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April 20, 2009

Comments

Kindly tell me the distinction between taxation and theft

Universal suffrage.

Why would any charity have to provide basic preventative health care for 300 million people?

Because that's the only way you can make any kind of meaningful comparison between the effectiveness of a charity providing universal health care vs. government providing the same? That was the topic under discussion, after all.

And yeah, I thought the idea was idiotic too.

Most Americans can afford to pay for it themselves.

Then again, so is this.

Also, yearly checkups are a waste of money for most young and healthy people.

Surpassed only by this.

I can't decide whether Mark is spoofing or just uninformed. Survey says?

Catsy just about said it all to Mark, and better than I could have. So let me make just one additional point.

If you can find 50% + 1 of the votes needed to enact your system of government, you win. Rural San Diego county, for example, has gone years without paying for region-wide fire coverage. Recent wildfires are causing friction (ahem) between the low-tax and the government-fire-response communities.

On health care, we as a country decided a long time ago that no one would be denied essential medical care due to lack of ability to pay.

If you want to change that decision, go find the votes.

"And again, this is the liberal utilitarian argument. It's okay to coerce people for a good cause."

Yes. America: love it, or leave it. Why do you hate America? Why not find a place where there are no taxes, and no government that imposes "laws"?

You'd obviously be happier. So, go find such a place.

Brett:

What I honestly don't understand is why you're more frightened of the government than you are of the medical insurance industry. I wrangle with some government agency maybe once a year, twice if you count taxes automatically; I wrangle with a medical insurance company or their effects at least once every six to eight weeks.

I have not been personally *afraid* of what the gov't will do, even when we discovered we owed $2K for last year -- they can cope, they'll listen to reason. I have been *afraid* of insurance companies, I have had to experience direct physical pain because of their decisions -- like, for instance, not approving a medication I need before a weekend. Or the time when my coverage lapsed for a month, and I had to cut back on my meds to skirt the edge of illness. Or my husband being in constant knee pain but the company not having agreed to surgery for him, because it hasn't hurt *enough* yet.

You say the government works by coercion and the frequent threat of violence, but I honestly do not see that as realistic threat. The threat I feel from medical insurance companies is direct and personal, a matter of my daily health. What Kate Michelman is experiencing -- what Gary Farber here is, for another -- is closer to a literal life-and-death struggle.

Are you saying that this isn't familiar to you, either personally or in people close to you?

First, there is the question of innovation in health care. Certain types of universal health insurance would squash it. I would want to avoid that for the most part. I would suggest that 'universal health care' pay for only treatments older than a certain number of years (7-10) unless the new treatment is cheaper than the old treatment.

I have no idea how this is being justified. Certainly I can't think of any compelling reasons for why this would be the case.

Matt C -- Type II diabetes is primarily caused by the patient, due to obesity (and old age)

??!

I've often said that conservatives really want to watch people starve to death in the gutters. Thank you for demonstrating this.

//If there was a way of ensuring that black people didn't get it, we'd have had national health care by 1970.

SS only got through Congress when originally passed (1935?) by excluding most domestics and agricultural workers.

Wonder who they were....

Posted by: Davis X. Machina | April 20, 2009 at 10:48 AM//

It was southern democrats, according to wikipedia. "Some have suggested that this discrimination resulted from the powerful position of Southern Democrats on two of the committees pivotal for the Act’s creation, the Senate Finance Committee and the House Ways and Means Committee.[citation needed] Southern congressmen supported Social Security as a means to bring needed relief to areas in the South that were especially hurt by the Great Depression but wished to avoid legislation which might interfere with the racial status quo in the South. The solution to this dilemma was to pass a bill that both included exclusions and granted authority to the states rather than the national government (such as the states' power in Aid to Dependent Children). Others have argued that exclusions of job categories such as agriculture were frequently left out of new social security systems worldwide because of the administrative difficulties in covering these workers.[20]"

Glad I could help you with that.

I'd like to point out that many republicans reject UHC because they don't think it will work in America...not because they hate helping people who fall victim to acts of God.

Ddddave, surely you should have more self-respect than to bring up this whole "The Defenders Of Racism Before 1965 Were Democrats" story as if this sad legacy were the defining feature of the modern Democratic party?

Yup, racist Southern Democrats were scum (the hint is in that first adjective there). But the Democratic party rather emphatically broke with that legacy; that's how LBJ famously "signed the South away for a generation or more". And that's how Nixon, and his heirs Atwater, Rove, and Bush picked up the South, which they largely hold to this day. Some of them even explained their strategy to do so in plain language.

It would be unfair to the modern GOP to say that it is defined by its embrace of Southern racism (or, these days, other rural intolerances, such as for homosexuals, Muslims, and Atheists), but it is far more true to say that the taint of Southern racism is a problem for the modern GOP than to say that it is a problem for the modern Democratic party.

"Glad I could help you with that."

Do you know anyone unaware of the racism of the Dixicrats? Do you believe anyone here is unaware of the racism of the Dixicrats? If so, could you name such people, please? If not, what's your point?

But there is apparently someone unaware of what happened to the Dixiecrats after the Democratic Party became less congenial for them -- or at least someone who pretends to be unaware and hopes others are as well.

I don't think it's that hard to understand. Most philosophical conservatives (not to be confused with the ideological monstrosity that calls itself the GOP) don't have a problem with inequity in society; they are more concerned with maximizing individual liberty and limiting the role of the state. Their opposition to universal health care flows naturally from those two premises. I don't agree at all, but I don't find it unfathomable either.

But there is apparently someone unaware of what happened to the Dixiecrats after the Democratic Party became less congenial for them -- or at least someone who pretends to be unaware and hopes others are as well.

Well, I would prefer to call an argument like that something along the lines of "un-informed", as opposed to dishonest or deceitful; I like to think the best of people...

Give me a break. When Davis X Machina asked "Wonder who they were....?", do you really believe he was suggesting it was democrats? I was just responding to him.

Administrative costs are a large part of what we are buying. Most doctors are now in group practices or at large clinics. Those groups or clinics have a large staff of people whose only duty is to deal with insurance companies. Virtually every claim is refused when it is first presented, and some have to be sent back with minor (and I do mean minor) tweakings. This isn't free, and ultimately our bills, regardless of how we pay, include the cost of these people's salaries.

I was astonished to find this out. I had thought it was a problem faced only by "alternative" practitioners, like massage therapists, for instance. But my family doctor explained it to me.

"Give me a break. When Davis X Machina asked 'Wonder who they were....?', do you really believe he was suggesting it was democrats? I was just responding to him."

No, I believe he was suggesting that "most domestics and agricultural workers" were African-Americans. That's grammatically what his sentence says, given the antecedent of "they."

Why you think he was referring to anyone else, I have no idea.

Give me a break. When Davis X Machina asked "Wonder who they were....?", do you really believe he was suggesting it was democrats? I was just responding to him.
Actually, it's pretty clear that Davis X Machina was asking who the domestics and agricultural workers were, and not who the lawmakers insistent on excluding them were.

The comment again:

If there was a way of ensuring that black people didn't get it, we'd have had national health care by 1970.

SS only got through Congress when originally passed (1935?) by excluding most domestics and agricultural workers.

Wonder who they were....

Posted by: Davis X. Machina
Surely you agree that "they" there refers to the Workers, and not to Congress, especially as Davis doesn't even refer to any faction within Congress?

Guys, if he doesn't know what a double negative is, he surely doesn't know what an antecedent is, which is why I suggested previously that he leave grammar to the grammarians.

[I haven't been able to get this comment through for a while, so a few bits have already been said, and better, but at this point it's a sunk cost issue, so . . .]

"That's pretty nasty, wanting people to die who could pay for the life saving treatment out of their own pocket."

Besides the not really true bit, one could also say, if responding in kind, 'that's pretty nasty, wanting people to die just because they can't manage to pay for life saving treatment out of their own pocket?' (And, of course, wanting people driven into bankruptcy, forgoing necessary care so they end up with much more serious (and costly) conditions, etc.)

"Since you insist on asking, because democracy is a sad, sad substitute for freedom."

Sure. Likewise, capitalism or mixed economies are sad, sad substitutes for a utopian paradise where "from each according to [their] ability, to each according to [their] need" actually worked. But in the real world . . .

Which is where we live, almost all of us in extremely complex, densely interdependent, and quite crowded societies. Even hunter-gather societies aren't "free"; it's hard to imagine how we'd manage it at this point in time.

And, of course, it seems incomplete to only look at governmental constraints on freedom, as opposed to also considering those chains forged by any other kind of oppression, stemming from any other imbalance of power. Gov't saying 'pay taxes or go to jail', etc. is a constraint on freedom, but so is being born into poverty, or as a despised minority, or facing megacorporations unrestrained by regulation, or facing certain kinds of widespread environmental problems, etc. (But of course, that's why I'm a modern liberal).

"kindly tell me the distinction between taxation and theft. "

Well, for starters (assuming we're talking U.S.-style taxation), one usually doesn't get a voice (to whatever limited degree, granted!), alongside ones neighbors, regarding who the thieves will be, how much they're going to take, and how the money will be used & re-invested in one's neighborhood. In fact, surprisingly enough, thieves rarely steal money in order to (granted, in part) improve the neighborhood, defend it against internal & external threats, aid commerce, and improve the general welfare; those few highly organized criminal organizations that make even the slightest gesture in this direction gain, I've always heard, a lot of (uneasy) support, because they're in fact providing services that legitimate government can't or won't (even if because of their own actions).

Mark and Brett owe me money.

Every move they make costs me.

But, I'm a gonna let it go this time.

But there will come a day, and I will come to them and I will ask them for a favor, and they will do me that favor, because I have asked nicely.

Gary and Warren, I stand corrected.
Phil, I'm sure there are things you don't do well.

"Stressed Americans postpone healthcare

"WASHINGTON (Reuters) – Twenty percent of Americans say they have delayed or postponed medical care, mostly doctor visits, and many said cost was the main reason, according to a survey released on Monday. . . . "We are seeing a positive correlation between Americans losing their access to employer-sponsored health insurance and deferral of healthcare."

Why don't you liberals be honest and admit that the government operates like the mafia?

Is there a Godwin analogue for mafia references?

I was going to respond to this by saying "agents of the government don't remove your teeth with pliers", but I'm not sure that's true anymore.

Nice Info. I like it. It is very important to stay on top of your health and have a check up at least once a year to ensure that you remain healthy. Many health problems are curable but you need to catch them in time. Do not wait to go see a doctor because it may be too late.

Phil, I'm sure there are things you don't do well.

Countless things. I try not to open my mouth about them, lest I look dumb.

The government doesn't remove your teeth with pliers? It prison rapes you, and then treats it as a joke; Is that good enough?

Look, democracy might indeed be the "least worst" form of government. And if we had a choice between the health care system being run by democracy, or a hereditary monarchy, the choice would be easy enough.

But democracy being the best of the worst doesn't mean squat when the choice is not which form of government will do something, but whether a form of government will do it, or it will be done some other way.

So, I will say, among forms of government I prefer democracy, but I prefer freedom to democracy. Living in a democracy doesn't mean you have to vote on EVERYTHING. In fact, the more you get to individually decide on, and the less you have to vote on, the better.

Im lucky enough to live in the UK where we have the NHS, although it is somewhat of a dated service i have chosen to taken the additional cover of health insurance providing me with shorter waiting times and the best medical facilities

Brett: So, I will say, among forms of government I prefer democracy, but I prefer freedom to democracy.

...okay, Brett, I've found the ideal place for you to live: Howland Island. You'll still have to deal with the infringement on your freedom of a government department visiting briefly once every two years, but other than that, you can be as free as you wish. Bye bye, Brett.

"I was going to respond to this by saying "agents of the government don't remove your teeth with pliers", but I'm not sure that's true anymore."

But using regulation pliers, and not more than one tooth within a 24 hour period, to allow the subject to rest* in between sessions - so it's all ok!

* well, not rest, but . . .

" In fact, the more you get to individually decide on, and the less you have to vote on, the better."

I'd say there are, at least, strong arguments for this. Personally, I'd like to decide to have reasonably safe and/or well-labeled food &medicine, a relatively clean environment, a basic safety net for my neighbors, fairly good public transit, some basic provisions against malfeasance in high places, and some limits on the ability for random folks to easily obtain rocket launchers and such.* Ok, so what do I do? Squeeze my eyes shut and concentrate really hard, like Hiro on Heroes?

(I am totally with you when it comes to yard care, though).

* YMMV

"a government department visiting briefly once every two years,"

Oppression!!! Guns being pointed at one's head!!! Etc.

Brett:

In case you didn't see it, I still have a question for you on the floor:

What about your *experiences* makes you more afraid of the gov't than of the medical insurance industry? Do you actually deal with the latter without fear, without feeling a direct, personal threat?

The government doesn't remove your teeth with pliers? It prison rapes you, and then treats it as a joke; Is that good enough?

It strikes me that you've lived under bad forms of government so long that you've forgotten the possibility of good government. Most western governments do not imprison the large proportion of their population that the US does, because most countries do not have the commercial prison-industrial complex that the US has. Most countries do not treat prison rape as a joke, instead they try to prevent it. I live in the UK, under a government that you would doubtless consider absurdly restrictive. I however like having a government providing a police force that helps to protect me, since I'm not sure I could afford my own private armed guards to do so. (And my eyesight's bad enough that you really wouldn't want me having a gun).

Mark:

Warren Terra pretty much covered this, but does anyone really need to point out the problems with paying people by the number of fires they put out or the number of burgled homes they investigate?

Also, how is old age a patient's fault? Should we all step in front of buses at 60? Or perhaps we should be set adrift. I will agree that measures to prolong a life by a few weeks are often pointless, but using insulin to add many otherwise healthy years to a life isn't.

The government doesn't remove your teeth with pliers? It prison rapes you, and then treats it as a joke; Is that good enough?

Actually, that is among the places I was going with that comment.

But using regulation pliers, and not more than one tooth within a 24 hour period, to allow the subject to rest* in between sessions - so it's all ok!

That's another.

So, I will say, among forms of government I prefer democracy, but I prefer freedom to democracy.

Your argument here seems to assume that no government equals freedom, for some useful definition of freedom.

You might want to consider if that is actually so, and/or if there is any evidence that it might ever have been so, or could ever be so.

The only scenario in which I can imagine "no government" being equal to "freedom" is if there are either no other people around, or if you can solve the problem of other people being around by going someplace else.

Otherwise, "no government" generally means the guy with the biggest gun gets his way.

Unless you happen to be the guy with the biggest gun, that's not really freedom in any meaningful sense. Even if you *are* the guy with the biggest gun, it's probably not really freedom in any meaningful sense.

That's not freedom, it's organized crime. Real organized crime, not penny ante "they made me pay my taxes" organized crime.

Can you give me any example from the entire history of the human race where people lived together in populations greater than, say, 100, without some kind of government?

By "government" I mean some mutually agreed upon set of rules and institutions, where the price of participation meant submitting to those rules and institutions, and a refusal to do so meant you were either punished or had to leave.

I'm looking for one example.

If no such example from, let's say, the entire Holocene can be found, maybe you should consider that you're looking for a pony.

So have we abandoned the myth that drug prices are driving health care costs in the US? I mean I'm glad to, but I don't want to take silence as assent.

I think drug prices end up being a flash point not because they are particularly important in the overall question, but because they are among the few places where average voters end up being exposed to anything like the real costs of health care. That captures the popular imagination, and then you get serious people suggesting that slaying drug companies is going to be a serious step toward saving costs in a national health care system.

We could cut drug profits to ZERO and still have dramatically more expensive US health care when compared to other nations.

The US government already spends about 4.7% of GDP for Medicare and Medicaid.

The US government already spends about 6.6% of GDP on public health care spending. See here

It already has public spending on health care comparable with Canada (6.7% of GDP, and very close to France (7.4% of GDP). It already spends more public money than the UK (6.4% of GDP). This looks even worse when you look per capita, because the US has a higher GDP per capita than almost all the comparable states.

The US government already spends more than enough to have the UK's rather crappy universal health care system. What's up with that?

Sebastian: So have we abandoned the myth that drug prices are driving health care costs in the US? I mean I'm glad to, but I don't want to take silence as assent.

Which is good, because all silence meant was that I went home for the day. Although in truth I don't know how I can meaningfully respond to criticism of an argument I didn't make--I never said drug prices were driving health care costs in the US, in fact I never said anything remotely close to that, so I don't know what myth you're talking about here. You just seized upon that one single data point and ran with it.

What I said was in specific response to this quoted line, which was one of four things that contribute to why we get less for what we spend on health care than other countries: "higher prices for the same health care goods and services than are paid in other countries for the same goods and services"

To which I pointed out that salaries "figure into this somewhat, but the real culprit here is bloat from drug company patent monopolies and kickbacks".

Note there that I'm not saying drug companies are the reason health care in America costs so much. I'm saying that patent monopolies and the like are the main culprit in why we pay more for the same goods and services than in other countries. See, for example, the entire brouhaha over people ordering medications from Canada because it's cheaper there. I'll give you a hint: it's not because of the exchange rate.

I would appreciate it if you would refrain from taking one small, specifically-targeted piece of my argument, inappropriately broadening its scope to turn it into the entire argument, and then using that straw man as a reason to disregard everything else I have to say.

Sebastian: The US government already spends more than enough to have the UK's rather crappy universal health care system. What's up with that?

As others have already pointed out to you, except you didn't seem to be paying attention: the US is spending far more than the UK, considered both if you were spending this kind of money per person (which you're not) and as a percentage of GNP.

There have been fairly subtle and detailed discussions about why this is, in this thread, which you do not seem to have been paying attention to and which I will not summarise for you. But yes: if the political will was there, which it is not, the US could run a universal health service at less cost than it now does, and provide a much better service than the UK.

"To which I pointed out that salaries "figure into this somewhat, but the real culprit here is bloat from drug company patent monopolies and kickbacks"."

Maybe I don't understand what 'the real culprit here' means in this context.

I was responding to the fact that the real culprit here is most definitely not drug costs.

"See, for example, the entire brouhaha over people ordering medications from Canada because it's cheaper there. I'll give you a hint: it's not because of the exchange rate."

I'm well aware of why people order medications from Canada. I'm beginning to suspect you don't. They order it from Canada because Canada doesn't pay a high enough price to pay for the research costs.

"I would appreciate it if you would refrain from taking one small, specifically-targeted piece of my argument, inappropriately broadening its scope to turn it into the entire argument, and then using that straw man as a reason to disregard everything else I have to say."

Considering that you just reiterated the exact same argument again, I'm having trouble understanding what other argument I'm supposed to be responding to.

Drug costs are less than 10% of medical spending. US health spending is almost double that of say Canada. Cutting drug costs to ZERO (which surely you understand isn't possible even in Canada) would still leave the US with about 180% of the Canadian costs.

You keep stressing good and services, without analyzing what the services component means.

You can spend more on services in two ways. First, you can use them more often. We do that in the US health care system. Second, you can pay the people providing the services much more money. We also do that in the US health care system.

That is the real culprit. I don't know what we should do about it. But I do know that focusing on drug costs isn't fixing it.

"Your argument here seems to assume that no government equals freedom, for some useful definition of freedom."

Not at all.

We're caught on the horns of a dillemna: Governments inherently limit freedom, but the absence of government is not a stable equilibrium. You get rid of one government, another will move in, or simply arise from petty thugs organizing. So anarchy is not feasible.

But that doesn't imply that we can't expand the portion of our lives which IS free. We live under a government now, but there are still portions of our lives which are neither constrained by government, nor coerced in other fashions.

We should seak to expand that portion, not contract it.

The key in understanding this has to do with two fundamental ideas.
The first is the term 'entitlement' vs. investment. It is cost effective for taxpayers to invest in government provided health care; private providers have been proven costly. In terms of the economy, investing in healthy workers and students means greater production; bankrupting swaths of our populace for their inability to afford health care has, by contrast, potentially catastrophically deleterious effects on the entire economy.

The second has to do with the left making this a moral issue. The moral issue actually is a preexisting, epochs long cultural imperitive of the medical profession contained in the Hippocratic Oath. It does not have to be the government's moral imperitive that every citizen get health care; that's the business of the medical profession; however, given that it is an essential tenet of the medical profession, the most effecient way to cover the costs incurred as a result is a very real concern of government and society. If conservatives and Republicans think emergency room socialism is the answer, they need to be held accountable for such Politburo thinking.

"As others have already pointed out to you, except you didn't seem to be paying attention: the US is spending far more than the UK, considered both if you were spending this kind of money per person (which you're not) and as a percentage of GNP."

You quoted me, but didn't see the distinction I made. "The US government already spends more than enough to have the UK's rather crappy universal health care system."

I'm well aware that the the US (both public and private expenditures combined) spend much more than the UK's public system. My point is that the US government already spends more than the UK's universal system.

Yet it isn't a universal system. The US government can't get universal health care out of spending at that level. I think it might be useful to analyze why the US government is ALREADY spending about enough money to get Canadian or UK universal health care but NEVERTHELESS only actually provides health care to about 1/3 of the population. (And that is a wild grope and remembering how many people the US government provides health care to. It might be lower.)

The US government [doesn't want to] get universal health care out of spending at that level.

Fixed that for you. If the political will was there to cut bureaucracy and extend health care to all, the US could do it. It's not, and so the US has an expensive and thoroughly crappy system which the NHS beats into a cocked hat.

I think it might be useful to analyze why the US government is ALREADY spending about enough money to get Canadian or UK universal health care but NEVERTHELESS only actually provides health care to about 1/3 of the population.

Certainly it would. But as you have already ignored all the analysis in the thread preceding, I'm thinking that, like the US government, the political will is not there.

Sebastian:

In case it escaped your attention, I had a question for you that rolled over to the previous page.

To take a specific example: Part of the cost of drugs in the US must be the costs of doctors and pharmacists wrangling with insurance companies, and the costs of the insurance company people doing the wrangling. If I were a Canadian, none of these expenses would be incurred, so how can drugs *not* costs more in the US? And isn't all that effort and expense pretty much completely wasted? Its only purpose can be to let the insurance company hold onto my premiums longer -- which is where they make their money, so as a for-profit business that *must* be their goal.

Here I am, asking again:

Brett, what in your experience makes you more afraid of the government than of medical insurance companies?

"If the political will was there to cut bureaucracy and extend health care to all, the US could do it. It's not, and so the US has an expensive and thoroughly crappy system which the NHS beats into a cocked hat."

What does that even mean? You are speaking too generally. Cut what bureaucracy? Medicaid bureaucracy? Medicare bureaucracy? And anticipating a possible rejoined--even if you think it is the insurance company bureaucracy, that doesn't explain why Medicare can't cover all the uninsured people in the US. It is already spending as much as the UK covers everybody with, why can't the US cover current Medicare patients PLUS 100% of the currently uninsured--at a minimum?

What is 'lack of political will' in that context? The US government has ALREADY committed to spending as much as the UK does for universal health care. That suggests either that there is something else going on in the US, or that the US government is running a horrifically inefficient program (like on the order 1:3 ratio of useful spending to waste).

Doctor Science: "Part of the cost of drugs in the US must be the costs of doctors and pharmacists wrangling with insurance companies, and the costs of the insurance company people doing the wrangling. If I were a Canadian, none of these expenses would be incurred, so how can drugs *not* costs more in the US?"

You are confusing 'part' with 'substantial part'. I'm fully confident that you have identified *an* area of increased costs. But again, it is just like Republicans saving the budget by attacking earmarks--you aren't dealing with anything substantial.

Drug prices are less than 10% of US health expenditures. Even if you believed that the savings from cutting out insurance company wrangling was 100% (that you could make drugs and drug research free) we would still be roughly at 180% of the Canadian spending level. I suspect that you don't actually believe that we could reduce drug costs to free, so the savings would be significantly less than that.

Further, you seem to be assuming in the rest of your question that there won't be anyone wrangling with government denial of claims, and that the government won't have people denying claims. Which seems a rather unreasonable assumption if you know Americans. ;)

For your point on profits, see also this

Insurance company profits make up about 0.5% of total US health care spending.

Maybe I don't understand what 'the real culprit here' means in this context.

No, you really don't, since you've insisted on misreading this line, completely absent its context, in exactly the same wrong way that I pointed out was wrong the first time you did it.

I was responding to the fact that the real culprit here is most definitely not drug costs.

The real culprit here--where "here" specifically and exclusively refers to the issue that we regularly pay far higher prices in the US than people in other countries do for the exact same product--I noted as being patent monopolies, kickback schemes for prescribing name brands over generics, and other similar mechanisms that US drug companies use to jack up the price that domestic consumers have to pay.

Please note--and it's annoying me greatly that I have to say this again, about as explicitly as I did the last time--that I am not making the argument that these factors are the primary driver behind the cost of health care in general in the US. I don't know how you keep getting that meaning out of what I've written, especially since this entire exchange started with you challenging my assertion that the biggest culprit in the overall cost of US health care being administrative bloat.

I'm well aware of why people order medications from Canada. I'm beginning to suspect you don't. They order it from Canada because Canada doesn't pay a high enough price to pay for the research costs.

No, people order it from Canada because the price is lower. The price is typically lower because of Canada's Patented Medicine Prices Review Board, which sets caps on the prices that can be charged for patented drugs that have no generic alternative. This reduces the impact of price gouging by companies that have an effective monopoly on a product where being able to afford it can be the difference between life and death.

Arguing that they don't "pay a high enough price to pay for the research costs" is a complaint from the pharma industry perspective, not any kind of factual cause of the price difference.

Considering that you just reiterated the exact same argument again, I'm having trouble understanding what other argument I'm supposed to be responding to.

Then I really can't help you. My initial argument was, and I quote: "the thing that bloats the cost of our current system the most is administrative overhead. Every serious plan I've seen addresses that in some fashion."

You challenged me to support that. That's fine. I cited one of the sources I had at hand, and unfortunately the link was eaten by along with my blockquotes in that comment, so the structure of my reply might not have been clear. The link was examining reasons why we pay more to get less, in terms of health care, and I quoted four of the data points it offered, then my thoughts on them in order.

This was offered in support of my argument about administrative costs. Drug costs were only one of the four data points, and the context of drug costs in that point wasn't about the cost of health care in general, but in specific reference to the difference in price that US consumers pay for the same thing vs. other countries.

For reasons passing my understanding, you decided to take my side comment about drug costs being the biggest culprit in the context of the issue of prices for the same thing in the US being different than elsewhere, and turn that into my entire argument despite the fact that I started out talking about administrative costs, pretty much jettisoning everything else that I said in favor of zeroing in on this one comment that was the absolute beginning and end of anything I'd said about drug prices.

Drug costs are less than 10% of medical spending. US health spending is almost double that of say Canada. Cutting drug costs to ZERO (which surely you understand isn't possible even in Canada) would still leave the US with about 180% of the Canadian costs.

That's nice, but I don't care because I never once advanced the argument that cutting drug costs was the solution to the cost of health care in the US, nor do I think it's so. You manufactured that out of one single tangential comment and I'm sick of going in circles trying to untangle what was really a very simple argument. You are arguing with yourself, not me.

This is going nowhere and I wash my hands of it.

Its more important to focus on a manageable system of universal health care, NOT universal health care INSURANCE. Those two concepts are not the same thing.

Universal health care INSURANCE implies that everyone will have access to products sold by private companies whose primary way of making profits is to deny you as much health care as possible in exchange for the premiums it takes in. It still remains an adversarial relationship at its core, which is not the best way to go as far as the health care issue goes.

Just my 2-cents.

Maybe it was the formatting of your 6:41 comment that made it look like a more important point than you meant. That was the one I quoted.

But if your point all along was that administrative costs are the main difference between the US and other countries, that isn't correct either.

Now it isn't an unimportant difference. But the difference in salaries is very striking see here for hospital doctors, or here">http://www.worldsalaries.org/generalphysician.shtml">here for the more general 'physician' category. It suggests that hospital doctors in the US are paid about double that of their UK or French counterparts, and almost 5 times more than Germans. For the more general physician category, it appears that US doctors on average get paid about 35% more than their UK counterpars and just under 200% more than French doctors.

I would guess that at least part of what drives the high salaries of US hospital doctors is the need to pay back the debts incurred in getting to be a doctor. It's part of why a universal health care system is just so much more practical than the US's crappy system: when healthcare is profit-driven, becoming a doctor is an expensive investment which must therefore pay off to be worthwhile. In countries where the government must guarantee health care, the government must also ensure there are sufficient numbers of doctors to provide it...

The political will in question isn't the will to spend money. The US has that. It's the will to reform the system. The profits from the medical insurance industry may be fairly low - but almost every last person employed in medical insurance is a bureaucrat - and most of them are almost pointless. So it's not the profits of the medical insurers that should be classed as waste - but the total costs.

The other part of political will in question is facing down the AARP. In Britain, national healthcare is rationed based on the QALY - the Quality Adjusted Life Year. (And then duly ignored by the doctors and paid up by the PCTs). We focus on the interventions that get the most improvement in life for the longest duration. In America public spending goes to the retired - those who are simultaniously the most expensive to treat and can gain the lowest absolute gain from healthcare.

And Brett, if you don't want government go live in Somalia or the Congo. And if you think that someone who is diabetic and doesn't have state healtcare is freeer than one who gets dialysis provided by the state, I've got a bridge you might be interested in buying.

Sebastian, part of my point is that you can't neatly separate out "administrative costs" from the cost of US health care overall.

you seem to be assuming in the rest of your question that there won't be anyone wrangling with government denial of claims, and that the government won't have people denying claims. Which seems a rather unreasonable assumption if you know Americans. ;)

I'm not assuming that it will never happen, just that it won't be such a huge part of the process. For the medical insurance industry, "deny, delay, confuse, refuse" is *policy*, it's how they make their money. It is not incidental or occasional, it's become the core element of their business.

The consequences of this policy pervade the US healthcare system. My meds cost more than in Canada in part because it costs more to get them to me, because the pharmacist has to hire someone to fight with the people the insurance hired to fight.

US doctors have to pay more for malpractice, in part because USans often *have* to sue to pay for long-term medical care that won't be covered otherwise. A disproportionate number of the vaccine side-effects suits, for instance, were by farm families -- because they tend to be self-insured, and can't cover the costs of a long-term catastrophic illness in the family.

I think it might be useful to analyze why the US government is ALREADY spending about enough money to get Canadian or UK universal health care but NEVERTHELESS only actually provides health care to about 1/3 of the population.

IMVHO, this is a really good point.

rusell:

If that "1/3 of the population" that the US gov't currently provides health care for means Medicare+Medicaid+VA, then the obvious answer is: it's a less-healthy-than-average part of the population. Old people, poor (and therefor stressed, tired, and ill-nourished) people, and people much more likely than average to have physical and/or psychological injuries. How do the US gov't rates compare to a matched population from other countries?

I'm as much for decreased health care costs as anyone. I max out my HSA every year and spend it all and more with a young, fairly healthy family. But I'm at a loss as to why we should take the NHS as a model or expect the government to be more efficient at providing comprehensive health care services. (BTW, besides hiring freezes and a few days of furloughs per month, has ANYONE in the government been laid off in this recession? And if so, was it federal government?).

If the facts and figures supporting Gammon's Law of Bureaucratic Displacement are accurate, NHS has followed the way of most bureaucratic endeavors. In 1948, NHS had 480,000 hospital beds, shrinking to 186,000 in 2000, while staff went from 350,000 to 882,000, and the biggest increase in administrative staff.

And why is all the "admin time" imputed to private insurance companies? My friends and clients in the industry (including a hospital administrator) complain about: 1) government regulation driving business models and 2) the problem of E.R's. When a huge portion of your patient base has the bills paid by the government subject to regulation, I don't know how anyone can argue that the system that exists right now is privately run. It's an amalgamation.

Do those advocating government-run universal health really believe that the government can be as efficient as private care and scoop up the profits in savings? And if so, for how long? Really?

Jes, how do you respond to Hanan? I realize he is politically opposite, but the articles he cites certainly give me pause.

Ezra Klein links to a report by the McKinsey Group examining the costs of care in the U.S. compared to similar countries:

McKinsey constructed the Estimated Spending According to Wealth (ESAW) index, which adjusts cross-national health spending for increases in per capita earnings and creates a clean baseline for comparisons.

McKinsey found that "input costs—including doctors’ and nurses’ salaries, drugs, devices, and other medical supplies, and the profits of private participants in the system—explain the largest portion of high additional spending, accounting for $281 billion of spending above US ESAW. Inefficiencies and complexity in the system’s operational processes and structure account for the second largest spend above ESAW of $147 billion. Finally, administration, regulation, and intermediation of the system cost another $98 billion in additional spending.

You'll notice that that adds up to $551 billion, not $477 billion. The discrepancy comes from the fact that we actually save some money on long term care.

A closer look at the study shows that 80% of the cost above ESAW is from hospital and outpatient care. Of that total above ESAW, 147B is operation expenses and support, 100B labor, 75B profits and taxes paid, 49B supplies.

Of the other costs above ESAW, 98B is admin and insurance, 57B outpatient drugs, 19B public investment.

Long term and in home care save 85B as Klein mentions.

Sebastian, IMHO, hit upon a few ideas I would like explored, namely 1) universal catastrophic health care insurance; 2) providing universal health care set at a level equal to cutting edge ten years ago (was the cutting edge really so bad in 1997?).

I'd also like to look harder at HSA's. One earlier poster lauded Singapore's system. Maybe the way to go isn't towards socialist medicine, but a move Brett's direction and a more libertarian approach (note to Brett: I use the term loosely; however, as the article notes, Singapore makes the U.S. look like Europe).

I wonder if we have really explored the private system. We hardly have a market and there is almost no transparency in the system where consumers can compare services and prices in any meaningful way. If you think to the contrary, you haven't looked at a hospital bill recently.

I just don't want our health care to go the way of the Department of Education. There is a market driven solution out there.

"If that "1/3 of the population" that the US gov't currently provides health care for means Medicare+Medicaid+VA, then the obvious answer is: it's a less-healthy-than-average part of the population. Old people, poor (and therefor stressed, tired, and ill-nourished) people, and people much more likely than average to have physical and/or psychological injuries."

The 1/3 of the population is Medicare+Medicaid+VA+government provided health care to government workers (I'm not sure who exactly those are, I presume the military at least, and probably civilian members of the DOD, does it count lost of people in DC or do they negotiate for private insurance?)

So far as I can tell, by an enormous amount, Medicare is the largest part of that cost (at least double that of Medicaid)

But either way your answer doesn't help us much unless old people in the US require about 3 times as much money to care for than old people in Canada, old people in the UK and old people in France. The government in Canada spends about as much in percentage of GDP and less in GDP per capita than the US government does. It does so while covering its old people AND covering everyone else in the country.

The fact that old people cost more for care would only be an explanatory factor if Canada, France and the UK didn't cover them. But they actually cover old people and drug addicts and really everyone.

So a really important question in my mind is "Why does the US government already spend more per capita on health care than Canada but only covers about 1/3 of the population?"

I won't even pretend to know the answer, but I don't understand why the question is never framed like that. It seems like an important question.

"providing universal health care set at a level equal to cutting edge ten years ago (was the cutting edge really so bad in 1997?)."

Just to clarify, this proposal is qualified by 'unless the cutting edge technology is cheaper than the 10 year old technology'. This would actually incentivize any company which is close to that price point to lower the price enough to get the much larger pool of government insured. It would also encourage the middle class to continue funding for technological advances by getting insurance that would cover the new stuff. Furthermore, similar concepts are how other countries operate in reality anyway, they just aren't explicit about it.

I won't even pretend to know the answer

Perhaps you should try reading the comments on this thread - reading them for the information they contain, rather than in order to defend the practices of the pharmaceutical industry? Just a thought.

I've read the entire thread, Jes. The suggestions I've seen thus far are either clearly wrong (like the one you cite, pharmaceuticals) or far too general to be helpful. If you have one in mind you could point it out explicitly rather than trolling.

Also there are many many suggestions that don't bear on the question of why the government already spends Canadian health care amounts of money while only covering 1/3 of the population. Insurance paperwork/profit questions probably aren't a very big issue in Medicare for example. (Now government paperwork might be a big deal, but that would be the fault of the government).

If the facts and figures supporting Gammon's Law of Bureaucratic Displacement are accurate, NHS has followed the way of most bureaucratic endeavors. In 1948, NHS had 480,000 hospital beds, shrinking to 186,000 in 2000, while staff went from 350,000 to 882,000, and the biggest increase in administrative staff.

Yes. Granted. And the admin spend of the NHS still kicks the arse of any private healthcare model. As for hospital beds, the very nature of them has changed - you have a lot less long stay chronic condition (we've eliminated things like iron lungs) and doctors can treat much more rather than waiting for patients to get better.

And why is all the "admin time" imputed to private insurance companies?

Because as far as healthcare is concerned, insurance is nothing but distilled bureaucracy. Insurance companies themselves do not provide any patient care. They just push paper around. Bureaucracy, pure and simple.

Some bureaucracy is good (I'm an NHS bureaucrat) - without sufficient bureaucracy you end up with a paddling pool sized amount of saline and a year's supply of unsterilized latex gloves but no sterilized latex gloves or basic pharmaceuticals on a ward. But when you are a separate company providing nothing other than bureaucracy and providing it on a continual full time basis then you can only be a parasite. At the very best the role of insurance companies in the healthcare sector should be that of regulator - but the regulator should not be on a commission.

Sebastian:

I can only think of two possible answers to your question. The opponents of universal health care would presumably argue that the United States does all the medical research for the world, and the rest of us free ride. You alluded to that argument in your comment about drug prices. Now, I know that as a universal rule, that doesn't hold true; Canada and Britain both have distinguished records in medical research. Paul Tsongas, the conservative democratic politician, one commented that he didn't know if he would have survived his bout with cancer if he had lived in Canada; it turned out the treatment that saved his life came from research done at Princess Margaret Hospital, the internationally renowned cancer treatment and research centre in Toronto. That leads us to the question, which I would like a cite for: how much of the world's research does the US actually do? Can we even determine that? How does the amount of medical research that comes out of the US compare with (a) the proportion of the world's population in the US, (b) the American portion of the Gross World Product, and (c)the proportion of health care spending in the US. My google search didn't turn up much in the way of hard number; maybe someone else will have better luck.

The other possibility: the American system spends so much money because so many Americans seem to see economics, and in particular health care economics, as a morality play rather than a search for efficient solutions.

To our anarcho-capitalist contingent: once jack-booted government thugs™ can no longer enforce the medical monopoly rules, the economic issues around medicine will matter much less. Get last of the medieval craft guilds (aka self-governing professions) out of medicine, and the contest between the Free Medicine and Microsoft medicine will drive prices down far enough that we probably won't need government involvement nearly as much.

Your research question isn't well formed. The question is not "How much research is done by the US?" The proper question is "How much research is funded by patent price sales in the US?". Discovering something in Switzerland that is paid for by profits from sales in the US implicates the same free riding problem.

"The opponents of universal health care would presumably argue that the United States does all the medical research for the world, and the rest of us free ride."

I certainly would say that the rest of the world pretty much free rides off of the profits created by pharma sales in the US. But that fact is not a good explanation for higher medical costs in the US because pharma products make a very small portion of total health costs. So proving or disproving that doesn't get us anywhere with the question I'm interested in for the purposes of this thread: why does the US government already spend Canadian levels of money on health care yet only cover about 1/3 of the population.

"The other possibility: the American system spends so much money because so many Americans seem to see economics, and in particular health care economics, as a morality play rather than a search for efficient solutions."

I'm not sure what "morality play rather than a search for efficient solutions" means. I especially don't know what it means in the context of Medicare or other government run medical programs. Could you give a particular example in the context of Medicare that might illustrate what you mean?

Well, I think in part it's because, instead of the government directly paying for indigent care, it's instituted rules which funnel indigent care through our ICUs. A perhaps unintended effect of insisting that emergency rooms can't turn people who can't pay away.

This encourages the indigent to wait until their conditions get really serious, and then show up at the emergency room for treatment, instead of getting medical care at the cheap stage.

The hospitals then treat this expense as an overhead that they put on the bills of everyone who can pay.

Sebastian "I'm not sure what "morality play rather than a search for efficient solutions" means."

The belief that people get the health care they deserve: so that if you are doing without health care, it is because you do not deserve it. (As the people who do without health care have usually been the very poor, who it is easy for conservatives to argue are obviously also undeserving, since if they were deserving they would have more money, this leads to denying health care to people who can't afford it.)

It derives from the same kind of thinking that argues that if you are very poor, all you really need to do is buy a fifty-pound sack of brown rice and a rice cooker, and so anyone who is badly off and hungry is undoubtedly so because they are foolish and thus don't deserve to be helped.

The NHS was, in a sense, also founded as a morality play: but an altogether different kind of morality play: a sense that we are all members each of one another, that the least should be helped without thought of whether they deserve it, only that they need it. The NHS wasn't founded for efficiency's sake, but for justice and kindness's sake: it merely proved to be also a highly efficient system for delivering health care to all.

"The belief that people get the health care they deserve: so that if you are doing without health care, it is because you do not deserve it. (As the people who do without health care have usually been the very poor, who it is easy for conservatives to argue are obviously also undeserving, since if they were deserving they would have more money, this leads to denying health care to people who can't afford it.)"

And this has to do with the US government spending Canada levels on health care while only being able to provide for 1/3 of the population how?

And this has to do with the US government spending Canada levels on health care while only being able to provide for 1/3 of the population how?

Maybe we could look to a system that covers more, or all, for less, for guidance, as opposed to sticking to what has failed here. And it looks like a public option, rather than a private mandate, helps get us there.

Ok, but if we can't figure out what went wrong with Medicare et al. such that the government spends Canada levels for less than universal coverage, how do we know we will be able to avoid problems like that in the new system?

And this has to do with the US government spending Canada levels on health care while only being able to provide for 1/3 of the population how?

Well, you've ignored all the comments in this past thread about why US health care is so much more expensive, so I didn't think it was worthwhile repeating or summarizing the explanations for you to ignore all over again.

But yes, it is quite expensive to have a system which ensures people who need healthcare don't get it until they're so sick they could die otherwise. And because denial of healthcare is regarded, by conservatives, as a system of morality, that's your connection.

"But yes, it is quite expensive to have a system which ensures people who need healthcare don't get it until they're so sick they could die otherwise."

Medicare is useable as a function of age, not 'so sick they could die otherwise'.

You are talking about the unisured, I think. Which unless I'm confused, Medicare rarely pays for.

You know, Sebastian, it would probably help you to understand why the US health care system is so expensive if you didn't just keep ignoring what people have to say about it. If, that is, you want to understand...

Let's say you have 100 people, and you have a warehouse with 1000 items in it. Each one of those hundred people is going to need from 5 to 15 items from that warehouse. They themselves may not be absolutely sure exactly which items they need, or what is in the warehouse that they can have.

You can set up a system where each person gets 15 minutes with an expert guide to check out the items in the warehouse and take what items they need with the advice of their guide. This could take 3 or 4 days, if you have only one expert guide, or a single day, if you have four.

You can set up a system where each person has to respond to a battery of questions about their lifestyle and their job and their credit history, and provide means-test information about their income and their family, in order to prove they do need some items from the warehouse and can't afford to buy them anywhere else, and then has to explain to a company representative exactly why they need what items they have listed, and then the company representative takes the list away to have it approved, and initially none of the items on the list are approved because that's company policy, so the list gets brought back and gone over again and this time perhaps some of them are approved, and then someone goes to the warehouse and fetches out the items that have been approved, and then each person has to re-apply all over again for any items they still feel they need that weren't approved.

The first system is a lot cheaper to run and makes sure everyone gets what they need. That's the NHS.

The second system ensures that no one gets anything from the warehouse unless they've definitely proved they can't pay for it and they really, really need it, no matter that some people die waiting and many more suffer slowly through the delays, no matter how much more it costs to make sure that undeserving people don't get anything and that poor people really have to struggle to get what they need. That's the US system.

How a paid up member of the human race sees it:

Eric's medication costs total $40,000 (£27,000) a year.

Though his is mostly covered by insurance, he says many don't have the luxury of having their life saving drugs paid for. He's currently advocating for universal health care within the US.
"I'm alive today because I have access to the latest medical treatment, the latest technologies, the latest drugs - because I'm an upper middle-class person with health insurance and I can buy life. And that's not fair."

Jesurgislac, do you somehow believe that Medicare does not involve going to see a doctor and having him diagnose what is wrong?

Sebastian, I don't believe that you have the political will to understand the answers to the questions you keep touting as "important".

That is quite an answer.

Multiple people have already responded, in some detail, to the questions you were touting as "important", in this very thread.

You don't appear to have paid attention to what any of them had to say.

Hence my presumption that you do not have the political will to understand the answers to questions you claim you consider to be important: since if you did understand the answers - whether or not you agreed with them - you could at least respond to what people have been saying, with considered agreement or disagreement.

You say that multiple people have responded, point to neither the persons nor the arguments.

The question I pose is: why does the US government already spend as much as Canada, and more than the UK, but nevertheless not provide universal coverage considering that it is spending universal coverage-sized money?

The main specific responses I have seen have been: pharama prices, insurance profit and insurance administrative waste.

Pharma prices aren’t the answer. They aren’t even a big piece of an answer. They aren’t a large portion of overall costs even if the price could be reduced to zero, which it clearly can’t.

Insurance profit is likewise an incredibly small part of overall costs. Furthermore Medicare and the like doesn’t typically pay into insurance profits. So that can’t be the answer.

Insurance administrative waste may or may not be enormous, but again Medicare doesn’t pay it anyway. They may or may not be a huge part of the private component of US health spending, but they aren't a huge part of the public spending. So that isn't the answer.

The other answers seem to share the same problem, they want to blame the spending on insurance companies and private waste. That may very well explain why the PRIVATE portion of US health care spending is so high. But it does not explain why the PUBLIC portion of health care spending is already as high as Canada’s PUBLIC spending and higher than the UK’s PUBLIC spending yet NEVERTHELESS fails to give anything like universal health care.

Now some people (mostly you) have suggested philosophical generalities about conservatives not thinking that poor people deserve to have good health or whatever. That of course is a nice generality that does nothing whatsoever to explain why the US government already spends more money per capita than governments which provide universal health care. And I hate to repeat myself, but the US government doesn’t provide universal care despite spending that much. Also Medicare doesn't target the poor. It is much more like Social Security.

Generally speaking, the arguments in the thread above are either so general as to be nearly useless, or specific but applicable to the PRIVATE portion of health care spending in the US.

If you would like to actually cite the many good arguments which pertain to public spending in the US (there are handy date codes at the bottom of each comment which facilitate that) please do so. Or you can merely assert without evidence yet a third time that I’ve overlooked the many obvious responses to that.

why does the US government already spend as much as Canada, and more than the UK, but nevertheless not provide universal coverage considering that it is spending universal coverage-sized money?

Yes. And, as I said, people have provided answers to that question, which you have - as you demonstrate in this comment! - not got the political will to understand, let alone respond to.

Or you can merely assert without evidence, yet again, that you did understand the answers, but that you're sure they're not the right answers, which is why you're not bothering to respond: merely to deny.

Ok, if multiple people have answered that very specific question, Sebastian isn't the only one who's missed it, I have, too.

The government is spending more money per capita than other nations spend on universal health care, to provide health care to a comparatively small fraction of the population. Why exactly wouldn't we anticipate that our government, were it to embark on universal care, wouldn't end up spending hellishly more?

I can see increasing the number of the covered possibly reducing the expense per person covered, but actually reducing the total expense seems absurdly unlikely.

"The government is spending more money per capita than other nations spend on universal health care, to provide health care to a comparatively small fraction of the population."

Is it the government spending that money, or people spending it, and isn't much of the money people are spending going to insurance company and private health care overhead?

If so, that's why.

Gary, Sebastian has, as far as I can read, made great pains to distinguish between health care spending by individuals in the private markets, and health care spending by government via the VA, Medicare, Medicaid and other such programs; and confined his repeated question to the latter type of spending. e.g., That may very well explain why the PRIVATE portion of US health care spending is so high. But it does not explain why the PUBLIC portion of health care spending is already as high as Canada’s PUBLIC spending and higher than the UK’s PUBLIC spending yet NEVERTHELESS fails to give anything like universal health care.

These are the same old typical arguments on why we should have socialized medicine. How about looking at some FACTS:

FACT: Medicare (which is already a form of socialized medicine) only pays 70% of medical expenses. Since doctors and hospitals are not payed the full value of their services, they make up the difference by charging other patients more. This is why hospitals charge twenty-five dollars for a band-aid. The Medicare program is another government program that loses money and therefore has to be subsidized.
And Medicare is broken and bankrupt. The only thing the government seems to be able to do is keep raising our taxes to fund a broken and failed program.

FACT: Socialized medicine has not worked in any country in which it has been adopted. It's a money losing proposition and has to be subsidized by the government. This is the definition of negative economic growth. And doing something that has been repeatedly proven not to work and expecting it to work is the definition of insanity.

FACT: Medicine is a finite resource. In an economic environment of negative growth medicine will have to be rationed. Those that need health care will have to wait, sometimes for months or years, to get the care they need. If you are suffering from a terminal illness and they decide you can't be saved, you will most likely be denied care. This is already happening in every country in the world that has socialized medicine. And this is why Canadians that have the financial resources are coming to the U.S. for health care.

FACT: One of the reasons health care is so expensive is because of excessive government regulation. If the government would get out of the way, market forces and competition would drive prices down. Consumers are the key to reforming health care. Not government. Not doctors and hospitals. Not insurance companies.

FACT: Health care is NOT a right. It is a privilege. Sorry people. As much as you would all like this to be a warm, fuzzy, Utopia, the fact is the world is a cruel place. Survival of the fittest is the way it is, both in the animal kingdom and also in human society. Get used to it.

FACT: ObamaCare is not about giving everyone equal access to health care. It's about government control of your lives by taking away your freedoms guaranteed by the Bill of Rights.

Here are two short booklets that explain the real FACTS:
"Facts: Not Fiction: What really ails the US health care system"
By Greg Dattilo and Dave Racer
and
"Why health care costs so much: The Solution - Consumers"
By Dave Racer & Greg Dattilo, CEBS

These can be purchased for the paltry sum of $3.50 EACH by going to www.alethospress.com/hcbooks.htm. You have to admit, seven dollars is a small price to pay to get educated about the health care "crisis". So how about it, people? I challenge you to put your money where your mouth is!

And if you think this is just a cheap come-on you should know that I am in no way connected to the publisher of these books. I'm only interested in getting the facts out in the open.

"And if you think this is just a cheap come-on"

I do, or otherwise you'd link to free information, which we can then duly ignore as the crap it is. After all, the fact is the world is a cruel place.

Socialized medicine has not worked in any country in which it has been adopted.

Wrong.

It's a money losing proposition and has to be subsidized by the government.

Socialized medicine has to be subsidized the government? You don't say!!

Health care is NOT a right. It is a privilege. Sorry people. As much as you would all like this to be a warm, fuzzy, Utopia, the fact is the world is a cruel place. Survival of the fittest is the way it is, both in the animal kingdom and also in human society. Get used to it.

Can someone explain the natural fallacy to this 'tard? And also how "fittest" isn't a synonym for "richest?"

Mr. Farber,

If you don't wish to fork over a little pocket change to get educated, that's your choice. In this country you still have the freedom to remain ignorant.

Phil,

Thanks for your infantile response. You can't refute my argument so you attack me and call me a 'tard. Then you even admit you can't explain the "natural fallacy" in my argument.

If you have an opinion, then go ahead, express it. I challenge you to get over your temper tantrum and come up with some logical reasoning to refute my argument. Tell me where I'm wrong!

Oh, and by the way, Phil, what country can you name where socialized medicine has worked?

Thanks for your infantile response.

You're welcome!

You can't refute my argument so you attack me and call me a 'tard.

You didn't make an argument. An argument doesn't consist of a series of unconnected bullet points.

Then you even admit you can't explain the "natural fallacy" in my argument.

If you don't know what the natural fallacy is, I can't force you to Google it. Nonetheless, you've fallen right into its pointy little claws.

If you have an opinion, then go ahead, express it.

I did! I called you stupid. That's my opinion.

I challenge you to get over your temper tantrum and come up with some logical reasoning to refute my argument.

"Temper tantrum?" Puh-leeze. I'm amused by you, not angered.

Oh, and by the way, Phil, what country can you name where socialized medicine has worked?

Oh, pretty much all of them, at least in terms of delivering longer life expectancy, lower infant mortality rates, better pre-natal and childhood health outcomes, etc. So long as we're classifying those things as "working."

No cites for you, though. Do your own homework.

What, he's responding? I had this guy down as an advertising 'bot and was thinking it's amazing how realistic their posts can be. Not a bot but a troll, eh?

Trolls: do not feed them.

Please.

Aw, not even a fruit basket? Fruit is healthy!

Perhaps a nice banana? Time flies like an arrow. Fruit flies like a banana!

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