Shouldn't we be referring to 'blue' dogs as 'red' dogs???? nt

[Captain Hilts]

[Fla_Democrat]

1. What about the Yellow Dogs?

:shrug:

[Captain Hilts]

4. We like yellow dogs. But Blue Dogs act like they represent Red states. nt

[Fla_Democrat]

12. Ahh, but..

should we then call them deep red dogs? :shrug:

[spanone]

2. i refer to them as republicans

[luckyleftyme2]

3. they live in a fantasy world

MiamiHerald.com VIDEO: Charles Gibson Spills the Oil Industry's Dirty Secrets ? - 16 hours ago
By MATT MITOVICH For the ABC News special Over a Barrel: The Truth About Oil (airing Friday, July 24, at 10/9 CT), Charles Gibson traveled the country to ...Seattle Post Intelligencer - 30 related articles »
shoots the "drill baby drill boys out of la la land!
good god how can they be so gullible? how can they stay in the 19th century when we are falling so far behind in the 21st?
well read their comments and you can see why!
drill baby drill;joe six pack;the pig with lipstick=jingles that keep you enslaved!
and now ya wanna bring back Newt the toot! the hot air man of the 20 th century!
much like tabor he hit his peak while being told he had no chance to win re-election in his own state!
drill baby drill another lie potrayed by the right to keep stealing your money!

[luckyleftyme2]

5. who fills their election coffers?

IS OUR NEEDED HEALTH CARE RELIEF BEING SABOTAGED BY THE RIGHT?
In conservative states, right-wing talk show hosts are spreading lies about reform. No wonder Blue Dog Dems are blocking health care overhaul.

There's a showdown at the House Energy and Commerce Committee corral. Seven Blue Dog Democrat members are banding together, and if they don't get their way, they can gun down the health care bill.

The Blue Dog Seven are spooked by pressure from their constituents and recent polls that show American's approval of Obama's health care initiative has dropped below 50 percent for the first time.

Drive across the seven states they represent: Arkansas, Georgia, Indiana, Louisiana, Ohio, Tennessee, and Utah, turn on your car radio, and you'll know why public opinion has changed. According to Pew research, 22 percent of Americans get their news from talk radio. And conservative talkers have been lying to their listeners about what's in the health care bill.

Lies from Sean Hannity like, "If you don't have private insurance the year that this bill is passed, you can't get that later on from your employer." Lies from Rush Limbaugh that the bill would "outlaw individual private coverage." Lies provided in talking points from the Republican National Committee like "Democrats are proposing a government controlled health insurance system, which will control care, treatments, medicines and even what doctors a patient may see."

Tell a lie often enough, and people will believe it.

And there is nobody there to call them on their lies. Nobody there to set the record straight. Nobody to push back against the propaganda that corporate radio promotes in its own political self interest. In the Blue Dog Seven states, just three stations broadcast any kind of progressive talk. Three progressive radio stations in seven entire states. But Sean Hannity "freely" prevaricates on dozens of radio stations; Rush Limbaugh deceives people on 98 in those seven states alone. 98 publicly owned frequencies where public debate comes second to selling ads for Snapple.

Special assistant to the President for Science, Technology, and Innovation Policy, Susan Crawford told Broadcasting and Cable magazine, "The administration understands the important role traditional terrestrial broadcasting continues to play."

Maybe they should be listening to FCC Commissioner Michael Copps, who says in Broadcast Blues, "If you're concerned about health care or you're concerned about the environment as your number one issue, fine, but a piece of advice from me, is you better make media reform your number two issue, because you won't get anywhere on number one without media reform."

Former Republican Senator Trent Lott had it right when he said Conservative Talk Radio is running the country. There needs to be a showdown, but it's the 1996 Telecommunications Act that should be gunned down.

http://www.alternet.org/media/141547/limbaugh%27s_ lies_...

[Marr]

6. Certainly seems more appropriate.

Why do we call them blue dogs, anyway? The name almost seems to imply that they comprise the traditional Democratic ground, while their opponents are outside extremists.

[Captain Hilts]

16. Since 2000, this phrase is bass ackwards. Counter-intuative. nt

[luckyleftyme2]

19. some of the lies being spread

here is some facts on national healthcare in other countries. I would like to point out that she states after taxes income in canada is only.i of a percent greater than ours; but she did not state that the american worker has to pay for his healthcare on top of this. I n my son's case he earns 30,000+ a year and he has to pay $104 a week for healthcare and his employer pays the rest. then you add the co-pays probably in a good year about $10 a week. remember this is after all taxes!
that is an additional 20% of his gross pay:
Myths about Canadian healthcare
Posted by Cory Doctorow, June 27, 2009 1:07 AM | permalink
Rhonda Hackett, a Canadian expat clinical psychologist living in the US, has an editorial in the Denver Post with a good round-up of myths and truths about Canadian health care. I've lived under the Canadian, US, British and Costa Rican health care systems and of the four, I believe that the Canadian one functions best (I'd rank them Canadian, British, Costa Rican and US). My experience with all four includes routine and urgent care. I've had firsthand experience of pre-and post-natal care in Canada, the US and the UK; I've also seen the Canadian, US and UK palliative care system in action.
On the other hand, I believe that the UK system of caring for elderly people is better than the others; Costa Ricans have better services for rural people; and the US has a better culture of retail service (outside of healthcare) than anywhere else I've lived.

Myth: Taxes in Canada are extremely high, mostly because of national health care.
In actuality, taxes are nearly equal on both sides of the border. Overall, Canada's taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.
Myth: Canada's health care system is a cumbersome bureaucracy.
The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

Debunking Canadian health care myths (via Digg) posted in: Economy , politics
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Discussion
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#1 posted by felsby, June 27, 2009 2:31 AM The US Healthcare system is by a large margin the most expensive and inefficient in the world. Salary for a huge herd of accountants and insurance clerks cost a lot - and doctors being silently forced into ordering unnecessary exams "just to make sure" (=we can squeeze a little more out of this patient") also cost a lot.

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#2 posted by Crawford Tillinghast, June 27, 2009 2:34 AM In before ZOMG, SOSHULISM! RABBLE RABBLE RABBLE RABBLE, TEA PARTY!

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#3 posted by thequickbrownfox, June 27, 2009 2:58 AM This reminds me, I need to go to the doctor for a new prescription.

I can go to my usual doctor, or any doctor. Cost? Nothing.

Cost of meds? Most common big-brand meds are available for $AU5.50 or even less if you ask for a generic.

Medicare Australia http://www.medicareaustralia.gov.au/about/index.jsp


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#4 posted by Jay Acker, June 27, 2009 3:00 AM Did someone say TEA BAGGING! I'M IN, RABBLE RABBLE RABBLE!

Seriously though in my own, very uneducated two cents is that of course the United States Healthcare system is the most expensive and bloated because its profits is what keeps the rest of the worldwide medical system afloat. Like one big buoy, the rest of it would sink without us, the pharmecutical companies use the United States to turn a crazy profit and then sends the rest out cheaply to the rest of the world.

I wonder if things would work if we toned the USA machine down.

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#5 posted by peterbruells, June 27, 2009 3:07 AM @Jay You need to seriously look at the prices "big pharma" charges in Germany and other European countries - they do run a nice and tidy profit over here.

Your assumptions are wrong.




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#6 posted by hassan-i-sabbah, June 27, 2009 3:08 AM Oh where would we be without the good ol US of A!!
Thank god you pointed that out Jay.Were just dumb euro scum aren't we?Please don't "tone" the "machine"
down!

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#7 posted by Keeper of the Lantern, June 27, 2009 3:31 AM I've always been baffled by the American response to a national form of health care. My fellow Americans will always give some kind of largely incoherent argument proving why it won't work but then, when you point out that all of Europe as well as Canada have it, they just shrug it off and ignore the fact. Or perhaps quip something like, "But it's bankrupting them" or whatever.

I think it boils down to almost brainwashing, a sort of quasi-theological belief (fueled by the Repugs) that it's somehow an inherently evil idea.


Oh yeah, they also always try to argue that they don't want National Health care because they don't want to get forced into some crummy public system, but pointing out that private doctors still operate in the UK just fine never seems to penetrate their brains.

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#8 posted by Anonymous, June 27, 2009 3:41 AM I concur with all of your comments. I've lived in the four countries you mention as well (I'm in the UK now).

I think you make a great point about the retail culture in the US. I think a lot of the perception of value in all the countries is related to the customer service you get. This is completely wrong, but it's just human nature I think.

There's also the Joe the Plumber problem. Americans like to feel like if ever became really rich, they'd have access to any service immediately. For this reason, I think the US will need to maintain a two-tier system.

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#9 posted by felsby, June 27, 2009 3:57 AM I hope Jay does not share his two uneducated cents with that many fellow americans. The fact is that money goes not from, but to the U.S pharmaceutical companies.
As I said, accountants and clerks are expensive. As a minuscule reminder of that fact, my neighboring city council has just made bus driving free - it was cheaper all in all.

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#10 posted by Kieran O'Neill, June 27, 2009 4:07 AM To add to the refutations of Jay's argument, pharmaceuticals are not the totality of healthcare - in fact, they're really only a small part. Also, there have not been a huge number of major advances in pharmaceuticals over the past few years.

You could make the argument that the United States does a large chunk of the world's biomedical research, but most of that is from tax money...

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#11 posted by zuzu, June 27, 2009 4:20 AM Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash.
It's a wash assuming you consume those benefits. Personally, I'd rather have the cash (which is liquid -- useable for anything) than rigid availability of particular services.

pharmaceuticals are not the totality of healthcare - in fact, they're really only a small part. Also, there have not been a huge number of major advances in pharmaceuticals over the past few years.
How have you arrived at that conclusion? The "healthcare debate" often focuses on catastrophes (which is a legitimate application of insurance), but most people's medical costs and experience has to do with routine expenses: diagnostics and drugs (including biologics / vaccines). Non-catastrophe medical products and services are where meaningful prices are needed most, yet because most Americans are actually over-insured, the insurance companies have completely mangled those price signals.




I've always been baffled by the American response to a national form of health care. My fellow Americans will always give some kind of largely incoherent argument proving why it won't work but then, when you point out that all of Europe as well as Canada have it, they just shrug it off and ignore the fact.

Rationing / cost containment is a legitimate issue. (Even with existing Medicare; have you seen Frontline's $10 Trillion And Counting?) Here's a coherent argument against nationalized healthcare (aka single-payor aka socialized medicine), if you're looking for one:

The Health Czar Can't Calculate

Experts agree that our healthcare system is unsustainable and in need of reform to promote better coordination, accountability, outcomes, and cost effectiveness. Regrettably, they also seem to agree that we need a robust central-planning authority — a health czar — to make this coordination happen.
But as economist Ludwig von Mises proved in his 1920 treatise "Economic Calculation in the Socialist Commonwealth," under central planning any rational economic calculation, that is, any method to efficiently allocate resources, is practically and theoretically impossible — not just of higher cost, lower quality, and reduced innovation; not just uncoordinated, inefficient, and ineffective; but literally impossible.
In practice, a health czar would have to evaluate the quality, revenue, and cost of complex production processes, and billions of healthcare goods, services, hospitals, pharmacies, nursing homes, surgery centers, diagnostic centers, laboratories, outpatient clinics, home health agencies, hospices, long-term-acute-care hospitals, ambulances, patients, physicians, nurses, therapists, and clinicians, all across geography and across time. The health czar must therefore consider an almost infinite number of permutations in order to correctly allocate trillions of dollars.
The health czar must also consider two additional exacerbating factors. First, like all goods, healthcare resources by their very nature are substitutable for one another. For some cancers, chemotherapy, radiation therapy and surgery may be substituted or complemented with one another. The health czar has to discover the natural substitutability of millions of healthcare services in accordance with the exchange relations that in a free-healthcare-market economy take place automatically, permanently, and instantaneously.
Second, capital can be invested to improve the efficiency and quality of any healthcare service. Hospitals may decide between investing in robots for pharmacy or the operating room to improve the productivity and accuracy of pharmacists and surgeons; or they may hire additional pharmacists or more experienced surgeons, or varying combinations of them. Simultaneously, the manufacturer of robots would need to decide to invest capital to develop either pharmacy, operating-room, radiation-therapy, or industrial robots and varying combinations of them and direct the production chain of all the inputs necessary to develop robots, such as software, research, labor, parts, raw materials, financial services, marketing, etc. This investment in production at both provider and manufacturer levels multiplies infinitely the permutations the health czar would have to evaluate.
In addition to facing the practical economic calculation problem outlined above, health reformers misunderstand pricing theory. Unlike the weather forecaster who faces a practical problem that can be resolved by the use of better satellites, faster supercomputers, and better equations and models, the health czar faces an unsolvable theoretical problem. He cannot forecast the price for health services because, by definition, prices can only be calculated by the free and unencumbered interaction between producers and consumers.
There are two reasons why it is theoretically impossible for the health czar to arrive at meaningful prices. First, contrary to popular belief, costs of production do not determine prices of goods. Prices are determined by the instantaneous valuations made by consumers and producers bidding against one another. By a process of imputation that flows from the consumer to the producer, prices of goods impute value to the factors of production necessary to make the goods that consumers demand. This imputation of value occurs when producers and entrepreneurs bid for the factors of production (labor and materials) in response to expected future profits, which sets wages for labor and prices for materials. Prices of goods, therefore, determine costs of production.
Since its inception, Medicare planners have come up with alternative valuation methods that unsuccessfully attempt to arrive at a rational price structure for health services. Medicare recognizes that "cost-based payment methods" (in which reimbursement is determined by allowable costs supplied by providers) are complex, result in unpredictable payments and spending for providers and government, and weaken providers' incentives for efficiency.<6> Medicare claims that these methods are being substituted for "prospective payment" (in which an initial operating and capital-payment base rate is adjusted by wage indexes, medical education costs, charity burden, long lengths of stay, etc.).
But despite these recognitions and claims, Medicare still uses cost information to determine prices. This is because the initial-operating and capital-payment base rate is always determined by the operating and capital costs that a set of "efficient" providers incur. When Medicare uses cost information to arrive at pricing, it uses the wrong economic cause-and-effect relationship and therefore distorts prices.
The second reason why it is theoretically impossible for a health czar to price services is that prices in a market economy are continually, instantaneously, and simultaneously created, destroyed, and recreated by the individual subjective valuations of consumers and producers facing the passage of time.
This process takes into account change in expectations, economic conditions, wants, scientific knowledge, income, needs, technological advancements, etc. But note that information about valuations is not created until after consumers and producers act in the real world by placing their respective bids. These bids are impossible to transmit to a health czar before they exist, before they are made real through human action. Until then, a central health planner has a universe of infinite possibilities stored in the minds of each of hundreds of millions of economic participants. This universe does not and can never constitute meaningful economic information until patients and providers act in the marketplace. And once bids take place and pricing information is created, transmitted, processed, and analyzed by the health czar and returned to the market place in the form of reimbursement rates and rules and regulations, it is old, distorted, and useless information that cannot possibly have any rational guiding content for patients or providers. It is wasteful, non-value-added, false, and misleading information.
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#12 posted by Anonymous, June 27, 2009 5:34 AM Zuzu, allow me to distill your diatribe so that others with less time on their hands may get their heads around it quickly:

A pharmacological cure for, say, malaria, does not exist because the people who need it don't really need it enough to come up with the cash to incentivize its development, whereas folks who've eat one too many quarter-pounders now and then take their indigestion extremely seriously, which is why there are so many treatments for that condition.

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#13 posted by Notary Sojac, June 27, 2009 5:38 AM Cory - the last paragraph of the source gets right to the point.

"For people like my 55-year-old Aunt Betty, who has been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. Aunt Betty — who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care — will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life."

In other words, for Americans who have health insurance, the Canadian system gets them what they have now, after they wait in pain for fourteen months.

For Americans who don't have health insurance, they get something they don't now have.

This is what the debate should be about. How much should those who now have coverage be forced to ration their allotment of care in order to expand the delivery of care to the have nots?

It's deceptive in the extreme to pretend that we can have (1) the best health care tech that America can devise (2) available on an on demand basis as soon as it's needed (3) to everyone (4) at no increase in cost. Something in that equation has to give.





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#14 posted by berberine, June 27, 2009 6:00 AM I really wish that I got to keep 81.9% of my gross pay. I am so below that, it's not even funny. I only keep 53% of my gross pay. My health insurance is ridiculous, covers little, and, when I go to the doctor's office ($35 copay) or need anything else done (blood work $70), I have to pay some more.

The sad thing is, when I lived in another state, I had far better coverage and paid less. I had the same company (Blue Cross), but, because they are different in different states, different places of employment are able to get better, or worse, benefits because of who does the negotiating.

When I lived in New York, my insurance was $104 per month for family coverage of medical, dental, and vision.

I now pay $521 per month for single coverage that only provides medical and dental. We optioned for two singles because there are only two of us and the family plan costs $1600 per month. We also got grandfathered in last year, so, if we had started a year later, we wouldn't be allowed to take single payer because we work in the same school district and, according to the contract with Blue Cross, single coverage is no longer available to people in the district that are family.

I'd be happy to have some sort of system like Canada, Europe, or anywhere else that can reign in the ridiculous costs of the USA. As it is right now, I'm debating on what to do because a pre-exisitng condition prevents me from getting any other, cheaper insurance. So, I'm stuck with overly expensive health care or drop it altogether.

I don't think that any health care system is perfect. There's always going to be a few things that could be improved, however, the American way of doing things no longer works and we should be prudent in studying how the rest of the world does things and try to take the best of those systems and implement them here. It's just that far too many Americans believe that socialized medicine is evil. Those are the people you need to convince and, unfortunately, I work with a lot of them.

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#15 posted by zuzu, June 27, 2009 6:10 AM How much should those who now have coverage be forced to ration their allotment of care in order to expand the delivery of care to the have nots?
How much do we do this for other necessities: food, shelter, clothing, utilities?

Do we ration housing because some people are homeless?
Do we ration food because some people are starving?

p.s. Focusing on insurance "coverage" is a red herring. The real problem is that prices of medical goods and services no longer reflect their scarcity in reality. This is a problem caused both by private and public medical "insurance coverage" (i.e. economic planning). (Originating in the wage controls from World War 2.)

Again, "contrary to popular belief, costs of production do not determine prices of goods. Prices of goods determine costs of production."

("The rising costs of healthcare" argument is backwards. Costs are rising because of insurance companies (or the government), not you, actually footing the bill.)

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#16 posted by Apreche, June 27, 2009 6:18 AM Everyone wants better health care, more health care, and they want it to cost less. It's just not possible. Sure, the system can be made more efficient in some places, but that doesn't negate the fundamental reality.

It costs a crapton of money to do medical research. It takes hundreds of millions, if not billions, of dollars to get just one drug to market. Someone has to pay for that. The money has to come from somewhere. Right now, the people in the US who are paying too much are subsidizing many of those costs for the rest of the world.

The other reality is that there isn't enough health care to go around. There aren't enough flu shots for everybody. There aren't enough organs for everybody. There aren't enough doctors, and they don't have enough minutes in the day to spend time with everyone who wants to see them.

We think it is morally wrong to deny treatment to people. We think every person should be cared for. I agree, that is definitely a goal to strive for. The reality is that is impossible. We need a system that determines who to say yes to and who to say no to. Health care has to be rationed, there is no avoiding it.

Yes, there are many ways to make our health care system more efficient. However, given the present state of medical technology, and the number of doctors, two things are true.

One is that if we want medical science to advance, someone has to pay for it somehow, and it is ludicrously expensive beyond your wildest dreams. Remember, Bill Gate's levels of money are still not even enough to stop malaria. All the billions of dollars raised for cancer research, and cancer is still aroudn.

Two is that not everyone can get cared for. People can't be going to the doctor for a little pain here, or a little cold there. Also, as much as you think it's morally wrong, people who are very expensive to treat simply can't be covered unless they can pay for it themselves. If someone is 80 years old with cancer, the government might have to say no when it comes time to treat them. The same may go for extremely ill newborns. The same might go for people with self-inflicted ailments like obesity or anything caused by smoking.

Our morally correct goal, to give everyone excellent and affordable health care, is currently not physically possible. It's sad but true. You have to give some things up. What's it going to be?

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#17 posted by Notary Sojac, June 27, 2009 6:23 AM Zuzu @13:

Do we ration housing because some people are homeless?

No, of course not.

But if there was a proposal on the table to provide the same standard of housing (number of rooms, size of yard, quality of fixtures) to every American regardless of ability to pay, we'd be rationing oak floors and Sub-Zeros in pretty short order.



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#18 posted by Anonymous, June 27, 2009 6:31 AM I live in Canada and I certainly am grateful for the health care system (which does vary slightly in terms of tax cost from province to province).

Ask Canadians if they think they are "giving up" other things for health care and I think the majority would say no. The standard of living in socio-economically disadvantaged areas is simply better here than in the States because we have access to health care and a whole host of other social programs.

I found the article to be fair and true. And I love/hate? how many comments from Americans here still say "impossible!" "you have to give some things up," and "I want that money in my pocket." Apparently, they just aren't getting it.

Health care is a right, not a privilege.

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#19 posted by Anonymous, June 27, 2009 6:42 AM I find myself amazed at how selfish some of the defensive arguments come across. =|

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#20 posted by Anonymous, June 27, 2009 6:43 AM There's an interesting paper at NBER which is a little more scientific than most discussions of the differences between US/Canada health care.

See
June E. O'Neill, Dave M. O'Neill

NBER Working Paper No. 13429
Issued in September 2007


Does Canada's publicly funded, single payer health care system deliver better health outcomes and distribute health resources more equitably than the multi-payer heavily private U.S. system? We show that the efficacy of health care systems cannot be usefully evaluated by comparisons of infant mortality and life expectancy. We analyze several alternative measures of health status using JCUSH (The Joint Canada/U.S. Survey of Health) and other surveys. We find a somewhat higher incidence of chronic health conditions in the U.S. than in Canada but somewhat greater U.S. access to treatment for these conditions. Moreover, a significantly higher percentage of U.S. women and men are screened for major forms of cancer. Although health status, measured in various ways is similar in both countries, mortality/incidence ratios for various cancers tend to be higher in Canada. The need to ration resources in Canada, where care is delivered "free", ultimately leads to long waits. In the U.S., costs are more often a source of unmet needs. We also find that Canada has no more abolished the tendency for health status to improve with income than have other countries. Indeed, the health-income gradient is slightly steeper in Canada than it is in the U.S.

Available at http://www.nber.org/papers/w13429
===============================================
One of their interesting observations is that infant mortality is higher in the U.S. than in Canada. However,at every birth weight, the mortality rates are about the same. The U.S. is better for very low birth rates.

The disparity in national averages arises because the U.S. has more births in the high-mortality groups (low birth weight mostly).

This example shows how one needs to be careful in comparing systems.



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#21 posted by Glossolalia Black, June 27, 2009 6:46 AM It's the 21st century. We're technologically able to measure the universe by way of telescope, walk on the moon, do DNA sequencing, etc. We (as a species) should be able to take care of everyone. The reason we don't: greed and incompetence -- varying, yet high levels of both.

The whole "why should I pay for services when I'd rather have my money" argument is persuasive on a level but you scratch the surface, it's another "Am I my brother's keeper?" argument.

YES. YES YOU ARE YOUR BROTHER'S KEEPER. If everybody felt the way you do, there'd be an illiterate genpop, there'd be a bunch fewer drivable roads and more bridges falling in, no police to protect you, no firemen to put out your burning home, etc . Yeah, it happens now, sure, but it's demonstrably worse when that compact (you pay taxes, we take care of things) breaks down.

The limping bare-minimum of health care we have in this country for the genpop is a big reason why we're not able to make the leap from a merely okay society to an admirable one.

We suck corporate dick, moan about how much we like it because of some weird societal Stockholm Syndrome, and would rather continue the suffering for the sake of ideology, specifically the "fuck you, I've got mine" caveman-like scarcity model.

We have the means to solve the problem, but not enough motivation. Or courage. We have the brains to solve the problem, but not the heart to care about it.

This country breaks my heart.

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#22 posted by zuzu, June 27, 2009 6:52 AM It costs a crapton of money to do medical research. It takes hundreds of millions, if not billions, of dollars to get just one drug to market. Someone has to pay for that.
Once again, you've got that backwards. Costs don't flow down to consumers; price signals flow up through the supply chain. Valuation originates with consumers, not with "raw materials" or "labor" or some such.

But if there was a proposal on the table to provide the same standard of housing (number of rooms, size of yard, quality of fixtures) to every American regardless of ability to pay, we'd be rationing oak floors and Sub-Zeros in pretty short order.
Why are we assuming that everyone is entitled to a Sub-Zero / Lexus level of healthcare?

Much of the scarcity problem could be solved by increasing the supply of doctors (which means more crappy doctors who work for lower pay). Substitute "doctors" for just about any medical product or service. (i.e. grow the pie)

It's better that poor people can afford an AMC Gremlin level of healthcare, than try to ration the number of Lexus available for everyone.

Consider that it's less expensive to fly to India for heart surgery and have it done there, than to have it done in the States. Imagine if that low-cost Indian doctor were available stateside without the whole flying to India part.

Or consider how people in southern border states can travel to Mexico to have dental cavities drilled and filled for $50 each, whereas I think the quote by my dentist in the USA was $300 each.

We need a system that determines who to say yes to and who to say no to. Health care has to be rationed, there is no avoiding it.
Who decides what to ration where and when for how long? (This is the heart of the aforementioned economic calculation problem.)

If someone is 80 years old with cancer, the government might have to say no when it comes time to treat them. The same may go for extremely ill newborns. The same might go for people with self-inflicted ailments like obesity or anything caused by smoking.
You want politicians and bureaucrats making those decisions? The same ones who vote to start wars, support growing a police state under the aegis of "anti-terrorism", and tell gay people they can't get married?

Imagine a TSA agent making the decision about whether you'll be granted or denied a cancer treatment or cochlear implant.

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#23 posted by Anonymous, June 27, 2009 6:53 AM Zuzu - your arguments, and Mises', are kind of blown out of the water by Napoleon Bonaparte's invention of the General Staff.

If you understand logic beyond the primitive ancient greek syllogistics, you might examine extensible hashing, cellular automata, and flocking behaviour (aka positional intelligence) and think about how higher order organizational techniques can be applied to human endeavors.

Before Napoleon, everyone made the same arguments against big armies that you are making against big healthcare: nobody could organize such a monster, it would inevitably be defeated by more efficient forces composed of federations of small entities, command and control would be inefficient, slow, ineffective, yada yada yada.

I can't stick around to have a more leisurely discussion with you, but do think about it.

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#24 posted by t3knomanser, June 27, 2009 6:57 AM My solution has always been to make offering health insurance illegal. Without those bastards manipulating the market, we'll get to see price adjustments without expanding the functional requirements we place on the government.

This is the one thing I'll never understand. Government is a system that already is overburdened by the functional specifications and it doesn't meet its SLA for a number of them. So we're going to tack on another, incredibly complex and demanding one? Not only that, but we're going to attach it at the root node of authority for governance?

While it works in some places, they're usually putting much less demand on the health care system than your average American, and the nation's health care system is generally smaller. When you look at England, you can see the probable future for American health care under a government-provided model.

The appropriate solution is for a non-market, NGO, or really, a network of non-market, NGOs to take on this functionality. The first step to that is getting rid of the existing market apparatuses.

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#25 posted by Anonymous, June 27, 2009 7:09 AM Thanks for the link, Cory. Having lived in the U.S. and Canada for approximately equal periods of time, I experienced comparable healthcare in both countries. The kicker is that, other than a few years as a student in Canada (where I was on private insurance as neither a citizen nor permanent resident), I've never had to worry about medical care costs here. In the states? A constant worry!

There are gaps in Canada's healthcare umbrella, sure. Medication outside of the hospital isn't covered by th provincial plan; dental, orthotics and eyecare are private insurance concerns. Even when I didn't get coverage from the provincial health plan and still needed to see a doctor, I benefited from the lower cost of medication and care that the universal system affords.

Still, the waiting times aren't all that different. I see, time and again, people on either side of the border having to wait or being put right through. It doesn't appear to be faster in the U.S. from this perspective. I have a relative in the state who's been waiting for six months now for a medical procedure to even be scheduled while a friend in Canada has, in that interim, been seen, scheduled, operated upon and is in recovery from the same procedure.

Now that I have a family, I'm reluctant to even think og returning to the States. That's all because of healthcare! Here, I have no worries that my children will lose coverage. There? It would be a growing fear.

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#26 posted by wizardofplum, June 27, 2009 7:15 AM #10 ZUZU Oh Yes "til you are diagnosed as a colon
cancer victim!God forbid,you will need more than
"liquid" cash.You will need the support of the
community at large and in my world,deserve it.#11
Exactly what planet are you from?You have just defined the ultimate selfishness,I begin to understand the moral decline that is infesting a
once noble nation.I am so grateful that I knew and
loved the Real America before you and your self-
seeking ilk were spawned.#14 Heil Hitler!when they
start to practice triage based on moral and ethical standards,you'll be the first to go ,boyo
and there might be some,one,to mourn your passing.

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#27 posted by zuzu, June 27, 2009 7:30 AM Oh Yes "til you are diagnosed as a colon cancer victim! God forbid,you will need more than "liquid" cash.
Or, I would have used some of that cash to purchase catastrophic health insurance (high deductible, low premium). My discretion, according to the tacit knowledge that only I possess.

You will need the support of the community at large and in my world,deserve it.
Um, who exactly do you think other market participants are? Aliens? Robots? Lizardmen? They're people just like you and me.

Yes, I need the services of doctors just as much as I need electricians, plumbers, car mechanics, and computer programmers. (i.e. division of labor)

We (as a species) should be able to take care of everyone. The reason we don't: greed and incompetence -- varying, yet high levels of both.
We can't even provide everyone with housing, food, clothing, and other basics yet. Scarcity is a real problem (that we're trying to solve!), not a made-up conspiracy of rich people to subordinate everyone else.

p.s. Singapore uses medical savings accounts and spends less than 5% of GDP on healthcare
c.f. Medical Savings Account (MSA), Medisave

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#28 posted by PaulR, June 27, 2009 7:37 AM You want politicians and bureaucrats making those decisions?
Do you want an insurance company's CEO, who's pay package is dependent on whether your 40 year old wife gets expensive but effective breast cancer therapy, making that decision?
It's a pretty easy calculation when comparing the various systems:
1) What does health care represent as a proportion of GDP?
2) What are the health outcomes for the population?
(You are living in a democracy, or at least the semblance of one, no? So, you're part of a society, not Alexander Selkirk living on 'Más a Tierra'.)

On both scores the American system is piss-poor.

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#29 posted by Anonymous, June 27, 2009 7:47 AM Health problems that can be easily treated such as high blood pressure and diabetes take up a sizable amount of the health care budget. People wait till their blood pressure is high and go in, then they've had a stroke, which is VERY costly to treat. This system costs 8-10X more than a simple office visit and preventative care. For people w/o insurance, paying $60-80 to see an MD for a checkup and a script then the cost of the basic meds is prohibitive, especially families with kids or on fixed incomes. (If you're on Social Security, you get a whopping $700-$800 monthly ballpark before taxes; then you pay for meds. Not much is left for rent, food and utilities).
Because the care is so costly, people cannot afford to pay, and then hospitals close. That's been happening all over the country is small towns for two decades.
Local communities bear that burden, not the feds. Middle class people get bent out of shape because taxes go up, and because those that cannot afford take themselves and their kids to the ER, to offset the costly health care system we currently have. We're already paying out the wazoo for health care, but not many people are getitng good treatment.
If anyone wants health care reform, it takes time and energy- email and call your elected reps because the lobbyists have their ears and unless they hear from us,the public, they're likely to go with the big guys.
WRITE and CALL= tell them you're a registered voter (but don't lie) and tell them this issue is the most important one right now.


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#30 posted by querent, June 27, 2009 7:58 AM @18

"Much of the scarcity problem could be solved by increasing the supply of doctors (which means more crappy doctors who work for lower pay)."

This bugs me. The early capitalist logic here is that no one does anything for any reason other than money.

IF DOCTORS MADE LESS, MAYBE WE'D GET HEALERS AS DOCTORS INSTEAD OF GREED-HEADS.

Not to say that they'd have to be poor. There's rich and then there's rich.

Also: to break the I'm-covered-I-want-immediate-treatment argument: is there any obstacle to having a private apparatus (for those who can afford it) along side the public one? Granted, the private sector would make less, because no one would be going broke to pay bills, but maximizing profit isn't what we're talking about, right?

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#31 posted by querent, June 27, 2009 8:00 AM PS

"contrary to popular belief, costs of production do not determine prices of goods. Prices are determined by the instantaneous valuations made by consumers and producers bidding against one another"

I'll grant that this makes sense, and that it seems like one of those trippy reconceptionings that can't help but be right to some degree, but it bugs me from a physical, finite-world standpoint.

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#32 posted by wizardofplum, June 27, 2009 8:01 AM #17 GLOSSOLALIA Good on you munchkin!there is hope
yet.Do you remember the story of Job?I will recall
His Nibs,called together all his angels for the
annual general meeting,all was going well until
who else?,Satan had to put in his pennysworth.The
ruler of this system of things,Old Nick, suggested
that the battle for mankind's soul was, as he had
predicted,just a matter of time. Selfishness and Me'ism would overcome the innate humanity that was instilled in Man from his conception.YHWH
countered,"See yon muckle laddie,Job? He loves me
in spite of our agreement not to meddle in the
affairs of man" So,Lucifer replied"Yeah! see you
Jimmy,he is wealthy,wonderful and wise,remove your sponsership,then watch!So,His Nibs did and
allowed Satan to inflict Job with a multitude of
afflictions.Job stayed firm and resolute and did
not bend.Nice to know you,pal.

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#33 posted by querent, June 27, 2009 8:06 AM PPS

"We can't even provide everyone with housing, food, clothing, and other basics yet. Scarcity is a real problem (that we're trying to solve!), not a made-up conspiracy of rich people to subordinate everyone else."

As a mathematician, a scientist, and an environmentalist, I DON'T think that scarcity is a real problem.

As Arundhati Roy said, there's a lot of money in poverty.

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#34 posted by Timothy Hutton, June 27, 2009 8:28 AM YAY! Simplistic answers to complex questions!'

I agree with Jay Acker - it is easy to discount the United States Medical system as bloated, in-efficient, etc. but in truth, I suspect it sponsors more medical research and moves medicine forward at a faster pace than any other "enlightened" health care system.

For further information, I defer to this post at Fox Business by Elizabeth MacDonald.

From the article:
But the health care reform debate is riddled with misleading myths taken as fact, myths that are torquing the debate beyond recognition, from the U.S.’s supposedly poor infant mortality rates, who really gets medical care, the level of uninsureds, who really pays for insurance, who actually can afford insurance and wait times for surgeries.

Most everyone agrees that the U.S. health system is broken and that the uninsured must get coverage.

But fixing the health system should be based on the facts, not on a statistical faith-based initiative mounted to ram through reform, where the data is either more nuanced on closer look or the statements made are simply not true.

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#35 posted by zuzu, June 27, 2009 8:33 AM Do you want an insurance company's CEO, who's pay package is dependent on whether your 40 year old wife gets expensive but effective breast cancer therapy, making that decision?
I want health consumers -- you and I (as the patient), consulted by our doctors -- to make those decisions. (again, c.f. health savings accounts (HSA))

That means: 1.) paying out of pocket for most drugs, diagnostics, and consults, but 2.) massive deflation in prices to at least 1/10th of their current insane overpricing (medical cost inflation caused by insurance companies).

So an MRI would only cost $100, and a monthly refill of your prescription drugs only $50. Consultation from a GP doctor (private practice) would cost maybe $75/hr. A CBC maybe $50 in lab fees from Quest Diagnostics. and so on.

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#36 posted by Timothy Hutton, June 27, 2009 8:33 AM Felsby said:


As a minuscule reminder of that fact, my neighboring city council has just made bus driving free - it was cheaper all in all.

That's great! I always wanted to be a bus driver...

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#37 posted by rschndr, June 27, 2009 8:37 AM She didn't mention that Canadians live about 3 years longer than we do, too. Probably because they don't get all stressed out fighting their insurance carriers.)

You could expect that to add to their costs, too, but obviously it's not breaking them. When you cross the border you will not see signs of a decline in the standard of living. In many cities it's hard to tell you're not in the U.S. Some of you need to do that, and then quit pretending Canada is impoverished by their massive health bureaucracy. Everybody else can see it.

The morning TV news I watch is Canadian, and you don't hear Canadians talking about what all the naysayers are talking about down here. That's beacuse those things aren't happening up there. Wake up! Canadians can speak up, and when there are problems, they sure do. The only recurrent themes I hear are 1) insufficient small-town/rural practitioners -- but hey, that seriously affects me in my U.S. town of 30,000 -- e.g., I only have three choices for a primary care physician under my HC plan, and must drive 75 miles for many specialties; 2) small-town hospital/clinic closings, due to their lower efficiency. At least there's a decent hospital here. But I had to fight with them every time I got blood work done, because their lab wouldn't honor an agreement with my plan's preferred lab system. So now I take a half day off and drive 150 miles to get it drawn, so it will be covered. I'm sick and tired of this crappy treatment.

Start looking at who's getting the return on their investment. Instead of those tired old eeeek-socialism! saws. Single payer is a great system. It's a MUCH smaller and more efficient structure, because the branches that deny claims and coverage are gone, along with the overhead costs of managing that activity. And when you take limitless investment profit and bonuses out of the picture, a lot of finance industry opportunists will hit the road. Makes it all kinda like government work, actually, so it fits right in.

But the current dragon is too big to kill with one shot. So I would settle for public option, for now. I believe it will provide some genuine competition for the insurance industry. Kinda like USPS Parcel Post competes with UPS and FedEx. They all have to stay on their toes. I can't find a quote for attribution of what I heard the other day -- "You say government is bloated, wasteful, and inefficient, but the insurance industry can't compete with THAT?!?!" They damn well need to, I'd say.

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#38 posted by wizardofplum, June 27, 2009 8:44 AM ZuZu-What exactly did you NOT understand by the
term"community at large"?Um.so strange that the other lizards that are in my milieu are willing to donate blood,bone marrow or a kidney to help you and your "cash-up-front brethren", when in need.Sadly,there are 45 Million "others" that do not have an option in the States.Yeah man! Satan
rules,"In Greed We Trust"plastic specie for plastic minds.

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#39 posted by Anonymous, June 27, 2009 8:52 AM Dentists in the Netherlands make excellent pay - as they should.

Standard treatments however are quite affordable. Standard standard filling E 46, more complicated filling E 76, and a root canal Euro 252.

http://www.tandarts.nl/index.php?option=com_content&task=view&id=20&Itemid=37

Dental work is not covered in the compulsary insurence. The dental coverage always is limited and the yearly premium is 25 to 50% of that limit.

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#40 posted by Anonymous, June 27, 2009 8:57 AM This entire debate is not about improving health care for individuals. It's about government controlling more of your life.

We keep hearing about 50 Million uninsured. This is a lie as you can read below. BUT even if it were true, the average cost per person for insurance ranges from $2,000 to $4,000 a year with a 2,500 deductible (Source: eHealthInsurance.com) for 114 different plans. Talk about real choice.
50 Million X $4,000 = $200 Billion. HELLO!! ObamaCare’s price tag last week was $1.6 Trillion, and they are trying to get it down to $1 Trillion. 5 X $200 Billion = $1 Trillion. HELLO!! Something stinks in Gotham here. This is madness and obviously meant to be a massive power grab. The more government you have the more government voters who vote for themselves the more we are out of luck. Ok we can also give everyone 2,000 for a Health Savings Account bringing the total to $300 Billion. Why is this not shouted from the house tops? OR Drive us to the streets before we lose our country to the Socialists whose real agenda is permanent power.
The actual cost considering the numbers below could be as low as $120 Billion to totally insure everyone less then the cost of bailing out GM. (Why did we let United Airlines go Chapter 11 and not GM? That is another article.) Is my math wrong? Why is no one talking about this? This is madness I say madness!!!
The official Census figure for uninsured in 2007 was actually 45.7 Million. But even that does not tell the whole truth.
- Of that number 9.7 Million are immigrants of which at least 5.6 Million are illegal.
- About 9.1 Million have household income above $75,000.
- Half (23 Million) of the 46 Million are between 18 and 34 and don’t feel they need insurance.
- 12 Million qualify today for Medicaid. (Source: Factcheck)
That leaves us between 5 Million and 20 Million of actual uninsured. Price tag for 20 Million is $120 Billion (20 Million X $6,000).

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#41 posted by wizardofplum, June 27, 2009 8:58 AM #27 Timothy Hutton-'Lor Tundering Jasus! anyone
that quotes Fox as a reliable source is in the wrong forum, try Craigslist Rant,you might find a
kindred soul there.

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#42 posted by davidasposted, June 27, 2009 9:01 AM #22, re: politicians or CEOs making decisions;

The Canadian healthcare system is run, ultimately, by politicians who either believe wholeheartedly in the value of a government-administered system, or know that universal healthcare has been so ingrained in the national psyche of Canadians that they could never get away with dismantling it. Case in point: the CBC (state-run television!) held a nationwide contest not too long ago called "The Greatest Canadian" and the winner was none other than the 'father' of national healthcare, Tommy Douglas.

I have a sense that if the U.S. actually implemented a universal healthcare system, politicians ideologically opposed to the system would seek to sabotage it at every opportunity, to 'prove' it didn't work... even if it did. Politicians in the U.S. rarely seek results, but instead confirmation of their own beliefs. I also wonder if the U.S. is too big to take to universal healthcare; AFAIK, those countries who have universal programs are small by comparison.

My experience as an American expat of the Canadian universal healthcare system has been amazing. Total coverage, free doctors visits and medications, and perhaps most importantly, as a person who did not have medical insurance for my last year in the U.S., peace of mind. I leave my house each day with the knowledge that if I suffered from illness or injury, I will not go bankrupt to fix myself. I cannot overstate the mental health benefits from that feeling of security.

Oh yeah, and I got my Master's degree for free. I'm working on the PhD right now (also for free).

There is life beyond the U.S., and life here is good.

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#43 posted by johnny_action, June 27, 2009 9:07 AM I have no problem paying a little bit more so that we all can have health care in the US.

One thing I don't understand is when will small business owners get it that universal healthcare is beneficial for them. Universal healthcare reduces the operating costs of having employees work and makes employees more mobile. Large companies that already can provide healthcare insurance should see reductions in the overall cost of their products. ( It costs less to produce the same car in Windsor Ontario than detroit due to just healthcare costs).


Workers comp helps people in some states and is unhelpful in others. I've worked with people who fell from big heights in a warehouse but had to keep working despite being very hurt because worker's comp in texas is a joke.

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#44 posted by chris, June 27, 2009 9:07 AM @zuzu: great comments, the more I read about economics the more apparent I can see many of your points. One example of our fun system here in the US... why can't I get the price of my doctors visit up front? Why can't I shop around for the best price? If I ask, how much will this cost me... I get a funny glance, and am told to call my insurance company... but how can I do that if I don't know what random tests/shots/meds the doctor will prescribe during my visit. Its hard to put prices on a person's well-being, but if nobody can see the prices then they can be whatever the insurance/medical 3-ring circus wants them to be.

I think one thing everybody can agree with is the current health insurance system in the US is inefficient. However, instead of comparing apples to oranges (UK, Canada are different countries than the US), different laws, different populations, different socio-economic environment. Lets do some real calculations and have some hard logical proof as to what solutions would be the most efficient in the long run. Instead of thinking with our feelings and anecdotes, we should be looking at non-biased studies.

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#45 posted by Anonymous, June 27, 2009 9:26 AM Sara Robinson at the Campaign for America's Future has written an excellent series on this that goes into even more detail than the original posting:

http://www.ourfuture.org/blog-entry/mythbusting-canadian-health-care-part-i

http://www.ourfuture.org/blog-entry/mythbusting-canadian-healthcare-part-ii-debunking-free-marketeers

http://www.ourfuture.org/node/39300

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#46 posted by Anonymous, June 27, 2009 9:31 AM I am so tired of people like Mises telling us what can't be done, while other countries come close enough to doing it to make the attempt useful.

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#47 posted by zuzu, June 27, 2009 9:35 AM Instead of those tired old eeeek-socialism! saws. Single payer is a great system.
If central planning works so well for medical care, why not other economic sectors?

How can a centralized authority effectively distribute scarce medical resources, but not other scarce resources such as cars, computers, housing, etc?

One thing I don't understand is when will small business owners get it that universal healthcare is beneficial for them. Universal healthcare reduces the operating costs of having employees work and makes employees more mobile. Large companies that already can provide healthcare insurance should see reductions in the overall cost of their products.
But they'll see increased costs in the form of taxes. There's No Such Thing As A Free Lunch.

The only reason employers began offering health insurance as a benefit to begin with was because of wage controls during World War 2.

Otherwise, you'd just pay your employees more cash, and it's up to them as individuals whether they buy healthcare, or better housing, or an HDTV, or whatever.

(And cash is mobile, whereas benefits aren't. The advantage with a Health Savings Account would be that you could save a portion of income, at your discretion, income-tax free, but that could only be used to purchase medical goods and services. So when you need healthcare, you have 33% more of your income available to spend on those.)

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#48 posted by Cappy, June 27, 2009 9:36 AM Quite aside from all of the theory and ideology that gets injected into this discussion; there is the mostly repressed comparison of the US and Canadian health care systems that really illustrates the failure of our system and the inescapable need for profound change.

Up until 1972, both systems were essentially the same in terms of cost and outcomes. The biggest exception was that, on average, Canadians lived a year less than Americans. But, in '72, all Canada went to their current system, and since that time, their costs have declined to very nearly half of ours, and their results have improved markedly over ours. Their life expectancy is now two years longer than the US, their mortality rate for preventable deaths (those that occur because there wasn't an appropriate and timely medical intervention)is much lower and their infant mortality rates are also lower.

In short, they are paying half of what we pay, and they getting better care when you look at the comparative results on a system-wide basis.

But, the arguments you most often hear in opposition to the single-payer Canadian system are that:

1. The Canadian bureaucracy is so overbearing that the whole system is breaking down under the weight of government inefficiency.

2. Their system is in jeopardy because Canadian doctors are fleeing in droves to the US, where they can make more money.

3. Waiting lines are so long and rationing is so restrictive that many Canadians are effectively denied essential care.

4. Because of these issues, Canadians don't like their system of health care and would prefer our system if they could get it.

Since I spend my winters in Mexico and get to know a lot of Canadians who do the same, I've made it a point to question them as extensively as I can on the above points. To a person, they have knocked down every one of these arguments. In fact, most of them just laugh at the suggestion that they might prefer our system to theirs.

I even talked to one couple that buy a special insurance policy that will expatriate them back to Canada if they happen to fall ill or are injured while traveling THROUGH the US! They are scared to death of the possibility of being trapped in an expensive US health-care facility...

So, if the Canadians are paying less, getting more, and are actually frightened of a health-care system that accounts for more than 60% of the bankruptcies of American citizens; whey are we arguing over the arrangement of deck chairs on our health-care "Titanic?"

In my opinion, the only reason a single-payer system (such as the Canadian system)is not on the table is because we have allowed the debate to skip past the fundamental determination of whether health-care is a privilege or a right.

If we decide it is, in fact, a right, just as fire protection, law enforcement, and education are; then we really can't have a problem going to a single-payer system and simply bypassing all of the theoretical diversion that the health-care insurance industry is throwing up to distract us and frustrate effective change...

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#49 posted by Anonymous, June 27, 2009 9:36 AM The comments section in that article was a bit scary. Some people really do prefer going through life blind.

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#50 posted by Anonymous, June 27, 2009 9:47 AM There is one answer to all the Canadians and Europeans that say the US needs socialized health care.

You are Europe and Canada. For the most part, your governments are not huge corrupt clearinghouses for corporate welfare, graft, kickbacks, and bribes. I know. I know, you've got some. But the US puts you to shame in the corruption and incompetence department. We rule when it comes to corruption and greed in government. Period.

Now. All those nice health care systems you have over there work very well in your countries.

If you think they will work in the US, keep dreaming. The steaming pile of corruption we have in our current health care system is about as good as we can expect right now.

Every time someone thinks something will work in the US because it works in Europe or Canada, think again. The US is a different animal.

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#51 posted by Keeper of the Lantern, June 27, 2009 9:51 AM Zuzu wrote...

"Once again, you've got that backwards. Costs don't flow down to consumers; price signals flow up through the supply chain. Valuation originates with consumers, not with "raw materials" or "labor" or some such."

No. The cost to develop a drug is what's so expensive. It costs literally billions to bring a new drug to market (aaOnce again, you've got that backwards. Costs don't flow down to consumers; price signals flow up through the supply chain. Valuation originates with consumers, not with "raw materials" or "labor" or some such.

I'd bet a lotta money that the true long term cost of drugs has to do with administration and not so much with the cost to develop or produce. in the US, there are a hellovalotta jobs tied to all that private administration, and that's going to be a factor, as well as the big Pharma companies desire to see huge returns on their investements.

The argument has been made that the US system in effect keeps the new drugs coming, but I don't buy that. I still continue to wonder if the right public health care system could actually extend the potential customer base significantly. Of course, the drug companies will still take a hit, but I bet it's not nearly as egregious as has been claimed.

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#52 posted by Anonymous, June 27, 2009 10:00 AM This is just anecdotal, but my experience with the Canadian health care system was good. There was never a question as to whether I'd get what I needed. When I moved to the US one of the first things I noticed was that not everyone had all of their teeth.

In the US things have not been so good. I spent a few years uninsured and of course did not seek care for anything. It's no fun to pay $150 for a visit to a clinic (with terrible, terrible queues) to get a bottle of penicillin.

My experience with insurers here is that they will sometimes decline a claim and then slowly back off as you pursue it, hoping that if they make it difficult enough you'll just pay. This, to me, seems almost criminal. I think they wanted us to pay $400 for stitches and a tetanus shot.

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#53 posted by Anonymous, June 27, 2009 10:10 AM 90% OF YOU ARE WRONG AND OFF TOPIC
The Canadian healthcare system has its flaws but the single biggest cause of the long waiting times is the SIMPLE SHORTAGE OF DOCTORS AND NURSES. That and that alone accounts for the cascading effect leading problems of lack of efficiency.

What Im saying is that if there was a glut of Doctors and Nurses (imagine a waiting list for MDs and nurses looking for work) there would be no problem with the Canadian system (and most for that matter). But what has been happening is the reverse: an erosion of the Public system in Canada where MDs and Nurses migrated to the private system (first to the USA then gradually into the Canadian private clinics) whereby the remaining the Doctors and nurses in the public system are OVERWORKED causing more of them to 'defect' into the private system.

The private system's efficiency is based on PRICING THE AVERAGE CUSTOMER OUT OF THE MARKET FOR HEALTH CARE.therefore no waiting times since most can't afford or find a family physician.

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#54 posted by Takuan, June 27, 2009 10:18 AM free people can choose where to live. They choose their vote. They choose to smoke or not, or to over-eat or over-drink. It's all about choices.
http://costofwar.com/

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#55 posted by dd528, June 27, 2009 10:26 AM I'm no expert on US or Canadian healthcare, nor on UK healthcare, but I'll give my perspective on the latter, being a British citizen.

In response to Zuzu's question (#36) about central planning, the reason that healthcare is an exception is because of what is at stake. Nationalised healthcare is big, bloated and inefficient. Here in the UK, these accusations are constantly levelled at the NHS, and they are fair accusations. It is not because the NHS is a model of efficiency that it is so important.

The point is that efficiency is not something to be valued in itself; it is a means to an end. In the private sector, everything boils down to the haves and the have-nots. In most cases, this isn't so bad. It doesn't make much difference to me if a large sector of society can't afford to buy a flatscreen TV. The difference is that healthcare is a matter of life and death.

With centrally-planned, nationalised healthcare, here in the UK, we have a bloated, inefficient monster, but it is a monster that promises healthcare to anyone, irrespective of their situation. As the American example clearly shows, universal healthcare will not be achieved whilst the system is privatised. Even people who can afford health insurance have to fight a battle over what they are entitled to if they do become ill.

In the UK, this is simply not a concern. If you are homeless and broke, or if you are a billionaire, you can walk into an NHS hospital or doctor's surgery or clinic and you will be treated. No reference is made to your economic circumstances or background, and those circumstances will have no bearing on the quality of healthcare you will receive. With the exception, of course, that if you are broke, the state will pay your prescription charges and travel costs for long-term treatment.

The inefficiency is the price we pay. It is not a model people wish to see in other sectors, because other sectors do not deal with life and death. So turning a profit is a bigger priority. In the UK, people realise that some things are too important to be left to private companies and the vagaries of the market. Even at the heights of her rampant economic conservatism, Margaret Thatcher didn't dare suggest disbanding the NHS. Many people in this country hold it to be the greatest achievement this country has made in its long history.

In America, if you have a life-threatening illness, and you are poor, then you die. In the UK, if you have a life-threatening illness, and you are poor, you will get treatment. That treatment will not be of quite the same quality or expedience that you will receive in the best private hospitals in the US, or in the UK, but you will get it, whoever you are.

In this country, people believe that, when it comes to life and death, people should be treated as human beings, not as consumers. And our country seems to be (marginally) less bankrupt than yours. Which is why people here tend to look at America - the richest country in the world, yet one that is happy to let the homeless and unemployed and destitute die unaided - and don't know whether to laugh or cry. Usually they just end up giving thanks for having been born on this side of the Atlantic. I know I do.

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#56 posted by noen, June 27, 2009 10:30 AM Hmmmmmmm I love the smell of Zuzu spam in the morning. Nothing says I R SMART! like reams and reams of fesh copypasta from Wikipedia and von Mises!

Just remember that this is the same ignorant and self centered ideology that destroyed the entire US economy with it's "Let the rich keep all their money!" mantra. The delusional idea that there exists a "magic hand" that will govern the markets, healthcare included, if we only "let the market decide" is what lead to last falls catastrophic collapse.

If you want US healthcare to follow the exact same death spiral of the financial industry then just follow those same Libertarian policies that directly lead to it's destruction.

TAXATION IS THEFT!!

Wooowoowoooowoowoooo!!11010

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#57 posted by Takuan, June 27, 2009 10:31 AM (try the "Trade-off Calculator", here's an example:
"Taxpayers in Seattle, Washington will pay $2 billion for total Iraq & Afghanistan war spending since 2001. For the same amount of money, the following could have been provided:
312,128 People with Health Care for One Year")

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#58 posted by Anonymous, June 27, 2009 10:34 AM Health Canada most statistics show increasing dissatisfaction, growing wait times, etc etc etc. See for yourself.

@ #30 rschndr:
I don't think you know what you're talking about. You do NOT have the lack of small-town practitioners which is a growing problem in Canada: your town has three doctors on your HC plan alone! In Canada, ALL the town's doctors would be on your plan - and they would all begin to leave.

Single-pay might be more efficient, but not for the reasons you give. Claims coverage & denial would still exist, and for the same reasons they exist under all insurance plans: to prevent fraud and unnecessary payment. When the single-payer system says you can only get treatment A if you have symptom B, they will need to ensure that you are eligible.

Incidentally, this is a problem with ALL insurance: doctors will fit treatment to match what the insurer will pay. This will NOT change with national health care.

@ #33 davidasposted:
Your education wasn't free; someone else just paid for it.




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#59 posted by Nylund, June 27, 2009 10:35 AM I've lived in both Canada and the US as well. I was just a poor student in Canada so my tax situation wasn't standard, but it was awesome.

Tuition, school books, rent, subway fare, etc. all tax deductible. As a student, I paid way less in taxes in Canada (well, actually, I paid none, and got a credit that I could carry forward year after year)

So I know that a student's tax situation is not the norm, but Canada won hands down for that. As for healthcare, its not even a comparison. I had an insurance nightmare in the US prior to going to Canada, lived there for years without ever worrying once about health costs, or paperwork or anything, and now I've been back nine months and I am already buried in bills and paperwork. I've already paid more than my annual Canadian fee and have gotten very little in return. Its a horrible and broken system we have in the US and I can't believe that anyone who has lived in any other industrialized nation actually thinks our system is better.

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#60 posted by Thebes, June 27, 2009 10:56 AM This article lists an absurdity!

After tax income in NEITHER nation is 80-some percent.

In actuality, once ALL taxes (sales tax, property tax, state and local taxes, phone tax, gas tax, social security, mandatory licensing fees, etc) are figured the amount in the US is nearly a 50/50 split, very slightly in favor of the tax payer. The actual AFTER TAX INCOME is about 55% for most Americans, who don't get decent roads, decent schools, or even basic health care for the money taken from them- rather they get bombs, coups, and a police state.

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#61 posted by dougrogers, June 27, 2009 10:57 AM ZUZU: "I want health consumers -- you and I (as the patient), consulted by our doctors -- to make those decisions."

Else you get chiropractors, quack cancer cures, faith healing and naturopaths who easily adapt to market conditions.

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#62 posted by Antinous / Moderator, June 27, 2009 10:59 AM I defer to this post at Fox Business

Thanks. That will make it easier for sane people to skip the rest of your comment.

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#63 posted by grimc, June 27, 2009 11:00 AM @57

You should probably point out exactly where in the 124 page pdf you think your points are proven.

And as long as you're in there, why don't you point out the graph that shows how many Canadians were denied healthcare because of a pre-existing condition.

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#64 posted by Anonymous, June 27, 2009 11:16 AM @ GRIMC

Difficulty obtaining routine service, information, and emergency care have all increased. 25.3% of Canadians report difficulty obtaining immediate care. Pg. 32

Out-of-pocket drug costs increasing steadily. Pg. 40

72% of Canadians believe that their system needs either a complete overhaul or fundamental changes.

I also think that it's interesting that there are clearly marginalized people under this system: something that many single-payer advocates seem to overlook. I'm not saying that the current system (in the US) is better, but i think that it's important to recognize that there are flaws in nationalized H.C. as well.

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#65 posted by billbryan516, June 27, 2009 11:25 AM U.S. health care?? Care implies that someone does just that...cares. They don't. It's a business just like any other major corporation in the U.S.
Here's the biggest problem. I challenge anyone in the U.S. who has the luxury of health care provided by their jobs to give it up and go out and get their own. Not only will you probably be turned down, but good luck affording it for you and your family...then there's the cost of prescriptions, deductibles, and regular visits not covered by your insurance. I am 36, work several jobs, and haven't been to a doctor in years. Why? I can't afford it. Would I have gone if I could...absolutely!! Have I needed to a few times...MOST DEFINITELY!!! I should go TODAY but I can't afford it. Millions of Americans are in my exact predicament. If something were to happen to them, they're dead in the water. Many Americans suffer and/or die from treatable conditions they can't afford to have treated or cured. It's high time we reform this dodgy system so ALL citizens are provided efficient, thorough, health care by doctors who aren't over-worked, regularly sued, and who actually "care", who pay attention to their patients, and who don't mis-diagnose and mis-prescribe medications.

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#66 posted by Takuan, June 27, 2009 11:26 AM worth a repost
http://www.youtube.com/watch?v=AzDwXr9szxw

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#67 posted by Takuan, June 27, 2009 11:35 AM http://www.youtube.com/watch?v=3pbKRc-0mSs&feature=related

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#68 posted by the_headless_rabbit, June 27, 2009 12:19 PM I find it very amusing that the only Americans who think their health care system is best are those who have never experienced a different system first hand.

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#69 posted by Anonymous, June 27, 2009 12:35 PM "You want bureaucrats making those decisions?"

Man, this argument always cracks me up. Who the hell do you think is making decisions about whether or not you and your family get health care and how much right now?

Bureaucracy is not just a function of government.

And, frankly, given the choice between two bureaucracies, I'm going to look at their motivations. Current corporate health care bureaucracy, with its motivation of taking in as much money as possible and denying as much use of that money as possible, is not the one I want making my health care decisions.

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#70 posted by Daemon, June 27, 2009 12:40 PM It's ironic that so many Americans have no qualms about dumping trillions of dollar into military, but shudder in revulsion/terror at the thought of spending a tiny fraction of that on universal healthcare.

They seem to consider killing people they don't know more important than saving the people they do know.

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#71 posted by tw15, June 27, 2009 12:55 PM Like #55 said, in Britain in matters of life and death, we believe in universal access.

Police, Defence and Healthcare: none of these should be available only to those who can afford to pay.

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#72 posted by zuzu, June 27, 2009 1:11 PM It's ironic that so many Americans have no qualms about dumping trillions of dollar into military, but shudder in revulsion/terror at the thought of spending a tiny fraction of that on universal healthcare.
Anti-imperialism and anti-collectivism are not mutually exclusive belief systems.

Perhaps we should have neither a military-industrial complex or a medical-industrial complex.

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#73 posted by grimc, June 27, 2009 1:28 PM @64

I agree with you that nationalized healthcare wouldn't be perfect and have it's own flaws, but even the flaws you point out in Canada's system are nothing compared to the problems of the US healthcare system, in everything from cost to availability. And the simple reason for those problems are US insurers are concerned more with their shareholders than their policyholders.

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#74 posted by RevRaven, June 27, 2009 1:38 PM I'm glad to see that BoingBoing, much like ABC, is spreading propaganda for the ObamaCare system (only unlike ABC, BoingBoing accept dissenting opinions!).

Here's my take on a few pieces from this story and the comments:

Even .0001 percent of my pay is too much for the Government to seize to provide health care for others or myself. I can provide for myself. I don't need the government to take care of me. And I don't want the Fed taxing my employer for providing me health benefits, because that would mean my employer would stop providing me health benefits, if they can't use it as a write-off when it comes to taxes.

Why do you want to grow the size of the Federal Government? And you want to put them in charge of your health care...the same people that can't deliver the mail, balance a budget or keep a secret. That's mindblowing. Everything the Federal Government has done, the private sector has done much better. Look at how horrible the education system is, thanks largely to Federal Government involvement. Do you want health care to be like that?

Or is health care going to be the one exception in the long, looooooong string of Government failures that will succeed? And if it will be: why will this succeed where so many other programs have failed?

I'll worry about my health care, you leave it and my taxes alone. I don't require aid from the Federal Government, I can manage on my own.

Because, that's what we're supposed to do.


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#75 posted by thequickbrownfox, June 27, 2009 1:44 PM Zuzu, you remind me of the John Sladek novel "Tik-Tok", hilarious sci-fi tale of a robot in charge of health insurance.

http://en.wikipedia.org/wiki/Tik-Tok_%28novel%29


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#76 posted by lesbianjesus, June 27, 2009 2:19 PM Zuzu, wherever you are, move immediately to the United states, you will be VERY happy.

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#77 posted by Tetsubo 57, June 27, 2009 2:26 PM Revraven - That is quite possibly the most insane thing I have ever read in reference to health care. There is no possible way that I and my wife could cover the cost of our own health care. None. Nor do I imagine that most Americans could afford it.

A Canadian style health care system would provide coverage for all and cost our nation less money. Health care is aright, not a privilege. You know, like in a civilized nation.

Under your method we wouldn't be able to bury the bodies fast enough.

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#78 posted by noen, June 27, 2009 2:28 PM Zuzu:
"Perhaps we should have neither a military-industrial complex or a medical-industrial complex."

Ladies and gentlemens there you have it. The Libertarian Utopia! NO military, NO medical system, NO police, NO firefighters, NO public utilities, NO public schools, NO public roads. What could possibly go wrong? Just the eternal Feudal State where the rich and powerful enjoy absolute rule and you get jack squat. If you're stupid enough to buy into that you deserve the utter hell that would be the inevitable result.

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#79 posted by GuidoDavid, June 27, 2009 2:34 PM "Even .0001 percent of my pay is too much for the Government to seize to provide health care for others or myself. I can provide for myself. I don't need the government to take care of me. And I don't want the Fed taxing my employer for providing me health benefits, because that would mean my employer would stop providing me health benefits, if they can't use it as a write-off when it comes to taxes."

I wish people would stop using selfishness as a basis for public policy. Whether we like it or not, we live in societies and we enjoy many benefits of such arrangement. Paying for other's education means we have more and better doctors, that people with children can take the risk of creating their own business without being afraid of not having health care.

And please, get real. According to that evil socialist pamphlet called Forbes, the US is not the most competitive nation in the world:
http://www.forbes.com/2006/09/26/finland-switzerland-denmark-biz_cx_pm_0927competition.html

A curious thing that all the other most competitive nations on top of the US provide universal health care to their citizens and have higher taxes.

Having a fraction of the population uneducated and with no health care is actually detrimental to all people, including the mega rich. An educated, creative and free labor force is better than having a feudal fiefdom from the innovation point of view. It creates wealth and allows to use all the intellectual potential. If you think that denying health care and education to people is going to work and that hiding in expensive, rich-only communities will save your ass, you are bound to a very unpleasant surprise. You need the wit of a lot of people to keep our current lifestyle, and you need that people to be healthy to work well. I hope it is not too late before you notice that unless you have an universal nano replicator or you are a hunter-gatherer hermit, you depend on other people for pretty much everything you do/enjoy.


Post Scriptum:
New Data. Indeed the US is the most competitive country in 2008, Denmark is second.
http://www.weforum.org/en/initiatives/gcp/Global%20Competitiveness%20Report/index.htm

Still, the argument is valid, high taxes and universal health care do not mean the demise of freedom, competition or means an anti-bussiness behaviour.

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#80 posted by GuidoDavid, June 27, 2009 2:36 PM I really do not understand people. Currently they pay MORE than other countries to cover less people, yet they are happy doing this and prefer to pay more than paying LESS and at the same time help others.

Is this a rational point of view or simply a mental disease of pathologically refusing to help others?

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#81 posted by wolfiesma, June 27, 2009 2:54 PM Talk of dismantling the medical industry is taking it a bit too far. Dismantling the insurance industry, on the other hand... now there's a notion that's way way way overdue. I don't know what the solution is, but the insurance agencies as they currently exist in the U.S. have no place in modern medicine, that much is for sure.

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#82 posted by Kehaar, June 27, 2009 3:26 PM Im Canadian, and a cousin of mine, also canadian, he graduated in canada with chemistry master degree and then first job landed was in USA in California starting at 250000 a year.

Hmmmm, still have little idea what he does as sales agent....

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#83 posted by Timothy Hutton, June 27, 2009 4:10 PM When I said:


I defer to this post at Fox Business

Antinous commented:


Thanks. That will make it easier for sane people to skip the rest of your comment.

I figured it was easier than asking you to stick your fingers in your ears and go "la-la-la-la-la-la, I can't hear you, la-la-la-la-la" as I read the article aloud.

Let me share this nugget with you (I'll wait while you cover your eyes to avoid reading anything that contradicts your world-view):

Everyone has access to health care. They may not have health insurance, but the law mandates everyone who shows up at emergency rooms must be treated, insurance or not, he reports.
About 14 mn of the uninsured were eligible for Medicaid and SCHIP 2003, a BlueCross-BlueShield Association study based on 2003 data estimated. These people would be signed up for government insurance if they ever made it to the emergency room, Sullivan says.

A whopping 70% of uninsured children are eligible for Medicaid, SCHIP, or both programs, a 2008 study by the Georgetown University Health Policy Institute shows.

The issue of uninsured children apparently has a lot to do with the reluctance of parents earning upto three-times their state's poverty level to find time to sign up for SCHIP or Medicaid... Figure out why they are reluctant to sign-up for free coverage that already exists and they qualify for and you'll be well on your way to making a major improvement in the lives of millions of children.

You can uncover your eyes now.


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#84 posted by Takuan, June 27, 2009 4:35 PM "the law mandates everyone who shows up at emergency rooms must be treated, insurance or not, he reports. "

even the indigent, aged and mentally ill videoed being dumped on the streets by hospitals unwilling to treat them?

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#85 posted by Takuan, June 27, 2009 4:37 PM http://www.manticeye.com/article.php?id=871_0_21_0_C

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#86 posted by wolfiesma, June 27, 2009 5:47 PM The long-term care and housing of the chronically ill can't fall on the hospitals alone, no matter who is paying the bill. When I saw the footage of the poor woman and heard the commentary about how the hospital had failed her, I didn't really get that. It seemed like a failure of the family system, rather than the medical system. If you don't have someone to pick you up and take you home when you get discharged from the hospital, that's a problem, but its not one for doctors to solve. Arranging for a cab to drop her off at the Rescue Mission actually seemed like a pretty humane thing to do. For me, the case highlights what a critical role a places like the Rescue Mission serve in our society. The solution has something to do with more funding for emergency shelter instead of the dastardly prison-industrial-complex. Which is where we put the indigent mentally ill today.





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#87 posted by Takuan, June 27, 2009 5:58 PM it's easy to end up alone.

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#88 posted by noen, June 27, 2009 7:05 PM Shorter Timothy Hutton:

"Let them eat cake."

That worked out real well for the last aristocratic class that tried that didn't it?

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#89 posted by GuidoDavid, June 27, 2009 7:22 PM Noen:

Look at here, at our "socialist paradise". Look the kind of monster that "Let them eat cake" allowed to arise. Look at all the crime due to poverty, lack of education and opportunities (even with free college, primary education is shitty and many never finish). An underclass is not a pretty thing. A violent underclass is a nightmare. It is very human to feel disgruntled. Even more when you know others have more and you cannot get some.





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#90 posted by zuzu, June 27, 2009 7:48 PM Ladies and gentlemens there you have it. The Libertarian Utopia! NO military, NO medical system, NO police, NO firefighters, NO public utilities, NO public schools, NO public roads. What could possibly go wrong? Just the eternal Feudal State where the rich and powerful enjoy absolute rule and you get jack squat. If you're stupid enough to buy into that you deserve the utter hell that would be the inevitable result.
Reductio ad absurdum. In my opposition to the military-industrial complex and medical-industrial complex (and prison-industrial complex, and the central banking that makes it all possible), I'm identifying the problems of corporatism, rent seeking, and regulatory capture.

To quote Ted Nelson:

I see Professionalism as a spreading disease of the present-day world, a sort of poly-oligarchy by which various groups (subway conductors, social workers, bricklayers) can bring things to a halt if their particular demands are not met. (Meanwhile, the irrelevance of each profession increases, in proportion to its increasing rigidity.) Such lucky groups demand more in each go-round - but meantime, the number who are permanently unemployed grows and grows.
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#91 posted by Anonymous, June 27, 2009 8:15 PM Has anyone seen these articles?

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

http://www.newyorker.com/online/blogs/newsdesk/2009/06/atul-gawande-the-cost-conundrum-redux.html

They demolish the US health care system

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#92 posted by Anonymous, June 27, 2009 9:06 PM Zuzu has catastrophic coverage, which he believes in because he's never had a catastrophe.

But this is an insight into the most perfect Libertarian mindset I have ever seen: scarcity in all but data (which is infinitely reproduce-able for negligible cost) and an unfettered supply-and-demand philosophy whereby IV antibiotics are worth an entire lives' income for your only child, but at least viagra is cheap.

Scarcity is low and decreasing on a global level for almost everything (yes, even medical care) but distribution has been easily and expertly tailored to serve the overclass. Why else would real estate be about "Location Location Location" rather than at least some value being attached to the property itself?

Americans are being lied to, frankly, as they do have universal coverage of terminal emergencies, just as in the rest of the civilised world. If they mandate treatment of an emergent life-threatening case, regardless the patient, then life supersedes cash. Why so ideologically opposed, then?

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#93 posted by tim, June 27, 2009 10:33 PM @ #33 davidasposted: Your education wasn't free; someone else just paid for it.
And in due course david will pay for someone else's education, assuming he is in a position where he is earning enough to be paying taxes. In the meantime, society benefits from a small improvement in the average level of education due to david no longer being an uneducated serf. If david opts for a career where he never earns much money but perhaps provides some value to society (say, carer, or artist, or whatever) then he couldn't have afforded to pay back a student loan anyway. I was also lucky enough to have the expenses of my several degrees paid for by assorted grants and bursaries. As a result I have, almost every year, paid more in taxes than the average salary whilst still having plenty to live very comfortably on. Society as a whole has benefited quite nicely from that little bit of ooh-err-missus-that's-socialism-that-is!
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#94 posted by Takuan, June 27, 2009 10:50 PM if it turns out to be true that universal medical care was always workable and possible, what will those do, who watched family die when common "wisdom" said it was not?

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#95 posted by Keeper of the Lantern, June 27, 2009 10:55 PM Revraven wrote...

"Look at how horrible the education system is, thanks largely to Federal Government involvement. Do you want health care to be like that?"

That's exactly the same illogical drivel a lot of Americans spew out, without actually thinking much about what they're saying.

The quick answer is, "hell yes, I'd much prefer this to nothing", remembering that nothing is what a huge % of the US population has.

No one is suggesting that private health care would have to dissappear. The UK actually has BOTH systems, and we pay insurance and see private doctors.

As for "taking care of your own health care", you either mean you are willing to simply up and die in the event of a catastrophe (in which case I salute you for your brave, stoic choice), or else you are absurdly wrong.

The question is one of risk management: There's always the possibility of a health issue that can cost more than any individual has. By pooling our resources we can ensure that most people are covered, even if the odds of my needing that coverage are small.

As for the government, I'd point out...

1. The Postal Service works just fine and competes quite well with UPS and Fedex.

2. Fire departments work pretty well in the US. Try privitizing those!

3. Our NYC subways work good enough.

No, government CAN work if we make it work. US schools don't work because parents have forced the schools to parent and discipline their kids.

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#96 posted by wolfiesma, June 27, 2009 11:31 PM "The Cost Conundrum" article in the New Yorker summarizes the problem of high medical costs as overutilization of medical treatment. I guess maybe I hang out with too many old people with comprehensive medical insurance, but it certainly seems that way. They are in to see specialists several times a month. It's run to the doctor every time you so much as have a question or concern, and the doctors are compelled to run every diagnostic under the sun to avoid malpractice. I love the old people in my life and don't want them to die, but come on, is it so bad to want some limits on the amount of health care the well insured receive?

Then you have the nightmare scenarios where you do need care and the insurance company gives you the runaround and adds so many layers of beaurocracy its like a part-time job just doing all the paperwork you have to do. You go ahead with treatment you think will be covered and then get stuck with the financially ruinous bills.

Either way, paying the insurance company, instead of paying for your care directly, does seem to be a big part of the problem.

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#97 posted by Roku, June 28, 2009 12:46 AM The only two health insurance systems that can possibly work are:
1- single-payer
2- fully privatized (i.e. we pay for all care, no public subsidized ERs or anything else).

2- is more efficient, but many people have a moral objection to it.

Most importantly, though, any hybrid system, such as we currently have, is doomed to failure - because the incentives differ from the desired result. An insurance company makes money by collecting premiums, denying coverage to subscribers, and denying payment to providers. This can never produce the desired result of health care.

Noen: "If you want US healthcare to follow the exact same death spiral of the financial industry then just follow those same Libertarian policies that directly lead to it's destruction."

Completely and totally false. You've been fooled by the bankers, who have extracted over $5 trillion from the government trough so far. A banking system in which the cost of money is determined by a government-granted monopoly cartel of bankers, in which banks (but no one else) have a government-granted right to create money out of thin air ("fractional reserve banking"), and in which the bad debts of banks (but no one else) are guaranteed by the government is not a free market - it's fascism.


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#98 posted by subheight640, June 28, 2009 2:19 AM What pisses me off the most about some more libertarian arguments is their strict ideological belief in the efficiency and effectiveness of the free market system, without any proof/evidence/data to back up their claims. All they can offer is some lofty philosophical mush.

The goals (I perceive) of American healthcare reform are:
1. Increase healthcare quality
2. Increase healthcare coverage
3. Reduce healthcare costs

Some libertarians claim that privatization is more "efficient." They often forget to define the word efficiency. Do they mean more improved healthcare per dollar? Or total healthcare costs per year? People have no measure of healthcare "efficiency"; that term is bullshit.

Some libertarians, through lack of imagination, cannot imagine a superior system than the free market. The fact is there is an INFINITE amount of government/societal/economic systems that man can create and use, the libertarian's repeated claims that the market is the best tool to sort all of man's problems out is ridiculous. They definitely haven't tried them all yet.

Libertarians need to recognize that free market principles lack a certain something called Humanity. On the other hand, the idea of health Care (The care of the sick or dying human beings) is based very much on humanity/compassion whatever.

Finally, many other countries seem to be pulling off some form of socialized medicine quite well. They don't seem to be on the brink of economic/societal collapse either.

BTW "The Cost Conundrum" was great.

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#99 posted by Ugly Canuck, June 28, 2009 3:22 AM Binding health-care to one's particular employment/employer is just like binding serfs to particular pieces of farmland IMHO...almost, but not quite, slavery.

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#100 posted by Anonymous, June 28, 2009 4:24 AM It's always entertaining to see such heated discussions - all of which avoid the biggest problem with health care. Litigation. After labor costs, one of the biggest medical expense categories is malpractice coverage and settlements.

My wife is a registered nurse. She has been in family practice since 1980. There are 4 doctors in the practice, making

The practice has had any number of 'nusiance' lawsuits, probably 25 that I can recall. None have resulted in a 'win' for actual malpractice, but all required insurance, legal expense and time away from other patients.

The most bizarre patient claim of malpractice was a woman who sued for total and complete amnesia from a colonoscopy - but she could remember that she had it done, and who the caregivers were.

John Edwards, who ran largely on a 'reform health care' platform, made millions as a personal injury attorney.

From my perspective, the only way a government provided health care system is going be successful is that a side effect will bring about a level of tort reform that congress itself will never pass.



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#101 posted by Padraig, June 28, 2009 4:57 AM I wasn't going to say anything as those who are intelligent to understand the arguments appear to have made them already.

Then I decided some moral support is always useful.

There is not such thing as a 'real capitalist economy'. There are mixed economies in existence, one of which is the USA.

Your roads, hospitals, school, food, electricity and a multitude of other things all come about because human beings are herd animals with a herd instinct. Some people like to think they are an island unto themselves. They are not. The very things (such as the Internet) did not come about because of people like them. It was because of people who thought of others - not as objects but as people. Without others we are nobody and have nothing.

The US health care system is crap. The great majority of health economists in the world think so. The absolute majority of people living in First World economies believe in social health care for all.

The rest of the arguments about cost etc are ridiculous and pointless. How to make it function better is a good argument. Value for money is a good argument. Of all the First World economies, whether it should exist is an argument that only really goes on in the USA.

It's sad for those who are disadvantaged.

To all those who 'get the point' - well done for keeping up the good fight.


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#102 posted by PaulR, June 28, 2009 5:11 AM Zuzu @ 27: "Singapore uses medical savings accounts and spends less than 5% of GDP on healthcare". The Wiki page on Singapore's Health care pegs it at 3% of GDP.

Apple, meet orange:

Singapore is an island/city state, with an area of about 710 sq.km, with a population of about 4.8 million. The population density works out to 6,760 per sq. km.
I'm quite sure that most of the land must be turned over to farming... /sarcasm

For comparison's sake:
Manhattan Island is 87.5 sq. km, , pop. 1.634 million, 18,674 people/sq. km.

Yup, fair comparison between Singapore and the US and with Canada.

US of A: 9,826,630 sq. km, pop. 306,774,000, 31 people per sq. km.
Canada as whole: 9,984,670 sq. km, pop. 33,696,000, 3.3 people per sq. km.

Hmm, aside from the that whole population density, econnomies of scale thing, what else could be reducing the cost of medical care in Singapore?
Well, according to http://en.wikipedia.org/wiki/Health_care_in_Singapore

"Singapore has a universal health care system where government ensures affordability, largely through compulsory savings and price controls...
...as well as "actively regulating the supply and prices of healthcare services in the country" to keep costs in check; the specific features have been described as potentially a "very difficult system to replicate in many other countries."

There goes the Hayekian Spontaneous Order...

Oh yeah, and so does the not wanting 'politicians and bureaucrats making those decisions', eh?

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#103 posted by BdgBill, June 28, 2009 5:33 AM What is this woman smoking? Taxes are equal in Canada and the US?

I am an American living in Quebec and can tell you that taxes are nowhere near equal.

Sales tax is 13%! I recently paid hundreds of dollars in taxes on the purchase of a new tv.

I still work and pay taxes in the US. I make 20k less than my girlfriend (who works and pays taxes in Quebec) but my take home pay is slightly higher than hers.

Many of my canadian friends who grew up with the canadian health care system say it's terrible.

Canada almost certainly does a better job at health care than the US will do. Anyone here have any experience with the VA?

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#104 posted by Perla, June 28, 2009 5:50 AM I've lived in Spain, in Ghana and Nigeria, in the US, now in the UK.

The sickest I´ve ever been is in the US. In fact, 10 years after been in the US, I´m still suffering aftereffects from my US diseases (viral infections claimed to be sinusitis, why don´t I try this new medication that the salesperson just brought?). Worst food poisoning in my life as well. Eaten street food in Nigeria and Ghana in a warm tropical environment, heaven for bugs and the worst food poisoning I´ve ever had was in the US. NOt once but 3 times. Those were the bad ones, I´m not counting the mild runny tummies.

Oh, and worst medical advice too, doctors were always trying out and selling new medications on me and screwed up my health. Doctors shouldn´t sell their souls to corporations, it´s wrong.

The only way I can imagine anyone defending the American system is if you have NEVER been in the healthcare system of European countries (and Canada and Australia etc). If you have been in most 3rd world countries, the US is better. You get ambulances, medications etc.
Fine, the US is bigger than UK, bla bla so it will never work but it has NEVER been tried in the US (a national healthcare system), so how the hell will anyone know if it works or not? YOu can at least try. The Americans here defending US healthcare, have they ever been in another healthcare system? Cause if not, you don´t know what you are talking about!!!!!

The UK system has its issues, the Spanish system has its issues and I complain about them regularly. UK has better mental health assistance though the way it´s organized seems like I´m in the 1950s instead of 2009, my Spanish doc prints out my prescriptions in fact everything and my medical history is updated, Spain has better medications (you can get practically anything as I realized when I had a very horrible sore throat and was in agony and tried to get cough medicine when I visited Netherlands, I didn´t get any, just some natural homeopathic crap) and if you can get a good doctor (difficult anywhere), you can get tests and stuff to your heart´s content. I often buy medications in Spain. 56 cents for my inhaler! 1.6 euros for my painkillers! I get my family to post medication.

So bad and good things and I even have a little supplementary health insurance that I used in Spain. And I complain regularly and frequently, healthy I feel. But always in the back of my mind is that I´m not in the US, thank heaven for small mercies.

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#105 posted by davidasposted, June 28, 2009 7:42 AM @ #58 ANONYMOUS

You are right; the government, in conjunction with private donors, has a hand in providing me with free higher education. They have an interest in enabling an educated, healthy populace. Crazy, huh?

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#106 posted by Takuan, June 28, 2009 11:45 AM http://news.bbc.co.uk/2/hi/health/8119116.stm

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#107 posted by dd528, June 28, 2009 2:13 PM Reading through some more of the comments here it does seem that a lot of the opposition that people in America seem to have to nationalised healthcare stems from the fact that they feel it should be their decision how they spend that portion of their money that would be taken in tax to support a health service.

It doesn't seem that the notion of tax monies paying for healthcare for those who can't fund their own healthcare enters the equation at any point. I'm curious to know if this is a principled opposition to the well-off having to subsidise care for those who are in difficult economic circumstances, or if it is simply because the health insurance culture that currently prevails in the USA means that people are conditioned to have a very individualist attitude towards healthcare.

Here in the UK, since the Second World War, the driving idea behind the NHS has been that those in society who can afford it should pay for healthcare for those who otherwise would not be able to. This was because, up until the 1940s, the poor relied on charity, or simply died painful undignified deaths, at a young age. Society here decided over 60 years ago that this was simply unacceptable. Efficiency or technological development had nothing to do with it. Indeed, people felt so strongly about it that Winston Churchill - a man who had just overseen the British contribution to Allied victory in the war - was resoundingly voted out of office so that a new social order could be constructed in the UK.

So my question to those on here who are defending the American healthcare system would be this: do you feel that the best-off in society have an obligation to subsidise healthcare for the poorest-off? And if not, why not?

I would also be curious to know what exactly you feel is the difference between America and Europe that means that nationalised healthcare would be a disaster in the US, whereas it is a (qualified) success here in Europe. Although, obviously, the nature of a comments section is that we must deal in generalities.

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#108 posted by Takuan, June 28, 2009 2:26 PM And, behold, a certain lawyer stood up, and tempted him, saying, Master, what shall I do to inherit eternal life?

26He said unto him, What is written in the law? how readest thou?

27And he answering said, Thou shalt love the Lord thy God with all thy heart, and with all thy soul, and with all thy strength, and with all thy mind; and thy neighbour as thyself.

28And he said unto him, Thou hast answered right: this do, and thou shalt live.

29But he, willing to justify himself, said unto Jesus, And who is my neighbour?

30And Jesus answering said, A certain man went down from Jerusalem to Jericho, and fell among thieves, which stripped him of his raiment, and wounded him, and departed, leaving him half dead.

31And by chance there came down a certain priest that way: and when he saw him, he passed by on the other side.

32And likewise a Levite, when he was at the place, came and looked on him, and passed by on the other side.

33But a certain Samaritan, as he journeyed, came where he was: and when he saw him, he had compassion on him,

34And went to him, and bound up his wounds, pouring in oil and wine, and set him on his own beast, and brought him to an inn, and took care of him.

35And on the morrow when he departed, he took out two pence, and gave them to the host, and said unto him, Take care of him; and whatsoever thou spendest more, when I come again, I will repay thee.

36Which now of these three, thinkest thou, was neighbour unto him that fell among the thieves?

37And he said, He that shewed mercy on him. Then said Jesus unto him, Go, and do thou likewise.

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#109 posted by Takuan, June 28, 2009 2:26 PM Do not turn away a poor man...even if all you can give is half a date. If you love the poor and bring them near you...God will bring you near Him on the Day of Resurrection.
(Al-Tirmidhi, Hadith 1376)

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#110 posted by Takuan, June 28, 2009 2:30 PM his is what should be done
By one who is skilled in goodness,
And who knows the path of peace:
Let them be able and upright,
Straightforward and gentle in speech.
Humble and not conceited,
Contented and easily satisfied.
Unburdened with duties and frugal in their ways.
Peaceful and calm, and wise and skillful,
Not proud and demanding in nature.
Let them not do the slightest thing
That the wise would later reprove.
Wishing: In gladness and in saftey,
May all beings be at ease.
Whatever living beings there may be;
Whether they are weak or strong, omitting none,
The great or the mighty, medium, short or small,
The seen and the unseen,
Those living near and far away,
Those born and to-be-born,
May all beings be at ease!

Let none deceive another,
Or despise any being in any state.
Let none through anger or ill-will
Wish harm upon another.
Even as a mother protects with her life
Her child, her only child,
So with a boundless heart
Should one cherish all living beings:
Radiating kindness over the entire world
Spreading upwards to the skies,
And downwards to the depths;
Outwards and unbounded,
Freed from hatred and ill-will.
Whether standing or walking, seated or lying down
Free from drowsiness,
One should sustain this recollection.
This is said to be the sublime abiding.
By not holding to fixed views,
The pure-hearted one, having clarity of vision,
Being freed from all sense desires,
Is not born again into this world.

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#111 posted by davidasposted, June 28, 2009 6:10 PM Takuan,

I riposte your BBC news article:

http://news.bbc.co.uk/2/hi/health/8123338.stm

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#112 posted by Takuan, June 28, 2009 6:23 PM that's an affirmation, not a riposte!

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#113 posted by zuzu, June 28, 2009 7:30 PM do you feel that the best-off in society have an obligation to subsidise healthcare for the poorest-off? And if not, why not?
For sake of argument: because theft is wrong.

Also, no one is obligated to do anything they did not voluntarily agree to.

Finally, appeal to majority is unacceptable. Just because a majority of people believe it's acceptable to steal from a rich minority does not make stealing any more acceptable than if one person stole from another (rich or poor).

(The idea being that for a moral code to be non-arbitrary / opportunistic, it must be rigorously consistent. So either theft is always wrong, or theft is always acceptable, but not that theft is wrong except for when it's popular or personally convenient.)

p.s. Sometimes I wonder if the whole "individuality vs. society" argument is really about "extroverts vs. introverts". Some people really feel a need to belong to a group (i.e. extroverts). Other people acknowledge and interact with others, but don't feel compelled to "belong" to them (i.e. introverts). Just as a majority of scientists, artists, inventors, etc. are introverts (but of the whole population, introverts are the minority), I wonder also if the majority of libertarian-minded people are also introverts. This can easily branch out into a larger "neurotypical" topic too.

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#114 posted by GuidoDavid, June 28, 2009 11:12 PM Theft is wrong. Right.
Isn't murder wrong? What about the theft incurred by children who go to public schools?

We all incur in debt, Zuzu. Some debts cannot be paid, only transferred.

BTW: I think that "To See the Invisible Man" would be a very proper scenario for people like you. You need no one? Go on, buddy.

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#115 posted by Anonymous, June 28, 2009 11:32 PM @REVRAVEN,

Rilly? Out of your million-dollar annual income, $10 a year is too much to provide health care for anyone else, let alone yourself?

That's the math you presented, not me. So you'd rather pay more than that per doctor's visit than help a single person other than yourself? Good job you have no family or friends, then. If you did, might you be willing to give $10 per year to them?

Who gives you money, and why?

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#116 posted by Marchhare, June 29, 2009 3:13 AM "one of the biggest medical expense categories is malpractice coverage and settlements."

And that hasn't gone up in real terms in 20 years. In many states it's gone down with "tort reform."

New canard please.

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#117 posted by Marchhare, June 29, 2009 3:14 AM To be clear: Awards haven't gone up. Insurance premiums have. But those aren't driven by larger damage awards.

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#118 posted by Marchhare, June 29, 2009 3:32 AM A couple good posts from Ezra Klein, who writes about healthcare for the Washington Post.

http://preview.tinyurl.com/crmkty

http://www.prospect.org/cs/articles?articleId=12683




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#119 posted by Iru, June 29, 2009 6:33 AM Zuzu: diatribe all you want, give all the "arguments" you want: THE FACT is IT WORKS. Ask any French, UK, German or Spanish citizen.

Also, this argument unveals what your arguments are all about:

" Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash.

It's a wash assuming you consume those benefits. Personally, I'd rather have the cash (which is liquid -- useable for anything) than rigid availability of particular services."

Its not what YOU CONSUME. While youre not sick, your taxes pay FOR THE PEOPLE THAT ARE SICK. While youre sick, THE OTHER PEOPLE PAY FOR YOUR CARE. You dont live alone in your community!!!!


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#120 posted by Iru, June 29, 2009 6:40 AM To Apreche #16:

"Two is that not everyone can get cared for. People can't be going to the doctor for a little pain here, or a little cold there. Also, as much as you think it's morally wrong, people who are very expensive to treat simply can't be covered unless they can pay for it themselves. If someone is 80 years old with cancer, the government might have to say no when it comes time to treat them. The same may go for extremely ill newborns. The same might go for people with self-inflicted ailments like obesity or anything caused by smoking."

ky, nz. Dnt cr fr ll nwbrns. Dnt cr fr ldrs. tc, tc. Wht's nxt: nly cr fr rn blnds?

Y mk m SCK. (Bt frtntly cn g t th dctr fr tht).


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#121 posted by Iru, June 29, 2009 7:11 AM Anonymous #40 sez
"The official Census figure for uninsured in 2007 was actually 45.7 Million. But even that does not tell the whole truth.
- Of that number 9.7 Million are immigrants of which at least 5.6 Million are illegal."
And? They should die because theyre inmigrants?

- About 9.1 Million have household income above $75,000.
And? If they have cancer they should sell their houses or die?

- Half (23 Million) of the 46 Million are between 18 and 34 and don’t feel they need insurance."
AND? Is there in the US a pact with the devil that says that people between 18 and 34 ARE NEVER SICK?

Man, you have serious issues. You're not human, you dont live in a community. It is YOU who are SICK.


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#122 posted by Anonymous, June 29, 2009 7:57 AM Google Chrome keeps throwing up messages that the Denver Post site hosting the article is also hosting malware.

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#123 posted by zuzu, June 29, 2009 8:38 AM BTW: I think that "To See the Invisible Man" would be a very proper scenario for people like you. You need no one? Go on, buddy.
This argument of "libertarians think they don't need anyone" has been raised several times and should be debunked:

I don't think anyone, libertarians included, believe that they are entirely self-sufficient. They didn't hand-craft their own laptops to write these posts. In fact, I'd find it difficult for anyone to identify as libertarian without understanding the concept of division of labor. Market trade is a distributed peer-to-peer means of social coordination -- one that doesn't require any "leader" or "boss" or hierarchy, but instead emerges naturally.

However, the difference between libertarians and collectivists here seems to be that the former believe that they are the absolute arbiters of all of their social interactions. They choose with whom and how they interact with other individuals.

Is that unreasonable?


Zuzu: diatribe all you want, give all the "arguments" you want: THE FACT is IT WORKS. Ask any French, UK, German or Spanish citizen.
"diatribe", nice weasel word.

Furthermore, this is a tired canard. "The system works!" Well, that depends on your definition of "works". The devil is in the details, and the massive oversimplification of declaring "we've achieved the results we desire, never mind the process that created it or the unintended consequences" is both reckless and intellectually lazy.

Its not what YOU CONSUME. While youre not sick, your taxes pay FOR THE PEOPLE THAT ARE SICK. While youre sick, THE OTHER PEOPLE PAY FOR YOUR CARE. You dont live alone in your community!!!!
People choose their own level of involvement to belong to any community or social club. For most of those, the chosen level of involvement is zero (such as the KKK). But a mandate negates that choice through coercion of violent force.

I'm responsible enough to save money for routine medical expenses and to purchase insurance against catastrophes (medical, collision for my car, etc.)

Please explain the justification for collectivization of medical expenses.

Man, you have serious issues. You're not human, you dont live in a community. It is YOU who are SICK.
Can we please refrain from ad hominem arguments. Leave your emotions at the doorstep when you debate this issue. Thank you.

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#124 posted by Antinous / Moderator, June 29, 2009 10:47 AM Leave your emotions at the doorstep when you debate this issue.

And there is the crux of the matter. If you choose (unproven and speculative) economic theory over compassion, don't expect other people to follow you.

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#125 posted by Takuan, June 29, 2009 10:58 AM I have it: let us hear from Americans who have lived in Canada and then returned to the USA. What do they think of the relative merits of the two systems? I am sure we can detect and shred any pretenders. Anyone out there with a legitimate tale to tell?

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#126 posted by GuidoDavid, June 29, 2009 11:12 AM "Furthermore, this is a tired canard. "The system works!" Well, that depends on your definition of "works". The devil is in the details, and the massive oversimplification of declaring "we've achieved the results we desire, never mind the process that created it or the unintended consequences" is both reckless and intellectually lazy."

The people using those systems lives more, they live better, they are in better health, they have lower infant mortality, and more important, they pay less per capita!!!! What other definition of "works" do you want? The cost is taxes, of course, but the cost of the American approach is sacrificing lives to the Market God, almost literally.

Look, it would be awesome if we could choose some things, I would choose to be twice as smart and focused, I would choose that Palestinians and Israelis would love each other. But we cannot choose that. We have constraints and limitations, and when you choose to feed the pockets of some fat cat instead of using that money to give further care to others, you are actually choosing the pain, misery and even death of others who are not as wealthy/smart/lucky/hard-working/focused as you might be. That is reckless. To claim "theft" is wrong and at the same time support a system where poor people cannot get care because is too expensive. I will support your approach when we live in a society where everybody is able to pay for his or her insurance. Maybe when we have Basic Income Guarantee. But again, we rely on other people to keep civilization going, and in their children, many times, more competent than their fathers.

Your approach would have killed me, literally, so you can be satisfied, not getting taxes and a CEO would be getting another bonus. Go on, let hose on top to use my corpse to get even more wealth and power and impose their will to even more people.

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#127 posted by Tdawwg, June 29, 2009 11:16 AM As opposed to all of those energetic, lively canards out there. Pleonasm FAIL.

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#128 posted by Takuan, June 29, 2009 11:27 AM I must say that attacking Zuzu for lacking empathy is not within the spirit of open debate. His is a point of view and should be addressed as such. I myself find it pleasantly carnivorous and quite honest. Certainly sweeter tasting then say hypocrisy.

Homo sum: humani nil a me alienum puto

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#129 posted by Jenonymous, June 29, 2009 11:30 AM All,

Sorry to be late to the party, but here's my 2c. Note that I work for a major pharmaceutical company, and the numbers that I'm about to give are generally acknowledged as close to the mark by both friends and foes of the industry.

Amount per dollar spent on US healthcare on cost of drugs: 1c-3c, depending on source material

Amount per dollar spent on US healthcare on HMOs and other 3rd-party non-healthcare-provider fees (ie any administuff not directly related to healtcare provision, so a receptionist at a hospital would NOT fall under this): 30c-36c.

So, yep, all sources agree that up to a third of all the money spent on healthcare in the US is gobbled up by HMOs and similar "businesses."

HMOs don't do surgery.
HMOs don't develop new drugs.
HMOS don't deliver babies, provide physical therapy, or help the handicapped get around.

All they do is eat money.

Get rid of them all and we've already solved a third of the problem.

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#130 posted by Takuan, June 29, 2009 11:44 AM http://en.wikipedia.org/wiki/HMO

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#131 posted by Takuan, June 29, 2009 11:47 AM http://www.youtube.com/watch?v=9QkgUkM0o6Q

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#132 posted by wolfiesma, June 29, 2009 12:13 PM Compassion is a quality we ought to cultivate within our own selves, for emotional health and spiritual growth, of course.

But if we are talking about public policy, I get really nervous when we invoke "morality." It seems a slippery slope on the way to justifying holy war and stealing away reproductive freedom.

Also, I cringe a little at slogans like "Healthcare is a right, not a privilege." To my mind, it is neither. It is, instead, a necessary component of a stable, functioning, economically healthy society.

Then again, if your goal is overthrow of the state to see what interesting innovations emerge in the anarchic wake... than, I guess the idea of public health care really isn't for you.

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#133 posted by Anonymous, June 29, 2009 12:19 PM @Kieran

You are incorrect. Most of the $94b spent on biomedical research is funded by industry, at about 57%.

http://www.ncbi.nlm.nih.gov/pubmed/16174691


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#134 posted by Tdawwg, June 29, 2009 12:19 PM If you forget that public policy has as its goal the betterment of the, um, public, then perhaps talk of empathy, morality, compassion, etc., would remind you. It's not about legislating right and wrong: it's about recognizing that bettering the lives of citizens is the goal of all rational, stable governments.

Empathy parts ways with policy at the latter's peril, and to the detriment of the people.

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#135 posted by Takuan, June 29, 2009 12:21 PM compassion
http://www.youtube.com/watch?v=bya1ZrC5bsk

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#136 posted by GuidoDavid, June 29, 2009 12:28 PM Tdawwg:

You are wrong. Creating wealth and keeping shareholders happy are govt goals. Not the fluffy, unsupported yucky feeling you just named.

/snark

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#137 posted by Tdawwg, June 29, 2009 12:38 PM Republican! Grover Norquistian!

/fake abuse

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#138 posted by zuzu, June 29, 2009 1:27 PM If you choose (unproven and speculative) economic theory over compassion, don't expect other people to follow you.
1.) The difference is between reality and wishful thinking.

2.) Your characterization of "unproven and speculative economic theory" completely misunderstands the nature of all complex systems studies, economics included.




The people using those systems lives more, they live better, they are in better health, they have lower infant mortality, and more important, they pay less per capita!!!!

First of all, I'll emphasize yet again, that it's a false dichotomy to choose between the broken over-insurance system in the USA and the nationalized systems of Canada, UK, France, etc. Both systems are terrible compared to if we had anything even close to a real market system for medical goods and services, which would make drugs, doctors, and tests truly inexpensive (and thus affordable).

The cost is taxes, of course, but the cost of the American approach is sacrificing lives to the Market God, almost literally.
There's very little "market-based" about the private insurance system in the United States. This is a misleading characterization.

To claim "theft" is wrong and at the same time support a system where poor people cannot get care because is too expensive.
Ok, here's the salient question: Why is healthcare expensive? Answer that, and you'll truly discover the answer to the healthcare crisis in the USA.

I will support your approach when we live in a society where everybody is able to pay for his or her insurance.
Again, insurance is a red herring. Address the origination of the cost of healthcare. (As I did.)

Maybe when we have Basic Income Guarantee.
As much as I would consider a Negative Income Tax (NIT) preferable to the current bureaucratic nightmare of welfare, minimum wage, social security, etc., this still creates an Red Queen's Race of inflation. (Because money is only a medium of exchange, and we're trying to solve the real problem of scarcity. No government edict can magically eliminate scarcity.)

I must say that attacking Zuzu for lacking empathy is not within the spirit of open debate.
For the record, I have plenty of empathy. I just don't see it as conducive towards the process of rational problem-solving. Other than as a motivation for wanting to solve the problem of scarcity in the first place.

Also, I cringe a little at slogans like "Healthcare is a right, not a privilege." To my mind, it is neither. It is, instead, a necessary component of a stable, functioning, economically healthy society.
Healthcare is a commodity, just like all of our other necessities: food, clothing, housing, water, etc.

Once again we'll have the negative vs. positive rights argument.

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#139 posted by JEM, June 29, 2009 4:08 PM I am Canadian, and my doctor decides what treatment I need, not my government or my insurance. She make sure I have pap tests and ultrasounds (without a wait I may add) and never once has refused me treatment because of the pre-existing HPV I picked up as a stupid teenager. I am thankful that I will never have to go bankrupt if I do get cancer.

I am glad that the money I pay in taxes will actually ensure treatment if I do fall ill, where money paid to private medical insurance would just be used to find ways to get out of paying for the treatment I need.

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#140 posted by Takuan, June 29, 2009 4:15 PM a-ha! And there you have it my dear Zuzu, in primate politics it is not sufficient to have empathy, empathy must be shown to be done.

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#141 posted by GuidoDavid, June 29, 2009 6:17 PM OK, Zuzu. It is great that you do not support the current butchery you have there. Now, please, do you have an example of a model that works (health standards similar to Western Europe) according to your principles? If not, it might be interesting to explore, but only once you fix all this and people are covered and healthy.

"For some cancers, chemotherapy, radiation therapy and surgery may be substituted or complemented with one another. The health czar has to discover the natural substitutability of millions of healthcare services in accordance with the exchange relations that in a free-healthcare-market economy take place automatically, permanently, and instantaneously."

Absurd. As others said, medical decisions for doctors, not for admins. Currently, greedy bastards that are required by law to put money first take those decisions in the US.

I am for healthy debate, but before I read long tirades of theoretical arguments, I want some proof that it works.

And I am all for liberty, but dead people can't be free, I'm afraid.

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#142 posted by zuzu, June 29, 2009 7:06 PM Now, please, do you have an example of a model that works (health standards similar to Western Europe) according to your principles? If not, it might be interesting to explore, but only once you fix all this and people are covered and healthy.
I wonder if in 1776 colonists in America asked "Where else in the world is a democratic republic like the one proposed by the framers of the Constitution working successfully?" before attempting it.

Or, in the in the mid-20th century, would you think that humans landing on the moon is impossible, despite the scientific and technical knowledge of rocketry, simply because there was no evidence of anyone actually doing it yet?

If you are on a sinking ship and all lifeboats have left, a passing piano lid to hold on to is a welcome life-saver. And yet that does not imply that the shape of piano-lids were the best design for life belts. -- R. Buckminster Fuller

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#143 posted by Iru, June 29, 2009 11:42 PM ZUZU, as i said, you have a problem. Cite all the erudite debates you want, but the question is: all your arguments are based on "I can provide care for myself, saving money for the time when i get sick".
Ok. But I say: "I care for my neighboor, KNOWING that he would care for me in the future".
You know what is the beauty of it? That with your system, if something unexpected happen (your bank broke, anything), YOU ARE DEFENCELESS from that moment on. With mine, I'M NOT.
I'm very happy that my tax money goes to help the people that cannot afford private care: inmigrants (even illegal, and don't tell me its not a problem, Spain have the higher rate of inmigrants after USA), people under the poverty level, etc. Know why? because i KNOW i'm not invulnerable, and something can happen to my life anytime, and i can be one of the poverty people.

"Justification for collectivization of medical expenses" ? I CARE FOR MY NEIGHBOOR. You?

And sorry for the innapropiate words i use, english is not my first language, only my third.

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#144 posted by zuzu, June 30, 2009 12:23 AM "Justification for collectivization of medical expenses" ? I CARE FOR MY NEIGHBOOR. You?
The Tragedy of the Commons




inmigrants (even illegal, and don't tell me its not a problem, Spain have the higher rate of inmigrants after USA)

I have no problem with immigration; in fact I strongly support the free movement of both capital and labor anywhere. Citizenship should be restricted to the privileges of voting and entitlements (and an obligation of dues i.e. voluntary taxes) -- like joining a social club, not a determination for where you can live and work. You should be free to work for anyone who will hire you, and live anywhere that you can afford to.

A cash-based healthcare system doesn't discriminate against "undocumented workers". A government-run system clearly does (based on tax revenue, it must discriminate against non-payors or become insolvent).

"I care for my neighboor, KNOWING that he would care for me in the future".
I would never trust my neighbors to dictate terms and conditions for what drugs I can put in my body or what body modifying procedures I can have done.

At least half of them are morons and yokels who think that cochlear implants are an abomination before God -- the imaginary man in the sky. Or who believe that women should be denied birth control pills; look at how long Plan B took to pass the FDA in the USA compared to Europe. Never mind the ongoing failure to admit that drugs have won the Drug War. Hell, there was a time when the "ick factor" prevented people with cataracts from being sighted again, because the cornea replacement was sourced from cadavers.

How will nationalized healthcare further politicize and cause chilling effects on the availability and development of performance-enhancing (including neuroenhancing) drugs? Or inhibit the development of reprogenetics and genetic engineering because of the stuporstitions and naivete of the masses? Or further limit and over-regulate against body modification? (Institutionalized professional medicine already has a false belief in conflating "healthy" with "normal" and proscribes against making anyone "abnormal" through the application of medical science and technology, even counter to the desires and resources of those seeking such options and possibilities.) It doesn't even have to be direct regulation, but self-censorship induced by the regulatory landscape.

Sorry, but I'm deeply skeptical of the possibility for disruptive technologies enabling transhumanism / extropianism coming out of anything but a free, open, and highly individualistic / autonomous development of medical science and technology, free of interference from both government regulation and professional ethics.

Morphological Freedom NOW!

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#145 posted by Iru, June 30, 2009 3:41 AM Zuzu:
"The tragedy of the Commons"
if you are not smart enough no to exploit something to the end not thinking of the future, its your problem.

"A cash-based healthcare system doesn't discriminate against "undocumented workers". A government-run system clearly does (based on tax revenue, it must discriminate against non-payors or become insolvent)."
Yes it discrimate, the undocumented workers earn less money, and if they want to becom documented, exploiters dont hire them.
And not, the system dont become insolvent, it just LOOSE MONEY. So what? ITS NOT ABOUT MAKING PROFIT. It can loose money and CONTINUE GIVING SERVICE WITH THE BEST OF QUALITY because we assume the looses!

"I would never trust my neighbors to dictate terms and conditions for what drugs I can put in my body or what body modifying procedures I can have done.
At least half of them are morons and yokels"
Your neighbors dont dictate terms and conditions on you. They simply PAY for them IF YOU NEED THEM TO SURVIVE AND BE HEALTHY.
And about you considering half of your neighbors morons and yokels... well, i think it says A LOT about you and your narrow mind.

Er.... Morphological freedom? Too many SF novels, my friend. Go out to the street once in a while.
Live. Talk to the people. Try to meet your love. INTERACT with your society and maybe youll revise your opinion about the people that, YOU WANT IT OR NOT, surround you.




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#146 posted by GuidoDavid, June 30, 2009 6:43 AM Yes, MORPHOLOGICAL FREEDOM.
What is wrong with that? That is part of freedom, the freedom to decide what we want to become, how to enhance ourselves. And that is not opposed to an Universal Healthcare System (Have you read James Hughes, Zuzu?). I go to the street, I interact with people, hell, I distribute Anarchist newspapers! That is a very nasty ad hominem, Iru. If you are gonna criticize Morph Freedom, please do it other than snarkin about "too many SF novels".

Zuzu: Well, I do think that H+ technologies can emerge from places with universal healthcare. Granted, the US has more positive attitude to H+ technologies (at least the liberals and digerati), than Europe, but Japan is even more progressive in morphological freedom, automation and robotics. And it indeed has an universal healthcare.

Please do not try to equate universal healthcare systems with ruthless states that crush people. The US has the highest incarceration rates in the world, even more than China, and Europe is a lot more progressive concerning drugs. I agree with you in that drugs are a private matter, however.

And you failed to give examples. In 1776, at least the founding fathers had a vision and a world that was terrible, there was not a single example of a good govt neither, of free people. Today, we know better, but we also have examples of systems that WORK. However you measure it. And those systems allow freedom of choice, you can pay for your care, if you want to and can afford it. Yet, you ignore those examples! I refuse to give up proved systems for theoretical arguments that look like they were designed to excuse selfishness.

However, there is a way in which I could support a society like the one you propose: An absolutely voluntary society in an isolated place. No children there. If you go there to live the Libertarian dream, go ahead, but be warned. I think such a palce would turn fairly soon in a feudal society and into social darwinism, but I might be wrong. Hell, I hope I am wrong and you show me one day your shiny towers and awesome biotechnology, your society where nobody is poor. But I do not think it is likely and I refuse to allow you impose such a society on children and those that for one reason or another cannot provide for themselves. You might think I am a fool, but we need those people. I am a welfare child and in a society like yours, I would be dead or cleaning windows.

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#147 posted by zuzu, June 30, 2009 9:11 AM And not, the system dont become insolvent, it just LOOSE MONEY. So what? ITS NOT ABOUT MAKING PROFIT. It can loose money and CONTINUE GIVING SERVICE WITH THE BEST OF QUALITY because we assume the looses!
There's not enough wealth being created to offset those losses. Medicare alone in its current form will bankrupt the United States (if such a thing were possible given a fiat monetary system) in just a few decades (IIRC).

No, the economy on the whole cannot afford to give everyone the best healthcare technically possible. We really are constrained by the scarcity of resources -- hence economics.

We really do have to make compromises. Poorer people really do have to settle for poorer medical care (like they would receive in, say, Mexico), just as they settle for not living in mansions and not eating steak and caviar everyday.

Go out to the street once in a while. ... And about you considering half of your neighbors morons and yokels... well, i think it says A LOT about you and your narrow mind.
Have you been out on the street? I have. Most people are TMZ-watching morons, not giving TED talks. I fully support an open society, but I also see the danger of the tyranny of the majority.

Japan is even more progressive in morphological freedom, automation and robotics. And it indeed has an universal healthcare.
What? Japan didn't legalize hormonal contraception until 1990.

They also delay the introduction of new drugs until it's been tested on their population. Sure, there's some argument for pharmacogenomics, but really it's just regulatory capture for the domestic pharmaceutical industry there. (Meanwhile, the delay in availability of new drugs kills more people than it saves.)

Please do not try to equate universal healthcare systems with ruthless states that crush people.
Rather, the problem is the politicization of healthcare. Instead of being a private subject, where you merely consult with the doctor of your choosing, a universal system puts the decisions of how much to spend and where to spend it (eventually with pressures about on what) in the hands of politicians and bureaucrats as central planners.

You keep saying that existing systems such as Canada or the UK give doctors free reign to provide health consumers with diagnostics, drugs, and whatever else. Never mind the need for market feedback to determine what new drugs and medical inventions are called for by health consumers.

To convince me that "the system works", I'd like to know how they've somehow solved the Economic Calculation Problem to do that? How do the current systems actually work (procedurally, consequentially), if they in fact work, as you claim?

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#148 posted by GuidoDavid, June 30, 2009 12:21 PM Got me. I stand corrected, thank you. However, Japanese are more progressive in some areas and they lack AFAIK, the "you are a hubristic bastard" meme. But they are also heavily traditional. Odd place.


I see you did not acknowledge you mistake of equating a ruthless state interfering with your right to use drugs with universal healthcare. Would you please acknowledge your mistake and stop dodging the issue? If we are gonna have a honest debate here, we must avoid that kind of arguments, I think.

Again, extreme regulation on drugs does not mean universal healthcare, neither the opposite. You could relax drug testing regulations on certain cases and still have universal healthcare. That is a non sequitur.

You can still pay for private care if you want better care. What is the problem with that?

"Rather, the problem is the politicization of healthcare. Instead of being a private subject, where you merely consult with the doctor of your choosing, a universal system puts the decisions of how much to spend and where to spend it (eventually with pressures about on what) in the hands of politicians and bureaucrats as central planners."

Right now it happens in an even worse way with the providers of care, who make your doctor give or not give you treatments. And if you do not have money, you are just DEAD.

"To convince me that "the system works", I'd like to know how they've somehow solved the Economic Calculation Problem to do that? How do the current systems actually work (procedurally, consequentially), if they in fact work, as you claim?"

I do not have to. I pointed to known and reliable statistics. Do you want me to google it for you? I do not want elaborated arguments that might or might not be true. I want actual facts of a system like the one you are proposing leading to more people living longer time.


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#149 posted by zuzu, June 30, 2009 1:54 PM Again, extreme regulation on drugs does not mean universal healthcare, neither the opposite. You could relax drug testing regulations on certain cases and still have universal healthcare. That is a non sequitur.
Actually it follows thusly: Those making the purchasing decisions determine what gets made and invested in. (Price signals go up the supply chain, remember?)

You can still pay for private care if you want better care. What is the problem with that?
The problem is with the distortion of price signals caused by government involvement (and in a more roundabout way, by the current "private" "insurance" system).

Right now it happens in an even worse way with the providers of care, who make your doctor give or not give you treatments.
Again, this is not a false choice between the current system and a government one. We have the third option of creating an actual market for medical products and services.

And if you do not have money, you are just DEAD.
That's just as true for food and housing, but I don't see the outrage for those causes in equal proportion as for healthcare. Perhaps this is because markets mostly work for those domains, but haven't been allowed to work for healthcare.

I do not have to. I pointed to known and reliable statistics.
My point is that you can't just point to outcomes and say "it magically works somehow". The ends don't justify the means.

I want actual facts of a system like the one you are proposing leading to more people living longer time.
You can't insist upon universal metrics, because of subjective value. Different individuals' values are non-comparable.

(e.g. Living an extremely long life might be hell in a hospital bed to some people, but would show up as exceptionally positive according to your "statistics". Or consider the statistics Lenin used for "miles travelled" in train shipping during the Soviet planned economy, where what actually happened is that trains shipped the same materials on wasteful useless journeys just to make the numbers look good.)

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#150 posted by GuidoDavid, June 30, 2009 5:37 PM Nice dodging, again.
Whether you measure infant mortality, child mortality at five YO, life expectancy, % of coverage, countries with Universal Healthcare do better than the US. There might be a choice, as you say, but colour me skeptical until I see more than words from you or von Mises. If you are wrong people will die. Some like me, amongst them. What we have here is choices between proved systems and the current one in the US sucks more than vacuum.

And of course I support welfare for those who need it. Tragedy of commons might happen, but not yet in Europe (Denmark has a 3% of unemployment, btw), despite decades of welfare, so your arguments look a bit slippery slopey, Zuzu. To me there cannot be freedom without basic needs covered. Right now it cannot be done, but, I agree with you that we must tackle the problem of scarcity first. Maybe then the kind of society you envision will be possible.

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#151 posted by Anonymous, July 1, 2009 12:58 AM And to think - with medical regeneration and other life-extending technologies - there will be more of us living longer and longer needing more care for more years - it can only get worse....

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#152 posted by Iru, July 1, 2009 2:22 AM Ok, ok, im not going to argue more.
Just 2 points:
- It works. You can say, and i agree, that is practically impossible to make it work in the USA today, but this is not because its a bad system, but because your actual system is impossible to change.
- I think the problem is deeply ingrained in the arguments of the type "the people around me are dumbs". When you think like that, youre really saying what you are.

Wich take me to one last thought: i've been in the USA, only for a month and about 8 years ago. But almost everyone i meet there were kind, easy-to-get-along people. Besides, your nation has done A LOT of good the world, hell, you almost alone got up from the ashes all Europe after WW2 !
Then why do you do that to YOURSELVES ? Why you are not generous with your fellow american? I really dont understand.


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#153 posted by Anonymous, July 1, 2009 5:53 AM why cant i get a simlpe answer to a simple question? how much more taxes to canadians spend for their health care???????????????

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#154 posted by cyberoid, July 22, 2009 10:43 PM Let's get real. According to Wikipedia, the US spends $713 billion-plus annually on its military. Canada spends the equivalent of $18 billion. That's $818 per Canadian versus $2,037 per American.

No doubt, if the US could reduce its military expenditures to anywhere close to Canadian expenditures, we could have remarkable healthcare in America, publicly funded and essentially free.

But the military waste renders it more difficult just as it renders universal education impossible) -- which is another reason, perhaps, why he US does waste so much. It's a power trip that keeps the rich healthy and the rest worried.

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

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[ThoughtCriminal]

7. Origins

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

[Captain Hilts]

14. Yeah, but since '00 Dems are Blue and Reps Red. Go NASA!

[dgibby]

8. How about we just call them what they really are?

Republican lap dogs.

[ThomWV]

9. Just call them fuckin' Republicans and be done with it.

[Kalyke]

10. I call them Blue Cross Democrats. n/t

[Captain Hilts]

13. Oh, I like that one!

[LeftishBrit]

11. Their British counterpart was generally known as The Poodle.

[Shagbark Hickory]

15. No. I just call them what they really are: TRAITORS. Corrupt TRAITORS!

[Captain Hilts]

17. Well, this term certainly makes more sense and is more logical. nt

[luckyleftyme2]

20. and the right is lying its butt off

Interestingly, after all these years I'm still capable of being shocked by truly willful, egregious lies in our public discourse. Spin -- even really bad, dishonest spin -- is one thing, but what you'll see in the video to your right is something else altogether (video courtesy of Media Matters).



For the record, the House health bill would create publicly-run insurance exchanges through which private insurers could sell their policies. But eligibility in those exchanges -- or "gateways" -- would be limited. The CBO projects that by 2019, 30 million Americans -- about one in ten -- would participate in the exchanges.



Within those gateways, people would have the option of buying into a publicly-administered insurance plan. About 10 million would be enrolled by 2019, according to the CBO.



Private insurance would remain unchanged for the overwhelming majority of Americans. You may agree or disagree with the merits of the proposal, but that's what it contains.

[Fearless]

18. I'd rather refer to them as toast... but I'd be getting ahead of myself.

:+

[elocs]

21. "Red" Dogs would rightly be liberal Republicans who break ranks with the party to vote with Dems,

but the Republican party, or simply Republicans, usually purge them from the party in one way or another (or they are beaten by a Blue Dog Dem) so few exist.

[Captain Hilts]

22. The connotation of terms 'red' and 'blue' have changed since these terms were hatched.

It all changed after '00.

When we talk of 'blue people' and 'shopping blue', we're talking about GOOD Dems.