In general, The Eye has looked kindly on Ron Wyden during his years in the Senate. So it’s with regret that we feel obligated to rip into him for his health care reform idea.
Wyden’s “Healthy Americans Act” – which has been getting a lot of attention as a supposedly reasonable compromise between conservatives (who basically want to do nothing) and progressives (who want a single-payer plan, also known as “Medicare for all”) – claims to fix the health care mess without any net increase in federal spending.
The act would, to quote Wyden:
- guarantee private health care coverage for all Americans;
- provide health benefits equal to those that members of Congress now enjoy;
- provide incentives for individuals and insurers to focus on prevention, wellness and disease management;
- establish tough cost containment measures that save $1.48 trillion over 10 years; and
- be fully paid for with the $2.2 trillion currently spent on health care in America today.
Sounds great, right? The one hitch is that Wyden wants to steer employers away from providing health care benefits to their employees. Instead he wants them to “convert their workers’ health care premiums into higher wages.” And then, theoretically, “employees … would be required to purchase private health coverage with their higher wages.”
There are a couple of rather sizable problems here.
One: How is the government going to MAKE SURE that employers give the money they save by taking away health benefits back to employees in the form of higher wages? Is it going to pore over the books of every business in the country? It sounds like an enforcement nightmare at best and an invitation to monumental fraud at worst.
Second problem: The basic premise of insurance is spreading the risk. The premiums paid by young, healthy people who don’t need much health care cover the costs of care for older and/or less healthy people; when the young, healthy people in their turn get older and/or sicker, other premium-payers cover their costs. The bigger the risk pool, the cheaper the insurance can be.
So what kind of private insurance coverage are working people going to be able to afford when they have to go out and buy it on their own with those (supposedly) higher wages?
Besides, as far as we can figure it out, Wyden’s plan would do nothing to contain the out-of-control costs of health care or improve the quality of care, other than encouraging preventive actions “like nutrition counseling, tobacco cessation and exercise” – all good things, but not panaceas. People who eat right, don’t smoke and work out faithfully still get sick, although you might not believe it from those spunky little “live healthy” stories you read in places like Parade magazine.
This country is looking at the best opportunity for meaningful health care reform it’s likely to have in decades – if not in history. We can’t throw it away by settling for some tokenistic, half-assed “reform” like Wyden’s.
PS: There’s going to be a rally in support of single-payer health care at Bend’s Pioneer Park at 7 p.m. Wednesday, July 8. Singer and labor activist Anne Feeney will perform at the free event, along with David Rovics, Jason Luckett, Pat Dodd and Citizen’s Band. For more information call 541-318-8169 or click on http://annefeeney.com.
This article appears in Jul 2-8, 2009.
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The key to the debate in its entirety is “required to purchase private health coverage” – kinda’ like auto insurance, which has been demonstrated in a number of states (most notable California) to be unconstitutional.
Ivan the Insurance Agent: profiting from the POTENTIAL of others’ misfortune.
Thanks for getting a comment in, Tom, before all the right-wingers pile on and start bleating about the horrors of “socialized medicine.”
Thanks, Bruce. You nailed it. Single-payer, Medicare for all, is the best way to insure that people get affordable, accessible, quality health care. The public option–if it is strong enough and adequatekly funded–might work. Wyden seems to think that bipartisanship is a goal. No, the goal should be the best possible legislation, whether it passes by one vote or 100. People get all bent out of shape about the cost in taxes without considering that this cost is instead of what they pay now. As Paul Krugman (and others) has noted, what we call costs, the insurance industry calls revenue. We don’t need ’em.
HBM
Heaven forbid if someone who believes something else offers an opinion other than yours. That would be not be acceptable. Who is the sheep here, the one who isn’t interested in contrasting opinions or those who have contrasting opinions??? Sorry to invade your inbred sanctuary of dogmatic liberalism.
With regards to socialized medicine, if you so believe it call it what it is. You are afraid of the truth. If we use the coercive power of the state to force everyone to join a common system, then what do we have? This is socializing health care. You may prefer an Orwellian world where we don’t call reality what it is, but I don’t. You are limiting my freedom, to socialize a large segment of our economy.
Mr Funke, you are saying this will be a zero sum game, same $’s in as what we had before??? I thought we had 40,000,000 without health insurance. Who is going to pay for that?
While you on the left love to trot out how you believe in individual freedom, you propose a system that “REQUIRES” that I join through the “COERCIVE” power of the state. What about individual freedom, and individual rights? Nope cannot have that now can we!!!
Why is it better for the Fed’s to pay my Drs. and not me. It is my life and my health, why should the government need to be in the middle? Why do you feel compelled to restrict my freedom, my choices, my decisions???
If we truly wanted to reduce the cost of health care we would recognize that what everyone is talking about is not truly “Insurance”, but instead a “Prepaid Health Expense Plan”.
Why not go the route of health savings plans, with people buying “Major Medical Insurance” to cover the role that insurance truly should play? Eliminate all the “Prepaid Health Plan” costs, be it through insurance plans, or through a coercive state enforced plan. This puts me in control of my medical costs, and eliminates admin costs everywhere. We tried that in the 1990’s and we wrote the laws in such a way as to make it impossible.
Sigh… it’s so sad when they roll out the demons of the “coercive power of the state” and that scary “socialized medicine” boogieman. To put this in perspective, it helps to substitute “police or fire services” whenever you hear one of these tools blather on about the evils of “socialized medicine”.
For example, let’s look at this jewel excerpted from a previous comment,
> Why is it better for the Fed’s to pay my Drs. and not me.
> It is my life and my health, why should the government need
> to be in the middle? Why do you feel compelled to restrict
> my freedom, my choices, my decisions???
Now let’s recast it,
> Why is it better for the government to pay for my police and
> fire protection and not me. It is my life and my health, why
> should the government need to be in the middle? Why do you
> feel compelled to restrict my freedom, my choices, my decisions???
Why does anyone need to explain how ridiculous is this line of argument? Why do we not hear protests of “socialized police services”, “socialized fire protection”, and “socialized military”?
Do these people really have any idea what they mean by “socialized”? The term has very little descriptive content but to these fools it sounds close to “Socialism” so, obviously, providing publicly-financed health care to everyone is just one step toward Communism and black helicopters landing in your backyard to take away your guns. Crazy.
So what does “socialized” in this context truly mean? Socialism? Government control?
How about a publicly-subsidized community service? Okay, now we can rationally discuss the relative merits of public financing versus free market economic forces in the delivery of health care. A suggestion… it’s helpful to do a little reading outside the right wing echo chamber… pretty much a requirement before one can have an educated discussion of health care economics is the seminal paper by Kenneth Arrow, “Uncertainty and the welfare economics of medical care”, published way back in 1963,
http://www.scielosp.org/scielo.php?pid=S0042-96862004000200012&script=sci_arttext
“With regards to socialized medicine, if you so believe it call it what it is.”
I don’t care what it’s called; I’m only interested in whether it works. Our present so-called “health care system” does not work. Anyone who thinks it works must have been living under a rock for the past 20 years.
Single-payer systems, such as the one in Canada, may not work perfectly, but they demonstrably work better. If you want to call them “socialized medicine” I don’t give a damn. I am not frightened by a name. I am much more frightened by the inadequacy and incompetence of our present “capitalist medicine” system.
“Why is it better for the Fed’s to pay my Drs. and not me.”
Unless you are very rich, chances are you are not personally paying your doctors now — or not very much. If you are over 65 Medicare (i.e. the government) is paying them, if you are indigent Medicaid (i.e. the government) is paying them, and if you are under 65 and insured your insurance company is paying them. So that argument is moot.
“It is my life and my health, why should the government need to be in the middle?”
Absolutely, it would be just terrible for the government to be making decisions about your medical care. It’s much better for insurance company bean-counters to be making those decisions.
“Why do you feel compelled to restrict my freedom, my choices, my decisions???”
Nobody would be restricting your freedom to get the medical care you choose where you choose. Even in Great Britain you still have the right to hire private physicians and go to private clinics if you have the means to do so.
Mr. XYZ, I generally feel that phoney monikers and anonymous posts lack credibity. Surely, you can use your real name. Or do you so fear the state that you are already underground? Everyone who has health insurance already pays for those who don’t, either through higher costs or when those without coverage are forced to rely on public services, emergency hospital care, etc. Not that you necessarily fall into the group, but I must say I am constantly amused that the same people who proclaim of the U.S., “We’re #1!,” are convinced that we are incapable of providing health care for all like they do in places like Sweden. If they can do it, and we can’t, we are a pitiful giant.
Ric,
Oh how I love the euphemisms. Health care will now become a publicly-subsidized community service. How about we engage in a overseas contingency operations on the high seas just off the coast of Myanmar? Orwellian through and through.
It is really revealing that you say “socialism” or “socialized” has no real descriptive content, and yet you must revert to euphemisms to avoid really discussing it. Socialism has very high descriptive content for me, and for a lot of people, including yourself, and that is why I am not the one who is afraid of the word “socialism”, rather the left is. They need to hide behind these euphemisms so they don’t allow people to see what exactly it is they are proposing. How about this, lets call it what it is, and then get to discussing the subject at hand.
With regards to police, or fire, or any manner of other public services, what is your point? I made no argument regarding those ideas, and at no point did I say we should not choose, as a society, to “socialize” all manner of different emergency services. Those were discussions held 220 years ago, and as a result this is where we are at today. The subject at hand today is not whether or not we should have a “publicly-subsidized police service”. The subject at hand today is, is it better to have a government mandated single payer health plan, where we are all forced to join, forced to pay for, and forced to accept its decisions on our health care needs? Why is forcing me into a health plan that decides what medical services I get, and decides how much it will pay for those health services is better than the alternative we have today? That of course was a subject you avoided addressing. What are you afraid of?
I know it is much easier to call me crazy, so as to avoid confronting the issues. It is much easier to blather on about a word, that you and HBM want to avoid hearing, rather than substantively discuss the issues. You think I disagree with you so….. I must be crazy.
Finally with regard to my reading on the subject, or partaking in the right wing echo chamber, wow your hubris is almost breathtaking. You haven’t the slightest idea about me, my ideas, my intellect, my education, what I do, nor how much I read, nor what echo chambers I prefer to frequent. That is OK, I understand that I have disrupted the sonic resonance of this Left Wing Echo Chamber. How dare I!!!
According to the CIA World Fact Book, 2008, the average life expectancy of an American is less than that of a citizen of Sweden, France, Canada, or Great Britain.
According to the CIA World Fact Book, 2008, the infant mortality rate in the United States is greater than that of Sweden, France, Canada, or Great Britain. In fact it is greater than Cuba’s.
A study reviewing health care spending data on 30 countries from the Organization for Economic Cooperation and Development (OECD) for the year 2002 found U.S. citizens spent $5,267 per capita on health care. The country with the next highest per capita expenditure, Switzerland, spent $3,446 per capita. The median OECD country spent $2,193 per capita.
Do the math. 300 million people in the USA spending $5267 means we are spending $1.6 trillion now to do a mediocre job of delivering healthcare to our citizenry.
Stop knee-jerking and parroting talking points and dio a little research and thinking on your own.
“It is really revealing that you say “socialism” or “socialized” has no real descriptive content, and yet you must revert to euphemisms to avoid really discussing it. Socialism has very high descriptive content for me, and for a lot of people”
The dictionary definition of “socialism” is “a theory or system of social organization that advocates the vesting of the ownership and control of the means of production and distribution, of capital, land, etc., in the community as a whole.” In other words, a system in which government owns and controls the economy, like that which existed in the late, unlamented Union of Soviet SOCIALISTIC Republics.
There is NO politician of any stature in America today who advocates “socialism.”
“Socialism” is a word that the right wing uses as a handy all-purpose pejorative to describe any government policy or program that might benefit ordinary working-class or middle-class Americans. It’s a cheap trick designed to hustle the uninformed rubes, like calling the estate tax “the death tax.”
“The subject at hand today is, is it better to have a government mandated single payer health plan, where we are all forced to join, forced to pay for, and forced to accept its decisions on our health care needs?”
Attacking a straw man — another favorite right-wing debate tactic. Even in a single-payer system like Canada’s or Britain’s you would still be able to go to private physicians and private clinics if you chose to.
I think barak has the best of intentions but we have a problem in this country that others like Canada, and Britian don’t have, it is called The Hypocratic Oath. This one commitment never to be broken has has cause us to have universal health care without paying the price. If we can go with rationed health care like Canada and Britian we can for once get the costs down to where we can afford it. I think Barak’s strategy to eliminate Medicaid is good because the biggest users of health care the elderly would then be reviewed by the Healthcare Czar on whether they should get the services they need after all what is the price of another year of life when it requires a hip replacement at $60,000. Stop the madness, if we can increase the death by cancer like Canada 15% higher than the US and add 6 months to a Colonostomy we can get the cost saving savings the Barak has promised. Wyden just doesn’t see the big picture, good senator but missing the point of must be cost effective long term.
XYZ,
Please reread my previous post. I did not address the post to you nor did I claim any knowledge about you specifically or your “intellect”, “education”, what you do, or how much you read. A persecution complex maybe?
I agree that I am occasionally afflicted with hubris; however in this case, I did not direct the suggestion about reading outside the right wing echo chamber to you specifically but rather to anyone who is willing to discuss *real* issues relating to health care economics rather than just fling around epithets and slogans straight out of the right wing talking points playbook.
You apparently have a strange definition of “euphemism”. Defining your terms is not the same as creating euphemisms, especially in the case where the term requiring definition is purposely being used as a weasel word to obfuscate the actual issues.
> It is really revealing that you say “socialism” or “socialized”
> has no real descriptive content, and yet you must revert to
> euphemisms to avoid really discussing it.
Speaking of hubris… There you go again, equating “socialism” and “socialized”. In my previous post, I did not say the term “socialism” has no descriptive content. But since you brought it up, what is your preferred definition of socialism? Classical Marxian socialism? European style social democrat socialism? The utopian socialism that gave us various forms of cooperatives and intentional communities? The various flavors of libertarian socialism? You do realize I hope that the term “socialism” encompasses a wide range of different and sometimes conflicting social and economic philosophies? So yes, without clarification, the term “socialism” can indeed be just another useless term with little descriptive content.
Equating “socialism” and “socialized” without defining either term and using both as interchangeable epithets is just dishonest propaganda. It’s amusing that as a result of my small attempt to pin down the definitions of these terms, you accuse *me* of avoiding a discussion of the real issues. Typical right wing nutcase tactic. Accuse your opponent of the very same behavior you yourself are engaging in and hope that no one will notice the dishonesty.
“Equating “socialism” and “socialized” without defining either term and using both as interchangeable epithets is just dishonest propaganda.”
Yes, and the right wing does it all the time, such as accusing Obama of being a “socialist” and wanting to bring “socialism” to America by (among other things) advocating reform of the health care system.
“Socialism” as used by the American right wing is nothing but a bugbear, a scare word they adopted after the word “liberal” lost its punch.
And please note I have never called you a “nutcase.”
BTW, since we’re on the subject, here’s a question that I have never seen a conservative even attempt to answer:
If single-payer (“socialized,” if you prefer) health care is so terrible, why hasn’t ONE SINGLE COUNTRY that adopted it ever gotten rid of it? If it’s the horror that conservatives make it out to be, why haven’t they scrapped it and gone to the American system of “capitalized” health care?
I’ll offer an answer, although I know you won’t accept it: It’s because they KNOW the American system is a bloody DISASTER. Our “health care system” is an international laughingstock.
Other countries don’t get rid of socialized medicine because socialized anything is hard to get rid of. Instead they(we) just throw more money at it infinitely. Like public schools.
“Other countries don’t get rid of socialized medicine because socialized anything is hard to get rid of.”
A masterpiece of tautological argument — “A is A because A is A.” My congratulations, sir.
Any other conservatives care to take a shot at it? I mean, c’mon — if single-payer health care is as horrible as you say it is, why haven’t Canada and Britain and France, among others, scrapped it? This should be EASY for you to answer.
Waiting … waiting …
… but not holding my breath.
HBM, pull your head out… Canada and Britain would love to walk away from their pathetic health care results…. the US has the best health care stat’s in the world do your bloody homework mate…
HBM
I do not know nor understand how the internal politics of Canada, or Britain work. I do not know what the process would be to scrap their universal health care, so I cannot comment on why they haven’t done away with it. I can comment though on what they think about it.
I know dozens upon dozens of people each that live in Canada, Britain, New Zealand, Germany, Sweden. And to a person each and every one of them have major problems with their health care system, and if they had the power to change the system in meaningful ways they would make radical changes to it.
For instance it takes 6 to 9 months to see a dermatologist, or other specialists, and often you have to travel long distances to see one.
In Britain you cannot get surgery for a cataract, or significant treatment for diseases of the the eye such as macular degeneration, or glaucoma unless you are blind in one eye. Lucky for me that I live in the US, because I was able to see a dermatologist for severe excema in 8 days, and was able to get cataract surgery within a month (and yes I am blind in one eye).
I can also comment that these other countries do not have the same tort system we have in this country. There is no doubt that one of the single biggest ways to reduce health care cost in this country would be to aggressively address tort reform. Oh yeah that won’t happen because the Democratic Party is nothing but a paid consultant to the trial lawyers bar. Look at how well the other major power base of the Democratic party has helped us in K-12 education. I know how you just love our education system in this country.
But using your argument, since they haven’t gotten rid of it then it must be good, we in this country have been having this same debate for 50 odd years, and yet we still don’t have a federalized single payer system. That would seem to indicate that the people of this country are not all that enamored of a federalized single payer system.
ric,
I will keep it simple for you. Socialize or privatize. We have a predominately privately funded health care system in this country. A federalized single payer system is not a “private” approach, but a “socialized” approach. A one size fits all, watered down approach, that will absolutely result in significant rationing of care, especially among the elderly, at greater expense because there will be no competition. Look at every single payer system in the world and that is exactly what you get. Oh year I know you can pay for your health care outside the system, if the system is inadequate. In other words, you don’t like what we offer, no problem keep paying for our system and pay again for all the stuff we don’t offer. The rich get the best health care, but they have to pay twice to get it.
As far as the “demons of the coercive power of the state”, well ric you can no longer make any claims against the Patriot Act, and the power it gives the government to invade our privacy, and perform warrant-less searches. You seem to feel it is nothing to worry about. I was simply responding to HBM, and his desire to prosecute for fraud all those businesses that don’t give raises in lieu of health care. I guess you and HBM feel the real boogiemen are private citizens, not the all knowing all seeing government.
“Canada and Britain would love to walk away from their pathetic health care results”
So (once again) why don’t they? Why don’t they scrap their systems if they’re so lousy and return to what we have? They have representative governments, they have elections, they’re not living under dictatorships.
“the US has the best health care stat’s in the world”
You’re joking. Please tell me you’re joking. I would not want to believe there are people who are so deluded walking at large among us.
The only health care statistic in which the US leads the world is the COST of health care per capita.
“I do not know nor understand how the internal politics of Canada, or Britain work.”
They work a lot like ours. They have elections and the people they elect pass laws — or repeal them. It’s not that tricky.
“I know dozens upon dozens of people each that live in Canada, Britain, New Zealand, Germany, Sweden. And to a person each and every one of them have major problems with their health care system”
And there are thousands and thousands of people in the United States who have had horrendous problems with our so-called health care system, in terms of access to care as well as quality of care.
Obviously the single-payer systems are not perfect. But the evidence (I’m talking about hard data, not anecdotes) consistently points to the conclusion that they’re better than the god-awful mess we have here. We spend more per capita on health care and get worse results than any other major developed nation. And that’s a fact, Jack.
“we in this country have been having this same debate for 50 odd years, and yet we still don’t have a federalized single payer system. That would seem to indicate that the people of this country are not all that enamored of a federalized single payer system.”
Or it might indicate that the medical/pharmaceutical/insurance lobby has done a hell of a good job of buying politicians and bamboozling voters.
Most Americans are very insular. They have little knowledge of the world beyond their borders and even less first-hand experience of it. They don’t know much about how the health care systems of Canada, Britain, France and other countries work beyond the horror stories that conservative pundits and politicians and the medical/pharmaceutical/insurance lobby feed them.
It confounds me that the very people who extol
the benefits of a results oriented system abandon that conviction when it comes to health care. Then, all that matters is perception, not the results.
Throughout these posts the contention is that the US market driven system is superior to the socialized/socialist system of countries such as Great Britain and Canada because that system rations health care and provides inferior service to the citizens. Some proponents of our market driven system trot out horror stories from Canada or Britain to demonstrate how horrible the prospect of such coverage is. They easily ignore the same faults, rationing and service denials when executed by an HMO or insurance company as though they don’t exist.
In another lifetime I worked in the claims processing division of Blue Cross in Southern California. The business model was simple: deny all claims. After the denial becomes impossible any longer and the insured is finally able to force the company to cover the claim, find any and all reasons to slow down the process and delay settlement. Deny and delay is the model for all insurance companies–I know because although I am no longer in the health insurance business, I deal with property claims daily for people who have auto accidents–trying to get them adequate coverage for their loss. Adjusters deny legitimate coverage and delay the process as long as they can before reaching a final settlement. Deny and delay.
Anyone who thinks they have adequate or full coverage under their private medical insurance plan probably hasn’t had to make a catastrophic claim. Hasn’t had the frustration of dealing with a long term illness. Hasn’t had to deal with the beast.
The reason the AMA has opposed universal single payer coverage for years is simple: money. Doctors don’t practice medicine as much as they form corporate practices to maximize income. Investigations have found a clear conflict of interest–doctors owning testing labs and equipment under different legal entities so they can prescribe needless tests and therapies provided by companies they own.
Drug companies develop and promote medications that are little better than what existed before solely because there is more profit in the new and improved expensive drug–if they can create the need in the mind of the consumer that this is the magic pill for them and they are entitled to it.
XYZ–your anecdotal evidence about the ‘dozens and dozens’ who ‘all’ have a gripe just means that you only socialize with people who piss and moan about health insurance they would NOT GET AT ALL in the USA. Then, you would hear them piss and moan about how expensive it is to buy it.
Clear Choice–coverage for a healthy, young family of four on a employer’s group health plan runs about $940 a month. Do you consider that affordable? It was the least expensive coverage across four different companies with all of the different options. Let’s see: 40 hours per week multiplied by 4.33 weeks in a month is 173 hours worked in a month. Divide that into $940. What do you know! Only $5.43 of every hour of our employees wages are going towards his insurance. Yeah, that works here in Central Oregon.
Raymond–best in the world? Why is our life expectancy shorter and our infant mortality higher? Oh, I get it–you’re one of those that doesn’t believe in facts or results. Just parroting the talking points you’ve heard fro talking head media personalities and like minded politicians that you listen to. I get it.
I am getting awfully tired of some of you pontificating about something you don’t know or understand. It’s easy to set yourself up as an expert because you know what you know.
Itรข โขs similar to the columnist Pauline Kael after the รข ~72 presidential election. (Oh, and by the way, this is how you actually gather evidence- not by listening to everyone who agrees with you.) She has been widely reported to say รข how did Nixon win, I donรข โขt know anyone who voted for himรข ย. (Nixon won that in a landslide) What she actually said was รข I live in a rather special world. I only know one person who voted for Nixon. Where they are I donรข โขt know. Theyรข โขre outside my ken. But sometimes when Iรข โขm in a theater I can feel them.รข ย At least she could admit, however blindly, how absolutely insulated her and her worldview was.
Too bad some of us can’t do the same.
And by the way, the Hippocratic (Not Hypocratic) Oath has been around since ancient Greece and is used in a multitude of countries, not just here.
I know, Raymond, you know what you know…
Stephen: Excellent points, especially this: “The reason the AMA has opposed universal single payer coverage for years is simple: money. Doctors don’t practice medicine as much as they form corporate practices to maximize income. Investigations have found a clear conflict of interest–doctors owning testing labs and equipment under different legal entities so they can prescribe needless tests and therapies provided by companies they own.”
In fairness to doctors, though, I believe that most of them really did go into medicine because they wanted to help people. If making big bucks had been their only goal they could have worked on Wall Street and made 10 times as much right out of college as they’ll make after 10 years in practice. What happens is the present fee-for-service system forces them to practice assembly line medicine — churning patients through as fast as possible, spending an average, nationally, of 12 minutes (!!!) on each office visit. This is ridiculous. No doctor can make an accurate diagnosis on the basis of 12 minutes with a patient. What happens is the doctor listens to the patient’s symptoms, prescribes a pill that’s supposed to help the symptoms and tells the patient to come back in a week or two or three if they don’t get better. And if they don’t get better the patient gets referred to a specialist, who might — just MIGHT — eventually make an accurate diagnosis after running through hundreds or thousands of dollars worth of tests. (Believe me, I speak from experience.)
Then I’m sure the peer pressure factor comes into it. A doctor sees his colleagues in the same specialty in the same area making $500,000 or $700,000 a year and thinks he ought to be making the same.
BTW the influence of the AMA isn’t what it used to be, fortunately — only about 20 percent of American doctors belong to it.
It’s still all about the money. The AMA contributed about $6 million over the last three election cycles to candidates for the senate and house. In 2004 the Repubs got more money than the Dems by a wide margin. As power waned for the Republicans, so did their level of funding. Last year the AMA donated more to the Dems than the Repubs–they saw the writing on the wall.
Is it any wonder that some of the Dems are waffling on an issue they have long championed?
We Americans get the government we deserve–bought and paid for by the quid pro quo donations of the special interest groups.
For the FACTS visit mediamattersaction.org/factcheck/200906110008.
And of course, you’re right–the AMA isn’t what it used to be. But then neither is the NRA and look at what they accomplish.
HBM I must say you truly are unbelievably arrogant. You cannot have your cake and eat it too. So the citizens of nations with single payer health care love it so much that they have kept it, while American’s have been duped and lied to keep their semi-private system. This proves that American’s are ignorant rubes who have been duped by the medical-industrial power structure of this country, but the citizens of Britain and Canada are enlightened, and those countries don’t have an entrenched medical-industrial complex? HA!!!! That is one of the differences between you and me. I am not so arrogant as to believe that I know and understand how the inertia and power structure of politics in Britain or Canada works, but you are so educated and enlightened that you know with ease.
I loved this one;
“Most Americans are very insular. They have little knowledge of the world beyond their borders and even less first-hand experience of it. They don’t know much about how the health care systems of Canada, Britain, France and other countries work beyond the horror stories that conservative pundits and politicians and the medical/pharmaceutical/insurance lobby feed them.”
That’s right we are ignorant fools, and we need the brilliance of people like you to save us from ourselves. All I can say to you is, “GET OVER YOURSELF”.
HBM you speak of facts left and right, and yet you don’t offer any. I know this is a difficult concept for you but correlation is not causation. You constantly make the claim that our health care system is bad, and yet you do not offer facts that in fact show that single payer systems “CAUSES” these supposed better results.
I will give a simple example, just because America has a higher death rate from sickle cell anemia than say Sweden does not prove, mean, or even indicate that the single payer health care system caused that the lower rate in Sweden, or that our partially privatized system lead to our outcome. There is a correlation, but the causal relationship is entirely the result of some other variable. So once again correlation is not causation, and your claims that single payer health care systems leads to or causes better results is not supported by the facts, nor any of the “facts” you offered up.
Here is a fact for you jack
In August 2008, the prestigious British medical journal Lancet Oncology published the results of an extraordinary study. The study found that America is much better at treating cancer than Europe or Canada.
As it turns out, Americans have a better survival rate for 13 of the 16 most common cancers. Among men, an American has nearly a 20-percent better chance of living for five years after being
diagnosed with cancer than his European counterpart.
American women stand a 7.2-percent better chance of living for five years after a cancer diagnosis than their European counterparts.
Perhaps thatรข โขs one reason why tens of thousands of foreigners come to the United States every year for medical treatment. Theyรข โขre usually seeking advanced and sophisticated procedures that are simply unavailableรข “or rationedรข “in their home countries.
http://liberty.pacificresearch.org/docLib/20081020_Top_Ten_Myths.pdf
One thing that is important about this study, is that it considered outcomes from common perspective, and can be used as a strong indicator of the effectiveness our private health care system over single payer. This study took patients in identical or nearly identical circumstances (they all had cancer and the degree of said cancer was correlated in the data so as to be a controlled variable). This then measured the outcomes based upon the quality of care received, which is often highly correlated to how the care is funded.
Finally when was it wrong to make lots of money being very good at what you do? So what if a local oncologist, or ophthalmologist, or any other Dr. makes $200,000, $500,000, or even $1,000,000? How is that any concern of yours, and why do you deserve to even have an opinion on that? Oh right I forgot, you are one of the brilliant ones, who will save the rest of ignorant rubes from ourselves.
Here is something from outside the Left-Wing Echo Chamber.
http://www.adamsmith.org/blog/tax-and-economy/why-interventionism-works-200907063801/
Why interventionism works
Written by Tom Papworth
Monday, 06 July 2009 06:02
Short Term Serial Correlation and Long Term Mean Reversion sound rather heavy. And so they should. They were conceptualised by statisticians, after all; people who make economists sound normal. Yet an understanding of these two phenomena helps explain why the myth that politicians can and do solve real problems continues.
Short Term Serial Correlation emerges because people like to see patterns. Random events are never evenly distributed; some areas will manifest more incidents than others. Geographically, there may be a larger concentration of accidents, or geniuses, or Stephens in one locality; chronologically, there will be more crimes, or jackpots, or bankruptcies in one month than another. For some of these there may be real causes (a criminal has moved into the area, thus triggering a local crime wave) but very often apparent rises or falls in frequency are just the results of random coincidence.
Long Term Mean Reversion is the inevitable “return to form”. If there is no cause for these clusters, in the long run they will even out. The average reasserts itself. Because there was no reason for the cluster of incidents, it is not sustained and everything returns to normal. All very dry stuff, you might think, and blindingly obvious. Except that this duel-phenomenon may explain why interventionism is so popular.
Take two examples: ร๏ฟฝ·
A number of traffic accidents in a short space of time lead to a public outcry and a demand that something be done to improve safety in what is, apparently, a dangerous stretch of road. Local people focus not on the 10 year average but the tragedies of the past 12 months. Action is called for and local councillors step in. Money is spent changing the road layout, building speed humps or erecting a camera. The following year the number of accidents falls (returns to the long-term average) and both councillors and residents claim it is a success.
ร๏ฟฝ· The economy goes into a bit of a slide. Shares fall and unemployment rises. Worried citizens demand that something be done to prop up asset values and protect jobs. The government – ever eager to please – steps in with a lot of expensive and headline-grabbing measures. After a period, economic activity recovers its upward momentum. Government officials are quick to point out that the recovery results from their own policies. Put like this, the significance of these phenomena should be obvious.
The natural instinct of people to cry that “Something must be done” very often leads to policies that appear to have the desired result. This perpetuates the belief that politicians can make a difference and that without them the world would rapidly go to hell in a hand basket.
XYZ–
Terrific. You reference a posting by Sally Pipes, president and CFO of Pacific Research Institute,an ‘expert’ who spends all of her time denying the health care crisis, global warming, and any other so-called ‘liberal’ cause that gets her funding for her group and her salary. She has no academic credentials in public policy, but that hasn’t prevented her from achieving a great deal of support as an expert from conservatives desperate for points to use in their argument.
With her รข ~BA with honorsรข โข in economics, Pipes leads a tiny รข ~think tank,รข โข Pacific Research Institute, and advances special interest (PRIรข โขs list of donors include Altria (formerly known as Philip Morris), Microsoft, Pfizer and ExxonMobil) agendas. PRI promotes itself a s รข free-market think tank,รข ย but Pipes offers little in the way of solutions. During testimony in Congress, Pipes simply regurgitated Sen. John McCainรข โขs (R-AZ) health care plan:
If we could change the tax code to level the playing field by removing the tax advantage from those who get their insurance through their employer, reduce state mandates that add between 20-50% to the cost of a premium, allow the purchase of insurance across state lines, and have medical malpractice reform, we could reduce costs and significantly reduce the number of uninsured in this country.
Pipesรข โข real contribution is her ability to conflate the administrationsรข โข health care proposals with the evils of socialized Canadian medicine and reference discredited health care crisis deniers along the way. For instance, when asked Pipes why รข don’t people who come from your point of view come to this committee and talk about constructive ways weรข โขre going to reduce preventable medical errorsรข ย and lower overall health care costs, Pipes quoted fellow health care denier Betsy McCaughey! McCaughey uses Pipes as a reference for her POV and Pipes uses McCaughey to support her POV. Circular argument. A uses B as a source; subsequently B uses A as a source because POVs coincide. Only in the world of the internet could such crap occur and be given credibility. ‘It’s written so it must be true!’
Pipes focuses on segments of the American health system where there is undeniable success, ignores the costs, and then ignores the much larger picture.
This is like saying that the M1 tank is great family transportation because it has great ability to withstand front end collisions. WTF?
Our system of health care is twice as expensive as Canada’s yet we have a shorter lifespan than Canadians. We have a higher infant mortality rate than Cuba, for god’s sake! Are those statistics you consider successes?
The actual cost to the people who survive these diseases such as cancer is so high, that even with full coverage insurance they usually end up destitute. If none of the ‘dozens and dozens’ of people you know have been the victim of an out of control costly medical procedure and treatment, had to deal with the insurers who seek desperately a way out of covering what they contracted to cover and what their clients paid for, and had their life savings disappear as they sought to stay alive, expand your circle of friends.
People who deny the health care crisis in this country, such as Pipes, are as crazy as the 9/11 Truthers. Pipes motives aren’t because she’s psychotic though–she says and writes what she does because she is paid to do it by the very people reaping the benefits of the system.
And, I don’t care what a doctor makes as long as his motives are patient care and treatment. Do you consider a doctor who drives up his income by assigning tests and treatments from labs and facilities that he owns in whole or part a conflict of interest or acceptable? Its happening!
Read some of the research done by Atul Gawande, an actual physician. Google health care costs in McAllen, Texas, and try to convince yourself that this is the tip of the iceberg. Remember it was a Republican president and Congress that backed prescription coverage for medicare (with the backing of Big Pharm.)
I have to say how totally predictable you are here. I disagree with you, so I am obviously ignorant and uniformed, and I know what I know only from the right wing talking heads. This mindset so betrays your thought process. You all are the smart ones, the rest of us are uneducated, and don’t know what is best for us, and we need all of you to take care of us. If I have the gall to challenge your conventional wisdom, then I clearly am out of line.
This quote says it all;
“I am getting awfully tired of some of you pontificating about something you don’t know or understand. It’s easy to set yourself up as an expert because you know what you know”. Stephen GET OVER YOURSELF.
Stephen you speak of lower life-expectancy and say this is proof that our health care system is worse than these single payer systems. This is an apocryphal. Life expectancy is heavily related to lifestyle, and proximity to violence. You choose to ignore those causes and instead make the leap of faith that who pays for health care determines life expectancy. You have the nerve to wag your finger at me about my supposed pontificating on this subject, and you make this claim.
There is no credible study that can say with any definitiveness that single payer health care systems cause a longer life expectancy.
Are you going to claim that the reason the life expectancy of a man in Zimbabwe is 35 years less than a British man is because the Brit has access to single payer health care and the Zimbabwean doesn’t?
What is the explanation that the life expectancy of a black man in America or a Native American less than a white man? They have the same partially privatized health care. Why is the life expectancy of a First Nations man in Canada less than a white man in Canada? They both have access to the same single payer system. Once again it is an apocryphal to make the claim that single payer health care leads to a longer life expectancy. Correlation is not causation.
With regards to rationing, I did not make the claim that our present system does not ration health care. No system is going to operate without rationing. Choices need to be made all the time. The claim I am making is that in our existing system the decision to ration will overwhelmingly be done by each individual, based upon their own reasons and their own circumstances. In single payer system the decision to ration my health care will no longer be made by me, but by some bureaucrat in the health care directorate. I know that HBM will tell me I will have the option to go outside the system to get the care that is being rationed away from me, but tell me why I should have to pay twice to get the care I deem to be necessary? Please tell me how that will increase my life-expectancy.
Actually Stephen I used the Lancet Oncology as my reference, I just cited where I read the publication of the Lancet’s study. So while you choose to focus your attack on PRI, you make a completely unsupported assertion from the Lancet that the people who survived cancer longer did so in destitution. You have absolutely nothing to support that assertion, you just made it up. It is on the internet now so it must be true, right?
You also do not read clearly what I post. I am not coming here in support of continuing with the existing health care system. I am simply challenging the unsupported claims that single payer health care will solve all of our ills.
“In August 2008, the prestigious British medical journal Lancet Oncology published the results of an extraordinary study. The study found that America is much better at treating cancer than Europe or Canada.”
I would like to know how well controlled that study was. Were all the subjects of roughly the same economic status? Did all the American subjects have the wherewithal to afford the best treatment in a timely manner?
There’s no doubt that you can get excellent medical care in America IF YOU CAN AFFORD IT. The Bentley is an excellent car if you can afford it — but how many can? A system in which a few patients can get the medical equivalent of a Bentley while most get Geo Metros — or nothing — is not something to brag about.
“The claim I am making is that in our existing system the decision to ration will overwhelmingly be done by each individual, based upon their own reasons and their own circumstances.”
Absolute nonsense. In reality the decisions are made by INSURANCE COMPANIES and the decisions are driven by the bottom line. Their goal is to take in the maximum possible in premiums while paying for the minimum possible care. And every year they make us pay more and more to get less and less.
If you truly believe that you as an individual are making the decisions about what kind of health care you get and when (unless, of course, you are extremely wealthy and pay for your care out of your own pocket) you are deeply delusional.
Good letter in today’s Bulletin about one woman’s experience getting emergency medical care in England.
Along similar lines, I’ve related the following story before on another blog, so if you’ve read it before just pass over it:
I have a niece who’s married to an Englishman and lives in England. For most of his adult life he’s had serious problems with ulcerative colitis. He’s undergone more surgeries than I can remember and has not been able to work in years because of his health. (He’s an engineer by profession.) In the United States I’m sure the cost of his medical care over the years would have run into the millions. If he were living here instead of Britain I’m sure he and his wife would be bankrupt and he more than likely would be dead.
Conservatives like to tell stories (usually involving “somebody who knows somebody who knows somebody who told me”) about the horrors of socialized medicine, so I thought I’d offer one from the other perspective. The health care system in Britain is not perfect — no human institution is — but the bottom line is that if you need medical care you get it, and you don’t have to impoverish yourself to pay for it.
Stephen,
You are a real piece of work. I did a google search on your post regarding Sally Pipes, and what did I find. It was a word for word un-cited copy of a post from the radicalized far left web-site
Thinkprogress.org.
http://wonkroom.thinkprogress.org/2009/03/17/pipes-peeps/
I went back and looked at your earlier post;
“I am getting awfully tired of some of you pontificating about something you don’t know or understand. It’s easy to set yourself up as an expert because you know what you know.”
What a hypocrite you are. You rely totally on far left radicalized web-sites, to the point of copying their posts word for word, but you choose to not cite this, and try to pass their words off as your own. You wag your finger at me about using anecdotal observations, and then immediately following you offer up your own anecdotal observation about “4 different” health plan options.
I may disagree with HBM, but at least he has the honor and guts to use his own words, and cite others when using theirs.
Hey–I blew that one and one other–the Pauline Kael quote. After reviewing my posts I found I had attributed all but those two and I will do better in the future.
My mistake does not make me a captive of ‘far left’ web sites any more than your occaisional use of far right web sites.
Also, don’t talk about ‘guts’ while hiding behind a handle ‘XYZ.’ Having the courage to put a name to your convictions doesn’t make them any less right or wrong, evidently. One does have to live up to one’s errors, however.
Your problem with socialized medicine appears to be an overall objection to being ‘required’ to participate and a fear that services and quality would decline because of rationing. When we as a society decide that people who cannot afford health insurance and health care should not get it because they cannot afford it or they should get a different level of care, then we as a society are already rationing health care. HBM mentioned the decisions being made by insurance bureaucrats already. What about the rest of us? By denying the need to cover people who need it but can’t afford it, aren’t we practicing a form of economic Darwinism that is rationing’s equivalent?
The problem remains–what do you propose as a viable, credible program for people who cannot get health care and for those in the future who will find themselves in the same circumstance? Health savings accounts are not realistic for those living pay check to pay check.
A proposal, please…
Geez… I go away for a few days and come back to find this thread still going.
Don’t have much to add. The thread is getting pretty long now and frankly I don’t see much value in continuing this debate here. However, I’ll offer two small points…
First, way up thread, XYZ suggests that my ridiculing of the “coercive power of the state” meme means that I can now no longer “make any claims against the Patriot Act…”. That’s just so silly that I have to point it out.
XYZ, I’ll take the lead from your own condescending words and “will keep it simple for you”… Opposing the *abuse* of power is not the same as opposing the *use* of power. Some libertarians are fond of glomming onto a near-anarchistic attitude that demonizes everything the government does. That attitude obviously is what I was making light of, and is key to understanding why no amount of data that demonstrates otherwise will sway you from your core belief that all those *other* countries with publicly-funded health care are worse than our own.
My second point is actually in partial agreement with XYZ. There is indeed plenty of legitimate room for disagreement about the interpretation of the facts concerning international health outcomes. But, contrary to XYZ’s assertion, this uncertainty is actually an argument in *favor* of universal coverage. Paul Krugman probably described this best in a recent column:
> Not many serious advocates of reform use the life
> expectancy differences to argue that health care
> is clearly better in other advanced countries than
> it is in the United States; when it comes to care,
> the general assessment seems to be that itรข โขs comparable,
> with no advanced country having a clear advantage.
>
> The reform argument actually goes like this:
>
> 1. Every other advanced country has universal coverage,
> protecting its citizens from the financial risks of
> uninsurance as well as ensuring that everyone gets
> basic care.
>
> 2. They do this while spending far less on health
> care than we do.
>
> 3. Yet they donรข โขt seem to do worse in overall health
> results.
Thanx Ric–
Krugman is succinct and to the point.
http://mises.org/story/3539
Krugman’s Rearguard Apologists
Mises Daily by Lilburne | Posted on 7/7/2009 12:00:00 AM
As most readers will know, a collection of damning quotes has surfaced recently, exposing Paul Krugman, the doyen of the economic Left, as having been completely backward on the most material economic event in our generation: the housing bubble. My recent article on the subject, “Krugman’s Intellectual Waterloo,” has elicited some pretty heated rearguard apologetics, which, in the present article, I’d like to sum up and knock down.
The first quotes that surfaced are from a 2002 editorial by Krugman. This was followed by a cluster of even more damning 2001 quotes collected by Mark Thornton. The first editorial could be twisted, if one was inclined to twist, into something seemingly benign. The second wave of quotes is much harder to mischaracterize (which is not to say that the most unquestioning of Krugman’s devotees don’t try). The laziest tactic of the Krugman apologists is to only address the more stretchable 2002 editorial, and completely ignore the 2001 quotes. But not even that approach, if accepted, helps Krugman’s case, since the 2002 editorial is damning enough on its own, once the benign interpretations of Krugman’s apologists are shown to be nonsense.
One protestation offered has been that a quotation offered in my “Waterloo” piece omits the context, which shows that Krugman was “merely” quoting someone else:
To fight this recession the Fed needs รข ยฆ soaring household spending to offset moribund business investment. [So] Alan Greenspan needs to create a housing bubble to replace the Nasdaq bubble.
The last sentence quoted reads in full,
And to do that, as Paul McCulley of Pimco put it, Alan Greenspan needs to create a housing bubble to replace the Nasdaq bubble.
“Partisan misquoting!” the apologists cry. But lets pull the lens back even further, and add even more context by including the whole paragraph, and the one preceding it.
A few months ago the vast majority of business economists mocked concerns about a ”double dip,” a second leg to the downturn. But there were a few dogged iconoclasts out there, most notably Stephen Roach at Morgan Stanley. As I’ve repeatedly said in this column, the arguments of the double-dippers made a lot of sense. And their story now looks more plausible than ever.
The basic point is that the recession of 2001 wasn’t a typical postwar slump, brought on when an inflation-fighting Fed raises interest rates and easily ended by a snapback in housing and consumer spending when the Fed brings rates back down again. This was a prewar-style recession, a morning after brought on by irrational exuberance. To fight this recession the Fed needs more than a snapback; it needs soaring household spending to offset moribund business investment. And to do that, as Paul McCulley of Pimco put it, Alan Greenspan needs to create a housing bubble to replace the Nasdaq bubble. [Emphasis added.]
So the first paragraph introduces the “double-dipper iconoclasts”, and then clearly states that he, Krugman, agrees with them. The second paragraph then outlines the “basic point” of the double-dippers, which again, he agrees with. And the basic point in question is that to “fight this recession the Fed รข ยฆ needs soaring household spending.”
Krugman then continues to say how the Fed would need to accomplish this goal, which again, he supports; he says that the recession needs to be fought with soaring household spending, which Alan Greenspan needs to induce by creating a housing bubble to replace the Nasdaq bubble. By writing, “as Paul McCulley of Pimco put it”, Krugman is not “merely” quoting another person; he is using someone else’s phraseology to express his own opinion.
Another protestation is that Krugman was saying the housing bubble won’t work, since later in the editorial he wrote,
Judging by Mr. Greenspan’s remarkably cheerful recent testimony, he still thinks he can pull that off. But the Fed chairman’s crystal ball has been cloudy lately; remember how he urged Congress to cut taxes to head off the risk of excessive budget surpluses? And a sober look at recent data is not encouraging.
But this protestation completely ignores the fact that when Krugman wrote in the editorial,
Despite the bad news, most commentators, like Mr. Greenspan, remain optimistic.
and
But wishful thinking aside, I just don’t understand the grounds for optimism. Who, exactly, is about to start spending a lot more? [Emphasis added.]
he was clearly characterizing a housing bubble as an object of optimism, whether or not he thought it was possible. In other words, at best, Krugman could be interpreted as saying that it would be great if Greenspan could pull off a housing bubble, but that he, Krugman, doubts whether he’ll be able to accomplish such a worthy feat……………..
see
http://mises.org/story/3539
for remainder of article
Here is a different take, quoting the Lancet Study;
“In August 2008, the prestigious British medical journal Lancet Oncology published the results of an extraordinary study. The study found that America is much better at treating cancer than Europe or Canada.
As it turns out, Americans have a better survival rate for 13 of the 16 most common cancers. Among men, an American has nearly a 20-percent better chance of living for five years after being
diagnosed with cancer than his European counterpart.
American women stand a 7.2-percent better chance of living for five years after a cancer diagnosis than their European counterparts.
Perhaps thatรข โขs one reason why tens of thousands of foreigners come to the United States every year for medical treatment. Theyรข โขre usually seeking advanced and sophisticated procedures that are simply unavailableรข “or rationedรข “in their home countries.”
So the American model is, at the very least, better at treating 13 of the 16 most common forms of cancer. There is a greater expenditure per capita with the American model, but the results are clearly better.
So the claim that the European/Canadian model provides similar results for less cost and as such should be chosen, is false at least in this limited scope (16 forms of cancer).
The issue should be framed as, “the American model provides demonstrably better results, but at a cost. Is the cost worth the results?”
Krugman and his ilk don’t make this argument because they know it is an argument they will lose. We all know that we pay more today for insurance that will provide access to better treatments, that will yield better results, that we are unlikely to need in the short-term, but may need in the long-term. That is the essence of insurance, and shows that the insurance model is working as it should be expected to work.
As far as a proposal, I am a strong proponent of “health savings plans”, with provisions for major medical insurance. I also am a proponent of modifying our unemployment insurance system, to create an “insurance” extender system. In a “HSP” world that extender would be an acknowledgment that “employer provided compensation for health care expenditures” is part of the compensation package, and if we are to provide employer funded unemployment insurance benefits that this benefit be included as well.
The “HSP” model would immediately address a very large % of “40,000,000 uninsured problem”. The 40 million number is a a generally misstated number. That number is a count of all the people who spent 1 day in the past 12 months without health insurance. Every person who changes jobs is included in the figure. With HSP people who are unemployed would still have access to the same pool of $ to cover their health care needs, because it is their money, and they can use the funds held therein to pay for major medical insurance even while unemployed. They are providing their own “insurance” for day-to-day health costs, and the savings they create is theirs, and can be used to cover costs when expenses are greater.
The reality is that 10-15 million people are the crux of the issue. I do not want to minimize that 10-15 million people, they are real people, and that is a large number, but to radically change the health insurance of 290 million people to address these 10-15 million is in my opinion at least excessive.
I know Stephen, you don’t believe HSP are an alternative, you have already closed your mind off to the possibilities.
As far as Krugman in general nothing I nor anyone else may say about Krugman will change your opinions of him. You believe he is brilliant “because he validates your opinions”. In any case, for those interested in understanding more about Krugman I offer up the following.
Krugman’s Rearguard Apologists
http://blog.mises.org/archives/010238.asp
Krugman’s Intellectual Waterloo
http://mises.org/story/3530
“So the American model is, at the very least, better at treating 13 of the 16 most common forms of cancer. There is a greater expenditure per capita with the American model, but the results are clearly better.”
Ah, there’s the rub! We have great cancer treatment FOR THOSE WHO CAN AFFORD IT — hardly a surprise. You still have not told me whether the Lancet study controlled for income levels. I would like to see a study comparing survival rates in England, Canada and the US among cancer patients in the bottom income quintile in all three countries. I suspect the results would be rather dramatically different from the one you cite so proudly.
To return to my earlier metaphor, a Bentley is a wonderful car but damn few can afford one. Likewise it’s possible to get wonderful medical care in the US but damn few can afford it. I am not terribly impressed by the fact that British rock stars and Italian movie actors and Arab oil sheiks come to the US for advanced medical treatment. I am more impressed by the fact that thousands of Americans are dying needlessly every year because they don’t have the financial resources to diagnose and manage treatable disorders like diabetes and high blood pressure. This is not only a national disgrace but a horrific economic waste.
HBM,
You have proven my point.
“the American model provides demonstrably better results, but at a cost. Is the cost worth the results?”
Krugman and his ilk don’t make this argument because they know it is an argument they will lose.”
That is the subject you don’t want to address. I provide you with a fact, and you chose instead to not address the crux of the issue, and rather throw up all manner of unsupported statements, and claim that they are “the facts Jack”. You get facts that don’t comport with your dogma, so throw up red herrings, and then ignore the results. You talk about all the people who die from our expensive health care system, but you don’t offer up a scintilla of evidence to support your claim. I offer up the facts, and you don’t want to address the core issue. If you want lower cost health care, that is based upon a third party single payer, and the results will be poorer than we have today. Are you OK with that.
Point 2
“As far as Krugman in general, nothing I nor anyone else may say about Krugman will change your opinions of him. You believe he is brilliant “because he validates your opinions”.”
You validate this as well. All manner of facts are irrelevant to you, if they don’t validate your opinion.
If you want to question the Lancet study, look it up for yourself. Do the research. Do what you claim the non-progressives never do, get outside your comfort zone and educate yourself.
Wow. I guess lacking quality, XYZ can always fall back on quantity. Okay, I can play that game too (although I think I’ll keep the quality too).
I see three rants from XYZ since my last visit.
The first rant was an 800-word ad hominem attacking Krugman. Not a single word on health care. Geez, not only does this guy have a persecution complex but he apparently really really hates Krugman. XYZ, chill out and focus man. Or is this just your way of trying to derail the conversation. Sorry, not biting.
The third rant seems like more of the same. Seems like this guy hasn’t really read Krugman as he’s accusing Krugman of avoiding talking about issues he’s actually posted quite a lot on. Oh, and I see XYZ is challenging us to “look it up” and “educate yourself”. Snicker. Be careful what you wish for. Which brings us to…
[continued on next post… damn discussion board limits]
[continued from previous post]
The second rant was at least on topic. Desperately clinging to the CONCORD study (published in The Lancet Oncology, July 2008) and claiming that it shows that publicly-funded health care results in lower cancer survival. It doesn’t do that of course… unless you only listen to the second-hand spin instead of reading the report yourself. Funny that XYZ accuses us of not doing the research when a quick reading pretty much destroys his argument.
First, let’s get one thing out of the way. The number one statistics principle: Correlation is not causation (hey, I see XYZ even acknowledged this in an earlier post… hilarious). Even if it were shown that some health outcomes are better in this county than another, it does not immediately follow that this is caused by the way we *fund* our health care. There are plenty of other differences that could account for different cancer outcomes, not the least of which is the long-running huge *government-funded* effort in this country aimed at cancer research and development.
Let’s also not forget that about 46 percent of the medical tab is already publicly-funded in this country. Private health insurance only pays about 35 percent while most of the rest is out-of-pocket. Our health care is *already* nearly half “socialized”. So any international comparisons are still largely going to be between countries with different types of largely or mostly publicly-funded health care. Since no developed country, including our own, has a truly non-publically-funded system, comparing countrywide statistics is never going to give a true measure of health outcomes in a mythical free market.
[continued on next post]
[continued from previous post]
But for the sake of this discussion, let’s ignore the issues above. Let’s see how XYZ interprets the CONCORD study,
> As it turns out, Americans have a better survival rate for 13 of the 16
> most common cancers. Among men, an American has nearly a 20-percent better
> chance of living for five years after being diagnosed with cancer than his
> European counterpart.
Umm… no. That’s not what the study says. Only four forms of cancer were looked at: breast, colon, rectum, colorectum, and prostate. Even if you split up three of those categories into women and men subcategories, you still only get at most eight subcategories.
Guess what, USA is number one in survival in only *one* of these subcategories: Prostate. But USA is also number two in breast and colon (men). And number three in colorectum (women/men), colon (women), and rectum (women/men). So yes, USA still does pretty well in these raw rankings.
How do the others do? Well, just looking at the top three rankings:
– Cuba is number one in breast, colorectum (women), colon (women), and rectum (men); number two in colorectum (men) and rectum (women); and number three in colon (men).
– Japan is number one in colorectum (men) and colon (men); and number two in rectum (men)
– France is number two in colonrectum (women) and colon (women).
– Austria is number two in prostate.
– Canada is number three in breast and prostate.
But contrary to the talking points XYZ dutifully relays, it’s actually pretty hard to derive much definitive information from these raw rankings. One can look at these numbers and naively conclude that Cuba is better that the USA in all but two of the subcategories. But when you include the margin of error, most of the top three are neck-to-neck across all categories except for prostate where the USA shows a clear lead. (hmm… I wonder why the one subcategory where US clearly shows better outcomes is the one which mostly affects older men)
What about the claim that American men have a “20-percent better chance of living for five years … than his European counterpart?” Hmm, let’s see. There is a fairly large variance among European countries so it’s instructive to do this calculation with both the best performing country in each category and the average across all European males…
Prostate:
91.9 (USA) – 86.1 (Austria) = 5.8 %
91.9 (USA) – 57.1 (Europe total) = 34.8 %
Colorectum:
59.1 (USA) – 55.6 (France) = 3.5 %
59.1 (USA) – 45.3 (Europe total) = 13.8 %
Colon:
60.1 (USA) – 57.4 (France) = 2.7 %
60.1 (USA) – 46.8 (Europe total) = 13.3 %
Rectum:
56.9 (USA) – 55.0 (Netherlands) = 1.9 %
56.9 (USA) – 43.2 (Europe total) = 13.7 %
Nothing here corresponds with the 20% claim by XYZ so I’m guessing that XYZ’s original source did some funky pooling of the all-Europe total from all four of these categories. Talk about both cherry picking and massaging your numbers; That’s just dishonest as the all-Europe numbers include quite a few very poor eastern European nations which clearly have less access to the best diagnostic and treatment services. When we compare the US outcomes to the best European outcomes, the differences are much less. So much less that, again, the reported margin of error suggests there is not much measurable difference at all.
Let’s emphasize this… A careful reading of the CONCORD study shows us that, except for prostate cancer, there doesn’t appear to be a significant difference in cancer survival outcomes between Americans and Western Europeans.
It’s noteworthy that this study also showed very large differences in USA outcomes when split up by state, race, and income, while countries like Canada showed very little differences across provinces, race, or income. The numbers clearly show that your survival rate in the US was strongly correlated with which state you lived in, what race you were, and how much income you made. [1]
It’s also noteworthy that this study and several other studies and related discussions caution against interpreting too much from these statistics at this stage [2]. More studies have been proposed which some hope will help to illuminate this area a bit more.
[1] Here’s another example study that shows a similar difference between US and Canada. There are more.
“An International Comparison of Breast Cancer Survival: Winnipeg, Manitoba and Des Moines, Iowa, Metropolitan Areas”
Annals of Epidemiology, Volume 13, Issue 1, January 2003, Pages 32-41
[2] Much of the European data came from earlier studies; the EUROCARE studies, also published in Lancet Oncology. Here’s an interesting discussion on some issues with those numbers.
“Cancer survival statistics should be viewed with caution”
The Lancet Oncology, Volume 8, Issue 12, December 2007, Pages 1050-1054
Geez, this thread is getting insanely long, isn’t it. Okay, just one more post and I’ll try to leave it at that.
XYZ wrote,
> Perhaps thatรข โขs one reason why tens of thousands of foreigners
> come to the United States every year for medical treatment.
> Theyรข โขre usually seeking advanced and sophisticated procedures
> that are simply unavailableรข “or rationedรข “in their home countries.
This is a fallacy.
From “content.healthaffairs.org/cgi/content/full/21/3/19”,
> The numbers of true medical refugeesรข “Canadians coming south
> with their own money to purchase U.S. health careรข “appear
> to be handfuls rather than hordes.
At the same time, “nearly a million Californians cross the border each year to seek medical care in Mexico, according a paper by UCLA researchers and colleagues published in the journal Medical Care”
* http://www.eurekalert.org/pub_releases/2009-05/uoc–n1m052609.php
And on the northern border, Health Card fraud, mostly by Americans trying to access the system with fake cards, has been a problem for years in Ontario and other Canadian provinces.
* http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1337725&blobtype=pdf
* toronto.ctv.ca/servlet/an/plocal/CTVNews/20070707/health_card_fraud_070707/