Nationalized Health Care Is Like Pulling Teeth — Your Own

The British have had a nationalized health care system for decades, and almost as long a list of examples why it doesn’t work. Three years ago, we discovered that hospitals in the UK threw out viable kidneys for lack of physicians qualified to transplant them. Now we find out that a shortage of dentists has led Britons to perform free-lance extractions to avoid an excruciating wait:

A shortage of National Health Service dentists in England has led some people to pull out their own teeth — or use super glue to stick crowns back on, a study says.
Many dentists abandoned Britain’s publicly funded health care system after reforms backfired, leaving a growing number of Britons without access to affordable care.
“I was not surprised to hear those horror stories,” said Celestine Bridgeman, 41, of London. “Trying to find good NHS dentists is like trying to hit the lottery because the service is underfunded.”
The National Health Service provides care to the vast majority of Britain’s people, often for free. Unlike doctors who work for the health service, dentists work on a contract basis and can leave whenever they wish.

The situation shows what happens when government crowds out the private market, even when it allows some private participation. Most Britons, whose tax dollars fund the NHS, cannot afford to add private dental services on top of the burden. Thanks to so-called reforms, almost half of Britain’s dentists won’t take NHS patients, and the rest have either long waits or work too far away from the patients who need them.
In a free market, the compensation for dentists would be set by market forces. Shortages would not long exist, because any shortage would make dental services more valuable and would incentivize more students to pursue that specialty. As with the transplant surgeons, shortages occur because government caps compensation and removes the incentive to specialize at all — and with dentists, who can opt out of the NHS system unlike their physician colleagues, the private market becomes exclusive to only those who can afford both the tax burden of NHS and the fees for dental work.
What happens then? The rich get dental work. The poor buy pliers and Super Glue. Actually, I could be wrong. The poor might borrow the pliers.
Six percent of the survey sample treated themselves out of frustration, including one man who extracted 14 of his own teeth. Twenty percent of the sample could not afford dental services. An additional 35% blamed their lack of dental care on a lack of NHS options close enough to them. That means a majority of Britons have no practical access to dental care, thanks to their government-run health care system.

61 thoughts on “Nationalized Health Care Is Like Pulling Teeth — Your Own”

  1. Having suffered from an infected tooth before and the excruciating pain that comes with it, I simply cannot imagine what it must be like to be in a situation where you cannot get an emergency appointment unless you are wealthy.
    But there you have it. Citizens of a country that once built an empire across the face of the world are now forced to pull out their own abscessed teeth for want of a decent, affordable dentist.
    A toothless lion, the once mighty Brittania.

  2. The British Health System is kind of like Monty Python’s Flying Circus Cheese Shop. The great advantage is, you never have to spend your money on a cheese slicer, because there’s never any cheese.

  3. I don’t think many (any?) liberals in the US recommend a UK style health care system. Generally, liberals believe the US could do a lot better (I think the US spends a lot more per person than the UK already).
    In any case, this feels like “argument by anecdote” which is something I thought conservatives didn’t like to do after getting a taste of that style from Sicko.

  4. “..liberals believe the US could do a lot better..”
    Uh, well yeah…anything’s better than having to pull out your own teeth with a pair of pliers, so that’s not setting the bar too terribly high.

  5. So exactly how would adding more payers (insurance companies) get more dentists into the system?
    Certainly reimbursements need to be looked at (Medicare has horrible rates for certain procedures, e.g. paps) but reimbursements from private insurance companies aren’t necessarily better/higher for health care providers.

  6. “reimbursements from private insurance companies aren’t necessarily better/higher for health care providers.”
    Actually I don’t believe this is true. Health care providers will generally drop a carrier that doesn’t pay. That’s the point. In a system not controlled by the government, market forces can be brought to bear. A dentist has some choice in which insurance he will accept and employers and individuals have choices in which insurance to buy and which dentist to use.
    In the UK system, a dentist has all the choices. He can go private and choose not to accept government patients. The consumer has no choice. If he doesn’t have the money to pay as he goes, he’s left with either inadequate dental care or no care.
    We’re not talking about some complicated dental treatment here. It’s simple tooth extraction (and frankly, it might not even come to that given a competent dentist. The tooth might be repairable).

  7. MarkT, the “anecdotes are not data” argument you are attempting to make ignores the fact that each anecdote is in fact a data point….. and that enough of them is going to tell you something. When every instance of socialized medicine leads to precisely this outcome, then what it tells me is that I’ll never endorse such a system.

  8. MarkT wrote:
    I don’t think many (any?) liberals in the US recommend a UK style health care system. Generally, liberals believe the US could do a lot better
    No, “generally”, liberals are completely indifferent to the practical consequences of their policies — indifferent to the point that they will push liberal policies as solutions to problems created by the same liberal policies.
    Take, for instance, the so-called “war on poverty”. In the decade prior to Lyndon Johnson launching his “Great Society” anti-poverty program — a decade in which there was very little spending on anti-poverty programs — the number of people living under the official poverty line fell substantially from 40 million to approximately 25 million. However, since 1969, when the programs really cranked up, the number living under the poverty line has increased from 25 million to 37 million, despite the expenditure of trillions of tax dollars on federal programs to “lift people out of poverty”. And the explanation is simple: the anti-poverty programs essentially pay people to remain poor, so millions choose to do so.
    Despite this blatant failure, every major Democratic politician continues to push for ever more spending on such programs. The reason for this is plain enough: they are not interested in eliminating poverty; they are only interested in looting the upper income taxpayers to buy the votes of the non-taxpayers.
    So it isn’t the least bit surprising that Democrats are pushing for more socialized medicine. They are indifferent to the fact that the socialization of medicine they’ve achieved to date in the form of the Medicare and Medicaid programs have utterly failed in their promise to make “healthcare affordable to all” and have, instead, made healthcare affordable to fewer and fewer. If they can further loot the taxpayers to buy still more votes, they will push to do so, regardless of the suffering it creates.

  9. Perserverence is normally an admirable trait. When people continue to strive to overcome obstacles that stop them achieving their goals, we usually admire and applaud them.
    In the case of gubmint-run health care, people who keep trying to achieve that should be locked up as criminals.
    Look at government-run health care in our own country. VA. Medicare. Medicaid. They are characterized by inefficiency and high costs. Yet some people want to put ALL of us under a similar system in the interest of “fairness” (which is to say, making sure that “the rich” don’t get better care than anybody else).
    It’s often occurred to me to wonder what our lives would be like if the gubmint ran them in the way that libs want the gubmint to run health care. Think of all the innovations that we take for granted, such as cel phones, A/C in cars, CD players, etc, etc, and ask yourself: would these things exist or be widely available if it were up to the government. The answer must always come back “no”. Why would the government “waste” tax dollars on such things?
    The same might be said for medical care. Why would the government spend billions (as the nasty ol’ pharmaceutical companies do) to develop new drugs or diagnostic devices or techniques? This is essentially what has apparently happened in Britain: the government decided that dental care wasn’t a priority, and so didn’t budget enough money to hire enough dentists to take care of the population. What sort of dental care do we think that the government WOULD provide? I can’t imagine the government wasting money on braces and other “non-essential” orthodontia, or if it did, the waiting lists would be horribly long.
    It boils down to this: do you trust the same organization that spends $400 on a hammer to take care of your health care?

  10. Or you could live here and view this news in context. That context is that dentristry was deliberately underfunded by the last Conservative government as part of their plan to kill off the NHS. They incentivised dentists to set up private practices, raised the fees on NHS treatment, lowered the training places and lowered the money paid to dentists for NHS work. The result is what you see, a half-private, half-public system that is simply a mess. Private coverage is exhorbitant (I have had lots of dental work done and even looking back on it, a private scheme would still have cost more than simply paying for the treatments myself) and few people pay for it. How can this be? one asks themselves, why doesn’t the market simply self-correct? To which the answer is that most private insurance is done through company packages.
    Essentially, what you are doing is looking at a mess that was deliberately created by people who wanted a private health system and saying “Look, that is a mess, see, public provision doesn’t work!”
    But you wouldn’t know that because all you have are these anecdotes.
    As an example of the benefits of NHS dentristry vs private, I recently had a filling done and I have an NHS dentist. I paid £45 for it. Privately I would have paid £56 (with the same dentist, who do NHS and private work, see what a mess it all is).

  11. Well, I have not had to pull my teeth with pliers, yet. But the price of dentistry here in the U.S. has led me to use superglue to replace crowns and fillings on multiple occasions. The “dental insurance” provided by my employer, a familiar drugstore chain, is worse than useless, costing about a thousand per year for at best two hundred per year in benefits–so most of us don’t bother with insurance. I’m slowly getting work done as I can afford it, privately; but don’t think we are in much better shape than the Brits in this.

  12. Actually the very same thing is happening in America. The well off get a Drs. prescription for anti-depressants. The poor go to the black market for pot.
    Class War
    Woe unto him who does not avail himself of the services of the medical cartel.

  13. Rafar wrote:
    As an example of the benefits of NHS dentristry vs private, I recently had a filling done and I have an NHS dentist. I paid £45 for it. Privately I would have paid £56 (with the same dentist, who do NHS and private work, see what a mess it all is).
    This ignores the vast amount of taxes that are paid to make the NHS fee lower than the “private” fee. It also ignores the fact that the “private” fee is not actually private, since the “private” provider’s costs are increased by having to pay those very taxes. So this is not a comparison of what a free market provides versus what a government-run system provides; rather, it is a comparison of what a heavily subsidized system provides versus what can be provided by those forced to pay for the subsidies.
    The bottom line is that you cannot get something for nothing, not even in England. You do not make healthcare cheaper by adding layers of bureaucrats and managers to the system, all of which must be paid. That only makes the total cost greater. All you can do is shift the costs off some individuals onto other individuals and thereby make it appear that some individuals are better off, all in the hope that the public will be too stupid to realize what is being done to them.
    Government produces nothing; all it can do is take from some to give to others. Thus, it cannot deliver a dollar of benefit to anyone without delivering a dollar of harm to someone else. And since, in fact, government always pays itself a salary for practicing charity with the taxpayer’s dollars, it must deliver more than a dollar’s worth of harm to someone every time it delivers a dollar’s worth of benefit to someone else. There is no escaping this reality.

  14. From the same article:

    The survey of 5,212 patients and 750 dentists in England found 6 percent of patients resorted to self-treatment, including one person who extracted 14 of his teeth with pliers. Other patients reported using super glue on crowns after they popped off, the study said.

    And the current US system is so much better, what with 44 million who don’t have insurance and all, not to mention the increased use of high-deductible policies etc…
    In other words, a higher percentage of Americans (one of only three OECD countries without public health care) are in the same boat because they are priced out of the system.
    Read more here: http://www.kff.org/

  15. Bondad wrote:
    And the current US system is so much better, what with 44 million who don’t have insurance and all, not to mention the increased use of high-deductible policies etc…
    In the first place, the fact that 44 million don’t have insurance doesn’t mean they don’t get medical care. I don’t have insurance and I get all the care I need. I just pay my own way.
    In other words, a higher percentage of Americans (one of only three OECD countries without public health care) are in the same boat because they are priced out of the system.
    Yes, the liberals have succeeded in partially socializing medicine here through Medicare and Medicaid and S-CHIP. And as a result, healthcare costs are continuously rising. And in response to the effects of this poison, you propose more poison.

  16. Rafar: Or you could live here and view this news in context. That context is that dentristry was deliberately underfunded by the last Conservative government as part of their plan to kill off the NHS. They incentivised dentists to set up private practices, raised the fees on NHS treatment, lowered the training places and lowered the money paid to dentists for NHS work. The result is what you see, a half-private, half-public system that is simply a mess.
    In other words, the dental care of Britons is subject to the caprice of politicians, and Britons are paying the price for political squabbling in London.
    This is one of the reasons that many of us oppose any sort of nationalized health care! Decisions like how many dentists (or GP’s, or chiropractors, or radiologists, or cardiac surgeons) there should be shouldn’t be made by politicians or bureaucrats.
    Stewart: Well, I have not had to pull my teeth with pliers, yet. But the price of dentistry here in the U.S. has led me to use superglue to replace crowns and fillings on multiple occasions. The “dental insurance” provided by my employer, a familiar drugstore chain, is worse than useless, costing about a thousand per year for at best two hundred per year in benefits–so most of us don’t bother with insurance.
    At risk of sounding heartless, have you considered either (A) buying private insurance; (B) getting a job with a company that offers better benefits, or; (C) shopping around the dentists in your area to see if one can perform the procedures at a cheaper rate or are willing to make a deal with you that will allow you to pay them back over time?
    Have you also considered that your company doesn’t provide better health care coverage for the same reasons that they don’t pay you $500k per year, i.e. your labor simply isn’t worth that much to them? I’m not trying to imply that you are a bad employee or anything of the sort, but rather that the skill set for your job simply may not be worth a higher amount of compensation. If your labor is only worth (for example) $50k per year in pay and benefits, it would ultimately be suicidal for your company to pay you $51k.
    This demonstrates several problems with health / dental “insurance”:
    1. To a large extent, it is not “insurance” at all, i.e. it doesn’t “insure” against some sort of health catastrophe, such as a crippling disease or accident. Rather, it is used to make the cost of health care, even routine health care, much cheaper for the individual. This grossly distorts market forces and hence prices.
    2. “Insurance” also removes much of the burden of making wise health care choices from the individual. This is, I think, one area where busy-body politicians and the insurance industry agree: Americans don’t make much effort at all to have good health. Americans tend to overeat and underexercise, leading to common problems such as cardiovascular disease. Too much sugar and not enough toothpaste lead to cavities and other dental problems. I wonder how much longer the average life expectancy of Americans would be – and how much lower our total health care costs would be – if Americans would simply walk more often?
    3. It removes the incentive – indeed, often even the option – for people to “shop” for the best health care. When the average person buys a car, for example, he often visits more than one dealership, reads reviews, and checks “blue book” prices to make sure that he’s getting the best deal. Who does that when going to the doctor? How many people pick a doctor at random simply because his office is near their house / work without bothering to see if his rates might be more expensive than another doctor a few miles away? The “cost” of an office visit is fixed by health insurance: you pay the same co-pay no matter which doctor you visit, so why bother to shop around?
    4. In the same manner, health “insurance” all but eliminates the need for doctors to compete on price. Why should a doctor try to offer lower prices or better service to attract patients when he’s going to be paid the same amount no matter what he does?
    5. Health insurance is considered a right of the worker and not a part of his total compensation. We know to the penny how much our hourly pay is, but most of us haven’t got a clue how much our company is “paying” us in insurance premiums.
    I also wonder how people ever got along fifty or a hundred years ago before there were such things as “co-pays” and “deductibles”. I guess they just died in the streets and their bodies were run over by the coaches of the rich…

  17. “Insurance” for routine costs is nothing more and n nothing less than a payment plan.
    The insurers can readily predict how much they will need to pay out, on average, and they add to that their own costs (and of course eeevil profit).
    And because of that, you pay not only for the routine costs BUT ALSO for the paper pushers who are “helping” you.
    It is unavoidable that it will cost more than paying directly.
    Insurance makes sense only for catastrophic events.
    Do not get fooled by the redefinition of a payment plan as “insurance.” It is a lie.

  18. basically the argument for national healthcare is that if one person has earned more than another, it is goverment’s job to make that person pay for the other’s needs. to be determined by… politicians calculating how many votes they need.

  19. I’ve never understood why liberals claim that the fact (if it is a fact) that we spend more on health care than Britain does is an indictment of the US health care system. Health care in the US is so much better, and so much more available, that even if it’s more expensive it’s worth it.

  20. Here is a list of the population to dentist ratios for EU countries vs. the United States, from best to worst:
    Greece 908
    Denmark 951
    Iceland 981
    Sweden 1011
    Finland 1041
    Norway 1089
    Germany 1358
    Belgium 1363
    France 1464
    Luxembourg 1491
    Switzerland 1499
    Italy 1561
    United States 1691
    Austria 2197
    Netherlands 2223
    Portugal 2472
    Ireland 2549
    UK 2645
    Spain 2688
    US data here: jada.ada.org/cgi/content/full/136/5/668
    EU data here in Table 8: scotland.gov.uk/library3/health/sacd-06.asp
    The US comes 13th out of 19. Not bad. Much better than in most other comparisons. Of course, you can make the US look better by comparing it to number 18.
    You can also look at the spread within countries. For example, the worst ratio within the UK “was found in Walsall (3,359 residents per NHS dentist).”:
    nature.com/bdj/journal/v190/n10/full/4801032a.html
    This is the worst that it gets in the 2nd worst country in the EU. Maybe this is where the people are pulling out their own teeth. What about the US? In the US, a dentist shortage is a particular area is deemed an HPSA (Dental Health Preofessional Shortage Area). There are 1,480 of these in the US. But what level is considered a “shortage”? A shortage is when the population to dentist ratio exceeds 5,000 to 1:
    “Four thousand six hundred and fifty dentists are needed to remove the 1,480 HPSAs in which 31,405,876 people reside (to reach a population to dentist ratio of 5000:1). Approximately 6,380 dentists would need to be added to achieve the HRSA standard of adequate access.”
    bhpr.hrsa.gov/medicine-dentistry/actpcmd/report2001.htm
    So in the US, we have nearly 1,500 areas (containing 31 million people)that have a ratio that is much worse than the worst area in the second worst nation in the EU. The people who live in these areas probably have no teeth left to pull out.

  21. “The British Health System is kind of like Monty Python’s Flying Circus Cheese Shop. The great advantage is, you never have to spend your money on a cheese slicer, because there’s never any cheese.”
    Well, yeah, except for the part where the NHS keeps killing good people I knew…
    Rafar… How many years has it been since the last Conservative government?

  22. I don’t find the occasional horror story about socialized health care all that convincing an argument against it, considering the staggering number of horror stories I’ve encountered in our system. Not to mention that you’re never comparing apples to apples, since we pay several times as much. I’m pretty sure that, given the decent but imperfect health care available to everyone in countries like Canada and the UK, if we copied the system then bumped up the amount of cash going into it, we’d see some good results. Ultimately, statistically, all of the socialized health care first-world countries kick our ass in the health of their citizens, so you can whip out all of the anecdotes you want.

  23. I agree docjim. One quibble with #3. In the US (private practice) you at least are competing with other doctors for patients in certain markets. So reputation, how nice your office staff is, offering better service matters some. Prices, however you are spot on. I chuckle when I read business types talking about shopping around for best price-doesn’t exist. My charges are set to be high enough that I cover the full reembursment of the best insurance. What I get paid is what the insurance company pays me. Write off the rest. That smigen of competition will go away once the govment takes over.
    I went to Kos the yesterday to see what they were saying about the Randi Rhodes flap. There was a diary by kos complaining that he had to wait 3 whole weeks for his insurance company to approve his CT. THe solution-single payor health care. They were all certain that he would get the CT right away without hassle when we have a NHS here. I couldn’t decide if I should laugh or cry. The funniest was a guy giving advice. He said avoid HMO’s-too much hassle and Beurocracy-go with a PPO…until we get a single payor system. IF you think HMO’s are bad JUST YOU WAIT until the gubmint becomes the mother of all HMO’s.
    I sometimes think the great divide between Right and Left is how closely the person ever worked in a market economy. All these descriptions of market forces, incentive etc is completely lost on the average Kossak.

  24. “Ultimately, statistically, all of the socialized health care first-world countries kick our ass in the health of their citizens, so you can whip out all of the anecdotes you want.”
    That is just plain not true. Go look up some cancer survival statistics and then come back here.
    And it’s good to see that liberal cliche “if we just pump more cash into a busted system it’ll start to work” still getting good mileage.

  25. Forget the anecdotes – here’s an inescapable fact, Canadians come here for medical treatments, we do not go there.
    As Ronald Reagan said you could tell a good country from a bad country by the purpose of its walls. Which way to the people want to go?
    Those that can, come here.
    All the arguments for socialized medicine come down to less quality for equality. Evidence of existing programs illustrate that equality is a myth. Unfortunately the less quality part is true.

  26. Let’s move past anecdotes and statistics for a moment. Let me ask those of you who support nationalized health care two questions:
    Why should I be compelled by force of law to pay for somebody else’s health care? Where does the Constitution give the Congress the authority to do this?

  27. that’s exactly right docjim. those with more forced to pay for those with less. gov’t adds nothing, just merely redistributes and does so to get the votes of those with less. all done for power. socialism doesn’t work long term but does get politicians elected. all great democracies and republics are doomed when the national treasury is given in exchange for votes. we are in that process now. where’s my debit card…

  28. Ok the data
    Let us look closer at the WHO study we ranked 37th in.
    “WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs).”
    OK so on the only data point that talks about the actual care given “Level of health care responsiveness” USA #1. Distribution of responsiveness 3-38 (so we are tied for 3rd with 35 other countries???-I think they may need a better system). And please explain how the “Distribution of financial burden within the population” Has ANYTHING to do with….ANYTHING regarding health care???? That is a blatant way to goose the scores of the nationalized systems (shockingly they all rank highly) over the US (54-57).
    Here is the lowdown of nationalized systems. Good at taking care of healthy people and getting them AN (not necessarily the BEST or most effective) antibiotic, immunization or BP med for cheap when things aren’t complicated. Will take care of catastrophic things (accidents, cancer-again not TOO agressive-you go to hospice earlier and if you show up with a ruptured abdominal anerysm you will likely be wheeled into a room to say your goodbyes rather than get a 50/50 surgery to save your life(may change in the era of endographs-but was standard of care in Canada) And if you happen to have a chronic illness you will get care and not go bankrupt. BUT if you have something not life threatening, but uncomfortable (sinus disease, joint pain/injury, tooth pain, etc) expect to wait a very, very long time before much gets done. Oh and don’t expect any new, innovative treatments or medicines.

  29. Looking closer at the WHO statistics-what a joke.
    Columbia in 4 of the 5 categories ranks at highest 50’s. Overall health is 74, level of responsiveness 82nd!! Yet they are #1 in distribution of financial burden and DING rank 22nd overall.
    Japan-1st in health, #3 distribution of health #6 level of responsiveness 3-38 distribution of responsiveness 8-11 finaincial burden but only rank 10th?
    France #1 overall health system is behind Japan in every category EVEN sharing financial burden???? How are they #1

  30. Socialized Health Care, Part I

    Since I posted this piece last week on the Canadian Health care and the SCHIP bill was vetoed by President Bush, the conversation over socialized medicine has heated up. I received a heated email from a flaming liberal filled with pleas for equality of…

  31. Yet another post from Ed… expert on British Health care and the NHS.
    “That means a majority of Britons have no practical access to dental care, thanks to their government-run health care system.”
    That’s pure BS Ed. They have as much access as any American does. They have to pay for it like any AMerican does. Most Brits assume that Dental care is not covered by the NHS. Until I saw the story, I didn’t know it was. I remember when the NHS did cover dental work and they did a good job but when my dentist opted out of the NHS (as did most) we paid for it like everyone else.
    So the Brits have to do what Americans do… what a disaster!!! Horror!!!
    Stop using one off horror stories to make your BS arguments Ed. The NHS has serious problems and your little polemic does not address any of them. Every time you post on the NHS you show your complete ignorance of the service.

  32. Yet another post from Ed… expert on British Health care and the NHS.
    “That means a majority of Britons have no practical access to dental care, thanks to their government-run health care system.”
    That’s pure Bull sh!t Ed. They have as much access as any American does. They have to pay for it like any American does. Most Brits assume that Dental care is not covered by the NHS. Until I saw the story, I didn’t know it was. I remember when the NHS did cover dental work and they did a good job but when my dentist opted out of the NHS (as did most) we paid for it like everyone else.
    So the Brits have to do what Americans do… what a disaster!!! Horror!!!
    Stop using one off horror stories to make your BS arguments Ed. The NHS has serious problems and your little polemic does not address any of them. Every time you post on the NHS you show your complete ignorance of the service.

  33. docjim:
    “Why should I be compelled by force of law to pay for somebody else’s health care?”
    You seem to be implying that universal health care will cost you more money. That may be true if everything else stays the same – meaning we continue to let pharmaceutical companies and insurance companies make insane profits. But why not change everything? Other first world systems are better in every measurable way, and cost less on top of it. Adopting a system similar to those in other first world countries would cost less, and perform better.
    To answer the question more directly – I want universal health care, even if it did cost more, for the benefit of society as a whole. I don’t have kids, but I have to pay for schools systems anyway. I don’t bitch about it for many reasons. First, I have empathy for other humans, but I know empathy is a foreign concept to right wingers. Also, I realize that educated people are essential to a healthy society and culture. A culture that allows 18,000 people a year (six 9/11’s every year) to die because they can’t afford to live is morally bankrupt. This type of disfunction in a culture manifests itself in many, many ways. I would prefer to live in a society that I could be proud of, even if it costs me a few dollars.

  34. Bennet: Actually I don’t believe this is true. Health care providers will generally drop a carrier that doesn’t pay. That’s the point. In a system not controlled by the government, market forces can be brought to bear. A dentist has some choice in which insurance he will accept and employers and individuals have choices in which insurance to buy and which dentist to use.
    It’s most definitely true. When you join a network, you are contracted with the rates you can charge your patients. In addition, your reimbursements are set. As I said, it’s not necessarily true that reimbursements (for every procedure) will be higher than Medicare. Yes some procedures you will definitely get higher reimbursement than Medicare (see my pap example) but across the board it is not necessarily true.
    Healthcare providers become part of the insurance companies’ networks to get access to the patients said insurance companies represent.
    I’m ALL for market forces bringing up efficiency and reducing waste. Mega-insurance companies, however, do not aid this. Furthermore, patients do not shop around for their healthcare like they would for a car – further weakening the free market aspects of it.
    The relationships between insurance, health care provider, and patient is not easily compared to other free market transactions due to a myriad of reasons – which I won’t bore you with here.

  35. Dave,
    Read above. In the measureable ways redarding the actual care given to the patient we are #1. In the measurable ways that benefit a socialist system (shared financial burden) we do poorly-because we are not socialist.
    I am all for changing insurance companies, especially the supposed not for profit Blues, and hey lets ding the lawyers profits while we’re at it. BUT, dave, if you want new drugs you might want to leave the pharm companies alone. (By the way YOU are also subsidising all those great health care systems of the first world. Drug companies charge more in the US because the monolithic National health services of the world refuse to pay over a certain amount (they threaten the patent of the drug in that country). So we in the US pay all the R&D costs and the rest of the world gets nice cheap drugs to keep their health care costs down)
    Really where they all save money is where we spend the most-the last few dozen days of life. If you never put the feeding or breathing tube into Terry Shivo-you’ll save a ton of money. There are criteria for who gets intubated, heroic procedures and how care procedes in ‘futile’ situations. Here Docs are too scared. If you withdraw support (aka pull the plug) even if the family agrees they can come back later and sue you for being premature. It can get really uncomfortable at times in the ICU. Rest of the world-person probably never got there in the first place. No right or wrong-but 1/2 of the medical dollars spent in a lifetime are in the last 90(?) days of life. We spend that half-they don’t.

  36. lexhamfox,
    I think that the point of Cap’n Ed‘s post is to highlight the fact that, contrary to what libs tell us, socialized / nationalized health care has some serious problems. Systems such as the British NHS are being billed in America as the “cure” that will give everybody cheap (i.e. free), efficient, state-of-the-art health care. It’s highly useful (!) to point out the problems with NHS and other such systems in an effort to educate Americans about the disaster that certain (liberal) politicians want to foist on us.
    You also say that Britons have “access” to dental care, whether it’s covered under NHS or not. Well, hell! All Americans have ACCESS to health care; it’s simply a question of who’s going to pay for it.
    And if I may say, you simply CAN’T convince me that Britons receive good dental care. I mean, really: British teeth are a worldwide joke.
    😉
    Ross: Here is the lowdown of nationalized systems. Good at taking care of healthy people and getting them AN (not necessarily the BEST or most effective) antibiotic, immunization or BP med for cheap when things aren’t complicated. Will take care of catastrophic things (accidents, cancer-again not TOO agressive-you go to hospice earlier and if you show up with a ruptured abdominal anerysm you will likely be wheeled into a room to say your goodbyes rather than get a 50/50 surgery to save your life(may change in the era of endographs-but was standard of care in Canada) And if you happen to have a chronic illness you will get care and not go bankrupt. BUT if you have something not life threatening, but uncomfortable (sinus disease, joint pain/injury, tooth pain, etc) expect to wait a very, very long time before much gets done. Oh and don’t expect any new, innovative treatments or medicines.
    This jibes with what my Canadian friend tells me. He had a coworker who ruptured himself and spent SIX MONTHS on disability, in pain, waiting to be scheduled for fairly routine, straightforward surgery. SIX MONTHS.
    Investor’s Business Daily had an article about the Canadian health care system a few months ago, and it was less than a glowing endorsement (1).
    Government researchers now note that more than 1.5 million Ontarians (or 12% of that province’s population) can’t find family physicians. Health officials in one Nova Scotia community actually resorted to a lottery to determine who’d get a doctor’s appointment.

    Baker describes a man who had a seizure and received a diagnosis of epilepsy. Dissatisfied with the opinion — he had no family history of epilepsy, but he did have constant headaches and nausea, which aren’t usually seen in the disorder — he requested an MRI.
    The government told him that the wait would be 4 1/2 months. So he went to Baker, who arranged to have the MRI done within 24 hours — and who, after the test revealed a brain tumor, arranged surgery within a few weeks. Some services that Baker brokers almost certainly contravene Canadian law, but governments are loath to stop him.
    Other private-sector health options are blossoming across Canada, and the government is increasingly turning a blind eye to them, too, despite their often uncertain legal status. Private clinics are opening at a rate of about one a week.
    The article also discusses the often invidious comparisons with the American “system” (I hesitate to use the word to describe the hodge-podge manner in which medical care is distributed in our country) and notes some interesting statistics:
    … if we measure a health care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50%; the European rate is just 35%. Esophageal carcinoma: 12% in the U.S., 6% in Europe. The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England — a striking variation.
    Like many critics of American health care, though, [NYT columinst Paul] Krugman argues that the costs are just too high: health care spending in Canada and Britain, he notes, is a small fraction of what Americans pay. Again, the picture isn’t quite as clear as he suggests. Because the U.S. is so much wealthier than other countries, it isn’t unreasonable for it to spend more on health care. Take America’s high spending on research and development. M.D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does. [emphasis mine – dj505]
    “There are lies, damned lies, and statistics.” How does one REALLY measure how “good” a health care system is? Dollars spent? Life expectency? Waiting times? Proponents of nationalized health care like to harp on the costs of health care in America under our present system and whine about people who are “uninsured”, as if “insured” is equivalent to “healthy”. They point to countries like Britain and Canada as examples of what American health care should be. From what I’ve read and heard, I say, “No, thank you!” I have no faith that our government, which has demonstrated little but bumbling incompetence in almost everything it tries to manage, can give me better health care than what I currently receive. Indeed, socialized medical care seems to me to be a perfect example of Churchill’s remark about the difference between capitalism and socialism:
    The inherent vice of capitalism is the unequal sharing of blessings; the inherent virtue of socialism is the equal sharing of miseries.
    I prefer to take my chances and get some blessings rather than slog along with the rest of the herd in equal misery.
    ———
    (1) http://www.ibdeditorials.com/IBDArticles.aspx?id=270338135202343

  37. dave,
    I’m not implying anything. I’m asking why I should be forced to pay somebody else’s bill, in effect laboring for them without any compensation. This is called “slavery”. There is no morally defensible reason why I should be compelled to do it. I also note that the Constitution does not give the Congress the authority to allocate money for this sort of thing. The Founding Fathers understood, as so many people today DON’T, that government is not a charitable organization.
    If I want to help other people pay for their health care, food, school, etc, then I will give to charity. I do not want the government to decide for me how “generous” I will be. I also do not want the government picking my pocket so that you lefties can feel virtuous. If you want to feel morally superior and have a “country you can feel proud of”, go volunteer for the Red Cross or give money to the Salvation Army. But leave me the hell alone.

  38. Ross:
    “ In the measureable ways redarding the actual care given to the patient we are #1.”
    I think you are very confused about the study. The US rates number one in responsiveness, but I don’t think you realize what that means. This is from the report:
    “Responsiveness is not a measure of how the system responds to health needs, which
    shows up in health outcomes, but of how the system performs relative to non-health aspects, meeting or not meeting a population’s expectations of how it should be treated by providers of prevention, care or non-personal services.”
    Responsiveness was measured largely by a questionnaire. Responsiveness concerns non-health aspects including respect for the dignity of the person, confidentiality, autonomy (these first three were rated 50%, and the following the other 50%), prompt attention, quality amenities, access to social support networks, and choice of provider.
    Responsiveness does not measure “actual care given to the patient” in any way. What does measure actual care is the DALE score:
    “Achievement of the average level of population health is reported in terms of disability adjusted life expectancy (DALE).”
    So in the measure that actually rates care given to the patient, the US ranks 24th.
    docjim:
    People tell me how proud I should be to live in the US. The more people like you there are that live in it, the less proud I am. I cannot be proud of the fact that my country allows people to die because they don’t have enough money. I guess I’m a miserable softie.

  39. Ross:
    About the US number one responsiveness rating:
    Because this was measured by a questionaire, this is by far the most subjective measurement in the study. In my view, when US citizens are filling out a survey that they know is measuring country performance worldwide, I believe that insane US exceptionalism will have an big effect on how those in the US answer. IMO, the irrational view that the US is always number one, regardless of the facts, will result in US citizens over-rating themselves. People in other countries do not have this psychological problem. Just my opinion.

  40. “People tell me how proud I should be to live in the US. The more people like you there are that live in it, the less proud I am.”
    Two comments, dave:
    1) Many of us feel the same about your ilk — the ignorance of cause and effect, the elevation of your personal feelings as some sort of universal yardstick of morality are the hallmark of a child or adolescent. The more adults like that, the less good for the country. [We’re usually gracious enough not to tell you that — but, since you seem to think it’s the right thing to do, it’s time to make an exception.]
    2) I, and several others, don’t really give a rat’s posterior about how you feel. But we REALLY don’t care when you expect to use your feelings to determine how the government should tax and treat everyone in the nation. It’s a recipe for disaster… but you’ll _feel_ good about it, and that’s as far as you take it.
    Thinking people go further than that, dave.
    “I cannot be proud of the fact that my country allows people to die because they don’t have enough money. I guess I’m a miserable softie.”
    Facts are facts. If you can’t afford something, you can’t — and the government is not a Magic Genie Compassionate All-Knowing Nanny ™ that can fix every wrong and slight.
    And you’re not a softie — not at all. Using other people’s time, money and effort is not compassion. You’re a wannabe dictator, like most of the left. You believe that if everyone else were forced to do things your way, things would be better.
    That hasn’t worked, won’t work, and can’t work. But you keep straining your rotator cuff patting yourself on the back.

  41. Ross:
    “BUT, dave, if you want new drugs you might want to leave the pharm companies alone.”
    I have been a medicinal chemist in oncology in the pharmaceutical industry for 20 years. The pharmaceutical industry is a gigantic scam. First of all, nearly all of the basic research that leads to new medicines is done in Universities, which is paid for by the public. It’s only when it’s time to make a profit that drug companies take over. On top of that, 90% of the research done in the pharmaceutical industry is redundant. Company A makes a truly new medicine, and companies B, C, D, E, F, and G all work feverishly to find holes in company A’s patent so they can come out with a me-too drug that is marginally better, if at all, just so they can grab 10% of the market. All of that is a waste, and could be better spent finding new medicines, if the object had anything at all to do with health care. And even when a pharm company finds a new medicine, it usually has the effect of lengthening the patient’s life by about 5 months. The cost of this, however, is tremendous, and could be used to do much more in other ways. For example, see this thread:
    captainsquartersblog.com/mt/archives/009946.php
    The thread was about how great the US is because we prescribe more Avastin than other countries. If you read my post there, you see that drugs like Avastin cost about a quarter of a million dollars for every life-year saved. As a comparison, a screening technique such as virtual colonoscopy costs $4,361 per life-year saved. Also, drugs like Avastin add a few months at the end of you life when you know you are dying. Screening, however, can add decades to a person’s life if a disease is cured before it becomes terminal. This is much more desirable. Problem is, drug companies don’t make money on screenings, so we don’t do it. It’s about money, not health.
    Look at this thread for another comparison between drug access in the UK vs the US:
    captainsquartersblog.com/mt/archives/010143.php
    (see post at June 7, 2007 8:01 AM)
    When you look at the availability of Herceptin, you find that the UK passed it before the US did. Also, in the US it costs $36,000 per year for those without insurance, and even for those that do, it can cost nearly $10,000 per year. In the UK, it is free. I know which option I would choose.
    pedandtic:
    “That hasn’t worked, won’t work, and can’t work.”
    Yes it can. It works in Europe, better and for less money. Nobody on this site has ever shown anything otherwise.
    So are you in favor of taxing people for school systems? Or public parks? Or roads? What if I don’t use these things?

  42. dave: I cannot be proud of the fact that my country allows people to die because they don’t have enough money. I guess I’m a miserable softie.
    Gee, I’m sorry about that. It breaks my heart that people like me aren’t willing to let people like you take our money so you can feel proud to be an American (not that I’ve EVER suspected that you were).
    If it makes you feel any better, “miserable softie” isn’t the term I’d use for you. “Thief”, while perhaps a little overstated, is closer to the mark. Perhaps after you and your fellow libs are done taking an ever-increasing chunk of my paycheck to fund your feelings of moral superiority and patriotism, you can take one of my kidneys. It must really make it hard to feel patriotic knowing that there are people who die for want of a functional kidney while millions of greedy Americans like me have an extra one. Imagine how proud you’d feel to be an American knowing that you took a kidney from me to give to somebody who otherwise would have died without it. Hey! Take one of my eyes and a pint of my blood while you’re at it and you could become the greatest patriot since George Washington! After I’ve recovered, you can force me under pain of imprisonment to build a house for some poor person or work a second job to pay for Graeme Frost’s private school tuition. When I die, you can covert me into Soylent Green to feed those millions of Americans who go to bed hungry every night.* The sky’s really the limit when it comes to purchasing moral superiority and a sense of patriotism with somebody else’s money. Or body parts.
    Out of curiosity, is this how liberals define “generosity” these days? Taking from one person to give to another? I know that the definitions of “lie” and “patriotism” have been revised, but I wasn’t aware that the meaning of “generosity” had been.
    ———–
    (*) I’m really starting to understand Jonathan Swift at this point. Or the Sheriff of Nottingham; I’m not really sure.


  43. pedandtic:
    “That hasn’t worked, won’t work, and can’t work.”
    Yes it can. It works in Europe, better and for less money. Nobody on this site has ever shown anything otherwise.

    I see reading comprehension is not on your list of things to do. Try, unlike most of your ilk, to quote accurately:
    [What pedantic really said]
    You’re a wannabe dictator, like most of the left. You believe that if everyone else were forced to do things your way, things would be better.
    That hasn’t worked, won’t work, and can’t work. But you keep straining your rotator cuff patting yourself on the back.
    See, I’m talking about FORCING everyone to live your way. That’s called a dictatorship. You’re saying that works in Europe, better, and for less money.
    So, either you’re (a) dim enough not to be able to read what I wrote, or (b) ignoring what I wrote and replying to what you feel like replying to [probable], or (c) admitting that the so-called ‘progressivism’ of Europe that you’re so fond of is really totalitarianism with pretty window-dressing.
    Which is it?
    “So are you in favor of taxing people for school systems? Or public parks? Or roads? What if I don’t use these things?”
    Unlike you, I am not a member of The American Non-Sequitur Society, Or By Bus ™. Since what you’re babbling about doesn’t actually deal with what I wrote, I won’t dignify it with an answer.
    But I will point out that you didn’t undertake the pointless and futile job of denying that your feelings should be the final arbiter of right and wrong. There may yet be hope for you in the dim and distant future.

  44. pedantic:
    “See, I’m talking about FORCING everyone to live your way. That’s called a dictatorship.”
    I think you are projecting, and I think it is you that wants a dictatorship. I would be quite happy with a vote on the matter. Especially after some public debates. Would you? Already a majority wants nationalized health care, and that majority would grow after some debates, when people are allowed to learn even more on the subject.
    query.nytimes.com/gst/fullpage.html?sec=health&res=9e06e7d71631f931a35750c0a9619c8b63
    pollingreport.com/health3.htm
    usatoday.com/news/health/2003-10-19-health-poll_x.htm
    (etc)
    So would you be OK with a vote? Or is it you that wants a dictatorship and is it you that wants everyone to live your way?
    My question in not a non-sequitur, and relates directly to the subject. Why are you forcing me to pay for schools through your fascist laws when I don’t want to? You just love being a dictator, right?

  45. docjim:
    Pedantic is unable to answer, but maybe you can. Do you think that it is OK for the government to “steal” my money for public schools, if I don’t want to give it? Or for public parks? Or the military? Is it OK for them to “steal” my money, as long as it benefits you, or you agree with it?

  46. dave,
    I’ll answer your questions, in the order you asked them.
    “Do you think that it is OK for the government to “steal” my money for public schools, if I don’t want to give it?”
    Since each community is responsible for the availability of education (in general), it is appropriate for a community to charge their residence’s for the education they provide. This can be done ether through user fees or through the use of local taxes like property taxes. I find it very troubling that, along with collecting and spending taxes on education, the federal government also imposes it’s rules and regulations on every community and their education programs. Those decisions, and the associated costs, should be left to the communities that educate the kids. It is, therefor, appropriate for me to pay for my local schools, but why should I pay for the schools in another community? I don’t support the collection of taxes, and the imposition of regulation, by the federal government.
    Or for public parks?
    Like schools, most “public parks” are local public properties and are under local control. There is no single park system. There are city, county, state, and federal parks. For the most part, it is the local communities that pay to create and maintain the public areas we call parks. As with schools, it is appropriate for me to pay for local and state parks, but why should I pay for the parks in another community in another state? I am willing to make an exception for Federal parks as that is PUBLIC land and is available to everyone.
    Or the military?
    The Constitution demands that the Federal Government maintain the military. Specifically, the Constitution states Congress is required:
    To raise and support Armies, but no Appropriation of Money to that Use shall before a longer Term than two Years
    To provide and maintain a Navy
    To make Rules for the Government and Regulation of the land and naval Forces
    To provide for calling forth the Militia to execute the Laws of the Union, suppress Insurrections and repel Invasions
    To provide for organizing, arming, and disciplining the Militia, and for governing such Part of them as may be employed in the Service of the United States, reserving to the States respectively, the Appointment of the Officers, and the Authority of training the Militia according to the discipline prescribed by Congress
    Since the Constitution requires that the federal government maintain a military, that government must also raise funds to pay for it. Those funds come from the general fund which is generated from federal taxes. I fully support the collection of taxes for the military as it is a constitutional necessity.
    Individual health care is one of the most private situations anyone can face. Nothing is more personal than seeking treatment for injury or disease. It is my right to seek, or not seek, any legal health care I deem necessary. If my personal decisions leads to an early death because of poor heath care or life style choices, that is my right. If I refuse to pay for health care, then I shouldn’t receive that care for free simply because you and others believe that it is better for society or think it’s for my own good to receive care I do not wish or to pay costs I don’t not like. The federal government has no place in such personal life choices. It is not up to the government, or any well wishing citizen, to demand that I pay for or receive medical care. Since the government has no right to dictate to me how I should handle my own health care decisions, it also has no right to collect money from me to pay for someone else’s personal heath care decisions.
    Federalizing health care will remove all personal choices and will force all to citizens to surrender one of the most personal decisions they can make to the federal government. That is a terrible idea as individuality and personal responsibility in the choices we make is the hallmark of the freedom we enjoy in America. If you are prepared to surrender your personal freedom to make your own choices as to your health and well being, then you have given up on the very freedom this country was founded to protect; the freedom to make personal choices. Why would any reasonable person be willing to surrender such personal choices to any government?

  47. dave;
    Consider. The purpose of government expenditure, arguably, is to spread the cost of a common good across the commons (i.e. us), so as to enable those same commons to enjoy the goods. Arguably. It also made sense for government to spend money on infrastructure, bringing the level of lifestyle up.
    Water management, sewerage, military and police services, immigration, border protection, I’d even lump public parks and education inside – these are all, arguably, common goods.
    But your bloody health care? How do I benefit from subsidising your health? I may never meet you, never interact with you. Whereas I can see what my money does with regards to sewerage systems – it carries my shit away. Too bad I can’t see it do that for yours, but mine will suffice.
    In Malaysia, the highest tax bracket is 26%. User pays for health. There is a nominal government healthcare system in place, where you can get treated for free if you really needed it (the usual long waits and crappy doctors – Malaysia requires newly qualified doctors to do an internship in government service before licensing them for private practice). No standard welfare system. I’m not even at the 10% bracket yet (but of course I earn less than 40k a year).
    That being said, I am covered for critical ilnesses and big ticket procedures, and next year I might go for the routine stuff coverage. Expensive, (about 10% my salary) but well worth it.
    This is why healthcare tourism is big in Asia, and why we have mega hospitals with super docs and modern equipment – it’s the wonder of the free market.

  48. Dr J. Before the shyster and his commie pals come for your kidney, they’ll take your kids. It’ll be better for both the kids and society given the fact that the “family” is usually selfish and racist.
    Your only defense against the commies is to use the fact that the U.S. Constitution clearly delineates the roles of the Fed military etc). Problem is, the shyster and his commie pals (and their enablers in the Repub and Dhimmi parties) have already discarded the Constitution.
    The “public schools” etc were nothing more than the slippery slope to the shysters’ winning.
    But only OMDB.

  49. dave,
    I’d say that Ray in Mpls has answered the question pretty well. One thing I’d like to add is my understanding of the concept of federalism. The federal government, under the Constitution, has extremely limited powers. It can print money, raise military forces and make war, negotiate with other nations, build roads, delivery the mail, and a few other things. Beyond them, it has no legal powers. The 9th and 10th Amendments give all other powers to the states and people. If the people of No. Carolina want to have a state-run health care system, this does not conflict with the Constitution so long as the rules of the system don’t discriminate in a manner that would conflict with the 14th Amendment. It’s still a terrible idea, however. (I believe that Tennessee tried such a system called TENN-CARE… which collapsed under its own weight a few years later and the state had to abandon it. I’m not sure about the details.)
    As for public education, I have become quite a critic in the past several years, mostly because the system is broken. Incidentally, this feeds into my overall lack of trust that the government can administer a health care system with any efficiency. If it were up to me, public education would end in the United States. Certainly the DoEd should be disbanded as education is not a Constitutional power of the federal government.
    Parks? Cities and states have the right to build them. As the federal government owns considerable public land, I see no problem with allowing citizens access to it for purposes of recreation.
    Military? Constitutional power of the federal government. Also, defending its citizens (collective defense) is perhaps THE main reason for a government to exist.
    swabjockey,
    I know. The libs tore up the Constitution a long time ago. Many people blame FDR. I don’t; I think he tried to do the best he could in a VERY bad situation. The problem is that, once the libs got a taste for using the federal government to remake America in their own image, they didn’t stop. We are now faced with the good prospect that a grasping, socialist shrew is going to take over our medical care… FOR OUR OWN GOOD.

  50. Ray in Mpls:
    “It is, therefor, appropriate for me to pay for my local schools, but why should I pay for the schools in another community?.. As with schools, it is appropriate for me to pay for local and state parks, but why should I pay for the parks in another community in another state? I am willing to make an exception for Federal parks as that is PUBLIC land and is available to everyone.”
    Sorry, I still do not understand. You say it is not “appropriate” for the federal government to tax for parks and schools, but it is “appropriate” for the local government to do so. If I am to adopt the right wing attitude of only caring about myself and not giving a crap if other people live or die, then why should I want the local government to tax me for schools and parks any more than I want the federal government to? Why, then, is the local government “stealing” (docjim quote) my money? “How do I benefit” (Greg quote) from subsidizing (through local taxes) your schools and parks?
    “If you are prepared to surrender your personal freedom to make your own choices as to your health and well being, then you have given up on the very freedom this country was founded to protect; the freedom to make personal choices.”
    Spare me the drama. You could still have a choice of doctors.
    “Why would any reasonable person be willing to surrender such personal choices to any government?”
    You would not surrender anything, and you would get better health care at lower prices. That’s why people find it attractive. I realize that you think every other country in the world is “unreasonable” in having universal health care, and the majority in this country is “unreasonable” for wanting it. Only you and your extremist friends understand how awful it is. So how about the issue between pedantic and me, which he does not want to address. How do we decide what to do? Do we do what the majority wants? Or do we do what you want, because you know better. Are we living in a dictatorship, or a democracy?
    Greg:
    “How do I benefit from subsidising your health? “
    The main benefit is living in a country that has some semblance of morality, even though I am sure that even if we get universal health care, that will not stop us from continually bombing other countries (for their own good, of course). I know that you don’t care about morality, but there are also effects on the culture and society as a whole when an entire class of people is neglected and ignored to the point that we will let 18,000 of them die every year rather than pay a few more dollars in taxes because we need to spend that money on cigarettes or cosmetics or plastic surgery or gas for our SUV’s or better bombs to kill people with or etc. When an entire class of people is treated like this, it has effects, such as crime. Maybe you will be effected by crime in your life. I am sure you will easily trivialize this or belittle it, but it is real, and a culture devoid of morality cannot survive. Do you have the gut feeling that this society is improving, or not?
    Docjim:
    “Incidentally, this feeds into my overall lack of trust that the government can administer a health care system with any efficiency.”
    Why can other countries administer a health care system efficiently, and the US cannot? What is wrong with this country if we cannot do what others can?
    “As the federal government owns considerable public land, I see no problem with allowing citizens access to it for purposes of recreation.”
    There are also taxes to maintain and run these parks. Why should they “steal” my money for this?
    “Federalism”:
    I am no constitutional expert, but I find it doubtful that a national health care system is being publically debated when it is unconstitutional. I have not heard this anywhere. I do not believe it.

  51. docjim:
    President Bush was asked this question:
    “…my hard question is, what we can we do to stop the genocide in Darfur?”
    Part of his answer was:
    “And people say, “Well, we got plenty of problems in America; why do you worry about something going on overseas?” First of all, we’re wealthy. We’re spending enormous sums of money. If we set proper priorities, we can not only help our own citizens, but I believe it helps our soul and our conscience, and I believe we have a moral obligation to help others.”
    So Bush thinks we have plenty of your money to help people overseas, but your saying we don’t have enought o help our own citizens. Do you agree with Bush? Why do we have a “moral ablogation” to help thos overseas, but not our own citizens?

  52. dave says:
    I think you are projecting, and I think it is you that wants a dictatorship.
    Nope. This is why I gave up discussing with you (I knew it was futile from the beginning, but watching you spout drivel gets to me sometimes).
    I: advocate people choosing how to get health care. They, as adults, are responsible for themselves, and choose.
    You: advocate the government telling EVERYONE they must get helathcare your way, because it makes you feel sad otherwise. When the government makes everyone do something, whether they like it or not, that’s force. When the government takes over your life and forces you to live the government’s way, that’s dictatorship.
    You adamantly bury your head and refuse to see that. Therefore, talking to you is best summed up by Scott Adams:
    “Trying to win an argument with an irrational person is like trying to teach a cat to snorkel by providing written instructions.”
    Goodbye.

  53. dave: I am no constitutional expert, but I find it doubtful that a national health care system is being publically debated when it is unconstitutional. I have not heard this anywhere. I do not believe it.
    Well, I guess we can fire the Supreme Court, or at least give them much longer vacations. After all, if the Congress would NEVER try to pass a law that is unconstitutional, what need have we for the Court? I guess Mr. Chief Justice Marshall was drunk or something when he came up with the idea of “judicial review”.
    /sarcasm
    I have asked this several times before, and I ask again:
    Please tell me what part of the Constitution authorizes the federal government to appropriate money to pay for citizens’ health care. If you CAN find it, please tell me how generations of Americans have missed it before now.
    dave: Why can other countries administer a health care system efficiently, and the US cannot? What is wrong with this country if we cannot do what others can?
    Part of the debate about this mess is that other countries CAN’T administer a health care system efficiently (o’ course, “efficiently” is a very subjective term). Please refer to my post October 17, 2007 1:21 PM. At any rate, I’m not interested in nationalized health care whether it’s administered “efficiently” or not. In my view, it is unconstitutional and a gross violation of my liberties.
    dave: So Bush thinks we have plenty of your money to help people overseas, but your saying we don’t have enought o help our own citizens. Do you agree with Bush? Why do we have a “moral ablogation” to help thos overseas, but not our own citizens?
    Oh, the ol’ moral equivalency argument. Always so much fun.
    1. Whether President Bush feels we ought to help those poor people in Darfur has nothing to do with whether or not we should nationalize our health care system. First, they are not related subjects. Second, I’m not aware that he has spent any money on Darfur. In fact, this has been a minor bone of contention from the left: Bush is willing to fight an “illegal” war in Iraq but won’t lift a finger to stop the genocide in Darfur (just as Slick Willie didn’t lift a finger to stop the genocide in Rwanda).
    2. I would have thought that you’d have realized that appeals to emotion don’t work well with conservatives, especially me. Why don’t you be totally blunt and ask me if I’d agree to spend federal money to save a four year-old child dying from pneumonia because her family couldn’t afford to pay the heating bill or provide warm clothes due to the Worst Economy Since the Great Depression(TM)? The answer is “no”, by the way. I would certainly be willing to send as much money as I could to help out, but I do not want Uncle Sam making that decision for me.
    dave: I know that you don’t care about morality, but there are also effects on the culture and society as a whole when an entire class of people is neglected and ignored to the point that we will let 18,000 of them die every year rather than pay a few more dollars in taxes because we need to spend that money on cigarettes or cosmetics or plastic surgery or gas for our SUV’s or better bombs to kill people with or etc.
    You’re wrong: I DO care about morality… just not yours.
    I’m sorry that you’re offended that people want to spend their money on themselves and not hand it over to the government to pay for other peoples’ health care or for any other programs that will make you feel good. Sorry; we live in a (sort of) free society, and an unfortunate corollary is that “free” people don’t always behave in moral ways… or at least in what we might personally think of as “moral” ways.
    This gets back to pedantic‘s point:
    See, I’m talking about FORCING everyone to live your way. That’s called a dictatorship.
    If you are so concerned about the plight of people who don’t have health insurance, then I’d suggest that you give more to charity and urge others to do the same. Americans are not a stingy people; as we saw after Katrina, many people are willing to give to help others. But you’re not advocating that: you’re advocating TAKING from some people to give to others. That’s not charity: it’s theft.

  54. Hey, Doc, d’ya mind? He was askin’ me the question, after all 😉
    dave;
    Full disclosure. I am a Christian of good standing in an Anglican church (not one of your namby-pamby POS liberal Episscopalian churches, either). That means I stand for morality by definition.
    Charity begins at home. This does not mean, by the way, that we should spend our money on ourselves and family before we spend on others (well, it can mean that).
    It means that it is our responsibility. Not government’s. We choose which forms of charity we intend to fund, not get them chosen for us.
    I tithe, by the way. Some of that money goes to a program we call ‘feeding the needy’. Some goes into operational costs (of course). Some goes into orphanages. And if someone needs to go for an expensive operation, our church funds it at least partway as well.
    Here’s the thing. I choose. Not my government. Here’s another thing. Some of my taxes goes to fund mosque building and maintenance. Would you like to see that happen? No? Well, then you can understand my reluctance to pay for stuff I gain no conceivable benefit from.
    Geez, just listen to yourself, why dontcha? Oh, if we don’t pay for their healthcare, this class of people might turn to crime, so we should pay them off! That, sir, is extortion. Blackmail. You bakayaro newhalf, think about what you are saying!
    Can you follow this simple chain of reasoning?
    1. Government should do government stuff. Stuff for the common weal.
    2. Government sucks at doing free market stuff. Stuff that rightly belongs in the control of the individuals participating in free enterprise.
    3. Health care is a free market thing. Insofar as government bears no responsibility to what you do to your body, except maybe in some legal areas. You are responsible for how you take care of your body.
    4. (you can fill in the blank yourself)
    Do you not even understand basic economics? There will always be people who do not want healthcare, because they prioritise something else over it. Supply and demand is supply and demand, and where there is no market failure (due to abuse of monopoly, for instance), govt should NOT interfere in what is, after all, the workings of the market.
    Let me tell you also how this works for me. I am employed, but my employer’s idea of a health plan is 30 bucks a month max for clinic visits (upon presentation of receipt). Clinic visits for me, by the way, range from 35-80 bucks.
    I have my own private health insurance, which covers big ticket critical illnesses and disability. Anotherpolicy is a life policy. Right now, I can only fund about a quarter of it; my Dad helps with the rest. I pay him back as and when I can.
    Malaysia’s idea of a safety net is pretty much what you get at the NHS; long queues, shoddy work (well, inexperienced docs, what do you expect).
    I’d love something like Australia’s Medicare system, but that is also in dire need of an overhaul. I intend to buy routine health insurance.
    So you see, I’m not speaking from a rich man’s perspective. My parents are pensioners. We are comfortable, but by no means rich or even upper class. My dad’s car is 10 years old (or older). I use public transportation, for cryin’ out loud (which in Malaysia is a joke).
    Put that in your pipe and smoke it. If some idiot somewhere thinks his entertainment system is worth mroe than his health, more power to him. I’d even present the Darwin Award in person. And I don’t even believe in evolution. It’s obvious human stupidity cannot be bred out, after all.

  55. Greg, RELAX.
    Don’t get so worked up over “dave” the shyster. You obviously haven’t been around the Captain’s Trolls enough to know that “dave” is an admitted Communist. Real hard core…you know, the type you read about in books. Old books from the ’50’s.
    “dave” the Commie shyster has advocated for the VIOLENT OVERTHROW of the democratically elected government of the U.S. (both Dem and Repub). I repeat: VIOLENT OVERTHROW.
    It is useless to try to “debate” him. He is an enemy of our “free” country. He and his thug-lackey pals need to be hunted down. Not “debated” with…certainly not worth you civilians blowing a gasket over. “We” have it under control.
    Keep that in mind if you really need to “debate” him. I record all his posts. My pals and I (DIA, CIA, ONI, NSA, NGA, NRO, PTA etc) haven’t found him yet, but we’re getting closer. You’d be surprised how much intel you can squeeze get out of these “anonymous” posts. Just a little more data is all “we” need…

  56. Greg,
    Your right of line, sir!
    I take it from your comments that you live in Malaysia? Can you tell me more about this “healthcare tourism” that you mentioned earlier? This sort of thing has been in the news around her (No. Carolina) a bit lately, mostly in the form of horror stories about people who go to faraway lands to get “cheap” medical care and wind up in a world of hurt when there are complications and they are far from “good” US health care.
    Incidentally, something like this happened to my father: several years ago, he was on a SCUBA trip in the Bahamas. Had a heart attack on his first dive. His description of the hospital in the Bahamas was… Frightening? Outrageous? Had it not been for a visiting doctor from Britain followed by a quick evac to Miami, he probably would have died.

  57. Swabbie;
    PTA? The golfie thing or the schoolie thing? 🙂
    Doc;
    Healthcare tourism is NOT for big ticket stuff like transplants, neurosurgery and otherwise life-or-death stuff. For that, you go either to the US or to Australia (which does, after all, have a private component to their healthcare system).
    It is mainly for other still major/serious work, like heart surgery, or hip replacement, but nothing immediately life threatening. The costs of these procedures is still significant (you get what you pay for, and this is so anywhere in the world, right?), but it is much less than, say, in the West (if you can get it done at all for pay).
    We are improving, but in Asia you really need to have health/travel insurance and a reasonably large wad of cash.
    Remember that the government-funded healthcare is basic, really basic. Our private hospitals, OTOH, are just fine and getting better all the time. I admit, the funding does partially come from you guys coming over for ‘Sun, Sea, Sand and Surgery’ 😉
    The point I was trying to make is that the free market works, and works pretty well, even in healthcare. Especially in healthcare. That 80 buck clinic also has its one little surgical theatre.
    btw, I tried the EM and STRONG tags but they don’t work.

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