Barack Obama

The Arrogance of Health Care Reform

Why do politicians with no business experience think they can run 15 percent of the economy?

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It's crazy for a group of mere mortals to try to design 15 percent of the U.S. economy. It's even crazier to do it by August.

Yet that is what some members of Congress presume to do. They intend, as the New York Times puts it, "to reinvent the nation's health care system."

Let that sink in. A handful of people who probably never even ran a small business actually think they can reinvent the health care system.

Politicians and bureaucrats clearly have no idea how complicated markets are. Every day people make countless tradeoffs, in all areas of life, based on subjective value judgments and personal information as they delicately balance their interests, needs and wants. Who is in a better position than they to tailor those choices to best serve their purposes? Yet the politicians believe they can plan the medical market the way you plan a birthday party.

Leave aside how much power the state would have to exercise over us to run the medical system. Suffice it say that if government attempts to control our total medical spending, sooner or later, it will have to control us.

Also leave aside the inevitable huge cost of any such program. The administration estimates $1.5 trillion over 10 years with no increase in the deficit. But no one should take that seriously. When it comes to projecting future costs, these guys may as well be reading chicken entrails. In 1965, hospitalization coverage under Medicare was projected to cost $9 billion by 1990. The actual price tag was $66 billion.

The sober Congressional Budget Office debunked the reformers' cost projections. Trust us, Obama says. "At the end of the day, we'll have significant cost controls," presidential adviser David Axelrod said. Give me a break.

Now focus on the spectacle of that handful of men and women daring to think they can design the medical marketplace. They would empower an even smaller group to determine—for millions of diverse Americans—which medical treatments are worthy and at what price.

How do these arrogant, presumptuous politicians believe they can know enough to plan for the rest of us? Who do they think they are? Under cover of helping uninsured people get medical care, they live out their megalomaniacal social-engineering fantasies—putting our physical and economic health at risk in the process.

Will the American people say "Enough!"?

I fear not, based on the comments on my blog. When I argued last week that medical insurance makes people indifferent to costs, I got comments like: "I guess the 47 million people who don't have health care should just die, right, John?" "You will always be a shill for corporate America."

Like the politicians, most people are oblivious to F.A. Hayek's insight that the critical information needed to run an economy—or even 15 percent of one—doesn't exist in any one place where it is accessible to central planners. Instead, it is scattered piecemeal among millions of people. All those people put together are far wiser and better informed than Congress could ever be. Only markets—private property, free exchange, and the price system—can put this knowledge at the disposal of entrepreneurs and consumers, ensuring the system will serve the people and not just the political class.

This is no less true for medical care than for food, clothing, and shelter. It is profit-seeking entrepreneurship that gave us birth control pills, robot limbs, Lasik surgery, and so many other good things that make our lives longer and more pain free.

To the extent the politicians ignore this, they are the enemy of our well-being. The belief that they can take care of us is rank superstition.

Who will save us from these despots? What Adam Smith said about the economic planner applies here, too: The politician who tries to design the medical marketplace would "assume an authority which could safely be trusted, not only to no single person, but to no council or senate whatever, and which would nowhere be so dangerous as in the hands of a man who had folly and presumption enough to fancy himself fit to exercise it."

John Stossel is co-anchor of ABC News' 20/20 and the author of Myth, Lies, and Downright Stupidity. He has a new blog at http://blogs.abcnews.com/johnstossel.

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  1. Stossel is clearly a fucking idiot. Hope and change can achieve anything.

  2. How do these arrogant, presumptuous politicians believe they can know enough to plan for the rest of us?….Under cover of helping uninsured people get medical care, they live out their megalomaniacal social-engineering fantasies

    All true. But how do politicians view themselves? Do they believe their own press releases? Or are they just cynical, power-hungry bastards?

  3. Don’t you understand? Something has to be done NOW!

    Granted, I look around and don’t see people being denied care. I don’t see people dieing in the streets from lack of medical treatment. I don’t see anything that’ll be fixed by the government plan.

    But Obama said something had to be done now, right? He wouldn’t lie, now would he?

  4. Why do you people hate tonsils? Who will think of the tonsils??

  5. I can pick up a three-month supply of three different prescriptions at Target for $10. I got an appointment with my doctor in two days and he worked with me to get the best deal.
    How is this “broken”?

  6. But, but 2/3rds of bankruptcies have medical debt! There’s no way to go bankrupt without having even a little medical debt, so it’s the cause of all of them!

  7. Volokh had a post yesterday commenting on why anyone knows who Ezra Klein is. Klein is taken seriously enough to have a WAPO collumn and pontificates on anything and everything and insults anyone and everyone who disagrees with him. Yet Klein has literally never done anything in his life but pontificate. He has never ran a busness, never participated in a trade or profession, and has never been so much as a real reporter gathering facts. But, we are supposed to take his views more serioulsy than the drunk guy sitting next you at the bar.

    The Volokh poster was commenting on the sad state of journalism. But really Klein is emblamatic of our entire political class. We have people who have done nothing but pontificate and participate in politics who think they are entitled to run the world. Cleaverness should never be a substitute for experience and wisdom. But sadly for our entire media and political class it is.

  8. Damn you John! I thought lawyers knew how to spell! Do you have any idea how much time I wasted having to mentally correct your shenanigans?

  9. Personally, I like emblamatic. It’s an emblem and a gun, all in one!

  10. You’re a romantic, SugarFree.

  11. Volokh had a post yesterday commenting on why anyone knows who Ezra Klein is. Klein is taken seriously enough to have a WAPO column and pontificates on anything and everything and insults anyone and everyone who disagrees with him. Yet Klein has literally never done anything in his life but pontificate. He has never ran a business, never participated in a trade or profession, and has never been so much as a real reporter gathering facts. But, we are supposed to take his views more seriously than the drunk guy sitting next you at the bar.

    The Volokh poster was commenting on the sad state of journalism. But really Klein is emblematic of our entire political class. We have people who have done nothing but pontificate and participate in politics who think they are entitled to run the world. Cleverness should never be a substitute for experience and wisdom. But sadly for our entire media and political class it is.

    Now piss off. All of you.

  12. em?blem?at?ic??/??mbl??m?t?k/ Show Spelled Pronunciation [em-bluh-mat-ik] Show IPA
    Use emblematic in a Sentence

    -adjective pertaining to, of the nature of, or serving as an emblem; symbolic

    http://dictionary.reference.com/browse/emblematic%20

    What are you talking about Sugerfree. That was actually spelled and used correctly.

  13. “SugarFree | July 23, 2009, 12:33pm | #

    Personally, I like emblamatic. It’s an emblem and a gun, all in one!”

    I get made fun of a lot on here for my commitment to spelling anarchy. But, I think Sugerfree’s post rises above all of that.

  14. John, for one who is erudite and intelligent, like yourself, an allegation that one is orthographically challenged is nothing less than downright defamatory!

  15. In socialist Qu?bec, we use to say that our animals are a lot better and faster treated than humans.

    For our State television, Radio-Canada (in French), the worst situation would be to have a private health care system.

    When they can, they will find rare abuse cases to send us the message: “See, you don’t want to be treated like a dog in an American hospital!”.

  16. John,

    You spelled it “emblamatic” the first time. I wasn’t quibbling about the usage I was merely defining the alternate spelling, as if you had deliberately created a portmanteau of emblem and the onomatopoeic “blam” in order to conjure the notion of an emblem that is also a gun.

    As always, not making fun of anyone’s typos, I live in a house of glass. Just skylarking.

  17. I was teasing John.

  18. John, I couldn’t understand your second post. Since it lacked spelling errors, my internal correction mechanism that I use for your posts was unable to translate it.

    Also:

    He has never ran a business

    He has never run a business.

  19. Got to quote Ann Coulter on this one:

    “Isn’t food important? Why not “universal food coverage”? If politicians and employers had guaranteed us “free” food 50 years ago, today Democrats would be wailing about the “food crisis” in America, and you’d be on the phone with your food care provider arguing about whether or not a Reuben sandwich with fries was covered under your plan.”

    Hardly an original thought, but memorably put.

  20. Why do politicians with no business experience think they can run 15 percent of the economy?

    Hell, forget the economics and costs (for a moment) of this boondoggle; the scariest thing is what makes a man who has no science or medical training think he is superior in knowledge to trained physicians and health care workers?

    The longer we go into this administration the more I’m amazed at this president’s arrogance. I couldn’t believe I actually heard someone who didn’t know what the hell he was talking about actually think he could give medical advice about tonsils and allergies to doctors!

    I used to think the right-wing crowd was just being wing-nut with their comments on his ego. Like Ted Rall, I apologize and Bush is actually looking sane (and that’s no mean feat) thanks to Obama.

  21. “Isn’t food important? Why not “universal food coverage”?

    I can live without food, I demand free sex from hookers paid for by the government: universal pussy coverage!!

  22. Yes, but if you get sex for “free” is it worth as much to you?

  23. Larry Summers ran Harvard.

    Their finances are a mess now, too.

  24. Biden is a buffoon. But he at least seems likable on a personal level He has no business being VP, but I would imagine he would make a decent dinner guest.

    In that way, I will take Biden over Obama. Obama the man, versus Obama the myth, seems like a complete prick on every level. I watch him in his interviews and news conferences and am can’t find one charming or pleasent trait about him. He never seems to smile or relax. He is always scowling. All the world’s problems are the result of the machinations of his enemies. He is very Nixon like but even worse. Nixon had all of the same characteristics. But despite this, I always got the feeling from Nixon that at heart he was a man who felt like an outsider and desperately wanted to be liked and accepted. He was forever the smart awkward kid trying to fit in. This made Nixon even at his worst a somewhat sympathetic figure. I get none of that from Obama. He doesn’t seem to have any interest in being liked or accepted. He knows he is liked and accepted. His ego seems to know no bounds. He is really starting to creep me out.

  25. All true. But how do politicians view themselves? Do they believe their own press releases? Or are they just cynical, power-hungry bastards?

    Some believe they are doing good things for Teh Peeple. Some are cynical, power-hungry bastards. Quite a few combine the two, using Orwellian doublethink to avoid excessive pondering about the inherent contradictions.

  26. I know you were kidding Naga.

  27. “I can live without food, I demand free sex from hookers paid for by the government: universal pussy coverage!!”

    As P.J. O’Rourke famously said, “If you think pussy is expensive now, just wait til it’s free” … or something like that

  28. About the only good news is that Senator Reid has just killed the idea of trying to ram this B.S. through the Senate before the August recess like Obama was trying to dictate.

  29. Thank you, John, for repeatedly checking yourself out of the debate and offering exactly NOTHING to address the policy problems that the industry, the patients, the Dems and the GOP alike recognize as critical. The grownups will take over from here and engage in the messy, impure work of political democracy.

  30. Obama is emblematic of “progressive” thought.

    See the depth of “progressive” economic thought?
    Even as murky as it is, you can see clear to the bottom.

  31. I find these anti-healthcare articles extremely disingenous. “It’s crazy to design the economy.”

    WOW. Humans have been designing the economy for millenia, from mercantilism to the slave trade to globalization.

    It’s “crazy?” When every other developed country has implemented some form of universal healthcare?

    I guess it was human hubris too that they dreamed to land on the moon, or build thousand foot tall skyscrapers. After all, how could humans possibly understand the complexities of the natural world?

  32. I guess while we’re waiting for the Market to reform health care, we can also wait for natural selection to treat cancer…

    I’m sure none of you visit doctors when you’re not feeling well, what with the risk of interfering with evolution.

  33. Thank you, John, for repeatedly checking yourself out of the debate and offering exactly NOTHING to address the policy problems that the industry, the patients, the Dems and the GOP alike recognize as critical. The grownups will take over from here and engage in the messy, impure work of political democracy.

    He’s offered the answers. The solution to the ‘policy problems’ is simple.. get rid of the policies that cause the problems. Remove the AMA’s chokehold on provider supply. Remove the tort industry’s fangs from the neck of the health care market. Eradicate all insurance mandates on what’s covered and who is covered. Mandated coverage means people will consume health care needlessly. Abolish medicaid/medicare and directly subsidize individuals who need it, and do not require they use it on health care.. because they will which causes inflation.

    He’s assuming the reader isn’t a subscriber to Disney economics. He’s apparently mistaken in your case.

    Everyone with a smidgeon of economic awareness knows how to reign in health care inflation. No one wants to do it, because it will only help us consumers. The current bill will create a health care monopoly. The purpose of monopolies is to cause price inflation.

  34. Wow the Kos crowd showed up. Where to even begin.

    “WOW. Humans have been designing the economy for millennia, from mercantilism to the slave trade to globalization. ”

    None of those examples are centrally planned economies. They are examples of government regulation of economies. There is a difference. We tried centrally planned economies in the 20th Century and the all failed miserably. Economies are too complex and there are too many second order effects for a government to centrally plan effectively. If they could, the Soviet Union and Maoist China would have worked economically.

    That is the nuts and bolts of the debate. If you think enlightened despots can sit on high and redesign and manage 15% of the economy effectively at all let alone after a few months of thinking about it, you are an callow undergraduate idiot.

  35. Wow the strawmen trolls aka KOS crowd are out in full force on this one.

  36. “I guess it was human hubris too that they dreamed to land on the moon, or build thousand foot tall skyscrapers. After all, how could humans possibly understand the complexities of the natural world?”

    Managing an entire economy for 300 million people is so much like building a rocket to go to the moon. Further, man has been so successful at managing large scale encomies in the past. Just look at the amazing standard of living achieved by the old Soviet Block? Are you guys trolling or do people really think this way?

  37. I guess while we’re waiting for the Market to reform health care

    How can the market reform health care when the government controls it? What’s in common with education market, the housing market, and the health care market? Government management markets all.

  38. Wow the strawmen trolls aka KOS crowd are out in full force on this one.

    I wonder why they bother? They should go trouble conservative boards where the readership might be economically illiterate enough to be bamboozled by their crap.

  39. No matter how much of our freedom the government controls, it will always find a way to blame any problems on those few remaining areas it doesn’t own.

  40. Tomcat1066 wrote:

    “Granted, I look around and don’t see people being denied care. I don’t see people dieing in the streets from lack of medical treatment.”

    Then you haven’t looked far. I know two working people who died in their 30s for lack of medical care, from diseases that could easily have been treated (pneumonia). They had no health insurance and by the time they went to the emergency room it was too late. I know a 63-year-old man who lives in an abandoned house near my house who is dying of cancer. He gets $600/month from Social Security which barely covers the $40 copayments for cancer treatment. He sets up 2 weeks a month to beg for money and food at a street corner. He is literally dying in the street. (I give him $100 a month. And yes, I checked with the hospital; he is a patient.)

    I know a carpenter and Vietnam war vet who has health problems from shattering his leg during training (a parachute jump). He suffered from a stroke at Lowe’s while buying lumber. They did not know he was a vet so they took him to a regular hospital. He has insurance for work-related injuries only, plus veteran’s care. He woke up from a mild coma 3 days later and the hospital charged him $80,000. They did essentially no treatment: just cat scans and a respirator for the first few hours. The insurance company said it was not work related and denied coverage. The hospital has taken his truck and his car and they will soon take his house and other equipment.

    Some middle class people imagine that emergency room care is “free” for poor people. This is nonsense. They charge thousands of dollars and if you do not pay they will take away everything you have and leave you homeless.

    I have seen many other horror stories like this. I personally known many people’s whose lives and marriages have been blighted by medical expenses, such as a young woman unable to marry or get a job because she has cancer and her boyfriend’s company insurance will cover her, and no company will hire her because they would have to cover a pre-existing condition . . . it goes on and on.

    Medical expenses bankrupt thousands of people every day and they destroy countless lives and fortunes. They are the largest cause of middle-class bankruptcies. The U.S. pays far more than any other country for health care, and our medical care stinks. If you do not see that you are living in a dreamworld, or you refuse to look. The Europeans and Japanese are far better off than we are. (And yes, I have lived in Europe and Japan and had treatment there.)

    Any system Obama comes up with would be better than what we have.

  41. The beauty of progressivism — if you disagree you’re promoting death and crap like that — is that not only does it lack a thesis, perhaps because of that critical fact, it also lacks verification.

    Indeed, progressivism depends on faith. On Hope & Change.

    So, no reason going in and no accountability coming out. We should form entire national governments on this stuff.

  42. Personally, I like emblamatic. It’s an emblem and a gun, all in one!

    Cleaverness should never be a substitute for experience and wisdom.

    I think we should just give John his lifetime RC’z Law award and be done with it.

    Obama the man, versus Obama the myth, seems like a complete prick on every level.

    Harvard Law School will do that to you. Trust me on this.

  43. Which is to say exactly what the comment above my last one illustrates by Any system Obama comes up with would be better than what we have.

    The most advanced (and therefore and thereby most expensive) health in the history of man and a figment of Jed Rothwell’s fevered imagination would be better.

    No fundamental thesis, no accountability. Jed’s experience is all we need to know…and leaping from it to ruining the present system is therefore justified.

  44. Medical expenses bankrupt thousands of people every day and they destroy countless lives and fortunes.

    [citation needed]

    They are the largest cause of middle-class bankruptcies.

    [citation needed]

    The U.S. pays far more than any other country for health care, and our medical care stinks.

    [citation needed]

    The Europeans and Japanese are far better off than we are.

    [citation needed]

  45. I wonder why they bother? They should go trouble conservative boards where the readership might be economically illiterate enough to be bamboozled by their crap.

    The leftists troll here for two reasons:

    1) Because they can without being banned.

    2) Because they know that Obama won the election with the help of a significant amount of libertarian and independent support, but the independents are increasingly appalled at what they’re seeing as Obama’s lies get exposed.

    Expect the lefties to continue becoming increasingly obnoxious and desperate as Obama’s poll numbers and support continue plummeting.

  46. oh lord, we even have cold fusion geeks showing up. (rolls eyes)

  47. Larry Summers ran Harvard.

    Their finances are a mess now, too.

    True as far as it goes, but the real reason Harvard is in so much trouble is they fired/ran off all the smart market movers who built that endowment up from nothing, because professors were mad that making billions paid more thousands then writing books no one will read.

    The replacements poured money into the market, especially expensive hedgefunds, and are now paying the price. Not to mention Harvard has spent almost $2B on new construction in the past 5 years.

  48. “I guess while we’re waiting for the Market to reform health care, we can also wait for natural selection to treat cancer…”

    The market isn’t being allowed to work because of all the current government meddling in the market. How can health insurance premiums become more affordible for more people when states mandate certain unnecessary treatments be covered by insurance policies and some states won’t allow high deductible catastrophic policies which would be lower priced policies which more people could afford and would result in more people shopping around for better priced routine care which would restore more competition in the medical marketplace and thus bring down medical costs.

  49. After all, how could humans possibly understand the complexities of the natural world?

    Of course we can — or at least smart people like me can. That’s why you should give me the power to rule over you. I’m smart and you’re not.
    See, I even have a university degree.

    Now shut up and get back to work, so you can pay your “fair share” of taxes. It’s only fair.

  50. On one of the rare occasions I listened to Rush (I was driving from Michigan back to Omaha, I had to do something!), the guest host was going over life expectancy. Currently, Bosnia [Bosnia!] beats us by a few tenths of a year. The point is, being a modern or semi-modern country puts your life expectancy around ~78 currently. The type or cost of healthcare doesn’t seem to have anything to do with it.

  51. As a long practicing primary care physician I can say that John Stossell is spot on. It’s been said that only two of the Administration’s cabinet have ever run a small business. I’m all for a model that provides medical care for all as long as it has a proven track record. So far, things aren’t looking so good for Massachusettes, the VA medical system, M’care/M’caid (both outgrew the pace of growth of the privately insured) and all nationalized single payor models. There’s lots that can be done but look to the Mayo model as the one that can give us the biggest boost toward better care for a larger proportion of our citizens.

  52. Jed: I hate to say it, but it was their own damn fault. They didn’t SEEK medical care at their own expense, hence they let themselves down, not the system. Yes, it would have been expensive, but they wouldn’t have died. Yes, they would have been responsible for the expenses

    And before you presume to lecture me on what hospitals do in regards to “taking away everything”, keep in mind that I have a good bit of experience in this area, both from the hospital side and in private collections. The fact of the matter is that the vast majority of hospitals will work with patients to work out a payment plan, but you have to ask for it and stick with it. If not, that’s on you too.

    Of course, you seem to “know” so many people with the short end of your imaginary stick that I seriously doubt anything you say. Your stories smack of scare tactics with no supporting data. Sounds like you drank the kool-aid, huh?

    I have known a hell of a lot of people who have shitty situations and have to adapt, whether it was divorce, car repairs, household fires, whatever. Uncle Sam isn’t lining up to bail them out either, and they shouldn’t.

  53. “The point is, being a modern or semi-modern country puts your life expectancy around ~78 currently. The type or cost of healthcare doesn’t seem to have anything to do with it.”

    In the aggregate that is true. Life spans are radically increased by access to clean water and anti-biotics. After that big increases get harder to come by. In the individual case, type or cost of healthcare makes one hell of a difference. If you are healthy person who lives to be 80 and drops over dead of a heart attack, then it really doesn’t make much difference whether you live in Bosnia or Italy or the US or anywhere outside of the worst parts of the Third World. But, if you are unlucky and happen to come up with cancer or diabetes, then it makes one hell of a difference where you live. Generally, you are better off being in the United States.

  54. Johnny John John, he of the “WOW” and the “We can too design an economy!”, ought to run down to the public library and check out Friedrich Hayek’s The Fatal Conceit. It really should be required reading in our high schools (along with The Road to Serfdom).

    I am no longer surprised, sadly, to see how often supposedly intelligent and well-educated “progressives” and “liberals” demonstrate their ignorance of the most important insights into economics in the 20th century, which came from people like Hayek, Von Mises, Coase, etc.

    Economies, societies, and civilizations cannot be designed. They grow and evolve organically. Attempts to design them demonstrate the fallacy (when applied to organic systems) of constructive rationalism. The Soviet Union was the poster child of Marxist constructive rationalism.

  55. “I think we should just give John his lifetime RC’z Law award and be done with it.”

    But if you did that, you would have to respond to my points rather than whine about my spelling. I don’t think you really want that.

  56. “I wonder why they bother?”

    I, for one, welcome our Kos friends into our sandbox. I don’t like living in a echo chamber, and I benefit from learning the best arguments of the other side.

    In fact, I sometimes lurk at kos to hear what they’re saying.

    I do wish they were more polite, however.

    Sincerely,
    Corkie the Dog

  57. No matter how much of our freedom the government controls, it will always find a way to blame any problems on those few remaining areas it doesn’t own.

    This.

    I’m going to utilize the freedom to steal this quote:)

  58. John: Just because the Titanic sunk doesn’t mean that man should not sail the seas. Besides, there are around 30 other countries using viable universal healthcare systems. Some of these countries are in debt, many are NOT.

    I was comparing healthcare reform to the moon landing because they are BOTH about CONTROL. In the case of the moon, man learned to country the atmosphere and laws of physics to get to the moon. In caes of healthcare, man can learn to CONTROL social and economic factors to try to MAXIMIZE coverage and HEALTH.

    It’s amazing that freemarketers cannot conceive of a human-designed system that could be superior to the freemarket system, when billions of examples lay throughout the world. Such systems (such as democracy, human rights, socialism, CAPITALISM) were all DESIGNED by people, then implemented by governments.

    BY THE WAY, universal healthcare works great in SO MANY OTHER COUNTRIES. You oppose universal healthcare, not because it works, or how efficient it is, but merely because of your ideological leanings.

  59. No worries faithkills. I stole it from someone. But I forget who.

  60. “Then you haven’t looked far. I know two working people who died in their 30s for lack of medical care,”

    Look at all the people who die in countries with socialized medicine while waiting for medical care because of the rationing.

  61. “John: Just because the Titanic sunk doesn’t mean that man should not sail the seas. Besides, there are around 30 other countries using viable universal healthcare systems. Some of these countries are in debt, many are NOT.”

    But all of them save costs through rationing.

  62. Liberty vs collectivism debates have one other thing in common: They invariably devolve into a subjective shouting match on cost-benefit ratios of the two ideologies.

    Such unpleasant conversations should be shut down with the simple pronouncement that collective health “care” simply wasn’t — beaning isn’t — enumerated in founding documents.

    Let’s say free market healthcare could, somehow, end up costing twice as much. Even if we brush aside the likelihood it’d also be four times more effective than otherwise, I’d still select my personal freedom and liberty above collective medicine.

    Further, I’d expect any socialist demanding otherwise by way of force of pet policy to come and take them from me. Preferably in the dead of night.

  63. Good article overall, although a couple of points.

    Liberals think they can run healthcare because it’s done in other countries, AND costs are controlled. In fact there are usually 6-7% of GDP less than in our country. So the idea that goverment can’t control medical costs is wrong. That being said, the way they do it of course is ration care.

    Americans of course don’t want care rationing, but the idea that government can’t control costs is incorrect.

    Now markets if properly designed can produce lower costs, and higher quality of care. BUT, incentives need to be properly aligned.

    IE, doing stuff like reimubursing for the number of tests run will result in lots of test being run. Incentives need to be strucutured to reward high quality care, not the most care. A bit harder but necessary.

  64. “Just because the Titanic sunk doesn’t mean that man should not sail the seas. Besides, there are around 30 other countries using viable universal healthcare systems. Some of these countries are in debt, many are NOT.”

    All of them have lower survival rates for fatal diseases and produce much less medical research than the US does. If you can’t make a profit on a new treatment, no one will research it.

    “I was comparing healthcare reform to the moon landing because they are BOTH about CONTROL. In the case of the moon, man learned to country the atmosphere and laws of physics to get to the moon. In caes of healthcare, man can learn to CONTROL social and economic factors to try to MAXIMIZE coverage and HEALTH.”

    If you think that doing the Newtonian physics it takes to go to the moon is the same thing as managing a system of 300 million people, you are crazy. One has nothing to do with the other. Human systems are too complex to be managed effectively. Read Hayak sometime. Seriously. There is a reason why centrally planned economies failed. It was because no one has the information necessary to plan an economy. You end up over or under producing everything.

    “BY THE WAY, universal healthcare works great in SO MANY OTHER COUNTRIES.”

    No it really doesn’t. People in Quebec wait in lotteries to get doctors. People in Sweeden go to vets because they can’t see doctors. The UK national health serice produces a new horror story every week. The US has higher survival rates for disease. It has better care for premature babies. It produces the vast majority of the major medical research in the world. These systems really don’t work as advertised.

  65. I do not know if the US can run 15% of the economy.

    I am pretty sure that business can’t. They have tried for 70 years and not come up with a good thing.

    I am willing to give government a chance. Although I would prefer to do it on a trial basis to see what works best. That might not be good, as some might get screwed. But since they are getting screwed in the current system, it would just be the status quo.

  66. One other thing for leftists to consider. If single payer is the solution for medical care, why isn’t it the solution for anything else? For example, why not a single payer legal system? Legal representation really is a Constitutional Right. Yet, people are denied it every day. If you are middle class and happen to get charged with a crime, you will be ineligible for a public defender and have to spend thousands defending yourself. People routinely forgo estate planning and tax advice because they can’t afford attorneys. People are also bankrupted every day because of legal fees associated with criminal charges and divorces. Worse still, rich people get gold plated legal advice while the middle class are left with none or second rate public defenders and legal aide attorneys. Even worse than that, there is no “legal insurance” market that pools the risk or helps people pay.

    It seems to me that all of the arguments for single payer healthcare apply equally well to single payer legal services. Why isn’t anyone calling for that?

  67. johnny jonjon, you do know that no country with universal coverage has gotten to the moon?

  68. “They have tried for 70 years and not come up with a good thing.”

    By what measure? The vast majority of the people in this country have health insurance and are happy with their healthcare. They created a system whereby not only medical technology would advance but also the vast majority of a 300 million person nation would have access to it. That is pretty good.

  69. Harvard Law School will do that to you. Trust me on this.

    You can always tell a Harvard man. Can’t tell him much…but…

  70. “democracy, human rights, socialism, CAPITALISM) were all DESIGNED by people, then implemented by governments.”

    Capitalism wasn’t implemented by governments. It’s what comes about naturally in the absense of government meddling in the marketplace.

    johnny john john, it seems to be going over your head that no individual or group within the government can determine proper costs of goods and services. Only the market can determine this through the interactions of the insurance companies, medical providers, and medical consumers. Politicians and bureaucrats are arrogant if they think they can determine prices better than the producers and the consumers.

  71. “It seems to me that all of the arguments for single payer healthcare apply equally well to single payer legal services. Why isn’t anyone calling for that?”

    Shhh! John, don’t give them any new ideas.

  72. Draco: We are all ignorant, including you. I’ve personally never heard anybody prove to me that the freemarket system is truly the most “efficient” or “best” for America. So I’m not going to assume freemarket is the only way to go.

    Besides why don’t yall want “leftists” posting? Just wanna talk to a bunch of yes-men and preach to the choir all day long?

    BTW here’s a nice read on how shitty US healthcare is:
    http://assets.opencrs.com/rpts/RL34175_20070917.pdf

    Some random stats on US care:

    -Greater mortality rates
    -Higher cost percentage of GDP
    -More deaths by medical errors per capita
    -Greater infant mortality (comparing countries -with like counting system)
    -Greatest healthcare cost growth
    -Lowest kidney transplant survival rate (between UK, New Zealand, US, Canada, Germany)
    -Fewer hospital beds per capita
    -Fewer doctors per capita than SEVERAL countries (like Germany, Italy, Belgium, France)
    -BTW Japan got USA beat in MRI and CT scanners despite their SOCIALIST leanings

  73. bookworm,

    As a Lawyer I would welcome single payer legal services. I would laugh my ass off to see big corporate lawyers turned into low paid public servents. Yeah, it would totally fuck everything up. But it would be oddly satisfying.

  74. “I am willing to give government a chance. Although I would prefer to do it on a trial basis to see what works best. That might not be good, as some might get screwed. But since they are getting screwed in the current system, it would just be the status quo.”

    Government has been given the chance in Canada and Europe and look at the lousy results. It has also been tried in Massachusetts with lousy results. Why should we think it will be any better under Obamacare when it hasn’t worked well anywhere else? The problem with trying it on a trial basis is that once it becomes established, it will be hard to undo as all government programs tend to be.

  75. Actually, I think reimubursement rates would be pretty easy to come up with. Take a national average of total cost (including admin etc) then add say 5-10% for profit. Providers that could come in under that would make extra, those that came in over would soon go out of business. Over time prices would fall, thus constantly pushing up efficiency.

  76. Fun fact: If you CAPITALIZE your WORDS you get the POWER to spew NONSENSE on any COMMENT BOARD you like and THINK it is the TRUTH. Thus is the POWER of the SHIFT KEY. FEAR IT!

  77. “We are all ignorant, including you. I’ve personally never heard anybody prove to me that the freemarket system is truly the most “efficient” or “best” for America. So I’m not going to assume freemarket is the only way to go.”

    It has worked in the past. To the extent that there are problems is due to government meddling in the system.

  78. Greater mortality rates

    What does that mean? Mortality rates for what? We have higher infant mortality rates because babies that are left to die in Europe and counted as still borns the US tries to save.

    -Higher cost percentage of GDP

    We are a rich country. What is wrong with spending on healthcare? Kenya probably spends less than we do as well. But I would rather live here. Further, we also have bad dietary habbits, minority groups with genetic pre-dispositons to things like diabetes and a propensity among our young people to shoot one another. Those factors have nothing to do with our healthcare system but drive up our costs.

    -More deaths by medical errors per capita

    Again, that is misleading. We also are more prone to do high risk and novel treatments. That is going to create more deaths by medical errors. That statistic in itself proves nothing.

    -Greater infant mortality (comparing countries -with like counting system)

    See above. More importantly, we have high rates of drug use and alchoholism among some of our populations. That will drive up our infant mortality rates and has nothing to do with our healthcare system.

    -Greatest healthcare cost growth

    We also have the greatest growth in technology. We also have an aging population. It makes sense that as the population ages, your cost grows. Moreover, we are a rich country. I dont’ see any problem in spending a lot of money on healthcare. It is important.

    -Lowest kidney transplant survival rate (between UK, New Zealand, US, Canada, Germany)

    That proves nothing without further information. Maybe we bad choices about who to give kidneys to. We do have a habbit of treating old people here rather than just letting them die, as much as that drives leftists nuts.

    -Fewer hospital beds per capita

    Comparted to whom? We have many more beds and doctors than Canada and the UK.

    -Fewer doctors per capita than SEVERAL countries (like Germany, Italy, Belgium, France)

    But manymore than Canada and the UK who have true single payer systems.

    -BTW Japan got USA beat in MRI and CT scanners despite their SOCIALIST leanings

    Japan is not a single payer system. Further, I am not sure that number of MRO and CT scanners is that relevent of a measure.

    Even if what you say is true (and you provide no links or proof) it doesnt’ show anything.

  79. democracy, human rights, socialism, CAPITALISM) were all DESIGNED by people

    They were not designed. They evolved.

    You seem to think that, just because a structure exists, it was designed.

    Do you also think that you were designed?

    Get a clue. Read Hayek.

  80. “Actually, I think reimubursement rates would be pretty easy to come up with. Take a national average of total cost (including admin etc) then add say 5-10% for profit. Providers that could come in under that would make extra, those that came in over would soon go out of business. Over time prices would fall, thus constantly pushing up efficiency.”

    That would be happening naturally in the free market.

  81. Well lets start with the canard about 47 million Americans uninsured.

    If we want to start to fix the health care system, lets fix the border first…so I dont have to wait in line for my red pill or my tonsils to be taken out cause the illegal needs help first.

    Or how about they fix the VA and Medicare first then move on.

    From Neal Boortz…http://boortz.com/nealz_nuze/2009/07/and-what-of-the-uninsured.html

    What’s the number we hear tossed around? Let’s settle on 47 million. OK, a few questions:

    How many of the uninsured are illegal aliens. Answer … about 25% of them. They came here illegally, they stay here illegally, they work here illegally … and we’re supposed to be upset that they can’t afford health insurance? If they get hurt patch them up and send them home.

    How many of the uninsured are young and just not buying health insurance because they think they’re pretty much bulletproof right now? I’ve seen estimates as high as 20 million .. almost one-half of the uninsured. Hey, they made their choice … let them suffer the consequences. Why do I have to sacrifice my health care freedom because some nimrods decide it is more important to pay for that new BMW and the flat screen TV than it is to take care of their health needs.

    How many of the uninsured are eligible for Medicaid or Medicare and just haven’t signed up for it? Millions. So … sign them up? Instead of taking over our health care, get these people signed up and take care of them under the programs we already have.

    And how many of the uninsured are in a transitional state … moving from one job to another and waiting for the new policy to kick in. Millions more. We’re going to turn out health care system over the government because of people changing jobs? How about just passing some laws that make health care insurance more portable?

    Remember .. there are solutions out there. The only solution acceptable to the Democrats is one that makes government more powerful.

  82. bookworm: Capitalism aint natural. The barter system is natural. The tribal system is natural. Capitalism is MAN MADE. Capitalism was created in the 16th century after the destruction of Feudalism.

    “It seems to be going over your head that no individual or group within the government can determine proper costs of goods and services. Only the market can determine this”

    AHA. That’s what I don’t agree with and you don’t have evidence to back up. That only the “market” can determine blah blah. The free market is ONLY a economic MODEL. A good model, but only a model.

    You’re sorta like those physicists that thought they had solved all the physics problems in the world by the 19th century, who only needed the Newtonian model. The Newtonian model’s decent for some engineering applications, but is far from the “truth.”

  83. John: Read the link if you’re interested in the statistics. They explain it in 50 something pages.

  84. Capitalism aint natural. The barter system is natural.

    You are so breathtakingly stupid, you have to be a spoof. No one this stupid could type on a keyboard or actually make it through the day without poisoning or electrocuting themselves.

  85. “How many of the uninsured are young and just not buying health insurance because they think they’re pretty much bulletproof right now? I’ve seen estimates as high as 20 million .. almost one-half of the uninsured. Hey, they made their choice … let them suffer the consequences”

    I was one of those people in law school. Two months before I got a job and health insurance I fell and cut my hand very badly. I ended up having to shell out about three grand on the deal. But you pay your money take your chances. Further, if truely are overwelmed by your medical expenses you can declare bankruptcy.

    I think a lot of people would support some kind of trur catastrophic medical coverage subsidized by the govenrment. If you don’t have health insurance and you get cancer, we ought to treat you. The problem is that people take that point and expand it to become, the government should own your healthcare.

  86. I’m going to posit that johnny john john is a sockpuppet created by one of the regular posters to undermine the statist side of the argument. Nice job. I think it might be more effective though if you left out the simulated brain damage.

  87. bookworm:
    “It has worked in the past.”

    Yah I agree that capitalism works sometimes. The world agrees. That’s why the world is almost all uses the capitalist system mixed with socialism.

    And you know what, the mixed system works TOO. And also, universal health care system WORKS TOO. It’s been working for decades in other countries, who use several various implementations of universal healthcare.

  88. Not that the brain damage isn’t a nice touch. It just makes trouncing him not so impressive.

  89. It’s like stealing candy from a retard.

    Which is trickier than you think. A lot of them can hug real hard.

  90. “Liberty vs collectivism debates have one other thing in common: They invariably devolve into a subjective shouting match on cost-benefit ratios of the two ideologies.

    Such unpleasant conversations should be shut down with the simple pronouncement that collective health “care” simply wasn’t — beaning isn’t — enumerated in founding documents”

    Exactly so.
    This is the best post of the thread.

    Here’s a couple of oldies but goodies from a couple of the founders.

    Each one of these quotes contain more wisdom than the sum total of the collective intelligence of all the leftists who have ever lived on earth have ever produced

    “I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents.”

    James Madison

    “The policy of the American government is to leave their citizens free, neither restraining nor aiding them in their pursuits.” – Thomas Jefferson

  91. Tomcat1066 wrote:

    “Jed: I hate to say it, but it was their own damn fault. They didn’t SEEK medical care at their own expense, hence they let themselves down, not the system.”

    I presume you are talking about my young friends who died in their 30s. (One I knew since my wife taught her in school as a child.) They were poor. Their employers did not offer medical insurance. They did not realize how sick they were until it was too late.

    The same thing happened to me when I was in my 30s. I got a bad cold that lingered for weeks. I went to the doctor twice. The third time I called him he said, “Let’s get you into a hospital” and the x-rays showed pneumonia. I was hospitalized for a week or so. The difference is, I had insurance and a family doctor and I could afford it. Take a poor person driving a 15-year old car with rent to pay who gets no time off for work for sickness or vacation. If she goes to the emergency room it will cost her thousands, plus a half-day all from work, because it takes hours. So instead of going, she takes over-the-counter medication and hopes for the best, and she may well die. That was a very common occurrence in the 19th century, and it is becoming common again.

    You are saying it is these people’s fault that they are up against the wall working all hours, barely scraping by, and they cannot afford a day without pay and thousands of dollars in medical expenses. You are cruel and you have no idea what life is like for poor people.

    “Yes, it would have been expensive, but they wouldn’t have died.”

    They did not realize they were at death’s door. Neither did I, even though I went twice to the doctor. Pneumonia does not feel so bad. That’s why Jim Henson died from it. You have to consult with a doctor to know how sick you are. Once it takes hold, it can kill within hours, despite the best care available. My young friend’s last words before they sedated her were “but its just a cold, there’s nothing much wrong with me . . .”

    “The fact of the matter is that the vast majority of hospitals will work with patients to work out a payment plan, but you have to ask for it and stick with it. If not, that’s on you too.”

    Oh sure. I have seen that at work. They show and reposes your car at 6:00 a.m., with the sheriff holding a shotgun if you resist, like they did with my Vet friend. Tell me about it! Yeah, real cooperative. Again, you know nothing about the everyday life of poor people.

    “Of course, you seem to ‘know’ so many people with the short end of your imaginary stick that I seriously doubt anything you say.”

    Okay, if you don’t believe me, read the newspapers. Visit any homeless shelter. Talk to any social worker or minister.

    Yeah, I know some poor people. You evidently do not. That’s fine but don’t imagine that just because you don’t happen to know anyone working at Wal Mart or a food processing plant on minimum wage with no insurance, there are no such people!

    “Your stories smack of scare tactics with no supporting data.”

    My stories are true, and you can learn any number of similar stories at a shelter or church. Or try talking to a homeless person. You should be scared. My father lived through hard times in the great depression. He told me, “when you see a hobo on the street, remember always that the difference between where he is and you are is as thin as a sheet of paper. It could be you next week.”

    “I have known a hell of a lot of people who have shitty situations and have to adapt, whether it was divorce, car repairs, household fires, whatever.”

    If that is the worst you have seen, count your blessings. How many do you know who ended up on the street? Did you ever meet anyone who lived through the Great Depression? You seem to have a short memory and a limited circle of acquaintances. I suggest you get out more.

    “Uncle Sam isn’t lining up to bail them out either, and they shouldn’t.”

    Uncle Sam damn well should help people at their ropes end. What is the point of having a government otherwise?

  92. Reading those quotes makes me want to kiss the Founding Fathers on the lips (if they weren’t guys and all rotten and everything). I think it’s dangerous to even take a small step down the safety net road. Once you start, there’s really no rational means of determining how far is far enough.

  93. Rotten as in moldering, not morally corrupt.

  94. Good answers to Johnny John John, John! Here’s some additional information for Johnny John John to consider which shows that the US health system is far more superior to the countries with socialized medicine.

    The following information comes from “The Top Ten Myths of American Health Care” by Sally Pipes.

    In Canada today, where slightly more than 33 million people live, more than 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 that wait is more than 18 weeks.

    As Brian Day, a Canadian physician and immediate past president of the Canadian Medical Association, explained to the New York Times, Canada “is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years.”

    In part, these waits are due to a doctor shortage. According to the Organization for Economic Cooperation and Development, Canada ranks 24th out of 28 countries in doctors per thousand people. When the government took over the health care system in the early 1970’s, Canada ranked second.

    Indeed, many Canadians can’t even find a doctor. About 10% are 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, about 11% of physicians trained in Canadian medical schools have moved to the US. The average Canadian doctor earns only 42% of what a doctor earns in the US.

    Canada also limits access to common medical technology. When compared to other OECD countries, Canada is 13th out of 24 in access to MRU’s, 18th of 24 in access to CT scanners, and seventh of 17 in access to mammograms. That lack of access is why Canada has seen a 9% decline in breast cancer screening for middle-aged women.

    The problems plaguing Canada’s health care system – long lines, lack of access to the latest technological equipment, and dwindling doctor supply – are unavoidable in a single-payer system.

    More than one million Britons in need of medical care are currently waiting for hospital admission. Another 200,000 are waiting to get on a waiting list. Each year, Britain’s National Health Service cancels around 100,000 operations.

    According to Britain’s Malnutrition Advisory Group, up to 40% of NHS patients are undernourished while in the hospital.

    Sweden’s waiting lists have led some patients to visit veterinarians. As perverse as that sounds, it makes perfect sense – Swedish patients in need of heart surgery are often forced to wait as long as 25 weeks.

    Every European government rations drugs to save money. Eighty-five new drugs hit US pharmacy shelves between 1998 and 2002. During that same time period, however, only 44 of those drugs were launched in Europe.

    European governments also control costs by paying doctors far less than what they would earn in a free market. On average, US physicians take home close to $300,000 each year. However in Italy the average doctor earns $81,414. In Germany, the average physician salary drops to just $56,455, and in France the salary is $55,000.

    Today, the US leads the world in treating cancer. With breast cancer, for instance, the survival rate after 5 years among American women is 83.9%. For women in Britain, it’s just 69.7%. For men with prostate cancer, the survival rate is 91.9% here, yet 73.7% in France, and 51.1% in Britain. American men and women are more than 35% more likely to survive colon cancer than their British counterparts.

    Much of this success is due to cancer screeniong, in which the US leads the world.

    There’s another reason health care costs more in America. And it’s not just because we are a very wealthy nation, demanding the most expensive treatments, technology, and drugs. We’re also investing more in medical research. Other countries are nowhere close.

    Today, the US is far and away the world’s leader in medical research and development. America produces more than half of the $175 billion of health care technology products purchase globally. And US governmental outlays on medical research also dramatically outpace those of other nations.

    In 2004, the federal government funded medical research to the tune of $18.4 billion. By contrast the European Union – which has a significantly larger population than the US – allocated funds equal to just $3.7 billion for medical research.

    Between 1999 and 2005, the US was responsible for 71% of the sales of new pharmaceuticals. The next 2 largest pharmaceutical markets – Japan and Germany – account for just 4% each.

    The US government already pays for more than half the nation’s health care expenses. As lawmakers contemplate expanding that slice of the pie, it’s worth noting that some European and Canadian leaders are pushing for their nations to reduce the government’s role.

  95. RC Dean,

    Medical expenses bankrupt thousands of people every day and they destroy countless lives and fortunes.

    [Barack Obama]

    They are the largest cause of middle-class bankruptcies.

    [Barack Obama]

    The U.S. pays far more than any other country for health care, and our medical care stinks.

    [Barack Obama]

    The Europeans and Japanese are far better off than we are.

    [Barack Obama]

    Any more questions?

  96. Jed Rothwell,

    Your statement had so many contradictions and provably false statements– or at least statements which appear false on their face (lacking further information) one hardly knows where to begin.

    As an employee of a large healthcare organization which has entire departments with full time employees making “charity writeoffs” and helping indigent people get healthcare for little or no money, I’m afraid that your anecdotes are left wanting.

    You’d have had a much easier time convincing me that a recenly laid off middle-class individual who wouldn’t qualify for medicare or medicaid (or government healthcare via the veterans administration) couldn’t get care… but unfortunately you chose to head down the path of poorest of the poor, making me wonder where all the government healthcare expenses for the programs listed above are going.

  97. “I presume you are talking about my young friends who died in their 30s. (One I knew since my wife taught her in school as a child.) They were poor. Their employers did not offer medical insurance. They did not realize how sick they were until it was too late.”

    It would be interesting to know the number of people in the US who died because of a lack of insurance vs. the number who died while on the waiting lists in countries with socialized medicine.

    But there are other ways to provide for the health care of the poor besides putting us all on socialized medicine. You can lower the income eligibility for Medicaid. You can have a voucher system for the poor. You can have tax credits to pay for insurance.

  98. Capitalism aint natural. The barter system is natural.

    I uhh, never mind. I need to get back to bartering my labor for tender.

    I mean, back to my capitalist job…

    I mean… I’m so confrused.

  99. bookworm: I don’t deny that Canada has its own problems. Like I said, no system is perfect (including the freemarket system). Besides, Obama’s not even using Canada as the healthcare model. There are other universal systems out there. They will have their pros and cons. If you want a good comparison of countries check out my link.

    One thing is for certain. Our system is need of reform. Plenty of people have argued our current system isn’t free market anyways. You’ve seen the evidence on how much we spend on healthcare and how its a drain on the economy. I say anything is better than what we got right now.

  100. Paul wrote:

    “As an employee of a large healthcare organization which has entire departments with full time employees making ‘charity writeoffs’ and helping indigent people get healthcare for little or no money, I’m afraid that your anecdotes are left wanting.”

    Evidently your entire department does not manage to cover everyone. There are 40 million people in the U.S. without insurance, and many more who have inadequate coverage, so it is not surprising that you cannot cover them all. As I said, visit any church, shelter or emergency room and you will find dozens of people you do not cover.

    If you do not care for my anecdotes, I suggest you read the ones related by Wendell Potter, former head of corporate communications, CIGNA corporation, here:

    http://www.pbs.org/moyers/journal/07102009/transcript2.html

    Some quotes:

    . . . I drove up 50 miles up the road to [a a health care expedition at] Wise, Virginia. It was being held at a Wise County Fairground. I took my camera. I took some pictures. It was a very cloudy, misty day, it was raining that day, and I walked through the fairground gates. And I didn’t know what to expect. I just assumed that it would be, you know, like a health — booths set up and people just getting their blood pressure checked and things like that.

    But what I saw were doctors who were set up to provide care in animal stalls. Or they’d erected tents, to care for people. I mean, there was no privacy. In some cases — and I’ve got some pictures of people being treated on gurneys, on rain-soaked pavement.

    And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care. People drove from South Carolina and Georgia and Kentucky, Tennessee– all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth.

    There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me.

    BILL MOYERS: What did you think?

    WENDELL POTTER: It was absolutely stunning. It was like being hit by lightning. It was almost– what country am I in? I just it just didn’t seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me. . . .

  101. By definition anything would include the Zimbabwe system.

  102. Yeah, I work with a woman who’ll walk a mile and stand in line for a half hour for a free ice cream cone (seriously).

  103. Besides, Obama’s not even using Canada as the healthcare model. There are other universal systems out there.

    Whoa…whoa…whoa… slow down there Mr. Dillinger…

    Libertarians have been criticized for screaming “Teh Socialism” when all Barack Obama is doing is trying to create a “public option” for healthcare. So is this the tacit admission we kind-of-sort-of knew was coming– that this is where he really wants to go?

    And secondly, supposedly they’re using the [rapidly failing] Massachusetts model for reforms. You know the one where costs went out of control faster than expected after the ‘reforms’ were put into place? The one where the plan administrators themselves said that expanding coverage was easy, controlling costs was “hard”, and that whenever you implement a system like this, there will always be “winners and losers?”

    That system?

    OH, and apropos of all this, did anyone catch the NPR bit where NPR is taking the word ‘reform’ out of their style guide because ‘reform’ indicates change for the good? I’ll try to find the link. Personally, I thought it was pretty explosive.

  104. They did not realize how sick they were until it was too late.

    The poor being ignorant and not getting help before it’s too late happens all the time in countries with robust welfare schemes.

    You have to be educated and middle class to know how to game the system for the most benefits.

    The only attention the poor get in those countries is when fat happy middle clas claims they don’t exist.

  105. “My father lived through hard times in the great depression. He told me, “when you see a hobo on the street, remember always that the difference between where he is and you are is as thin as a sheet of paper. It could be you next week.”

    Which is a great possibility for a lot of us if Obamacare passes. Look at the chronically high double digit unemployment in countries with socialized medicine.

  106. The biggest problem about for profit healthcare is that when you introduce profit into the equation doctors will begin to prefer more expensive tests and operations over cheaper ones. Here’s a great article about that prob

    http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

  107. “Besides, Obama’s not even using Canada as the healthcare model. There are other universal systems out there.”

    Yeah, and they’re all bad. See my lengthy post above. It mentions other countries besides Canada.

  108. Capitalism aint natural. The barter system is natural.

    Self contradictory. Pure capitalism is barter. You’re confusing what we have with capitalism. What we have is a managed market, with many government controlled monopolies, the most damaging of which is monopoly on specie.

    But due to the easily confused.. we tend to use the term ‘free market’ rather than capitalism.

    To whit.

    The free market is ONLY a economic MODEL.

    No the free market is not a model, it’s what happens.. you know.. when people are ‘free’ to perform consensual transactions in a ‘market’. Which never exists for long because collectivists use government to ‘manage’ things.

    You are cruel and you have no idea what life is like for poor people.

    So just how many years of my life do you think it’s ok to enslave me for because you get sick?

    The overall tax burden in the US is ~ 46%. Consider that means out of a finite 40 year work life we’re working almost 20 years for the benefit of someone else.. does this make sense? Who are these ‘someone elses’ we are all helping? How much more do you want?

    I grew up poor. I have every idea what life is like for poor people. That’s why I am trying not to be one. And I am specifically not trying to deflect responsibility for my life onto other people.

    We’re not heartless. But your way doesn’t work

    The greatest good for the greatest number is accomplished by freedom.

  109. “The biggest problem about for profit healthcare is that when you introduce profit into the equation doctors will begin to prefer more expensive tests and operations over cheaper ones.”

    And those more expensive tests and operations are probably better than the cheaper ones. But let’s assume you’re right johnny john john. Overall, the US healthcare system is better by far than the countries with socialized medicine because of all the rationing in those other countries. And it would be even better if we had a true free market in medicine but Obama’s not moving in that direction because he’s such a big believer in big government.

  110. bookworm: whatchu talking about “chronically high double digit unemployment”. Several Universal healthcare countries are doing better than USA

    http://upload.wikimedia.org/wikipedia/commons/5/5a/World_map_of_countries_by_rate_of_unemployment.png

    http://en.wikipedia.org/wiki/List_of_countries_by_unemployment_rate

  111. Interesting that this Jed Rothwell is using as his examples the poorest of the poor who already have a system in place to help them (Medicaid).

    If thes people are so ignorant and helpless that they can’t get help now, what makes you think they’d know how to apply for benefits under Obamacare.

  112. Evidently your entire department does not manage to cover everyone. There are 40 million people in the U.S. without insurance, and many more who have inadequate coverage, so it is not surprising that you cannot cover them all. As I said, visit any church, shelter or emergency room and you will find dozens of people you do not cover.

    My wife visits an Emergency room every day… because. she. works. in. one.

    You’re moving the goalposts Mr. Rothwell. First, people were dying in the streets because they couldn’t get any care. Now they’re getting care, but just not in a way you find acceptable.

    And didn’t this 40 million ‘uninsured’ people get debunked some years ago because it was discovered that many millions within the 40 million had coverage through some other pathway, just not through an employee provided plan?

    As for my knowledge of the emergency room, I’d imagine that I’ve probably forgotten more about how they operate than you’ll ever know.

    And my response to the interview you posted is simply this:

    I never denied that people aren’t getting adequate or enough care. And I never denied our system needs reform. Welcome to the forum, if you spend more time here, you’ll begin to learn of some of the proposed reforms we libertarians would like to see. For your reference, start with Bookworm’s post above. It’s actually a pretty nice summary of how you could expand coverage to the “uninsured” while probably lowering costs and avoiding healthcare “rationing” which the Obama administration has twisted itself into linguistic knots attempting to avoid the words. At least Peter “infanticide-is-ok-when-I-say-it-is” Singer is more honest about the issue.

    Healthcare is not a limited resource. The government is priming you for believing it by telling you it is, so when they take control of it everyone will be reserved to the fact.

  113. http://en.wikipedia.org/wiki/List_of_countries_by_unemployment_rate

    Johnny john john… john…. john… joooohhhhnnn…. You actually posted a wiki reference to countries by “unemployment rate” to prove that they’re doing better than us?

    Should I give you five minutes to think that through and post a retraction?

    No, I’m gonna drop the 2000lbs of bricks on ya right now. At the height of the Soviet Union, what was their “unemployment rate”? I’ll give you a hint, according to official statistics, their unemployment rate was 0% My BAD! That wasn’t a hint, that was the fucking answer. I’m always doin’ that.

    Bzzzzzzzzzzzzzzzt, thanks for playin’ Johnny john john johnaroonie, johnalicious, johnabomasticatus!

  114. I’ll add another inconvienent fact to the mix for the leftists who hold up other western nation’s socialzed medeicine systems as an example of success.

    Not a single one of those nations would be in existence as an indepedent country today if they had been receiving military protection welfare from the United States ever since World War 2.

    Absent that, they wouldn’t have been able to spend anything on social welfare programs. They would have had to devote virtually all their resources to their own militaries for defense – and they STILL wouldn’t have been able to survive against the Soviet Union and /or the Chinese.

  115. Pure capitalism aint barter.
    Capitalism = an economic system based on private ownership of capital

  116. make that “if they had NOT been receiving military protection welfare”

  117. Pure capitalism aint barter. Capitalism = an economic system based on private ownership of capital

    Wow. You are either 6, a retard, or a spoof. Either way, you are not worth talking to.

  118. Paul : I trust wikipedia more than I trust you. I never said that the evidence was infallible, but it was the easiest one to get.

    You’re just avoiding the evidence anyways. I found other more “reputable” links, but wikipedia always has the best presentation.

    The “fact” is that many European countries using universal healthcare have superior unemployment rates to USA. Deny that if you want, but that’s the statistic.

  119. Pure capitalism aint barter.
    Capitalism = an economic system based on private ownership of capital

    So in a barter system, you don’t own the fruits of your labor? And you don’t trade your labor for goods or property?

    Man, I have never in my life seen a man dig his own grave faster than you are Johnny john johnaroo.

    Sorry, pure capitalism is barter. Even unpure Capitalism is barter. For Chrissakes, Johnny john johnabanabobanna, Obama’s version of capitalism is barter writ fucking large. Large corporations and Unions make donations and do campaign work for Mr. Obama, in return he gives them favors, property and taxpayer dollars. Barter, pure and simple.

  120. “There are 40 million people in the U.S. without insurance”

    Actually 45.7 million. Who are these 45.7 million?

    Almost 18 million make more than $50,000 a year and could afford health insurance but prefer to spend their money on other things. That figure represents 38% of that 45.7 million.

    Ten million of the 45.7 million aren’t even US citizens.

    As many as 14 million of the 45.7 million are poor and low-income Americans who are fully eligible for current government assistance program like Medicare, Medicaid, and SCHIP. The problem is, they’re just not enrolling in those programs.

    That leave 3 to 4 million who are too poor to buy insurance but not poor enough to qualify for government assistance. Wouldn’t it be better to give these people vouchers or raise the income requirement to include them as qualifying for Medicaid or SCHIP or allowing them to purchase high deductible catastrophic policies or giving them tax credits to purchase insurance or encouraging people to create a charity fund for them rather than putting us all on a socialized medicine plan that will create rationing in this country?

  121. Pure capitalism aint barter.
    Capitalism = an economic system based on private ownership of capital

    Barter economies traditionally have no medium of exchange. Hence, any economy that has any kind of medium of exchange isn’t a barter economy.

    Would anyone care to take a guess when a barter economy was used beyond the early agricultural stage of development?

    Paul, BTW, has it pretty well nailed. I can confirm from personal experience what he says about the operation of health care organizations and the “medically indigent”.

  122. “You are saying it is these people’s fault that they are up against the wall working all hours, barely scraping by, and they cannot afford a day without pay and thousands of dollars in medical expenses.”

    I have run across this fallacious notion before on another thread arguing with a leftist about whether healthcare was a “right” and we were all collectively obligated to ensure everyone got it.

    They seem to think that stating that somene didn’t “deserve” their misfortune or wasn’t at “fault” for something that happened to them somehow “proves” that other people are responsible for that person’s welfare.

    There is no connection between one concept and the other.

    In order to prove that person A was responsible for remedying something that happned to person B, you would have to prove that person A personally caused the misfortune that befell person to to occur.

    Otherwise, it makes no difference whether something that happened to someone was “their own fault” or not. It wasn’t anyone else’s “fault” either.

  123. In a true barter system you don’t have a common unit of exchange… I know we’re arguing about semantics but I try to stick to strict definitions of things.

    The barter system only refers to the method of exchange. It does not refer to the entity that performs the exchange, whether it be “public” or “private”.

    So barter != capitalism.

  124. Kreel Sarloo wrote:

    “‘They did not realize how sick they were until it was too late.’

    The poor being ignorant and not getting help before it’s too late happens all the time in countries with robust welfare schemes.”

    It isn’t a matter of being ignorant. I am well educated and experienced with disease, but I did not realize I had pneumonia until it reached a dangerous level. When my elderly father had it, he was talking, eating and comfortable. A few hours later he took a nap and died. (He was hospitalized with other problems, so it was no shock. The point is, it does not feel so bad.)

    It is a matter of access and cost. In Japan people seldom die for lack of access. There are small clinics everywhere and anyone, rich or poor, feels free to visit a doctor when he or she is not feeling good. It is much more convenient than the U.S. even for wealthy people (like me) because the clinics are close, there is no waiting, and you don’t need an appointment. You figure “why not go and get something for this itch/pain/cough?” I know people who found they had serious conditions because they went in for what seemed like a minor problem. A middle-aged farm woman I knew on an island in the Inland Sea was feeling kinda bad but not horrible, just short of breath and crummy and dizzy. She walked a kilometer to the village clinic and an hour later they transported her to the mainland and her in heart surgery. She lived another 20 years.

  125. Paul : I trust wikipedia more than I trust you. I never said that the evidence was infallible, but it was the easiest one to get.

    You’re just avoiding the evidence anyways. I found other more “reputable” links, but wikipedia always has the best presentation.

    Oh, you thought I didn’t trust your source because it was Wikipedia. Re-read my message. Read it carefully. “The official unemployment rate of the Soviet Union was 0%”. That is a fact. Soviet Union had 100% employment. *sigh* I dunno, John, I still feel that deer-in-the-headlights vibe comin’ from ya. Ok I’ll spell it out for you.

    100% employment is not a good metric to base whether a country is ‘better than you’ or not. Did you notice Botswana has a 7.5% unemployment rate? Botswana. If you’re not “getting” what I’m saying, accuracy of Wikipedia COMPLETELY aside, UNEMPLOYMENT IS NOT THE ONLY METRIC YOU WANT TO USE TO SHOW SUCCESS!

  126. BTW I never advocated barter, if you think I am doing so. I just merely said that the barter system is the “natural” economic system that preceded capitalism, as practiced starting in the 16th century. Obviously.

  127. “Capitalism = an economic system based on private ownership of capital”

    Now define capital, and you’re in business Johnny boy.

    Hint: Sometimes it’s money, and sometimes it isn’t.

    If you don’t get that barter requires private ownership of “capital”, it may be a little hard to help you there buddy.

    You see… for you and I to trade something, a few prerequisites need to be met. 1. We have to each agree that what the other has is more desirable than what we currently hold, 2. We must each agree that what each other has is owned.

    If we didn’t recognize private ownership, then (given your arguments thus far around here) you’d probably try to just take what you wanted by force.

    That would be undesirable to me and ultimately bad for you since the use of force tends to have some other consequences…

    Now… Scale that idea up a bit, say it’s not just me trading “stuff”, but me producing the stuff to begin with – why do you suspect I might be interested in using massive amounts of my time & energy to produce stuff if I believed you would later come whack me on the head and take it from me without giving me anything in return? I’m curious.

  128. Paul: I was responding using the unemployment measure because I was refuting something bookworm said.

    If you want to see GDP per capital, Several universal healthcare countries STILL BEAT THE USA. If you trust that measure better. Look it up if you’re not convinced.

  129. According to the CIA world factbook – Cuba currently enjoys a robust 98.2% employment rate! Well done Cuba!

  130. No shit capitalism MAY use a barter system if desired, but a BARTER SYSTEM does not have to use a completely capitalistic system. They are not the exact same thing

    Get yalls definitions straight.

  131. So barter != capitalism.

    But capitalism == barter. Or let me be more clear, the IRS says that capitalism is barter, and actually, more specifically, barter == capitalism. And barter is a form of monetary exchange. If I paint your house and in return you trade me that totally sweet 69 Camaro in your driveway, the IRS is going to be very interested in my reporting that on my next tax return. So what are we arguing about?

  132. BTW I never advocated barter, if you think I am doing so. I just merely said that the barter system is the “natural” economic system that preceded capitalism, as practiced starting in the 16th century. Obviously.

    Sorry, John, I missed this post.

    Unfortunately, then if I take your statement at face value, then we’re really stuck on the definition of “natural”. Capitalism was a ‘natural’ outgrowth of the complications of barter on a complex economy. So by my definition, capitalism is ‘natural’.

  133. Gilbert Martin wrote:

    “. . . They seem to think that stating that somene didn’t “deserve” their misfortune or wasn’t at “fault” for something that happened to them somehow “proves” that other people are responsible for that person’s welfare.

    There is no connection between one concept and the other.

    In order to prove that person A was responsible for remedying something that happened to person B, you would have to prove that person A personally caused the misfortune that befell person to to occur.”

    When it comes to disease and medical care, Winston Churchill and I disagree with you. There are self-induced illnesses such as cancer from smoking and obesity. But with most common diseases, such as pneumonia or heart disease, it is not the patient’s fault. It is not anyone’s fault: getting sick is a random event, like getting into a traffic accident when you are sober and driving at the speed limit. It can happen to anyone.

    Therefore, Churchill reasoned, we should deal with it the same way we deal with a traffic accident or fire. We send the police and firemen out immediately. We fix the problem. We don’t ask if the victim is rich or poor, a good citizen or a criminal. It is society’s problem because no one chooses to be sick and no one can help getting sick. You do not “personally cause the misfortune” when your neighbor’s house catches on fire, but you don’t begrudge the public expense of sending the firetruck either. (I hope you don’t! Only Ayn Rand would be that crazy.)

    This is a practical matter. Morality and your obligations hardly enter into it. We are not talking moral abstractions: we cannot have infectious sick people wandering the streets or dying in the gutter. You don’t want to live in a place where things like that happen, believe me.

    No two products are services are exactly alike. The laws of economics are abstractions that in real life do not apply imperfectly or without distinction to computers, food, and movie tickets. Some things are necessary for life, and others we can do without. Some demands are elastic and others are not.

    Medical care is not like any other aspect of life, and it is far different from anything else we pay for. For one thing, we don’t want it! I never go to the doctor for pleasure. So it does respond to the rules of supply and demand the way other goods and services do. We cannot treat it the way we treat your choice of automobiles or houses or I-pods.

  134. Jed Rothwell | July 23, 2009, 5:04pm

    You quoted me and then wrote two paragraphs in which you did not contradict a single thing i said.

    Outcomes for the poor and ignorant are almost always bad.

    If someone like your friends had waited as long because they did not realize how bad their conditions were the outcme would have been the same in Britain under the NHS or Canada with single payer or France or any other place you want to mention.

    If you leave things too late it doesn’t matter who’s paying.

  135. Medical care is not like any other aspect of life, and it is far different from anything else we pay for.

    Some would disagree.

    For one thing, we don’t want it! I never go to the doctor for pleasure.

    And this is where we come to the seemingly insurmountable barrier. Some people do go to the doctor for pleasure. Your reasons for going to the doctor are your reasons. To have a central planning agency telling you when, where, how and if you’ll go to the doctor poses some seriously moral questions. I don’t doubt you’d disagree. I think the problem here is that you believe that a central planning agency will always make the right decision because like Robert Macnamara thought in Vietnam, with enough data, we can analyze our way to success. We respectfully disagree.

  136. bookworm wrote:

    “. . . Wouldn’t it be better to give these people vouchers or raise the income requirement to include them as qualifying for Medicaid or SCHIP . . . rather than putting us all on a socialized medicine plan that will create rationing in this country?

    What are you talking about? This is nonsense. No one plans to put “us all” on “socialized medicine.” They don’t do that in Japan, Europe or Canada.

    Rich people in these countries go to superb hospitals with private rooms and a nurse on duty at all times. Not all rich people: I know some who don’t mind going to ordinary hospitals. The point is, if you have money and you want to pay extra for deluxe unlimited medical service, you can. It is available. You can get medical insurance or you can pay a la carte. No one is forced into the national health care systems.

    I myself would be happy with the regular national health hospital service in rural Yamaguchi Japan. It seems as good as any hospital based on outcomes for ectopic pregnancy, open heart surgery and other problems my friends have had there. Except that the food is awful. If I ever find myself there, I will pay someone to bring me decent food from the shop down the street, which is very good.

    As for rationing, we already have it in the U.S. and it is much more severe than Japan or Europe. It works like this: if you have no money and no insurance, you get nothing. You suffer and you may die from some minor illness that a middle class person would get treatment for. Wealthy and middle class people get their share of the ration, poor people get misery, pain and death. All of us get much crappier, more painful, inconvenient, impersonal care than a poor person living in rural Yamaguchi gets, and society-wide we pay 3 times more for the privilege. At the end of life, instead of treating you with dignity and painkillers, they string you out with machines and pump ever last dollar you have put aside for your children.

    Why Americans put up with this outrage I do not know. I suppose it is because most of them have never lived overseas and do not realize how bad our system is.

  137. “When it comes to disease and medical care, Winston Churchill and I disagree with you”

    Winston Churchill?

    What Winston Churchill thought about it is irrelevant.

    He wasn’t involved in the either the drafting of or ratification of the United States Constitution.

    The 10th Amendment confines the federal government to powers enumerated in the Constitution. There is no enumerated power containted therein that authorizes the federal government to establish a mandatory participation socialized medicine scheme.

    Scroll back up and read the quotes I provided by James Madison and Thomas Jefferson.

  138. Paul wrote:

    “‘For one thing, we don’t want it! I never go to the doctor for pleasure.’

    And this is where we come to the seemingly insurmountable barrier. Some people do go to the doctor for pleasure.”

    Yes, there are few people who do this. There are even a few who drag their children; Munchausen by proxy syndrome. But this sort of thing is very rare and it has no impact on medical costs. It is also a mental disease which should be treated in its own right.

    “Your reasons for going to the doctor are your reasons. To have a central planning agency telling you when, where, how and if you’ll go to the doctor poses some seriously moral questions.”

    In Europe and Japan no one ever tells you when, where and how you’ll go to the doctor. You just go, whenever you feel like it. There is no waiting, either, and most people live a few kilometers away from a clinic. The National Health people might, conceivably, prevent you from getting a $300,000 treatment that is unlikely to do any good, but if you have the money you can always pay for it yourself.

    No one I know in Japan has ever been denied treatment for anything, and I know lots of people who have undergone lots of treatments over the last 40 years, including very expensive procedures.

    In any case, in the U.S. we have health insurance companies doing exactly what you describe: rationing health care. Telling people where they have to go. denying procedures in ways that never happen in Japan. Why do you think that privately run, for-profit planning agencies are better than centralized ones? Because there is competition? There is practically no competition. The health care industry is made up of gigantic cartels.

    I think the problem here is that you believe that a central planning agency will always make the right decision . . .

    I have lived with national health care and seen it operate for 40 years in Europe, Japan and Canada. Your ideas about these systems are fantasies.

    First: it is entirely voluntary. There are plenty of private hospitals in these countries that will do whatever you like for huge sums. Obviously, things like plastic surgery are not covered by the N.H.S.

    Second: the quality of care and overall outcomes are FAR better than the U.S. Longevity, hospital infection rates, and all other relevant statistics show they are far ahead of us overall. Patient and family satisfaction is much higher. 70 to 80% of the people in these countries are happy with their system. In the U.S. it is 40 to 50%.

  139. Except that the food is awful. If I ever find myself there, I will pay someone to bring me decent food from the shop down the street, which is very good.

    Arguments about socialized medicine aside, you can’t do that. Hospital diets are usually planned very carefully because you may be in for a condition which doesn’t allow the intake of certain foods. Just sayin’.

    It works like this: if you have no money and no insurance, you get nothing.

    First: wrong. This is a demonstrably false statement. It is in direct contradiction of established fact.

    Secondly, must we go into a distinction between resource rationing and price rationing?

    Price rationing is a completely different form of distribution which is why some economists don’t even like to call it rationing. As someone months ago said in another thread, OF COURSE we ration by price, that’s why Jay Z has five lamborghini’s, and you don’t have any. Tell me you see the difference. Please, just tell me you at least recognize that difference.

    Wealthy and middle class people get their share of the ration, poor people get misery, pain and death.

    This is just the kind of hyperbole that causes the debate to stop dead in its tracks.

  140. “we should deal with it the same way we deal with a traffic accident or fire. We send the police and firemen out immediately.”

    Using that logic, we should have single payer house insurance and single payer life insurance in addition to single payer health insurance.

  141. “Price rationing is a completely different form of distribution which is why some economists don’t even like to call it rationing. As someone months ago said in another thread, OF COURSE we ration by price, that’s why Jay Z has five lamborghini’s, and you don’t have any.”

    Indeed so. Rationing involves government force. The market doesn’t ration. The outcomes are the result of voluntary transactions entered into by people exercising their right to freedom of contract and private property rights.

  142. Plus, there are not 47 million Americans without coverage. Closer to 10. We could deal with that easier than overhauling (translation: wreaking) the healthcare system.. It could also deal with those who had insurance but lost it (as of now, those people are those who fall in and out of the 10 million without insurance who are also not eligible for existing programs).

  143. Paul wrote:

    “‘Except that the food is awful. If I ever find myself there, I will pay someone to bring me decent food from the shop down the street, which is very good.’

    Arguments about socialized medicine aside, you can’t do that. Hospital diets are usually planned very carefully because you may be in for a condition which doesn’t allow the intake of certain foods. Just sayin’.”

    I realize that, but if I do not feel like following the doctor’s orders, I don’t. What are they going to do, call the police? I never let doctors push me around.

    Some of the other people I know who were in the hosp. in Yamaguchi also had food brought in. Sushi. Against doctor’s orders.

    When my grandmother was in her last weeks of life, circa 1978, she finally called an ambulance and went to the hospital. She had catered meals brought in ever day and paid the bill every night. She feared losing control most of all. She asked the doctor “can you keep me here against my will.” The doctor said, “lady, you called the ambulance to come. Call them again, and they’ll take you home.” He knew how to deal with her.

    “‘It works like this: if you have no money and no insurance, you get nothing.’

    First: wrong. This is a demonstrably false statement. It is in direct contradiction of established fact.”

    I realize that some poor people do get charity, but many do not. If you doubt this, I suggest you talk to any minister or read the article by the Wendell Potter from Cigna. Or do you think he is also lying or making up stuff?

  144. “If someone like your friends had waited as long because they did not realize how bad their conditions were the outcme would have been the same in Britain under the NHS or Canada with single payer or France or any other place you want to mention.”

    Ummm in Canada they would just walk into any hospital and get treated. In USA, the only way to find out how sick you are is to visit the doctor. If you find out it was nothing you just wasted your money. The fact that someone has to perform risk analysis before going to the doctor makes decisions far more complicated. This is further complicated by the fact that nondoctors don’t have the expertise to perform risk analysis.

    In a universal health care system the risk of going to the doctors’ becomes almost zero, the worst thing that could happen is you waste your time. So overall more people would go to the doctor (as proven by various statistics in universal health care countries) in a universal health care system. Arguably, people would ultimately be healthier because of that.

  145. Barter economies traditionally have no medium of exchange. Hence, any economy that has any kind of medium of exchange isn’t a barter economy.

    Do you mean to define ‘capitalism’ as that one in which there exists a government monopoly and government mandated currency?

    Because other than that everything is a medium of exchange. The only way to then define ‘barter’ would be when no one ever exchanges the result of a transaction with another party, which would basically mean there could only be two commodities in the world. If Joe has meat and needs grain, and Jim has grain but needs vegetables, and John has vegetables but needs meat they will all die of malnutrition unless something becomes a medium of exchange.

    So far as I know barter is a capitalist system by definition, regardless of the convenience or inconvenience of mediums of exchange.

    If you don’t own property how can you trade it?

  146. True as far as it goes, but the real reason Harvard is in so much trouble is they fired/ran off all the smart market movers who built that endowment up from nothing, because professors were mad that making billions paid more thousands then writing books no one will read.

    The replacements poured money into the market, especially expensive hedgefunds, and are now paying the price. Not to mention Harvard has spent almost $2B on new construction in the past 5 years.

    The new construction binge went on under Summers’ watch. And rather than secure funding as they normally did, Summers gave the OK to borrow to the hilt for it. I know faculty at Harvard who questioned the sudden change in building policy and they were all essentially told to fuck off. All that was Summers’ doing.

    Harvard’s change in financial policy started under Summers’ watch and now they are paying for it.

  147. In Europe and Japan no one ever tells you when, where and how you’ll go to the doctor. You just go, whenever you feel like it. There is no waiting, either, and most people live a few kilometers away from a clinic.

    Your tactic seems to be to throw in a dozen “facts” all of which beg some question, but muddle the concepts so completely, that it’s becoming harder to respond to you. I’ll do my best.

    Firstly, you’re using “europe” as an all-encompassing concept of ‘universal healthcare’ within which there are many different systems. For the purposes of your example of ‘no waiting’ (which is abject bullshit), let’s take France which most agree has relatively few waiting lists.

    France provides a basic, universal health insurances through large occupation-based funds. The General National Health Inusrance Scheme covers 83% of French workers, while other occupational specific (e.g.: for agricultural workers, for the self employed, for miners, etc.) cover the remainder. About 99% of individuals are covered by this universal health insurance system.

    However, France utilizes more market-based ideas than most people realized. Copayment rates for most services are 10%-40%. About 92% of French residents have complementary private health insurance. [emphasis mine]

    In essence, the French system avoids widespread rationing because, unlike true single-payer systems, it employs market forces. Even the OECD says that the “proportion of the population with private health insurance” and the degree of cost sharing are key determinants of how severe waiting lists will be.

    Translation: France is not as public a system as many people believe. It relies heavily on an underlying free-market system. Source.

    After France, waiting lists can get long and ugly– especially the more public and less private their systems get.

    Skipping the ‘most people go whenever they want’ because that’s a vague assertion from which one could take several meanings.

    Moving to most people living within a few kilometers of a clinic. What does this mean? Would you like me to take a random shot of every tiny to large metropolitain area in the unitied states, red-dot the clinics and calculate if “most people live within a few kilometers of a clinic”?

    Dude, seriously, I remember a study years ago which showed that there were more advanced cardiac facilities in Los Angeles county than there were within the entire country of Canada. My wife (who works in the emergency room and did a long stint in the NICU) often receives patients from Canada because there are no facilities at all in some segments of Canada. And after the Canadian supreme court totally messed up canada’s healthcare shit (to coin a phrase) the Canadian system was under pressure to actually start giving people care— not just “access” to care. So they send their patients down here. And believe you me, they tended to send their toughest patients here.

  148. Ummm in Canada they would just walk into any hospital and get treated. In USA, the only way to find out how sick you are is to visit the doctor.

    ?!!!!! Say what?

  149. Actually medical care does respond to competition just like other goods and services. And with competition will bring lower costs, and higher quality.

    In fact that was something that was hammered again, and again at the hospital I used to work at. People do have a choice for many types of medical care(even some ER care in more populated areas).

    Primary care certainly has a choice, and most of your big operations are scheduled well in advance giving you plenty of choice for providers there too. You don’t think people won’t drive an extra hour or two if they think the care is better?

    I do think our current system is broken, mainly because the link between who pays (or when they pay) and who/when people get services is broken. This results in to much services being consumed, and people not caring about price.

    For example, how many parents take like Johnny to the doctor every time he gets a cold? What for, they can’t do anything for him anyway, it’s a dam virus. And if you do go, you don’t need to see a docotr anyway, a nurse practioner would be more than competant to diagnois, at a quarter of the price.

  150. Ummm in Canada they would just walk into any hospital and get treated.

    Do tell. You should try that plan sometime, rofl.

    In USA, the only way to find out how sick you are is to visit the doctor.

    Unlike in Canada where there’s no doctors in hospitals? You’re one confused puppy.

    Regardless while you cannot walk into a hospital and get treated in Canada, you can in the US.

    In a universal health care system the risk of going to the doctors’ becomes almost zero. So overall more people would go to the doctor (as proven by various statistics in universal health care countries) in a universal health care system.

    And this will be a great boon for the overuse of the health care system do you think? Won’t cause more inflation hmm? Clearly when things are free people stop over consumption amirite?

    Arguably, people would ultimately be healthier because of that.

    Oh I SEE now. Because something is free people will use it more resulting in more needless treatment and reduced health care availability for people who really need it and this will make all people ultimately healthier.

    Arguably.

    By an authoritarian idiot.

  151. I will again contribute my blog to this variety of discussion – though it was a bit more directly related when Reason had mentioned the Peter Singer piece but here everybody:

    Why We Must NOT Ration Health Care – written just last week in response to the egregious Peter Singer piece in NY Times Magazine “Why We Must Ration Health Care”

    Some quotes that are relevant to this discussion immediately:

    “So let’s clear this up right now. To most people, the word rationing has a specific meaning, and that is this:

    Rationing
    -noun
    1. a fixed allowance of provisions or food, esp. for soldiers or sailors or for civilians during a shortage: a daily ration of meat and bread.
    2. an allotted amount: They finally saved up enough gas rations for the trip.

    That definition is what economists might refer to as “non-price” rationing. So when Peter Singer uses the word “ration” with no qualifiers in the New York Times, the average reader immediately assumes the Webster’s definition. And thus without thinking about it, readers are subtly lead to believe that there is no difference between price rationing (markets) and non-price rationing (government or other agent of force).

    Non-price rationing is a concept that can, by definition, only apply to an entity with centralized control of the provision in question. Thus the word applies to top-down monopolistic systems such as government, which can control all supply of a given good and then distribute an “allotment” to people by fiat, leaving you unable to get the good otherwise.

    By contrast, a decentralized free enterprise system for that same good is in fact quite the opposite of that definition of rationing!

    In a free market system (and even in most aspects of our current hampered market “mixed economy”), it’s you – not the government or any other authority – who decides what value a good or service has, and you are not limited by anything other than reality and your ingenuity.”

    and…

    “The fact is, we simply don’t hear about the high cost of medicine as a consequence of government intervention very often.

    For example, when was the last time the New York Times bothered to mention that it costs around 6 years and $1 Billion[15] to get a new drug approved by the FDA? The American public rarely hears that the FDA has more than doubled[16] the number of clinical trials needed for new medicine. No one bothers to mention that Medicaid & Medicare chronically underpays[17] private health care providers for their services – forcing them to make up their losses by charging private insurers & patients more than they otherwise would. Nor does anyone remind the American public that with the help of congress & funding of the US taxpayer, the AMA restricts[18] the number of medical licenses granted and thus the number of available doctors is always kept at a minimum – a standard tactic for any union to keep out competition for labor and force employers to pay higher wages to the members of their club. These are just a few of literally hundreds of examples where government intervention has directly caused a significant increase in the cost of medicine in the United States.

    But these topics aren’t even addressed by Peter Singer! Nope? The assumption readers of his Times article are required to hold is that Sutent costs $54,000 and that’s that. The cost of the drug is high, fixed, and there’s nothing to be done about it. Singer presents a world where you have Option A: Let greedy insurance execs “ration” health care, or Option B: Let a (non-greedy?) government bureaucrat do it.

    But Professor Singer forgets to give you Option C: Get rid of the ridiculous government interventions into the market. Allow insurance companies to compete nationally, allow competition in medical licensing, allow nurses & other non-MD health professionals to treat minor injuries & illnesses and set up their own practices, remove the barriers to new competition, make it easy for drug companies to license their inventions to other manufacturers and get the government out of the business of paying for health care entirely.

    The answer to Peter Singer’s scenario is not to sit around deciding who we should let die. The answer is to produce enough so that everyone can live.”

    Sorry to drop some knowledge and run, but I gotta go do some more work now kids… So that I can pay for my own health insurance… OMG… at $60 a month with a relatively high deductible, it’s sooooooo hard!

  152. Paul: I think almost all universal-healthcare advocates want market forces to help control it. There is no healthcare system completely controlled by the gov’t in the world (at least I don’t think, maybe Cuba), and nobody is advocating that. Many systems still use private insurance or private doctors, or public insurance or some sort of combination of those things.

    However, more importantly, many people (like me) want universal healthcare. Exactly how we implement it I dunno.

    Also, nobody disputes that USA has the best cancer facilities in the world. That probably has to do with the fact that the USA has the largest cancer rates in the world too, and our system merely caters to our own needs. There is nothing to prove that post-universal healthcare our cancer facilities will worsen.

  153. And… one more thing… How come for all the statist morons posting today the alternatives are:

    A. “Evil greedy capitalist pig” doctors & insurance companies who charge you more just cause they hate you and 40,000,000 uninsured = 40,000,000 inches from DEATH!!! OMFG!!! America HATES poooor people!

    and…

    B. Magical unicorn fairyland where you just waltz down to your local clinic and they treat you perfectly and cure every disease for freeeesies!

    ?

    I imagine if I lived in a world where things were all bad or all good and there were no trade offs at all I too would be mystified by anyone who didn’t want “free” medicine.

    TINSTAAFL FTW!

  154. In a universal health care system the risk of going to the doctors’ becomes almost zero, the worst thing that could happen is you waste your time.

    No, the risk of a ‘free system’ is that it gets overused and costs the system an ever increasing amount of the GDP. Johnny jj, meet economics, economics, meet Johnny jj.

  155. Lastly, Johnny John John. I’m impressed, you are extremely high functioning for someone with your disabilities. Good for you.

  156. That probably has to do with the fact that the USA has the largest cancer rates in the world too, and our system merely caters to our own needs.

    Our system caters to our needs? I thought that the whole point of this discussion was that the system doesn’t cater to our needs. And on the largest cancer rates comment, can you drop a citation on a brother?

  157. There is nothing to prove that post-universal healthcare our cancer facilities will worsen.

    There is nothing to prove monkeys won’t fly out of your anus either. I wouldn’t buy those futures tho.

    However, more importantly, many people (like me) want universal healthcare. Exactly how we implement it I dunno.

    I know.

    First you make other people work more of their lives for you and take their money. Then you further burden the system by giving away free healthcare and removing all incentive to not wastefully use healthcare resources. Then when people stop becoming doctors because they are force to treat people who don’t need treatment, have to turn away people who do need treatment, have their wages capped, and health care supply continually declines and costs go up, then you set up rationing bodies. The old are the first to go of course. They already had a youth after all. And blessedly to the politician they have fewer years left to vote, so if you’re a politician it’s easy to triage this.

    Again.. how many years of my life is it ok for you to enslave me because you got sick? And as soon as you put a number to that question I’m going to put a number on the value of your life to me.. and compare it to other peoples’ lives.

  158. One other thing to consider, is the American healthcare consumer finances the majority of medical advances in the world. Europe, Canada etc gets away with paying less for drugs etc because WE pay more thus allowing enough of a profit factor for the companies to spend the billions in research to develop them.

    So…

    Maybe we should pass a law that European providers can’t pay less for a drug than we do!

    A little bit more cost sharing sounds like a good idea to me, lol

  159. Paul wrote:

    “Moving to most people living within a few kilometers of a clinic. What does this mean? Would you like me to take a random shot of every tiny to large metropolitain area in the unitied states, red-dot the clinics and calculate if ‘most people live within a few kilometers of a clinic’?”

    I believe you misunderstand. The “access” problem in the U.S. is mainly in rural areas and in poor neighborhoods. Some people in rural Georgia live 50 miles from the nearest clinic, and many poor people do not have cars or reliable transportation, or they are elderly or disabled. So they don’t go to the clinic for some minor problem that turns out to be major.

    I mentioned the farm woman in Ohshima, Yamaguchi. The clinic in town 20 years ago had an elderly doctor (a sweet fellow) and antiquated equipment. It was not the kind of place you would go for serious treatment or may not even a complete physical. It was fine for asthma medicine, or a tetanus shot and stitches — the sort of thing you often need in the countryside. Mainly, it was excellent as a referral service. When my friend went there she had no idea there was anything seriously wrong, and I wouldn’t have a clue, but an experienced doctor with a stethoscope could recognize this problem and call an ambulance. Community based service of this kind is invaluable. In Georgia we are starting to see this with walk-in clinics in drugstores.

    Regarding Canada, laugh all you want, but yes, people really do go the hospital or doctor whenever they feel like it. No hassle, no delay. Same in Japan. We are not talking about people going in for complex expensive procedures. You can save a lot of lives and give people happier lives by fixing cavities and giving tetanus shots and asthma medicine and stitches when they need it. In Georgia, a large fraction of the adult rural population have no teeth. Denture services are everywhere. Having no teeth is pretty miserable. It affects your diet and outlook and quality of life. In rural Japan that is extremely rare, because going to the dentist is free, and the dentist is nearby. The only farmer I know who is missing many of his teeth bashed them in with a farm accident. They do have a lot of accidents out there.

    The population in rural Yamaguchi Inland Sea is the oldest in Japan, making it about the oldest in the world. They are incredibly healthy people. A lot has to do with lifestyle and food and so on, but I know several dozen people who would have died long ago were it not for the N.H.S. By U.S. standards they are nearly all elderly poor people.

  160. I believe you misunderstand. The “access” problem in the U.S. is mainly in rural areas and in poor neighborhoods. Some people in rural Georgia live 50 miles from the nearest clinic, and many poor people do not have cars or reliable transportation

    Yes, there are always people that choose to live in areas so remote (love that open space!) who live 50 miles from a clinic. I know people like this. Seriously. And to…the…last… they choose this lifestyle. I’m not sure if a public/universal system would fix this. And there’s plenty of evidence that a free market system addresses it better. If there’s a cluster of people that make a clinic economically viable, one will open. However, you said, and I quote “most people live within a few kilometers of a clinic” What was I to take as to the implication? That in the US “most people don’t live within a few kilometers of a clinic”? Again, I’m not sure if ‘universiality’ answers this particular problem.

    We’re becoming men in a burlap sack trading anecdotes for a living here. I work in one of the poorest neighborhoods (often referred to as ‘underserved’) in the Seattle area. The entire landscape is literally dotted with clinics, both large and small. The fact is that in this country “most people are within a few kilometers of a clinic” so we can probably put this end of the debate to bed. Any discussion of transportation to and from a clinic isn’t even a healthcare discussion. That’s something else entirely. So let’s not muddy the water with that.

  161. comrade wrote:

    “we should deal with it the same way we deal with a traffic accident or fire. We send the police and firemen out immediately.”

    Using that logic, we should have single payer house insurance and single payer life insurance in addition to single payer health insurance.”

    That is incorrect. House fire insurance applies after the fire is extinguished and the building is declared safe (or condemned). We are talking about immediate expenses during the disaster, when people’s lives are in danger and the fire might spread to other houses. That has to be a shared, public expense.

    Along the same lines, when someone is sick, especially with a contagious disease, we must take care of him and keep the disaster from spreading. What follows after he recovers is his own responsibility. After a long illness he may lose his job or have his marriage collapse, but that is not society’s problem.

    If your house burns down, after the fire department goes home, if you cannot rebuild, you have to sell the land and move on. If after you recover from illness your life is not the same you have to rebuilt that, too.

    Of course if the disease physically disables you, leaving you crippled, or in pain, or with impaired vision, then you never fully recover and society has to take care of you if you cannot take care of yourself. In any civilized modern nation that is how things work. Gilbert Martin points to the Constitution and says it does not authorize us. I think it does with the General Welfare part, but in any case, if it does not, I feel no more bound by it than I would by the Bible. I am not going to stone people to death for homosexual behavior or for wearing cloth made of two different fibers, or for picking up sticks on Sunday. And I am not going to be bound by 18th century standards of health care and society. We live in a high tech modern and we must deal with it and make the best of it and I say to hell with ideology and theory. I favor pragmatism.

  162. Regarding Canada, laugh all you want, but yes, people really do go the hospital or doctor whenever they feel like it. No hassle, no delay.

    Oh yeah you can go there, and if all you need is a bandaid you might even be seen in a reasonable time frame. If it’s something serious that requires a specialist you better hope you it’s nothing you will die from in a few months. The average wait time for a referral from a GP is over four months.

    I guess in Canada 4 months amounts to ‘no delay’.

    I have a better answer: ‘no thanks’

    Don’t try that ‘Canadians can walk in and get treated crap’ here. The data is readily available to show you are lying. And anyone knows who has ever lived in Canada.

    For the ER care that you will get treated for in Canada expeditiously you can get treated in the US just as well. The difference is when you have something seriously wrong with you that’s not trauma. That’s when you are screwed in Canada.

    And for trauma? You’re still better off in the US.

    Regardless of ability to pay.

  163. Yeah… Again… US System = Evil Capitalism, Canad = Magic, no lines, no wait, better care, FREEEE!!!

  164. Paul wrote:

    “Yes, there are always people that choose to live in areas so remote (love that open space!) who live 50 miles from a clinic. I know people like this. Seriously. And to…the…last… they choose this lifestyle.”

    Nearly all of them were born there and lived there all their lives. They have no education or money and no way to leave. So no, they did not choose this lifestyle. They were born into it. The people who could choose left long ago.

    “I’m not sure if a public/universal system would fix this.”

    It fixes the problem in rural Japan and in Europe. It is a deliberate policy to establish local clinics. Things are not as spread out there, but it is still pretty isolated and hard to get to, especially on the Islands.

    “And there’s plenty of evidence that a free market system addresses it better.”

    Comparing Japan, Europe and the U.S., I see no such evidence. Healthcare does not fit the normal rules of free market competition well. Neither does Microsoft Windows today or telephone service circa 1960. Some things fit economic theory better than others.

    “However, you said, and I quote ‘most people live within a few kilometers of a clinic’ . . .

    I meant in rural Japan.

    “What was I to take as to the implication? That in the US ‘most people don’t live within a few kilometers of a clinic’?”

    Not in rural Georgia or Pennsylvania.

    “Again, I’m not sure if ‘universiality’ answers this particular problem.”

    It does in Japan, by deliberate policy.

    “I work in one of the poorest neighborhoods (often referred to as ‘underserved’) in the Seattle area. The entire landscape is literally dotted with clinics, both large and small.”

    Seattle is very wealthy compared to the rest of the U.S. or Japan. Even the poor sections are well served and economically viable. Drive through rural Georgia and Alabama and you will see 19th century levels of poverty, with people living crumbling shacks (mainly trailers these days) with outhouses. That is the kind place I have in mind. They have outhouses (cesspools) in rural Yamaguchi too. Everywhere, in fact. On a summer afternoon the whole village stinks. Of course there are also pigs and cows contributing to the miasma. The average income was $6,000 a year 30 years ago, and it isn’t much higher now. But the level of education and healthcare is far above the U.S. standard, and probably every bit as good as Seattle or Atlanta.

    “. . . and the fact is that in this country ‘most people are within a few kilometers of a clinic'”

    That is nonsense. Most people in rural Georgia are not even that close to a grocery store!

    “Any discussion of transportation to and from a clinic isn’t even a healthcare discussion. That’s something else entirely.”

    You are completely wrong about that. Transportation and access are vital to healthcare, especially with elderly and disabled people. If people cannot get to the clinic it does no good. Many people have no cars or licenses or can no longer drive because of vision problems and other disabilities.

  165. “Comparing Japan, Europe and the U.S., I see no such evidence. Healthcare does not fit the normal rules of free market competition well.”

    We don’t have anything remotely approaching a free market in health care.

    Haven’t you been paying attention? If not, see my post above at 6:28. Also note that government spending accounts for well into the 60% range of all health care already in the US. We have a bizarre hodgepodge of highly regulated & controlled market driving some innovation with a big yolk of government strapped around it combined with a few acutely stupid incentives that keep stuff like insurance tied to employment… Your first mistake, however, is to believe that we have a free market. Not by a long shot.

  166. “Seattle is very wealthy compared to the rest of the U.S. or Japan. Even the poor sections are well served and economically viable.”

    Also, incidentally, many, many parts of Washington surrounding Seattle are rather poor. Try anywhere East of Redmond or South of Tacoma before you reach Vancouver (WA, not CA), or anywhere in the middle of the State… Just saying.

  167. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

    Here’s a great documentary about healthcare. For those libertarians who don’t mind having their views challenged.

  168. I’m still waiting for an answer from Jed Rothwell.

    Jed, did your young friends die because they waited too long to have their pneumonia treated or was it because they couldn’t afford to pay?

    I only ask because someone close to me might die from prostate cancer in Wales, because between a number of “public option” (Australia, England etc) agencies that assured him (after several biopsies) that he was A-OK – except that is, until he wasn’t.

    For what it’s worth I think it’s quite possibly due to honest mistakes.

    One of the problems is that here in an ‘merica he’d have a serious malpractice case.

    So, tell me, are you willing to accept the fact that some ignorant, stupid people may be so out of touch with their well-being that they don’t get necessary help (in spite ot the fact that there are public agencies that provide such help) while others through no fault of their own, but also through no fault of the caregivers impose huge costs on the system due to unfounded malpractice decisions.

    Remember, you don’t get American style malpractice awards anywhere else in the world.

  169. Jed Rothwell,
    Georgians not having accessibility to health care is Georgia’s problem – it should not become a problem for the tax payer in Arizona. Of course, you think otherwise, but this is where we differ

    We DONT MANDATE and CO-ERCE people into “caring” for others – if you want to care for other people, please do so – dont mandate your sense of moralism on me.

    And if you dont like your 18th century Constitution, take it from some one who is from India – you are so much the poorer for it.

    One thing that is obvious to me after viewing the politics in this country – you are well on the way to a second Civil War. Only this time, it wont be fought with guns, but it is going to cause much more agony and pain.

    I have been patiently reading Jed Rothwell’s posts and you can get the sense that NOTHING that you say will ever open his eyes to the other side of the argument when it comes to nationalized health care.

    After RAMBLING on and on and on about some place in Japan, revealing absolutely NOTHING, Jed now wants every American to feel sorry for the conditions of Georgia’s rural poor – it some how didnt occur to him that it is Georgia’s responsibility ! But this is what happens when you are ignorant of the 18th century Constitution and consider yourself “pragmatic” !

    What this country desperately needs to do is find an amicable way to dissolve itself. It is unbelievable that there are so many people who are soo deeply divided on such fundamental things in life actually want to live in one country.

    Please, PLEASE come up with an explicit living and breathing Constitution instead of doing it indirectly aka “New Deal” and “Great Society”.

    And by the way, Jed, did you know that your precious Government is FIFTY TWO TRILLION DOLLARS IN THE HOLE because of Ponzi schemes like Social Security and Medicare ??

    http://www.amazon.com/exec/obidos/ASIN/0061241873/associatizer-20/

    Try picking up the book “Where Does the Money Go” ? before you yap on about the greatness of Japanese health care.

  170. I’m still waiting for an answer from Jed Rothwell.

    That answer will arrive when the Sun starts setting in the East.

  171. Nagarajan,

    You raise good points.

    And one of them prompts me to ask, if your friends were so sick, where, Jed Rothwell, were you?

    Were you like every typical liberal sitting around demanding that “someone else” do something about it.

    Kind of tells me how much you actually care. Not at all, if it’s any trouble to you, I’d guess.

  172. John, your mouth must be pretty dry and you teeth full of twigs, because what you dish up here is a classic example of “straw man argument”. Good for you! But you’re right about one thing, and that is that health reform may not work – but not because of the reasons you might put forward.

    The prime reason it might fail is that they are not going to kill off the health insurance companies. You see, these need to be eliminated completely. Basic level health care, and we can argue about what that level is, but nevertheless, basic level health care must be free, universal, financed through taxes, and not insured. A single payer system. Anything less indeed has a high risk of failing, or a the very least, not fulfilling its goals.

    Here’s our current system. Plan A: Joe Six Pack has a heart attack. Joe is fortunate to have good medical insurance with his company. Yes, he has to fill out hundreds of forms, but in the end when all of the insurance companies finally settle up, he goes home healthy. And good the news is he only has to pay 20% of his health care costs. Whoopee!

    Now for Plan B: Joe has no insurance. He gets limited and delayed treatment. He is on the hook for hundreds of thousands of dollars. He doesn’t have hundreds of thousands of dollars. His house is foreclosed to pay the debt. He goes on welfare, funded by… taxes! How ironic is that?

    Well how about Plan C, a single payer universal access system? Jean Six Pack has a heart attack. She gets suitably prompt, appropriate health care, as judged by doctors who are motivated in their actions by outcome, not procedures rendered. She leaves the hospital, is never sent a single piece of paper, and above all not a bill. She pays nothing and goes back to living her life.

    I have first hand experience with plan C. It works John. I have seen it. Repeatedly. Is it perfect? Are there screw ups? Yes John, there are. But it is vastly better than plan A, and certainly plan B.

    What Obama is trying to do is not a plan C. Rather than free, no stress, everything gets paid for, no paperwork health care, it’s gonna be almost free, most things get paid for, as long as you work through a raft of paperwork you cannot begin to comprehend, all while you try to recover from your nervous breakdown by being deluged with medical bills and insurance reports, made in America health care.

    God help us!

    But don’t you worry John, I’m sure that no matter what happens you’ll be in plan A, fully capable of making that 20% payment. You keep spewing forth your straw man drivel.

  173. http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/view/

    Here’s a real heartbreaker about American healthcare.

  174. Yes, johnny john john, anecdotes are ever so helpful.

    droth, people fall through the holes in the “social safety net” everywhere.

  175. How come no one mentions all of the 100% free charity clinics which exist out there in the US?

    Even in my small southern town there is one, not to mention at least two federally funded private run places that only charge me $20 per visit.

    It is a myth you can’t get free/affordable healthcare if you are a poor loser like I am.

  176. Oh yeah, I also walked in with no appointment and got service within 15 minutes. My medication is only $4 a month. The appointment itself was $20. I had a full barrage of blood tests done too, for $10 each, $20 total.

    So I spent $44, and every month after that I’ve spent $4. If you can’t afford that then I’m pretty sure you qualify for other types of government assistance… Not to mention the FREE clinic you can go to that is open until 9pm.

    Screw off leftist scum. You will ruin everything good we already have with your idiotic continued barrage of new legislation and baseless assertions.

  177. Oh yeah, also.. thanks for all of the inflation and idiotic minimum wage laws. It will destroy my fixed income budget.

  178. John, great piece as always. I too am a fan of Hayek and am currently reading his “Mirage of Social Justice.” I am concerned our fellow citizens may be behind the curve on this issue. I particularly am concerned about those who say something must be done so we should just do the first thing that someone proposes. Very scary logic. Why not trust people to do the right thing for themselves?
    I would be honored if you or others here might try my blog at aneducatedcitizenry@blogspot.com.
    Keep up the good work. If you have any interest to speak to a group of high school seniors I would love to have you visit my government class. I am a teacher trying to open some minds.
    Thanks.

  179. We don’t have anything remotely approaching a free market in health care.

    You are right. And we never ever will.

    This is what libertarians need to understand, so they quit blathering about fantasies which will never happen and start providing real solutions.

    However, health care is riddled with market failures. Health insurance is riddled with even more and bigger market failures. The “free market” system would be a failure anyway. This is academic, however, because we will never attempt it.

  180. You are right. And we never ever will.

    This is what libertarians need to understand, so they quit blathering about fantasies which will never happen and start providing real solutions.

    However, health care is riddled with market failures. Health insurance is riddled with even more and bigger market failures. The “free market” system would be a failure anyway. This is academic, however, because we will never attempt it.

    Probably the least insightful comment I’ve ever seen, and there have been a lot of them in these health care forums lately.

    Please explain to me how the commenter is right that we don’t have anything remotely approaching a free market in health care but that health care and health insurance are “riddled with market failures.” You contradict yourself within two sentences.

    I won’t even ask you to explain how you’ve come to the conclusion that the free market system would be a failure anyway (though according to you it already is, even though we don’t have one–try to follow the tangled logic) because I doubt you have a reason besides the fact that you find free markets unsavory for some irrational (as in, instinctive and not studied) reason.

    Fucking mongoloid.

  181. ben tej

    When you understand that to Chad a market failure is any outcome that he doesn’t like, you’ll be able to understand his drivel.

  182. Kreel Sarloo wrote:

    “Jed, did your young friends die because they waited too long to have their pneumonia treated or was it because they couldn’t afford to pay?”

    Actually, the other person died from untreated diabetes. The young woman could afford to pay, of course. If your life is at stake, anyone can afford $50,000. She lived with her mother and together they could afford it. Here is how it works. Take a person working full time at a low paying job with no insurance, no time off for medical leave, and no family doctor. To see a doctor she has to take a half-day off, wait for hours, and spend thousands of dollars. (That happened to me lately after a minor bicycle accident, and I have insurance!) If she takes time off, or spends a week at home recovering from illness, she is likely to be fired. She gets a bad cold and bronchitis. She hopes it will get better on its own, as most colds do. She takes over-the-counter medicine and puts off going to the doctor for days or weeks. It gets worse. One night her mother finds her choking and close to unconscious and calls an ambulance, but by that time it is too late.

    Such people are not stupid. It is not easy to tell the difference between stubborn bronchitis and pneumonia. As I said, I had a case that may well have killed me if I had not gone to the doctor twice and the hospital the third time. I have excellent medical care; I am 10 minutes away from the hospital; and I can always take time off, so there is no impediment for me. Yet even I was in danger. So it is no surprise that people who must make great sacrifices to get medical care often put it off until the problem is so severe it costs tens of thousand of dollars or it kills them.

    “I only ask because someone close to me might die from prostate cancer in Wales, because between a number of “public option” (Australia, England etc) agencies that assured him (after several biopsies) that he was A-OK – except that is, until he wasn’t.

    For what it’s worth I think it’s quite possibly due to honest mistakes.”

    This sort of thing can happen with any system of medical care, in any country. Medicine is not an exact science. However, most diseases are fairly easy to diagnose. No doctor will have difficulty recognizing a serious case of pneumonia or a heart attack, and most people die of things like that. Basic medical care and a quick check with stethoscope would save thousands of lives and billions of dollars in the U.S. If a person working at low wages could take 20 minutes off for lunch, drop in at a clinic and find out she has a serious lung infection, obviously she would go to the hospital!

    “So, tell me, are you willing to accept the fact that some ignorant, stupid people may be so out of touch with their well-being that they don’t get necessary help . . .”

    There are such people of course. But my young friend was not ignorant or stupid. She was poor and unlucky. Thousands of people like her die every week from diseases that are easily prevented. That is why U.S. longevity is far below other developed nations, and why so many of our people live with chronic poor health and misery, and lose all their teeth in their 30s.

  183. Kreel Sarloo wrote:

    “droth, people fall through the holes in the ‘social safety net’ everywhere.”

    This is true, of course. However, in some countries, more people and a higher percent of the population fall through the net than in other counties. In countries such as France and Japan, only a few hundred thousand people fall through the net, and even an unemployed alcoholic bum can see a doctor or dentist. In the U.S. more people fall through the safety net than the entire population of France. And yet we pay two or three times more per capita for healthcare than they do!

    If that is not a dysfunctional system, I don’t know what would be.

  184. Am I wrong in saying that it seems like government fixes the price of healthcare? In which case how can you expect the free market to work efficiently?

    Why do some doctors charge you more if you have insurance? Why do pretty much all insurance policies have co-pay for normal visits that only cost $90 or so ($60 from some private doctors here if you don’t have insurance). It doesn’t make sense to pay even $30 per paycheck on insurance that makes a piddly $90 to spend on your well being to $20 copay if you see the doctor less than once every 3 months.

    Insurance should only cover surgery, catastrophe and maybe more moderate incidents, broken bones etc..

    The problem is healthcare prices are quite fixed and the insurance companies don’t really care if they are fixed a little too high cause they are still making money off of all of the people who never see the doctor but have WAY too much coverage (ie, MOST people).

    If prices were not fixed and doctors were forced to price competitively because everyone realized they are paying for insurance that they don’t need then we’d be well on our way to solving the problems we have.

    I’m a poor loser who dropped out of high school and I can figure this much out for myself.

    Also Jed, your friend is stupid, or you are lying. What the hell supposedly cost $50,000 dollars? What kind of diabetic treatment costs that much? My mom recently got BRAIN surgery for less than that. You sir, are a lying sack of sh*t.

  185. Jed, are you sure you aren’t the one with a dysfunction?

  186. Thousands of people like her die every week from diseases that are easily prevented. That is why U.S. longevity is far below other developed nations, and why so many of our people live with chronic poor health and misery, and lose all their teeth in their 30s.

    Incorrect. In America the poor are characterized by obesity. This carries immense health risks, heart disease, diabetes, I can go on. However they are entirely avoidable and accepting those risks is entirely voluntary.

    The simple truth is that our poor are overfed which leads to a tremendous health care burden. Of course if you feed people whether they work or not, many won’t.

    It may come as a surprise to you that

    (food + no labor) = fat++
    fat++ = mortality++

    We’re that fattest nation and extreme obesity reduces life expectancy by 20 years in men. Obesity kills 100,000 to 500,000 people a year in the US.

    But this is the fault of the health care system right?

    I’m already working half my life enslaved to your ‘good ideas’ and now you want more from me to pay for the health care of people that have self caused pathologies?

    NO

  187. poorman wrote:

    “Also Jed, your friend is stupid, or you are lying. What the hell supposedly cost $50,000 dollars?”

    I do not know the exact cost but that is approximately what emergency ER treatment for severe pneumonia costs. The patient underwent some sort of surgery and never regained consciousness. Her mother did not relate the details. We only heard about it the next day.

    “What kind of diabetic treatment costs that much?”

    Amputation of the leg. The average cost for that in the U.S. is around $60,000. He survived that but died soon after.

    “You sir, are a lying sack of sh*t.”

    And you appear to be suffering from cognitive dissonance.

  188. faithkills wrote:

    “Thousands of people like her die every week from diseases that are easily prevented.”

    That is true and important. There is no doubt that obesity is a leading cause of ill health in the U.S. However, it is not the only cause of ill health.

    “That is why U.S. longevity is far below other developed nations . . .”

    It is one of the reasons, but a careful examination of the statistics shows that there are other major contributing causes. Also, obesity is widespread in other countries that have much better healthcare than the U.S., at a much lower cost.

    “. . . and why so many of our people live with chronic poor health and misery, and lose all their teeth in their 30s.”

    Dental caries is not caused by obesity. It comes from lack of dental care. Wealthy fat people usually have all of their teeth.

    “Obesity kills 100,000 to 500,000 people a year in the US.

    But this is the fault of the health care system right?”

    It is the fault of the fat individuals, the agricultural price support system, the food marketing corporations, the grocery stores, the education system, and the health care system. There is plenty of blame to go around. Fortunately, that means there are plenty of ways to fix the problem.

    “I’m already working half my life enslaved to your ‘good ideas’ and now you want more from me to pay for the health care of people that have self caused pathologies?

    NO”

    You would prefer to pay for the effects of their ill health, even though it is 2 to 3 times more expensive than fixing the problem?

    When the people around you working in your stores and offices suffer unnecessarily or die young, it costs you money. One way or the other, you pay. Why not fix the problem? It is as if you lived next to an unsafe highway in which traffic accidents killed people every day. Why not begrudge the money to fix the pavement and put in safety rails and reflectors? You save money in the long term. Why are you so anxious to impoverish yourself and everyone else for no reason. Why are you obsessed with political ideology? Americans used to embrace empirical, tried and true, commonsense solutions to things like traffic accidents and public health. We can greatly reduce obesity and other health problems at very little cost.

  189. Jed,

    I have a hard time believing they had to pay $60,000 to get a damned limb removed. Especially, when my mother paid about that much to get brain surgery recently.

    I’m also still confused how the system killed this person?

  190. Unlike Britain ans Australia, where they lose them in their teens. 🙂

    Damn, I can’t believe all you kids are still at it. I’m done with this one.

  191. Jed,

    Why aren’t Canadians losing their teeth in their thirties? Medicare does not cover dental work.

    And dental work done by the NHS in Britain is a joke around the world.

  192. You would prefer to pay for the effects of their ill health, even though it is 2 to 3 times more expensive than fixing the problem?

    No I want to fix the problem by correcting all the causes for health care inflation.

    Remove the AMA’s chokehold on provider supply. Set objective standards for med school admission and med school accreditation. Same for all provider educations systems.

    Tort reform. Loser pays. Done.

    Remove all provider lobby insurance mandates for their specialty.

    Remove all insurance mandates period.

    Remove insurance tax breaks.

    Remove all drug subsidies. Sorry seniors, we’re going to have a safety net but the only criteria is poverty. If you don’t want to be the victim of the rationed care triage resultant from single payer you can pay for your own drugs.

    Right there you’ve gutted most of the causes of health care inflation decoupling and put us on a back to where health care was par with the rest of the economy. It would take a few years but it will happen.

    Then the safety net.

    Demolish medicare, medicaid, etc. Take the entire amount trillon+ spent publicly for health care divvy it up by use. Consumers in poverty have two options for participation, funding follows participants choice. Consumers may switch freely between plans.

    Option 1) Establish accounts for all persons in poverty into which they receive a health care stipend. Any monies not spent in 5 years they may withdraw and use as they please. This is the only way to subsidize something and not cause inflation. People must be able to keep the money they do not spend.

    Option 2) This is your authoritarian progressive managed healthcare playground. Establish outcome oriented compensation. Ration all you like. Make it more efficient than the free market if you can. I don’t expect you will but who knows, regardless the point is care of last resort.

    This is economically sound, and will work. As inflation becomes less distorted the ability for individuals to afford healthcare will increase drastically. This in turn makes even the managed care option more efficient.

    As a sound plan, authoritarians will of course hate it. However I would like critiques from anyone economically literate on how to tweak it, or if I missed a factor.

  193. poorman wrote:

    “I have a hard time believing they had to pay $60,000 to get a damned limb removed.”

    Then I suggest you go to the library, or look up reliable Internet web sites that discuss medical expenses, or ask a surgeon. The fact that you do not believe reliable sources (or that you refuse to look at them) is not a valid argument against these sources.

    Of course it is a lot cheaper in other countries. In the UK: “The average cost of distal bypass surgery was found to be UK Pounds 11,278 for amputation.”($18,510)

    http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102236963.html

    “I’m also still confused how the system killed this person?”

    If the system does not contribute to U.S. mortality rates then why do you suppose more Anglo-Saxon Americans die from this disease than British people? Race, levels of obesity and other factors are very similar in both groups. Their only advantage is access to medical care.

  194. If the system does not contribute to U.S. mortality rates then why do you suppose more Anglo-Saxon Americans die from this disease than British people?

    There’s no data to support the question you are begging here.

    Race, levels of obesity and other factors are very similar in both groups.

    How can race be similar between a racially homogeneous group and a racially heterogeneous group?

    Their only advantage is access to medical care.

    No need to address this patently false assertion since the premises are flawed.

  195. After reading this entire thread (yeah, I know, overexposure is bad), I feel that I should offer my sincerest condolences to ‘johnny john john’ and ‘Jed Rothwell’ for the horrible head injuries that they suffered as children.

    As sad as it is that they had to endure this affliction, there is evidence that, with substantial therapy, and maybe some drugs, they will be able to, at least, start working toward becoming useful members of society (fast food service is probably the limit, though).

    And if they choose to reject that treatment, then all I can say is that the thing next to their plate is a spoon, and that the pudding will make them happy.

  196. Undisputed Fact: USA has the most “market based” healthcare system *in comparison to* the rest of the developed world

    Undisputed Fact: USA spends the most money out of all the developed countries on healthcare

    Undisputed Fact: In terms of infant mortality, general population mortality, average life expectancies, and overall healthcare insurance coverage, USA fares among the worst of all developed countries

    Hate to sound like a broken record but if you dispute those facts, do the research on BOTH sides of the ideological argument. It all adds up to a fucked up system, and the more socialist systems fare much better. Yes, Gov’t in other countries have socially engineered a solution that provides superior health to its citizens.

    http://assets.opencrs.com/rpts/RL34175_20070917.pdf
    http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/view/
    http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

  197. Government run health care has already by tried and tested. Allow me to tell you a tale of 2 state, one in which I live. Some years back the state introduced it’s own health plans called “Basic Health” A noble, inexpensive and generous plan I quickly switched my family to. Concurrently the state mandated additional requirements upon the private health carriers who were soon drivien out of business from this state, leaving only a couple of anemic options and our wonderfully government run Basic Health Plan. Fast forward 15 years amidst many modificaitons and now we have a government plan which is underwater financially, requires all speciliazed care to be PREAPRROVED, and yes by a bureucrat, closed to any new enrollment. A State in which all but one or two insurance companies are now refusing to come back into the local market because of the past, and the private market which does remain is expensive becuase it has morphed into an adverse risk group. But remember Basic Health can no longer afford to accept any new members for now becuase of all it’s red ink. In fact last word I heard is they will be disenrolling up to 1/3 of it members to be left to go where? Now the alternative is to raise taxes, reduce (ration) benefits or ????? And if this doesnt shake your chair check out the mess they created in Mass with mandatory coverage. Private enteprise may not be perfect but last time I checked we live a lot better than in other managed economies.

  198. Assuming a lot of the problems are overly restrictive state regulations which can’t be fixed at the federal level, how have prominent Republicans tried to inform the public of this fact?

    It seems like disgust with the HC system has been brewing for quite a while (as real wages moved in the opposite direction of premiums), but Reps haven’t seen it as a worthwhile issue next to military/cultural wars.

    Is it possible for federal law to undue state regs, and have these been proposed?

  199. “Undisputed Fact: USA has the most “market based” healthcare system *in comparison to* the rest of the developed world

    Undisputed Fact: USA spends the most money out of all the developed countries on healthcare

    Undisputed Fact: In terms of infant mortality, general population mortality, average life expectancies, and overall healthcare insurance coverage, USA fares among the worst of all developed countries”

    Undisputed Fact: The US has nothing remotely resembling a free market at all, and least of all in health care. I believe it is fair to say that there is no more highly regulated, controlled, influenced & government funded sector of our economy.

    Undisputed Fact: The US is responsible for the vast majority of innovations in medical technology & life-saving drugs.

    Undisputed Fact: The US has a much higher survival rate for serious diseases such as a cancer.

    Undisputed Fact: The US saves far more premature babies and some of them die after the fact which makes John’s “infant mortality” rate “fact” not a fact at all, but bad statistics that have already been demolished around here.

    Undisputed Fact: Life expectancy has fuck all to do with health care beyond the basics and is affected by a hundred other factors.

    Undisputed Fact: johnny john john is a retard.

  200. Malone: Every scientist knows that every statistic is affected by millions of factors. That doesn’t make the statistic invalid.

    Life expectancy IS a valid measure of citizen health. Of course it’s not an “absolute” measure of health. Of course it is influenced by thousands of factors. That’s why I provided several DIFFERENT kinds of measures of health instead of just one.

    Despite all those statistics’ flaws by themselves, taken as a whole one cannot but realize that US health is far worse than other industrialized nations.

    I know many of yall just can’t admit that gov’t might be a solution to a problem, but don’t be blinded by single minded ideology. Government planned health has led to many satisfied customers in many countries.

    Also, USA has the greatest cancer rate of any developed country. It’s no surprise we are so good at treating it; we have the most experience. I’ll give you that one. We are good at treating cancer (and diabetes). But we’re terrible at preventing cancer and diabetes. Other countries are a lot better at that.

  201. “Also, USA has the greatest cancer rate of any developed country. It’s no surprise we are so good at treating it; we have the most experience. I’ll give you that one. We are good at treating cancer (and diabetes). But we’re terrible at preventing cancer and diabetes. Other countries are a lot better at that.”

    [Citation Needed]

    Try again Tony, I mean Chad, I mean John…

    Sorry, I forget which vapid liberal is debating again.

    Learn your history, understand why the US is struggling with high costs, drop the phony statistics (and yes, they are phony and idiotic measurements which reflect virtually nothing of value related specifically to the *systems* employed from country to country), and also perhaps take a step back and realize that health care – like everything else – doesn’t get provided by magic.

    Go do yourself a favor and look at any list of the most significant technological developments in medicine and figure out how many of them were invented or developed by the United States or in conjunction with the US.

    Try this one: Physicians’ Views Of The Relative Importance Of Thirty Medical Innovations from the Health Affairs Journal (notably peer-reviewed).

    Of just the top 10, 8 of those were developed by doctors in the US either partially or entirely.

    Dig a little deeper buddy. Also, if you would learn basic arithmetic, that would probably help you realize why the systems you’re so excited about are all either already bankrupt or they’re damn close. France, the UK, Canada, Sweden have not “controlled costs” at all even with all the rationing.

    Also, as someone else on these boards once noted: It’s amazing that people in Europe would look at the “lower” cost of things like health care in their countries and avoid asking why everything else costs so damn much.

    You may call what we’re talking about “ideologically driven”… and to the extent that I’m not ever going to support the idea that people should be *forced* into paying for or providing services for other people, it is.

    But the economics isn’t. You are engaged in defending a MASSIVE ball of economic fail. Logic, history, data, arithmetic and fucking common sense contradict your idiotic points.


  202. But the economics isn’t. You are engaged in defending a MASSIVE ball of economic fail. Logic, history, data, arithmetic and fucking common sense contradict your idiotic points.

    This is so well-reasoned, so moderately expressed, and so interested in actually convincing someone else, I have little more to say.

  203. Our goal should be to cover all individuals through private health insurance. We are not prepared to turn our health system over to the government. Advocate for greater transparency in both quality and price information. Place both the decision making ability and healthcare dollars in the hands of the consumer. Support the Friends of the U.S. Chamber and sign the Health Care petition at http://www.friendsoftheuschamber.com/takeaction/index.cfm?ID=40 .

  204. My only point is that if you take the Bible straight, as I’m sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won’t get the full deal by just doing regular skill english reading for those books. In other words, there’s more to the books of the Bible than most will ever grasp. I’m not concerned that Mr. Crumb will go to hell or anything crazy like that! It’s just that he, like many types of religionists, seems to take it literally, take it straight…the Bible’s books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on…the Bible’s books were written by people with very different mindsets…in order to really get the Books of the Bible, you have to cultivate such a mindset, it’s literally a labyrinth, that’s no joke

  205. It is true that health reform will have a lot of harmful effects. In Vietnam the medical reform related to porcelain b?c s? cho r?ng is quite similar

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