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 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

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.

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