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The mirage of U.S. healthcare

August 26, 2009

On healthcare, the White House is struggling with a political riptide that threatens to drag it into deep water.

Americans, as they contemplate change, have suffered a weakness of nerve. The main reason is that nearly two thirds of Americans are apparently happy with their healthcare coverage, for all its deficiencies. Repeated reassurances from President Obama that those who like the existing set-up will not be forced to change, have had little effect.

A change of tactics may be in order. The administration must do a better job of underlining the glaring defects of the existing system. The genius of the U.S. healthcare is in providing the illusion of value and security. For their own sake, Americans must be encouraged to set aside jingoistic claims about having the best care system in the world and look more honestly at its short-comings.

Let’s start with value. Most Americans are blissfully unaware that their healthcare system provides appallingly little value for their money. This is because when it comes to costs, they see only the tip of the iceberg. While companies typically pay about three-quarters of an employee’s family premium — on average $12,680 a year — individuals ultimately bear the burden. In a free market, companies do not hand over to their workers more than they absolutely have to. Money spent on healthcare is carved out of take-home pay or other benefits.

“We pay for healthcare in considerably lower salaries,” Uwe Reinhardt, a Princeton University economics professor, said in a telephone interview. “The system seduces people into thinking care is pretty cheap. We are kidding ourselves if we think that the shareholder pays.”

One measure of this financial sacrifice is that employer premiums are now 17 percent of median household income — up from 15 percent in 2003. From 1999 to 2008, family health insurance premiums rose by 119 percent.

With healthcare costs rising fast, it is small wonder that middle-class Americans have failed to wring real pay increases out of employers. The drag on pay will increase further, according to research by the Commonwealth Fund. The foundation estimates that without reform, the cost of premiums could double again by 2020 — gobbling up still more take home pay.

The second big healthcare mirage is security. If the current downturn has demonstrated one thing, it is the fragility of an employer-based healthcare system. Lose your job — as more than 6.5 million have in this downturn — and your insurance can disappear with it. (COBRA provides only a temporary patch and can be expensive.)

It also means that you can lose your coverage if you get very sick. “Get so sick you can’t work, you can also forfeit coverage,” Gary Caxton, an analyst with Kaiser Family Foundation, said in an interview. The very idea of insurance is to protect you during a crisis. Instead Americans are getting insurance that works only when the sun shines. “The American system is least good at the worst times,” as David Cutler, a Harvard healthcare economist, puts it.

The final illusion is that the healthcare system can be relied on in the longer term. In reality it is taking on water fast. This is most obvious in small companies. Less than half of companies with fewer than 10 employees now offer insurance, down from 57 percent in 2000, according to the Kaiser Family Foundation. For all companies, the percentage is down from 69 percent to 63 over the past 8 years. Companies are also starting to unload a growing share of costs onto employees anyway.

Deductibles for most employees have more than trebled since 2000 — a trend that looks almost certain to continue. This is all before you take into account the prodigious quantity of tax dollars soaked up by healthcare.

As the private sector has faltered, the state has been forced to step in. The result is that America is stumbling toward nationalization.

A recent Gallup poll found the share of Americans dependent on the state for healthcare — including Medicare, Medicaid and VA benefits — had climbed to 29 percent from 26.5 since the start of 2008. If you include the 17 percent of U.S. workers employed by the state, then closer to 40 percent are covered by the government.

Americans need to take a good look at their existing healthcare system, warts and all. It is the administration’s job to hold up a mirror to U.S. healthcare. If they fail to do so, the U.S. will pass up an opportunity to build a system that’s fair, sustainable and offers better value.


Americans are fearful of what they do not understand. It is human nature to defy the essence of change, however, it is apparent that healthcare is in desperate need of some tweeking. Many Americans must decide between paying their bills or paying for healthcare. Many jobs provide health insurance but at such a high cost that it is deminishing the ability for people to pay for food, shelter or utilities. Americans need to understand that President Obama and his cabinet are trying to make it affordable for all Americans to be insured. I personally am outraged by all the resistance. I work in healthcare and have seen retirees losing their benefits, my husband is disabled and I cannot afford insurance while working two jobs. I am raising two children and taking care of my husband while trying to pay for the mere necessities of life. It is less expensive for me at this point to pay out of pocket for office visits and prescriptions than it is to pay premiums for my entire family. I pray everyday that an extreme emergency does not arise. So to those people who are fighting to keep things the way they are I pray that they do not lose their jobs, retire, or become disabled because they have no idea what its like in my neck of the woods. Hey, I understand that we may have to pay higher taxes there is always a downside. However, I would at least know where my tax dollars are going. I would know that I am paying for us to be able to go to the doctor before we are on our death bed. Many Americans do not seek the care of a physician when they are ill because its either that or no house. Then enter the influenza pandemic. President Obama is not God and in the real world things are not perfect, but at least he is doing something. I feel better that he is making decisons and not just watching as we go through struggles. The US economy and healthcare did not just fall apart in one day it is going to take time to make improvements I have to believe that change is a good thing. Change is the basis of America.

Posted by Tami Koon | Report as abusive

The genius of U.S. [here you can just fill in the blanks ... "Education", "Healthcare", "Food Safety", "Defense", "Homeland Security", "Securities Exchange Commission", "Global War of Terror", "Patriot Missile Shield"...] is in *****providing the illusion of value and security.********

Americans must be encouraged to set aside jingoistic claims about having the best [fill in the blanks] system in the world and look more honestly at its short-comings.

Americans were just forced at gunpoint to destroy 700,000 perfectly good motor vehicles that poor people could have used to commute miles and hours a day to some minimum wage job in some urban gulag. That “service” cost $1.8B to Big Auto and Big Car Dealers, but the American taxpayer cost was $4.2B with “administrative overhead”, a 40% Federal markup and that’s cheap!

Most of the Federal programs have up to, believe it or not, a 95% “administrative overhead”, as when General McKierney made the mistake of saying in an interview that the 2007 expenditures in Iraq were $27B and almost nothing in Afghanistan, when here we were told that Defense needed $50B in “emergency funding for Iraq, Afghanistan and *****other undisclosed national security purposes”.**** He was sacked after the elections, and now we have blood-and-guts McChrystal and S.A. Holbrooke saying we need another ‘surge’ of $100B, that’s $200B in one year without any audit, without even justification!!

Yes, American has the best healthcare system, and some of the finest mansions in the world too, but you and I are never going to set foot in them! While the uber rich get the Mayo Clinic, we get bologna and mayo with some quack holding a foreign medical degree nobody ever heard of, wired into the Medicare system, getting paid by Big Pharma to experiment on nursing home patients. Why do you think they have to choke down two handfuls of pills a day?! What a national disgrace, no, an international disgrace, our US “healthcare” system is!

Posted by Timothy Lynch | Report as abusive

As I read through this article and many comments, I hear ‘America is afraid of change’, ‘the system is broke’, ‘the current system is not sustainable’, ‘why don’t we demand something better’, etc. I do not understand why we must turn to the governement for an answer. The government has proven (repeatedly) that it cannot manage social programs effectively or efficiently and, in fact, is running a budget/deficit that is not sustainable. This country was built on competition, supply and demand, and drive for improvement – it is impossible for the government to deliver this because it ‘cannot go out of business’. If you want a taste of a government run health care system, then stand in line at your local DMV or Post Office – I hope you like the customer care and speed of delivery.
PS – Don’t be fooled by the Public Option. If we get a Public Option, the private insurance companies or ‘competition’ will surely be out of business in 5 years – who can compete with a tax-funded Public Option? THEN we will have only ONE OPTION – like it or not.

Posted by EVJ | Report as abusive

@EVJ: UPS seems to compete well with Post Office??

Posted by Raj | Report as abusive

The public isn’t against health care reform. It is the millions that the health care industry is pouring into fighting health care reform that makes it seem that way. I don’t know why so much media coverage is given to the few who protest against health care. It is as if the media have also been paid off to televise protest against health care in order to fool the population into thinking that we don’t support it. How many “red necks” are really against health care when half of them don’t work?

Posted by Avg Joe against CEO's | Report as abusive

EVJ, the only reason private insurance would be out of business competing against the public option is if private insurance can’t do a better job than the public option. It is a public *option*. People would need to choose the public option over private insurance. Now, why would they do that? I mean anti-reform people keep talking about how bad the public option is, yet you seem to be saying that it will be so good that everyone will eventually choose it… so, we shouldn’t be allowed to have it. Huh?

Regarding budget deficits: Only about nine years ago we were running budget surpluses. If the economy starts adding more jobs than it’s losing by the end of next year, we’ll likely see surpluses again in about six years.

Posted by Kirk | Report as abusive

Health and education. These are the two largest social programs.

Well, we have many private schools, in spite of the fact that property taxes are a major burden (read public school tax). If good private schools can thrive than why can’t good private insurers thrive.

Public “option”? No brainer.


Posted by Barton Poran | Report as abusive

this is just pure hogwash! it is always about the employees these days. nice,,,,but who hires them, trains them , and pays them!!!! the employers costs have gone up much more,,,,,higher taxes, higher salaries, and higher over head! the govt has failed to make Social Security work and they have had around 70 yrs to do so! yet, you think the govt can make a govt health care program work that fails in every country that does it????????? hogwash,,,, worst yet most of these countries are about the size of Texas? where did you get you education??

Posted by brad gillam | Report as abusive

I think the spirit of pursuing a national health care program for all is good, but do not kid yourself!
There are ramifications, both good and bad to deploy such a grandiose task as national health care.

Here are just some issues to consider and ponder.

Who pays for it?

The writer of the article suggest that Americans are not getting value for the health care they have today. While it is true, the cost has gone up and the benefits have been curtailed, Americans still have more choices for health care than most nations. Right now, employers pay for it and it’s typically subsidized by the employee at some level. The proposed new health care will require employers to pay for the national health care in the form of a tax. My question is, do we need to burden businesses and corporations with more tax obligation. If it is more the factor to consider is will this drive more businesses off shore and capital investment dollars along with it, thereby adding to the increasing unemployment roles along with increase strain on the government to provide with a tax base loss?

Will health care services be curtailed?

I have a friend who lives in Canada. He tells me, a doctor’s appointment is like getting an appointment with a King.
It’s an appointment sought with a purpose and when you get it, you sure don’t want to miss it. Canadians will alter their schedule to make sure they make that appointment. Talk to a Canadian and they will concur. Further this friend unfortunately had a son who was badly addicted to drugs. When he sought medical attention, he was told that he would have a 2 year waiting list. He told health care officials his son would be dead if he had to wait that long. When he inquired as to why the length of the wait, he was informed that there were only so many communities with specialized care that handled that type of treatment. He took his son to the States for treatment.

Can we really rely on the US Government to administrate Health Care?

Take a look at Cash for Clunkers. The program was a big hit and consumers cashed in, but the government was overwhelmed and could not keep up with the dealer request for voucher reimbursements. The government could not even provided an accurate accounting with how many vouchers had been received, validated and reimbursed until days after the program was ended. Congress even noted their own deficiency in administrating this program. Now this was a limited time program for $3 Billion dollars. How do you think the US Government will do administering an ongoing program that will spend Trillions? Have you ever talked to a service man or woman?


JGT: Are you kidding, the Canadian healthcare system is better than the U.S. Your newly appointed director to the CMA, (Canadian Medical Association) says Canada’s healthcare system is in a ‘Crisis’. If you believe Canada’s healthcare is so much better please feel free to move back.

Posted by Doug | Report as abusive

For once, an article that pinpoints exactly what it is that the present administration has failed to find: tangible objectives for the health reform campaign. A very well written article that perfectly describes the state of the debate in the United States today; something few other journalists seem capable of doing.

Posted by ISUer | Report as abusive

2/3 are happy? I’m thinking that the stat really translates into 2/3rds are relatively HEALTHY so as not to be aware of how the system works. And it sounds like the other third doesn’t count, even though that’s 100 million people.

The Brits spend between $7K-$8K per person for healthcare and have better outcomes. How about this for a polling question — “How would you like to receive an additional $4K-$5K a year from your employer and have better results in your medical care?”

Posted by Cheryl | Report as abusive

The real issue is our government receives care at no cost to them but from our taxes…It should be available to all people.. Are they not for the people or the insurance company?

Posted by jj | Report as abusive

Liberal minds and liberal thinking.
Americans pay less for health care while the federal government’s deficit increases by 100 billion dollars a year. How is this cheaper ??? Your accounting is irresponsible and mindless. Wakeup Democrats!!


Cheryl is right. Most Americans are healthy, so they have no idea how bad our current system is. Most Americans just go in for check-ups which is usually a no hassle affair. That’s because it is low cost for the insurance companies. Just wait till you need surgery or expensive medication. Then you’ll see who tries to ration care. The older I got, the more horror stories I heard. Then my dad got sick and I got to experience it for myself.

He missed a week of chemo because of his insurance company. It was important that the chemo run concurrent with radiation. How much of my dad’s life will be cut short because of the insurance company’s delay tactics? He’s 100% with a private insurer. Had he been with traditional Medicare with heavily regulated Medigap supplemental insurance there would have been no problem. The thing is he thought he was in a Medigap plan! These private insurance “Medicare Advantage” plans are the biggest scam. Taxpayers pay 30% more to fund them and they provide worse care just when the patient needs the plan to work.

Anti-reform people talk about the fraud that goes on with tradition government administered Medicare, but they never talk about how much of the fraud is recovered by Medicare. See, traditional Medicare pays first so that care isn’t delayed. Then if there is fraud they go and get the money back. It is the recovery statistics that anti-reform opponents use to complain about rampant fraud, but they fail to mention that the government gets the money back.

Posted by Kirk | Report as abusive

Timothy Lynch.

What a post…

I have checked many Blogs, newspaper forums (worldwide) concerning health care for the populace of a particular Nation & have never seen an \’American person\’ with such a clear perspective. It is a pity there are not many more citizen such as yourself!

Posted by Iain Charles | Report as abusive

I think it is a huge misconception “most Americans are healthy” I am 5’10″ and I am OVERWEIGHT, however i am working on loosing more. I have no problem with competitive insurance, but I am a very responsible individual who is trying to get healthy. As I go out and look around I’d day most Americans ,myself included, are at least overweight. A simple physical taking smoking,drinking, weight ,blood pressure,Cholesterol, resting heart rate, and if all is good a nice little stress test. Compile this and if someone is determined unhealthy from the test then give them 90 days to show an acceptable improvement in their lifestyle. Preventative measures will help a ton, America has really slowed on the smoking now we need to get up and push ourselves away from the table a little earlier and get some cardio. Insurance cost based on healthiness good competative rates. Very healthy= very low rates. Is this fair high risk drivers pay more. Iron out the kinks put the responsibility in the hands of the individual and if they don’t want to do it make’em pay.


Wow Mike, you’ve changed my view 180 degrees. I’m going to call my dad up now and give him 90 days to take responsibility for his cancer as it was obviously caused by his choice of lifestyle. He certainly doesn’t deserve further health care if he can’t shed the cancer in that time.

Posted by Kirk | Report as abusive

Americans dont like universal healthcare as that implies taking care of america’s poor with tax payers money. And america’s poor are significantly black and others whome the rich white conservatives dont give a shit about. All this free market, government interventions is just crap they did not as much as whimper when their personal freedom were taken away by bush under security. its racism thats coming in the way of universal health care

Posted by Kiran | Report as abusive

WoW , I just knew some one would come with something like this ,i was addressing people who have nothing wrong with them obviously , pre-exsisting conditions would not be included as well as family history. There are FACTORS YOU can change, now please people have some common sense about my statement. I am so very very tired of lazy people who wanna hide behind statements like that. Oh it is also true , some cancers are associated with obesity as well. Remember , Factors that can be changed by us. If it can’t be changed then it is not a target of my comment, please now lets put on our COMMON SENSE hats!


Yes Mike, you just knew someone would read your comment for what it is: Blaming sick people for being sick.

All Americans have a right to health care without the threat of bankruptcy. It is time that this country delivers on this basic human right. The health care reform being proposed by the White House delivers on this right without affecting those that are happy with their current coverage. It is time to get this reform written into law.

Posted by Kirk | Report as abusive

One of the big problems with health care is that we treat it as a privilege, not a right. Although I have a hard time understanding how one can be in pursuit of happiness when sick, we have been conditioned that health care is an industry like any other, where money can be made. Other countries have recognized long ago that health care is a fundamental right.
A second major problem is that most Americans have never traveled outside the country and have never been exposed to other systems. As a frequent traveler, I had the privilege of having had encounters with a few other medical systems. I can say that the one we have pales in comparison with the ones in many other countries.
Until we have a better educated population that learns to adopt solutions from other cultures if they suit our needs, the health care debate will remain an exchange of poorly understood and poorly documented information in which the only winner is the insurance industry.

Posted by Allan | Report as abusive

Obama has come to office with promises of “change” by reversing two longstanding problems that afflict the USA: (1) health-care, (2) climate-change.

Now health-care affects the USA only, while climate-change affects the whole world. I’m not a USA citizen, so I’ll leave (1) for the North Americans to debate to fight over their new civil war (politically only, we hope, though violence wouldn’t surprise me given the tone of some bringing back “Nazism” and “Communism” from the dead).

On the other hand climate-change is a problem that afflicts us (earthlings) all.

My concern is that, in spite of my initial skepticism, Obama looks set to be able to do *some* change. But I doubt he’ll be able to pull a double whammy on these two issues. And if I had to choose to sacrifice one, that is (1). Also, (2) is more likely to succeed, because it’s not an “American-only” issue, where big corporations can push their agenda by corrupting enough members of Congress as easily, and many countries (especially EU and Japan) are now in a position to support changing the climate-change.

However, I do hope for my fellow USAmericans, as well as for the rest of the world that he can push through both policies and that they may enjoy a truly civilised health-care system, like most of us do on this side of the pond, instead of their current medieval robbery.

Posted by Oscar Lima | Report as abusive

Mike (August 29th, 2009 11:55 pm GMT)

your sense logic would make everybody laugh, if it didn’t have tragic consequences. Between the lines of your lifestyle description (which is beyond the point of universal health-care), I think I understand that what you claim is that a “free” (let’s call it this way) health-care system such as the USA’s encourages people to be more responsible vis-a-vis their health.

Strangely enough though, the places where health-care is 100% universal (e.g., Sweden, France, Italy, Japan) people seem to be much more healthy that in those where the system is not universal. Surely a “French paradox” if you believe in such divinities as the invisible hand of the free markets…

Posted by Oscar | Report as abusive

amazing that no one is actually talking on how to pay for all this–any idea on how to pay health care for 50 million americans?–forcing them to pay for is going to get 50 million americans very angry–can keep our present insurance–big deal if my co payments go up and they will–someone has to pay for welfare patients–they are the only ones wo will benefit from all this sound and fury–the dr? they are going to be very angry and I assure you some will lave the profession–they will be nickled and dimed at every turn–the lawyers hopefully will be very very angry if caps are placed on their cases–all i say is bend over and render to caeser

Posted by ilaboo | Report as abusive

Excuse me folks, but health care is NOT a “right”, it IS a privilage. It cost money, sometimes a lot of money. And all this is paid for by those of us who “pursue hapiness” by working for it. There are and will always be thos less fortunate, those who ar accidentally hurt, by their own mistakes or those of others. Hey what evere happened to families taking care of their own. How about charitable organizations, over and over again are proven to handle money more efficiently that any central government. The US of A was built on ideals of small local control government, and people taking care of themselves. If you want to see change via government, look into legislation against monopoly-sized health care companies, ridiculous health-related lawsuits and such. I’m convinced that expanding the governmental healthcare system will lead to more corruption, and yes, higher overall cost to the majority of us.

Posted by Toolman | Report as abusive

Most polling respondents in America seem to have a differing view of the state of America’s health care than the author of this piece. A large majority of them — as many as 75% by some polls — are satisfied with the insurance they have — and, presumably with the care their health insurance provides them.

I have to agree with them. I am retired, and am insured by a combination of Medicare and an insurance plan provided by my former employer. I recently suffered a heart attack. The care I was given — at an emergency room, and then at my provider hospita (Kaiser) — was excellent. There were NO ISSUES with the quality or thoroughness of the care I was given, nor the responsiveness of the doctors, nor with my insurer and medicare paying their insured portions of the costs incurred. The system worked the way it was meant to work.

I don’t dispute that there are problems in the system that need to be fixed, nor that the system in general costs too much. But I do dispute the idea that the entire system must be scrapped, and replaced by an all-new health care system. We should fix what’s broken, and keep what’s working.

I do dispute that the government should throw the old system out in its’ entirety, cobble together an all-new one, and then operate the resulting health care system. They are simply not capable of creating a RATIONAL all-new health care system that works, or of CONTAINING THE COSTS, as is evident in Medicare and Social Security (as well as in nearly every other large federal bureaucracy.)

For those who doubt this, I refer you to the FACT that the bills now before congress are incomprehensible (try reading HR3200 — I have!); were written in an entirely piece-meal and uncoordinated fashion; and were NOT EVEN READ by congress before being voted on. This massive congressional mess — if not deep-sixed as it should be — will be placed into the hands of nameless federal bureaucrats to “flesh it out” in the form of hard-edged rules, and the result will be “interpreted” by an army of lawyers and all levels of our courts for many years to come.

Congress should focus on FIXING the evident existing problems (widespread fraud in Medicare, and ridiculous legal costs, to name a couple…) BEFORE they even CONSIDER tackling any systemic revisions. Congress wants to throw the baby out with the bath water, and they don’t want to bother with even testing the water first!


Posted by Mike | Report as abusive


Health care is absolutely a right. Some people like to point out excerpts from the Constitution or human rights treaties that we have signed. I simply say it is self evident. Anyone who thinks health care is not a right lacks common sense.


You are already paying for all those people. You are paying more for them now than you would under universal coverage, because they get treated at the hospital instead of seeing a doctor before their illness gets out of hand. Do you think hospitals are treating the indigent for free? Nope, you are paying for it right now.


Several people here have already addressed your points.

Most people don’t realize how bad the system is until they get truly sick (not a cold, but a serious illness). Most people are healthy so the system looks fine to them – hence the “mirage” of decent health care. This is one of the main points of the commentary.

Our current system is not being “thrown out”, it is being reformed. If you like your current insurance you get to keep it. If you don’t like it, you get new options to choose from. The reform bill is long precisely because it is grandfathering in so many things to ensure that the change doesn’t adversely affect people that are happy with the way things are. The bill would be a lot shorter if we did just throw out our current system, but most Americans don’t want to do this.

I’m glad that you are happy with Medicare, but you don’t seem to want younger people to have the same options as you. Why is it that you feel it is fine for you to be in a public plan, but you don’t want to give me the option to be in one?

Posted by Kirk | Report as abusive

The solution to the healthcare crisis is quite simple: just do away with health insurance. As long as there’s a rich third party paying for health care, all the doctors and hospitals will continue soaking the system for as much as they can. With no health insurance companies to stick a big bill to, they will have to lower their fees or go broke. This means doctors will have to start driving Fords instead of Mercedes, living in moderately priced homes like the rest of us, and shopping at Wal-Mart instead of Tiffany’s. Hospitals won’t be able add more unneeded office space, grab up more land to expand, or harrass patients about past-due bills. But as long as the insurance industry exists, there will be no meaningful change in our healthcare.

Posted by Mufaso | Report as abusive

Healthcare as a human right? Yes, but in a sense. Each person has a ‘right’ to be treated by a doctor.

But only if they can pay for the treatment, or have another person is willing to pay on their behalf.

Human rights begin and end with you. Your rights allow you to do something without interference, or to prevent people doing something to you.

But your human rights do not extend to other people being forced to make positive acts for your benefit.

While you have a ‘right’ to healthcare, this does not extend to demanding the taxpayer to pay your bills.

A man has a ‘right’ to privately own property. But that doesn’t mean he can demand other people to pay his rates.

Africans can claim a ‘right’ to clean water, but this does not mean they can demand the water of other people.

You have the right to defend yourself from harm. But not to demand other people to defend you.

Otherwise your human rights would negatively effect other people, and the whole rights system would fall apart.

Where universal healthcare is provided to all, it is because a government has the money, resources and the incentive to do so.

And when the government provides you a tangiable benefit at the taxpayer’s own expense, then that benefit is a privilege. Not a right.

Posted by Haha | Report as abusive

Toolman — you are indeed a tool, and should be hiding in a shed.

Posted by John | Report as abusive

The thing that most writers fail to mention is that most of the proposed reforms could be dealt with by outlawing the most onerous practices of insurance companies. Doing so does not require a public option. Nevertheless, everyone needs to recognize that outlawing denial for pre-existing conditions, capping annual out-of-pocket expenses, stopping policy cancellations, etc. will increase the cost of insurance. This may be offset to some extent if insurance is mandatory for everyone thus bringing into the insured group all of those younger and healthier people who require little medical treatment.

Posted by ultima | Report as abusive

Oscar needs to reflect on what will happen in places like France when the cobination of increasing medical care costs and demographics (or low fertility rates) catches up with the universal health care plan. There will not be enough people in Europe to pay for the panoply of social programs offered by the governments.

There are several differences between Medicare and Medicaid participants and those in the pre-Meidcare category. First, those in Medicare are past their earning years. Second, what private insurance company would be willing to insure the older and less well people typically found in Medicare? Medicare folks would quickly trade their insurance plan for the youth and general wellness of the pre-Medicare set. Third, Medicaid provides for the indigent so a public program already exists for those who cannot afford health insurance. Perhaps the means test for Medicaid seems onerous to some while imposing the costs of universal health care on their neighbors does not.

Posted by ultima | Report as abusive

Mike says that health care is absolutely a right. It is interesting that so many millions if not billions of people have no access to health care. That seems to suggest that it is not a right but something you have to earn to receive. We throw terms like “right” around too loosely for them to have meaning.

Posted by ultima | Report as abusive

kirk wrote, “The health care reform being proposed by the White House delivers on this right without affecting those that are happy with their current coverage.”

This is a myth. A public option will be the deathknell for all existing private plans. Private insurers will not be able to compete with a subsidized public plan and therefore will have to fold their tents and fade softly into the night along with all of their investors including 401ks and other pension plans.

Another myth is the prohibition against the participation of illegal aliens. Without a provsion requring every applicant’s bona fides to be checked, that prohibition is not worth the paper it is written on. This is an exact analogue of the immigration fiasco. We pass laws to regulate immigration and entry into this country but then emasculate them by our failure to secure the borders, and apprehend and repatriate illegal aliens. Obama and others are being completely disingenuous about this.

Posted by ultima | Report as abusive

One might well ask Kiran why America’s poor are significantly Black? Do you suppose it has anything to do with a pervasive sense that the government and working people somehow owe them a free ride. There is something inherently wrong with taking from one what he has worked for to give to another who has not. After years of affirmative action, the problem still exists. There is no simple answer but surely removing incentives to better oneself is not the answer. Every government handout in some way removes a part of one’s incentive to get an education and work hard at earning a living.

Posted by ultima | Report as abusive

Only the fringe elements of America refer to health care as a “privilege”. Health care is a basic human right. It is humorous to read statements that attempt to prove health care is a privilege simply because not everyone has it. This is like saying that because the genocide in Darfur happened, it is not a violation of human rights.

Think about what these “health care is a privilege” people are really saying. They are saying that you need to earn the privilege to health care. So, when that 8 year old kid slips and cracks his head open, he better have done something to earn the “privilege” to be stitched up.

Anyone with common sense knows that kid deserves treatment. These “privilege” people do not believe this. These are the type of people that are opposing health care reform.

The health care reform being proposed by the White House is very good. It pretty much doesn’t change anything for the people that have insurance and are happy with it – except guaranteeing that they don’t lose coverage when they get sick. It reduces the cost of caring for the indigent and keeps many of them from ending up at the hospital. This will reduce delays for everyone. The public option brings down costs further by forcing competition into the insurance market. Everyone wins with the reform, except maybe the insurance companies that are currently rationing care to their patients.

The only people that don’t want the plan once they understand it are the private insurance companies. Not because they’ll be put out of business, but because they will have to redirect their obscene profits to the actual care of their patients.

Posted by Kirk | Report as abusive

I should add that it is a myth that the public option will be subsidized. The public option will be paid for through premiums from those who participate, just like private insurance.

The only subsidy in the health reform bill is a credit to get health insurance if you can’t afford it. This credit can be used either for private insurance or the public option.

The reform leaves the choices up to the individual. You have more choice under the reform being proposed by the White House.

This is a very good resource for debunking the misinformation regarding health reform:

This is a more general resource for the health reform:

Posted by Kirk | Report as abusive


You cannot just claim something is a ‘right’, just because you don’t like the alternative.

Human rights can give you freedom, or prevent others from harming you. In some rare cases, it might impose a duty on someone to act fairly.

But where does universal healthcare fit in?

How does a failure to provide healthcare impact on freedom? The individual is not effected, and is free to do as he pleases.

The Government is not harming you by not providing healthcare. They are just failing to intervene in harm caused to you by another source.

If it is a duty, then imposed on who? And why? Are you implying that the African governments ‘must’ provide healthcare to it’s people? What about India, China, or Russia? Are they in breach too?

For that matter can you point out where, in UN law, this supposed right to *universal* healthcare is set out?

You cannot just begin on the assumption that it is a human right. You can’t just call something a right because you want it. It has to be set out, somewhere.

How’s that for a scary thought? Human rights only exist if they are set out by the UN. And that means they are a product of law, not a magical halo we get born with.

People who say ‘The right to universal healthcare is self evident’ are simply admitting they can’t justify it. Rights are not proven by common sense, but by international law.

Posted by Haha | Report as abusive

The public option will not be subsidized. It will be paid for through the premiums of participants just as private insurance is paid for. In fact, the only subsidies that exist in the healthcare reform proposals are credits for people that can’t afford insurance and credits for small businesses. In both cases the credits can be used to purchase either private insurance or participate in the public option. The public option is not given special treatment. The choice of where the credits go is up to the participants.

A boring academic reply regarding the right to healthcare… yes, I know normal people don’t care about this:

The Declaration of Independence set out a serious of rights as being self-evident. Why did our founding fathers not write a long treatise explaining why people had these rights? It’s pretty simple. Common sense dictated that these rights exist and who really cared if England claimed that they weren’t rights, but were instead the privileges of nobility. This disconnect is the very reason we separated from England. The same applies to healthcare.

Posted by Kirk | Report as abusive

That is: series of rights

I hate typos.

Posted by Kirk | Report as abusive

Ok. That’s fair enough.

1. Please point out the relevent UN law which sets out universal healthcare as a human right.

2. Or point out where universal healthcare is set out in the Declaration of Independence.

3. Is it in the Bill of Rights? Or Magna Carta?

If not, then universal healthcare is not a right. Just yet another opinion on how some people think the world should be.

The founding fathers decided to recognise certain rights, and didn’t care if England agreed. Likewise, if some people believe universal healthcare is a right, the rest of America doesn’t need to care.

At the end of the day, a right needs to be set in law. If a right is not in law, it can’t be enforced. If a right can’t be enforced, it doesn’t exist.

Posted by Haha | Report as abusive

Yes, at the end of the day a right needs to be set into law, because laws must protect basic human rights. The right to healthcare without the threat of bankruptcy will finally be set into law in the United States once healthcare reform is passed. I’m glad we’ve come to agreement on this.

Posted by Kirk | Report as abusive

Haha seems to think legal rights are the only rights. Human rights are moral rights. Hopefully they are legal rights as well, but even if they aren’t they still exist.

Posted by Toadstool | Report as abusive

I was wondering if our congressmen and senators are looking at VAT (Value Added Tax), so everybody will pay for it, no matter what. Then small companies nor middle income folks has to be free from the burden of paying this entitlement? Just a thought.

Posted by Butch | Report as abusive

VAT is a regressive form of taxation. It is a flat tax on goods which takes a greater percentage of income away from the working poor than from the wealthy. VAT has no place in the United States and is not needed to fund the healthcare reform. VAT has not been proposed by the White House or by any serious proponent of healthcare reform. It has however been proposed by those who oppose healthcare reform in order to add yet another bit of misinformation to the already voluminous amount of misinformation already out there.

As has been said many times, we are already paying for healthcare for all Americans. We pay for this healthcare through increased hospital costs which are passed on to insurance companies which in turn pass them on to you as higher premiums. This is because no one can be refused treatment at a hospital – as it should be. So, those without health insurance let their condition worsen until they are hospitalized. After all, they can be, and are, refused treatment by general practitioners.

Think about a mild infection that can be fixed with oral antibiotics. If you can’t afford to see a general practitioner, you don’t get the antibiotics. So, your infection worsens until you are hospitalized and put on intravenous antibiotics. This requires an overnight stay at the hospital. Is this a cost effective system? No, but it is the system we have now.

The healthcare reform fixes this problem by ensuring that everyone is insured. This means that people that are currently uninsured will start seeing general practitioners when they get sick. This will reduce costs as these people will not end up at the hospital. We don’t need to look for more money to pay for healthcare reform as it is actually cheaper than our current system.

Posted by Kirk | Report as abusive

You misunderstand me, Kirk.

My questions remain unanswered. Where is universal healthcare set out as a human right? Can you point it out to me?

If it isn’t set out as a human right in international or American law, then it is not a human right at all.

If changes in legislation provide for universal healthcare, this does not suddenly make it a human right. After all, laws can easily be changed.

Logically, a benefit given by such legislation would be a privilege. Something granted at the sufferance of the government, only so long as it chooses to keep the legislation.

I believe that I should be able to walk as I please, up to and including trespass on private property. But you know what? Just because I say I have a human right to trespass, doesn’t make it so.

Posted by Haha | Report as abusive

I haven’t misunderstood you at all. Neither has Toadstool who nailed it.

I will rehash something I wrote earlier regarding the fringe’s view of healthcare as a privilege.

“It is a privilege to receive healthcare.”

Let that sink in.

An 8 year old child trips and busts his head open. He has no money – obviously. His family has no money. Should he be stitched up or left to die? This is an easy answer for normal people. Stitch him up. This is not an easy answer for the fringe; the same people that are working so hard against healthcare reform.

No, it is a long bureaucratic debate with these people where things like the “Magna Carta” will be brought up. (Read the comments here to see that one) Perhaps the word “tyranny” will be thrown out. Yes, it is very tyrannical not to stitch up an 8 year old who is bleeding. I mean seriously, there are basically three groups of people fighting against this healthcare reform.

1) The misinformed. I can’t really blame them given the sheer amount of misinformation being thrown about. People have to work. People don’t have time to sift through all the garbage out there.

2) People disconnected from reality. These people are easy to spot. Just look for them throwing out stuff like “tyranny”, “Magna Carta,” or perhaps “Louisiana Purchase” when talking about healthcare reform.

3) People with a financial interest to make sure healthcare reform doesn’t go through. This would primarily be the private insurance companies and the congress members and senators they have bought.

Posted by Kirk | Report as abusive

It was a simple question. Why is universal healthcare a human right?

A question you seem unable to answer. Your only real answer is ‘because’. You could have said so in less words.

You can choose to slur people as misinformed or as members of the fringe if you wish to. Such personal attacks are recognised for what they are, and indicate the weakness of your argument.

While you are good at saying something is a human right, you are not that good at justifying your assertion.

And this is not surprising. People who already believe that universal healthcare should be a human right, rarely need convincing of why this is so.

Which is why it is a lot easier to ‘preach to the choir’ then to actually justify one’s position.

Good day to you.

Posted by Haha | Report as abusive


Universal healthcare may not be a universal human right as you say, but then maybe neither is the right to free speech, or the right to privacy, or freedom of movement. But we all realize that life would be pretty miserable without those things. So why don´t you put yourself in the shoes of someone who lost their job and can´t provide health coverage for their family?

Americans don´t even bat an eye and allow the government to spend billions and billions on defense to protect their “freedom” and BS but don´t really care enough about neighbors and coworkers to allow a safety net of universal healthcare in case things go wrong.

Instead there´s a predatory healthcare system in which insurance companies can easily walk away and deny coverage, and a pharmaceutical industry that charges ridiculously inflated prices.

I am lucky and greatful to have a successful career in finance and will probably never be affected by this in any meaningful way. In fact one of my motivations for success has been the fear of living in a country at the mercy of selfish idiots like you.

I´m originally from Spain where private healthcare is excellent and public healthcare is costly and inefficient. But if I´m unemployed and get cancer, I know the government will provide me with care. I may need to wait an hour in a public hospital to see a doctor but at least I can treat my condition. Why should the less priviledged receive a death sentence if faced with illness?

Americans, wake the f”"”k up.

Posted by alejandro | Report as abusive

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