Universal Health Coverage

[Haggis@wk]

To expand on Shapley’s comments I see that Frontpagemag.com has reissued the 1993 Ayn Rand Institute speech on HillaryCare.

Health Insurance is Not a “Right”

Just one of the quotable quotes:

…

As with any good or service that is provided by some specific group of men, if you try to make its possession by all a right, you thereby enslave the providers of the service, wreck the service, and end up depriving the very consumers you are supposed to be helping. To call “medical care” a right will merely enslave the doctors and thus destroy the quality of medical care in this country, as socialized medicine has done around the world, wherever it has been tried, including Canada (I was born in Canada and I know a bit about that system first hand).

This speech is aimed more at the immorality of making UHC a “right” and not the impracticalities (though those are legend) and echo Shapley’s and my thoughts.

When it comes to the impracticalities then I think the divisions between supporters and opponents rest on two questions, one of which I’ve never heard asked.

“Does UHC work?” Yes

and

“Will it work forever?” No

Most of us will live to see the end of socialized medicine in most European countries; it’s already started in France with the increase in privatized insurance and cutbacks in Germany have been coming for a long time.

And since the demographics clearly show that the number of potential payers into the UHC accounts is declining the only way to continue the service is greater taxes or elimination of services.

All European countries have medical debts measuring in the Billions of Euros that haven’t been paid. Its all well and good to point to how little GDP is spent on UHC when the unpaid medical debts are measured off the books and not included in GDP.

UHC in Europe is a government ponzi scheme and the demographics will force it to go the way of all cons.

[Selma in Sandy Eggo]

Remember when you took $5 and a signed note to school and a nurse gave vaccinations on "shot day"?

Not only do I remember "shot day", I remember the PTA-sponsored "shot night"s. Parents and preschoolers encouraged to attend, babysitting will be provided (for babysitter, read "Selma and Her Classmates"). I was at them all. Mother volunteered, wore her nurse-lady costume, put on her hat and her pin, and shot people until all the vials ran dry.

Interestingly, the biggest users of hospital emergency rooms are not the poor and indigent. They are the middle class. Those of us who wont take time off work to see the Dr or take our kids in.

Hmmm. I'm sort of that way - when I was choosing my primary care provider, I hunted for a clinic that had good family practice, good pediatricians, and a walk-in urgent care clinic. It's in the basement, between the vampire and the records room, and runs until 9 at night (open weekends and holidays). In my experience, kids seldom get sick when it's convenient for the parents.

[Shapley]

In response to the use (or abuse) of emergency rooms, doctors in this area have begun to open walk-in clinics with extended hours, and the emergency rooms have added 'convenient care' facilities to handle non-emergency visitors. The 'convenient care' is nice, but usually still costs more than the walk-in clinics.

In either one you are more likely to be treated by a nurse-practicioner than a doctor. Not that there's anything wrong with that.

RE: Vaccinations. Attending Catholic Grade school, we usually had to go to the County Health Care Center or to the Public School for 'shot day'. I remember getting the sugar cubes with the 'red stuff' on them. Do they still do that?

V/R
Shapley

[OperaTenor]

Facing a personal medical catastrophe alone with no backup or financial support system has a way of changing one's perception of the right to health care.

Especially when it happens more than once...

[Selma in Sandy Eggo]

That red stuff on the sugar cube was your Sabin polio vaccine (attenuated live virus) and you should have gotten it more than once. It's now an orally administered liquid that's included in your kids' regular immunization schedule, and I believe they give the first dose long before a baby is ready to eat a sugar cube.

Saints Salk and Sabin deserve a cathedral. A really big one.

[Haggis@wk]

From Mark Steyn’s “America Alone”

By Mark Steyn

In 2004, Debrah Cornthwaite gave birth to twin boys at the Royal Alexandra Hospital in Edmonton. That's in Alberta. Mrs. Cornthwaite had begun the big day by going to her local maternity ward at Langley Memorial Hospital. That's in British Columbia. They told her, yes, your contractions are coming every four minutes, but sorry, we don't have any beds. And, after they'd checked with the bed-availability helpline "BC Bedline," they brought her the further good news that there was not a hospital in the province in which she could deliver her babies. There followed seven hours of red tape and paperwork. Then, late in the evening, she was driven to the airport and put on a chartered twin-prop to Edmonton. In the course of the flight, the contractions increased to every two and a half minutes--and most Lamaze classes don't teach timing your breathing to turbulence over the Rockies.

How many Americans would want to do that on delivery day? You pack your bag and head to your local hospital in Oakland, and they say: Not to worry, we've got a bed for you in Denver.

Euro-Canadian socialized health care is, in essence, subsidized by American taxpayers: since the end of World War Two, Washington has assumed the defense costs of its allies, thereby freeing up those countries to spend their tax revenues on lavish social programs. But, if America follows the Hutton plan and "joins the world," it will reduce its defense expenditures to Euro-Canadian levels. So the next time a tsunami hits Sri-Lanka or Indonesia there will be no carrier groups to divert and save lives. So more people will die, waiting the weeks and weeks it took the sleepytime gals at the United Nations to arrive. Were America to "join the world," it would have to reduce its funding of the UN and other world bodies to European levels. And it might have to scale back its domestic agencies so that they're no longer able to serve in effect as international ones. Which will be tough when some kid in some village on the other side of the world comes down with some weird illness no one's seen before and they want to FedEx the test tube to the Centers for Disease Control in Atlanta to figure out what's going on. Indeed, even relatively advanced societies admired by the likes of Will Hutton take it as routine that the CDC is a kind of Health Ministry of last resort.

When SARS leapt from China to infect Toronto's hospitals in 2003, the principal contribution of the WHO (World Health Organization) was to issue a travel advisory warning visitors to steer clear of Ontario, leaving it to the CDC to provide advanced and practical analysis of the problem. Toronto's mayor, Mel Lastman, had a hard time keeping track of all the aconyms, and in one press conference launched into a bitter attack on the damaging effects of the travel advisory issued by the CDC.

The doctor next to him tried to correct him: "Who," she said.

"The CDC," he repeated.

"Who," she said.

"The CDC," he repeated, wondering why she hadn't heard his answer to the question the first time. This diseased version of the Abbott and Costello routine went on a while longer, before the doc realized she had to spell it out: W-H-O, the World Health Organization.
"Oh, yeah. Them, too," said Hizzoner.

Yet under the who's-on-first shtick lay an important truth: if an infection shows up in an Atlanta hospital, no American doctor looks for guidance from a Canadian government agency. But if it shows up in a Toronto hospital, the Ontario health system takes it for granted the best minds of the CDC in Atlanta will be staying late at the office trying to work out what's going on.

The answer to that Canadian doctor's vaudeville feed--"Who's on first?"--is America. When something goes awry, in a Sri Lankan beach resort or a Toronto hospital, it's the hyperpower who shows up. America doesn't need to "join the world": it already provides a lot of the world's infrastructure.

© Mark Steyn, 2006

[OperaTenor]

Yet every person I've *ever* spoken with who lives in a country with socialized medicine(dozens, at least) wouldn't have it any other way.

I guess they're all just a bunch of ignorant ostriches...

PS. Steyn's about as objective as MoveOn.

[Haggis@wk]

Yet every person I've *ever* spoken with who lives in a country with socialized medicine(dozens, at least) wouldn't have it any other way.

I guess they're all just a bunch of ignorant ostriches...

PS. Steyn's about as objective as MoveOn.

Since they can't have it any other way the point's moot and it's possible to be subjective and still be accurate.

[BigJon]

That group would consist of three independent entities; care providers, patient advocates, insurance providers.

You have just described an existing plan. That's the Kaiser Foundation Health Plan. The rest of your paragraph goes on to expand on the KFHP; except the "without debate" part. I used to have Kaiser.

You forced me to do some googling, but I don't think I have. Can you point out where the patient advocate is independent of the insurance provider? I can't find any mention of that. Kaiser seems just like any other HMO.

You seem charmed by Tragedy, covenants, and Commons. I'm not sure how my doctor will feel about being equated with a fish in the sea, or the grass on the village pasture. And a covenant is a contract - we're now back to lawyers.

I'm charmed by liberty and freedom of choice.

My doctor is exchanging a service for fee, you are the one saying that access to her is a common. If I need to accept that, I'm just trying to see how to make it work the best.

You and Shap have a perfect right to oppose my preference, though, and I suppose we'll end up with some origami'd political compromise. Unless enough people feel as I do, and we end up voting on the matter.

Uggg! If we vote, it's gonna look just like the folks who accepted their employer's plan. "Hey, that looks like a free lunch, I'll take it."

[Selma in Sandy Eggo]

Kaiser seems just like any other HMO.

Oh, trust me, it's not. It owns hospitals and clinics, hires doctors and nurses and secretaries and x-ray techs, staffs and stocks a pharmacy. There's also a bookkeeping department and sales staff and legal staff. There's also a Quality Assurance and Patient Ombudsman department.

All the other HMOs collect money and pay bills; they have no care facilities, no medical staff, provide no care. They are all about cash flow.

[Selma in Sandy Eggo]

How about we simply return to the Public Health Department services that I remember from the '50s? Is that enough liberty and freedom of choice? What we have now is either vastly superior to the '50s, or incredibly inferior, depending on your financial position.

[BigJon]

Kaiser seems just like any other HMO.

Oh, trust me, it's not. It owns hospitals and clinics, hires doctors and nurses and secretaries and x-ray techs, staffs and stocks a pharmacy. There's also a bookkeeping department and sales staff and legal staff. There's also a Quality Assurance and Patient Ombudsman department.

So what made them suck so bad?

All the other HMOs collect money and pay bills; they have no care facilities, no medical staff, provide no care. They are all about cash flow.

I knew you were smarter than the average bear, you get it.

[Selma in Sandy Eggo]

So what made them suck so bad?

Where did I say they sucked so bad? I said I used to have them.

...I knew you were smarter than the average bear, you get it.

What is it that you think I get? Yes, I understand that a HMO pays (most of the discounted) bill, from money they acquire by selling a policy to me. They keep most of the money they charge me, most years, and make an indecent profit even after the bills and their hefty operating expenses are paid, also out of the money they charge me. My gripes with them lie in their profit margin (excessive), their "review of medical necessity" strategy for delaying or denying payment for medically recommended services, and their pricing and acceptance policies (fewer policies at a higher premium to low-risk applicants).

From the tone of your "you get it" I suspect that you think I've agreed with you on something. I also suspect that you're wrong but just out of curiosity, what is it?

[jamiebk]

[Selma in Sandy Eggo]

You're right. I think everyone has a firm opinion on this.

[Haggis@wk]

You're right. I think everyone has a firm opinion on this.

I'm certainly not ready to give up on this.

My humble suggestions:

Buy a stronger whip

Change riders

Say "This is the way we have always ridden this horse"

Create a training session to increase our riding ability

Compare the state of dead horses in today's environment

Harness several dead horses together to increase speed

Declare that "No horse is too dead to beat."

Provide additional funding to increase the horse's performance.

Purchase a product to make dead horses run faster

Declare that dead horses run better, faster and cheaper when dead than alive.

Form a quality circle to find uses for dead horses.

Revisit the performance requirements for horses

(and my favorite) Promote the dead horse into a management position.

[piqaboo]

Now now jamie, we are still defining terms. Until that prelim is completed, we havent even started on the beating.

[Shapley]

German 12-year-old boy becomes worlds' youngest sex-change recipient

Courtesy of the German tax payers...

[jamiebk]

Yes…yes…and with socialized medicine we will find ourselves involved in all manner of ethical dilemmas such as,…dare I say, abortion and related. Those in favor of course demanding it be covered, those against demanding that their premiums (or taxes) not be used for it or that it not be "covered". This is but one issue. How about all the issues over fertilization, or perhaps who gets cutting edge experimental treatments. What if you have lots of money and can afford other private care? Once again the "haves" get access to superior care (as many say they do now)

I think the program we currently have needs correcting, but it works. More pressure needs to be put on employers to offer at least catastrophic health care cover for employees. Maybe that is in the form of a tax incentive or maybe it’s a penalty that will accrue in a fund to cover those folks anyway.

Most of all, people need to understand that medicine is not a cure all and stop holding Drs and hospitals responsible for every little problem. Legal costs are overwhelming the system and there needs to be some cap on the liability issue.

So...the reason that I posted the "dead horse" is that I see very little movement here with regard to people's opinions onthe board...my own included.

[barfle]

Form a quality circle to find uses for dead horses.

I think I made that point here. There was a use, but now all you can do with the likes of Barbaro is stuff them like Trigger.