Where the healthcare debate seems bizarre

July 22, 2009

healthcare-globalpost

global_post_logoMichael Goldfarb serves as a GlobalPost correspondent in the United Kingdom, where this article first appeared.

In America, the health care debate is about to come to a boil. President Barack Obama has put pressure on both houses of Congress to pass versions of his flagship domestic legislative program prior to their August recess.

Good luck.

Opponents are filling the airwaves with the usual litany of lies, damned lies and statistics about socialized medicine and the twin nightmare of bureaucratically rationed health care and high taxes amongst allies like Britain, France and Germany. So here is a brief overview of health care in some of Europe’s biggest economies: Britain’s National Health Service is paid for out of a social security tax. Services are free at the point of provision. No co-pay, no reimbursement. The budget last year was 90 billion pounds (about $148 billion). That makes the average cost per person about 1,500 pounds ($2,463).

The NHS is big — huge, in fact. With 1.5 million employees it is one of the largest employers in the world. Only China’s People’s Liberation Army, India’s state railways and good old Wal-Mart employ more folks. Sixty percent of the NHS budget goes toward salaries.

The French system is run on a compulsory purchase of insurance through the workplace. The insurance cost is based on how much a worker earns. Low-income workers pay nothing. The average contribution per person is about $4,000. The government sets fees for services and negotiates the price of drugs with pharmaceutical companies. (See related GlobalPost story “Why French doctors still make house calls.”)

Service is not free at the point of provision. But reimbursement for costs is swift and in the case of catastrophic illness all fees are waived. People are free to purchase supplementary insurance from private companies.

With a compulsory insurance plan, as in France, German care is universal and equitable. Germans pay approximately 14.3 percent of their earnings to buy this insurance. As in France, people are free to buy supplementary private health insurance. Each system is unique (as are all the systems around Europe) but they have two things in common that make them different from the United States: Coverage is universal and the cost of care as a percentage of GDP is significantly less.

For Europeans — even those who would label themselves conservatives — American attitudes to setting up a universal health care system with strong state participation and management seem bizarre. The peace of mind that comes from knowing that in an emergency you will be taken care of and you won’t be financially ruined has no price. Why resist it?

Beccy Ashton, policy adviser at health care think tank The King’s Fund, worked for more than half a decade in the U.S. She explains the difference this way: “In Europe healthcare is regarded as a human right. In America, people think of it as a commodity that you buy.” If you look at how the Big Three’s health systems came into being you realize changing American attitudes may be difficult.

Britain and France created their systems out of the rubble of World War II. Pushed from below, the leaders of both nations sought to bring greater social equality to their societies. Social security systems were set up with equal access to health care given pride of place.

This wasn’t done without facing down doctors and insurance companies, but politicians are never so bold as when the public will for something is clear. In 1945 in both Britain and France, there was no going back to the status quo before the war started. Germany’s system has the weight of history behind it. Its origins can be traced back to the first era of German unification when Chancellor Otto von Bismarck created the First Reich. In the 1880s he set up a system of compulsory health insurance by workers and employers and other forms of social security. He did not invent the system out of nothing. There had been a tradition among the German guilds going back to the Middle Ages of members making compulsory contributions to help their brothers in old age or if a colleague had to stop working because of injury.

Clearly, America at this moment in time has not recently experienced an epoch-shattering historical event like a World War and despite Obama’s comparative popularity, he doesn’t have the clout of an Iron Chancellor to simply decree what he wants and know that Congress will rubber stamp it.
Beccy Ashton points out, “The President must be aware of the fine line he has to walk. If he goes forward with a radical agenda, he knows you’ve lost before you’ve started.”

So people in Europe continue to watch with bemusement as American legislators grapple with reforming a system that basically needs to be junked. Professionals like Ashton answer calls from reporters and try to refute right-wing misinformation that floats around the debate. Those damned lies and statistics.

The only statistics on health care systems that really matter are life expectancy and infant mortality. Both speak to accessibility and affordability. If you want to know how the U.S., the wealthiest nation on earth, stacks up, here you go:

In life expectancy, the U.S. ranks 38th or 45th depending on whether one uses the United Nation’s statistics or those compiled by the CIA. (In both cases, life expectancy in Cuba is higher!) According to the CIA World Factbook, the U.S. has many more infant deaths than its EU counterparts or northern socialist (to right-wing ideologues) neighbor, Canada. While the U.S. has 6.26 deaths per live births, Canada had 5.04. Britain, France and Germany? 4.85, 3.33 and 3.99, respectively.

Other health links from GlobalPost:

Winter in the time of swine flu

Coming home from school with strawberry condoms

(Pictured above: Healthcare reform supporters rally outside U.S. Senator Sam Brownback’s office in Overland Park, Kansas, July 9, 2009. REUTERS/Carey Gillam)

81 comments

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The comment about infant mortality is grammatically incorrect. I think he’s trying to outrage us but it’s hard to tell when the sentence on statistic doesn’t make sense. “While the U.S. has 6.26 deaths per live births, Canada had 5.04. Britain, France and Germany? 4.85, 3.33 and 3.99, respectively”. So 6 people in the U.S. die every time a child is born? How is that possible? One would assume he means it’s 6 infant deaths per 100,000 births or someother large number but who knows. Why should I do his research? Reuters isn’t paying me.
Nonetheless, we’re talking 1 more child more lives simply because of socialized healthcare? Do we really know? It couldn’t be life style or other social conditions? How about drug use? More teenage births, unwanted pregancy etc. etc. etc.? Nope let’s don’t look into it. I’d rather give up my Liberty. After all, Liberty and Freedom aren’t that important in the big scheme of life are they?

Oh yes, one last thing. Accuracy verses deception. You don’t have to be inaccurate to be deceptive. Example: “In life expectancy, the U.S. ranks 38th or 45th depending on whether one uses the United Nation’s statistics or those compiled by the CIA. (In both cases, life expectancy in Cuba is higher!)” Let’s let the “CIA” comment go, despite it’s clear relevance to the topic of nationalized healthcare. The reason he doesn’t use the actual “years” of life expectancy here is it is so miniscual that it takes away from the authors argument. So from the United Nations division of statistics, June 2009 as the latest update for the years 2005-2010, both Cuba and the United States show life expectancy of a male as 77 years and women as 81 years. Hmmm? “But the article said….”. Yeah, what are the chances the media would be wrong or what did he mention about lies and damn lies? I’ve actually seen statistics on this broken down to a number, for example, such as 77.2 years vice 76.9 years. The differences are minimal. But it makes for a more dramatic statement if you say “38th in the world” or “45th”. Let not get bogged down with little details such as the difference between 1st in the world verses 38th in the world is only less than 3 years. And why is it? Well, the author would like you to believe its the cost and accessiblity of healthcare because he believes in socialized medicine. But is it? Couldn’t it be life style, other social conditions, climate (Global warming’s responsible for everything else), and who knows what other factors effect life expectancy? Yeah, let’s not dig too deep. I’d rather see my country turn to a medical system that costs me Trillions of dollars whether I like it or not. I can use those extra 2 years of my life socialized medicine gives me to pay for it.

Posted by Randy Threet | Report as abusive

Conservative Republican arguments against universal health insurance should be called indeed what they are: un-Christian and immoral. Battling the complete deafness to the plight of their neighbors and the poor are the founding principles of the teachings of Jesus Christ. Let it never be said that this is a Christian nation if it cannot support its neediest.

Posted by Jason Shilling | Report as abusive

I cannot believe what I am reading: health care for all wasn’t in the Constitution so therefore it’s invalid?? That’s crazy. The government does many things that are not in the Constitution. In addition, many things that *are* in the Constitution and Bill of Rights are now illegal or eroded more and more every year in America.

Posted by Karen Eliot | Report as abusive

Of those posters who think that what we’ve got now is great (or even ok) I’d like to know what they think about the regular, fairly healthy folks who go bankrupt when something goes wrong with their health? You know, the stories we hear every day about those that thought they had good health insurance but then got screwed over by the insurance company. Or are those all lies? I hope that never happens to you.
These deluded posters are kind of pathetic when they scream (you can almost hear the screaming from your computer, can’t you?) about how any kind of reform will take their freedom from them and put their health care in the hands of the government. Don’t they know that their health care is decided by their insurance company? Every little detail is profit driven. I’d rather have government officials that we’ve elected in charge than the greedy b*&#stards that get richer while average hard working Americans who thought they were covered are denied the kind of care they need (after paying huge sums of money for years). Insurance companies usually start any correspondence regarding claims by denying that they need to pay out, it’s standard proceedure. They send you a bill as though you are the one who has to pay. If you want them to honor their obligations then you need to fight for it and then you still might lose. What kind of freedom is that?
As far as poeple coming here for needed care, I’m sure that happens but what about the growing business of arranging for Americans to go to other countries for operations? Or is that a lie too? It’s not a lie, it’s called medical tourism. These facilitating companies will fly you to another country, put you and loved one(s) up in a hotel, cover the operation, hospital, everything and save you thousands of dollars. Our system is broken, greed is ruining everything. We wouldn’t need so many government programs and regulations (or these medical tourism companies) if it weren’t for greed. We’ve tried the “give all the money and tax breaks to the rich folks and they’ll take care of us little people” too many times. It never works because of greed.
There will always be high-end facilities and doctors for those that can afford more. Most of us just want what’s fair.
My employer pays a LOT to an insurance company to subsidize my and my wife’s health care. I pay about $4,800 per year as my part, and it’s the low-end HMO. Then there are the deductibles, co-pays, etc., etc. It’s really ridiculous.

Posted by John | Report as abusive

“July 23rd, 2009 1:15 pm GMT – Posted by AusTx
Everything looks good on paper until you look at the real details. The benefits of the European systems seems to be that you are cared for, but at a very high personal cost that is mandatory (a tax). Well, I know that I’ll be cared for in the US if I just walk into an ER regardless of whether or not I actually pay. The real difference is that the US has more illegals that are uninsured than in Europe. What happens in Europe of you are not from EU and can’t pay? While we are on the topic of comparing systems, why don’t we look at the healthcare system of China. It seems to work very well in keeping costs low. My point is that the US system has it’s flaws but it basically works. What’s broken is Medicare, Medicaid, and the other government run medical programs. Maybe that should cause everyone to stop and think for a minute. Can the US government create a more efficient medical system than the free markek? The Chinese medical system appears to be run on the free market model more than here in the US. Go figure. Or am I confused somehow? Look at it from the flip side of the coin. I think it is bizzar how much Europeans are willing to be taxed and controlled.”

I’m sorry but you are taxed and controlled to such an extent that your personal freedom of drinking a beer and smoking a cigarrete without government harrassment is non-existent.

Posted by Dan | Report as abusive

I have a question for all our European friends making comments here. Do your state run health insurance plans penalize people who don’t sign up for them? Obama’s plans (both versions) will impose a FINE on people who don’t enroll in health insurance. I mentioned in an earlier post that every hospital in my area offers a medical care coverage program for low income people. These are not insurance plans. If Obama’s plan becomes law, these hospital plans will not meet the definition of “insurance” and therefore, I will get fined 2.5% of my meager adjusted gross income if I elect to stay with a healthcare plan that actually works for me, the medical facility, and every one else involved. And can anyone explain to me why it is okay to take money from other people to pay for my health care?

Posted by Eljay | Report as abusive

When I was a child I had great health care, and earned it, because I was a hard worker. If I hadn’t been a hard worker, like most other children, I surely wouldn’t have deserved to have my collapsed lung treated when I was 12. It sure felt good to deserve health care.

My cousin didn’t deserve health care as a child, apparently because he was irresponsible. When he he was having severe stomach pains at age 13, he didn’t have it checked out because he knew he couldn’t afford it. His appendix eventually burst. His pain was great, his hospital stay long, and his medical bills were enormous. Pathetically, he couldn’t pay for it himself and it ruined him – bad credit score and missed football season. If he had had the foresight, he would have worked harder for insurance so that he could deserve to be taken care of.

Many of the responses I’ve read talk about universal health care as being unfair. Well, judging who deserves health care or not is a tricky business, in fact morally dangerous. Not everyone can get health care, through no fault of their own. The plain and simple is, everyone deserves to be taken care of when they need it, and our country is perfectly capable of making that happen. In fact, we could have the best health care in the world for all of our citizens if we were willing.

Some people believe that they are more important than others, to the point where their “earned” luxuries are more important than the life and wellfare of their fellows, including children and the elderly. They aren’t even afraid to voice this selfishness in public. Shameful.

Posted by Jake | Report as abusive

“The only way you guys are going to fix things is if you stop listening to what you’re told and do the research yourself. Do what WORKS not what someone tells you works.”

So we should do what YOU are telling us works…ok.

A major difference that is not being considered here is that we Americans are a bunch of fat, sedentary slobs. In places like Europe and Asia meal portions tend to be smaller and more balanced nutritionally, and people *gasp* WALK to get places.

We shoot each other, crash our cars into each other, and generally don’t take excellent care of ourselves. I don’t understand why we should be expected to support people that make no efforts to support themselves.

Posted by Ian | Report as abusive

So, the national health care system in Great Britain is the model we should seek here in the US? Why is it then that this author fails to mention the rationing and lengthy delays involved in securing treatment in Great Britain — particularly for elderly women with breast cancer? What about the many reports by the English that most (all?) extensive diagnostic procedures are blocked or heavily rationed until illnesses are well advanced?

Who among us wants a “universal” health care system which ducks its’ responsibilities in order to provide cheaper a medical program?

Let’s have reform, but let’s have the best plan available by insisting that each and every member of congress, and each and every federal employee is covered to exactly the same extent in exactly the same national health care system that the congress constructs for the rest of us.

Why does congress continue to avoid being in the same plan they want to foist off on the taxpayers?

If you want to fix US health care is to look at what driving up the cost. Who’s making the biggest profit out of our health care and why. I have no problem with universal health care- I just have a problem with the private insurance/ pharmaceutical companies who’s making a huge profit out of my money giving me less than mediocre care. Look at how the Fed gov just hand over medicare part D drug plan to the private insurance company– taking profit away from our state gov. Obama’s plan is virtually the same, forcing small business to buy insurance from a pool of private insurance companies sharks. It basically a monopolize pool- the insurance companies take turns lowering their coverage and fees each year- so everyone of them would have a fairly equal distribution of members. For instance last year Kaiser was the cheapest plan, but this year the same plan is offer at a substantially higher price- much more than their so call competitors. Bottom line winners are insurance companies. Take care of the greed that drives health care cost so high- and we can apply universal health care at lower price. If Obama doesn’t fix this profit for health care problem– corruption still lingers and I not supporting anything.

Posted by Yo | Report as abusive

This author has hit the nail on the head. The fact is that we Americans do indeed treat health care as a commodity to be bought and sold. But health care is in fact a human right and should not be discussed in terms of money.

While money is important it’s not nearly as important as health. And if the focus is on health first, then one will find that our health problems have very efficient and cost effective solutions that will solve our money problems as well.

Our focus is not on human health. And this is core problem.

Equal health care should be available to all persons, but only so far as they stay within the guidelines of healthy, safe living. If I eat 20 big macs a day for 10 years, am 200 lbs overweight, should the rest of our society have to pay for my knees, heart disease, diabetes, … and other illnesses directly attributed to obesity? If I smoke crack all day, should my teeth be paid for by the taxpayers? If I decide to free climb up the side of a mountain, fall and break my back, should the taxpayers pay for my rehab and lifetime of needing medical attention?

You play outside the boundaries, you pay for yourself. There needs to be sound limits on what is provided for by the taxpayers and what constitutes personal injury.

And please review your ‘urban myths’ of cost, life expectancy, and infant mortality rates, they are not due to universal health care, they are due to better care, more auto accidents and homicides, and higher teenage birth rates. All choices that we, as taxpayers would have to pay for.

US health care costs are adversely impacted by two things: our tort system and distortions imposed by State and Federal govts.

From a three-dimensional perspective it becomes apparent that mainstream American bipartisan politics every so often schedules completely sham “debate” on hot-button issues and, in a full-court perversion of the process, totally buries any hope of reasoned consideration of very serious issues such as health care and education.

Dimension One: So-called HillaryCare appears to have been designed and set up in order to be shot down without hope of triage, as though in its time it was the best laid plan that highly-paid Congressional geniuses could possibly have come up with. So it is now with ObamaCare, which – by side-stepping and suppressing the logical Single Payer model – falls lamentably short of detailed review of the core issues… namely, that medical professionals and their patients alike are being bled to death by the gluttonous beastly vampire parasite commonly known as the American Insurance Industry, whose profits are based on the creation and sustainment of a vast, almost incurably sick population who are condemned to endure shoddy medical attention in exchange for crippling financial exposure on the part of the Sick themselves. Making private insurance mandatory is another way of valet-delivering those in most need unto those insatiable profiteers with most to answer for. From sheer lack of wealth on the part of American citizenry at this time, there is no way the contemporary chimera known as ObamaCare will result in anything but total submersion of American public wellbeing.

Dimension Two: In the above regard, and in this regard alone, American health care may be said to lead the world. How can something that costs so much and delivers so little even dare to call itself a form of health management? Not so much out of boldness as due to an epidemic lack of corporate managerial ethics, one ventures.

Dimension Three: On a national scale, American healthcare problems have less to do with short-run costs than they do with profit apportionment, and the absence of public regulation and oversight brought to bear against predatory insurers. Health care is much more than a hot-button issue – it’s a basic human necessity and should be treated as such.

Amazing, perhaps, but true beyond dispute: Medicare actually works. To forget this, and to lapse into formulaic anti-government diatribe at all costs is to completely overlook and perhaps deliberately obfuscate the inevitable results of “following the money”. Somebody makes a fortune off of America’s sickness every single day, and that somebody isn’t “the doctors”, “nurses”, “illegal aliens” or any of the other stooges trotted out by defenders of the status quo. It’s the monolithic insurance cartels and their friends in the pharmaceutical business.

Insurance rackets and Big Pharma walk away with the dough while America sickens itself into powerlessness. No sensible justification of the status quo is to be found, virtuous in neither in terms of financial prudence nor affordable medical outcome -yet the ability of pundits to de-fang the debate into a series of hot button-flashes continues. Which in itself is rather sickening, to add insult to injury.

Virtually no-one who has spent time in countries featuring so-called (by certain so-called Americans) Socialized Medicine takes at all seriously the ludicrous assertion that medical standards in these nations are in any way inferior to those that generally prevail all across America. With practically vanishing exceptions, virtually no-one has ever traded a place in line for non-cosmetic surgery in Canada, the UK, Germany, Ireland, Scandinavia (extend list at will) for a comparable spot in the United States.

The above and other red herrings need to vacate the public forum if debate on this topic is to be considered at all serious. America’s sick and needy aren’t getting any better in the meantime. They’re getting worse and, worse, angrier. At the present rate it won’t be long before they’ve developed resistance to the hot-button wastage of their time and patience.

Posted by The Bell | Report as abusive

I find this history lesson as extraneous information. What is really nonsensical is quoting the statistic of life expectancy. What about murder rates, accidents, obesity, etc?? Life expectancy is NOT the issue so much as quality of care, survival upon diagnosis; in these types of discussions you’d have to admit that the US leads the world.

Posted by Susan McLaughlin | Report as abusive

Small correction: Bismark’s unification of Germany established the SECOND reich. The first reich was Charlemagne’s empire.

Posted by John C. King | Report as abusive

It is very sad to see American politicians playing with the lives of those who put them in power. It is even more shameful that these criminals, greedy, lying politician who cry about social medicine are themselves covered by social medicine. They receive billions of dollars in bribes from insurance companies and drug companies, so they side with profiteers instead of the public. They need to be hanged because they are traitors. They pay allegiance not to the country but to money.

US leads the world today in nothing except in wars, fighting, killing and destruction of other countries. Schools are degraded for lack of fund, but there is always money for wars. What a country?

Posted by Theo | Report as abusive

My conservative friend called me a communist and a traitor because I want people to have access to health care.

Does he call my retired grandparents communist and traitors also because they invest in the public option called medicare?

He won’t be happy until we are all begging for seven-days-a-week work at big retailers selling slave labor goods from actual communist countries!

Posted by Dennis | Report as abusive

I can only speak to my own experience, but in my life so far I’ve lived in Australia, the US, and Denmark. I loved living in all three places – and if I had to choose where I’d get sick I’d choose Denmark in a heartbeat(and Australia second). Yes I pay higher taxes here than I did in the States, but not *that* much higher, and ultimately I still pay less for health care than I would in the US. So my family gets more bang for our buck (or kroner), and we’re still free to buy private insurance if we want it. More importantly though, I know I’m making my fair contribution to a society where access to highest-quality treatment is a right rather than a commodity, and where no-one goes broke because of health care costs that are no fault of their own. And I certainly don’t feel any less ‘free’ than I did in the US (maybe more so – I can buy a beer at the supermarket without being carded and then drink it in the street if I wish. So much for ‘socialist tyranny’!)

Look, whatever the pundits try to scare you with, the US isn’t going to turn into Sweden or Denmark – it took those countries decades to get what they have and they defend it fiercely. I can’t see America even getting to a hybrid public/private system like Australia’s. But please don’t stifle your justly famous talent for innovation and improvement by falling into the “exceptionalist” trap of assuming the US is always inherently better and can’t learn from anyone else. As a society, you deserve better than that.

Posted by Patrick | Report as abusive

This article makes the same mistake that most pundits for universal health care make. They take the position that insurance equals health care. This is simply not true. Healthcare is about outcomes. The infant mortality rate is often brought up as evidence of this. In the U.S. it is 6 per 1000 and in Canada where everyone has insurance the number is 5 per 1000. This is not a proper comparison because the population, diet, geography, genetics, etc are not the same between the countries. Within the U.S. the infant mortality rate is 6 per 1000 for Caucasions. It is about 13 per 1000 for blacks, so the first conclusion one would make is that there is a difference in the proportion of those populations with respect to insurance. That might be relevant, but if you look at Hispanics in the U.S. the rate is 6 per 1000 and they have the lowest proportion of insurance. So there is a difference, but it can not be attributed only to insurance. This mistake of equating insurance and health care is described very clearly by a Canadian physician in his book The Cure. It should be must reading for anyone embroiled in the health care debate.

Posted by Allen Kraska | Report as abusive

Of course this article makes the huge mistake that health insurance equals health care. For example, did they mention the fact that nearly 2 million canadian families could not get a simple doctor check up for over 2 years? (as of 2005). Or that in Britain, Women in labor are being turned away from hospital wards and driving extra hours in labor to find someone who can help them deliver, or worse deliver a baby in the hall or outside… sounds like GREAT health care to me!

The idea that “The only statistics on health care systems that really matter are life expectancy and infant mortality. Both speak to accessibility and affordability.”
could not be more wrong.
Let’s think of all of the factors that go into life expectancy… hmmmm.. actually let’s name but a few of the infinite factors beyond quality of health care…
diet, physical activity, stress levels, smoker or not, alcohol consumption (all individual personal choices – nothing to do with healthcare)
oh yeah and how about genetics?? – Blacks and Hispanics have a lower life expectancy than caucasians…
Infant mortality rate is a complete scam statistic, the exact definition is skewed and different between countries. Still births can be labeled just that, as in the socialized med countries, or as an infant mortality, as in the majority of the US hospitals. Hmmm the WHO spotlights infant mortality as a major percentage of healthcare rankings… and all of a sudden socialized countries’ rates go down.. but at the same time still births go up? Not to mention mortality rates from 1-5 year olds… which is astronomically higher in Cuba despite their oh-so-low infant mortality rate (You know – that country some obese guy made a movie about praising their healthcare over America’s). Socialized medicine has central control and doctors are told to limit infant mortality rankings because they know it’s spotlighted (however poor a judgement system this may be)

Don’t believe me? Look up articles, research, thesis’ online that talk you right through the calculations of the WHO”s health rankings… and in some cases WORSE healthcare gets you BETTER rankings!!!! Absolutely absurd.
THE ONLY STATISTICS that ACTUALLY can correlate to quality of health care systems are outcomes when people get sick or have a diagnosis and comparing country to country…
Say you get cancer (I wish this on nobody reading this)… want the best chance of actually being alive in 5 years?.. you better be in America.
Life expectancy? – how about the QUALITY of life years for the end of life??? Not to mention choices you actually have as a patient at the end of life…

In summary, this is just another pro-socialized healthcare article that fails to actually show any understanding of the very rankings used to back this viewpoint.

Posted by freegal | Report as abusive

Regarding The Bell’s comments:
Health insurance do not make money off of the sick, those are the people they lose money off of. If everybody stayed healthy, they still get their premiums, and lose nothing to hospitals. Elementary logic.
Who gains from people staying sick (in both socialized and NON countries)? Doctors… they can make more money and mostly are guaranteed jobs with more sick people, even in socialized countries. So blame the doctor’s based on your rant.

But in actuality, the AMA is the medical cartel that has caused a lot of the problems in America, they keep med school applicant’s/grads down to limit competition, keep their salaries up, among other benefits for themselves. Why don’t we actually try a free market healthcare system before saying it doesn’t work. We already know socialized healthcare provides rationed care decided by beaurocrats and access to waitlines of years in many cases (even for simple check-ups); also it is a never ending economic drain on society because of the inherent flaw of having no way to control costs over time other than controlling wages, and controlling who gets what, rationing care…

Posted by prochoice | Report as abusive

“You play outside the boundaries, you pay for yourself. There needs to be sound limits on what is provided for by the taxpayers and what constitutes personal injury.”

The problem is that, the people you say must pay for themselves, already did.. through there taxes. So what you really mean is that they have to pay for YOUR healthcare AND their own.

Elective abortions better not be covered in socialized systems either… talk about personal injury, not to mention the thin line of ethics crossed by taking (stealing) somebody’s tax dollars and forcing them to fund something they believe is murder of an infant.
Why stop at eating and smoking behavior? Why should I pay for the idiot’s care who took the chance to go ride a motorcycle? or sped in a car on the highway? How about the child who’s parent’s didn’t want to vaccinate him as an infant and ended up with hepatitis? should society pay for this care now because the parent’s had different ethical belief’s about vaccinations, regardless of the increased risk they posed. Or will it be that everyone will be forced or coerced through taxes/fines any means to GO to the doctor and get these treatments.

This is one of the ethical problems of universal healthcare. What is covered? Who is covered? Should never be addressed to a society as a whole. It is an individual question that must be answered by each person/family, and the choice must be each of ours to get insurance that fulfills our own beliefs. And not have our money stolen from us to fund something we might think is murder, or promotes irresponsible behavior, or is simply fundamentally against what we believe in.

Posted by DJB | Report as abusive

“Clearly, America at this moment in time has not recently experienced an epoch-shattering historical event like a World War ”

No, instead we were the ones that sent our troops over to europe twice to win both World Wars. Then we set in place the Marshall Plan. Maybe now it is time to pay us back for our generosity in blood. I suggest Europe pay for all Americans to have free health care. This sounds fair, because it is exactly what the debate is about and will solve the major hurdle. Who will pay for this health care plan? Those that work will end up paying for those that don’t. But if the europeans pay for it then it is a win win situation. Europeans can say see we told you so and no American will have to fork out a dime for the lame and lazy.

Posted by Bart | Report as abusive

Pfft. I love how the author decries statistics and then turns around and uses the numbers he likes even though they completely ignore demographic differences between the countries being compared.

He also, very importantly, ignores the fact that the only reason these countries are able to provide the care they do is because of the innovations in medicine that come almost solely from one source: the United States. We are the only country left where someone can innovate in medicine and be rewarded for their efforts.

From an excellent article on the Swedish health care crisis by Walter Williams:

Dr. Olle Stendahl, a professor of medicine at Linkoping University, pointed out a side effect of government-run medicine: its impact on innovation. He said, “In our budget-government health care there is no room for curious, young physicians and other professionals to challenge established views. New knowledge is not attractive but typically considered a problem (that brings) increased costs and disturbances in today’s slimmed-down health care.”

Full article: http://www.capmag.com/article.asp?ID=545 1

Of course, the most important point in this whole debate is that it is immoral to force one person to pay for the health care of the other. Until and unless people understand Individual Rights (as we used to in this country) we are screwed anyway.

Learn about rights here: http://capmag.com

Answer from France: (Nota: Christian is a firstname)
Quote from David:
“Of course, the most important point in this whole debate is that it is immoral to force one person to pay for the health care of the other. ”
So, in your country, soldiers are forbidden? Some who protect someone else…
In Europe, when I pay to be sure others are healthy, I protect my girls from epidemies. Ask why USA have hundreds of deaths from flu H1N1 and France none.
It’s because, in France, sick people goes to doctor because it’s nearly free (we have to pay 1.5$ out of 50$). In USA, from what I heard, they don’t go because they can’t afford the price, so the epidemy spreads.
Universal Insurance is ALSO defense of the country and of ALL the citizens. That’s why even illegal immigrant have free access to health in France (at least for basics and vital issues).
Hope this widen the debate.
I apologize for my poor english (even, as said my english friends, if my english is better than your french :) )

Posted by Christian | Report as abusive

This is a bunch of crap! I’ve lived in England and the HC is the pits. It would take us 6 months to get a normal check up and most of the doctors were not educated. Also, I had a friend who got cervical cancer because England kept upping the age to get the test from 18yr to 20yr and then 25yr. If we go to this system we are going backwards. This is not the answer!

Posted by Sandra | Report as abusive

To David and all those who think that innovation in medicine comes exclusively or even largely from US companies, you’re simply mistaken. By way of an exemple, yesterday’s Wall Street Journal online published an article about early detection of Ovarian Cancer, the two sites that conducted the research werer on at Stanford, and the other in the UK. The same UK that has had the NHS since WWII. Novo Nordisk, a leader in Diabetes Research is based in Europe. Bayer, is based in Germany. The Japanese have been leading in medical imaging as have the Germans (Siemens).

We need to wake up here and realize that like everything else, health care innovation is global and will stay that way. We need to stop being afraid and figure out a way to do what NEARLY EVERY OTHER COUNTRY we compare ourselves to has done and find a way for a well-run, accountable, government health care system that not only pays for but provides care to function alongside private insurers who actually have to seek out all the customers they can get their hands on vs. just the ones least likely to actually use the services in question. Some of the existing companies will no doubt not be able to compete. C’est la vie. As long as no American ever again has to ask themselves if they should buy their medication or buy their family’s groceries. That’s what health care reform is about, not whether innovation will survive.

Posted by Michael Williams, MD | Report as abusive

so if health care system is so great in Australia, Great Britian and Canada, why do I see so many of those folks visiting Thialand for surgeries and treatments?

Health care is not a human right. I’ve never seen that on Maslov’s Hiearchy of Needs. But then again, I wasn’t raised in a socialistic country. I was raised in America, where we value individual thought, independence and freedom from government intrusion in our lives.

And to me that is the single biggest issue! Yes, I don’t want to pay for someone else’s health care. Yes I’m upset that those elected officials voting on the issue haven’t even read the bills they’re voting on. Yes the cost is too high. But most important to me, is I don’t want our inept government involved in my health care.

For you socialist that like your government health care, I’ve got 47 million more members, what’s your shipping address?

Posted by mike | Report as abusive

My dearest American friends

I was born and raised in a socialistic country as Mike just told and, surprise surprise, my healthcare system is not perfect, I see everyday people struggling to get an appointment with the doctor, I see public manifestations of discontentment with what my country is doing with the public healthcare system. And yes I see people crossing the Atlantic Ocean either to go to United States or Cuba, yes….. Cuba, and Thailand to get second or even third opinions about something that has been wrongly, or not, diagnosed in their home country, or even to get an operation because the waiting lists were to dam long, or because these people can afford it… I don’t know. There is a million excuses for all of the above, but there is no excuse for letting people dying of cancer just because you can]t afford either the treatment or the insurance….nop that I never saw in my socialistic country.
It is not needed in my very modest opinion, of a person born and raised in a socialistic country, to something to be mentioned in a theory in psychology such as Maslow’s hierarchy of needs that is dated of 1943, to be considered a HUMAN RIGHT.
And my dearest American friends, as Mr. Mike wrote, and I quote – I was raised in America, where we value individual thought, independence and freedom from government intrusion in our lives…end of quote, I specially like the last sentence…- freedom from government intrusion in our lives it’s the cherry on top of the cake!!! Well sure because my government follows me every step of the way of my life. When they legislate something I have to obey the laws, in America is different?????
If I do any harm, I have to pay either with social service or jail or pay a fine, is it different in America??????? Or what you are trying to say is that every one in your country do whatever they want with their credit cards and money, and the rest of the world ends out paying with a world crisis!!!! Or a bandit like Madof put the biggest scheme in the history of schemes!!

Ps- I am sorry for my awful grammatical construction of the English words I just wrote!

Posted by Hugo | Report as abusive

Interesting analysis. I still prefer Singapore method of managing healthcare.
It’s an automatic opt-in personalized (the premium based on age of individual) system with option to upgrade. The government provides heavy subsidies for lower income and various schemes so that basic medical care is available to all.
Those who want better service can upgrade.