TCS Daily


Socialized Medicine Is Already Here

By Michael Cannon - September 6, 2007 12:00 AM

Congressional Democrats are trying to expand government health insurance to children who don't need public assistance, while their party's presidential hopefuls are concocting even grander schemes to achieve "universal coverage."

"That's socialized medicine!" cry the Republicans. President Bush asks whether we want a government-run health care system or a private system. Republican presidential hopeful Rudy Giuliani accuses Democrats for lusting after the socialized systems of Europe, Canada, and Cuba. In a recent television appearance, Sen. Hillary Clinton (D-N.Y.) emphatically denied the suggestion that she supports socialized medicine.

Was Clinton being disingenuous, or are Democrats really trying to foist socialized medicine on the American people?

The question seems silly once you consider how socialized our health care system already is. Government already finances about half of Americans' medical care, so you might say our system is already half-socialized. Yet we are much farther along the road to socialized medicine than even that would suggest.

Consider two distinguishing features of socialist economies. The first is that the government decides what individuals may produce, what they consume, and the terms of exchange.

That is largely true of America's health care system. Government controls production and consumption by determining the number of physicians; what services medical professionals can offer and under what terms; where they can practice; who can open a hospital or purchase a new MRI; who can market a drug or medical device; and what kind of health insurance consumers may purchase.

Government bureaucrats even set the prices for half of our health care sector directly, and indirectly set prices for the other half. When you read about Medicare over-paying imaging centers and hospitals, or that it's impossible for Bostonians to get an appointment with a general practitioner, it's largely because the bureaucrats got the prices wrong, and those rigid prices do not automatically eliminate shortages and gluts like flexible market prices do.

A second feature of socialist economies is that there is little incentive to make careful economic decisions, because government has put everyone in the position of spending other people's money.

Canada may have the most heavily socialized health care system in the advanced world. Yet America's system is as much a tragedy of the commons as the Canadian system, where health care is ostensibly "free." In each country, only about 14 cents out of every dollar of medical spending comes directly from the patient.

How can America's health care system be "socialized" when we rely on the private sector more than any advanced nation? Because it doesn't matter whether the dollars and the hospitals are owned publicly or privately. What matters is who controls how they are used.

In 2007, the average family of four will pay $25,000 for health insurance - nearly 30 percent of their income. About $14,000 represents taxes that fund health programs for the elderly and the poor. In other words, the government controls the lion's share.

The remaining $11,000 purchases the family's own coverage, usually through an employer. Though we count that as "private" spending, the government largely controls that $11,000 as well.

Congress provides a substantial tax break for employer-controlled health insurance. That sounds nice, but it means that workers who want to control their coverage themselves face a tax penalty. That penalty often forces such workers to pay twice as much for less coverage. That benign-sounding "tax break" effectively requires Americans to let someone else control a large chunk of their incomes and their health care decisions.

We may call that "private" spending. But notice the hallmarks: government denies individuals control over their economic decisions, and encourages them to act as if they were spending someone else's money - in this case, their employer's.

How can our system be "socialized" if we don't force patients to wait for care, as other nations do? America does ration by waiting - just ask any Medicaid patient - though we do so less often than nations where governments arbitrarily limit medical spending.

But that's because we commit the opposite sin: our government encourages unlimited health care spending, which causes enormous waste.

For example, the federal Medicare program essentially makes an open-ended commitment to pay for whatever medical care seniors and their doctors demand. That may be why researchers at Dartmouth Medical School have estimated that Medicare purchases $60 billion in useless services every year. That's nearly one-fifth of all Medicare spending. It also may explain why we spend 50 percent more on medical care than other advanced nations without making ourselves noticeably healthier.

Surely, America doesn't have socialized medicine of the Canadian or British variety, or socialized medicine borne of some deliberate plan. But American politicians should stop pretending that socialized medicine is some far-off dystopia.

To paraphrase Keyser Söze, the greatest trick that advocates of socialized medicine ever played was to convince the American people that we don't already have it.

Michael F. Cannon is director of health policy studies at the Cato Institute (www.cato.org) and coauthor of the forthcoming 2nd edition of Healthy Competition: What's Holding Back Health Care and How to Free It.

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143 Comments

Amen!
This is the message I often try to convey to several of the less informed members of this forum: fixing the problems that trouble the American healthcare system (the best, most innovative healthcare in the world BTW) requires LESS government interference not more.

Gesundheit!
so if there were less interference by government insurance companies would be happy to write policies on families with children with pre-existing conditions? Can you explain this?

Help us out here....
This was intriguing:

>. That's nearly one-fifth of all Medicare spending. It also may explain why we spend 50 percent more on medical care than other advanced nations without making ourselves noticeably healthier.

But wait - all these other countries have much more government involvement in medical care than the US. Why are they paying so much less, and getting not just equal but (judged by standard measures) superior results. And much better preventive care. Please explain.

My ignorance: Does the govt really control where doctors can practice?
Could use some help on the following questions.

Does the govt really set an explicit figure on the number of doctors? Do they set a specific number by speciality?

If a doctor practicing in Los Angeles moves to Sacramento (all in CA), does that doctor need to get a written authorization to continue being a doctor?

Is there an explicit limit on the number of MRI machines that can be sold each year, or just a limit on what type of entity can buy one?

Lem an interesting case
"Why are they paying so much less, and getting not just equal but (judged by standard measures) superior results. "

In France and Italy they make less than us do they 50 percent less by GDP is really about %66 less. They really spend about 1/3rd as much on medical care. And what do we get for spending so much more on medical care? We get slightly better infant mortality and about 1 year more of life expectancy.

Many advocates like to say that we get higher infant mortality and lower life expectancy I will explain why I disagree: To compare infant mortality over countries you must add still births to infant mortality in both countries and then adjust for the amount of fertility treatments and then adjust of race. The adjustment for race is sometimes protested against by advocate of socialized medicine on the grounds that blacks in America have higher infant mortality because they are poor and in socialized system this would not matter but in fact Hispanics have lower infant mortality than non-Hispanic whites and blocks not only have higher rates if multiple births than white do. So it seems that poverty and lack of access to health care are not causal. Also look that infant mortality for Maoris in new Zealand and aborigines in Australia (both countries have socialized medicine. Same with life expectancy adjust for accidental death (people in the USA drive more) and whites live longer in the USA than elsewhere Asians live longer in the USA than in Asia and blacks live longer in America than elsewhere.

See the “Eight Americas” study http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0030260

Also see http://news.scotsman.com/index.cfm?id=11972006 Italy does better than GB on life expectancy because Italians are lass likely to be alcoholics.

Also see the RAND's Health Insurance Experiment http://www.rand.org/health/projects/hie/
The RAND's Health Insurance Experiment shows that medical care above and beyond vaccinations and antibiotics has such a small effect of health that it gets lost in bigger effects like accidents, over weight, the amount of exercise people get, smoking and drinking etc in life expectancy.

Michael Moore likes to pretend that insurance companies like to hold back medical care but in fact compared to the countries with socialized medicine they are way to generous. Private companies have a much harder time saying no to their customers than governments do. Michael Moore likes to argue that people in America are dieing from a lack of healthcare but the opposite is true.
Is this a good deal for us? I do not know.
There is a case that can be made for socialized medicine but it is the case that we spend too much, that the extra year of life is not a good year and that we would better off having more money and less healthcare like the French and Italians have. I personally think that deregulation would be a better first shot a reducing spending but again a case can be made see(http://www.econtalk.org/archives/2007/05/hanson_on_healt.html).

Does the govt really set an explicit figure on the number of doctors?
"Does the govt really set an explicit figure on the number of doctors? Do they set a specific number by speciality?"

No but they with the AMA through licensing keep the numbers down. They also have and effect through the licensing and funding of medical schools.

"If a doctor practicing in Los Angeles moves to Sacramento (all in CA), does that doctor need to get a written authorization to continue being a doctor?"

No but if they cross state lines they must be licensed in the new state.

Here's a kleenex
Yes. They would.

Why would you think they wouldn't? With less government interference, federal and state, single payors and employers could form and join groups to have far more purchasing power. If the person is employed, as it happens today, their employer would not allow the insurance provider to exclude a family due to a pre-existing condition. If people were allowed to form such groups or unions they would do likewise.

You have so very little knowledge, not surprising of course, of the amount of overhead generated by government regulation and oversight. I am not advocating the complete withdrawal of governmental oversight of the medical establishment just a pull back to allow the markets to adjust and evolve and innovate.

Help? You are quite beyond it.
Where are they getting superior results? Where is there better preventive care?

Please cite these "standard measures" we are judged by. Considering what you have sourced on the subject in the past you possess nothing but subjective blather put out by socialized medicine advocates.

Nice job Flo
Good dose of reality but don't expect this patient to have a positive outcome from your treatment.

Non-response
What "government interference" stands in the way of organizations or others forming such groups now? And how would lower income families be able to afford it, when they can't afford it now.

>You have so very little knowledge, not surprising of course, of the amount of overhead generated by government regulation and oversight.

Why not show how much more you know by offering specifics?

So if you wiggle the numbers the U.S. numbers don't look as bad
But no matter how much you wiggle you still have us spending twice as much money for the same or perhaps (if you dont worry about black people's health numbers) better performance.

As for this:

>Michael Moore likes to pretend that insurance companies like to hold back medical care but in fact compared to the countries with socialized medicine they are way to generous. Private companies have a much harder time saying no to their customers than governments do. Michael Moore likes to argue that people in America are dieing from a lack of healthcare but the opposite is true.

You offer no support, none for this assertion. Where does it come from?

I see you are unable to speak to the issue and are reduced to namecalling
I've discussed the statistics in the response to Floccina's attempt to dismiss the differences. Thank you for sharing.

And speaking of the 'Eight Americas" study....
Here's the conclusion: is this really a vote of confidence in what a bang-up job the American health care system is doing?

Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.

I see...
that your understanding of economics is as limited as your understanding of the healthcare industry. I also noticed you offer up nothing of your own to counter my arguments. It is often the case when one answers questions with questions that they possess no answers of their own. Which is consistent with your stance of never offering any solution of your own. How very Democratic of you.

Please look into how a market is affected when large groups of consumers band together to demand lower prices. In the insurance industry today a large employer gets better rates. Is it possible for you to understand this concept?

The lower income families would be able to afford it by purchasing lower cost healthcare plans which will provide the services THEY wish to pay for, not what the federal or state government says insurance providers HAVE to provide.

Can you understand that concept?

Less government interference would lower the costs of healthcare as would people having more ability to choose the products and services they wish to purchase.

Do you believe that the lowering of the cost of healthcare might possibly benefit your hypothetical lower income children with hideous diseases?

>"Why not show how much more you know by offering specifics?"

Becasue you have shown a complete lack of any ability to respond intelligently to them. Simply put, you start by knowing nothing of the subject and proceed to discount any specific subject matter I present.

Perhaps I could engage someone with a more reality based view of how things work but I am stuck with you.

Answer this one: how great is this problem, the dead horse you continue to beat?

Let us consider the breakdown of those 45 million uninsured:

- 37% of that group live in households making more than $50,000 a year says the U.S. Census Bureau. Last I checked that was above the poverty line.

- 19% are in households making more than $75,000 a year. We are now over half of the 45 million who are not poor at all.

- 20% are not citizens. They do not deserve access to our healthcare system for free.

- 33% are eligible for existing government programs but are not enrolled. This is a personal responsibility issue as I have demonstrated with your own sources.

So your basic premise that this is a major problem if false.

For all its problems, the U.S. ranks at the top for quality of care and innovation, including development of life-saving drugs. It is only substandard by your sources when the criterion is proximity to socialized medicine.

So where...
do you believe the original numbers come from? It is amazing that you can scream "wiggle" when the original target of those numbers have been wiggled half to death to make them fit the pre-determined outcome they wanted.

And then throw in a little accusation of racism:

>"if you dont worry about black people's health numbers"

and your desperation and ignorance becomes quite evident.

Sit down and be quiet. Adults are trying to speak.

Lem but I do worry about black people's health.
Lem You wrote:"But no matter how much you wiggle you still have us spending twice as much money for the same or perhaps (if you dont worry about black people's health numbers) better performance. "

Blacks live longer in the USA than elsewhere!

Would you saying that Japan's healthcare is so much better than Sweden’s and Frances because the life expectancy in Japan is so much higher? If not does this say that you do not worry about Caucasian people's health numbers?

Lem wrote:
“>Michael Moore likes to pretend that insurance companies like to hold back medical care but in fact compared to the countries with socialized medicine they are way to generous. Private companies have a much harder time saying no to their customers than governments do. Michael Moore likes to argue that people in America are dieing from a lack of healthcare but the opposite is true.

You offer no support, none for this assertion. Where does it come from?”

I did but perhaps I was too subtle. You need to integrate and think about the following ideas:

1. The Rand health insurance experiment that I linked showed no benefit for at least the last 30% of healthcare spending. Showing that the insurance companies allow too much spending.
2. The fact that aggregate healthcare spending in the USA is so much higher than in France and yet outcomes are not very different implies that the insurance companies ok too much care.
3. The Eight Americas study that that I linked show that widely differing health outcomes is not due to a lack of access. In fact it showed that poor northern rural whites live longer than urban dwellers who generally have more access.

Put it together and it looks like the insurance companies are paying for lots of care that give no benefit.

I hope I am not being too subtle again but look up evidence based medicine and how people react to it. The whole idea that medicine would be based on anything other than evidence at first absurd and unlikely but there is a reason why evidence based medicine is a new idea and an idea that there is resistance to. Before you jump to too quick a conclusion on this consider the history of medicine coming from 100 years ago when going to a doctor was about the worst thing that you could do for your health. Think about blood letting, leaches, incantations and poisons as medicine.

Floccina didn't attempt...
she/he DID dimiss the differences. You countered with nothing

You don't play victim very well nor did you offer any kind of discussion on statistics. Please source it if it occurred.

If true
"No but they with the AMA through licensing keep the numbers down. They also have and effect through the licensing and funding of medical schools."

then this is worse than government intervention. It implies that the AMA is functioning as a mediaeval guild to restrict labor supply and drive up costs and practitioner earnings. So, does this constitute a monopoly pricing structure?

partly addressed through public health strategies that reduce risk factors for chronic diseases and
"partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries."

Do you see what they are saying...

and BTW tell me do Native Americans in Canada and Aborigines in Australia and Mioris or poor people in Scotland do as well as these underprivileged groups in the USA?

Here is a hint, in part of Scottland males have life expectancy of 54 years....It is becuase they drink an afful lot.

"partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries."

It is about public health strategies that would discourge Speeding, homicide, smoking drinking and encourgae exersise! Not about radiation treatement for cancer.

Except you're not speaking to the problems.
I mean, you say:

>The lower income families would be able to afford it by purchasing lower cost healthcare plans which will provide the services THEY wish to pay for, not what the federal or state government says insurance providers HAVE to provide.

Ok, so they get cheap insurance and then their kids need more care than the cheap insurance provides. What happens then? Or the cheap insurance denies their claim because of whatever bogus reason.

We're not going to let them die. So they wind up being treated and we all wind up paying for it.

>Less government interference would lower the costs of healthcare as would people having more ability to choose the products and services they wish to purchase.

Right now many people can't purchase health care at any price because of pre-existing conditions. How woud less government regulation make insurance more rather than less available to them?

Ok, regarding the medically uninsured. You bring up a set of statistcs about the uninsured, leading to this conclusion:

"So your basic premise that this is a major problem if false."

You may think it's false. Many others disagree - here are the results of a recent poll:
http://cthealth.server101.com/poll_uninsured_critical_problem.htm
so your idea is all these people are just mistaken.

Maybe it's because of stories like this:
http://dynamic.wjla.com/printarticle.hrb?s=wjla&i=402157
why not call the parents names & say this doesn't show that there's a problem?


Again: nothing to offer on topic
But thanks for sharing.

That still doesn't compute
"Blacks live longer in the USA than elsewhere!"

Here's an interesting statistic:
Immigrants to the United States may not necessarily find a better life than the one they left behind, but they are likely to enjoy a longer one—longer even than native-born Americans, according to research published recently in the Canadian Journal of Public Health. Male and female immigrants to the United States live 3.4 and 2.5 years longer, respectively, than their U.S.-born counterparts, and that gap widens dramatically in the black and Hispanic populations. Whereas U.S.-born black men have a life expectancy of 64, their immigrant counterparts live to an average age of 73; and whereas U.S.-born Hispanic men live to 73, on average, their immigrant counterparts have a life expectancy of around 77.

>1. The Rand health insurance experiment that I linked showed no benefit for at least the last 30% of healthcare spending. Showing that the insurance companies allow too much spending.
How about for people without insurance?

2. The fact that aggregate healthcare spending in the USA is so much higher than in France and yet outcomes are not very different implies that the insurance companies ok too much care.
Again, how about for people without insurance?

3. The Eight Americas study that that I linked show that widely differing health outcomes is not due to a lack of access. In fact it showed that poor northern rural whites live longer than urban dwellers who generally have more access.

It shows drastic problems not only with health care but with a host of other systems. For you to take it as an endorsement of the current system is preposterous.

What part of the phrase "dispariites ...are enormous by all international standards" don't you under
I mean, sure, the problems can be "partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries." But from the argument and statistics in the story, that's only a small beginning.

>It is about public health strategies that would discourge Speeding, homicide, smoking drinking and encourgae exersise!
And nobody is arguing against these in any country anywhere. But to say that this is all that can or should be done is ridiculous.

That's only true if you ignore the data
you've been corrected on this very point dozens of times.
No doubt you have to be corrected on it hundreds of times in the future.

As always, you believe what you want to believe, data be damned.

A complete lack of any ability to respond intelligently.
(Spoken to Lemming Mule): "You start by knowing nothing of the subject and proceed to discount any specific subject matter I present."

Don't feel insulted, Tlaloc. He does that to everyone. I once countered a stupid anti-capitalist argument of his by citing the real story of a real company which has a real website, and instead of doing any research (or, apparently, even going to the website), he told me that he'd never heard of the company in question, even though said company appears in Forbes magazine on at least an annual basis.

Such are the tactics of the weak and the cowardly.

"Perhaps I was too subtle."
Youth is wasted on the young, and subtlety is wasted on Lemming Mule.

Speaking of weak and cowardly - where's the backup from this anecdote
What real company? What was my mistake? What was your argument? By all means, show us all how dumb I was.

Complete inability to do anything but namecall demonstrated again.
You really have nothing at all to contribute but these lame one-liners.

Ah yes, the old wildcard retort
allegation that I said something proven wrong at sometime in the past.
what I said - missing
what was wrong with what I said - missing
By all means supply the variables. Alternative, please find something else to do with your piehole.

Sure, you can find American subgroups that have better numbers than French overall
That proves exactly zip. And it proves even less when the devastating conclusion of the study is presented: the US has gigantic inequalities in health by population If you think this indicates that the American health care system is a huge success, let me forward some email from the Ivory Coast that will make you a heap of money.

Sure, you can find American subgroups that have better numbers than French overall
That proves exactly zip. And it proves even less when the devastating conclusion of the study is presented: the US has gigantic inequalities in health by population If you think this indicates that the American health care system is a huge success, let me forward some email from the Ivory Coast that will make you a heap of money.

Monopoly Pricing Structure
Yes, it's one of the main reasons the market is unable to lower costs. We are caught in a vise, on the one side the drive for greater and greater profits, on the other a guild structure which limits competition. The only real solution is to get rid of organizations like the AMA, and allow the market to function freely, or step in and restore some sort of sanity to the industry… why do I have to pay 5K a day for a semi-private hospital room? It’s because hospitals exist to make money, and competition is carefully managed.

Get a life
Cheap insurance means higher deductables, not less care.

You seem to have a problem with people having to be responsible for themselves. Life is hard work.

I agree about the pre-exisitng condition issue. However, how come emplyees are not held to this standard as are individuals? Insurance companies do not want to fool with individuals and thus they don't want your business. Well the hell with that.

The solution is that we all belong to a group and end employer based insurance and make it all private purchased with employer funds as a benfit.
The current system gets to be more of a joke daily. However, look how England is now telling people how to live or lose coverage.

Are you so eager for a nanny state you will give up all your freedoms?

I am one of the pre-exisitng crowd and I am not going to call for state health care. Are you?

why not call it 'socialist lite'
This would sound more trendy and up to date. Also, those who are supporting socialist-classic do mention about how the nanny state doesn't allow you to get health insurance from out of state companies. How do they justify that stupid policy again? Here's also another article about how crappy the canadian system is: http://www.city-journal.org/html/17_3_canadian_healthcare.html
Their system used to be called 'pure Stalinist', but even their own supreme court said it should tone down to socialist-like too.

Yes, they would
They would cover those kids with pre-existing conditions because a significant number of people would be covered by their church who would take the financial hit as a matter of social justice. The Catholics would do it. How about your religious denomination? How about the Shriners? Would they not cover children with pre-existing conditions?

Allowing groups to enroll across state lines and to free them from costly coverage mandates would improve coverage.

Get an argument
I have no problem with people being responsible for themselves, and their children. The problem in this particular case is, when they aren't, we all have to pick up the pieces.

>Cheap insurance means higher deductables, not less care
The problem with this is, it means people are faced with high out-of-pocket costs for preventive care. So they don't get it. So small problems becomes big ones. Then we all pay much more than we would if they had attended to it in in timely fashion.

If we're not going to take the attitude of, if they can't pay, let 'em die, we can either live in denial, or arrange a health care system that speaks to the realities of who people are and how they live, and to the fact that lots of people don't have money.

>The solution is that we all belong to a group and end employer based insurance and make it all private purchased with employer funds as a benfit.
Except who's going to enforce us all being able to be part of a group? And what do we do about people between jobs?

>The current system gets to be more of a joke daily. However, look how England is now telling people how to live or lose coverage.

England's only one model. There are dozens more, most of them much better. Check it out.

No system is perfect
Government systems today mean that people die. Private systems will have people die. There is no perfect system. What free market advocates are looking for is a system where fewer people get caught up in the gears and destroyed and where an individual can, through personal effort, reduce his chances of disaster even further than the average.

I can't see why this is such a controversial attitude but for socialists it is.

Pay attention to the details
Our infant mortality stats are horrible because if a young tyke leaves the womb, draws two breaths, and dies, we count that as part of infant mortality. Some countries count a baby who dies 23 hours post partum as a "still birth" and nobody runs their numbers like we do. Other countries routinely deny care to the elderly or slow them down in lines until they die while we pour huge funds into extending 90 year olds with terminal diseases an extra 3 months.

Recategorize deaths and deny care at EU levels and our stats will suddenly look much better and our expenses will go down too.

Now part of our problem is behavioral. We don't get as much exercise as we should and we indulge in vices of the rich. But that's largely because we *are* rich, even compared to the core EU states. Part of our problem is also policy. We allow many immigrants with poor healthcare histories to enter the country and that stresses the system too. Part of the policy problem is defensive medicine, which adds hundreds of dollars to the per capita medical bills in the US.

There are real problems in US health care. They are not as bad as most socialists think and many of them would be improved by less government interference.

Oh
So I refuse to be responsible for myself so your going to force the rest of to make me or fund it?

How does that make me more free?

You can lead a horse to water but can you force them to drink?

You don't get it
It's not about you. It's about the rest of us.

In the current system, we have to pay for you even if you do the wrong thing, and then it costs us much more.

We just set it up so we pay to do the right thing for you even if you don't take the steps. It works out cheapter.

>You can lead a horse to water but can you force them to drink?

Drink, no. But you can give them some shots.

Why not address the costs of HEALTH CARE, not INSURANCE?
The costs of lasik surgery have fallen dramatically and the quality of the service has increased dramatically. Most insurance companies do not cover this procedure.

Do you think that if hospitals and clinics had to compete for patients like lasik surgeons, the costs of ALL medical procedures would drop?

Do you have investments in health insurance companies? Is that why you are more worried about insurance instead of the actual costs of care?

Who expects perfect??
The system we now have is insanely expensive, and still leaves millions and millions out in the cold. If you drop the scare word "socialism" and just look at results and human consequences, the systems in effect in just about all industrialized countries other than the U.S. work better. Because this is true, the only argument people like the author of this essay have left is to yell "socialist! socialist!" And that's really not much of an argument at all.

I guess you've never heard stories like these
" am a self-employed male that was foolish enough to use A B C B S as my health insurance provider. I was paying about $90 a month for catastrophic coverage. I think health ins. is BS, but after fracturing my clavicle and being treated like a pariah at the hospital (I'm assuming they thought since I didn't have ins., that I couldn't pay), I figured I better get it so that doctors would treat me like a human being. I gave B C my hard-earned money for over two years w/o incident (of course I never filed a claim either) when, all of a sudden, they cancelled my policy for no apparent reason. I'm a healthy guy. Don't have any health problems or history of them so this surprised me. After contacting the company numerous times without ever finding out exactly why they were cancelling my policy, I contacted the state health ins. division. It turns out that
B C invented a child for me. Apparently after I (a male) had given birth to this child, I had neglected to pay for: 1. co-payment of charges for said miracle birth and 2. increased coverage rate due to the addition of my new baby. The state ins. division allowed B C to get away with this preposterous means of taking my money and running and did absolutely nothing to punish B C or prevent them from doing the same sort of thing to someone who is far less fortunate than I.
The lesson I learned from all this is that health insurance is wothless and a waste of money if you have to pay for it yourself. If you get sick or injured, go to the emergency room and lie about your identity because the doctors don't care about your health either. The health "care" industry is America is just that- an industry. And like all other industries, they care about one thing above all else:"

all one has to do is read every report on healthcare on this site
the archives are there, and easily accessible.

How about for people without insurance?
RAND Health Insurance experiment. In late 1970s, U.S. Government created a randomized experiment. Previously people had looked at correlations with health--exercise, sleep, wealth, diet, pollution--but you don't see a correlation with medicine! Puzzle. True in both developed and undeveloped countries. Can be criticized for not controlling for enough things. RAND experiment was to test overall. 7000 random people in many cities, let half the people get free medicine and half had to pay full price. Those who had to pay didn't take as much--so far as expected, demand curves slope down. Health care demand is relatively inelastic--that is, relatively unresponsive to price. Dropping full price to 0 resulted in a 40% increase in quantity. Did the people who got more medicine get any healthier? You'd think it would make a difference. But maybe people who got it free mostly just used that free aspect for trivial things like the sniffles or a twisted ankle. Turned out that comparing the extra care people got when it was free to the care bought at full price, doctor evaluations were the same. Looked afterwards at the case and evaluated appropriateness (failed 1/4 of the time), severity of diagnosis--same percentages in both halves of the population. That is, both groups went in for medical care for the same mix of things, same severity levels, and got the same care. Bottom line: quality of health care wasn't any different by any standard. One qualifier was eye glasses. People in the "free" group got free dental and eye care as well. Those who got free glasses could see better--no surprise. If you count that as medicine, then more medicine is correlated with improved health. But if you take glasses out of the sample, there was no effect. How did they measure effect? Previous studies looked at death rates. RAND study looked at 25 measures such as blood pressure, other overall measures. Treated children and the elderly separately. No tangible measure of health showed that amount of medical care had any impact. Inconsistent with previous correlation experiments that had apparently shown that countries or states that spent more on health care had healthier citizens.

Lem from the Eight Americas study
Lem from the Eight Americas study:

“The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15–44 y) and middle-aged (45–59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations.”

Now keep in mind correlation is not causation bad health can keep ones earnings down. Maybe short term thinking not wanting to delay gratification causes both poverty and bad health. An interesting area of study would be do black professional athletes, who can afford the best in healthcare and have very high social status have high life expectancy.

Look at this:

“Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations.”

So Lem now tell what is your plan to improve life expectancy of blacks and Native Americans in the USA and Canada, blacks in Great Britain, poor people in Scotland, Moiri in New Zealand, Aborigines in Australia, and Caucasians relative to Asians in the industrialized countries? Since you seem to believe that these are problems related to systems that can be improved.

BTW I actual gave a reason why we might consider socialization of medicine, that is to spend less on healthcare which in seems will have a very small impact on health. Here is another possible reason but one that I have not researched sufficiently that is to prevent the financial stress that could be caused by a really big hospital bill.

BTW here is the link on that

http://www.econtalk.org/archives/2007/05/hanson_on_healt.html

BTW as for me I think that marginal healthcare helps but by such a small amount that it is hard to find it. Unlike Robin Hanson who seems to think that it does not benefit at all.

Here's the problem
Namely that professional standards have to be maintained. Otherwise, we would have homeopaths and osteopaths wandering around claiming to be doctors without any standard of performance, training or accountability. It's the principal reason why simply reverting to an unregulated market structure won't work. Lamentably I have no solutions to suggest.

Sure I am
You are just incapable of understanding the real issues.

>"Ok, so they get cheap insurance and then their kids need more care than the cheap insurance provides. What happens then? Or the cheap insurance denies their claim because of whatever bogus reason. We're not going to let them die. So they wind up being treated and we all wind up paying for it."

Whereas in your socialized medical scheme we don't? If you advocate socialized medicine, which you do, you lose the right to complain about paying for everyone's healthcare. End of story.

Or perhaps you are like Edwards and will force people to into doctor's offices to determine their physical and mental well-being?

Take the word "cheap" and change it to "inexpensive" which is what it would be if medical costs come down due to a withdrawal of governmental interference in the healthcare system.

>"You may think it's false."

No. I proved it false with Census data. You don't counter this at all.

Your first source is an opinion poll. This is not a poll of people who have problems accessing healthcare, it is a poll of people's PERCEPTION of a problem. Two very different things.

So yes, all of those people are wrong or at least uninformed.

Your other source is stupid in the extreme and merely plays to emotion, not reality. Was the child properly diagnosed? Was he enrolled in governmental healthcare programs that so many neglect to enroll in? What is the parental situation? Was the doctor incompetent? Treatment should not be dictated by insured or uninsured.

I hate to break this to you but healthcare is staffed by human beings who can make mistakes. I should know since one of my duties is isolating those doctors who make too many of them.

When you lack facts, go with the anecdotal. Always a good strategy when all else fails. I am sure you will state that I wish children to die.

Children dying is a tragedy but you cannot lay the blame for an infected abscess going to the brain on being uninsured. Even well insured people die from minor ailments that get infected. Inadvertant infections are a leading cause of deaths in healthcare.

But hey, how about countering my facts with facts of your own? Or just stick with the idiotic demonization tactics. Could I be racist next? That is always one of your favorites. But perhaps I am thinking of your other personality, Beatles1.

You do
>"The system we now have is insanely expensive, and still leaves millions and millions out in the cold. "

Instead you want an insanely expensive government solution that will provide a majority of Americans with substandard healthcare.

>"If you drop the scare word "socialism" and just look at results and human consequences, the systems in effect in just about all industrialized countries other than the U.S. work better."

How do they work better? Your opinion needs to be based in fact. Please provide some.

As for calling is socialism, what euphemism is currently popular with the socialized medicine advocates? We can call it whatever you wish but it doesn't mean that it isn't socialized medicine.

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