Opinion

The Great Debate

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)

Comments
81 comments so far | RSS Comments RSS

“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.”

And here is where your bizarre argument falls flat on it’s face. It’s not the purpose of government to be an employer. It is also not the purpose of the government to decide what level of care I receive, how much I pay for it, or how long I need to wait to receive said care.

Only those with the complete and total inability to understand the purpose of liberty and the free market would waste time making arguments for nationalized programs and, in the same breath, claim that it will not impact the free market.

It is also quite obvious that you do not keep up on current news or you would know that our liberal thieves in government are floating yet another tax on a single group of citizens to help for their “reform”.

You sir, are the one spreading damned lies.

Posted by Rick | Report as abusive
 

Since the countries you mention are comparable to large states with the US, how do each individual state in this country rank against countries with socialized medicine? Combining data from states with poor social services (TN, WV, MS, AL, LA & AR) with data from states with better services (CA, NY, MA & WA) tells me nothing. Also are benefits interchangable in different countries like they would be in different states? If I am on holiday (or work) in another country, I should be able to receive the same services I do in my home country. Would we have such agreements with Canada and Mexico to cover non-citizens?

Posted by Scott Hess | Report as abusive
 

As an American, I can provide two huge examples of why people in the US resist universal health care.

One is that somehow, the public has been convinced that the current system gives people great freedom and choice relating to their healthcare. In actuality, health insurance companies often drive coverage. A friend had his galbladder removed and his insurance company refused to pay for it because it was not percieved as a formally diagnosed condition. On a personal note, I was bitten by a cat once, and my insurance company initially refused to pay for my anitbiotic shot because it was considered an unnecessary immunization. I had to virtually throw a fit for the insurance co. to agree to reimburse me. The doctor who performed the galbladder surgery for the friend agreed to personally fight with the insurance company for reimbursement. Insurance companies call the shots. You have the freedom to obtain any treatment you want, but your insurance company may choose not to pay for it, thus having the effect of limiting your healthcare options.

The second issue is that when it comes to any question of taxes in the US, Americans are extremely selfish and would rather keep money in their pocket than give some of it up in order to serve the greater good. Our schools stink because of this attitude. Our roads are often filled with holes. A heavily traveled bridge in Minnesota actually collapsed last year. Yet, if you asked the average American if they would be willing to pay higher taxes for better schools, smoother roads or safer bridges and the answer would be “hell no”.

 

Damned Lies [Goldfarb],
Your statistics are correct, but incomplete. Please keep in mind our healthcare is actually better age from 30 to end of life by several measures. Why? I would like to understand that better before I sign off on a bill.

Additionally, we are a nation of obese people. 60% of health care problems are behavioral [diet and excercise], but I see nothing addressed in these bills or your discussion. Without addressing this, our costs as a % of GDP will be higher.

Furthermore, end of life health care options will change. It will be rationed. Obama is avoiding the term, but it is unavoidable. I would like to know the details. The New York Times had an article on it that left me unsettled.

I am hoping that both sides [including you!] can quit throwing mud without addressing real issues that are unique to America.

Well, I can wish in one hand and …. in the other, and see which one gets filled first, something like that.

Anthony,
Chicago IL

Posted by Anthony | Report as abusive
 

Thank you Michael Goldfarb for your excellent description of the health care system in the U.S.(i.e., needes to be “junked.”

Alan Goldfarb (no relation).

 

Funny you mention damned lies and statistics, then bring up infant mortality rates. Infant mortality rates are computed under different and more generous criteria in other countries- if an infant is under 500 grams, many countries do not count it as a live birth-the US does. In some countries, if an infant is alive for less than 24 hours, it is counted as a stillbirth- the US accounts for this as a mortality.

And the quality of a country’s healthcare system is only a correlate with life expectancy. America has some of the fattest, laziest people on the planet. No amount of doctoring or care can reverse the terrible lifestyle choices Americans make for themselves everyday.

The only reason why Europeans can afford treatment is because medical and drug companies were able to deploy it profitably to Americans first. Good luck seeing medical breakthroughs when America is paying drug companies a pittance for treatment.

Posted by Charles Mcguy | Report as abusive
 

Winge and whine all you want but my own anecdotal evidence suggests government has been involved for years, and if there was a single payor my insurance would not get ripped off when I need service out of state, my doctor officing in the hospital where I have my lab work would not operate record keeping separate from the hospital, and every time I see someone new I wouldn’t have to create my medical record from scratch. Better yet, Healthcare would no longer be a bargaineing chip in union negotiations. My wifes employer is trying to delete spousal coverage. The state often dictates how many beds can be alocated to the hospitals in the state. I was referred to a surgeon for a hip replacement 3/25/05 and couldn’t get in for a first contact until 6/20/05. Don’t even try to scare me with that rationing BS. Some people. They’ll say anything, especially if it might open the door to dissention division and defeat of our Presidents initiative. Trust me, I wont give up on single payer. Social Security might be a good vehicle, and by the way, if we cut employer contributions to half of what they are now and extend employee contributions to the full extent of income no one will even notice (enough to hurt) and we would fund that liability for ever. Run the numbers.

Posted by DanO | Report as abusive
 

I am a “Northern Socialist” a.k.a. Canadian, although for a Canadian I lean towards a more capitalist outlook, most Canadians would consider me a conservative monster for advocating a “two-tiered healthcare system” (universal healthcare supplemented by any form of optional healthcare). While I am generally leery of government intervention, and we must keep in mind that nothing is free, anything provided by the government is paid for by the taxpayers. We the people pay for everything, because there is no one else here (corporations are useful, but, fictional entities owned by real people).

Neither side should complain about the other side using statistics (misusing on the other hand…), in fact statistics are one of the only tools available for making a decision rationally on this subject. And in this case the facts speak for themselves. The average US citizen pays far more money to get far less quality healthcare, as compared to the average Canadian citizen. This is including the contributions from the government (taxpayer). I have taken many economics courses (getting top marks in most), and I am well aware that government intervention rarely gets better results than the market left to its own devices. But, in THIS case the evidence is overwhelming that the Canadian system provides far better quality care, for a far lower cost to society as a whole (the European systems do too from what I’ve read). While it is true that in theory the “rich” CAN pay more and get better quality care, in practice even most “rich” Americans DO pay much more and STILL get lower quality service than “poor” Canadians (many studies have shown this).

The bottom line is clear: the vast majority of Americans would be better off both financially and health wise with a universal healthcare system. Anyone who would want to pay more and get less, just to ensure that they do not pay one cent to help any of the “undeserving” poor, should probably examine their motives, moral character, and claim to rationality. “It’s not the purpose of government to be an employer”, absolutely true, but it IS the purpose of the government to try to safeguard and improve the well being of its citizens. I am all for small government and the free market, because they usually do lead to the greatest good for the greatest number, but I don’t think that we should blindly adhere to this principle even when it is plainly obvious that in THIS case the greatest good for the greatest number lies elsewhere.

Conservatives can talk about liberty if they must but the question remains: why do they want the vast majority of Americans to be worse off? This includes the vast majority of conservatives. The Canadian healthcare system is not perfect, but it is abundantly clear that the Canadian system stands head and shoulders above the American healthcare system.

Posted by Jon_Sociologist | Report as abusive
 

I don’t deny that US healthcare is extremely inefficient. But you’re making a mistake when comparing overall spending with Europe. The state-funded systems there also have their massive inefficiencies. But they are from another source.

What you haven’t taken account of is that government spending is “more expensive” than private spending. Additional government spending requires an increase in the tax rate which reduces GDP by altering incentives. Christy Romer estimated that a tax rise resulting in a $1 increase in revenue reduces GDP by $3.

My take is that what is firstly regulatory changes that result in competitive healthcare provision and secondly “product diversification”: there needs to be rationing of healthcare at different levels at different prices. Then you can avoid the US problem of too-costly healthcare and the European problem of everyone being treated at the same level and funded completely by tax. You can have a moderate level of subsidization, not 100%.

Posted by CSMR | Report as abusive
 

Ninety Five Percent (here is another statistic) of all Americans’ health care issues are directly related to lifestyle choices. We have bought the lies that the FDA and AMA have pushed. The ‘food pyramid’ is wrong. High fructose corn syrup is not ‘natural’. Carbonated beverages destroy you joints. This is about money, not health. If you want health, grow your own food…the exercise will do you good.

Posted by Jim | Report as abusive
 

I work for a defense contractor, and have for 23 yrs.
Anyone who thinks they want the government to have any more influence on healthcare has their head up their arse, real deep!

Posted by wa | Report as abusive
 

Just look at it this way:

CURRENT HEALTH SYSTEM: you pay and you pay, it all goes to the pockets of insurance companies shareholders. You might be drop out if you are too expensive.

EUROPEAN STYLE HEALTH SYSTEM: You pay and You pay, maybe a bit more, and it goes to a pool, where you can pick it up any time. It will not go to shareholders”s pockets BUT to an old lady unable to pay, or a cancer patient.

Think, where would you rather put your money??

Posted by Miguel | Report as abusive
 

My father has socialized medicine. No not Canadian, American. He is over 65. He loves it. Could he get health insurance at 79 years old? NO. It is not profitable. Sorry dad. Health care is only for the healthy.

We are not talking about getting you car fixed. We may be talking about your child’s sight or ability to walk.
I have had Cigna thru my employer and they denied every claim until I fought with them. The insurance co deices what care I get not my Dr.
Sorry not everyone can have access to health care.
NO Sorry not every CEO can have a Rolls etc…

(Cut and paste from Forbes.com)
H Edward Hanway
Total Compensation
$28.82 mil (#35)

5-Year Compensation Total
$78.31 mil

H Edward Hanway has been CEO of Cigna (CI) for 6 years. Mr. Hanway has been with the company for 28 years .The 54 year old executive ranks 3 within Health care equipment & services

 

All what they say about the healthcare system is a bunch of lies. I lived in Canada, had two children and did not have to pay anything. A small premium was deducted called OHIP to pay for the healthcare when I was working. but when I stopped working I still got healthcare but did not have to pay. Here in the US when you stopped working everything goes to the dogs. You have to sell your soul to pay for anything healthrelated. Did anybody find out whether these people in Congress get life time healthcare even if they do not serve in the congress anymore. As long as they get a free ride they do not know what a common man has to undergo. Just like they receive whopping pensions, even when they go to prison, unlike us who even after working 30 years do not have anything called pension.

Posted by rangini | Report as abusive
 

Rick and Charles,

Yeah, right, lads, and George W. is a good ol’ boy from Texas. That’s sarcasm, by the way: George is actually a nasty piece of work from Greenwich, CT. (I used to live a few miles down the road from the Shrubs). In other words, you people will believe anything.

Posted by Eibhear | Report as abusive
 

Unlike the author of this piece, I have been following the actual legislation that has been proposed. In short, the legislation would cost me personally in excess of $80,000 per year more than I currently pay for my family. That is outrageous and unfair. That is reason enough for me to oppose the plan as written.

Secondly, the rationing of health care in Britain is not a myth or a lie. It is a fact. My father’s cousin’s daughter died in her early twenties a couple of years ago because the National Health Service refused to treat her condition. Treatments for her condition in the U.S. were available, but in the U.K, they wouldn’t treat her! By the time my family found out about it, the poor girl had been bravely fighting the NHS for a couple of years. We started raising funds to give her private care, but the U.K. government wanted to tax the funds! Before we could fight our way through the bureaucracy, she had died. As far as I am concerned, “national health care” murdered that poor girl. And, that is a fact.

Posted by Joe | Report as abusive
 

The health care system in the United States is fine. The argument for the government sponsored plan rests on the assumption that poor people don’t get health services in this country… which is completely false. Every hospital I know of offers a plan to make services affordable for the working poor, a group to which I belong. I do not have health INSURANCE, but I do get medical care.

The people I have spoken with who are resisting Mr. Obama’s plan are doing so because, in a word, it is UNFAIR and because Mr. Obama, within the first year of his tenure, already has an enormous credibility problem.

We have had detrimental legislation hastily shoved down our throats this year… and we are choking on it.

Posted by Eljay | Report as abusive
 

I feel sorry for the people of America.

As the richest country in the world it rates at 72nd from 191 countries for Overall Level of Health according to the World Heath Organisation.

For context: Colombia, Chile, Costa Rica and Cuba are rated 22nd, 33rd, 36th and 39th respectively.

The Free-market system is obviously a roaring success.

 

That Europeans look at the US debate on healthcare reform with bemusement is interesting, but not all important or relevant. That’s like us Midwesterners opining that Europe’s abandonment of its Christian foundation is a source of bemusement. “So what?”, Europeans would say. I think most Americans would agree that the scale of the federal government and its increasingly grand claim on Americans’ lives is a cause of great concern. With specific regard for healthcare reform, the singular element of the Obama administration’s plan is a tax-subsidized insurance plan that would compete with private plans. (And let’s not forget that the proposed plan would mandate coverage of elective abortions and require private plans to do so, as well.) US States that border Canada have hospitals full of Canadians who, despite their wonderful single payer plan, come to the US for surgery. So, while we’re glad Europeans are deriving some amusement by this, we’re not impressed by Europeans’ blithe attitude toward the loss of their liberty and their lack of understanding of the great issues at stake.

Posted by Mike in Indianapolis | Report as abusive
 

The United States became the strongest, greatest country on Earth due primarly to capitalism!

Perhaps we are not yet ready to become just another wimpy socialist nation.

 

One fact that is usually overlooked is that the fedral and state governments are already involved up to the neck in healthcare. For instance, all states have laws that ration healthcare by limiting the number of hospitals that can be built in any area. This surely inhibits the free market from functioning effectively. All states also mandate that no one can be refused treatment at an emergency room regardless of ability to pay. While I understand the charitable impulses that drive these regulations, we must be honest that they limit competition and shift cost from those who cannot or will not purchase insurance to those who make the sacrifices to purchase coverage for their family. I have long been of the opinion that government must get totally out of the healthcare business or jump in and manage it entirely. This hybrid system we currently have seems to be the worst possible option.

P.S. The comments about obesity, nutrition, etc. are spot-on. Americans need to turn off the TV, put down the diet soda, and get some exercise. Our diets and habits are making us one of the sickest populations in the world.

Posted by Bob | Report as abusive
 

It’s all well and good to think that health care works in America, that is if you can afford it (like most old white republicans). Otherwise, you’re just SOL, but you’re probably too busy trying to support yourself to really take part in the debate.

When I tell my collegues here in Germany that I probably wouldn’t have health insurance if I still lived in the states, and that many of my friends don’t, they can’t believe it.

Especially as a young person, if you deem it important, health care can use up a very large portion of your income (it’s probably not supported by your employer, and your income probably isn’t very big to begin with). These are the people who should be keeping the economy going by making those all-important first purchases, but the current healthcare system is really making them too poor to do so. As for young people who decide they can’t afford it? We’ll be paying for them in the emergency room or later in life because they did not get the preventative care they needed.

Anyone who thinks the system works is either afraid to admit that Americans don’t actually have the best health care in the world, or is right – the system works,but only for them.

Posted by enigma | Report as abusive
 

Cuba has better health care for everyone than we have. Here, anyone out of work or self employed has no coverage, and can easily die without basic diagnostic tests and treatment for illnesses as simple as pneumonia, or end up in debt that can take away their homes and small businesses. It’s just pitiful, and anyone who doesn’t get it has their ostrich-head down a hole. How come a third-world country like Cuba has universal coverage, and The World Leader USA does not? Rich people like Rush Limbaugh rely on fancy insurance plans to supply them with unlimited narcotics, while poor people go without antibiotics and insulin. Nice.

Posted by Dave Ebert | Report as abusive
 

It comes down to one of the statements in this article…Euoropeans see healthcare as a right, and Americans see it as commodity.

Nobody in America is denied health care. Period. The truthful statement would be that Euoropeans see health INSURANCE as a right, and true Americans see it as a commodity…because it is.

It’s insurance, the best health CARE is you taking CARE of your body. The problem stems when you have people claiming how health care is sooooo important while they are eating a cheesburger, and a drinking a coke. People that don’t take care of themselves, and complain about health care are hypocritcal. People that complain about health care costs, and carry an I-Phone, have all of the premium channels on their cable program, and play on an Xbox360 are hypocritical.

When something is important to an individual, they should make it a priority in life. They should prepare as much as possible for it. Your good health isn’t a right, and it is SELFISH for anyone to think that someone else pay for their health. And pay for it by force through the military backed government.

The costs, statistics, and other jabberwocky don’t even matter. It’s “your body”…a famous liberal slogan…well take care of your body, and accept the fact that we are all living in reality. You can’t govern reality.

Posted by Eric | Report as abusive
 

I think Americans overestimate the degree to which the Canadian healthcare system is government-owned. Government drug covereage is limited and really only for low-income people, as far as my Ontario-based experience tells me. In this province, routine dental and optometry are not covered either. Some lab services are not covered. Those are costs that group benefits programs cover or defray, but when I haven’t had benefits, I have been able to absorb most of these costs easily out of pocket, instead of digging into savings. I just can’t imagine living one health-disaster away from bankrupcy, or having the next decade of my life dominated by a health-disaster-related debt.

Americans seem to view universal healthcare as a form of welfare or a handout. I think in Canada we view it more as a government-run co-op. Our system has its ideological roots in the agrarian activism that surrounded the Saskatchewan Wheat Pool, the Credit Union movement, insurance mutuals and insurance co-ops. Resources are pooled and benefits alotted so as to produce the best options. It’s not a handout. We are members of the system. We support it as well as benefit from it.

Cooperative risk-pooling is different from having rich private entities underwrite the risk, but exercising your member rights in a co-op is not the same as taking a charitable handout.

Perhaps the real cultural barrier to universal healthcare in the US is a distrust of collectivism of any kind – as if collectivism of all kinds pose a threat to individualism or individual freedom. But that only applies to salient collectivism, i.e. the collectivist projects that are new to people. No-one seems to be clamouring for the abolishment of public police or fire fighting forces in favour of a user-pay system, mediated by rich people who would underwrite a community’s crime risk and pay only for those police services that would allow them to grow their profit margins.

This has all been said before, of course. All the perspectives in this debate are so tired.

Posted by Neil | Report as abusive
 

This is in reply to Scott Hess’s question. I live in the UK, and if I am visting a country within the European Economic Area (or Switzerland), thanks to the European Healthcare Insurance Card you are entitled to receive the same level of non-private and non-elective coverage as any insured person in that country provided I am carrying the card. So in short, the answer is yes.

Posted by Nakul Pande | Report as abusive
 

Listen up people. We Americans who are against this radical reform of health care are not immoral. We’re not the rich, conniving, greedy bastards you take us for. It’s not that we do not want to help people. That’s not it at all. You who accuse us of being the fattest, most overweight, disgusting nation while also condemning those of us who do NOT want to pay for everyone else’s health care need to get your head out of your ass. Do you have any idea what exactly we’ll have to pay for?!?

I have no qualms giving money to help a sick child with cancer, an elderly lady who needs financial help mending a broken bone, a teenager that was hit by an illegal in an uninsured vehicle, a single dad of 5 who needs surgery. What I DON’T want to pay for that fat slob next door, who lives off of McDonald’s, cheetos and soda who needs medication because of his gross lifestyle or the obese mother of 3 who eats box meals and take-out and lets her kids do the same, allowing a lifestyle that will not go without medical complications! And since our nation is so depressingly self-absorbed, ignorant and scared shitless of the most minute bacteria, there are so many people that go to the doctor for the slightest thing.

Now for a rough generalization:
On another note, do you realize just WHO will pay for others’ health care in this country? Think about it: there’s a socialist Democrat in office right now. Who do socialists not like too much? The rich Conservatives. Conservatives make up a large part of what? Business owners. Why? Because they KNOW HOW TO HANDLE MONEY. Who do they employ? Only the rest of the country, and then some. What happens if these rich people are taxed excessively? 1) They will stop donating (yeah, get this, rich people make up the majority of donations in this country), 2) they will have to cut back not only on donations, but on their employees which means lay offs and less benefits, and 3) they’ll just leave.

The conclusion is this: our nation’s people don’t know how to take care of themselves. If the obese/poor dieters get a “free ride” (paid for by others, of course) they’re not going to change. It’s not my fault they made those health decisions, and I just don’t want to shell out my money to help them continue to degrade. It’s their fault, let them pay for it. As for those with conditions they otherwise cannot help, the rich are happy to continue donating to hospitals. Lastly, Americans need to learn to save money, not spend money that 1) doesn’t exist and 2) they don’t earn.

Posted by Duncan | Report as abusive
 

It doesn’t require a mental giant to repair our medicare program. lst take those who never paid into the program out of the Social Security and medicare program. Stop the trial lawyers from taking everything to court for their 33 1/3% fees that runs up malpractice insurance fees that increases the medical costs. Do this just for a starter and perhaps the government would see the value of common sense application to a problem. Once stability is realized at this point you can branch our and solve other problems that needs attention.

Posted by Jas H | Report as abusive
 

Insurance is the problem – not the solution.

When you get car, or house, or even life insurance, it is for a fixed amount of money.

But with health insurance there is no limit. And you have already paid a ton. Do I want an MRI? – sure why not. Do
I want a triple bypass surgery even though I am 93? – of course. All the other fat smokers have been milking the system for years – why shouldn’t I get mine since I behaved my whole life.

And so nobody cares what anything costs – ever.

People don’t care. You are dying, or you were forced to pay for decades instead of saving the money, so why not.

The doctors don’t care. They are happy. The fancier
care you request – the less likely they are to get sued
(you got top of the line the whole way down the tubes).

And the insurance companies don’t care. Like the doctors they are actually happy. They pass on these primary costs and 10% of more money is more money for them. It makes the CEO look like he is clever and growing the Co – give him another raise.

Somebody has to care about the cost, for the costs to
be reasonable. Insurance doesn’t make anyone care about the costs. It makes them care less – a lot less.

Solution:
Every service and drug less than $3000 should be out of your pocket (no insurance – learn how to save money). $3k to about $1M should be insurance (who cares how it is done). But notice the cap. That is important (it should probably vary with age). When you
die 1/3 of the unused portion of the cap (say $1M) goes to your kids/estate (now you care how much of it you waste). You can take it out in your last 3 days – or you
can act wisely and for the good of the whole. Freedom – your choice. But at least you are motivated to care about the cost.

Posted by Bubba | Report as abusive
 

“And here is where your bizarre argument falls flat on it’s face. It’s not the purpose of government to be an employer.”
– Rick

Interesting… So we should disband the military?

Posted by Keoni Morrell | Report as abusive
 

“The only reason why Europeans can afford treatment is because medical and drug companies were able to deploy it profitably to Americans first. Good luck seeing medical breakthroughs when America is paying drug companies a pittance for treatment.”
– Charles Mcguy

Interesting… Wasn’t there a debate not more then 8 years ago about how we need to get rid of the FDA because people in europe were getting drugs that WE COULDN’T?

Posted by Keoni Morrell | Report as abusive
 

Thanks so much for this article. People need to understand that countries with government run healthcare are not falling apart, and that people are actually happy with it! Idk about you, but if Obama does not pass healthcare reform, I will move to country that has reasonable healthcare, France Germany and Britain all seem like good choices. I will not raise my kids under the current American healthcare plan.

Posted by Hector Maquieira | Report as abusive
 

Even if there are a disproportionate number of obese people, smokers, drinkers, etc., why do you suppose that they currently uninsured? Doesn’t their current participation in our healthcare system already increase costs? By arguing that you’ll be paying for their sickness with a national insurance system, you’re ignoring that you’re already doing so.

Even those that are uninsured affect your current healthcare system. They go to your ER’s and get triple bypasses. Who pays for it? Premium increases! Now what if this same individual regularly visits a doctor, who helps him change his lifestyle? You save!

Posted by EK | Report as abusive
 

The current reform does not address one of the biggest cost drivers to health care – Blood Sucking Lawyers. The AMA estimates that 30% of medical tests are so-called defensive medicine; tests conducted for the sole purpose of defending oneself in a medical malpractice lawsuit. OB-Gyn’s in Miami, FL pay on average $238,000 / year in medical malpractice insurance. Outrageous jury awards in the tens of millions of dollars are so common, that they are no longer reported in the media. You can’t watch TV for an hour in the US without seeing commercials for Sleazy Medical Malpractice Lawyers. Tort reform of the medical malpractice laws would do more to lower the cost of health insurance than anything that is being proposed in Washington. It will never happen, because the Democratic Party is owned by the Trial Lawyers. Trial lawyers and their political action committees contributed 135 million dollars to Democrats at the national level last year to keep badly needed tort reform from happening. (The Republicans took in a paultry $47 million.) Tort reform to do away with medical malpractice claims is the quickest way to reduce the cost of health care in America. Thankfully, our friends in Canada, the UK, France and Germany are not saddled with these corrupt laws that drive our health care costs.

Posted by Osprey | Report as abusive
 

this is just disgusting, i’m 24 years old and i seem to get this healthcare “reform” much better than alot of ignorant minds stuck in denial. My question is for those who support such a radical anti american health “reform” legislation, why is Obama sooo impatient in trying to get this passed? why? he’s only been in office for 7 MONTHS! and he thinks he already knows whats best for our health reform..haahaa.

He sure hasn’t come down to my state and have one of those stupid “community organized” town hall meetings, to ask me what do i think of such reform. He’s already going to make my children suffer and the next generation suffer with owing tons of money. I hope his resouces dry up and that that digusting health “reform” of his dies! WAKE UP AMERICANS!!!

Posted by p | Report as abusive
 

I just love reading these arguments against single payer health care. With all of the money WE have paid for dubya’s illegal wars, all of the money WE have paid Haliburton and the cheney family in the past eight years, WE could have funded songlepayer healthcare for the next hundred years! And We wouldn’t have all of those pesky DEAD YOUNG AMERICANS to deal with. But No the Repugnicans must protect their partners in crime,continue to lie about healthcare, even in the face of the evidence that it WORKS in England, France, Germany, Holland….

 

Government has never ran any program in an efficient way it has always cost more than the private sector while delivering the least amount of product (As if anything is produced by Government).

Posted by Think | Report as abusive
 

Each European country allows you to purchase an additional private insurance plan. Why would you need to do this if the national plan is supposed to be so good. American drug companies are capped on prices they can charge in European countries as are the amounts physicians and hospitals can charge. Hospitals are also given government money that comes from other taxes.

Posted by D Carpenter | Report as abusive
 

I feel that the elephant in the waiting room is this:

Medicare, our current federally subsidized plan, actually only pays about 33% of EVERY hospital bill that crosses their desks. The rest the hospital has to write off as a “contractual adjustment.” So the hospital has to charge more, just to recoup expenses. Thus the cost of medical care goes up.

I’ve heard often lately how Medicare’s books are so clean, and how they’re the example of an efficient government system.

Well any business practice can be efficient if you only have to pay 33% of your bills.

Medicare is one of the biggest causes of the inflating cost of healthcare in America.

Or, put another way, our government is one of the biggest causes of the inflating cost of healthcare in America.

I’m not opposed to a universal healthcare plan for Americans…I just don’t trust our government to implement it.

Posted by Jeremiah | Report as abusive
 

Explain to me why Canada and England citizens continually come to the USA for treatment when they are placed on a waiting list for years before they will receive treatment? Example, a lady in London needed a knee replacement, she was placed on a two year waiting list. She came to the USA and was operated on and in recovery for three weeks. The whole process took six weeks. Try that in Germany, England, Canada or France. Kids have been sent to the USA for serious operations fron Canada because they haven’t the facilities to do the surgery. How many MRI machines do they have in the whole country of Canada? Is it six or seven? How many of the countries that have socialized medicine have the illegal aliens population that the USA has and we have to take care of in our ER rooms and hospitals? I guess that is our socialized medical program? We do need gov’t. control on the cost of medicine and some way to have the same health care that our congressmen and senators have and pay for it the same way they do. How many of the worlds hospitals are ever listed when identifying the best hospitals for people to survive serious medical trauma. I have never seen any foreign hospitals on the list, only USA hospitals. Why do so many doctors from other countries come to the USA to practice medicine? There must be other reasons than money. As to the person that said he will move to another country to get good health care—Well what are you wating for? George

Posted by George | Report as abusive
 

Why is socialized health care not good enough for us? How about why is slavery not good enough for us?

In all past civilizations men were ruled by kings, emperors, war lords, popes etc. But when America was founded, we didn’t say, “Hey, that has been good enough for everyone else, we should have a king, too.” (Actually many did.) Instead we acted on the most significant discovery in the history of mankind, the discovery of Individual Rights. That’s the right of INDIVIDUALS to choose the course of their own lives and to take responsibility to pursue – not be guaranteed – happiness.

America is a Republic with a Constitution charted, NOT to carry out the whims of the majority, but rather to defend individuals against the majority. Elections are merely to select those who create laws that uphold and Obey the Constitution. Our Founders specifically rejected Democracy as mob rule.

The reason we should reject socialized health care is because it is an immoral attack on the rights of doctors, nurses, medical product makers, hospital owners, AND patients to control their own lives.
Health care should be purchased through voluntary contracts for health care services.

One cannot have a legitimate moral right to work provided by someone else, even if the government makes it a law.

Posted by Objectively Speaking | Report as abusive
 

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.

Posted by AusTx | Report as abusive
 

Nationalized heath care. Wonderful idea, one small problem. Our CONSTITUTION, as written, does not enumerate or grant the necessary power to create the proposed plan. But, perhaps that doesn’t matter. While our gov’t doesn’t have the granted authority, it apparently has the power.

Posted by James | Report as abusive
 

Governments employ people to protect the interests of the people (gov’t). They are called soldiers.

If America had a universal plan then everyone would be able to have health care just like prisoners in our jails do.

But then to make any money with that type of system you would have to elect a president who would eliminate the competitive bidding process. Wait we had one of those already!

Posted by Gerry Powell | Report as abusive
 

One important fact completely left out is the quality argument. Why are our cancer clinics, orthopedic surgery centers, etc., etc. full of waitlisted Europeans and Canadians (including politicians and the wealthy)? Because your system doesn’t reward doctors for being brilliant, you have shoddy third-rate care which you wait for endlessly and pay for excessively in your own systems.
Mind your business, and if you get something terminal that your offshore cut-rate doctors can’t fix, come here and we’ll fix it. That’s how it works.

Posted by Matt | Report as abusive
 

hahahaha life expectancy and infant mortality are the only important factors??! What a freaking idiot. No, those are the only stats you could find that would even come close to suggesting socialized medicine works better than our free market. You shallow drone in your utopian fantasy land. How about the fact that I can set an appointment with my doctor now, and see him tomorrow? How about if I want 20 tests run, I can get 20 tests run, just for the hell of it? How about the fact that any woman can have a mammogram performed any time they wish, and they aren’t required to have a golf ball-size lump in their breast beforehand?!

We have the greatest healthcare system in the world, so stop comparing us to countries that are trying to UNDO their failing socialized systems. Our system has faults, and needs some reform to get costs under control and cover pre-existing conditions, but it is still the greatest in the world, and comparing ourselves to other countries for guidance is like Tiger Woods asking me for pointers on his swing. The free market will FOREVER produce the best of humanity’s potential, as it always has. Brainless drones like yourself have collectively brought about the destructions of great societies since the beginning of history, with your pathetic delusions of an imaginary world where irresponsibility and laziness thrive.

Posted by Josh | Report as abusive
 

The last paragraph shows exactly the kind of nonsense you’d expect from a liberal/socialist/marxist/etc. “The only statistics on health care systems that really matter are life expectancy and infant mortality.” Really? Just those? Of course, speaking of lies and damn lies, exactly how does one come to that conclusion? Certainly not with any tangible fact. It just feels right to say those things to help your position. As with most liberal butterfly, puppie dog and rainbow ideas, it just doesn’t hold up in the real world.
So let’s forget for one moment that the U.S. government has no constitutional authority over or, more importantly, responsiblity for, our health care. This is a political issue to help bolster liberal power with the perception of good deeds. The vast majority of the country isn’t screaming for this. Only Democrat politicans are. No one is dying in the streets for lack of care. That does not happen here. Some have had catastrophic illness wipe them out financially but that’s the overwhelming exception to the rule. Life’s not fair and no amount of Liberal government intervention will change that. The government doesn’t exist to prevent life’s accidents, bad luck, unfairness etc. The Constitution of the United States states; “…Life, Liberty and the pursuit of happiness”. Not “Life, Liberty, free healthcare, purchase of a new house even if you can’t afford it, no natural disasters, lower drug costs, Global community over country, bailout unions, banks and car companies , and the guarantee of happiness”. Funny how no one rushes off to Germany, England, France and Canada for better healthcare. But let’s not let the obvious getting the way of emotional arguments.

Posted by Randy Threet | Report as abusive
 

Alright, let’s clear up a few misconceptions for you Americans.

1. We do not personally pay more through taxation than you pay through insurance, no matter how cheap you think yours is. I’m begging you guys- go look at the stats instead of copying something a lobbyist told you.

2. We do not have longer wait times. I know it’s hard to believe what with all the conservatives shoving it down your throat but for all essential procedures wait times are less, the same, or only moderately more. Again, look up the stats yourself. Wikipedia has a nice list of references for you to check out, all of which are legit.

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.

Posted by Dudely | Report as abusive
 

This is easy. One of you is in line with me for front row concert tickets. The ticket clerk looks at your paycheck, and decides that your front row seat will cost you $30. Fine. The ticket clerk looks at my paycheck, and decides that my price for the very same ticket will be $200. Currently, that would be illegal, but people don’t seem to think that’s a problem when we’re talking about healthcare reform.

How would you like to have the same healthcare you have now, but at twice or three times the cost? Better yet, what if you could have better healthcare, and force your neighbor to pay your bill? This is exactly what we are talking about doing right now.

I had surgery recently, and my out of pocket costs were over $4000. Lots of people say, “That’s why we need this healthcare reform!” Well, healthcare reform is going to cost me at least $2500 per year. That’s a lot to pay when you are healthy and don’t need much medical attention. I currently pay $120/month for medical insurance, including dental and vision, supplemental cancer insurance, and my employer pays the balance, not taxpayers. In the near future, I will have to pay over $200/month for what will certainly be less coverage, and taxpayers will have to pay for any shortfalls. $4000 for one surgery is starting to sound pretty cheap to me.

Maybe I’m suffering from dimentia, but it seems to me that somebody will get free insurance at my expense, and I will have to pay twice as much for less coverage for myself. Of course, I only represent the 20% of the population that now pays 80% of all the taxes in this nation. It will be easy for the other 80% of America to rob us blind, until there is no money left.

I am perfectly happy to pay my own bills, and I can afford them, because I live within my means. I have a very small home, and I drive one of the cheapest cars in America. This way, when the economy sniffles, I don’t have to panic. I’m not stylish, and I don’t buy the nicest clothes, and I don’t eat in expensive restaurants. I don’t eat fast food. I cook, and it’s pretty cheap to cook at home. I am what you might call independent, right up until the government takes away my money and gives it away to some stranger who did not earn it. If I had three kids out of wedlock and no high school diploma I guess I’d be collecting checks from the government instead of working for a living. (That would be YOUR tax dollars, by the way.) The thing is, I was taught growing up that it is better to starve than to depend on others, so I worked seven days a week for 12 years, taking 14 days off work during that entire time. From age 18-30, I was a laborer in a textile mill. I saved my money and made good financial decisions. Now, the rest of America calls me ‘wealthy’ when they aren’t cursing me for my greed. Do you want to be demonized for working hard and paying your own bills?

Who will pay the bills when the wealthy people are finally bankrupt? Who will provide this low-cost healthcare to the rich when they become poor, or will we still throw them under the bus and steal whatever they have, as we do now? When there are no rich people left to hire workers or buy goods, where will the rest of America find jobs, and who will buy their trinkets? And, you politicians, who will fund your campaigns when CEOs have no money to spare?

Posted by james | Report as abusive
 

Our government has never been good at running anything. I certainly do not want them in charge of my health care. I work hard and am not rich.
Some of you get bogged down in comments about Rush Limbaugh and W., like they caused the situation are throwing out cheap shot excuses for everything that is not going their way. I am sick of this name calling, blame game. Free loaders that want to choose another country to live in-are more than welcome to go.

Doctors are not a group of blood sucking, money grabbing jerks. Most are afraid of being sued by lawyers and trying to cover their liability insurance. Our laws have to be revised to cap medical claims. Tort reform would do more than anything else to lower our health care costs.

Questions for the Canadian: Do you realize how many Canadian doctors currently practice in the USA? Where would you go for health care, if your life depended on it?

Posted by Cindy | Report as abusive
 

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