January 15th, 2006

The right to health care?

Occasionally, I come across someone who proclaims that health care – high quality, universal and reasonably priced - is a “right,” one to which all Americans are entitled.

It sounds perfectly wonderful.

In fact, most Americans believe it to be truth (but of course, most Americans believe in ghosts, UFO’s, Medicare solvency and vote Republican, too).

I hate to be a curmudgeon.

Well, sort of: actually, I relish it. But my response is given guiltily, almost like I’m asking a child why he really thinks there is a Santa Claus.

I ask: “Do you believe that every American has a right to food? Or shelter?”

I go on: “After all, without food or shelter you could be dead in a month! Without health care, you could easily live to be 80. If health care is a right, surely food and shelter are too!”

Most people acknowledge I have point. Upon further reflection, they usually say that government should give people access to a minimum of food and shelter, as well as health care.

Of course, every society that has promised all of these things has been a ridiculous soviet-style failure.

But people who would promise such things are rarely students of history.

Curmudgeon that I am, I press: “If you say that people have a right to food, does that mean they get government vouchers to go to their favorite restaurants?”

The curmudgeon is then looked upon as the idiot.

“No! They don’t get the best food! They are on public support,” comes the usual reply. “They get the basics. Flour, cheese and milk. They don’t get to eat at Olive Garden on the public’s tab!”

And of course, they are right. I couldn’t have said it better: When people are on the dole, they should not get the best (Whether Olive Garden can be considered “the best” is a matter of opinion…).

If the poor do get the best, you make the millions of people paying their own bills look like idiots. Why would a poor family struggle to put dinner on the table when their section eight neighbors eat at TGIFridays every night for free?

The answer is: they wouldn’t. They too would try to take advantage of their poverty. Poverty becomes attractive (as weird as that sounds).

Shouldn’t that same logic apply to health care?

If you depend on public assistance to pay for your drugs, why should you get the latest and greatest?

Why should you get Lipitor – a state-of-the-art modern statin – that costs $350 a month?

For $30 a month, you could have generic Mevacor – a drug that was “the best” in 1985 (and is still pretty good today).

Modern angioplasty and hip replacements? Those are for paying customers, bub. You’re going to have to make do with simple drugs and painkillers, just like the super rich did in 1980.

My point is simple: we can guarantee a right to basic minimum in health care, but it has to be a minimum – something that most paying customers would consider unacceptable (health care a la 1980). If you make the government option too attractive, everyone will take it, and the program will bloat until it is unsustainable.

In the end, the universal health care debate boils down to a lesson in simple economics.

People who want to make health care a right want it to be high quality, universal and reasonably priced.

The unfeeling laws of economics – which don’t care what you “want” - say that you can have any two of those things, but not all three.

You want health care to be high quality and universal?

You will not be able to control the costs.

Not unless you believe in Santa.

The question is: Do you?

(This post is crossposted at Therapy Sessions)

Posted in Economics, DailyFeatured



38 Comment(s)

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  1. Cranky Liberal Says :

    Oh man John, when we have more time, you know I’m going to argue this one just like I did when you posted it originally.

    First, we already pay a heavier burden than any other country in the world for medical care. We spend 15% of our GDP and more money per capita than any country in the world. That should net us the best health care right?

    Nope.

    Then it should be universal at least right?

    Nope.

    Maybe it is at least containing the cost?

    Nope.

    You make an interesting point when you argue about the “right” to health care. Here is the difference. A person can reasonably be expected to go to work and be able to afford the basic neccesities of life. Hard work and an education means you can probably afford at least adequate food and shelter. It also means you could not pay 2 hours in a hospital. A better job and a better education means you can afford a nice house, a good car and meals at places that don’t start with MC, and you couldn’t pay the doctor bill for anything more than a cold without it hurting painfully. Have a devistating illness and all but the richest of us would be bankrupt,and then without treatment anyhow.

    The cost of medical care is so beyond what can reasonably be afforded by a person that they cannot pay it themselves.

    That is of course why we have insurance. With insurance we spread the risks and lower the cost per person. But of course that’s the rub. The insurance business is just that - a business. They are in business to make money. They do not do it by providing medical care. They do it by acting as the paper pushing, claim denying middle man, whose goal in life is to minimize their risk (ie sick people who might cost them money) at every opportunity. We end up with a system that compeetes not to cover, one that adds endless layers of paperwork for the doctors, hospitals and paitents (and having done some medical billing in my time, I speak from experience) and does so with less efficency than Medicare.

    I do not buy the fact that Universal Coverage would be in any way shape or form worse than the system we have now. Other countries, Canada, France, Germany, and Great Britain all have systems that do a better job for less money (per capita) that we spend today.

    You laid out three criteria and our system fails on 2 of 3 without thinking, and the quality aspect is questionable when you factor in price. So no John, I do not believe in Santa. I just understand that right now, I’d settle for having any two of your three. It would be a marked improvement.

    ,,


             
    Comment score: 5.0
  2. steve Says :

    Where to begin with this one.

    I like John’s points.

    We spend $4200 per student in a public school. $4200 per student per year! This includes the failures, deliquents and degenerates that turn our schools into institutionalized baby sitting versus a real education. Schools spend a lot money on defense with metal detectors, on campus police and student aids. Every year it’s low test scores and an underachieving America.

    Our military is at war. The greatest military on the planet. Can’t get basic armor to protect them from road side bombs. The technology is there, the money is there, we could totally do it and we can’t.

    Hurricane Katrina. The federal government is rumored to have been a failure in its ability to protect the people.

    So there you have it Cranky. Three liberal talking points regarding the federal government. And you want to put health care in the hands of the feds?

    Are you crazy?


             
    Comment score: 1.0
  3. ken grandlund Says :

    John and Steve-

    If you’re up to a little reading on this subject, I’ll direct you to 4 essays I posted on the topic of Health Care, it’s value to society, and several reforms that we could implement that would (a) cover everyone, (b) cost less than we spend now, (c) preserve choice for patients, (d) ensure that doctors and patients decide what care is best, (e) improve health care across the board, and (f) split the costs between people, the medical-industrial complex, and government.

    The ideas I present represent “thinking outside the box” so try to keep an open mind while reading. Here are the links:

    http://4commonsensenow.blogspot.com/2005/05/is-there-doctor-in-house.html

    http://4commonsensenow.blogspot.com/2005/05/your-money-or-your-life-costs-of.html

    http://4commonsensenow.blogspot.com/2005/05/doctor-will-be-with-you-shortly.html

    http://4commonsensenow.blogspot.com/2005/05/affordable-health-care-does-not-mean.html

    You may need to set aside 20 minutes or so to get through this. Sorry, but I’m not your basic “sound bite” writer. Open your mind and take a look. Read the posts all the way through to the final paragraph before throwing up your hands and saying something like “typical liberal hogwash.” These ideas are a starting point after all.

    It is interesting to note that one of the direct causes of industry outsourcing jobs from the US is because of the high costs of health care in this country. Affordable health care not only relieves pressure from individuals while improving quality of life, it also makes sense for our economy. Further, it is disingenuous to ascribe to the theory that the amount of money in your bank account automatically means you deserve better health or health care than someone with less. I’m not accusing you of being a Christian, but if either of you are, that point of view certainly does not embrace classic Christian ideology.

    Finally, my father just underwent his 5th open heart surgery. The final costs will likely come in somewhere over $100k. He recently received a bill for a two day hospital visit for a portion of his ordeal and the bill came to $8000. All they did was put him in a bed for two days, give him an antibiotic IV for an undiagnosed and still unproven “infection” and then send him back to the hospital he had his surgery at originally. (They doctor didn’t want to “deal with him” since he was not the original doctor.) $3000 of that bill was for the “antibiotic.” By the way, after working for over 30 years in the Teamsters union, my father’s congenital heart problems (meaning he was born with them and they did not occur because of any thing he had done to himself) finally became too acute to continue working. He has been actively managing congestive heart failure for the last five years, while on disability pension and Social Security disability, putting off this surgery as long as possible, because he simply couldn’t afford the costs. (You can read all about that here: http://4commonsensenow.blogspot.com/2005/12/cheating-deathagain.html )
    Now according to you, we should have just let him drop dead. Maybe so, but I’d bet your thoughts would differ if you or your family were facing an identical situation.

    As I say in my last essay, nobody should expect free health care. Indeed, that our taxes would support a medical program like I describe means that we ARE paying for health care.


             
    Comment score: 5.0
  4. The Bastard Says :

    You know what I find funny is that all the conservatives fight for the rights of corporations to operate freely and pay less in taxs, blah, blah, blah but when a group of people want to take the burden of medical costs off the shoulders of the corporations they say “no way”.

    What’s up with that?

    I say we go universal, cut the cost of medical care to the companies but implement a “health tax” for the companies to pay. Why? Because it is still in the best interest of the companies to have healthy workers. Heck it’s in the best interest of the federal government to have healthy citizens.

    My uncle has cancer and is battling it like a champ, worked for the DEA for over 30 years, just retired a few months ago and now he has nothing because of his medical bills. Doesn’t seem right.

    As far as I’m concerned it is in the best interests of both the government and the corporations to keep us healthy and strong, let them pay for all our health care. It’s about us people not them. We die to make them all rich but yet you protect their inerests.

    And we are fed the American dream to keep them rich. Well, it goes like this, how many rock bands are out there and how many actually make it and how many actually sustain success? We all fall somewhere in the middle of that scenario. Working slaves to the man is all we are but yet we all want to defend their wealth, why?

    I’m gonna go hit my easy button now.


             
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  5. steve Says :

    Bastard sorry about your uncle.

    Ken, I must be mistaken. I think the issue is an either or. Do you want Universal Care or Affordable Care. There would be a huge difference in both programs.

    Bastard, can you hand the liberal pipe back to Cranky, I think he wants to dream too!


             
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  6. ken grandlund Says :

    Steve- Why must this be an either/or situation? Universal does not necessarily mean free, nor does it mean unaffordable.

    Think about it- taxes are paid by you and me- if they are equitably distributed through a specific program, in this case health care, then we are simply operating on a type of pre-paid program. That does not equate to free in my book. As it is now, we pay the taxes and get little in return. We pay more in premiums on top of the taxes and still get the shaft.

    The problem is not with having Universal care or Affordable care- it is with those who lust for profit at any cost and those who think their wealth puts them above those with less.

    The solution requires a paradigm shift in thinking about what health care is. It should not be simply about making the biggest buck off the sickest people. It should be about…gasp…health care. There is no reason for health care to be unaffordable other than unbridled greed at the expense of sick people. An honest, universal plan could and would be beneficial to government coffers, business bottom lines, and individuals while promoting good health, better education, and medical advances that actually help people who need it.


             
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  7. Cranky Liberal Says :

    Let me ask you again Steve, do we have either affordable or Universal care now? Right now we do not meet even two of the three criteria that John lays out.

    Medicare works Steve. Frankly you better it hope it does because for the vast majority of us who are under 60, that’s going to be our ONLY health care when we are elderly.

    Armor for the military and Katrina? Yeah, I have a solution for that - vote the people in charge out of office and get people who live in a “reality” based world.


             
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  8. steve Says :

    “get people who live in a “reality” based world.”

    You mean ones who dream about Universal or affordable healthcare right?


             
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  9. Mikmik Says :

    “Of course, every society that has promised all of these things has been a ridiculous soviet-style failure.”

    Sure. WTF is your problem. You will be begging this soviet style failure for Oil, water, and food in ten years. I have never had to worry in my life about whether I or any of my countrymen were considered worthy enough to deserve a doctor, place to sleep - even call home, or something to cook in that home.

    Your country is turning into a cesspool, you know that, I know that, the whole world knows that.

    Your country is moving in the opposite direction from all the Soviet style failures you talk about, bevause we have better quality of life, and longer life expectanvcies than you.

    We can hold our heads up high with pride because we choose to have a country where we value people more than money and property.

    I don’t have to worry about fucking insane idiots trying to push christianity into our schools, or our Government.

    I look at our scandals, which I though were bad, and laugh now because we are so pure compared to your corrupt society, because we are not as simple as you wish the world is and try to treat it.

    That is the fucking problem with your whole country, and not everyone by a long shot is simple, but Libertarians can be simple and idiotic just as much as freeper, or they can be sensible, and know that being a little bit considerate of those less fortunate, and providing them with a gaurantee that they will not be left to die or get second rate or no medical attention if they need it to live or even just get better.

    Because My Soviet style Failure, that provides the medical care, the shelter, and the food that you ridicule makes my country what it is, and my world what it is, I would never trade places with your finacially or morally bankrupt society in a million years.

    And FYI… the one correlation, in fact proven cause and/or link, that gives my country, and Holland, and Norway, and etc., etc, longer life span, and better quality of lives, is because we have our rediculous Soviet Style failure approach.

    So even if you somehow get the twisted notion that there would be no poor people if we let them die and fend for themselves, we know that the world is not a simple black and white place and we know that we are actually being selfish AND humanitarian at the same time, by having the balls to realize that helping others helps everyone.

    You just don’t get it, do you, you just can’t get past the shallow thinking, it’s in there somewhere.

    I agree with almost 100% of the stuff I read here, and I love the site LewRockwell, and Antiwar.com, but I just sort of shake my head when yet another irrational freak characteristic shows its ugly head like a discovered brain tumour that was there all along.


             
    Comment score: 4.5
  10. Jersey McJones Says :

    10 Simple Points Favoring Universal Healthcare

    #1 Most everyone needs healthcare at some point or another. If you are dumb enough to think that you are somehow the exception to that rule, then the likelyhood of you hurting yourself doing something stupid is even greater.

    #2 The Cheapest and Fairest Insurance Pool is the one with the most Participants.

    #3 Because we have a Corporate/Insurance/Pharmy Triopoly controling prices through Selective Pooling and Antiregulatory controls on the Pharmies (a private insurance company can negotiate drug prices but Medicare can’t…), it is too expensive for an Individual to purchase Insurance. An Individual can not compete with a Selective Pool, or any pool, really.

    #4 The per capita GDP spending on healthcare in america is 14.6%, compared to 7.9% in the rest of the developed world, and is the most expensive at around 1 Trillion dollars.

    #5 Insurance companies make some 200 billion in profits annually.

    #6 Fraud could attribute for another 100-250 billion, much of that fraud is prepetrated with either the passive or direct abetting of actors among the Providers, Insurers, Employers, or the Pharmies - and sometimes it’s institutional (that’s when Eliott Spitzer gets into a mood).

    #7 The 6.7% difference between the per capita spending in the US and the rest of the developed world is roughly the the amount of profits and incompetence of the Insurance Industry.

    #8 All we really need from Insurance is Risk Assesment and Actuation - that is to say: Estimating the costs of illness, stupidity, and disaster, and checking to see if claims are kosher. American Insurance has failed at all.

    #9 A universal system, with competitive private actuation and realistic governmental risk assessment, would have the largest pool and could negotiate prices with manufacturers and the AMA et al could negotiate face to face with a single payor, and there would be incentive to process claims in good order.

    #10 Actual healthcare costs per individual do not vary much state to state as the human body tends to be the same state to state. Therefore, a national system is meritted.

    JMJ


             
    Comment score: 5.0
  11. Jersey McJones Says :

    Oh, and Mr. Rogers, the vast majority of liberal people are pretty educated - we know that there is no Constitutional Right to Healthcare. We say that it SHOULD be a right, but not that it is. It is a Right in most other Developed Nations, but that’s because most of those nations have Constitutions that were written in the 20th century. They also have the Right to Education, as we should.

    The Constitution might have to be amended to get these human rights, but, in the meantime Federal Law could do the trick. And it doesn’t mean the end of the Insurance Industry. It just means that they’ll been accountable and have to do a better job.

    One thing I learned a long time ago - beaurocracy is bearocracy and corruption is corruption where ever you go - public or private. With real competetive actuation, where contracts are won and lost based on performance, corruption and waste could be greatly reduced.

    Universal Healthcare isn’t just some dopey conservative-like, simplistic, sound-bytey plan. It’s a comprehensive change in the system whereby the least possible damage is done in the conversion.

    JMJ


             
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  12. John Rogers Says :

    Well, I’m sorry that I can’t respond to each person individually. But I will try to summarize the points I see.

    1.They do it in Europe, why not here?

    Well, Europe has had a great deal in the last few years. Their defense has been paid for by the US, and they have had the right to sell their goods freely here. This has freed them up to spend money on health care.

    And spend they have: the budget of the average European country is dominated by the costs of health care. Yes, they can use government power to control prices. But only on technologies where someone else has paid the costs of R and D.

    That “someone else” has usually been the US – we spend more on health care than anyone else – and naturally, because we dominate pharmaceutical R and D: all of that research is being done here.

    An interesting variation of this argument has sprouted recently: since other countries spend so much on health care, they put companies in the US at a natural disadvantage: after all, American companies – unlike their competitors which benefit from national health care– have to pay for employee health care. This will eventually cost American jobs.

    Unfortunately, these people are right – partially. But I’m not worried about competition from a bunch of lazy Europeans. Look, I have yet to see any business publication that is worried about the competition from a has-been continent, larded with social programs and suffocated by demographics.

    I’m more worried about India and China – two billion people who think an 18 hour day is luxurious, and whose idea of health care is a bottle of aspirin.

    My job is threatened by them – not the geriatrics in Europe.

    But you know what? I hope India and China grow. And grow fast. Their growth over the last three decades has accounted for an interesting phenomena: the number of people living on less than a dollar a day (adjusted for inflation) has been cut in half in the last thirty years.

    A world that is wealthier is likelier to be more peaceful.

    As the father of two boys who might someday be soldiers, I think that is worth spending a few years working at Walmart.

    2. They have to be able to do it, I need it!

    These are the hardest points for me to deal with. I am, after all, a recovering liberal. I’d love to be able to save the world. I once joined Plowshares, and dreamed of joining Greenpeace. I did spend time in the Peace Corps (Sierra Leone, 1991), and perhaps that was my undoing.

    I have watched the public debt grow to an unbelievable level. Medicare will default on its promises within two decades, and Social Security will follow shortly thereafter. Anyone who depends on the promises of these two programs is a fool.

    In the wake of their defaults, they will leave trillions of dollars of money owed. That money will be paid off by my children.

    They have done nothing to earn such a debt. They can’t even vote yet.

    Yes. Life is sometimes unfair. Sometimes, death claims people or disease causes great pain.

    But that does not mean you can pick the pockets of generations who can not yet speak for themselves.

    I’m sorry to be so blunt, but that is just the way it is.

    3. You are an asshole. How dare you try to tell me I can’t have the best health care?

    Here’s to you Mikmik. Maybe someday you’ll a simple maxim: the first person to stoop to insults is the person who just ran out of ideas.


             
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  13. Cranky Liberal Says :

    John, good points. It still doesn’t answer how France can spend less per person than we do and have UNiversal Health Care. Or England, Canada,or any other country with that system. That’t the flaw in your argument. You say that “They have ben getting a free ride” and I agree. We on the other hand have been getting the equivalent of a dishonest cab ride in a town we don’t know during rush hour. We spend more, not less - so all the money that they spend - big deal. If they were spending MORE per person than we do, then your point works that we would be subsidizing them.

    Yep they pay less for medicine because OUR drug companies sell it to them for less? Why? Because they love Europe? No, because of the same reason Wal-Mart sales toasters cheaper than the Mom and Pop store down the road, they can negotiate a better deal. The drug companies don’t have to sell there. If they need American’s to subsidize England, then change that dynamic. Here we get no such break. Look at the new Medicare perscription drug plan that forbade that institution to negotiate drug prices? Why?

    Using India and China as a reason not have Universal Coverage is crazy. That would argue we should do away with all insurance period and just let people who make enough money go get health coverage. Of course those countries have some for of health coverage for their people (sad as it is, and India is looking at increasing spending). They are not the model we should follow. WE need to be the model they adopt. I do not want our country to emulate the third world, do you? And I more than most peopel in well versed int the competition they present.


             
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  14. Liberal Jarhead Says :

    There are some elements to this conversation that are seldom brought up.
    The first is that health care would cost a lot less if it was really health care - what we really have here is sickness care. Every additional dollar we invested in health promotion and illness prevention would save several dollars of treatment. Of course, a lot of that would involve lifestyle changes that would not require drugs or professional expertise. That would be hard on the pharmaceutical companies and the doctors, who use their deep pockets to keep things oriented the way they are.

    The second is that a big piece of reducing sickness would be better environmental regulations, and we know how eager big industries are to be regulated and how good legislators are at putting the interests of their voters ahead of the wishes of the lobbyists who pay for their campaigns. Typical case: as was reported a few years ago in Censored, the annual report on stories that should have been major news but were ignored by the supposedly liberal mainstream media - the annual Breast Cancer Awareness Month activities (all those media ads, ribbons pinned on people’s clothes, earnest pleas for women to get mammograms and early treatment) are funded by a large chemical company (I don’t have the book handy or I’d give the company’s name but it shouldn’t be hard to track down.) Any organization that gets any of that funding has to accept the stipulation that they can talk about diagnosis and treatment all they want, but they are not to mention looking for causes or ways to prevent breast cancer. That company happens to be the world’s biggest manufacturer of the chemical considered to be the carcinogen responsible for more cases of breast cancer than any other pollutant. Just to put the cherry on top, the same company is the world’s biggest manufacturer of the primary medication used to treat breast cancer! Nice racket they have going, eh?

    A third is that by failing to make routine preventive medicine available to a lot of people, we guarantee that they’ll end using the ER for their medical care, which is the most expensive way to provide it. We as taxpayers and insurance policy holders end up paying for that ER care anyway; so in that sense we are providing a half-assed and very inefficient form of universal care. We’re just doing it in about the most expensive way I can think of and causing a lot of needless suffering in the process.

    Finally, there are horrible amounts of administrative/bureaucratic overhead caused by the natural tendency of any organization’s executive level to grow and feather its own nest, and of chiseling caused by the profit motive leading insurance companies to deliberately and systematically minimize and delay benefits payouts as much as they can. I work in a field that depends on this system (I’m a psychotherapist) and every time I’ve had to spend hours on the phone arguing with HMO case coordinators to get approval for basic treatment for seriously mentally ill people whose families were barely scraping by, then drive home past those companies’ beautiful new glass-and-marble office buildings with parking lots full of Lexuses and Beamers, I’ve gotten so pissed I’ve ended up beating on the steering wheel, and I’m a pretty laid-back guy. It’s a relief to be working where I am now, in a mental hospital for severely disturbed inmates in a state prison, because I don’t have to deal with managed care.

    Our system in this country is broken. Some of the problem is indeed because technology and science have advanced to the point where things are possible that are so expensive that it will never be possible to provide them for most of us. But that’s a relatively minor piece of it. Single-payer universal health care systems have problems; they aren’t panaceas - but they’re better than what we’ve got. The only person I’ve talked to lately that had serious heartburn with that concept was a psychiatrist who makes $280,000 a year and draws great glee from telling people who make a mere five figures about his salary, and his reasons were all about how it would affect poor little him (he actually expected me to sympathize and was offended when I didn’t!) We hear a lot from American doctors about how awful Canada’s system is, but when I’ve talked with medical professionals from Canada, they’ve laughed at that and said they’d take their system over ours any day, as either professionals or patients.

    Watch out for deception and fallacies in what people say on this subject. Things like offering false choices (it’s either what we’ve got, or the most horrible alternative they can find); straw man arguments (making up a ridiculous distorted version of what the other person said, then refuting that instead of addressing what he/she actually said); and arguments ad hominem (attacking the person rather than addressing what he/she said).

    I also did a fair amount of management consulting in process improvement when I was a program manager for the state health department, and one of the truisms we used to teach to community groups is that every system is perfectly designed to produce exactly the results it produces. If you want a different result, change the system. This system is perfectly designed to produce obscene profits for pharmaceutical and insurance companies and six-to-seven-figure incomes for doctors, freedom from regulation for the polluters who cause a large share of health problems, and very poor health outcomes for the working class and lower-to-mid middle class, along with horrible health-benefit cost problems for small-to-medium-sized employers. If that’s what we want, we should keep the system we have.


             
    Comment score: 5.0
  15. jerseymcjones Says :

    Mr. Rogers, please feel free to look up any and all of my numbers. They come from reliable sources. So either stop lying, or get better informed. It’s one or the other.

    Europe’s defense is not paid by America. We are simply sitting on our hands over there. There is nothing to defend them from and there hasn’t been in a generation. If we left tomorrow, they would spend very little to defend themselves against the nothing that we are defending them from. Typical Cold War rhetorical bullshit.

    The taxpayers pay for R&D too, the pharmies spend about $200 billion. That is NOT the reason we pay more for healthcare in America, as the R&D numbers are the same per capita in the rest of the developed world. Educate yourself.

    And you’re “not worried about “competition from a bunch of lazy Europeans,” huh? First of all, in all likelihood, you are a European, so grow up and stop being such a jingo. Europe IS our number one competitor in the world. They have a trade surplus with us and their goods tend to be of higher quality and sell better internationally. Productivity in Europe is roughly the same as the US. Put down the shit rags and read a real journal.

    And you’re “more worried about India and China – two billion people who think an 18 hour day is luxurious, and whose idea of health care is a bottle of aspirin,” huh? Yeah, you should be, the sleazy con scum, like those at CATO, are in a race to bottom against those guys. And if your job is threatened by Indians and Chinese, perhaps you should look at the cheap labor sleazy con scum as the problem and not the solution.

    Yes, it’s good that India and China are growing. I agree. But even they are concerned with the value of our dollar, which they need for export and investment, as we are run by a bunch of whores in Washington these days, selling off and cannibalizing the American dollar in the name of short-term gains for the real powers that be.

    Yes, it is true that “A world that is wealthier is likelier to be more peaceful.” Thankfully.

    “As the father of two boys who might someday be soldiers, I think that is worth spending a few years working at Walmart.” I don’t even know what that means…

    If the cap were lifted on the payroll tax, and unearned income was fully taxed, and the military was pared down to what the Founders envisioned (again the sleazy hypocrite cons forget THAT), SS and Medicare would be fine. Period.

    The only unnecessary debt your children will be paying is for the sleazy con tax cuts and war spending. That adds up to EXACTLY the borrowing the govt is doing now. Look it up so look smarter in better circles.

    You are not “picking the pockets” with national health insurance any more than you are with private insurance. Healthcvare for all, like education for all, is in everyone’s interest. In fact, you would be picking you less because there would be no profit margin.

    How dare you say that anyone shouldn’t have the best healthcare. Who the f’n hell are you? Why should you have any better care than anyone else. What? Are you are satanist or something?

    I know this was for Mimik, because you obviously lack the accumen to take me on, but I had to respond. You are either ignorant or lying, and I suspect it’s a combination. There is nothing worse than rationalizing preconcieved notions born of purile, narrow self-interest.

    I will respond to anything you write this way.

    Ciao!

    JMJ


             
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  16. jdhunter Says :

    National Health Corps.

    Fantastic opportunity for bright people who WANT to be HEALERS:

    Send Contractors to medical school (nationalize all medical schools.) Contractors get national license. Contractors work for a salary (100k tops) for 20 years. Anyone bails out loses their license. Private agents may compete (service at NHC clinics is free.)


             
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  17. John Rogers Says :

    Jersey McJones:

    You’re so angry and pissed off I have no desire to listen to you. From my point of view, this is what you sound like:

    “Look asshole, I deserve my health care, the best health care in the world, and dicks like you - working with Chimpy McHalliburton’s Amerikkkan conspiracy - are trying to keep it from me. Look, the site proves everything you say is wrong:

    http://www.tofugarden.org/raggedyanneliberals.

    See there! Those numbers are true! In your face, pal.

    And check this out: http://www.Ilovewindfarms.com/nationalheathcare

    Told you, you pecker. Go to hell, asshole. You got to learn to tolerate peace, love and understanding, you neo-con piece of butt cheese…”

    Would you even bother talking to a person like that? I wouldn’t.

    If you want to debate, I’m here. If you want to convince me you are right, feel free. But when you come at me with your regurgitating liberal opinion with a helping of insults, I tune you out.

    So next time, chill out, have a decaf and slow down.

    Maybe I’m retarded, but I like to tackle these points one at a time.

    Without the hatred.

    P.S. I’m sorry I thought you were a girl…


             
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  18. mulligan Says :

    Well, I was going to make some of the points that Liberal Jarhead made but he beat me to it. He also did a better job than I could have.

    When I was a kid my parents took me to the doctor at least once a year. It didn’t matter if I was sick or not. At least once I went to make sure that everything was still good. Was I up to date on shots? What was my height like compared to other kids my age? My weight? It was called my annual check up.

    As an adult, I don’t get one of those because my insurance won’t pay for me to visit my doctor for a “wellness” visit. Except, that is, for that visit related to being a woman, that is.

    As for the rest of what I was going to say, just go back and read Liberal Jarhead’s comment.

    To his comment I say “Ditto.”


             
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  19. Jersey McJones Says :

    Mr. Rogers, I’m not angry, just impatient.
    Look John, I have very, very good insurance because I’m relatively skilled - but also because I earn a little less than my industry’s average - and I also have far, far better overall benefits than in almost any industry.  And I’m very healthy, outside of a few physical injuries.  But I understand how fickle our human light can be, so I make sure my electric is paid.  I believe EVERYONE should have what I have - even you.  You apparently are not a Golden Rule man as much as myself.  We can work on that.
    I would not argue your numbers with you, nor have I.  I only argue the context in which you place them.  You are rationalizing in an almost adolescent way: "But Dad! All the guys are going to the party!"  You can play with numbers all you like, but if you can’t explain the other numbers then you don’t understand any of them.  Prove yourself and show me where the trade, accounts, and annual balance deficits go.  Show me here this war is going.  Go ahead.  I’ve got the numbers AND the extrapolations - let’s see yours.
    Fuck peace, love and understanding.  I want Empirical, Provable, Evidentiary, Logical, Pragmatic Problemsolving - not simplistic, tunnelvisioned, sound-bytey, CATO-esque Corporatist Apologetics from a sycophant.  You can fiddle in front of the fire all you like, so that when you tell me that you are tuning me out, you are telling me something I already knew.  Tune me out at your own peril, John.  It’s just another thick brick in the wall.
    No hatred (bait ‘n switch con-word), John.  I’m just not your typical "liberal."  In fact, unlike the dunderheaded zombies of the grassroots Right, there is no such thing as a typical liberal.  That’s why, historically, Liberals are the ones who do all the great things and conservatives are the ones we don’t even remember anymore - or worse.  That’s also why I may seem hot, caffeinated and fast to your average conservative.
    Or perhaps you are not the average conservative…
    Don’t give up now, Mr. Rogers.  ;)
    JMJ
     
     


             
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  20. John Rogers Says :

    Jersey:
    Very well. But I’m not going to engage in arguments where "fuck you asshole" counts as a clever retort.
    Now please go slow wih me, because I am slow.
    Now what is your first problem with me? One at a time please.


             
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  21. Jersey McJones Says :

    I hold no personal grudge against you, John.  In fact I’m damned giddy that you’re here.  I love debating, and it’s all the more fun when opposite spectrums come to the fore.

     

    And you’re obviously not slow - coy, but not slow.  ;)

     

    My only “problem,” would be that you are not taking the fight all the way.  You have to be able to answer contrarian points, lest you seem like a high-end troll, posting well and then taking flight.

     

    I gave you ten points, earlier, you have yet to step up to most of them.

     

    Let’s go!

     

    JMJ   


             
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  22. John Rogers Says :

    Jersey: one point at a time (Cranky, this is kind of response to you as well….):

    Most everyone needs healthcare at some point or another. If you are dumb enough to think that you are somehow the exception to that rule, then the likelyhood of you hurting yourself doing something stupid is even greater.

    Everyone needs food and shelter too. Do we organize a massive state-controlled program to see that everyone gets a 4000 sq. foot McMansion and vouchers for three meals a day at their favorite restaurants?

    No, we don’t do that because it would be silly. Millions of people would quit their jobs to live on the dole. I’d love such program if it could work. But it wouldn’t. Yes, there are programs like food stamps and section eight housing. But most people can do better than that.

    My point is this: if you want to offer people drug coverage, for example, it can’t be the same drug coverage that rich people get. That sounds horrible, but it is true.

    Why not?

    There currently 45 milllion people in the US who lack health insurance. Let’s say we decide to pay for all their drugs! Yippee! Sure, Medicare costs $500 billion a year and it is still going bankrupt, the budget deficit is $400 billion, the baby boomers have just started collecting Social Security, and every middle class family is struggling to make ends meet (at least according to our media), but we are the richest country in the world. All those diabetes drugs, statins, beta blockers, proton pump inhibitors, asthma pills will cost…I don’t know …hell, $100 billion. No problem.

    But whatever bill you think you’ll pay will grow. And it will grow very fast. People who now struggle to pay for their drug insurance will stop. Why? Because the government is giving them a better deal. No insurance company premium can match the government’s – which would paid by other people. Those anonymous taxpayers. Companies that offer their employees drug coverage would stop doing it. Why? Because they are greedy bastards. Well yeah, but they are logical, greedy bastards: why would they pay out something in benefits that the government is giving away for free?

    And pretty soon, you reach a point where going further and further into debt is no longer an option. This is hard for Americans to take, but the world won’t keep lending you money forever. When it looks like you are going to have trouble paying off your debt, your bond ratings go down, and it becomes more expensive to service your debt. (Ask California: it’s bonds are approaching junk status.)

    So we will have to raise taxes. You can raise them on the rich, but the rich find the loopholes. Jackasses like John Edwards make $300 million a year and only pay 12% of their income in taxes. (of course, we could just hit the rich at a flat 30% rate and eliminate their deductions, but I imagine “flat tax” is a dirty word in these parts. It shouldn’t be).

    But you will find that there aren’t enough rich people, and you will also find that the more you tax them, the less they invest, and the less the economy grows. As the economy slows, you have more people out of work - and most of the people losing their jobs tend to be poorer to begin with - more people applying for government aid.

    Soon you have to raise taxes on that “struggling” middle class.

    National Health Care - taken in the context of ALL government obligations - would be a disaster. We already face disaster, but it would make it much worse.

    But why can’t it work here? They do it in Europe!

    Yes, they do it in Europe. And through the process I just described (which is already quite advanced on the continent), we could look just like them. Europe’s high tax economies have been stagnant for a decade (gee, I wonder how that happened?) and they have double digit unemployment (we haven’t seen that since the Great Depression). And the picture is even worse for young people for whom the unemployment rate is more like 1 in 5. Europe is dying (literally, it will soon come to a point we won’t see until 2030: for every old person on a pension, there will only be two workers).

    Following Europe is suicidal.

    Our competition – like it or not – will come from low wage, low benefit countries. You can stamp up and down and wish really hard that it wasn’t the case. GM and UAW are learning it now. GM was once “too big to fail,” and it made some really big promises. Promises that it can’t possibly keep today. Trying to keep those promises is preventing it from competiting in the marketplace (in economics, competing in the marketpalce goes under a highly technical term: economists call it surviving).

    I get the feeling many of you feel the same way about the US government. Our government has already made too many promises.

    Making more will only hasten our demise.

    Instead of talking about offering more government benefits, we should be talking about means testing the ones we already give out.

    For example, do rich senior citizens really need Medicare or Social Security?


             
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  23. Jersey McJones Says :

    Okay, you’ve got a lot there.

    You make the argument, right off the bat, that healthcare has a wide tolerance of quality like by the analogies of shelter and food.  A successful society does not tolerate homelessness and starvation because they are symptoms of, and stimuli to, further social ills.  So, we need set a baseline standard, not qualified by best/worst or cheapest/most expensive, but qualified only by what a person needs to live and have the opportunity to be productive.  It’s a give and get, not unlike that of a healthy family - regardless of wealth.  Education should be treated like this as well.

    For healthcare too, there need be a baseline standard.  Again, not qualified by subjective factors like “best/worst” or cold calculations like “cheapest/most expensive,” but only but what a healthy (literally & figuratively) society needs to continue and succeed.   No, of course a baseline would not include boobjobs for insecure but otherwise healthy women.  But then, neither is some Communist state that you seem to think Liberals desire.  Really, you need to try to understand that you currently do not understand what the hell a Liberal is, and what the Golden Rule is too.  You throw me a little with some of the things you say.

    Anyway, the thing about healthcare is that everyone NEEDS roughly the same thing.  Rich people could still buy there own insurance for their boob jobs and tummy tucks, but when it comes to needing a kidney, to say one man’s life is worth more than another’s because his bank account is worth more than another’s, is to show serious moral and ethical deficit.  Think of it this way - how much do soldiers make?  Is a fake eye for a man who lost it in combat less worthy than a fake eye for one-eyed heiress?

    Now, we spend 14.6% of our GDP on healthcare now.  The rest of the Developed World spends 7.9% an average.  And yes, we are the most expensive single nation and that by several points.  That’s a 6.7% difference from average.  Around a half-trillion dollars right there, per year, as far as our money is concerned.   There is no friggin way in wackyland that you are going to tell me that our system is some 90% better, in whatever terms you’d like to apply, than the average of rest of the Developed World.  I mean, come—on.

    And you sort of answered yourself, to my delight, with your last question.  Should social programs be means tested?  Sure!  Take that baseline again - no subjective standards.  If a man lives in a mansion, does he need rental assistance?  No.  Should he pay the tax for others to have rental assistance, for a time, if they really need it?  Yes (he still may need it someday).  If a man retires a multi-millionaire, should he recieve SS?  Wouldn’t it not just be taxed away anyway?  No and yes… anyway.  All this on a progressive sliding scale now, no simplistic toggles.  Onto Healthcare - Should a very wealthy person still have to pay taxes for the baseline for all?  Yes (he still may need it - and probably will, the way things are going).  Should he have to purchase his own insurance if he wants elective services?  Yes.  Does everyone deserve the right to the same standard of quality for NEEDED services?  Yes.

    You have to answer me these things:

    If you are measuring the quality of healthcare by the amount we spend on it, thereby justifying the almost 50% more for it that we spend on average, than would you argree that we should spend that much more on Education, since there’s no way in heck that you would dare say that our education system is 90% better than the rest of the Developed World?  Or shall we privatize that too?

    No other country does that - and they’re almost all better than us at education.

    Castro’s wacky funland over in Cuba is famous for it’s healthcare and education, which are ranked among the best in the world.  Why do you think that is?  If Castro was everything like an American capitalist - except for his handling of education and healthcare - would you find his approach more appealing?  Why couldn’t that happen, if you say it can’t?

    JMJ

     


             
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  24. John Rogers Says :

    For healthcare too, there need be a baseline standard.

    Well, I’m glad we agree on that. But a “baseline standard,” by definition, is not top quality. At some point, you are going to have to tell people on public assistance “no, you can’t have that.” Every country that has a “universal” system rations care – usually for the elderly. It’s a necessity. Even then, most of the country’s of Europe have done it so poorly that the costs of government obligations have overwhelmed them.

    The problem? The baseline standard has to be high enough that it is humane, but it has to be low enough that it will only appeal to the most desperate.

    Make it a really attractive option, and everybody will try to take advantage of the government program – and costs will explode. Our government cannot afford another program metastasizing out of control. We can’t afford the ones we already have, and they must be reined in.

    Or future depends on that.

    I thought health care was pretty good in 1980. Why not guarantee every American a standard of health that resembles that that was only availableto the super rich in 1980? It would be affordable (all the drugs are generic), but it would be considered horribly cruel. At some point, someone would have to say “yes, we have a drug that could take care of that, but we can’t give it to you.”

    No one wants to be that person. That is the problem.

    We are not talking about “boobjobs” and “tummy tucks” here. We are talking about life saving therapies.

    Now, we spend 14.6% of our GDP on healthcare now….. If you are measuring the quality of healthcare by the amount we spend on it, thereby justifying the almost 50% more for it that we spend on average, than would you argree that we should spend that much more on Education, since there’s no way in heck that you would dare say that our education system is 90% better than the rest of the Developed World?  Or shall we privatize that too?

    I’m not defending the current system. There is nothing market oriented about it. It’s kind of hard to have a market if you don’t know the price of anything.

    And America is getting a raw deal. We do spend more than anyone else. On everything. Education, entertainment, military, police, dog food, energy prisons. …

    I have yet to hear liberal note – correctly - that we spend more money per student on education than anyone else in the world and that our students are nowhere near the top in international surveys. Both facts are true.

    That might be taken as indictment of our mediocre public school system

    Are you suggesting that our public school systems need reform because we are not getting our money’s worth?

    Good. I agree.

    Castro’s wacky funland over in Cuba is famous for it’s healthcare and education, which are ranked among the best in the world.

    This is one of the silliest myths out there. Cuba’s system is fine if you break your arm. But if you have breast cancer, you are as good as dead. If you have heart disease or a stroke, you’re done for. Hell, if you have AIDS, you are quarantined until you die.

    A doctor is only as good as the drugs he has in his hands. Wonder drugs cost money, and Cuba doesn’t have any money. On the entire island of Cuba, there are two MRI’s – and they are mainly used for VIP’s. My local hospital has three.

    You sure you want that system here?

    When Saudi multi-millionaires need health care, they could go anywhere in the world. Where do they go? Cuba? Not a chance. They come here.

    There’s a reason for that.


             
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  25. Jersey McJones Says :

    Again with the “quality?”  How can you measure the quality of one kidney transplant over another?  Or, for that matter, one kidney over another?  They must all be of highest quality possible.  There are no Rolles Royces of kidneys.  There’re all the same. 

    And you would say to a poor person, “No, you can’t have that kidney, a wealthier person can pay for it and you can’t?”  Would you say that to a 5 year old poor child in comparison to a 95 year old wealthy man?  Do you see the classist, “let them eat cake,” callousness of that assertion?

    And why should it be a welfare issue?  If everyone deserves the same quality healthcare for the same ailments that we all get, rich or poor, why should one be favored over another?  If everyone is paying into the system, does not the wealthy person actually get a break from the cost of paying for only himself anyway?  Does it matter what kidney it is, as long as it works?  And how does anyone lose in a single-pool, single-payor system?

    You’re points about Cuba are specious at best.  The only reason Cuba ever suffers supply shortages is because of the embargo.  Period.  Everyone knows that.  Cuban physicians are among the world’s top and with the right equipment would be more proficient than even American physicians by all accounts.  If the embargo was lifted, Cuba would make a fortune just from tourism alone.  Very specious, John. 

    Now, I’m not a Castro apologetic.  I’m just pointing out that an honorable civil profession is just as fulfilling as a private one.  It’s true they quarentine AIDs, but they are on an island, AIDs is killing off small nations similar in demographics to Cuba, and the quarentine is in apartments where the quarentined people live with their families and friends.  It’s not nice, but it isn’t the comic-bookish, evil supervillian-type thing the fantacial anti-Cuba Right would have us believe.  

    Now, I can see by your cancer metaphor, that you believe that all government programs are inept (except the military, right? Of course), and everything social-statey should be charity and/or privately run.  You distrust our government because you have an innate dislike for our representative government and the ability of the people to work collectively toward common goals - opportunity (education, healthcare, baseline food and shelter).  You believe that charities can do it?  Did you know that charities put in about 2 billion a year in America for food, for example?  That’s great, right?  Well, the actual need, that the government flits in the rest for, is around 60-80 billion.  Charity doesn’t come CLOSE to covering it. 

    As for schools, it is the very notion that somehow localities should pay for education - “Home Rule” - that causes the system to suck.  What we have are cookie-cutter copies of schools from town to town, instead of regional systems paid for evenly by a Single Payor.  That’s what they have in competitor nations, that’s why they succeed where we fail, and you, you sir, would go even farther in the wrong direction and make school something for only those that could afford it.  You must have some sincere desire to turn America into Somalia.  

    The fact is, we are the only Western nation with this sort of private healthcare.  We have a massive trade deficit because we saddle the burden on our employers.  We spend almost twice the per capita GDP on healthcare as does the average of the Developled world.  Our life expectancies are lower than the Western World.  We work more than them to have the things we have even though all we really have to show for it is toys.  If our system was better, it would be more cost efficient and our life expectencies would be higher.  So, by all measures, our suystem sucks, just like our “local” property-tax based education system sucks, but you want to make it even suckier by making the worst parts worse and the parts that work for everyone else absent?  Jees.      

    And yes, we know where the Saudis go.  After all, Bush gave them pictureless fast-track visas to come over here and fly planes into buildings in New York and elsewhere.  I’m sure there are Cuban doctors who have treated Saudis.  Doctors are a major export of Cuba’s.  Yet they still have plenty… hmmm… 

    JMJ


             
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  26. John Rogers Says :

    Jersey:

    Again with the “quality?”  How can you measure the quality of one kidney transplant over another?  Or, for that matter, one kidney over another?  They must all be of highest quality possible.  There are no Rolles Royces of kidneys.  There’re all the same.

    So I suppose a kidney transplant in Buenos Aires is no different than a kidney transplant in Los Angeles? The hospital, rates of hospital acquired infection, on call staff, heart monitoring, anestesthia, after care, nursing…

    Of course not.

    Drugs are simple. Look, there are new drugs – which are amazing (and amazingly expensive) and there are older generics, which were the best a decade ago, and are still pretty good.

    One is “high quality” and the other is not that bad, but still second best.

    And you would say to a poor person, “No, you can’t have that kidney, a wealthier person can pay for it and you can’t?”  Would you say that to a 5 year old poor child in comparison to a 95 year old wealthy man?  Do you see the classist, “let them eat cake,” callousness of that assertion?

    And you would tell a child in 2020: “Look, we have no money for your school. It’s too bad you’ll never have a real job because of the moribund economy. And it stinks that we can’t keep you safe. But, by the way you owe $300,000 to a generation of self absorbed boomers who ran up the tab and handed you the bill, before they died. And if you don’t pay it, we’ll put you in jail for tax evasion.”

    Now, I can see by your cancer metaphor, that you believe that all government programs are inept (except the military, right? Of course).

    Putting words in someone’s mouth is quite rude. I usually ignore that kind of stuff when I see it.

    For the record: Military procurement is one of the most inefficient aspects of our government, and I have been quite critical of it in the past. The military industrial complex is alive and well.

    Here you go again, putting words in my mouth (that is a sign of frustration): that’s why they succeed where we fail, and you, you sir, would go even farther in the wrong direction and make school something for only those that could afford it.  You must have some sincere desire to turn America into Somalia.

    Whatever.

    You’re points about Cuba are specious at best.  The only reason Cuba ever suffers supply shortages is because of the embargo.  Period.  Everyone knows that.  Cuban physicians are among the world’s top and with the right equipment would be more proficient than even American physicians by all accounts.  If the embargo was lifted, Cuba would make a fortune just from tourism alone….Doctors are a major export of Cuba’s.  Yet they still have plenty… hmmm

    Look, an acquaintance of mine works as Chief of Medicine at a hospital and he has worked with several of these Cuban wunderkinds. They are good at basic stuff. They can treat wounds and soothe the elderly. They are enthusiastic about their jobs. But when he asked, they didn’t even know what a beta blocker was.

    Beta Blockers have been around for- I don’t know – about thirty years. About fifty million pampered westerners take them.

    That’s a true story. And the doctor in question – the Chief of Medicine - is a very liberal guy. That was why he was working with these people to begin with.

    Yes, Cuba is a wonderful haven. So wonderful that people are dying to leave. When they do, they bring their pictures so they can show Americans what the vaunted Cuban Health System really looks like:

    Wanna see?

    I’m sure they are all fakes - and so are the people who took them - all these people in Miami who came over in the Mariel boatlift when Castro said he would not shoot them if they tried to leave his paradise….

    Me, I look at the pictures and I can tell you I wouldn’t want to take a dump in a Cuban hospital.


             
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  27. Jersey McJones Says :

    Mr. Rogers,

    By “quality” I did not mean, nor did I have reason to believe that you thought, we were comparing quality between nations - we were comparing, in that context, the spectrum of quality in the US.  I’d tell you to refer back to the context, but you do get back to it anyway when you use the new/old drug example of quality.  It’s a poor example.  Even today doctors prescribe drugs based upon whatever it is you need.  There’s no ”better” or “worse” drugs.  Either they work or they don’t.  The generics are simply drugs that have outlived there intial patents, or are so vital to society that if whoever holds the patent can’t get the drug out there, the government opens it up.

    You’re whole “quality” argument is both non-existant and comes from a very classist, immoral and unethical place.  I don’t know why you persist to continue along this lose/lose line.

    And then you bring up the cost argument, again, and in ridiculous terms.  We are spending more now than anyone else, our care is not nearly as better as the cost differential, and you claim that doing as they do will break the books?  Can you not observe the obvious falsity of that argument?  You’re system has already failed.  We have 45 million uninsured, many of them kids.  We are cannibalistically profiteering off our healthcare.  The difference in profits alone is 200 billion!  DOES THE INSURANCE INDUSTRY WITH IT’S 200 BILLION IN PROFITS AND 100-300 BILLION IN FRAUD LOSS MAKE UP THE DIFFERENCE IN THE VALUE IT ADDS TO HEALTHCARE?  Do you really thing that?  Is having private insurance, that doesn’t cover some quarter of the population, worth the 300-500 billion in extra cost?  Everyone else is doing something else and you want even more of the status quo.  When can you just admit that your way has already failed?

    As for your second-hand, stereotype anecdote about Cuban doctors, the educated world knows for a fact that the Cubans are among the world’s best.  Period.  You really should look this stuff up, because every Cuban I know, pro- or con-Castro, admits that fact.  I know more Cubans than most people because of where I have lived.  Just because they don’t know how to play with our fancy toys, that doesn’t mean they can’t figure them out fast enough.  As for life on Cuba, I know it is unpleasant, I know it is totalitarian, I know it is not free - I’m simply pointing out that even a poor country like that (poor probably because of the embargo more than anything else) can provide better and more universal care than we can.

    I could show you some pictures of American clinics, hospitals, convolescent centers and the like that would turn your stomache just as much.

    Your arguments here are all seriously flawed.

    Show me even just a quarter trillion dollars worth of value added by private insurance to the healthcare system and I’ll tip my hat.  Until then, your arguments can’t even get off the ground.

    JMJ   

     


             
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  28. John Rogers Says :

    Jersey:

    You had said - basically - that a kidney transplant is a kidney transplant. You know - now at least - that that is not so. There can be differences in quality and cost. The rest is window dressing.

    You seem to continue to belive that the current system is “mine.” I have said repeatedly that we have system where the free market cannot exist - because no one knows how much anything costs. This isn’t my system. It’s a clusterfuck…And it is clusterfuck that is surely bankrupting future generations who can’t even vote yet. You never seem to address that, but I can sense that your frustration is growing (the insults, speaking for me, YELLING, the exclamation points!!!!!)

    As for Cuba, not knowing what a “beta blocker” is more than just a matter of not being up to date on western “toys.” Beta blockers are ancient drugs.

    If it wasn’t for modern drugs, doctors would still be bleeding people with leeches. Maybe in Cuba, they still do this. Not knowing what those drugs are or what they do is a serious flaw…Once they learn what beta blockers are we can go on to second semester med school and talk about things like angiotensin II antagonists and TNF inhibitors. This is high tech shit. You don’t learn it sitting in a backwater dressing wounds and quarantining the hard cases.

    Ask 100 Americans whether they would trust such “a doctor.” Go ahead.  I’ll wait.

    But here’s a question: would you favor a system that gave every American a Cuban level of care? Guaranteed? The average Cuban makes $3000 a year. I’m sure they can afford all the latest therapies on that, with a little help from Uncle Fidel. Right. The GDP of Cuba is $38 billion. They don’t spend real hundreds of thousands of dollars to save cancer patients with modern drugs. They let them die.

    How about this: For every person on the new US health service, we’ll spend the entire per capita GDP of a cuban citizen every year? That is every dime that the average Cuban sees all year.

    $3000 a year. We have drugs that go for $3000 a bottle. Even in Europe. Wonder drugs that are very popular.

    There isn’t enough money on the whole island of Cuban to cover a tenth of our uninsured for a month at what we consider to be an American level of care. You can talk all you want, but the money just isn’t there.

    You want to argue they are getting great care. How are they affording the drugs that we consider the cornerstone of that care? They are poor. Give them a bottle of aspirin and they think they’ve come out ahead. 

    How about a Cuban level of care for Americans on the government tab? Wanna take that deal?

    Something tells me you won’t. You like the idea that everyone gets free- but substandard - care in Cuba.

    You think we could do it in America too: except every American gets free - top quality care, that is: the latest drugs and operations.

    And you don’t see the problem with that? 


             
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  29. Jersey McJones Says :

    Mr. Rogers,

    Nice try with the child psycology.  I guess writing ediquette is a big deall for you.  I will try not to use any creative licence in my puncuation and case, so as not to make you feel attacked.  Jees.

    I’m not “frustrated,” Roger, just trying to get you to address points honestly.  Nice try, again.

    Cuba has no money because of the embargo, therefore their level of care is reflective of that.

    Your anecdote is a pile of bullshit.  Nice try again, though. 

    So, if it isn’t the status quo, and it isn’t what the rest of the developed world has, then what is your brilliant new idea?

    JMJ


             
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  30. John Rogers Says :

    “Cuba has no money because of the embargo, therefore their level of care is reflective of that”

    So which is it? Is Cuba’s care great and cheap? Or substandard, with points for effort?

    Do you want a Cuban level health care in the United States?


             
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  31. Chris radulich Says :

    At a time when many companies are dumping heath insurance and many more are dumping it retirees I see no alternative to a national health care system. What I find suprising is that business are not holloring for it. You can not hear a business report nowadays that does not have some company whining about their health care costs and how it makes them less competitive on the world market. Frequently they say this in relation to european countries. Personnelly I think we need to start including Pensions in as part of this debate. Business have shown that they are not willing to live up to their obligations and do what amounts basically to stealing from their employees.

     

     As for the quality of healthcare I can only tell you that the few canadians and europeans that I have met do not want to trade their system for ours. 


             
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  32. Daedalus Says :

    “3. You are an asshole. How dare you try to tell me I can’t have the best health care?”

     

    Yet that is exactly what you are telling poor people they can’t have. 


             
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  33. Jersey McJones Says :

    That’s exactly what I can’t figure out, Chris.  Why does business allow this burden on itself?  Perhaps because the “insurance industry” is really just an “investment banking” industry.  The same folks in corporate America, who surely would love not deal with healthcare anymore, are heavily vested and dependent on this sector.  You have to figure that most at the very top of corporate America probably make more in insurance/pharmy investments than they pay in taxes.  So it’s a lose/lose for them as they would lose their parasitic profiteering machine and still have to pay the taxes.  Boo-hoo, huh?

    So, they’re robbing Peter to pay Paul, or, in the case of the modern corporatist, they are robbing from their children to pay themselves.

    Mr. Rogers, enough with the Cuba already, okay?  You’re missing the entire point and your way off on a tangent.  The tragic joke I am making here is that the Cuban medical system has a very good reputation according to the world, would have the best if there was no embargo - please look all this up, it’ll take you all of 10 minutes - everyone has fair and cost efficient healthcare, Cuban’s life expectencies are longer, they have more attendents at birth and lower infant mortality rates, and it goes on and on.  The joke?  That we are comparable to a third-world, despotic, isolated island in the Carribean. 

    We are importing doctors from third world nations now, Mr. Rogers, in the vain effort to drive down costs on what has become a margin anyway - the actual net a doctor gets for service.  We are cannibalizing the system - investing in an industry that is just an arbitrary regulatory creation.  You’re a conservative, right?  You know what that means, right?  That is everything the government is not supposed to be about, right?  Either the govt pays the contract or they stay the hell out, right?  This is why Chris and I are confused.  Where do laizze faire capitalists miss this point?  They should be all for change.  The modern system is a regulatory nightmare, and more layers of parasites will only make it worse.  Where you’re missing this, I don’t know.  2 out of 3 people agree with all this.  I’m not a friggin’ loony, Mr. Rogers. 

    Now, let’s hear your answer.  What do we do.  Pay as you go?  WalMed?  Somalia-Style?  You want more of what is proven not to work, and less of what is proven to succeed - which, in this case, is the fairest, most cost efficient system for all.  Where profiteering comes in is beyond me.  Where the “insurance” industry adds all this wonderful value is so beyond me that I will say now that anyone who believes that today’s “insurance” industry adds net value to the healthcare sector is a moron.

    But, of course, you didn’t say that, Mr. Rogers.  In fact, I’m still waiting for your new, un-Cuba related idea…

    JMJ


             
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  34. pia Says :

    Want to go back to something that you said about “poor people and food”  Read in a blog last week that it’s sickening when people on foodstamps use them to buy soda, candy and the like.  It’s unhealthy in large quantities but this was a blanket statement.  Should people on food stamps be only allowed to buy flour, mac and cheese, stuff like that?

    Or should “poor people” be given the right that they have now, to buy any food, until the stamps run out?

    The woman was going to exclude disabled people but you can’t always tell who is, though you can always judge

    Same thing with health care; won’t say how much I pay–it’s a hell of a lot.  I live in Manhattan and the premiums are over a hundred dollars a month more than in the rest of the city–$200 a month more than neighoring counties

    It excludes all dental care, and some medications. I have to get referrals from my PCP for all specialists.  The choices I had several years ago about going to doctors I want to go to no longer exist.  Feel as if this is Medicaid for the wealthy, though I’m not.  Why don’t I get cheaper health care?  Because I live in Manhattan and you get what you pay for.

    It feels as if I’m going broke trying to give myself a limited amount of choices; and no if I needed a kidney transplant wouldn’t be upped on a list or would expect to be

    I never used to believe in national health care because of limited choices; but since all of our choices have lessened, I very strongly believe in it now.

    I can’t imagine what it’s like being on Medicare and having to find a good supplement.  I assume that by the time I’m eligible for Medicare it either won’t exist or the supplement will cover most basics and be as expensive as my premium today

    Many people worked all their lives, had their pensions cut or taken away, and never expected to need Medicaid

    I found your post to be both flippant and unfeeling.  Yes certain medications from 1980 are as effective today as they were then. So is asprin.  The side affects from asprin can be deadly.

    But medicine has evolved much since then; there are more effective medications for many conditions that have less side effects than most meds then and require lower dosages

    What seems to be more expensive now, can be cheaper in the long run.  But that isn’t taken into account.  As a self professed student of history you should know that.  As you should know that all medical costs for all Americans have spriraled out of control

    This isn’t a problem just concerning “poor people”  There are people who go broke just paying for health care because they develop a serious condition and their insurance companies deny them necessary treatment

    Be flippant about it.  Just remember that unless you’re in the top percentages of all wage earners, with a guaranteed for life job and health insurances, or just “rich” this problem might affect you when you least expect it

    Oh right, people should save for these problems.  People do; some people can be insured, have 500k in savings and go through it in one big illness.  Then they go on Medicaid, and become the “poor” people you want to have use less expensive products that might not be as effective in fighting their conditions, and keeping them in remission or just alive.

    What should they do next?

    You made really blanket statements without considering individual variables, and I kind of lose my sense of humor when it comes to discussions about health care and the poor–because we might all end there

    But I guess you’re too smart, and have it all figured out.  If you have a solution please let us know.  Because your argument was about as valid as the woman’s who wants “poor” people to not be allowed to buy junk food–even if the family rations it as a weekly treat


             
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  35. John Rogers Says :

    To all:

    Here are a few of the questions you have asked:

    Why does business not seem to want the government to take care of its employees through a national health system?

    I imagine that quite a few business would love the government to come in and pay for their health costs, just as they would favor any other type of corporate welfare. GM and the airlines would love it. However, the very people who are proposing that the government do that are the same people who raise corporate and other taxes to pay for it.

    Msot businesses know how things are working in Europe. They have subsidaries there. They know  that European growth has been sluggish at best. Nobody is worried about the workers of Belgium, France or Germany taking over the world.

    They are worried about China and India.

    There is a reason why the US is such a better place to invest than Europe. Why do BMW, Mercedes, Toyota, and Honda come here to build their cars?

    What do I propose?

    Alright, so it appears no one really wants Cuban health care in the US.

    You won’t like it, but here’s what the future will look like. Your company probably already has a tax free health savings account. You will save a portion of your income there to cover routine predictable costs: drugs, doctor’s visits, etc. You will have an out-of-pocket maximum that you can spend in any year.

    Insurance will only kick in with the catastrophic stuff. Exactly how car insurance works. Car insurance does not pay for fill up or oil change. Heck, it won’t even pay if your car throws a rod.

    No, you won’t like it. But if you you want to pay for insurance as you have it now, it will be even more expensive than that. Most people will opt for the savings plan mode (many already do it for things like day care).

    The main advantage of this program: it will control costs. Whole Foods has been doing for its executives for years, and it has done just that.

    Suddenly, people are asking their doctors how much things cost. INCREDIBLE.

    You are so unfeeling.  People need Medicare!

    I know. Seeing that the program is going bankrupt, we need let people know that we will not be able to have such a generous program - or anything like it - in the future.

    I’m sorry, but that is just the way it is.

    If I wrote a check to a charity for a million dollars, am I really a nice guy if the check bounces?


             
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  36. Jersey McJones Says :

    John…

    Europe is doing fine - maybe not for multinational, short-term, take-the-money-and-run investors - but the people are happier, have longer life spans, more time with family, trade and budget surpluses, etc.  Fuck “growth:”  it’s just a catch word for “rich getting richer.”  And the powers that be are not “worried” about China and India as they make a fortune of their low-wage productivity.

    Why are foreign auto-makers here?  TO avoid tariffs, John.  Jesus man, don’t you read the financial pages?

    As for your goofball Neo-con ”plan:”  How the fuckin’ are millions of working-poor supposed to put their subsistance wages into Health Savings Accounts?  What, you want another Chilean privatization plan?  Your “plan,” has already failed in Britian.  Read about it, will ya’?

    The reason a healthy nation takes care of it’s least off is to maintain stability and provide the opportuniy for upward mobility and real growth as opposed to the “growth” of the wealthy that uyou can’t seem to differentiate.  It’s logic, not bleeding hearts.

    John, you’ve got a lot of growing up and living to do.  Get around, check out the world, read from different sources and educate yourself.

    You sound like a spoiled little suburban teenager.

    JMJ       


             
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  37. John Rogers Says :

    Jersey:

    John, you’ve got a lot of growing up and living to do; Get around, check out the world, read from different sources and educate yourself.

    You sound like a spoiled little suburban teenager.

    Alright. Very well. Just remember who started with the insults. They are not a substitue for ideas.

    I won’t insult you back, but I will point out that you seem troubled by your own knowledge:

    You know that the country is running huge deficits, and borrrowing money from overseas to finance them (all politicians are to blame for this).

    You know that the obligations our government already has are overwhleming, and they will swamp future generations. We are in no position to embark on great new round of reckless spending.

    You know that Europe isn’t growing, is in decline and faces an uncertain and unhappy future , imprisoned by its own demographics.

    You know Cuba is really a shithole where health care is minimal at best - nothing like the level of care Americans desire.

    Yet you want to believe we can continue to borrow from the future to fulfil the promise of socialism.

    I leave with a paraphased quote: There may very well be times when you need to burn your furniture to heat your home. But when you do so, you should not delude yourself into thinking you’ve found some great new source of energy.

    The money we are spending today is drawn from a check we’ve written to ourselves, forged with the signatures of our children.

    By the time you (and most of this nation) realize that, it will probably be too late.

    The death of a republic comes when people find they can vote themselves money.


             
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  38. jerseymcjones Says :

    John, I’m sorry, it’s just the libertarianism strickes me as youthful indisgression.  Yes, dependent social state is in no one’s interest.  But there’s a time for capitalism and a time for socialism.  The two are no mutually exclusive.  There’s a reason why the constituions of all modern developed nations include the rights to education and healthcare and it’s because people realize that profiteering from such vital human untility is anathema to civil society.  America is just old, that’s all.  We have to catch up with the times.  Do you really want to revert to the status quo of 200 years ago?

    Peace, JMJ 


             
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