« Sunday Discussion: Who Will Have the Biggest Impact on the '08 Elections? | Main | The Real Cause of Terrorism »

...And This Is What We Want Here?

Whenever the subject of health care in the United States comes up, a lot of people talk about the "health care crisis" and the need to move towards a single-payer, government-run system.

The first part of that is a crock. We have no health care crisis in the United States. We have considerable disagreement about health care FUNDING, but the care itself is unimpeachable.

The other part is almost as easily dismissed.

Virtually without exception, there is one simple rule to governance. If you want to find the least efficient, least effective, and most expensive way to achieve something, put the government in charge of it.

So, just what does that mean when applied to the field of health care?

Well, for starters, long waits. Perhaps too long waits, as one former Liberal cabinet member discovered. She has cancer, but it's a readily-treatable kind. So readily treatable, officials decided she could wait. She disagreed, and fled to a country where the health-care system is so horrifically messed-up, someone recently made a documentary showing how terrible things are.

Government control can also lead to other things... such as rationing health care. When bureaucrats are in charge of micromanaging the funding of health care, they become de facto deciders on such matters. "If you take the King's gold, you play the King's tune," as the old saying goes. And when the King says that you will take his gold and no one else's, you do what he says.

And if the King (or his functionaries) decide that a cigarette smoker won't properly benefit from treatment, then that's just too damned bad. He can just learn to live with his broken ankle until he smartens up and stops smoking.

A while ago, there was some discussion about denying certain health care to people who would "abuse" their treatment. Liver transplants to people with a history of alcoholism, or other types of transplants to drug users. The idea was that transplant organs are an extremely scarce resource, and should be reserved for those cases where people will gain the most benefit from them. This case is a step beyond that, where treatment is being denied for reasons only tangentially related to the treatment.

Can this be far from state-run euthenasia? Where the government does a cost-benefit analysis and says that certain people simply are too expensive to treat? Before I read about Mr. Nuttall's case, I would have said that anyone who said such a thing was being hysterical. But now, I'm not so sure.

Yes, our system of paying for health care has problems. But I remain absolutely convinced that the surest way to make it even worse would be to put the government in charge of the whole shebang.


TrackBack

TrackBack URL for this entry:
/cgi-bin/mt-tb.cgi/24134.

Comments (36)

Heavy government involvemen... (Below threshold)
jpm100:

Heavy government involvement at any level would be a disaster.

If the government only entered the 'insurance' part, it wouldn't be long before they started fixing prices for procedures, doctors visits etc. and indirectly micro-managing healthcare.

Even the Canadian system started out as 'insurance' oriented. The Ontario plan was named Ontario Health Insurance Plan (OHIP).

The USA has a health crisis... (Below threshold)
BillyBob:

The USA has a health crisis only for those who are too lazy to work or too cheap to pay for insurance. Somehow, these people think they are entitled for free health care and that I should pay for it.

These cheap bastards can go to the Emergency Room at a hospital and get treatment for free along with all the illegal aliens. Just tell them your name is Jose NoMoneydez and you'll be taken care of no charge. The bill gets passed on to tax payers.

Pathetic. I don't have a college education, yet I manage to stay married to 1 woman for 22 years, raise 2 kids without drug, alcohol, pregnancy & STD problems and now am paying for college for 1, all the while staying gainfully employed and paying insurance premiums. I even paid premiums during a self employment stint.

I have no sympathy for lazy and cheap bastards. We have the best health care in the world.

What is not needed is a hea... (Below threshold)
FreedomFries:

What is not needed is a health care system w/ insurance companies skimming the first 30% cost for extremely overbloated executive compensation and shareholder wealth. What is not needed is HMO procedure approval driven by the profit motive to deny the insured the medical assistance required in order to enhance their bottom line.

We do not need a health care system driven by HMO amoral bottom-line greed. Health care costs and access should never be driven by profit incentive greed, obtained ONLY through the denial of coverage.

Until there is a balanced remedy to this situation in the US, the health care in this country is screwed. Proper and adequate medical care should not come at the cost of the economic destruction of families, who even though insured, are all too frequently driven into bankruptcy or insurrmountable debt.

One can cite all their favorite piddly anecdotes from failure in other systems as a defense to retain profit greed in America's health care but the simple reality is that many other nations w/ a single -payer system rank well above the US (37th) in life expectancy, something that could not occur if they were all waiting in lines and dieing for lack of medical care.

Exactly Billy Bob, 85% of A... (Below threshold)
WildWillie:

Exactly Billy Bob, 85% of Americans are covered by an insurance plan. The dimmers want to change the system for the incompetent 15%. Typical. ww

"health care in this countr... (Below threshold)
jpm100:

"health care in this country is screwed"

This is centerpiece to this whole article. It isn't health care that is screwed. It is funding.

Its an attempt to smear the issue so people who are relatively secure in their funding are made to believe they are being victimized somehow as well through poor quality.

Fried, kindly cite some pro... (Below threshold)

Fried, kindly cite some proof that our health care system is NOT one of the (if not the) best in the world that is NOT related to how it is paid for.

Or STFU.

Your choice.

J.

Hey "fast food" guy read po... (Below threshold)
jhow66:

Hey "fast food" guy read post # 2 over and over again until it melts into that peas size brain that you seem to have.

Hey "fast food" guy read po... (Below threshold)
jhow66:

Hey "fast food" guy read post #2 over and over again until it melts into that pea size brain you seem to have.

If you have the bureaucracy... (Below threshold)
hermie:

If you have the bureaucracy deciding who should be denied treatment, you also have them deciding who can be put to the head of the line. The 'elites' can be given favorable placement on transplant waiting lists. You can have political 'elites' like Teddy Kennedy pushed up for a liver transplant, over a 27 year old schoolteacher from Des Moines.

Take business & competition... (Below threshold)
BillyBob:

Take business & competition out of the health care industry (ie, have the government do it) and you'll see doctors flee in droves. We'll end up importing sub standard doctors from third world countries like England has to. No one wants to work for peanuts and no one cares in a government health care system. Service and attitude goes right down the shitter.

Freedom Fried is just a miserable loser who is jealous of people who make more money than he/she/it does and can afford better things.

Freedom Fried is just spouting leftist talking points of wealth envy and it's somehow my fault that I make more than lazy bastard like him/her/it and that's NOT FAIR.

Ever wonder why FreeFried is this way? Could it be how he/she/it was educated?

Government schools followed by years in college with leftist losers spouting Marxist ideology (since they are miserable as well).

Tough shit FreeFried. Get a job, pay your premiums and STFU.

The US is headed for a heal... (Below threshold)
jpm100:

The US is headed for a health care crisis, though. Not for the reasons the left want you to believe.

It has to do with spiraling costs. Those are for two reasons.
1) New Technologies
2) Lawsuits and fear of them

#1 is no quick answer however technology can lower costs as easily as it can raise them. And new technologies actually mean the quality & capability of care are increasing.

#2 has become such a huge problem, the rate of students graduating and going into a primary care role have plummeted recently. No one wants to become a one. The net pay after malpractice premiums isn't worth the risk of being sued. Right now, only a specialist makes the kind of money to be worth the risk. All these suits also has the side effect of taxing the system with unnecessary tests driving up costs.

I'm sure none of the politicians are not alarmed because they plan to solve the lack of doctors with H-1B visa dumping. That worked out really well for the UK this past summer.

The Irony is that none of the Democrats would ever touch #2 at the outset with any of their plans. But later as a socialized system approaches collapse, they will eventually block them almost completely.

Do we REALLY want the same ... (Below threshold)

Do we REALLY want the same people who brought us:

the AMTRAK train network
Transportation Security Agency's lines
BATF's inaccuracies, and the
Army Corps of Engineers levee system

and numerous other money- and manpower-wasting programs...

To attempt to consolidate and administer health care for the country?

I lived with military health care for 10 years active duty, and 13 years reserve time. I'll take the civilian system any day.

A doctor will care about his or her patients when he's dependent on them for his paycheck - when the government is footing the bill where's the reason to care how good a job you'll do? No matter how badly you treat them, no matter how inefficient your handling of them is, they've got nowhere else to go.

Case in point - back in the day I went to the base optometrist to see about getting contacts. The first appointment available was six months down the line for them. The base I was at wasn't a large one, and the eye clinic waiting area was usually empty. But by regulation there were a certain number of appointments for 'elective' stuff like contacts, and you got those on a first-come, first served basis.

In this case, it took six months to get the first free appointment. (And I still had to pay for the contacts.) Why wouldn't they increase the number of appointments to fit demand? Because that wasn't how the regulation was written. If the book said you had X number of appointments for a specific time period, you had X number of appointments available, not X+1... even if there was more demand for them.

Any optometrist who tried that in the civilian world wouldn't make it.

I would imagine things are a bit different today, but not much. Get government involved, and you're looking at rationed care pretty fast. You're also going to be getting 'baseline' care , as in care that'll be better than nothing... but you can also get that now with various drugstore 'doc in the boxes' and emergency room care.

About all I can say is whenever government wants to 'give' you something, you'd better check your wallet to see what's missing and inspect very carefully what they want to 'give' you to make sure it's what you think it is.

Do we REALLY want the same ... (Below threshold)

Do we REALLY want the same people who brought us:

the AMTRAK train network
Transportation Security Agency's lines
BATF's inaccuracies, and the
Army Corps of Engineers levee system

and numerous other money- and manpower-wasting programs...

To attempt to consolidate and administer health care for the country?

I lived with military health care for 10 years active duty, and 13 years reserve time. I'll take the civilian system any day.

A doctor will care about his or her patients when he's dependent on them for his paycheck - when the government is footing the bill where's the reason to care how good a job you'll do? No matter how badly you treat them, no matter how inefficient your handling of them is, they've got nowhere else to go.

Case in point - back in the day I went to the base optometrist to see about getting contacts. The first appointment available was six months down the line for them. The base I was at wasn't a large one, and the eye clinic waiting area was usually empty. But by regulation there were a certain number of appointments for 'elective' stuff like contacts, and you got those on a first-come, first served basis.

In this case, it took six months to get the first free appointment. (And I still had to pay for the contacts.) Why wouldn't they increase the number of appointments to fit demand? Because that wasn't how the regulation was written. If the book said you had X number of appointments for a specific time period, you had X number of appointments available, not X+1... even if there was more demand for them.

Any optometrist who tried that in the civilian world wouldn't make it.

I would imagine things are a bit different today, but not much. Get government involved, and you're looking at rationed care pretty fast. You're also going to be getting 'baseline' care , as in care that'll be better than nothing... but you can also get that now with various drugstore 'doc in the boxes' and emergency room care.

About all I can say is whenever government wants to 'give' you something, you'd better check your wallet to see what's missing and inspect very carefully what they want to 'give' you to make sure it's what you think it is.

If this posts twice - please delete the first one. (Or the second. But please, not both!)

Aw, buggers. And I refresh... (Below threshold)

Aw, buggers. And I refreshed twice, too, before hitting post that second time!

"The USA has a health crisi... (Below threshold)
Rance:

"The USA has a health crisis only for those who are too lazy to work or too cheap to pay for insurance. "

You might include "or have been downsized out of their insurance plan" to your list. Most Americans are a pink slip away from having no insurance. The major cause of bankruptcy is major medical expenses.

I agree that AMTRAK and the Corp of Engineers aren't good models for our health insurance. However, "I don't know, but not that!" isn't a solution to the problem.

"The USA has a health cr... (Below threshold)
FreedomFries:

"The USA has a health crisis only for those who are too lazy to work or too cheap to pay for insurance" Billy "Bozo" Bob

Of course, Marie Antoinette had the solution centuries ago, "Let them eat cake." The problem w/ the goddamned poor in this country is that they are too damned dumb to know of the medically restorative values of a diet rich in cake.

Re: post # 1:jpm, ... (Below threshold)
epador:

Re: post # 1:

jpm, sounds like you are describing Medicare... ...which has been around for a few decades. Price-fixing, in fact the entire re-imbursement system now, is all derived from Medicare.

Re: JT's Post:

I am a strong believer in consumer controlled and driven health care. Give the consume back control of how they spend their limit health care dollars. If they waste them, that's their business. Let Darwin decide.

However I do believe that Public Health - vaccination, communicable disease prevention, public hygiene (food & water production, service, storage and delivery, air quality) and disaster preparation/response require some form of societal, hence governmental, control. If left to individual choice, these areas can not develop in a manner that benefits society. Decentralized systems (the USCG or SOCOM systems, for example) work better than heavily centralized and controlled systems (Medicare or the USSR military).

Charity care does have it's place. Without it, sick folks from the poor and dysfunctional part of society drain further resources of society AND they are a pool of potential pathogens that can affect everyone. Without it, they drain the ER and hospital resources of small and large communities, which affects us all. Without it, they go sick to their jobs in fast food outlets, food production and distribution centers, and wander our discount stores and public transportation spreading whatever they can communicate. Without mental health resources (so many who used to be institutionalized are now societialized without sufficient care resources) they wander our towns and woods a danger to themselves and those they meet.

If we don't have an effective societal system to deal with these problems, our health as a society suffers.

Hey Freedom, what about the... (Below threshold)
SCSIwuzzy:

Hey Freedom, what about the trial lawyers that have litigated insurance costs through the roof? What part have they played in things?

FreedomFries -<blockq... (Below threshold)

FreedomFries -

AUE: FAQ excerpt: "Let them eat cake!" John Wexler writes: "French law obliged bakers to sell certain standard varieties of loaf at fixed weights and prices. (It still does, which explains why the most expensive patisserie will sell you a baguette for the same price as a supermarket.) At the time when this quotation originated, the law also obliged the baker to sell a fancier loaf for the price of the cheap one when the cheap ones were all gone. This was to forestall the obvious trick of baking just a few standard loaves, so that one could make more profit by using the rest of the flour for price-unregulated loaves. So whoever it was who said Qu'ils mangent de la brioche, she (or he) was not being wholly flippant. The idea was that the bread shortage could be alleviated if the law was enforced against profiteering bakers. I have seen this explanation quoted in defence of Marie Antoinette. It seems a pity, after all that, if she didn't say it."
Gee, government intervention didn't help with a problem. How novel and unprecedented!
FreedomFries silly screeds ... (Below threshold)
SPQR:

FreedomFries silly screeds are pretty amusing. Like this one:

We do not need a health care system driven by HMO amoral bottom-line greed. Health care costs and access should never be driven by profit incentive greed, obtained ONLY through the denial of coverage.

This is so hilarious because in the '70's, the legislation to permit the creation of HMO's ( Health Maintenance Organizations ) was specifically pushed by liberals like Ted Kennedy. The purpose? To create profit incentives to improve health care. The whole point of an HMO was to allow pricing "per capita" for health care. This would create an incentive to the HMO to do preventive care to drive down their costs per patient.

The only reason that HMO's were not more successful is because in truth all the claims of how much preventive care would save in health care costs have been illusionary. Nonetheless, a study a few years ago was published by the British Medical Journal comparing Britain's National Health Service to Kaiser Permanente. The conclusion was that Kaiser provided better service at approximately the same cost.

As I said, FreedomFries' screeds are hilarious. Devoid of actual useful content, but hilarious.

The average employer cost t... (Below threshold)
FreedomFries:

The average employer cost to insure a worker w/ a family of 4 is $11500. The average worker payout for participation in that coverage is $2973, which is available for only 61% of wage earners. The remaining 39% can fork out the entire $11,500 out of pocket.

Since 2001, the cost of health insurance has skyrocketed 78%.

Rather than the BillyBob Bilge of #2 above, it is not the case of lazy slobs refusing to cough up the $11,500 cost of health insurance out of a nationaal median $49K household income, or even the minimum wage earner coughing up $4700 out of his superfulous wage of $12,000/year for doing nothing of sufficient value to merit a living wage.

As for the above idiots who would claim that the severe rize in health care costs is due significantly to litigation, prove it. That old bromide is 100% rightie kook shit.

BTW my recent opthamologist visit for an eye pressure check and field vision test topped out at $320 for 30 minutes, most of which was spent w/ an assistant rather than the MD. Presumably, 75% of that cost was malpractice insurance.

SPuQQeRActually, i... (Below threshold)
FreedomFries:

SPuQQeR

Actually, it was old Tricky Dick who 1st propounded the idea of HMO's because it appealed to his Republican egalitarian sense of profiteering through the denial of coverage as a means to enhancing the bottom line.

FreedomFries, you remain ju... (Below threshold)
SPQR:

FreedomFries, you remain juvenile and ignorant.

Freedom Fries and responsib... (Below threshold)
WildWillie:

Freedom Fries and responsibility should not be used in the same sentence. His mantra is "give me, give me, give me." ww

And the same liberals who h... (Below threshold)
spurwing plover:

And the same liberals who have bumper sticker reading KEEP ABORTION LEGAL are the same ones who have bumper stcikers reading SAVE THE REDWOODS,SAVE THE RAINFORESTS,SAVE THE WHALES

Is FreedomFried like 18 yea... (Below threshold)
Michael:

Is FreedomFried like 18 years old?

From his behavior, Michael,... (Below threshold)
SPQR:

From his behavior, Michael, that's an upper range estimate.

Not to mention the incompetence with statistics, as above where he compares numbers that are apples and oranges. The median household is not a family of four. But FF hopes that you won't recognize that sleight of hand.

Not to come to FF's defense... (Below threshold)
epador:

Not to come to FF's defense, but the un- or under-insured (meaning whatever insurance available plus disposable income can't meet regular health care needs) rates are pretty high these days. If they were in a true free-market system, they might have a chance, but in the managed-health systems, and drunk with reimbursement specialists and sub-specialists driving the current health care system, they haven't got a chance to enjoy the high quality of care that is available to those with the bucks and the insurance to pay for it.

I wouldn't be so excited about comparisons to the National Health Service. It doesn't say much about the quality of Kaiser to say its better than NHS.

JL: Don't neglect to look at the other side of the coin - do you want the fellow taking care of you to have his only interest in how much money you mean to him in re-imbursement? Whether its soaking you or your insurance plan?

Perhaps it is not a great c... (Below threshold)
SPQR:

Perhaps it is not a great comparison, epador, but it puts paid to the claim that nationalized health care would be cheaper.

I don't follow your argumen... (Below threshold)
epador:

I don't follow your argument. Our version of NHS would likely be much different from the version already activated on the other side of the pond by the Anglo-Socialists. Kaiser doesn't begin to resemble what an all inclusive HMO would cost. They are notorious for ditching their high-cost patients and keeping the low cost/high premium types.

As an orthopaedic surgeon, ... (Below threshold)

As an orthopaedic surgeon, perhaps I can shed a little light. Smokers develop both small and large vessel vascular disease. Such reduced blood supply to the extremity can be improved if it's large vessel disease, but not if it's small. The fact that this gentleman already failed to heal his fracture and now it's two years later is a bad enough sign. He's at very high risk of complications including failure of bone healing even with surgery, skin breakdown due to failure of the incisions to heal, and development of infection. His risks would be even higher if he were also overweight and/or diabetic.

Fixing the ankle in such a patient would be the equivalent of painting rotting siding.

That said, if he's at such high risk that fixing the non-healed fracture (nonunion) isn't an option, particularly if he keeps smoking, then they could at least offer him an amputation, which would be likely to solve the pain issue and leave him ambulatory on a prosthesis.

National health care would ... (Below threshold)
Mitchell:

National health care would be more expensive, not less, causing increases in taxes like you haven't seen yet, along with the social security bailout. We'll enjoy the feds taking up all the oxygen in the economy no doubt.

And, we'll end up with crappy health care--I have been to enough single payer countries and spoken with enough people to know it's crap, so bugger off if you have a gripe about that.

We'll then end up paying higher taxes, and those of us who can afford it, will need supplemental private insurance to cover decent docs and care, so we won't wait 13 months for a multiple pregnancy delivery, etc.

This is not hard, if you think about it.

There is also that factor o... (Below threshold)
Rich:

There is also that factor of the people who completely abuse the system from the start. There are people who just want to be taken care of instead of actually working for themselves. They come in with all kinds of symptoms to E.R.'s looking for drugs,notes for work or to get light duty or handicap passes. I worked at one place where women would come in with abdomen complaints just so they could get the bloodwork done for pregnancy. All on the taxpayers dime. There are the people who look to scam the insurance companies. Some interesting tv shows have been on of them getting caught on camera. As much as people cry about the corporates they should also be getting after the people who abuse the system or cheat it and drive up costs.

Rich is right. While FF li... (Below threshold)

Rich is right. While FF likes to attribute the rising cost of insurance or health care to greed, the abuse of any system by the public is abysmal. With companies paying at least 50% of their employees' insurance plans, the employees don't have any interest in the cost of their prescriptions or care. They get name drugs when generics are perfectly fine and they clog up hospitals and doctors offices with incredibly minor issues; colds, minor cuts and scrapes, etc. What will happen when the government tells them "It's free!"

I recently talked to several insurance brokers while shopping for a plan for our company and each of them attribute prescriptions to the rising cost of insurance over litigation costs. We are over-prescribed.

National health care wou... (Below threshold)
hansel2:

National health care would be more expensive, not less, causing increases in taxes like you haven't seen yet, along with the social security bailout.


And, we'll end up with crappy health care--I have been to enough single payer countries and spoken with enough people to know it's crap, so bugger off if you have a gripe about that.

You speak with such absolute certainty. Well, idiot, if you are so absolute in your conclusions why don't you provide us with some absolute facts to back them up. Not editorials. Not articles from Town Hall or some other right wing lie-hole.

Absolute facts. Something that can't be refuted. Not hearsay by a few goons you might have spoken to in Sweden. Because if you can't find that, you should speak like you have an opinion instead of making absolute, bone-headed statements.

Canadian patients routinely... (Below threshold)
Who's John Galt?:

Canadian patients routinely suffer and die while waiting for their "free" health care. The National Center for Policy Analysis notes, "During one 12-month period in Ontario,...71 patients died waiting for coronary bypass surgery while 121 patients were removed from the list because they had become too sick to undergo surgery." Without exception, someone always pays for things that are "free". Somehow.

Just a note: As a percentage of GDP, total taxation is 28 percent higher in Canada than in the United States. Hmmmm. Higher taxes for diminished care. Sounds as though the government is involved.




Advertisements









rightads.gif

beltwaybloggers.gif

insiderslogo.jpg

mba_blue.gif

Follow Wizbang

Follow Wizbang on FacebookFollow Wizbang on TwitterSubscribe to Wizbang feedWizbang Mobile

Contact

Send e-mail tips to us:

[email protected]

Fresh Links

Credits

Section Editor: Maggie Whitton

Editors: Jay Tea, Lorie Byrd, Kim Priestap, DJ Drummond, Michael Laprarie, Baron Von Ottomatic, Shawn Mallow, Rick, Dan Karipides, Michael Avitablile, Charlie Quidnunc, Steve Schippert

Emeritus: Paul, Mary Katherine Ham, Jim Addison, Alexander K. McClure, Cassy Fiano, Bill Jempty, John Stansbury, Rob Port

In Memorium: HughS

All original content copyright © 2003-2010 by Wizbang®, LLC. All rights reserved. Wizbang® is a registered service mark.

Powered by Movable Type Pro 4.361

Hosting by ServInt

Ratings on this site are powered by the Ajax Ratings Pro plugin for Movable Type.

Search on this site is powered by the FastSearch plugin for Movable Type.

Blogrolls on this site are powered by the MT-Blogroll.

Temporary site design is based on Cutline and Cutline for MT. Graphics by Apothegm Designs.

Author Login



Terms Of Service

DCMA Compliance Notice

Privacy Policy