In Anticipation of Gov't-Run Health Care…

Columnist Ron Hart writes:

To quote P.J. O'Rourke, "If you think health care is expensive now, wait 'till it is free."

After regulating into submission the auto companies, banks and Fannie Mae (thus giving the Federal government large stakes in all of them), the Dems now plan to use their magical business prowess on one-seventh of our economy, the best health care system in the world.  At long last, our banking, car manufacturing and health care will be as efficiently run as [AMTRAK], the DMV, the Property Assessor's Office and the Post Office….

In a year when Fed Ex and UPS made billions and paid taxes, the United States Postal "Service" lost $2.4 billion. What makes the loss more interesting is that most of that money was lost in the mail.

Since there is little demand for their "service," the USPS has now raised the price of a stamp to forty-four cents in response.  Our government will apply the same logic to Chrysler and GM upon gaining control of them. If the 2012 Cobalt does not sell at $13,000, the government will simply raise the price to $92,000 and eliminate two of the cup holders….

As Fed-Ex and UPS have proven in package delivery, free market competition is the answer to affordable health care in America. If health care consumers were allowed to shop for their services, had to pay for it directly, and really understood the pricing, the system would fix itself by sorting out the winners and losers.

Whole thing here.

Comments

[classwarrior]

Let's see, the "best health care system in the world" costs more in both relative and absolute terms than any other, trails many nations in life expectancy and infant mortality, leaves nearly 50 million uninsured, with more than 700,000 personal bankruptcies per year due to medical bills (most of whom were privately insured). Heckuva system!

[Face the Muzak]

If you want an example of just how good the government will be at running health care, just look at the public schools in Washington, D.C.

[John]

The problem is that the government isn't very good at controling costs. If I run a business and my employees are stealing, I will go out business. But if someone is stealing from the government, the government goes merely on. The market eliminates crooked businesses. Since the government can't go out of business, the market can't eliminate crooked government programs. To compensate, the government has to hire bureaucrats to make sure the money is being spent properly. It then has to hire more bureaucrats to make sure the first group is doing their jobs and so forth.

Government run healthcare is going to sky rocket costs and reduce service. To keep from being ripped off, the government is going to have to hire a bureaucracy to monitor everything. Once it does that, it will have to cut services to feed the bureaucracy. Healthcare will end up like innner city schools with "administrators" and "auditors" making huge sums of money in a system that somehow can't provide basic services despite eating up one quarter of the GDP. But, it will be great for the public employees unions and give politician the authority to control people's lives.

[Face the Muzak]

" 700,000 personal bankruptcies per year due to medical bills"

[citation needed]

[Seward]

Does the U.S. really have the best health care system in the world? From all indications, is not all that better or worse than that found in other industrialized nations, the one difference being that we pay a lot more for than they do for that level of performance.

Anyway, the government is already heavily involved in the health care market; be it in the form of state and federal mandates, tax incentives, and direct outlays of government funds. I'd guess that 50%-75% of U.S. health care treatment has the government's finger in it somehow or another.

This is not a defense of government run healthcare; far from it.

[Face the Muzak]

"leaves nearly 50 million uninsured,"

More bullshit. The number frequently thrown around was 47 million. That was recently reduced to 46 million. To call 46 million "nearly" 50 million is disingenuous.

It's also worth noting that the 46 million isn't the same group of people living without health insurance for years on end, a good chunk of that number is folks in transition and young adults who simply do not want to pay for insurance.

[Seward]

John,

Since the government can't go out of business...

Well, governments can go out of business. Somalia's did.

Side note: recently I learned that Somalians are doing better without a central government than they did under one.

[robc]

Face the Muzak,

He cant cite it because it is a lie.

~50% (which may be 700k) of personal bankruptcies have health insurance debt as part of their debt. That may be $10 or $100,000. In most cases it is a very small part of the debt. Credit cards and etc take most people down.

[John]

"Let's see, the "best health care system in the world" costs more in both relative and absolute terms than any other, trails many nations in life expectancy and infant mortality, leaves nearly 50 million uninsured, with more than 700,000 personal bankruptcies per year due to medical bills (most of whom were privately insured). Heckuva system!"

Not like you will listen, but I will engage the troll on this one. First, our life expectancy is lower because of lifestyle choices such as eating too much, doing drugs and shooting each other that have nothing to do with our healthcare system. No healthcare system is going to keep someone who weighs 300lbs and has 240 cholesterol by the time they are 40 alive as long as some Japanese person who has 8% body fat and 140 cholesterol. In the same way, no healthcare system is going to stop young black men from shooting each other. Those things drive life expectancy.

Second, our infant mortality rate is higher because we save more babies. Children that are called still born in Europe and the rest of the world, go in incubators and live here. But since a lot of premis die, we get stuck with having a high infant morality rate for our trouble. But it does give nitwits like you a chance to commit a bit of sophistry.

Third, the US survival rates for cancer and other terminal diseases are much higher than anywhere in the world. In addition, the US is ht engine that drives medical research. Our for profit system has saved millions.

Lastly, many uninsured are that way because they choose to be. I was uninsured for several years in my 20s. I was young, in school, didn't have a lot of money, and made the choice to chance not having health insurance. Those numbers you give include people who have made the rational choice not to have insurance. I will take those numbers over the filth, wait times and general incompetence of the systems in the UK and Canada. Most importantly, I will bear any burden rather than have people like you controlling my access to healthcare.

[grimaldius mensch]

" 700,000 personal bankruptcies per year due to medical bills"

[citation needed]

Mikael Moore told him so

[Seward]

Face the Muzak,

Well, because mandates, regulation, etc. significantly increase the cost of insurance, younger people tend to opt out of insurance to avoid the "tax" they would otherwise have to pay as a result of those mandates, etc. So much of the non-adoption is a perverse result of government policies jacking up the prices of health insurance.

[John]

Whenever you are dealing with the current Democratic Party, you need to look at an action from the angle of "how does this allow the baby boom to steal from the young?". What BO is going to try to do is force everyone to buy government health insurance. To work any health insurance plan must have healthy people paying in to pay for the unhealthy. What BO plans to do is force young people to buy gold plated health plans from the government. This will allow the baby boom to further steal from the young. That is usually what it comes down to these days.

[robc]

Seward,

Yep, a lot of 20-somethings would buy a bare-bones, high-deductible, dirt-cheap policy if their state allowed it.

I had one back in my 20s, before KY changed their law and made my policy illegal.

[Seward]

BTW, Cato had a few months ago a roundable on the issue of what health system performs best and I believe the general consensus was that the U.S. system wasn't superior generally speaking, but was much more expensive.

[Face the Muzak]

Thanks in advance to bookworm:

bookworm | May 21, 2009, 8:52am | #

Who are these 50 million uninsured?

The US Census Bureau estimated in 2007 that there were 45.7 million uninsured.

Almost 18 million of the uninsured make more than $50,000 a year. They are usually relatively young and don't feel the need for health insurance. They would rather spend their money on other things. Why should we, the tax payers pick up the tab for these people who can afford to pay for health insurance on their own?

10 million of the uninsured aren't American citizens.

As many as 14 million are low-income and already covered under Medicaid or SCHIP but for whatever reason have not enrolled in these available services.

Doing the math, that leaves 5.2 million. Doesn't it make more sense to reform the health care system to make it more competitive to bring down prices of health care and insurance so more people can afford it rather than to put our country on a socialized medicine program that has been a big failure in every country it's ever been tried? We need to undo state mandates that have driven up the cost of health insurance. More states need to allow lower priced catastrophic policies. People need to be allowed to purchase insurance across state lines. We need reform of tort law. We need a voucher program for the poor. There are lots of things we can do to make health care more competitive and lower priced without adopting a disastrous socialized medicine system.

[robc]

I think auto insurance is a good example. Low income people with a crappy car will buy the least insurance they can legally get away with. Collision only and hope they dont damage their own car. Of course, some drivers try to get away without insurance too.

Same thing for health care, only the equivalent policies arent legal.

[Seward]

John,

Well, you are going to have avoidance problems with that just like you do with mandatory car insurance; and that will of course require the state to create a bureaucracy to check up on your health insurance status.

[spambot]

"My oldest child plans to use her summer vacation from Vanderbilt to intern for Republican Senator Saxby Chambliss."

Sigh. Knocks head against wall. If you are trying to convince people who are not died in the wool Republicans with your article I can't think of a worse sentence to start it off with. You just lost all of them there.

We are so screwed if this is the opposition.

[John]

"Well, you are going to have avoidance problems with that just like you do with mandatory car insurance; and that will of course require the state to create a bureaucracy to check up on your health insurance status."

But insurance doesn't reduce costs. It just determines who pays. If I get sick and have a $100,000 medical bill, it really doesn't make any difference to the system at large if that bill is paid by the insurance company or paid by the hospital and passed on to the insurance companies in the form of higher costs. True, I am not kicking into the pot by paying insurance rates. But so what? Insurance premeniums isn't the only way I can contribute. You could make a portion of my health costs inelligible for bankruptcy protection. You could do lots of things besides require me to buy insurance and all of the bureacracy and cost that entails. People act like insurance is somehow free healthcare and it is not. From a systematic point of view, insurance just determines who pays, not how much is paid.

[Seward]

John,

Well, the ultimate problem may be that we have locked ourselves into a system of healthcare payments that may have made sense when the vast majority of treatments were things like broken bones, but does not make any sense when more and more healthcare costs are associated with the problems of old age. A lot of the room for innovation has been sucked out of the air as it were by the ever increasing level of government intervention in this area.

[Face the Muzak]

"but does not make any sense when more and more healthcare costs are associated with the problems of old age." Someday, the last baby boomer will die. That will be a glorious day.

[Isaac Bartram]

Someday, the last baby boomer will die. That will be a glorious day.

Yes, but we will have stolen all that money that was saved up in in the Social Security Trust Fund, so there won't be any left for the rest of you.

HaHa. Tough luck, young'ns.

[classwarrior]

Face The Muzak/ robc:

http://www.msnbc.msn.com/id/6895896/

Are you just as skeptical about claims made by Reason writers? robc- I think this is a second time you've called me a liar without citing your own proof. Learn some manners!

[John]

"A lot of the room for innovation has been sucked out of the air as it were by the ever increasing level of government intervention in this area."

And don't underestimate the effect of the AMA and the medical professional cartels. Private companies like CVS and Wall Mart could do a lot to provide affordable basic care but are prevented from doing so by the cartels. Long term, the way to reduce costs is through investment in capital. You need to develop machines that can do the day to day grind and diagnostic work of doctors. You also need to develop communications systems that allow PAs and nurses to do more work with patients under the supervision of a centrally located doctor. Those are the things that actually reduce the cost and improve the efficiency of healthcare. Figuring out ways to let nurses and PAs be as productive as doctors.

[phalkor]

It's going to be awfully scary how old, diseased, and entitled the next generation of retirees will be. I may have to become actively disrespectful to seniors as a result. Due justice for how I was treated as a teen.

Muffins.

[classwarrior]

Speaking of citations and proof, John do you have any peer reviewed studies to show that life expectancy differences are soley due to the American lifestyle? Furthermore, in my book a "health care system" includes public health care measures designed to improve public health generally. Finally, I'm Canadian, but my wife is from MN, has been treated under both an HMO and the Canadian system. She very much prefers the system here.

[Joe_D]

It's been a while since I studied healthcare systems, but I'm interested to learn more. With all the conflicting politicized garbage that gets tossed around, I don't know where I can find a reliable source of information.

Can anyone recommend some good sources from non-political-hacks? I'd like to understand how our mixed system compares with gov't run systems and how free-market folks envision a solution.

Thanks.

[John]

"Furthermore, in my book a "health care system" includes public health care measures designed to improve public health generally."

What exactly will those measures be? We really have gotten to the nub of the issue here. Goverment healthcare is and always will be about controlling people. Once the government pays for my healthcare, people like you get to tell everyone how to live and what they can and cannot do. While that thought no doubt gives someone like you an orgasm, it frankly scares the hell out of me.

As far as US life expectancy, where are you studies that say lifestyle choices don't affect life expectancy? Further, black men in this country under the age of 25 have a higher violent death rate than men under the age of 25 had in America during the second world war. Every time an 18 year old black male dies in a drive by, our life expectancy takes a hit. The high murder rate in this country is self effident. So also is our high obesity rate. And this country has large populations of African Americans, Hispanics and Native Americans who are genetically pre-disposed to chronic diseases such as alchoholism and diabetes that greatly reduce our life expectancy. Indeed, white people generally live about 4.4 years longer than black people.

http://www.medpagetoday.com/InfectiousDisease/PublicHealth/5271

[spambot]

"Finally, I'm Canadian, but my wife is from MN, has been treated under both an HMO and the Canadian system. She very much prefers the system here."

Canada's system is run like an HMO in that it rations care to cut costs. Major differences are that you can not sue the government (maybe you can LOL but good luck) and if you don't like it you don't have anywhere else to go. In the states I pay the extra $5 a month for a PPO instead of an HMO because I want more choice. Problem fixed.

We like your Canadian system here in Atlanta. Emory University Hospital is loaded with ex-pat Canadian docs who got fed up with the crappy system in the great white north and moved down here to work.

[TrickyVic]

"""But insurance doesn't reduce costs. It just determines who pays. """

Exactly. It determines who pays the higher costs. As long as we have a system that is willing to pay higher costs, we can't reduce costs. HMOs were intended to reduce costs, they were hated.

""" Private companies like CVS and Wall Mart could do a lot to provide affordable basic care but are prevented from doing so by the cartels.""""

like theses

[TrickyVic]

I'll try that again.

like these

[onparkstreet]

Who has the best healthcare?

Define best 🙂 Everyone's got a different definition, if you think about it, except for the whole, "I'd like to live a long time," part.

*classwarrior, the CDC website has a section on infant mortality and the difficulties in using that metric.

[JB]

Healthcare from the TSA. Look forward to your anal probe every doctor visit.

It's easy to fix healthcare and the Democrats are not serious about it. If they were serious they would propose actual reform. How about capping salaries for any healthcare worker (doctor, nurse, hospital administrator) at $30,000 a year? They can sacrifice for the greater good.

I'm sure that will solve all problems.

[who cares?]

This is a great illustration of how there are two ways to argue on behalf of limited government/the free market, or really for any political perspective.

1) it works better
2) it's morally preferable

I find it's usually easier to adopt the latter, and this is a prime example. So, I don't give a damn if our system is expensive, produces lower life expectancies, etc.

The state just doesn't have a right to interfere in my health care. Certainly not any more than it already does.

[spambot]

"We really have gotten to the nub of the issue here. Goverment healthcare is and always will be about controlling people. Once the government pays for my healthcare, people like you get to tell everyone how to live and what they can and cannot do. While that thought no doubt gives someone like you an orgasm, it frankly scares the hell out of me."

Indeed. What cracks me up is folks like me are called "market fundamentalists" and "slaves to idiology" when the reality is those who are in favor of government run health care are the ones who are basing their opinion on the ideology that healthcare is a right that the government should provide. It doesn't matter whether it works, that is just the way it should be.

I am not a slave to ideology, I am just greatly opposed to ideologys which I know do not work and at best cause more problems than they solve. One does not even have to look outside the US. Tennessee decided to adopt Hillary Clintons plan from 1994 lock stock and barrel for their state and it has been a disaster.

http://www.opinionjournal.com/editorial/feature.html?id=110005987

[TrickyVic]

John | May 21, 2009, 11:26am | #

"Furthermore, in my book a "health care system" includes public health care measures designed to improve public health generally."

What exactly will those measures be? We really have gotten to the nub of the issue here.

AMA PQRI 2008

Take Care New York

[phalkor]

Every time an 18 year old black male dies in a drive by, our life expectancy takes a hit.

Taken out of context, that statement reads as if Americans share a collective life force that is being constantly diminished by drive bys. Maybe I'm nutty.

Of all the potential governmental collossal waste of resources and powerful intrusion into my personal affairs, health care is by far the scariest. Too many are comfortable with ever-increasing dependence on the state.

[P Brooks]

But insurance doesn't reduce costs. It just determines who pays.

Exactly.

[TrickyVic]

Insurance is scheme that uses money from people not using the service to pay for those who do.

If you want real market rate health care, keep the government out of it and eliminate insurance. If a doctor charges $150 for a visit and no one can afford it, the doctor would need to lower the price. If you can't afford it, too bad. Which sums up why we will never have market rate health care.

[P Brooks]

How about capping salaries for any healthcare worker (doctor, nurse, hospital administrator) at $30,000 a year? They can sacrifice for the greater good.

And think how much they'd save in taxes, if they were making less than $250k!

[spambot]

" Too many are comfortable with ever-increasing dependence on the state."

Agreed, we lost enough ground in the past 8 years with folks rolling over their rights in the name of "security". Why is anyone shocked that this is happening. What is hilarious is that they are trying it when the country is on the verge of bankruptcy.

[Anonymous]

I believe both the US and Britain/Canada have it wrong. It is quite possible that with deregulation etc the US could provide a better service than it does presently. Certainly our British system is one giant bloated beaurocracy that eats funding, but I'm not ultimately averse to the idea of some form (namely the scandinavian form) of universal healthcare. I do admit I need to look at the issue more and I'd like to see the results of a more free market system before I commit myself.

[Anonymous]

Second, our infant mortality rate is higher because we save more babies. Children that are called still born in Europe and the rest of the world, go in incubators and live here. But since a lot of premis die, we get stuck with having a high infant morality rate for our trouble. But it does give nitwits like you a chance to commit a bit of sophistry.

QFT. Also, we count babies born even if their chances of survival are below average. To wit:

First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country.

Yeah, some people would call that "genocide." In Europe, it's just government business.

[Lost_In_Translation]

Things that are cheap:

flu shots, physicals, aspirin, cuts, small bruises, routine dentist cleaning (maybe $150 outlay once a year)

Things that are not cheap:

cancer treatment, heart bypass surgery, c-sections with epidurals, life saving invasive surgery to keep a man with many bullet holes alive.

The insurance system should be hailed by the least well among us. It allows them to take on enormous amounts of debt to keep their barely functioning body alive without the cost of slavery (congrats to BK laws). The sob stories about people that can't afford cancer treatments should be viewed from a historical perspective. 100 years ago, their cause of death would have been "sickness unknown" or something minor.

We're just a bunch of whiners.

[T]

We're just a bunch of whiners.

How dare you denigrate my 1st Amendment rights like that! I have the right, nay, the sacred duty as an American to petition my government for redress of grievances. Never mind that the government had nothing to do with my grievances and has no enumerated power to address them. I'm by god going to exercise my protected rights! If it comes across as whining, you should read the words of the Founding Fathers and reconsider your point of view, bucko!

[robc]

classwarrior,

http://content.healthaffairs.org/cgi/content/abstract/25/2/w74

17% != 50%

[robc]

Learn some manners!

Go fuck yourself with the lying Harvard researchers.

[Brett Stevens]

More bureaucratic regulation is always a productivity-killer.

Bureaucrats believe in control rules, not reward and demerit on the basis of performance.

Another sign our society is dying...

[DBN]

You need to develop machines that can do the day to day grind and diagnostic work of doctors.

John,

You must be joking. Sure, you can automate a diagnostic algorithym, but if you know to gather the appropriate information FOR the algorithym, you already know the algorithym yourself.

In any case, diagnosis is not even a major part of the "day to day" grind of primary care; most conditions are either healthy or carrying previously diagnosed condtions. Roughly a third of of visists in many primary care practices are for psychiatric issues.

Maybe you should follow a doctor around his/her clinic for a few days, and see what we actually. You seem to think that physicians are assembly line workers or technocrats.

Anonymous,

All the countries in that US News and World Report article use the W.H.O. defintion, which defines as live birth any infant showing independant signs of life, irrespective of degree of prematurity or weight.

[DBN]

Another sign our society is dying...

Yes. Look at what universal healthcare has done so Switzerland. Cheer up, Chicken Little.

[Lost_In_Translation]

It's algorithm

[Face the Muzak]

Members of Congress under investigation:

http://www.citizensforethics.org/files/20090520%20-%20Members%20of%20Congress%20Under%20Investigation.pdf

[Lost_In_Translation]

Switzerland has less people in it than Virginia, the highest (sales and property) taxes in continental Europe, strong border controls with a people that mostly share common heritage.

...but sure, we can pull off what they've got...

[Face the Muzak]

"Face The Muzak/ robc:

http://www.msnbc.msn.com/id/6895896/"

Do you have a copy of the survey questions?

There are lies, damned lies, and statistics
- Benjamin Disraeli

[Anonymous]

but if you know to gather the appropriate information FOR the algorithym, you already know the algorithym yourself [sic]

Which means one is qualified to digitize it, which improves the tools available to every poor schlub for his own use. Tools leverage quality of life on the fulcrum of knowledge.

Unless you think some types of information are better left completely obscured for the danger a partial relevation would cause...

[robc]

Muzak,

See the link I sent. Google around some, I couldnt find anything today but in the past I have seen a breakdown and a large percent of the bankrupticies had

[robc]

less than $1k in debt.

^^^that was the important part of what was eaten

[;-)]

algorithym ==> Al Gore Rythm n Blues . . . .

[kinnath]

Class Warrior:

Insurance != Health Care System

Insurance provides some leverl of protection against the risk of a future negative event.

A public Health Care System is welfare.

Please stop bitching about insurance not providing comprehensive health care. If you think there is an argument to be made for a new entitlement program, then make it. Otherwise, shut the fuck up.

[natural liberty]

It takes alot of wealth to keep the heart of a terminal old person ticking long after nature says it should have stopped. If a rich person wants to stick a finger in Gaia's eye, so be it. But taxing the general population so that the average old person can throw Gaia to the ground and fuck her in the ass, well that's just wrong.

[bookworm]

"algorithym ==> Al Gore Rythm n Blues . . . ."

His first hit: The Slow Zombie Strol

[Kreel Sarloo]

Switzerland has less people in it than Virginia, the highest (sales and property) taxes in continental Europe, strong border controls with a people that mostly share common heritage.

...but sure, we can pull off what they've got...

Well we could probably even do it the Swedish way if only we were a country of nine million Nordic Aryan Lutherans.

[bookworm]

"Can anyone recommend some good sources from non-political-hacks? I'd like to understand how our mixed system compares with gov't run systems and how free-market folks envision a solution."

"The Top Ten Myths of American Health Care" by Sally Pipes

[robc]

how free-market folks envision a solution

A free-market solution is easy to understand. As with any other good/service, you can only purchase an amount that you can afford (ignoring credit and etc). So, if you need a health care product, you either pay cash for it or you "prepurchase" it by buying insurance.

If you cant afford it and no one gives it to you, you dont get it.

Problems all solved.

[short, fat bastard]

I remember the good old days when "health insurance" was called major medical -- it covered trips to emergency rooms and hospitalization. You paid the family doctor our of your own pocket.

{sniff} I miss those days {sniff}

[robc]

In the real old days, when major medical was pretty much nonexistent, you could get minor medical via your community organization.

For example, if you were a mason, your local lodge might have a doctor on staff who would take care of basic medical for you and your family and it was paid for via your dues.

The AMA put a stop to that.

If you cant afford it and no one gives it to you, you dont get it.

But that's not fair. Fair is getting what you deserve, and giving what you can create. "Can" and "deserve" are value judgements. Since god is dead and only a mass of individuals can legitimize any action or judgement, government is the natural tool to incentivize individuals, eg jack boots on neck and taking poor white trash's children away from them because they're not black.

[Marc]

This is a great illustration of how there are two ways to argue on behalf of limited government/the free market, or really for any political perspective.

1) it works better
2) it's morally preferable

I find it's usually easier to adopt the latter, and this is a prime example. So, I don't give a damn if our system is expensive, produces lower life expectancies, etc.

The state just doesn't have a right to interfere in my health care. Certainly not any more than it already does.

Seconded. I'm not a g-d utilitarian.

[James Anderson Merritt]

Bookwork sort of beat me to it, but I wanted to suggest that Al Gore form an ensemble singing group called the "Al Gore Rhythm," to take its place in music history alongside that other hit-making machine fronted by a prominent politician, the "Mike Curb Congregation." Peas in a pod, though I would hope that the "Al Gore Rhythm" would sound more like Kraftwerk and less like the Osmond Family.

[James Anderson Merritt]

xxx Bookworm, sorry... 😉

[robc]

Thirded. Utilitarianism can (and does) lead to evil.

[bookworm]

"Speaking of citations and proof, John do you have any peer reviewed studies to show that life expectancy differences are soley due to the American lifestyle? Furthermore, in my book a "health care system" includes public health care measures designed to improve public health generally. Finally, I'm Canadian, but my wife is from MN, has been treated under both an HMO and the Canadian system. She very much prefers the system here."

Regarding Canadian health care, the author of the new book "The Top Ten Myths of American Health Care", Sally Pipes, is from Canada. She pointed out that, "Medical authorities in Canada decided that my ailing mother was too old and too sick to merit the highest quality care. She, along with other weak and elderly Canadians, were hastened to the fates by actuarial calculations in what is truly a dehumanizing system of triage...When the government pays for health care, saving money can easily become a more pressing concern than saving lives." She pointed out that in a population of 33 million, 800,000 citizens are currently on waiting lists for surgery and other necessary treatments. Fifteen years ago the average wait between a referral from a primary care doctor and treatment by a specialist was around nine weeks. Today it is more that 18 weeks. Wait until your wife gets put on a waiting list and see how well she likes Canada's system.

Canada ranks 24th out of 28 countries in doctors per thousand people. Before the government took over Canada's health care system, it ranked 2nd. There is such a shortage of Canadian doctors, that 10% of the public is currently seeking a primary care physician. In Nova Scotia, health officials have resorted to using a lottery to determine who gets to see a doctor.

Over the past decade, 11% of doctors trained in Canada moved to the US. The average Canadian doctor earns only 42% what a US doctor earns.

Canada is 13th out of 24 in access to MRI's, 18th out of 24 in access to CT scanners, and 7th out of 17 in access to mammograms. Canada has seen a 9% decline in breast cancer screening.

Now, regarding lifestyle influences on death rates: According to the US Department of Justice, the US homicide rate was 5.9 per 100,000 in 2004. It was 1.95 in Canada, 1.64 in France, and .98 in Germany.

According to the Department of Transportation, America had 14.24 fatalities per 100,000 people from auto accidents in 2006. In Canada, it was 9.25, France was 7.4, Germany in spite of their high speed autobahns was 6.19.

Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa concluded that people in the US who don't die from auto accidents and homicides outlive people in every other Western country.

[Tacos mmm...]

For example, if you were a mason, your local lodge might have a doctor on staff who would take care of basic medical for you and your family and it was paid for via your dues.

The AMA put a stop to that.

Ah, the sepia tones of the idealized past...

Basic medical care is not expensive. A visit to a generalist costs about $100, a little more or less depending on where you live. That's less than most monthly cable bills, and unless you have to visit a doctor every two weeks, you hardly need to be a lodge member to afford it.

Where the past fails to reflect the present is that once, basic medical care was ALL that was available. So you could afford all of your care out of pocket (or through your lodge). The explosion in prices has been due to advancements in acute, surgical and cancer care with technologise and expertise that just wasn't available during the good old days, and the payment models that were in use 60-70 years ago simply aren't going to work today.

[bookworm]

"Seconded. I'm not a g-d utilitarian."

I like to argue from a libertarian standpoint AND a utilitarian standpoint. I'm a libertarian first, but it just so happens that utilitarian arguments give us added amunition, but I would support the libertarian argument first and foremost even if the utilitarian argument didn't back it up.

[;-)]

JAM, no problem

[EscapedWestOfTheBigMuddy]

Canada is 13th out of 24 in access to MRI's, 18th out of 24 in access to CT scanners, and 7th out of 17 in access to mammograms. Canada has seen a 9% decline in breast cancer screening.

I had a Canuckian Grandfather (though he had a green card and lived in southern California). He made regular business trips to Vancouver, where he would get his checkups. Whenever they showed any work needed he would

1. Find out how long the waiting list was on National Health
2. Call a clinic he liked in Seattle and schedule the work (cash on the table) for the return trip.

Glaring example 4--6 month wait for an ultra-sonic kidney-stone smashing in Canada, or "How's Tuesday?" in Washington.

Take that for what you will.

[DBN]

Switzerland has less people in it than Virginia, the highest (sales and property) taxes in continental Europe, strong border controls with a people that mostly share common heritage.

My point is not that we are Switzerland. My point is that universal health care is not by necessity inefficient, as some on this thread seem to think, nor will it lead to social collapse, rioting in the streets, and man on dog sex.

To prove this, all you need to supply are some counterexamples. Switzerland is one.

Secondly, while Swiss sales and property taxes are higher than most other continental nations, the income tax rates are dramatically lower (peaking at less than half the US rate) and are the lowest in continental Europe. It's difficult to compare to the US, but in many locales sales and state income taxes here approach or exceed 10%. Depending on where you live in the US, you may we worse off taxation-wise than in Switzerland, particularly if you're in a higher income bracket.

What common heritage (overlooking the presence of three official languages in Switzerland, which hints that this is not quite the case) and border controls have to do with anything is beyond me, since even the elimination of all illegal immigration would not substantially influence our current healthcare situation.

[bookworm]

"with more than 700,000 personal bankruptcies per year due to medical bills"

In countries with socialized medicine, the taxpayers pick up those expenses. When people start complaining about their high taxes, the government starts rationing services to bring down the costs.

[Yakov]

"That's less than most monthly cable bills"

Yeah! What's up with the cost of cable? I pay Comcast $139.69/month. Every quarter, I pay them enough to buy a 37" HDTV. WTF???

[bookworm]

Switzerland doesn't pay anywhere near what we pay for the military. Maybe that's a big reason for their low tax rate.

[P.J. O\'Rourke]

SWISS

Racial Characteristics:
Mountain Jews in whose icy clutches lay the fruits of grave misdeeds committed in every clime. Under cover of their sanctimonious Red Cross organization, they have penetrated all the governments on the planet and, concealed by a flutter of blood drives and nurses' caps, lie sucking like leeches at the marrow of the gold, chocolate, clock, and army knife industries of nations beyond number. Pathologically clean, they sterilize their children at birth, which accounts for their low rate of population growth and leaves them more room to hide heaps and piles of money in their tiny, Alp-ringed repository of snow-covered sin.

Good Points:
They rarely yodel in the home.

Proper Forms of Address:
Butter balls, cheese knees, big fat Swiss.

An Important Question Concerning Switzerland's Economy:
What do you call a Swiss banker who likes Italian lire better than Deutsche marks?
Queer.

[robc]

Where the past fails to reflect the present is that once, basic medical care was ALL that was available.

You know, I failed to consider that ... no wait ...

In the real old days, when major medical was pretty much nonexistent

Huh. I guess I did consider that. Crazy that I led off my post with that comment.

[robc]

Switzerland doesn't pay anywhere near what we pay for the military.

At the cost of 3* weeks of slavery every year for 20* years.

*or more, my boss when I worked in Swizerland was a colonel**, he had to do an extra 4 weeks every year (and was well past the military retirement age). Probably doesnt count as slavery in his case.

**maybe. That was what his boss (who was Austrian) had nicknamed him. Not 100% sure on his rank.

[Tacos mmm...]

Huh. I guess I did consider that. Crazy that I led off my post with that comment.

In that case, nothing you said was really relevant. Thank you for the nice chance to reminisce, though. Now go take your water pill.

[DBN]

Switzerland doesn't pay anywhere near what we pay for the military. Maybe that's a big reason for their low tax rate.

That would be a good place to start trimming for us. In a nuclear and satellite age, a conventional military uncessary to protect us from invasion, and just gets us into trouble when we use it to invade other countries.

[JJripkin]

Hart said the best HMO for most is the"Walk it Off Plan"

He is damn funny this guy.

[KellyTemperance]

Every King and tin horn leader in the world comes to the USA when they have a medical problem. Hart is right, we have the best system. The metrics the WHO use is based on socialized medicine, and demographics of countries that are much healthier than our slugs.

[WandaWazzz]

Hart also suggested once that instead of Viagra, his HMO gave thier insured a Popsicle stick and duct tape. He is good!

[Anonymous]

In a nuclear and satellite age, a conventional military uncessary to protect us from invasion, and just gets us into trouble when we use it to invade other countries.

Too bad the government won't maintain their satellites properly and allows fascists to convince them to prevent businesses from building nuclear power plants. Didn't you know? Aggressive defense is aggressively offensive to our brother nations, like Iran and North Korea.

[robc]

nothing you said was really relevant

It is still relevant. There is no reason that organizations couldnt handle health care the same way today. They wouldnt have specialists on staff, but basic care up to a certain point could be covered with a large deductible-type policy for the bigger stuff.

Sure, you could do it that way anyway and just pay cash for the small stuff, but people dont want to do it that way. And, by negotiating with a GP, the org can get a group discount. Which was why the AMA had the practice banned. Cant be letting docs underbid each other.

[Tacos mmm...]

Sure, you could do it that way anyway and just pay cash for the small stuff, but people dont want to do it that way. And, by negotiating with a GP, the org can get a group discount. Which was why the AMA had the practice banned. Cant be letting docs underbid each other.

Sounds like... an HMO. In fact, HMOs descended from prepaid health plans, like the Masonic example you gave. 15 years ago, these were all the rage. Until, as it turns out, people preferred to choose their physicians over the benefit of a group discount.

[robc]

Tacos,

Well, yeah, I prefer the choice too. Are you opposing relegalizing it or something? Maybe some people might prefer that option.

A multitude of options.

[cuernimus]

What common heritage (overlooking the presence of three official languages in Switzerland, which hints that this is not quite the case) and border controls have to do with anything is beyond me, since even the elimination of all illegal immigration would not substantially influence our current healthcare situation.

It means you can have more specialists in the fields that your populace is more genetically predisposed towards, and less or no specialists for conditions that they are not. You could only achieve this in the United States by completely screwing over people of certain backgrounds, and given our history, it will probably be black people. Sorry you guys with sickle cell anemia, and they we're just about to cure it, too. Tough luck.

[TrickyVic]

""""In the real old days, when major medical was pretty much nonexistent, you could get minor medical via your community organization.""""

Like This?

[TrickyVic]

Damn! I'll try that again.

Like this?

[jpinsatx]

Hmmm? Health Care for ALL Americans is Simple!

1) MERGE Medicare, Medicaid and CHIPS into one single "Income Based" system for children, poor and elderly citizens.

2) REQUIRE insurance companies to provide the same basic coverage for EVERY uninsured citizen, regardless of health status, at affordable rates.

3) ALLOW insurance companies to "Profit" by offering additional benefits and options to those who qualify and are willing to pay the difference.

As for Funding?

1) Changing from an "Emergency Treatment" to a "Preventive Care" system will save local communities billions, maybe even trillions of taxpayer dollars!

2) Consolidating and utilizing existing systems will expedite the process and make administration more efficient and cost effective!

3) Small business will be able to compete globally and hire additional taxpaying employees!

4) Wealthy seniors will pay their fair share!

The Tremendous Burden on Future Generations will be Greatly Reduced!