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We Know What We Like   | Main | The POR Recession

The Coming Health-Care Bailout


Categories: Business, Economics, Political Commentary
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Paul Hsieh (M.D.) has some thoughts on the inevitable issues with "universal health care."

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12 Comments

New European wrote:

"The United States is the only wealthy, industrialized nation that does not provide universal health care."

"The US currently (2007) has the most expensive health care of any OECD country and also has the highest percentage of costs paid privately with some of the worst health statistics in the free world."

There can't be any link between the two, can it?

Jay Manifold wrote:

The US has provided free (or incredibly cheap) health care to everyone below the "poverty line" (which is to say, about at the 85th percentile of worldwide income), and to everyone over age 65 no matter how rich they are, for over 40 years.

So the demand is that we provide "universal health care" now. I anticipate the demands for "universal dental care," "universal mental health care," and "universal housing."

Oops, scratch that last one -- we're already doing it. Buy the biggest house you want, claim you were misled into signing the mortgage, and get the taxpayers to bail you out ...

But back to the issue at hand. We could easily drive costs down by rationing. Nationalizing health care and then denying treatment to anyone over age 70 would be quite effective. That's pretty much what's happened in the UK.

"Some of the worst health statistics in the free world" - sure, if you include blighted urban areas where the predominant culture encourages out-of-wedlock births and violence. Also vast stretches of low-density countryside where nearly the entire population lives more than an hour from a hospital. Which is precisely why aggregate statistics are so misleading. Three-quarters of the American population lives in communities that are as safe and healthy as any ever created by human beings.

So, no, there isn't a link between the two. Correlation is not causation.

But there is a direct causal link between lifestyle and longevity. Always has been, always will be.

I don't see anyone emigrating to Europe (or Canada) for the "free" health care.

narciso wrote:

Can we make apple to apple comparisons, you don't compare the US to France, or Germany or even the UK; but to predominantly Europe as a whole. The whole US/Canada comparison is equally flawed.

Did I miss understand that post some time ago;that was what you wanted, right. McCain was too wishy washy and Sarah's faction of the party was too preocupied with "Sky Gods" as Gore Vidal would say. Enjoy your National Health Service. Tell me how it turns out.

New European wrote:

"The US has provided free (or incredibly cheap) health care (...) to everyone over age 65 no matter how rich they are, for over 40 years."

"Nationalizing health care and then denying treatment to anyone over age 70 would be quite effective. That's pretty much what's happened in the UK."

Poor Brits, with their life expectancy of 79.5. But hey, it's two years longer than US!

So maybe you're right about the problem being "vast stretches of low-density countryside where nearly the entire population lives more than an hour from a hospital." Let's see Australian life expectancy ... 80,5! Damn it.

Rand Simberg wrote:

You continue to use stupid parameters for the discussion. Many other factors go into life expectancy than "health care."

Anonymous wrote:

"You continue to use stupid parameters for the discussion."

The ever charming Rand, my pleasure. How can a parameter be stupid is beyond my recognition, I thought they can only be (in)appropriate. Anyway you offer no other parameter, stupid or wise, so I'll try just one more time - infant mortality - US 6.0, UK 5.0, Australia 5.0.

For some reason I have a feeling this one will be called stupid too.

Brock wrote:

Supporters of Universal Care must ask themselves how far they are willing to go to save someone. To the utmost? That gets expensive. At some point we need economic triage if we're going to prevent health care from absorbing 100% of non-essential economic activity.

Opponents of Universal Care must ask themselves how comfortable they are with poor people dying of easily preventable causes. They also need to ask themselves if they are comfortable with the fact that some people will win the genetic or environmental exposure lottery and others will lose it, and that's just the way the cookie crumbles.

I think it's ethically necessary to have some form of social insurance in the health care space. Just like we have welfare we can have universal care under a certain economic floor. Medicaid already does that though, so let's just make it (and the medical industry generally) more efficient. Medicare can go away if Medicaid is extended to the elderly. Further, we need to recognize that some people just get a bad set of DNA (or are unwillingly exposed to toxins or other harmful effects), and that putting money in an insurance pool against this "bad luck" is not a bad idea. That's real health insurance (as opposed to the extended service "warranties" we're sold today).

Jeff Mauldin wrote:

Guess what, Anonymous? You're right! That's stupid! The U.S. works much harder to save infants with difficult problems at birth, and places like the UK simply let them die and don't count them in their infant mortality statistics. Incidentally, this also has an effect on the life expectancy value as well.

In the UK people buy private health insurance because the national care is so bad. Joy! You get to pay for a gigantic government program that delivers poor health service with long waits and then, on top of that, you have to buy additional health insurance if you want decent care.

The US health care problems stem from (1) government run medicare and (2) the history of government regulation and tax policy which tied health care insurance to employment (and also encouraged people to think of any use of their health insurance as 'free').


Jay Manifold wrote:

New European Pseudonymous Coward:

I'll be less polite this time around. The American aggregate statistics are misleading because African-Americans have dramatically lower life expectancy, caused by, among other things, a violent death rate comparable to that of pre-surge Iraq. That death rate is caused by a disgusting culture and horrendous lifestyle choices.

To a lesser extent, the same problem occurs in Hispanic areas. Racial minorities (other than Asians) also have much higher rates of organ failure, including heart disease, stroke, kidney failure, and liver disease. Largely a result of lifestyle choices.

A much smaller portion of the Australian population lives in low-density areas, so that comparison won't work either.

I repeat: we have been handing out nearly-free health care to some of the richest people ever to live on the face of the Earth for 40+ years. The main result has been to drive up costs. Apparently that's not enough government-mandated catastrophe for the PC crowd.

Michael Kent wrote:

"The United States is the only wealthy, industrialized nation that does not provide universal health care."

New European, 2008

"The United states is the only wealthy nation that does not have a monarchy."

Old European, 1788

Sometimes being free means going it alone.

Mike

Daveon wrote:

In the UK people buy private health insurance because the national care is so bad.

No, not really. For a start in the UK it really is insurance, and it's usually accessed via an NHS doctor. Most of the schemes that people have require a referral from your NHS GP before they'll pay out. If you pay to go private they often won't let you see a specialist.

What people have it for is to jump the inevitable queues that happen in central health care systems.

However, the reality is that you have something life threatening that needs urgent treatment, the NHS is the best route and, frankly, even for cancer treatment the NHS trumps private. Even if you have private you'll probably be treated in an NHS hospital anyway.

Why is it that when people argue this they don't look at systems other than the UK and Canada... how about France? I hear very few people complaining about the French system.

New European wrote:

(Jay Manifold) "I'll be less polite this time around."

You weren't polite the first time, and I clearly understood your racial agenda then.

(Michael Kent) "Sometimes being free means going it alone."

No need to feel besieged, really. After all it's an initiative of US president supported by (some) US citizens.

(Daveon) "How about France? I hear very few people complaining about the French system."

Doesn't count at all. They are the evil socialists.

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