Notes from the British HCR experience
There’s an excellent letter from a British observer at the Corner, describing the British experience with government health care and contrasting it to ours. You would do well to read the whole thing. Here are a few excerpts (emphasis mine):
[T]here were no real losers in the Britain of 1948 [when their system was first set up]. Only a tiny handful of very rich people had any experience of great medical care””and they were rich enough to pay higher taxes AND private insurance premiums. Everyone else got roughly the same medical care; but now the middle class got it for nothing as most of the poor had done before. Nobody lost””not for another fifteen years when the quality of medical care began to decline noticeably. And by then they were hooked. By contrast almost every insured Ameerican [sic] is a potential loser under Obamacare. And some of those considered to be winners””i.e., the currently non-insured””will feel like losers if they are forced to insure and then remain inconveniently healthy.
So, for all sorts of reasons, opponents of this bill should not feel deterred from hope of repeal by the British experience. At the very least they have a window of opportunity to reverse the legislation of about eight to ten years. It’s doable if you think it’s doable””not if not.
The article points out that when the British system was implemented it had strong bipartisan support. This is completely different from the situation right now in this country, and the difference makes it clear that we are dealing with more—far more—than a simple difference of opinion about health care reform. We are dealing with a rogue government bent on tyranny, and their plans do not stop with health care.
Nevertheless, the same principle is true: it’s fixable if you consider it fixable. But you must remain focused on that task, and mindful of the wiliness and ruthlessness of your opponents.
“Let the lawsuits begin.”
In the UK the National Health Service is now being referred to as the National Death Service.
I think his time table for fixing it is way too optimistic.
It has to be repealed before all the new government agencies, bureaus and departments are established. Once those are staffed up, it won’t be repealed for the simple reason that no government bureaucrat will have the courage to vote his job out of existence. And you can be certain all those new government employees will be unionized under SEIU, so it will be almost impossible to even lay people off.
If we don’t take back all three houses by 2012, I think we’re doomed to live with this disaster until the government goes bankrupt under the weight of all these liberal entitlement programs of the past 75 years.
On a historical note, Britain’s NHS was founded with…Marshall Plan funds. (Marshall Plan funds were also used in the other great socialist program(me), public housing projects that built the tower blocks that the Brits are now dynamiting, unfortunately evacuating them first.) In the 1980s Norman Tebbit used to say that the NHS was the largest employer in Europe after the Red Army.
Contrariwise, German Marshall Plan funds (which were about a third as much as was given to the UK) were directed (by the Allied occupation governments) into rebuilding the industrial plant rather than consumption, laying the foundation of the Wirtschaftswunder, while Britain declined economically until Thatcher.
Gotta be a moral in their somewhere.
If Scott is right our only fallback will be to outrun the deteriorating health care system with health care tecnical improvements for as long as possible. America is better positioned to do that than any nation in history, but I still doubt it will be enough. The feedback loop of less research will be working against us.
Sorry “their” –> “there.” Damn homonyms!
A View From Britain? It doesn’t look very authentic to me; the terminology, certain phrases and spelling ‘programme’ as ‘program,’ would suggest it’s been written your side of the pond. Of course, it could have been written by a British expat, who has lived in the US for many years and has adopted American terms and spellings, but then it wouldn’t be ‘A View From Britain.’
Some of the information used in the letter isn’t correct either. Occam’s Beard is closer to the mark when he says that Marshall Plan money was used to help establish the NHS (though he then mistakenly goes on to suggest the money wasn’t invested in infrastructure.) From memory UK borrowed 3.7 billion from US and 1.5 billion from Canada, which it used across a whole host of projects, including rebuilding large areas that had been bombed. Unemployment was low in the post-war years, and continued to be low throughout the 50’s, 60’s and 70’s until Thatcher was elected, then it went up – and GDP fell. It recovered a few years later, and continued on its previous trend.
Link to quick summary with lots of graphs and trends.
http://www.parliament.uk/commons/lib/research/rp99/rp99-111.pdf
Straw man alert. I didn’t say — or imply — that none of it was, but rather where a lot of it went.
Way, way off base. Marshall Plan funds were a gift, not a loan. A gift that Britain largely wasted.
You make the Winter of Discontent sound positively idyllic. Electrical power every other day, corpses piling up unburied because of strikes, Britain the “sick man of Europe.” Good times, good times.
Hello, my friends at neo-neocon. Been a while. Just thought I’d check in here to see what the zeitgeist was about HCR among you folks…
I just wanted to say — comparisons to England’s NHS aren’t really reasonable as the NHS is a fully government-run health care system. Although many conservatives have conflated all the different systems out there, it’s really worth teasing them apart because they work very differently and have very different track records.
England’s system is fully government-run health care. Everything is owned and run by the government, and it is funded through taxes.
France’s system is partial single payer: the government pays for 70% of the bill and private insurance pays for the remaining 30% (usually paid for by your employer, though individual plans are available at a relatively low cost), and hospitals and doctors are all private. Patients have complete freedom of choice when it comes to doctors, and there’s actually quite a bit of private sector innovation there, like home health care services that come to your door, and so on. Wait times are relatively low and quality is high; and the French spend about 1/2 as much as we do on health care.
Then you have a system like Switzerland’s, which uses all private insurers, private hospitals, and private doctors — similar to the system we just passed, with subsidies for low income. This system also provides high quality of care at a much lower cost than our system, and manages to get universal coverage without any direct government payments.
The bill that just passed is very close to Republican proposals in prior years. It preserves market dynamics in insurance, it’s similar to what Nixon proposed and what Republicans proposed to counter Clinton’s proposals in the 90’s. Everything remains private: insurance, hospitals, doctors. I think it’s a sensible, balanced, moderate bill.
I might note: French patients have FAR more choice than the typical American in our system… most Americans are enrolled in HMOs or other restricted insurance that means we can only go to certain doctors. In France, you can go to any doctor… and insurance costs are quite low.
OK, here are figures. The funds to the UK from the US represented a loan credit of US$3,750 million at an interest rate of 2%, with repayments spread over 50 years. We finished paying the debt off in 2006. An additional loan of US$1,250 million was obtained from Canada.
http://en.wikipedia.org/wiki/Anglo-American_loan
Martyn, the emergency loan you’re talking about preceded – and is quite distinct from – the Marshall Plan.
Let me give you your next talking point. To the extent that Marshall Plan funds were used to purchase consumables (e.g., food), those purchases were primarily of American goods.
In reference to Mitsu’s thoughtful input concerning the French system, you (all) might want to peruse this 2009 article for additional perspective: “None of this is free, of course. The share of taxes in the French economy is more than 40 percent. In the United States, it’s just over 25 percent.” The article also alludes to their system actually flirting with bankruptcy, as well as doctor’s earnings significantly lower than in the U.S.; it’s reasonable to wonder how durable that system would be here.
Yes, their taxes are significantly higher, but then again those taxes don’t all go towards health care — they go towards many government services which we don’t provide here. However, the point is that the *entire* French spending on health care, including public and private funds, is far less than we spend. If the French spent even 80% of what we do their system would certainly not be coming close to going bankrupt.
My main point, however, is the health care bill that just passed is a particularly American, very conservative, free market approach to universal care, an approach that has been proposed by Republicans in the past, and bears little to no resemblance to the NHS in England.
Mitsu,
One thing those high taxes don’t, however, go towards is French national defense. That little item has for many years been taken care of by us Americans. That is likely to be one of the things about to change–we won’t be able to afford defend the French or any of the rest of the EU. And anyone “over there” who thinks that won’t matter because there aren’t any threats worthy of the name had better think again.
And of course the health care bill that just passed is only the beginning. The Democrats themselves have been very proud to say so. The resemblance to the NHS is likely to be a process over a relatively short time. I don’t think you know much about free markets or conservatism, frankly.
It’s never going to look like the NHS. Be realistic — we BARELY managed to get this bill passed with huge Democratic majorities, and it doesn’t even have a public option. There’s no way in hell an NHS-like system will ever be enacted in this country. We won’t even have a French-style system with 70% government insurance and private doctors and hospitals — though such a system could arguably be more efficient than what we have — because it is politically impossible.
Ho-hum. It was not so long ago–mere weeks, or even days, really–that people were saying that the one we now have would ever be enacted. It was called dead, requiae were pronounced upon its corpse.
And yet . . . and yet . . . .
The one we now have was supported by a majority of both houses. It was only pronounced dead because of the lack of a *super*majority in the Senate. An NHS-style system has no support from anyone, period. There is only one senator in Congress who even supports a single payer system — that’s Bernie Sanders — and even he isn’t advocating an NHS-style government-owned system, just a single payer system a la France.
Mitsu, Have you checked out Anthony Weiner’s (D -NY) stance on single payer? My impression is that there are many Democrats in the House that would support single payer in a minute.
I have heard this new law described as government run healthcare where the insurance companioes are the intermediaries who collect the premiums and pay the medical bills – all at the direction of the Feds. So, what we have is ostensibly a partially private system when it is, in fact, fully government controlled.
Here’s something to think about:
Rushworth M. Kidder, The Health Care Debate: Why So Brutal? Mar. 22, 2010, Ethics Newsline.
“As the health care debate lurched toward its volatile closure over the weekend, I was reminded of a conversation I had years ago with a veterinarian. I’d met him while I was addressing a conference of equine practitioners – horse doctors, in common terms. Like many in attendance, his practice was among wealthy families that bred horses for racing and showing.
When I asked him to describe a typical ethical dilemma arising in his field, he had no difficulty responding. You’ve got a winning racehorse, he said, that’s worth millions but that’s sprained an ankle. It’s no sicker than you would be if you sprained your ankle, though it will never again run as fast as it once did. So the owner asks you to certify that the horse is damaged beyond repair and order it shot so he can collect his insurance.
“The problem,” as my friend put it, “is that your patient is not your customer.”
Read it all here:
http://www.globalethics.org/newsline/2010/03/22/brutal-debate/
When the customer is the government, the Dr. will pretty much be forced to do their bidding whether it is good for the patient or not.
Yes, there are more House members in favor of single payer, but as I said, NHS is NOT a single payer system. France’s system is single payer (with supplemental private insurance). NHS is a pretty badly run bureaucratic mess (though statistics show that despite their bad rep they get reasonably good health care outcomes overall, though not as good as ours or France’s). But evidence shows that the primary factor keeping quality up and wait times low is keeping doctors and hospitals private, as they are in France. There’s no one in the US advocating that the government take over health care entirely, and even if we instituted a single payer system here (extremely unlikely) we would certainly allow supplemental insurance (as they do in France) so there would still be market freedom as far as how much coverage you wanted to get.
But as for describing this as “government run health care” that is simply not true at all. There’s nothing government run about it. The insurance companies still pay your doctor or hospital in the same way they did before. They’re ALL private. There’s no public option.
What the law does is preserve our existing TOTALLY PRIVATE system of health care but establish some basic standards. Insurance companies have to spend 80% – 85% of your premiums on health care. They can’t cancel you just because you get sick (as many have). They can’t deny you coverage because of a preexisting condition. They can’t set a cap on total benefits. In exchange for this, the government will set up exchanges that allow individuals and small businesses to get group purchasing power by combining their forces to buy insurance on an exchange. There are subsidies for people with low income to buy insurance, and for some small businesses. Etc.
There are also cost control measures, incentives to modernize health care IT and so on.
Aside from these reforms all of which I believe are very sensible, there’s absolutely no “government control” of health care. Government is not the “customer”. You still buy insurance from private insurance companies and they pay your doctors, exactly as before.
Mitsu, I hope you are correct.
Even if you are, this will not “bend the cost curve down.” Only tort reform, agressive reduction of fraud and waste in Medicare/Medicaid, and market oriented reforms will do that. This bill does none of those things.
For those who might be discouraged, I commend this U-Tube video to your viewing.
http://www.youtube.com/watch?v=lwk1aHU-pms&feature=player_embedded
I actually agree with you that tort reform would help, though it’s hard to estimate how much. Malpractice insurance is actually a tiny percentage of the cost of health care at present.
There are cost control measures in the law:
http://voices.washingtonpost.com/ezra-klein/2010/03/the_five_most_promising_cost_c.html
I’m particularly optimistic about the Medicare commission which allows various cost reduction experiments to be done which the commission can force Congress to vote on and make law; these experiments could also be used as templates by the private insurance industry.
Mitsu wrote with a straight face, “there’s absolutely no “government control” of health care. Government is not the “customer”.”
No. Government is the controller. What did the 2733 page bill say. Did it say for 2733 pages, “The U.S. allows the insurance companies to do x, y and z”?
No.
And as the “customer” we better not be one who buys a “cadillac” plan or what Mitsu?
We either better belong to a union or we’ll have to lower our “cadillac” plan to a non-cadillac plan quick so that we can do away with such nonsense just like the luxury tax was gotten rid of in 1990.
You extremists crack me up with your “sensible” and “no government control”.
If you believe yourself you need professional help.
And Mitsu… It CHANGES the argument to look at the cost of malpractice insurance when tort reform doesn’t just help with malpractice insurance. Either you are TRYING to be stupid or you are deliberately and repeatedly focusing on malpractice insurance when people keep telling you what good tort reform will bring.
For somebody who can string a bunch of concepts and words together well…. I can only assume you are doing it deliberately.
Please admit once and for all that tort reform does not just go at malpractice insurance costs. If you don’t….. well then… you proved my point.
And as for cost reduction…
It’s done by bringing two things into the equation.
1) Free market – which we’ve been getting away from for 3-4 decades.
2) personal responsibility – this attitude that health care is a right and should be “free” is too pervasive now and is the reason for health costs.
When the one example that Obama cited talked about a woman who DID NOT get care when she needed care (that was her choice) because she had a “catastrophic plan” and didn’t want to pay for her doctors visits even though her family had a history of breast cancer…. I can only say that was not wise. She finally went to the doctor when she had stage 4 cancer and then Obama BLAMES it on the Unites States not providing her care.
REPEATEDLY, the left, Obama, Mitsu lie to the American people to make their points. We can deconstruct your arguments and point to irresponsible claims.
Pardon me. I used to be a liberal pre-1991. I am quite sick of your negligence in trying to understand an alternative viewpoint. If you had any LISTENING ability you’d see how your government mindset is costing this country’s future.
My kids and grandchildren will wonder why this all happened. You and Obama are committing generational theft.
Good night.
The free market is a cost reducer in many cases, but not all. There are obvious cases where it fails, and it has horribly failed in our case. We have the most expensive, most inefficient health care system in the world, as I keep saying, we spend twice what other advanced democracies spend, on average, and get only mediocre results, on average. We have wait times and rationing (by HMOs, primarily). And that’s even though we’ve got 45 million uninsured Americans, who use the ER for medical care, which is one of the most expensive possible ways for them to get care.
As for tort reform, I agree that one of its salutary benefits would be to reduce the incentive for needless tests. But another thing that would reduce that incentive would be to change from a fee for service model to a bundled payment model — there are provisions to experiment with that model in Medicare. Other cost reductions will come from Health IT infrastructure improvements, something also provided for in this law.
This is not a “government takeover”. It is government regulation of a market that has spun wildly out of control. We were on a path to fiscal disaster, as every projection showed. Health care costs were spiraling with no end in sight. So if you’re really concerned about costs, that’s one of the biggest reasons I support this law.
I am, as I often say, a pragmatist. I believe in what works. I believe in markets, but I also believe that markets work better with some, minimal, regulation. We should have food inspectors. We should have restaurant inspectors. We should have traffic laws. We should have health insurance regulation, like every other advanced democracy.
What the heck is an “advanced democracy” if it can’t defend itself? The U.S. has allowed all of your “advanced democracies” to spend 50% of their money on health care for all while the U.S. protects them. What happens when we can no longer afford to defend ourselves, let alone all of the “adv. dems” that we shelter?
Let’s move on to the Climate Crisis now that we have solved this health care thing. Finding Bigfoot and Santa should be right after that one, too.
“What the heck is an advanced democracy”
Almost but not quite a people’s republic, as in DKPR.
A lot of the challenges to Mitsu are a bit off-topic. His basic point is that NHS is apples-and-oranges to our HCR, and that other European systems, more similar to HCR, have not had the dire consequences we see in the UK. Much of HCR is what Republicans suggested before.
Fair enough. That congressional Republicans might well have sold us halfway down the river given the chance, and that we have not replicated all previous errors, I tentatively grant. I think Megan McArdle’s offered wager over at The Atlantic still applies. We will, in the main, pay enormous sums of money for little or no measurable improvement in health care outcomes. We will “feel better,” not in a medical sense, but only in a psychological sense. And only half of us will even feel that.
Mitsu lied when he wrote, “There are obvious cases where it fails, and it has horribly failed in our case.
We have NOT had a “free market” in the last decade. 1/2 of medical costs are paid by the government and the health insurance industry is the most regulated industry besides hospitals themselves.
Mitsu observed, “We have the most expensive, most inefficient health care system in the world,
Because of people like you – making laws and regulations that impose costs – in bed with the trial lawyers – can’t even put in a 2733 page bill anything about tort reform. You and your kind are failures. Failures to recognize what is. Failures to even recognize alternative points of view. We’ve HEARD your view repeatedly on the nightly news and newspapers. Your view is in the decline because it is so outdated and misinformed.
Mitsu without common sense wrote, “Other cost reductions will come from Health IT infrastructure improvements”
I’m at the top of the IT field (hold many certifications – with 21 years of experience) this claim simply isn’t true. Not True. It is a claim by government politicians that do not hold water. If I were to tell you who I provide IT service for it’d be too much information – suffice to say – I know it is BUNK. Mitsu, I know you like to repeat the government line because you believe it. But the line is without merit.
Mitsu wrote with no conscience, “I am, as I often say, a pragmatist.”
um…. no you aren’t. I am. I’m a centrist. I’m a pragmatist. I’m a realist. I once was a libertarian who wanted a cut in government by 80%. Now I know as a realist that isn’t possible. I’d truly like to see government FREEZE levels of spending at 2008 levels of spending for 10 years (not cuts) while we re-prioritize what we spend on as a nation. That Mitsu is a pragmatist. You – are an extremist.
Mitsu channeling Hugo Chavez wrote, “markets work better with some, minimal, regulation.
2733 pages isn’t minimal. This on top of 1,000’s of pages of regulations already putting costs out of control.
Mitsu without living in reality wrote, “We should have food inspectors. We should have restaurant inspectors. We should have traffic laws. We should have health insurance regulation,
We have all those things Mitsu. Nobody is calling for removing food inspectors, restaurant inspectors, traffic laws, etc. Though we could change things a little – 2733 pages and taxes upon taxes and spending after spending is NOT the direction we can afford.
This is generational theft continued.
You are responsible.
Occam’s Beard
You seem to have a propensity for wandering off-topic. Try to stay focussed. You’ve also got your facts wrong.
The NHS happened before the Marshall Plan. It was designed under Churchill’s wartime government – the draft bill was in 1944. The National Health Service Act 1946 enabled the funding for a programme of hospital acquisition, re-building (every London hospital had suffered bomb damage), equipment installation, regional board structures, recruitment, training, etc. using some of the Anglo-American loan as capital. The programme commenced straight after the legislation passed in 1946. The National Insurance Act 1946 ensured the running costs were fully funded from tax receipts in the form of additional insurance payments The additional insurance payments came into effect when the service started in July 1948. The NHS was up and running before the Marshall Plan. This is why I said you were “closer to the mark” than the letter author’s claims. It was the American loan, (or arguably the Canadian loan) that was used as capital and invested in new equipment and refurbishment, but no Marshall Plan funds had been received before the NHS was established.
My point to this thread was to question the authenticity of the letter, ‘A View From Britain.’ You seem to want to engage in nationalistic arguments. You won’t get me on that – I don’t attach much importance to where someone happens to be born. Nor do I attach much importance to ‘left and right’ dogma. They both seem to have contradictions. I’m more interested in people and policies, regardless of political ideologies.
Dear big government Mitsu types,
http://www.breitbart.tv/shocking-audio-rep-dingell-says-obamacare-will-eventually-control-the-people
No control?
Dear Mitsu non-IT types,
http://online.wsj.com/article/SB10001424052748703580904575132111888664060.html?mod=WSJ_hpp_sections_opinion
IT will not be the answer. Take it from me.
Mitsu: you are either a fool or a troll, perhaps both. You have a long history at this blog of asserting the most preposterous things in the most reasonable tone, as though hoping that we will mistake the appearance of reasonableness for reason. The health insurance market has been highly regulated for quite some time now, in case you’re not aware of that. It has not been anything resembling a free market situation for a long long time. These particular regulations in the HCR bill are an increase in regulation designed to drive the private health insurance market right out of business in just a few short years. And I predict they will succeed in doing so. And then we will have to turn to our kindly progressive government overlords to save us from the situation they created.
The problem with market regulation is the aim of this regulation and the means employed. No real market satisfies all Adam Smith basic assumptions necessary for market efficiency: infinitesimally small effect of individual market agent moves on aggregated parameters, like prices or marginal production costs. The regulation should be aimed to correct these deviations – for example, anti-trusts laws. That is, regulation should promote competitivness and resrict individual market agent’s ability to deform prices and game the system. It should also ban dishonest competition, so we have laws to defend intellectual property rights – patent law, laws regulating use of trademarks, and so on. Nobody among free-market enthusiast ever object this type of regulation. What they object is market-bending regulation: prohibitively high taxes, protectionist tariffs, administrative price control, etc.
>fool or a troll
Neo, please, at least grant me the honor of being a fool in your eyes. I am most certainly not a “troll”; i.e., I am posting things which I certainly believe to be the case.
Of course I know that the insurance market has been regulated — but to say it has been “highly regulated” I believe is clearly an absurd characterization. Relative to every other industrialized nation our insurance market has been comparatively unregulated. They aren’t even subject to antitrust law, meaning they can legally collude on price. The medical loss ratios they are allowed are very low, far lower than in every other industrialized nation. Yes, there are some regulations, but aside from Hawaii and Massachusetts the regulatory environment is exceptionally weak.
I understand that your assertion is that these regulations will “drive insurers out of business” and that’s certainly a rational argument that we can have. However — what’s your evidence for this? Switzerland has a heavily regulated all-private insurance market, with regulations much more strict than those in the current HCR bill, and their insurance industry has not gone bankrupt. It’s doing just fine. I mean, I can understand that if you have a libertarian view that more regulation is ALWAYS bad, you might take this point of view, but I obviously don’t think more regulation is always bad, so I’m looking for actual empirical evidence.
I can assure you that most of my friends on the left believe that this law will actually save the private health insurance market from itself. Some of them vociferously argued against passage of this bill because they believe that it would have been better to let health care costs continue to spiral upwards to the point that the whole system would have collapsed, forcing single payer as the only obvious solution. If you want to look for a leftist conspiracy it would have been that — i.e., NOT passing HCR was what most of my friends on the far left wanted.
We can debate whether or not this bill will or won’t destroy the health insurance industry, but at least I hope you acknowledge that for most of us who supported the bill, that was definitely not our intention. I personally think a regulated private insurance industry supplemented with exchanges, etc., as in this bill, is the right approach to stabilizing our health care system. Single payer is another option I think has a chance of working, provided you also allow supplemental insurance, but I am against NHS-style solutions as the empirical evidence suggests they have significant problems.
BTW, though a lot of attention has been given to Massachusetts’ relatively recent health care reform law, few have paid attention to the fact that Hawaii has had near-universal coverage for 40 years and it has among the lowest health care costs in the nation:
http://www.nytimes.com/2009/10/17/health/policy/17hawaii.html
Mitsu: well, I guess it’s “fool” then. Your intentions are good—and you know how much that’s worth.
And I couldn’t care less what all those other industrialized nations of Europe—that have paid hardly anything for defense but have relied on us to do so, and are still in dire economic straits—do, or what your useful idiot leftist friends believe. As your mother used to say, “if they jumped off a cliff, would you follow them?”
Although I suppose you would. But don’t ask me to.
Mitsu wrote, “Relative to every other industrialized nation our insurance market has been comparatively unregulated.”
So what. If somebody else bungee jumped off a bridge does that mean we have to? We provide incredible care. Cost is an issue and more regulation makes our costs higher as well as our attitudes, lack of tort reform, and fraud as well as our personal attitudes towards being responsible for our own health. We are much more obese.
Mitsu lied when he wrote, “They aren’t even subject to antitrust law, meaning they can legally collude on price.”
Provide evidence. This is a flatly false claim. Additionally, there are BIG differences in price between the major insurance companies. They are constantly having to adjust price because of expectations of what should be ‘covered’ and regulations and medical costs. SHOP FOR ONCE !
Mitsu, Hawaii is having budget problems and the governor issued a statement about dismantling this system. Your arguments only dig your hole deeper.
I have noticed you and a couple other people bringing up the fact that they pay less for defense than we do, but I’m not sure what the relevance of this is. That would only be on point if we actually somehow paid less for health care than they do, and we’re talking about ramping up our spending to match theirs. But in fact we ALREADY are paying roughly twice, on average, what they do. My point is their systems are much more efficient than ours, despite the fact that they have much more government regulation than we do.
I.e., the debate, from my point of view, is what is the optimum level of government regulation to get the best quality of care for the lowest cost? It seems to me the evidence is strong that our system was not optimal, that systems like NHS are too far in the direction of government control, and that the sweet spot is in the area of Switzerland, France, Holland, Japan, which all have excellent health care outcomes but still spend much less than we do.
Baklava: I used the jumping-off-a-cliff metaphor, you used the bungee-jump-off-a-bridge metaphor. I guess it reflects the difference in our ages :-).
Quality and accessability of health care is not the main factor determining outcomes as measured by medical statistics. Healthy habits are more important. And here American population is far behind of many advanced European nations. Norwegians, for example, have much better life expectancy, but they also have better dietary habits, more exercize and less alcoholism. Obesity is almost absent in Norway: bike in summer, ski in winter – and NO junk food! A sizable part of US population has very unhealthy habits, high cholesterol level, hypertension, diabetes, and this drives up health care costs and leads to worse outcomes.
>flatly false claim
I’m not sure what you’re talking about — this is a well-known, not controversial claim, at all. Insurance companies have an exemption from antitrust law in our country (this is actually something some conservatives have called for repealing as part of their market-based health care reform ideas, and I of course support this).
>Hawaii
Every state is having budget problems. This doesn’t change the fact that Hawaii’s health care costs are among the lowest in the nation. The probability that they will actually dismantle their system: zero. I’m willing to wager on that!
neo 🙂
Mitsu,
Please cite your reference for Hawaii. It should include all medical costs including Medicaid, Medicare and the State costs as well as out of pocket costs.
I’m referring to the NYT article I just linked. I’ll have to do more research to find more comprehensive data.
The free market is a cost reducer in many cases, but not all. There are obvious cases where it fails, and it has horribly failed in our case.
GREAT! then you wont have a problem naming three things that would constitute your “OBVIOUS cases.
that is, you wont mind debating in a way that is FALSIFIABLE… that would be honest…
rather than use these catch phrases from the ivory tower.
i will point out that your examples better be from prior to the 1850s… if not, then its not a free market example!!! (and even then it may not be!)
We have the most expensive, most inefficient health care system in the world, as I keep saying, we spend twice what other advanced democracies spend, on average, and get only mediocre results, on average.
BS… i work in that health industry, and your WRONG… COMPLETELY WRONG..
first of all… we are NOT a democracy
RUSSIA AND CHINA are democracies
and we are a republic
and if you remove measure of socialism as a key measure (like the world bank does). THE OTHERS FAIL…
e have wait times and rationing (by HMOs, primarily). And that’s even though we’ve got 45 million uninsured Americans, who use the ER for medical care, which is one of the most expensive possible ways for them to get care.
we have wait times? your completely out of your gourd… we have ZERO wait times other than appointments… and if your not hung up on just one place of care, you can get anything you want done in 24 hours…
and that last part about using the emergency rooms is what proves the whole rationing and lack of care thing WRONG.
that is, the emergency rooms are full because we cant refuse care. GOT THAT? you come in, and you get treated NO MATTER WHAT… and you dont get different treatments!!!!!!!!!!!!!!!!
Other cost reductions will come from Health IT infrastructure improvements, something also provided for in this law.
no they wont… want to guess what i do as my job in the research hospital i am in? i am in HEALTH IT.. i came from INSURANCE… (and i do a lot of other things too).
the hospitals are mismanaged as they are mostly run by socialists who keep thinking to tap the state. they are not run at all efficiently or well.
last year i picked 30,000 dollars in machine parts for some science projects to help the docs out of the trash. you would be appalled at the waste.
but the waste is from the socialist bureaucracy…
good equipment gets thrown out daily. good furniture and cabinets. machines and such that can be reused for the students to do research are thrown out.
i have watched IT personnel sit around doing nothing for 6 months…
BECAUSE its so state run, and socialist!!!!!!!!!!!!!
if it was like a corporation, i can tell you it woudlnt be like this. they would first off all not be dominated by..
drumroll please SEIU
yes… THATS the guys forcing your medical up!!!!!!!!!!
they are the ones that keep you from firing, like with the teachers. they are the ones inflating costs..
why?
because them Mitsu will think that its broken and concede control over his own life to them as a fix.
duh.
This is not a “government takeover”. It is government regulation of a market that has spun wildly out of control.
hows this mitsu… i will come up with a bunch of mandates that you have to follow.
then you will let me know if its a takeover of mitsu’s life by artfldgr.
care to play that game?
nope… because taht would show your lying, and just spouting things you dont understand.
so if i come up with a bunch of ruls you have to comply with or suffer fines, penalties and imprisonment where i can put you to work at a lower salary, or put you in isolation… as punishment..
and you dont think i control you?
and to make sure it fits… you dont get a say in what i impose on you. there is no place to appeal to, that will give you a different answer. you cant go to antoher company as they dont exist.
care to make your argument over again?
I am, as I often say, a pragmatist. I believe in what works.
spoken like a true delusional socialist
if thats true.. then you would say ermove the shackles of the stae and let the free market fix it.
then maybe we will ahve doctors give houscalls again like when i was young.
do you remember housecalls mitsu?
I also believe that markets work better with some, minimal, regulation.
then your an idiot..
the state has only one power… the power to impede.
it has no other power.
so you let me know how slowing things down can speed them up.
Single payer is another option I think has a chance of working, provided you also allow supplemental insurance
Mitsu… it cant work.
ever hear of a politician fixing a ticket?
then you will realize that they can fix your health that way too.
the goals of the state and the patient are antithetical and the state gets paid regardless of outcome, and generally before services.
so the best way for the state to save money is to not provide care… they dont take the taxes based on level of care, but presumption of such.
so the more they can take, and not provide, the more they make!!!!!!!!!!
if the state was not in medicine, then the state doesnt get money up front. they dont get money on the back. thehy dont get the money.
the hospital or carer needs patients to charge for services RENDERED unlike the state who gets to charge for services PRESUMED.
and there is no way to correct the state!!!!!!!
they dont listen to us… so do you think whenwe compalin about billions in health care and no treatments, that we can get it to change?
nope… they are paid before there is treatement. so there is no way to withold payment upon poor performance.
the state doesnt ahve any money, but ours. so if you fine the state, you fine yourself.
for a person who claims to understand this, your an idiot
And what kind of tort reform is in Hawaii? Lawyers running rampant??? 🙂 I’d bet the trial lawyers don’t have the same freedoms there.
From the NY Times article, “There are clear problems with Hawaii’s system. Hospitals on the outer islands are small and losing money. With unemployment rising, so, too, are the ranks of the uninsured – which is now 10.7 percent of nonelderly adults.”
From the same article, “Barbara Zacchini, owner of Pizzeria Zacchini on the island of Hawaii, said she makes sure that her 17 part-timers work less than 20 hours a week so she does not have to pay for their care. “I’m for universal health care,” Ms. Zacchini said, “but it’s tough to run a business in this state and in this economy.” ”
Doesn’t mention anything about trial lawyer freedoms 🙂
“They aren’t even subject to antitrust law, meaning they can legally collude on price.”
McCarran Ferguson in insurance died years ago… just after i stopped writing software developing rates and rules…
The McCarran—Ferguson Act, 15 U.S.C. §§ 1011-1015, is a United States federal law that exempts the business of insurance from most federal regulation, including federal anti-trust laws to a limited extent.
The McCarran—Ferguson Act was passed by Congress in 1945 after the Supreme Court ruled in United States v. South-Eastern Underwriters Association that the federal government could regulate insurance companies under the authority of the Commerce Clause in the U.S. Constitution.
The Act was sponsored by Senators Pat McCarran (D-NV) and Homer Ferguson (R-MI).
Isn’t that interesting…
Do you know anything about this law Mitsu?
The question before the Court was whether or not insurance was a form of “interstate commerce” which could be regulated under the Commerce Clause of the United States Constitution and the Sherman Anti-Trust Act. The general opinion in law before this case, according to the Court, was that the business of insurance was not commerce, and the District Court concurred with the opinion.
and so, they prevented, still to this day… the national insurance market and the savings of the economy of scale that would have brought.
what mitsu doesnt know is that insurance is where the really big fish of state park their money! (or one place).. and so where the politicians park their investments (like the fed), a whole bunch of odd wasteful games that put money in their pockets gets played.
but mitsu likes such regulation… he said so!!!!!!!!
As a result, on March 9, 1945, the McCarran—Ferguson Act was passed by Congress. Among other things, it:
* partially exempts insurance companies from the federal anti-trust legislation that applies to most businesses[1]
* allows for the state regulation of insurance
* allows states to establish mandatory licensing requirements
* preserves certain state laws of insurance.
and so as a result of one of those nice laws that mitsu likes… the collusion he says the state will stop, was created by the state!!!!!!!
let me show you that again mitsu
partially exempts insurance companies from the federal anti-trust legislation that applies to most businesses
you see.. it takes a politician to write a law to allow for the kind of games you think that they write laws to stop.
withotu that law…. then they would be open to the lawsuits and other things for doing what you allowed them to.
us guys on the right, we didn’t like this fascist type collusion between the state and corporations against the people (but that’s normal for socialist states!)
so mitsu… did you know that it was two progressives (socilists) that sought to control business and crreate rules, like you say is proper, that created the sitution that you want to empower politicians to fix?
do you really think that they are going to fix waht they created for themselves against constitutional law?
no way… they have an army of mitsu’s defending them against themselves. (called playing both ends against the middle. monkey in the middle)
by the way mitsu… whats going to happen is that the insurance companies may go as far as writing insuracne, but they ahve all the data in a monopoly for doing the math and setting rates.
by the way mitsu.. where in the 2733 page document do they remove the exemption from law?
now the interesting thing is that this collusion is only used to compute RULES…
rates are what you get when you combine your costs of opertions with the rules and you get your RATE.
ISO and others used the collusion thing to get around not having enough data to create rules.
years ago, they used to create rules, and then apply the data given to them by insurance companis and generate rates fro them.
before health care as socialist battering ram was around, they were going to repeal this.
however, without repealing this, what will happen is that the single payer you want will come out and be created by a nationalized version of the industry core under Ferguson.
the government just doesn’t have the data to do the actuarial analysis (as i used to write), and be accurate. so ultimately the tiny people in the industry will lose their jobs.
but just like in forfeiture, and other areas, what will be left is this state owned run core that the politicians and others already have the money in place to take advantage of in the change.
they are happy mitsu will help them centralize all sap to pass through their maple tree to be tapped.
just so the record is straight… McGarren was a VERY bit anti communist… but still a progressive.
those that know their history, would realize that it was he that tried to get lattimore, the man who coined the term McCarthyism, convicted of perjury.
he attempted to stop a lot of the things that todays progressives are using to take over the state and our lives.
below is a quote..
I believe that this nation is the last hope of Western civilization and if this oasis of the world shall be overrun, perverted, contaminated or destroyed, then the last flickering light of humanity will be extinguished.
I take no issue with those who would praise the contributions which have been made to our society by people of many races, of varied creeds and colors.
America is indeed a joining together of many streams which go to form a mighty river which we call the American way.
However, we have in the United States today hard-core, indigestible blocs which have not become integrated into the American way of life, but which, on the contrary are its deadly enemies.
Today, as never before, untold millions are storming our gates for admission and those gates are cracking under the strain.
The solution of the problems of Europe and Asia will not come through a transplanting of those problems en masse to the United States. …
I do not intend to become prophetic, but if the enemies of this legislation succeed in riddling it to pieces, or in amending it beyond recognition, they will have contributed more to promote this nation’s downfall than any other group since we achieved our independence as a nation
so the fights we are just joining now, were over years ago… that is, we didnt believe the people that said we woudl end up here.
we belived the progressives which said all the reasons why it wont bet that way… the same as today
The immigration provisions of the act were later superseded by the 1965 Immigration Act, but the power of the government to deny visas for ideological reasons remained on the books another 25 years after that.
Furgesson is a more boring character.
i have visited his grave.. (its in Woodlawn Cemetery with the vanderbuilts and others)
Just to be clear, my main reason for posting here is to make clear what it is those of us who support HCR are arguing, what we hope to achieve, and what are actual policy positions are, because I see a lot of fear and misrepresentation here and on other sites. I have less hope to actually convince you that my views are correct, but at least I can try to lay out what they actually are.
So, to that end: as far as I can understand the position you guys are taking, you seem to basically believe that regulations are usually harmful, lead to more inefficiency, and so on, with some but very few exceptions. You also seem to characterize those of us who disagree with that position as being in favor of *maximal* regulation, to the point that any attempt to add more regulation is just sleight of hand, a first step towards our eventual goal of wanting total centralized control of everything. (Meanwhile, I might note that the left tends to think the right has similar nefarious intentions of wanting total control of everything).
But what I, and Obama is of a similar mindset, want is optimal regulation. That is to say, some regulations are bad ideas and some are good ideas. The antitrust exemption for health insurance I believe was an example of a bad law. So I don’t like “all regulation” or everything the government does: in fact, I subscribe to the principle that if you have a choice between two regulatory regimes and both achieve equivalent results, it’s better to choose the one that involves less regulation, not more.
This is why I believe this law, though it has no public option, may well be preferable to a law that contains a public option. The empirical evidence shows, however, the systems like France’s have slightly lower cost than systems like Switzerland’s, which rely entirely on private insurance. This may be because lowered amounts of paperwork and other complexities might achieve some economies of scale in the French case. However, perhaps keeping the insurance industry entirely private might encourage private sector innovations and increase choice which in the end might be worth the inefficiencies.
But in any case, I just wanted to come here to make clear what it is I and others are arguing, and that is:
1) We do NOT believe that “every regulation is a good regulation” — there is a complex relationship between regulations, stability, cost, efficiency, etc. Our goal is not maximal government control; to the contrary, I agree with many ideas from libertarians, including the notion that markets are efficient ways of achieving many ends. I simply think more regulation is optimal (in the sense of achieving efficiency and lowered cost) than you guys do.
2) The point of the HCR law is not to “drive insurance companies out of business”. Even if you think that will be the effect, that is not the point of it. I also don’t think you’re correct about this. The far left actually shared the same goal you had: they wanted to kill this bill. However, that’s because, unlike you, they believed the system was going to implode on its own, and in fact I think the evidence is very strong that they were right. Health care costs have been skyrocketing at twice the rate of inflation for decades.
Finally, regarding waiting times, I’ve posted this before but I’ll post it again: Business Week article on the long waiting times many Americans face even today:
http://www.businessweek.com/magazine/content/07_28/b4042072.htm
Asked if insurance companies might raise their rates on health coverage and blame the increases on the new health-care bill, Pelosi said that the insurance companies should be aware that they’re not “automatically included” in the new health exchanges the bill creates.
“Unless they do the right thing, they’re not going in,” she said. “They will be relinquishing the possibility of having taxpayer-subsidized consumers in the exchange,” she said.
Nancy Pelosi
wow art. that. is. liberal fascism.
Mitsu wrote, “you seem to basically believe that regulations are usually harmful”
As written by big government leftist types yes. If the POLICY that is written does not help the consumer or businesses or lower costs – or help increase the influence of personal responsibility and rewards poor choices. then yes. It is bad.
Mitsu wrote, “You also seem to characterize those of us who disagree with that position as being in favor of *maximal* regulation”
2733 pages is about as maximal as you can get. Have you seen the flowchart of this bill? The inter-dependencies on each branch of government. It’s a spaghetti mess nightmare. At this point I’d rather have single payer except that single payer eliminates personal choice and competition and inserts government. This hybrid maximal government over regulation bill does the worst thing for Americans. And you are responsible as much as Obama. You voted for the man and CONTINUE to argue in favor of the worst possible option.
>single payer eliminates personal choice
Well, like I said, you can have single payer but also have supplemental insurance. So if you want coverage over and above the basic coverage the government provided in such a plan, you’d be free to buy a supplemental package, just like seniors can buy supplemental insurance above and beyond Medicare and so forth. So single payer might in fact be more streamlined and efficient than the bill that just passed.
However, I still think that the bill that just passed has a pretty good chance of providing some creative options through the operation of the market that a single payer system might not. For example, some insurers might focus more on HSAs, others might focus on alternative care, etc. So, I think a wait and see attitude is in order.
And just as an aside: regarding the length of the bill. A bill like this has a lot of moving parts, plus legislative legalese can be very verbose, etc. What I mean by “more” vs “less” regulation has to do with the actual effect of the bill, how much government involvement there is in terms of regulating private enterprise.
The irony is that a much more government-centric approach, i.e., single payer, would in fact probably result in a shorter bill. But I don’t think it’s unreasonable to say that a single payer system involves more government interference in the market than a system which relies entirely on private insurers. The system we have, which involves private insurers, is obviously more complex, has more moving parts, and many interrelated pieces, and thus I don’t think it’s particularly surprising that the resulting bill is relatively long. But I think it may be worth it to preserve our American style system where we do believe more in markets than do European countries which tend to trust government to do things for them more. Although I’m a strong supporter of HCR I am to the right of most Europeans, and I believe we ought to make an effort to preserve market dynamics to the extent possible. I just think the system we had already was careening towards that cliff that Neo doesn’t want to jump off of. I personally don’t want to drive off that cliff, and that is where I think we were headed.
Mitsu wrote, “I personally don’t want to drive off that cliff, and that is where I think we were headed.”
Because of politicians and people like you.
Common sense reform would’ve turned us around.
“The system we have, which involves private insurers, is obviously more complex, ”
Well, yes and we arrived here via decades of “optimal regulation” hence the only cure according to your colonized mind is “More of the same but this time we’re going to do it better!”
Right. If we could have more of this pecksniffian garble it enhance the whiff of sanctimony that rises from these eructations like fumes from a distant latrine.
I am getting pretty tired of Mitsu’s one sided form of conversation.
Just to be clear….
Mitsu is going to skirt our points, and not participate, in that way he can avoid (in his mind) being wrong indefinitely…
So, to that end: he will keep restating OUR positions, and not address our challenges to his points. in this way, he always keeps the eye on the other, not him. he has no need to learn or to change, he has only one mission, to change us.
Exhibit A:
because I see a lot of fear and misrepresentation here and on other sites. I have less hope to actually convince you that my views are correct
He has yet to establish what is truth. EACH time we ask a question that would basically force him to admit he is wrong, he drops the whole discussion line, and restarts a new one. Like some bizarre robot, he goes bzzzzz click reset… and starts as if there was no discussion yet. And then he tries to analyze our position, completely without any knowledge of where we got our position ideas. (Being a relativist he cant measure anything, if the whole world was communist and exterminating people he would feel bad we were missing the party, as he has pointed out with health care)
you seem to basically believe that regulations are usually harmful, lead to more inefficiency, and so on, with some but very few exceptions
See how insulting he is. We are not even allowed to be sure about what we are sure about!!! We SEEM, as in not actually… no Mitsu, WE KNOW… you on the other hand do not know, and so your best is to put us on relative ground and have our knowing equal your not knowing by converting it to SEEM.
Bzzz… click… reset..
You also seem to characterize those of us who disagree with that position as being in favor of *maximal* regulation, to the point that any attempt to add more regulation is just sleight of hand, a first step towards our eventual goal of wanting total centralized control of everything.
Again… SEEM… we characterize people who only have an ADD operation with no delete no remove, no cancel, and no erase, have no option but to keep building up things. That in the absence of a process of removal, there is no other end result.
Whether you WANT that end, or not, your Confucian concept of perfected rules and stagnation, don’t work, they can only lead to one thing, totalitarian control.
It is not us that has a problem its you that has a problem.
Your problem is that you cant calculate the results. Your mentally crippled. We don’t disagree that if the ideas were possible, that they would be something to strive for, but they are not possible
What’s worse is that they require the destruction of the only thing to have improved men’s lives in the history of the universe. FREEDOM (a synonym for capitalism and property ownership).
You see.. your problem is that you think we think you WANT that end. and the REALITY of it is that if you knew what the heck you were working towards you would not be working towards it!!!!!!!
The common ground is freedom. and you have been taught that you can be free with a never ending stream of contradictory rules that you cant follow that impose punishments for not complying.
Only socialists could convince a man born free that he would be freer under huge burdens of restrictions, punishments, and mandates.
Meanwhile, I might note that the left tends to think the right has similar nefarious intentions of wanting total control of everything
That’s because PARANOIDS project their condition to all others. and SOCIALISTS and collectivists are paranoids…
You fear people being free
You fear the disruption of progress and its replacing things
You fear a future with no defined goal
You fear a productive force with no driver
The left projects themselves onto their enemies. they pretend to know you by knowing themselves. but they are parasites or sociopaths. So they think that the good people think like them!!!!!!!!!!! (Which is why they degrade to get them before they get us)
You can read this paranoia from the first days of the soviet union, and in George Kennans long telegram. You can read how they will influence and take over organizations (section 4), rather than compete in the open.
That’s paranoids… even you are so afraid of losing a point, you wont listen, but will keep resetting the conversation until you wear us down and we concede.
But that’s not wining the debate, that’s attrition…
But what I, and Obama is of a similar mindset, want is optimal regulation.
And that’s what you don’t get. first of all, you and Obama are not the same. Obama is a populist Stalinist with Maoist ideals. You are no more in line with the dear leader than anyone else is. this is a form of the socialist disease where they think that somehow saints become totalitarian rulers and so on. if only Stalin knew, because Stalin and I are alike.
Here is the problem..
There is no such thing as optimal regulation
DON’T YOU GET THAT?
Hayek won a noble prize in economics proving that…
And how do you propose to get that optimal regulation?
Do you have the omniscience of god? ( I will assume your answer is no)
Do you have a formulae and process to get to that regulation?
Also the answer is no.
So all you have is blind faith that there exists for every situation a perfect rule, that only god could know?
So since your not god, and Obama is not god since your not (you both can’t be)
You both do not know what such a regulation would be like, IF your faith was not misplaced in blindly assuming with absolutely no reason, it exists.
This means, that you’re a social engineer. And that is what Dr Mengele of Nazi fame was.
You do not know this regulation
There is no formulae for creating it
You only have a faith that there has to be such
And so you’re going to experiment on innocent people till you find it.
WELCOME TO THE SOVIET UNION…
Which is exactly how it was and is.
Here is our position now that I clearly defined yours (whether you realize it or not)
We also believe that your not god.
Obama is not god, nor any one else is god in corporeal form.
We also do not care for blind faith when it comes to using a gun in the hands of the state to force us to comply with people who are not god, but are willing to experiment to find out if their pet theories of the world are right or wrong (and even worse when they have already been run and found wrong, lets do it again)./
Here is what you also don’t get Mitsu.
Why not try our ideas to experiment in the future? Given your relative views, unless you make an arbitrary and capricious choice for statist, your choosing to join the side that thinks its wrong to experiment on people, is just as arbitrary and capricious.
Except for the fact that our side was the side that created the world in which you could argue this right now without fear. That you have the technology in your hands to work with… (the other states your dreaming of keeps such out of your hands, your too dangerous to have it)
the only way you can get out of this logical bind you put yourself in and I revealed is if you can prove the existence of optimal regulation… AND prove that optimal regulation (an impedence) can outdo a system with no impedence
This is why you wont win us over. we are not stupid enough to think that people that don’t know what they are doing, and obviously so, should get to experiment in our lives. even worse, they do so with no care to methodology or outcome. that is, they flip the dials and if its bad, they keep flipping them. if something good appears, they pretend to take credit for it… (this is a trick that is beyond Mitsu to comprehend though)
That is to say, some regulations are bad ideas and some are good ideas. The antitrust exemption for health insurance I believe was an example of a bad law.
But you have no idea how that works!!!!!!!!!!!
You cant even name it.. you cant even say how it works and was implemented and why!
[and I fear if I tried to explain it, your mathematical knowledge is not sufficient. But it has to do with the more information you have the better your actuarial predictions are. and that the exemption was to allow pooling of data so that better actuarial data could be developed. And what did they develop? Break even numbers. that is, they ONLY develop numbers that say that you need to charge X to break even. Then each insurance company takes that number and adds to it its operation costs. That is, its buildings, advertising, electricity, OBAMA TAXES and they compute how much they have to charge to break even. Then they add 2% and pray that the conditions that the actuarial projections were made from don’t shift. So they don’t collude on price, they cant. The state sets price. they can only collude on minimum amount to charge to break even. In this way they avoided repeals of McCarran Fergusson]
So I don’t like “all regulation” or everything the government does: in fact, I subscribe to the principle that if you have a choice between two regulatory regimes and both achieve equivalent results, it’s better to choose the one that involves less regulation, not more.
YOU LIE!
Your not following that…. as if you compared the US in the past, and the US now, your lying metric would tell you that a huge bill by the state having to do with your health is not the states job.
If it was not for the state, and its games, the costs would nto be that high
But there is no way to show this to you Mitsu, since you look at the surface and think you know everything. that you have no idea of first order basic premises…
Skipping over your bullsht pub option line
The empirical evidence shows, however, the systems like France’s have slightly lower cost than systems like Switzerland’s, which rely entirely on private insurance.
You’re an idiot. please tell us how these numbers are developed?
I will bet you can’t. And so you ASSUME that they are reflecting the same things.
First of all, we have 300 million people, and France is about the size of one US state.
I know why your picking france… because WHO picks france.
You did NOT do any research in your pick, you just follow the ideals of your great leader, who you said is exactly like you. (fool)
in its 2000 assessment of world health care systems, the World Health Organization found that France provided the “best overall health care” in the world.[23] In 2005, France spent 11.2% of GDP on health care, or US$3,926 per capita. Of that, approximately 80% was government expenditure.[18]
The left has already updated wiki to fit their ideas. So lets just work with the 2005 number.
In 2005, the United States spent 15.2% of GDP on health care, or US$6,347 per capita. Of that, approximately 45% was government expenditure.
France spends 2.3% GDP on defense
US spends 4.28% of GDP
I now will give you some facts..
From the journal of magnetic resonance imaging
Although France is a modern, developed country, which spends nearly 10% of the gross national product on healthcare and has a highly praised level of medicine, the number of modern imaging scanners, such as CT (595), MRI (182), and PET ([5]), is quite low when compared to other European countries. Politics and a long-standing tradition of centralization are prominent among reasons for such an underdevelopment. This situation has resulted in another French paradox not linked to wine consumption. The French life expectancy is very high, but the number of imaging equipment is very low. J. Magn. Reson. Imaging 2001;13:528-533. © 2001 Wiley-Liss, Inc.
And VERY low when compared to the US.
FRANCE, CANADA, and the others ALL have special tourist companies whose specialties is sending the patients to the US to get treated.
End part I
>we arrived here after decades of “optimal regulation”
Since we have had by far the least regulated health care industry in the industrialized world, we’re the last advanced economy to have implemented any form of universal health care, I would disagree with you about that. I think we’ve arrived here after decades of overly weak regulation.
Artfldgr: The main reason I don’t reply to every point you guys make is because I don’t have enough time to reply to them all. I’m just one person and you guys are many. I certainly have responses to everything you’re writing, but I am not going to write them all down, due to lack of time.
But as I said above I realize I’m not going to convince you that there is such a thing as optimal regulation — though I find it odd that you’d dispute this, you seem to be saying that ANY regulation is a mistake. I.e., you think we’d be better off without a building code, with no health regulations for restaurants or food or medicine, with no safety regulations for toys or consumer goods, get rid of every regulatory agency, etc.? Well, if that’s really your position, fine, but I really disagree.
As for “proving” my point, again — I’m not trying to prove my point here because I don’t think I can convince most or even any of you. I am merely trying to make it clear *what* I am claiming and what most liberals claim. I can’t think of a single person, even on the far left, who would want total Soviet-style government control over everything. That’s obviously ridiculously inefficient, not to mention oppressive. But even the most socialist government in Western Europe is nothing like the Soviet Union. I.e., compare and contrast Sweden, with the highest per capita income in the world, to the former USSR. There’s no comparison whatsoever.
My argument is that regulation and social democracy all exist on a spectrum which can support markets and democracy and high standards of living. I actually prefer the American calibration of this, which is far to the right of most European countries, because I like the fact that our economy is more entrepreneurial than theirs. We have more startups, more creative destruction, etc. However, I think we’re a tad too far to the right, and moving the needle a little left is what I personally prefer. Again: not trying to convince you I’m correct, just trying to establish what my position is.
No matter how much you may hate my views, I think it’s hard to argue that any country in Europe, or Japan, is a Stalinist hell hole just because they have far more government involvement in their economies than we do. That’s all I am saying: there is a spectrum of opinion, but no one wants to build gulags or put commissars in charge of everything.
No Mitsu,
We’d rather solve problems.
Seems you’d rather make the situation worse.
Mitsu
Good series of posts.
compare and contrast Sweden, with the highest per capita income in the world, to the former USSR.
yeah… since sweden doesnt have the highest per capital income… Luxembourg wins that prize (followed by bermuda), then the US.. (using the PPP method).
(smoke from yer ass now cleared)…
and your whole post is a waste since your not arguing with anything i or anyone else here has said, your only stretching credulity so you can fit your butt through the hole..
i dont hate your views, i hate that you think your a clever manipulative person who plays games with people as a means of entertaining himself.
your views are not representative of liberals as a collective. your history tends to be broken, and your points are like your given an assignment in rhetoric class to take 5 points and work them into an argument.
worst of all is you really dont know what your position is as your knowlege or rather your experiential knowlege is not wide enough to actually understand.
Again: not trying to convince you I’m correct, just trying to establish what my position is.
why?
who are we for you to come and visit to establish your position on things? Buddha? Siddhartha?
your disarming point means nothing as you are not a lord, potentate, glitterati, or anything like that, your just a regular Joe.
so your point is kind of like walking into a deli and saying no, i don’t want to order, i just want you all to understand my views on baloney, and leave.
you really don’t think much as to what you say and its context and so forth, do you?
I think it’s hard to argue that any country in Europe, or Japan, is a Stalinist hell hole just because they have far more government involvement in their economies than we do.
and i think it would be harder to blow smoke our your arse if you had a telephone pole stuck up it.
but neither statement has any point to it.. does it?
you CAN argue that no other country has ever been as free as the US and no other country has ever achieved and given to the world what the united states did in under 150 years. no other country and peoples have ever given so much money, goods, food, medicine, and assistance to living beings as yet recorded since time itself started. no other place has been such a clear beacon and inspiration to millions of people who emulate her success every day, and seek to tear her down in jealousy and greed. no other place has given us so much, no other peoples has shared so much. before she was here, there was no other way to live but by kings and despots. because of here even stalinist hell is not stalinist hell!!! japan is not a feudal imperialist monarchy! and i could go on covering countries till the numbers of people helped who forget would exceed a billion easily
your turn mitsu
oh.. and financially speaking.. we all wouldn’t be in this place financially if the world didn’t believe in the US to the point of crediting us this much..
so yeah we have a lot to lose and not just freedom
and sweden is 26th by ppp calculation
atlas method brings it up to 11, but pushes US only down to 5th..
and by the way… if you looked at such lists over time since the 1800s mitsu… we have always had a place in the top spread… never anywhere else..
This selection of opinion polls shows that many are not as hostile to this bill as some would suggest.
Opinion Poll summary
Obviously I can’t speak for every liberal in the United States, but since most of my friends are liberals and I talk politics with a lot of them a lot of the time, I have a pretty good idea what liberals think. And none of them are in favor of maximal government control, which is often an undercurrent in many of the posts you guys make.
Regarding Sweden, I was referring to the standard of living; by various measures Sweden has been at or close to the top of the list (this includes value of services provided by the government). For example, child care is provided by the government, you can join a gym for next to nothing, etc., due to all the government subsidies, so “standard of living” takes that into account. In any event, my point was simply that Sweden, despite their extensive government programs, is not some Soviet-like state. While I personally much prefer the economy of the US, which I feel is more dynamic and creative — these other countries are not awful places to live.
After being flayed and folded and stuffed back into your own fundament by Artfldgr, mitsu, I would think you would have at the very least enough shame to either engage or slink away. I don’t know, maybe you just don’t do shame. Not surprising given the liberal chat with your “liberal” friends.
As someone else remarked elsewhere today: “We have reached the point where in our current political system the only things the left is remotely “liberal”€™ about have to do with sex, i.e. situations involving peoples’ genitals coming into contact. Oh yes, I’ll agree, the left is very liberal on matters involving peoples’€™ genitals coming into contact. They are true-blue principled believers in that sort of liberty. They care very deeply about genital liberty, I’ll grant. That’€™s very, very important to them and prominent in their lives and thinking. (Where they and others can put their genitalia.)”
That’s pretty much the strong suit of liberals today. Very popular in the Bay Area. But then so is MRSA.
Child care provided by government? Big whoop! More free time for genital liberalism.
Cheap subsidized gym fees? Boy that makes life worth living too! That’s really what it’s all about.
Gerard I love you, even if I can’t agree with you.
However — you are as always a fantastic writer. Too bad you work for the other side … 🙂
Well, at least I am not a paid minion of Satan.
Mitsu wrote, “I have a pretty good idea what liberals think.”
Too bad you REALLY don’t know what conservatives think. When you state our position to us – it’s waaaay off.
You need some listening skills. Or you can continue being negligent.