancer has an 80% chance of coming back.

    If you are thinking of paying for chemo out of your own pocket (remember you saved up in step 1) learn that it costs about $30K to $50K per treatment. The insurance company that was paying it pays less than half that because they have bargaining power. You don’t.


  232. Jaydub, can you give us a percentage of insured people of which this happens to?

    According to the studies quoted around here, nobody. But google is your friend.


    All in all, I prefer a system of private insurance over a national health care plan.

    Me too, but the gremiums in charge at the insurers here give crappier-than-government service at private sector prices.

    Only people trying to spin this as a bad idea based on dogma, and people who don’t know what they’re talking about (the left) are saying nationalizing. There are ways this can be done, and has been done, using the private sector.


    National health care plans cause overusage of the system and therefore high taxes which stagnate the economy with chronically high unemployment and rationing to cut down on those high costs caused by the overusage of the system.

    In theory, that’s true. But then again I spend an inordinate amount of time managing my own care, and would probably better off making money instead. Sadly, I can’t find anyone to outsource this to that’s not grossly incompetent.


    Also, to cut down on costs, research and development is cut back. Why do you think more new medicines come from the US? If we go to a national health system, who’s going to be creating all the needed new medicines and technology?

    There more medications patented here, but not developed here. Their marketing departments will have you believe otherwise though.

    This might frighten you, but there aren’t that many pharmaceuticals outside the startup phase headquartered in the USA anymore. According to Wikipedia (I know, but I have real work to do), 4 out of the world’s top ten are U.S. based. Most have significant presences in the welfare states you so despise, because they have a great deal of access to research funding there, plus a massive cadre of professional students to leech off of. I used to work there, doing that.


  233. “Fine. Let them suffer in their bad luck, and if their kids grow up to be violent home invaders, you hope that they won’t prey on you, and that their victims have good health coverage.”

    Ha!

    Spare the creakly old liberal theory about poverty being the root cause of crime.

    Just like every other liberal theory about anything, it’s never been proven to be true.

    Nice to be called something other than right wing for a change.

    Poverty is a factor. By no means the only one, but it’s a factor. Madoff aside, there aren’t many rich people in prison, which would lead one to the conclusion that they can either afford to buy the system, or don’t commit crimes.

    A friend of mine wrote his PhD in Demographics on the number of times a dollar circulated within an identifiable community, and that relation to the average wealth over generations. Interesting stuff. Stats can be twisted though, as we all know.


  234. I’m not sure I understand the reasoning, but the point seems to be that the inefficiency of the US health care system is what boosts the US economy.

    Yep. More five year plans, I say!

  235. Gilbert Martin | May 8, 2009, 5:20pm | #

    And what constitutes “fairness” is in the eye of the beholder.

    So are liberty, the pursuit of happiness, and even life.

    As I mentioned earlier, the problem most people have with libertarianism is its very narrow (but “pure”) concept of liberty.


  236. “Point is, you’re connected to your neighbors, so live with that. You don’t have to help, and government has no business mandating that you should. You can choose to be a prick, and get even more pissed off when that neighbor won’t help you jump your car in the dead of winter. Just don’t bitch you’re now getting to feel the shit end of the stick.”

    The fact that I oppose government mandates has nothing to do with whether I choose to help my neighbor do something or not.

    Love your selective quoting there, Gilbert. Thankfully you included my statement that clearly says I agree with you.

    But some posters probably don’t stop to help people with broken down cars, even just to get them off the road (choosing to honk instead) or volunteered a day in their life. That doesn’t make them bad people, but usually those are the ones that are “me first” navel gazers.

  237. You want to treat the population as a herd of sheep to be tended.

    The fact is that they largely are. That is why your ideology flops every time it is even remotely attempted.

    If I had a nickel for every psychological study that has demonstrated large portions of people behaving irrationally, I’d be set for quite a long while. And it only gets worse when all the externalities inherent between us, and between current and future generations, are involved.

  238. So ask the libertarians this:

    Now, if you had the option of getting a health plan for some percentage of your pre-tax income, that could not turn you down, as an OPTION, would you think about taking it?

    If it covered your household (as in spouse and cohabitating kids), would you do it then?

    What if, just say, you chose private instead, as in “opted out” because of better services or lower prices, should the public system have to take you back?

    Just thoughts.

  239. Now, if you had the option of getting a health plan for some percentage of your pre-tax income, that could not turn you down, . . .

    That wouldn’t be insurance. That would be welfare.

  240. You want to treat the population as a herd of sheep to be tended.

    The fact is that they largely are.

    At least you’re a transparent, jealous, arrogant prick.

  241. At least you’re a transparent, jealous, arrogant prick

    I am not jealous.


  242. kinnath | May 8, 2009, 7:34pm | #
    Now, if you had the option of getting a health plan for some percentage of your pre-tax income, that could not turn you down, . . .

    That wouldn’t be insurance. That would be welfare.

    I suppose if you consider welfare a voluntary alternative to homelessness, sure. You sign up for it if you think you need it. On the other hand, as a percentage as a service would go farther than your income tax does as a service to you today.

  243. “Nice to be called something other than right wing for a change.”

    I don’t know whether you’re a full blown liberal or not.

    What I said was the theory that poverty is the root cause of crime is a liberal theory.

    And so it is.

    And, like I said, it hasn’t been proven to be true.

  244. I have tried to post this several time and all I get it a blank page and nothing more. Completely reloaded so here goes again.

    “On nearly every economic front, their performance has been worse than America’s-even, surprisingly, in controlling health care costs.”

    Why was this surprising? It always takes more energy to carry ballast. I understand that some horse races are handicapped by adding ballast to even out the difference between the better of two horses. Besides this, when did insurance become a cost cutting measure. It is to spread risk rather than cut cost. Neither can government “insurance” reduce the liability against that insurance. Private insurances have liabilities so they must charge enough to cover the risk and make a profit. Do you know a different way that is workable?

    We are being misled by what insurance can and cannot do. Of course, a liar will always lie to his presumed advantage. He will not lie to provide an advantage for me. We should take a more comprehensive look at who this universal health care is going to benefit. It should be a forgone conclusion that the government is not really concerned about my well being so we need to look elsewhere to find motives.

    There are many stories of medical corruption and this is an open invitation to more corruption, not less. Don’t take my word, do your own research without jumping to convenient conclusions. The truth will always be covered as much as possible.

    The government tends to favor those who control the government and not those who are under government control. Probably enough said If what the government claims about health were true we would never have survived to this point.
    Whit

  245. Even die hard non-realists arguing against reform in the health services industry are no longer arguing that our current system works in any meaningful FINANCIAL way. Instead they’re reverting to scare tactics, (you know the thing that sold us on so many outrageous and un-American things like TORTURE) and are warning people that they won’t get health care IF there’s universal health care. Time for a reality check, in addition to the uninsured we have those who cannot afford treatment once they get that yearly freebie checkup. Stop the stupidity and first DEMAND that your go it alone types OPT OUT OF GOVERNMENTAL HEALTH BENEFITS for civil servants at the state, local and federal level. These benefits are cheaper and better than anything an ordinary citizen has an option of selecting. SKIN IN THE GAME as your types are prone to sell requires non participation in this expensive perk for our civil servants.

  246. “You want to treat the population as a herd of sheep to be tended.”
    “The fact is that they largely are.”

    Anyone who doubts that the majority of people are not sheep doesn’t know much about social psychology, from Milgram’s obedience experiments and Asch’s conformity studies to studies on the authoritarian personality. Throw in the many studies over decades on IQ and the ability to think critically and you get the true picture.

    Case in point. Recall the poll taken about the time of the Iraq invasion (after months of very clever propaganda by the Administration) that showed that the vast majority of Americans (around 70%) believed that Saddam was behind 9/11. The result was even higher among members of the military–90% or more, as I recall.

  247. Sigh. Polls are not people. They are averages. People have opinions for all kinds of reasons. One person’s reasons rarely have more value (that is, more likely to produce an objectively correct judgment) than another person’s, despite the fact that the first person may believe themselves to be “educated” by getting prejudices from college instead of a job, from watching Jon Stewart instead of Letterman, etc.

    This is a roundabout saying that if you think people are sheep, you’re absolutely right, starting with you.

  248. “. . . by getting prejudices from college instead of a job. . . .”

    Them eggheads.


  249. Gilbert Martin | May 9, 2009, 12:09am | #
    “Nice to be called something other than right wing for a change.”

    I don’t know whether you’re a full blown liberal or not.

    What I said was the theory that poverty is the root cause of crime is a liberal theory.

    And so it is.

    And, like I said, it hasn’t been proven to be true.

    None of my friends have had their muggers drive off in Porsches, or bother to wear an Armani suit. And few people, again, except Madoff, who are in jail, are what you would call rich (say, more than one generation in an upper tax bracket).

    You’re using a straw man once again anyways, because you’re selectively quoting me into absolutes.

    Poverty is one of many factors, and you can argue how all these come to be. Disenchanted people are more likely to say “fuck it” and roll someone. Does poverty cause crime in and of itself? Certainly not, and I never said so. But most crimes (stock fraud excepted) are (generally) less common in higher income zip codes than lower income ones.

    If you have stats (as in, per 100,000, not subjectivist blabber) that say otherwise, feel free to counter.

    So I say, figuring out something workable to reduce the families pushed into poverty because of illness is worthwhile. You’re paying the taxes for others’ crap service already (unless you’re really libertarian), and as tax payers we would be irresponsible (or sheepish at the very least) not to ask if that money can’t be spent better, or is better off not being spent in the first place.

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