Monday, June 15, 2009

Obama's Government Health Plan Will Look Like Public Schools

Geoffrey P. Hunt's illustration of ObamaCare, posted on American Thinker this morning is the most accurate and intelligently deconstructed piece I've read on the subject. If only I could communicate these concepts as cogently to the willfully ignorant Obama sycophants in my world. He writes:


Much of the speculation around Obama's health care reform centers around a single payer government monstrosity resembling either a larger bankrupt Medicare platform or the discredited national health schemes in Canada or the UK. Yet it's just as likely Obama's inspiration is the failed public school model.

The government school monopoly, compulsory with mediocre results, unaffordable and ungovernable with beleaguered local taxpayers hopelessly unable to force accountability from teachers' unions co-dependent with democrat party legislators, is a perfect model for Obama to finance and ration health care for the masses.

Who can argue against the noble objectives of universal healthcare? Horace Mann's education reform exhortations in the late 1830's and 40's were eerily parallel to the pitch for Obama today: full inclusion, mandatory attendance, standardized pedagogy, along with coerced community participation by virtue of local taxes providing funding. It promised to eradicate illiteracy, violence and vice. For decades, the payoff was impressive. But one hundred years later, Mann's idealism would be corrupted by John Dewey's progressive advocacy of self esteem replacing subject matter mastery. Finally, any hope for high performance pedagogy was thoroughly crushed by President John F. Kennedy's executive order enabling collective bargaining and unionization of public school teachers. It is safe to expect none of Mann's idealism but all of today's public school abominations will shape Obama's health care system.

In a seductive overture to private health plan stalwarts, Obama says the government health care system will not be a mandatory substitute for private health care preferences, only an option. Of course those who remain in a private system will face double jeopardy -- covering their own private medical costs while suffering higher federal taxes to pay for somebody else's -- in the same manner that private school parents, opting out of horrible local public schools for far better independent alternatives, must pay private school tuition while still shouldering ever escalating property and state income taxes to educate those poor wretches who cannot escape the government's incompetence.

Those who cannot afford private health care, whose employers would rather pay higher taxes instead of underwriting actual medical claims, will also be victimized just as parents with no choice have to send their children to lousy government schools. Want to see what demotivated clock watchers -- doctors and nurses alike -I n a government run clinic would look like? Just spend a few hours in a typical public high school faculty lounge. Want to see what government hospital administrators consumed by micro-management of trivialities would look like? Just spend a few hours at a typical Public School Board or School Committee meeting.

And who would thwart the temptations for the government health care bureaucrats to regulate medical care provided by private institutions who accept federal grants for medical research? Check out the hostility towards home schoolers these days from State Boards of Education . And given the enthusiasm shown by Congressman Barney Frank and Treasury Secretary Tim Geithner alike for government control over compensation of executives running government financed private companies, why wouldn't they have an equally big appetite to regulate pay and benefits for doctors wherever they practice? Tenure for marginal practitioners and those twelve step compensation tables embedded in nearly all teachers' contracts wouldn't be far behind.

Well at least one group of health care professionals might vote for the Obama health care public school model -- medical residents. Imagine trading off those legendary 36 hour shifts for three months vacation every summer. But such relief would be short lived as civil service exams, just like state mandated teacher certifications, would soon be more important than Medical Board exams. After all, isn't government run enterprise all about proving mediocrity can be delivered consistently to everybody while pretending to actually know something about anything.

Obama showed his hand in yanking the school vouchers in the DC school system. When private choice threatened to disinfect the stubborn bacteria in DC's public schools, choice was flushed. Expect more of the same under Obama's public school system look-alike for health care. (Source)-emphasis added

58 comments:

DJ Black Adam said...

Conservatives need to stop singing this tired song. Either come up with a reasonable alternative or move on.

I know alot of Brits, they don't seem to unhappy to me about their health care.

All the Right is doing is protecting the cash cow of health care companies and pharmacutical companies, it is really pathetic and shallow.

Ilé Meroë said...

As it stands the US spends far more per person than any other country on earth without achieving better results than comparable developed nations. I do not understand why this is a good thing for anyone outside the insurance and health services industries.
As for rationing medical treatment, the US simply uses a different type (price rationing) and I'm unsure why it's better than rationing according to medical need.

When it comes to public schools most other comparable countries have decent public school systems. The way that they achieve this is no great secret but you seem to feel that Americans are less capable than the Swedes, Germans Finns, Koreans, Australians Japanese and (dare I say it) even the French.

uptownsteve said...

DJBA

Exactly right.

Conservatives thrive on complaining, appealing to fear and fostering divisiveness.

They never offer solutions.

And, as they proved over the last 8years, they absolutely SUCK at governing.

JudyBright said...

http://www.heritage.org/Research/HealthCare/bg2128.cfm

You might not like it, but it is a solution offered. And it makes too much sense.

Zabeth said...

Why not have health insurance operate more like auto insurance where everyone pays out of pocket but they choose the type of coverage they want (and that they can afford) as opposed to having their employer or the guvment decide what's best.

Conservative Black Woman said...

Thank you Judy Bright. Here's an alternative DJBA, leave healthcare alone. Let's keep things just as they are. How about that?

Isn't it true that the federal government already provides or subsidizes health insurance for nearly 40 million elderly Americans (Medicare); approximately 40 million low-income Americans (Medicaid); nearly 10 million federal employees, retirees, and their families (FEHBP); and roughly 5 million veterans? Save for the (FEHBP) folks (who actually have private insurance) ask any one of these group members how they feel about it...actually the Medicaid people probably wouldn't have it any other way(I know that was a bit mean of me so... SOME of the medicaid recipents)

DJ Black Adam said...

@CBW:

You wrote: "Thank you Judy Bright. Here's an alternative DJBA, leave healthcare alone. Let's keep things just as they are. How about that? "

Un acceptable. Just like energy, something has to change. WHY?

Facts:

Nearly 46 million Americans, or 18 percent of the population under the age of 65, were without health insurance in 2007, the latest government data available.

Source: DeNavas-Walt, C.B. Proctor, and J. Smith. Income, Poverty, and Health Insurance Coverage in the United States: 2007

That being said, that is unaccepteble AND poses a health risk to others AND cost us money ALREADY.

Anonymous said...

The post "Obama's health plan will be like public" is just so much class propoganda, as no Obama plan as yet been unveiled.

The President has made a commitment to reforming the U.S. health care delivery system to expand its coverage and to reduce its overhead or administrative costs, but has left it to Congress to devise a plan.

Nor does the author's reliance on the Reagan era dogma that government is not the solution but the problem hold as much sway as it once did, now that we've witnessed the bankruptcy pleading of General Motors, the distressed sale of Chrysler to Fiat, the virtual overnight evaporation of Lehmann Brothers, etc.

Thank God, Bush didn't succeed in "privatizing" social security.

Smile said...

Alot must not mean a lot because a lot of Brits are very dissatisfied with their health care.

There are studies (inclusive of five (5) countries that show a high level of dissatisfaction.

http://www.neoperspectives.com/britishhealthcare.htm

http://www.ncpa.org/
Greg Scandlen: But people know when services are being withheld, and they resent that someone else is deciding what they may and may not have -- especially when that same someone has promised to provide everything for free.

Australia, Canada, New Zealand, the United Kingdom, "a majority calling for fundamental or completely rebuilt changes in the system."

"... respondents reported that it was somewhat, very, or extremely difficult to see a medical specialist or consultant. In addition, approximately 20 percent of respondents in four of the five countries reported that they were often or sometimes unable to get care because it was not available "

Health Care System Reforms
Strategies to Improve Access

http://www.telegraph.co.uk/news/uknews/1576704/Dont-treat-the-old-and-unhealthy-say-doctors.html
A health correspondent from Telegraph Uk writes, Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives.

Fertility treatment and "social" abortions are also on the list of procedures that many doctors say should not be funded by the state.

About one in 10 hospitals already deny some surgery...

Paul Mason, a GP in Portland, Dorset, said there were good clinical reasons for denying surgery to some patients. "The issue is: how much responsibility do people take for their health? If an alcoholic is going to drink themselves to death then that is really sad, but if he gets the liver transplant that is denied to someone else who could have got the chance of life then that is a tragedy." He said the case of George Best, who drank himself to death in 2005, three years after a liver transplant, had damaged the argument that drinkers deserved a second chance." he said.

Also:
http://www.justlanded.com/english/UK/UK-Guide/Health/Private-healthcare

http://www.justlanded.com/english/UK/UK-Guide/Health/National-Health-Service

London - On the eve of his election victory in 1997, Tony Blair famously declared that Britain had 24 hours to save its derelict National Health Service.

So it is acutely awkward for his successor, Gordon Brown, that, 10 years later, his government is scrambling to fend off accusations of crisis in the NHS following a damning report about hospital infections that critics say is symptomatic of a wider malaise in British health care.

This has been going on for a while: Even in 2000 72% in the United Kingdom felt that their health care needed "fundamental change" or to be "completely rebuilt." They're less satisfied now. Let's keep up and be genuine.

"Although the British health care system may be the least unpopular, the fact that more than seven out of 10 citizens want at least [fundamental change] is no endorsement."

Also:
http://www.opinionjournal.com/extra/?id=110006785

Smile said...

Doctors cannot stop you from ruining your health in a million different ways.

Few people seem to know what has actually happened in countries with government-controlled medical care. Maybe it's not interesting to wonder why so many doctors in Britain are from Third World countries with lower medical standards - or why people from Canada come to the United States for medical treatment that they could get cheaper at home. Our highest cost of living doesn't compare to their exorbitant costs. Or why US doctors volunteer their services/medicine to those who have gov health care, and save lives.

One of the best and widely known solutions is prevention. We 'should' take better care of ourselves. We should practice good health measures.

It would be cost effective for consumers to purchase individual health insurance across state lines.

Deal with immigration in an appropriate manner. Likewise illegal immigration.

We need to slow the growth of health care cost.

What do you think of this:
http://www.brookings.edu/es/hamilton/200705Butler.pdf

Anonymous said...

@Smile:

Life expectancy in those countries with "government-contolled health" you cite is greater than life expectancy in the U.S.

Canada beats the U.S. in that regard by two years. The same countries also have significantly lower infant mortality rates.

Those facts alone are more telling than all the patient satisfaction survey data of your several posts--especially when one considers that the U.S. spends far more on health care than those countries.

uptownsteve said...

Anonymous,

"Do you want to conserve segregated housing patterns that exist throughout U.S. or the reduced access of blacks to health care or the old arrangements law and practice that made rape an occupational hazard of domestic workers, the chief occupation of black women working outside the home for most of the past century? What do black conservatives want to conserve?

Further, wouldn't calling yourselves "negro" or "colored" conservatives be more in keeping with the conservatives' veneration of the past? Please help me to understand."

LOL!!!!

Great questions.

Don't expect any response from the black righties though.

They're too busy "performing".

DJ Black Adam said...

@Smile:

So it seems that MANY Americans are unahppy with our system and MANY Brits are.

Since I am not in The UK, I won't comment on what needs to be done in the UK with their system. As far as the US System goes, we need some change, perhaps aspects of the different systems need to be applied to each to improve each.

Smile said...

@Anonymous said...
"Life expectancy in those countries with...especially when one considers that the U.S. spends far more on health care than those countries."
Thank you for your reasonable approach. You bring up areas of valid concern, some of which I feel we can all do something about. Some of the statistics in these areas are confusing, which makes it more difficult, but it's helpful to discuss it with someone objective, such as yourself. It also makes it a pleasure, so thank you again.

Cost of health care: What springs immediately to mind is the legal aspect for example: In the UK if one looses a court case they must pay.

Infant mortality: World Health Organization, (WHO) defines the standard for infant mortality but only the USA follows it, so we can recognize where we're not comparing apples to apples.. The variants need to be taken into consideration. : reporting dismal from other countries, behavior of expectant mother, obesity, age of mother at delivery (where the US has far younger or far older women gestating), infertility choices and multiple births, breast feeding. The decline in Sweden’s maternal mortality rate since the 1930s parallels that in other Western countries. Medical technology was certainly a major factor, but its success was dependent on the emergence of the Western welfare state.- http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1448444
Also found interesting: http://www.princeton.edu/~ota/disk1/1994/9418/941803.PDF At any rate, there is plenty of room and reason to practice better choices individually which we seem to do less the more "advanced' we become and in spite of technology.
Though it seems to be complicated (and sometimes unnecessarily so imo) when our objective is based solely on a better outcome and solutions, we can find many ways that we can improve life expectancy/quality in every area if we want to make these choices.

We may not have all the answers, be able to overcome all challenges or do so as quickly as we would like, but we can make a difference and have better results when we have an objective and reasonable approach.... Again, kudos to @Anonymous.

DJ Black Adam said...

@Smile:

You wrote: "Cost of health care: What springs immediately to mind is the legal aspect for example: In the UK if one looses a court case they must pay."

Look, let me cut to the chase, what it comes down to in the US is selfish simple minded people like YOU whoa re manipulated by your base greed. "Whose gonna pay for it" etc., fact is, people like you can only be moved when the Bubonic plague hits, and your fear is then mobilized, and you have to allow for public health care to save your own arse.

Smile said...

@UTSeve
"Do you want to conserve..."

"segregated housing patterns" No. This shouldn't be conserved. Yet, neither should it be denied. It's important to allow (conserve) a persons preference here.
"reduced access of blacks to health care" No. Yet, an environment that encourages genuine discussion, conserving opportunity and willingness to look at all issues and angles of issues, is helpful.
"rape" No, no, no, and no.
"call conservatives negro or colored" You can continue to do so though it's not helpful if your intent is to make things better for everyone, but that is your choice. A person's ability to make choices, right or wrong, is worthy of conservation imo.

"LOL!!!!" I'm not sure what you mean. Humor is helpful and should be conserved though.

Smile said...

@DJ

"...we need some change, perhaps aspects of the different systems need to be applied to each to improve each." Perhaps and whatever works. The main thing being whatever works. It has to be based on a greater desire for what works. If based on what we may think as "party line" or "right v left" then we're not really being objective. When it comes to finding solutions that work, I don't care where these fall on a "party" preference. Many things are bigger then that imo, don't you think?

Categorizing me personally isn't necessary. We should be able to have a discussion, even though you may disagree with me. The fact is, you're making assumptions about me when....actually you don't know. I'm unaware that dogma is helpful as regards health care. I'd refer you to that anonymous person upstream.

Let's agree that we won't have to agree on everything but we can still discuss issues that are important.

Smile said...

Litigation does drive up the cost of health care. I'm not saying that people should not be able to litigate. I'm saying that this too is a contributing area and needs to be considered.

If any (of you/us) can manage to provide/pay for expensive health care but those who can't or find it a challenge and would like to find helpful solutions, is this greed because one is cognizant of cost?

I see it as important to be cost effective and perceived it to be somewhat mutual to everyone and a problem with health care. Perhaps I'm wrong and it's all about what one means when using a word.

DJ Black Adam said...

@Smile:

"The fact is, you're making assumptions about me when....actually you don't know. "

Actually I never said I know, it is how you and most conservatives come off, selfish people.

If the shoe fits, say ouch and wear it.

Anonymous said...

@Smile:

Data collection in England, France, Germany, and Canada are not so dismal that life expectancy and infant mortality rates in those countries with state control health care delivery systems cannot be compared with those of the U.S. Here, I have excluded Cuba where male life expectancy reportedly is more than 2 years greater than male life expectancy in the U.S. in deference to possible objections to the reliability of the data: 'We know how them damned commies lie about everything!'

Nor can legal expenses acount for the lower cost of health care in those countries against the background of their better results and the world's estimate that the U.S. has the most able doctors and the best medical schools.

The problem is something even I hesitate to write: Free market principles cannot be relied upon to manage all exchanges of substantive value. No one seeking cancer treatment shops for the least cost provider, and doctors, unlike butchers, cobblers, and barbers, do not provide price information and regard price inquiries as insults, attacks on their status.

Thus, it can be seen that ours is not a free market system. Nor even is it private, as nearly all transactions involve some third party footing the bill. It is our nearly religious belief in "market forces" and "the spirit of capitalism" that stands in the way of solving the problem. Recognizing that such problems exist stands as the test for the U.S. in the coming decades.

Anonymous said...

For everyone who thinks this is a good idea, wait and see. That's all I say to people these days that think this is a good idea. Hopefully your memories of what we had remains intact. Don't think that your option for private healthcare will remain viable either. Only the extremely, extremely wealthy will be able to opt out of the public system. Then everyone will still be complaining about the rich, and politicians getting better healthcare. Don't think those higher ups in govt that are pushing this thing are going to go to the "system" doctors you'll be going to. For the life of me, I don't know why people insist on government being in control of everything. No one trusts them, yet people are clamoring to put them in control of things. Did they do such a bang-up job with SS or Medicaid? For people without healthcare who want it(lots of people take their chances without it) there are already state funded options for free and low-cost healthcare.

What's wrong with reworking the system we have that allows choice, gives incentives to doctors? We can rework it to purchase healthcare. Why the mad rush to give gov't control?
To the person who spoke about the healthcare system in Cuba, stop choosing to believe a lie. Their lifespan is not higher than ours. Try getting surgery, or safe healthcare in Cuba, if you actually live there. The citizens have shameful hospital and healthcare conditions. The "good" hospitals are for tourists. Castro left Cuba for his surgery. Just stop.

Smile said...

@Anoy...
"Thus, it can be seen that ours is not a free market system. Nor even is it private, as nearly all transactions involve some third party footing the bill." Now, that is hitting a nail head imo but it causes all sorts if discomfort to look at.

Yes, we can and should make these comparisons. I'm glad you and I do. Still, the differences in the information reporting is widely disparate. We must make note of these areas. Regardless, it doesn't change the need for better solutions.

IMO believing in a free market while thinking something is mandated by such when it's not, doesn't underline invalidating free market. I agree, having a "religious" attachment to them is a bit much :)

You've brought much to the discussion here and for me that also magnifies the complexity. It is very complicated. As time allows, I look forward to more discussion with you.

JudyBright said...

The problem is something even I hesitate to write: Free market principles cannot be relied upon to manage all exchanges of substantive value. No one seeking cancer treatment shops for the least cost provider, and doctors, unlike butchers, cobblers, and barbers, do not provide price information and regard price inquiries as insults, attacks on their status.

Thus, it can be seen that ours is not a free market system. Nor even is it private, as nearly all transactions involve some third party footing the bill. It is our nearly religious belief in "market forces" and "the spirit of capitalism" that stands in the way of solving the problem. Recognizing that such problems exist stands as the test for the U.S. in the coming decades.


Let me get this straight, you say we do not have a free market system (a fact with which I agree with) and use that as proof to say a free market system won't work? These problems you talk about are caused by the lack of competition in the current system.

If individuals had the choice of which insurance to buy, instead of employers or government, then insurance companies would have to adjust their products and cost to meet the demands of individuals. If price structures were more transparent and available, then doctors and hospitals couldn't play the games they currently play.

Free market forces haven't acted on the health care system for quite awhile, and this has accounted for much of the cost increases.

And if a doctor won't give you a price, screw them and go to another doctor, if he's in network that is. Doctors provide a service, and are paid for that service. I pay other professionals for services and don't accept arrogance from them, why should I from a doctor? The white coat? Fancy degree? pleeez.

There are a lot of cultural issues that are at play here too that affect health care cost and outcomes, and the government has done nothing but make it worse. (for example the prescription drug entitlement passed by the previous administration)OMG did I a conservative just criticize GW Bush? LIke OMGoodness!!!!1!!!!!

People in the U.S. have been brainwashed by doctors and the medical establishment, where in other countries people don't worship doctors and prescription drugs like Americans do.

In many other industrialized nations, a midwife attends a birth unless there is some complication, which is cheaper and actually has better outcomes than our typical American highly medical hospital births. But anyone (like me) who talks about this makes everyone freak out because we've been brainwashed since birth to think doctors are so much smarter than we are and always know best.

This is just one example where the problem is not who will pay, but how something is handled. Pain can often be managed with chiropractic care, diet, acupuncture, etc, but everyone thinks that the only way to go is to get an expensive prescription from an M.D. This is a cultural problem, not a money problem.

And I still want to know who these benevolent dictators are that will run this system, and why it won't be run by the typical corrupt and innefficient government bureaucracy with no accountability. Please tell me where to find these saintly government servants.

DJ Black Adam said...

@Anon:

"It is our nearly religious belief in "market forces" and "the spirit of capitalism" that stands in the way of solving the problem."

Amen.

Anonymous said...

"To the person talking about healthcare in Cuba, stop believing in a lie."

Anticipating your reaction, I explicitly excluded Cuba from consideration at the outset. Yet, now that you appear to have ignored the deference I have shown you, consider this:

Cuba has such a surfeit of doctors that it has been able deploy doctors to relieve suffering throught the developing world. If only to keep Castro in his cage, shouldn't we launch something like the Cold War Space Race with an analogous public medical service corp?

Of course, the first deployment of our corp probably would have to be in the Mississippi Delta or West Virginia rather Africa or Latin America where Cuba has deployed numerous doctors. Then after our health metrics up to the standards of England, Canada, German, or Sweden, our health corp could compete with Cuba head to head for hearts and minds thoughout the developing world.

Of course, no such thing probably could happen any time soon because it would make medical care in the U.S. a much less valuable "commodity." Market forces and the spirit of capitalism would prevail against it.
Hey, pal, wake up and smell the coffee.

DJ Black Adam said...

@Anon:

"Of course, no such thing probably could happen any time soon because it would make medical care in the U.S. a much less valuable "commodity." Market forces and the spirit of capitalism would prevail against it.
Hey, pal, wake up and smell the coffee."

Preach

JudyBright said...

You people are delusional. You mean to tell me that no American doctors go to other countries and donate their time? That is beyond absurd.

I'm sure all developing countries are so thankful for the armies of CUBAN doctors that treat their sick.

But I forgot. It only counts if the governments forces them to do so as official agents of the government. And the fact that the U.S. is the primary fund source for UNICEF doesn't count either.

And Cuba's health care is deplorable, except for rich foreigners and the governing elite. I think you guys watch too much Michael Moore.

DJ Black Adam said...

@Judy:

You wrote: "You people are delusional. You mean to tell me that no American doctors go to other countries and donate their time? That is beyond absurd."

Yes they do, however it is not like there is a traveling Doctor Corps (Like the Peace Corps or the Marine Corps) that the US has. If there is, please let me know.

You wrote: "And the fact that the U.S. is the primary fund source for UNICEF doesn't count either."

No one is saying we don't do good, we could do more. FURTHER and to the point, we have people dying in emergancy rooms everday that wouldn't if our system was better in the front end.

Anonymous said...

@Judy, Judy, Judy Bright

I did not use the observation that the U.S health care delivery system is not a free market and not private to argue that free markets don't work.

Instead, I used it to say that free market principles do not subsume or encompass all material exchanges--much as Newton's laws could not cover quantum mechanics.

You owe it to yourself to think the idea through as it is the crucible of numerous other 21st century issues. Are there no domains of material exchange that do not--for inherent, cultural or historial reasons--comply with free market principles? Is there nothing that cannot be monetized?

Anonymous said...

@anonymous:

Cuba's surfeit of doctors are rented out by Castro to the tune of approx. 3 billion annually from those developing countries to which they are dispatched. The doctors make about 25 per month. They,unlike American doctors don't volunteer, they are sent. The married doctors are sent, wives and children aren't allowed to go. They serve as anchors so the doctors will come back home to Cuba.

Have you heard of Doctors without borders, Medicorps, PeaceCorps? American doctors volunteer in these programs in poor countries. No one forces them to go. Hospitals and charity organizations fly people from around the world for treatment.

As for poor people in the Delta or Virginia. Medicaid still exists, charities exist, and there isn't a hospital in America that turns away a sick person. Ask illegal immigrants.

America doesn't have to compete with any third world country for the hearts and souls of its people. They routinely come by the millions from all over, even if they don't fully know what they'll arrive to , they well know what they left. They've already decided who won they heart and soul.

And you best believe that medical care is a valuable commodity. Try being sick. You are better off being a poor sick person in America with healthcare system than a poor one in most places in the world. At least we still have a choice of doctors and our services aren't rationed (yet).

Go ahead and blindly support this move to a single payer system. Just don't get sick at an old age or desire elective surgery. You'll have to take whatever is left of your highly taxed paycheck and go to Cuba to see one of their surfiet of physicians. Work it out, bro.

Smile said...

I supposed there was going to be an intelligent conversation about health. Well, pardon me for not realizing that there is a greater desire to make points and hurl insults. This kind of talk is a dime a dozen and has been so thoroughly accomplished elsewhere it's hard to believe there are those who see something to capture from it. But by all means, knock yourself out.

This thread has devolved into party line rhetoric, which is useless to me.

Anonymous said...

"At least ... our services are not rationed (yet).

No, not so. Services currently are rationed by income. Consider the case of 12-year-old Demante Driver who died year before last because bacteria from a badly decayed tooth migraged to his brain.

If his mother had the money for an $80 tooth extraction or if any of her jobs as a baker, construction worker, and home health aide had provided health insurance or if any denist accessible by bus accepted Medicaid, if their Medicaid card had not lapsed or if Demante had not been poor, he would not have died from tooth decay (See Washington Post, B-11, February 17, 2007 or Google the name)

I could recite news accounts of hospitals dumping indigant elderly patients unto the streets, but Demante Driver's death within the shadow of the capitol ought to be enough to disabuse you of the notion that medical services currently are not rationed in the U.S.

Demante would have been better off had he been a citizen of any other "advanced" industrial society or-- dare I say -- Cuba. Oh, brother, I know that last word, Cuba, offends your civil religion of rugged individualism, market forces, and the spirit of capitalism; and it was rude of me to mention it.

Forgive your po', blind, unthinking bro, my brother (I shall think of you as such since you referred to me as bro) and permit me this last thought:

What would happen if the President undertook a national goal of doubling or even trippling the number of primary care physicians in the U.S. by paying for their education in exchange for some period of public service? Wouldn't he a fire storm of opposition from those with vested interest in keeping medical care a relatively scarce resource? Enough said about rationing, bro.

Anonymous said...

@anonymous:
Why we give up "pretty damn good" in the search for perfection is a mysterious human condition. We have the opportunity to look at how gov't healthcare plays out around the world. We can see what works and what doesn't. Yet we head towards a system that will give us less choice, remove incentive from physicians, and will put the gov't in charge of a massive amount of the economy. Historically a bad move for innumerable reasons, yet we forge ahead anyway.
A decayed tooth is a long standing condition that could have been taken care of at some point prior to bacteria spreading to a 12 year olds brain. The card lapsed? The situations described are unfortunate but the exception not the rule. Wide scale public healthcare decreases the quality for most. The exceptions will be the very wealthy few.

As I stated earlier, American physicians already volunteer plenty of their time, no need to bribe them with loan forgiveness to do public service. I think more than anything what irks me about the argument is the insinuation that America is somehow some selfish evil country because we have a relatively free market. But,enough already. Two irreconcilable world views are in play here.

Constructive Feedback said...

Hey Steve!!!!

What is going on in the Prince Georges County Public School System with all of the suspensions?

Is it "racial profiling" now that all of those Democrats run the place?

Keeping Discipline In-House
Proposal Tackles Pr. George's Schools' High Rate of Suspensions

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/14/AR2009061402453.html

Anonymous said...

As a cancer survivor I just do not want a health care program akin to Canada's. In Canada the people have to wait 4 weeks to several months to see a specialist. If I had to wait several months to see my oncologist, I may not be here today. I guess that is one way to selectively eliminate people from the country and make people more dependent on the government. I do not really have a solution, except one thing I think that will help is to do away with the pre-existing conditions that have made many people uninsured. I dread loosing the insurance that I currently have, for that very reason.

Canadians wait longer for medical care.......

In 2006, the average amount of time spent waiting to receive treatment after referral by a general practitioner averaged 17.8 weeks across Canada. At 14.9 weeks, Ontario had the shortest waits. Prince Edward Island, Saskatchewan, and New Brunswick had average waits of 25.8 weeks, 28.5 weeks, and 31.9 weeks, respectively.

Patients referred to a neurosurgeon waited an average of 21 weeks just to see a specialist. Getting treatment required an additional 10.7 weeks.

Patients waited an average of 16.2 weeks to see an orthopedic surgeon, and another 24.2 weeks for treatment to be performed after the initial visit.

The number of people routinely waiting for services is staggering, according to the report. In 2003, the most recent year for which data were available from Statistics Canada, approximately 1.1 million people had trouble accessing care on a timely basis.

About 201,000 had problems obtaining non-emergency services. An additional 607,000 had problems getting in to see a specialist, and about 301,000 patients experienced problems obtaining diagnostic procedures.

"So much for the myth of government-run health care being compassionate and fair," said David Gratzer, a Canadian doctor and senior fellow at the Manhattan Institute. "Canadians wait and wait and wait."


http://www.heartland.org/policybot/results/20368/Canadians_Wait_Longer_for_Medical_Care.html

Anonymous said...

Very interesting isn't it:

Ever hear of Claude Castonguay? Maybe not, but those who follow the health-care debate have certainly heard of his creation. Castonguay fathered the single-payer system in Quebec that locked out private insurance, the one which advocates of nationalized health care in the US love to cite as a success story. However, Castonguay has reached a far different conclusion about his creation:
Back in the 1960s, Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies.
The government followed his advice, leading to his modern-day moniker: “the father of Quebec medicare.” Even this title seems modest; Castonguay’s work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast.
Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in “crisis.”
“We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” says Castonguay. But now he prescribes a radical overhaul: “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”
Castonguay has realized — a little late — that socializing medicine creates a shortage-management system. It limits the resources available, which drives down the level and the quality of service. Without free-market competition and under a burdensome regulatory scheme, there are no incentives for investment, and not even “massive” amounts of government spending can solve those core problems.
What does Castonguay suggest for Canada? He wants the immediate legalization of private insurance. Since the government now owns all caregiving facilities, Castonguay recommends that they lease space to entrepeneurial physicians and care-giving companies to get more services available to Canadians. Right now, the Canadians actually pay Americans to see their citizens, those whose urgent needs cannot be addressed in a timely manner. Not only is that a gigantic hypocrisy — the state system paying private-sector providers in another country — but it also sends money outside of Canada that would remain in Canada if they had private sector health-care options.

Anonymous said...

@ anonymous 8:15..............My point exactly. If these people are so for single payer they need to just look at our neighbor.

Hey CBW where is your friend from Canada. I have seen him post before.

Anonymous said...


"The average time patients in Boston wait for an appointment to see a specialist has increased ... to an average of 50 days and can be up to a year ..."

--Medical News Today
May 20, 2009


"[B]oth data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems."


--BusinessWeek
July 9, 2007


uptownsteve said...

CF

"What is going on in the Prince Georges County Public School System with all of the suspensions?"

Must be all those black folks, eh CF?

You are one sad individual.

Anonymous said...

@anonymous 10:33pm: You said "[B]oth data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems."

Boston is deeply liberal. They should check what they are doing wrong if this info is true for Boston. If it is, for shame. We need to look at what's happening in other parts of the country. If people are waiting that long all over America, then we need to abandon what we are doing and not continue down a road to a single-payer healthcare system that will absolutely guarantee these outcomes for everyone.

Anonymous said...

Even the CBO(Congressional Budget Office) has now said that Obama's plan to overhaul the system will cost around 1 trillion. It will still leave 35 million Americans without insurance. It is worth it to overhaul something and only bring down the numbers by a small percentage? They are saying that the cost of this coverage will be 65K per person per year(in right now dollars) This is the CBO, a government agency. Of course, the O administration is going with their own numbers. Personally it just proves that the takeovers of industry aren't for the benefit of the people, it's to consolidate power to the state.

This is the kind of stuff I read about in Russian History class. It's mind boggling what I'm witnessing in my country. How can people honestly think that gov't ownership of the economy is a good thing? Does anyone know history? I bet you there are many immigrants out there that can't believe they have sought sanctuary in a country that is moving towards practices of the gov't they left.

Constructive Feedback said...

[quote]Must be all those black folks, eh CF?

You are one sad individual.[/quote]

So is this your only defense to explain HOW this is happening in this PROGRESSIVELY run county?

Ironically I saw how leftist Donna Edwards is focusing on being the "Black Critic" of ISRAEL as the Jewish Left now provides cover for Black leftists.

Maybe SHE needs to start focusing on issues closer to home. Ya think?

Malcolm Kirkpatrick said...

DJ: "All the Right is doing is protecting the cash cow of health care companies and pharmacutical companies, it is really pathetic and shallow."

Your argument is pathetic and shallow.

1) Use of the terms "left" and "right" in political discussion indicates a one-dimensional view of the political continuum which I do not share.
2) Market-oriented economists who study the health care industry do not "protect...the cash cow of health care companies and pharmaceutical companies", they study how institutions (including legal institutions) shape the incentives of people in the health care industry. Artificial shortages (e.g., the AMA's accreditation of Medical schools, the FDA's drug-approval process) raise the cost of care. The tax code, with corporate taxes and exemptions for pension and health care, also contribute to the high cost of health care. Some economist compared the increase in the cost of surgery or drugs for humans to the increase in the cost of analogous services for dogs and cats (veterinary care). Human care increased more. Why?

The government of a locality is the largest dealer in interpersonal violence in that locality. There is no magic in violence. People do not become more intelligent, better-informed, nore altruistic, or more capable (except to the extent that they can invoke violence) when they enter the State's employment rolls.

You will die. The US could devote its entire GDP to health care for DJ Black Adam alone and it would not be enough. You will die.

You want to live longer and healthier? Stop smoking. Eat your veggies. Reduce consumption of fatty foods. Get more exercise.

Does it bother you that "the poor" generally get lower quality care than "the rich"? That's what it means to be rich. Wealth is synonymous with options. Rich paople have more options.

I have not seen the inside of a doctor's office in 20 years. I used to buy health insurance when the winter swells arrived (September through April), but since I no longer body-surf, I have "gone naked" for the last 20 years. If I get an infected laceration or puncture, I take the antibioltcs which my friend giver her rotweilers.

Eventually, I will die. So will everyone else. Your God, the State, cannot do anything to prevent it.

Malcolm Kirkpatrick said...

Ile Meroe: "...most other comparable countries have decent public school systems. The way that they achieve this is no great secret but you seem to feel that Americans are less capable than the Swedes, Germans Finns, Koreans, Australians Japanese and (dare I say it) even the French."

Sweden subsidizes parent choice of schools, through tuition vouchers. Germany assigns students to career tracks around sixth grade. Korean ad Japanese kids spend a lot of time after school with private tutors.

"Most other comparable countries..."? Dunno. Some Canadian provinces subsidize parent choice of school. Singapore, Belgium, Ireland, the Netherlands, the Czech Republic, and Hong Kong subsidize a parent's choice of school.

Gerard Lassibile and Lucia Navarro Gomez
"Organization and Efficiency of Educational Systems: some empirical findings"
__Comparative Education__, Vol. 36 #1, 2000, Feb. pg. 16

"Furthermore, the regression results indicate that countries where private education is more widespread perform significantly better than countries where it is more limited. The result showing the private sector to be more efficient is similar to those found in other contexts with individual data (see, for example, Psucharopoulos, 1987; Jiminez, et. al, 1991).
This finding should convince countries to reconsider policies that reduce the role of the private sector in the field of education".

Deanna Bland Hiott PhD, MSN, RN said...

You go girl!!! Every time I drop by you hit the nail on the head! We home school and have for almost 14 years now. Also, I am a nurse. I do not want the government educating me, employing me, or providing my health care for me...I wish America would wake up and see that their individuality, the power to think and provide for themselves is being siphoned away by "Big Brother."

I want excellence not mediocrity!

Also, I work in a hospital...NO ONE IS TURNED AWAY...it is against the law!!! And the patients that don't have insurance can apply for medicaid and get retroactive coverage if they qualify.

DJ Black Adam said...

@Southerndrawl:

You wrote: "Also, I work in a hospital...NO ONE IS TURNED AWAY...it is against the law!!!"

No you just stabilize them and then transport them to the county hospital as soon as you think its o.k.....

You also wrote "And the patients that don't have insurance can apply for medicaid and get retroactive coverage if they qualify."

And what if they don't qualify and don't have insurance because they couldn't afford it?

Looking forward to your answers.

Malcolm Kirkpatrick said...

Adam,

These are your (policy-makers') choices: You either enslave doctors or you enslave taxpayers or you allow care providers and care seekers to meet on mutually acceptable terms. Everyone can afford some kind of care. Wealthy people have more options; that's what it means to be wealthy.

Inevitably, someone decides whether the next dime spent on a given condition is worth the gain. That someone will either a care-seeker (or relative) weighing the added health benefit against the other uses of his/her bank balance or it will be a Washington bureaucrat weighing aggregate health benefits from a category of ailments against the other uses (medical and other) of available assets. "Available" in this case means "whatever the IRS can extract".

Malcolm Kirkpatrick said...

Steve,
In an earlier thread, you called the assertion that the per-pupil cost of the DC school system is the highest in the US a "canard".

The figures given here for DC ($15626) and New Jersey ($16587) put DC in second place, but "total revenues for education" divided by "September enrollment" or "ADA" seldom equals the figure given for "per pupil expenditure", so the figures are quite loose. Dunno why.

NCES counts DC as a "State" for purposes of comparison (along with DOD schools and American Samoa). Very likely, some individual, wealthy school districts (e.g., Beverly Hills) spend more than any State-level aggregate figure. The figure Andrew Coulson gives here indicates a higher figure for DC than for any other State-level polity.

In any case, international comparisons and comparisons with independent schools and homeschoolers indicate that every US State spends far more than needed to teach the regular-ed students in its age 6-18 population to read and compute.

The US "public" school system has become an employment program for dues-paying members of the NEA/AFT/AFSCME cartel, a source of padded construction and supply contracts for politically-connected insiders, and a venue for State-worshipful indoctrination.

DJ Black Adam said...

@Malcolm:

You wrote: “Adam, These are your (policy-makers') choices: You either enslave doctors or you enslave taxpayers or you allow care providers and care seekers to meet on mutually acceptable terms. Everyone can afford some kind of care. Wealthy people have more options; that's what it means to be wealthy.”

You give false choices and propose by that actuality a false dichotomy. First off right now it is corporate bureaucrats that determine what level of health care people get, this predicated mostly on maximization of profits, that is unacceptable for this commodity.

As for “enslaving”, taxes will be paid it isn’t a matter of paying or even how much it is a matter of priorities.

It is my assertion that most of the health care industry should be NON PROIFT Corporations, heavily regulated for the protection of the consumer / citizen and further that doctors by committee determine standards as to what is the health care standard. I.E. determining how much the taxpayer funds should provide for funding for health care for the sustaining of life in situations like cancer and other terminal illnesses, of course wealthy people always can use their money to go beyond that, and perhaps private for profit insurers can have policies for the average guy for that. BUT, basic and in this country that means pretty damn good health care should be available to the average citizen at NO COST aside from what we pay for this in our taxes.

Malcolm Kirkpatrick said...

The government of a locality is the largest dealer in interpersonal violence in that locality. The State (government, generally) shapes society through violence and threats of violence. Policy (the complex of threats) shapes citizen behavior through the incentives it creates.

Choices are constrained to the degree that they are not free. "Slavery" and "freedom" are stark (dichotomous) representations of a continuum (more or less freedom).

Profit-seeking corporate bureaucrats do not determine the level of care I get, or I would see doctors more often. No physician or surgeon has made a dime off of me in 20 years. "Profit" is a bookkeeping term, the difference between total revenues and total costs. Any organization which does not make a profit must attribute all revenues to costs. This says nothing about the motives of people in that organization. People do not become more intelligent, better-informed, more altruistic, of more capable (except in their access to the tools of State violence) when they enter the State's employment rolls or work for a tax-exempt organization.

(Adam): "...taxes will be paid(insert;-mk) it isn’t a matter of paying or even how much it is a matter of priorities."

If enough voters decide to let the State set priorities, this will be the case. I do not see the advantage of aggregating authority for individual treatment decisions in some State committee.

(Adam): "It is my assertion that most of the health care industry should be NON PROIFT Corporations, heavily regulated for the protection of the consumer/ citizen..."

a) What do you mean by "should"?
b) Advocates for regulation usually offer "protection of the consumer/citizen" as the rationale for any regulation. Most libertarians would agree. Libertarians differ from socialists in how much regulation they expect will advance the interests of consumers. Since regulated industries have a stronger incentive to manipulate the regulators than does the average consumer, industry insiders usually determine policy. Economists call this phenomenon "regulatory capture".

(Adam): "...and further that doctors by committee determine standards as to what is the health care standard."

This pretty well guarantees regulatory capture.

(Adam): "...basic and in this country that means pretty damn good health care should be available to the average citizen at NO COST aside from what we pay for this in our taxes."

Subsidized goods are over-consumed. This feature guarantees incredible waste.

One enormous problem with the "public goods" argument for State provision of any charitable good (education, health care, etc.) is that corporate oversight is a public good. The State itself is a corporation. Oversight of State functions is a public good which the State itself cannot provide. State assumption of responsibility for the provision of public goods transforms the "free rider" problem at the root of most "public goods" analysis but does not solve it.

What does it mean to say: "We should all ride non-polluting flying carpets to work instead of cars"?

DJ Black Adam said...

@Malcolm:

This assertion: "Profit-seeking corporate bureaucrats do not determine the level of care I get, or I would see doctors more often."

Is fundementally flawed. Heath Insurance companies are "INSURANCE" companies, simple as that, financial services corproations which primary goal is maximization of their OWN profits, NOT the health of any individual.

Therein lies the problem. Either these companies become non-profits, or th egovernment should provide the service of insurance of the citizen. Doctors should determine criteria for treatement, treatments considered "non standard" or "expereimental, should only be elective and there for profit insurance companies can insure or the rich can purchase.

This is how it SHOULD be. Your almost religious belief that the private sector can or will or is doing better or will do better than a private option in this issue, is blocking your ability to see clearly.

Malcolm Kirkpatrick said...

(Malcolm): "Profit-seeking corporate bureaucrats do not determine the level of care I get, or I would see doctors more often."

(Adan): "This assertion...is fundementally flawed. Heath Insurance companies are "INSURANCE" companies, simple as that, financial services corproations which primary goal is maximization of their OWN profits, NOT the health of any individual."

How does this establish that my statement is "fundamentally flawed"? I determine my level of care. Profit-seeking insurance corporations get nothing from me. I might buy catastrophic coverage with a large deductible if I find the right plan.

No one has found a better way to summarize the various preferences and priorities of large numbers of people than the price mechanism (markets). How to weigh the value of some doctor's time, some plastic tubing, some stainless steel? Put it on the market and see who will pay the most for it. Otherwise, it's up to whomsoever has the largest crowd of thugs behind him.

(Adam): "Therein lies the problem."

I do not see the problem. Everyone is motivated, comatose, or dead. Money, threats, or something else (love, altruism, guilt) motivates everyone who is neither dead or comatose. Money is more reliable than altruism, more available than love (why would a surgeon love a stranger?), and less destructive than threats of violence.

(Adam): "...This is how it SHOULD be."

Who made you Pope?

(Adam): "Your almost religious belief that the private sector can or will or is doing better or will do better than a private option in this issue, is blocking your ability to see clearly."

"The market" is what happens when the State defines title, bans threats and violence by non-State actors, and enforces contracts. Your almost religious beleif in the healing power of State violence is blocking your ability to see clearly.

DJ Black Adam said...

(Adam): "...This is how it SHOULD be."

Malcolm Replied: "Who made you Pope?"

The proper term for my station is Emperor, however you can call me His Royal Majesty.

Malcolm Kirkpatrick said...

(Adam): "...This is how it SHOULD be."
(malcolm): "Who made you Pope?"
(Adam): "The proper term for my station is Emperor, however you can call me His Royal Majesty."

LOL (literally). Thanks. We were at risk of getting serious.

Paul Ervin said...

@ BJ Black Adam:

Actually if you are emperor, it would be , "his imperial Majesty"

Just sayin!

DJ Black Adam said...

@Paul:

Thanks, I wouldn't want to have to have anyone summarily executed for addressing me improperly or with an “insolent tone” (direct hint if you missed it). You have to pardon me, my time amongst commoners has made me forgetful of my proper royal titles and customary protocols.

Freedom4All said...

Maybe the reason the US spends far more per person, Ile, is because we take care of people who might have been turned away in countries with rationed care. I'm a visiting nurse in Jersey City and Newark (NJ) and I doubt most of my elderly patients with multiple diagnoses would past Ezekial Emmanuel's guidelines. When I call 911 when my 80-something patients have had a stroke, a heart attack, or had a reaction from the chemo they get for their prostate cancer, the ambulances come promptly, they are admitted to the hospital, and they are taken care of. I can't imagine being told "you're too old, too sick, and don't fit the guidelines." No doctor or nurse wants a government "medical ethics expert" to come between them and the patients they care for. I also speak for my friends in the neonatal units of NYC and Newark. These preemies are the others that might not pass the ethics test. Preemie care costs a bundle. Try telling the parent of a preemie, or a special needs child, that their child doesn't meet the guidelines.

Freedom4All said...

DJ Black Adam--I've recently visited Bulgaria and Greece. Try to find a doctor there when you're sick! They've all left the country or only take cash because the govt. pays them so little for what they do. And are you aware of how many doctors have left the northeast because of frivolous lawsuits? Thousands! They've left for states that have tort reform. Nobody can make anyone be a doctor--four years of college, four years of medical school, 4 years of residency just to deliver babies, and then get low pay and sued? Fuhgettaboutit!