Stossel Solves the Health Crisis with Capitalism

[DaN K. StAnLeY]

Quote:

Would you want to do that? Or would you rather just go without insurance?

I don't see what good it would really do if it also said this:

Quote:

CoverTN plan benefits are very limited compared to traditional insurance. For instance, these plans do not have an out-of-pocket maximum, so they do not protect against the potential of catastrophic medical costs. In other words, there is no limit to the amount of medical bills a member might have to pay for a major illness or injury, such as disease treatment, or injuries sustained in an automobile accident for example.

[kellyb]

Originally Posted by DaN K. StAnLeY

I don't see what good it would really do if it also said this:

It pays up to $25,000 in hospital costs per year, though. It's fairly rare that one individual will rack up more than that per year, even with hospital costs.

[kellyb]

Either way, so you'd rather just go without health insurance?

[ponderingturtle]

Originally Posted by kellyb

It pays up to $25,000 in hospital costs per year, though. It's fairly rare that one individual will rack up more than that per year, even with hospital costs.

Yes it would save people who have moderate health care needs in a year from having to go bankrupt.

[Rolfe]

Originally Posted by Toke

I think you got it the wrong way around.

Assuming that a x-ray mashine cost a fixed amount from the manufacturer, the cost would be a lower percentage of your money if you were richer.

Payscales tend to be higher in richer countries, but I would expect it to follow GNP giving you the same percentage.
Unless you have a more uneven distribution of income, where hospital staff in general get a smaller share of GNP than in the UK.
Then you would end up with a lower percentage.

That's a good point.

From what we see of the US system, it's either complaints about the lousy quality of state-funded care, or complaints about the rocketing cost of insurance cover. None of that sounds like extra voluntary spending by the affluent to me.

I suppose Dan's idea does chime to some extent with the scenario of the insured patient "grabbing everything he can get" because it's "free" (or rather, paid for in higher premiums), but I'm pretty sure neither that, nor Daddy Warbucks choosing to have his quadruple bypass done in the most luxurious private clinic in Florida, explains a doubling in healthcare spending right across the board.

Rolfe.

[Rolfe]

Originally Posted by DaN K. StAnLeY

I was just thinking that there are a bunch of programs you can get on if you have a sick baby, so it seemed like HC wouldn't be a factor.

Just returning to this one. Excellent. Truly civilised. Sounds terrific.

Except - this is "soc HC"!! This is compelling you and others to pay for someone else's healthcare! Goodness, the mother may have been improvident! She may have spent her money on junk food and makeup instead of saving so that she had $10,000 a week (wild guess) to buy a special care neonatal cot! The baby may even have been premature as a result of the mother spending her money on cigarettes!

Even worse, once the baby is born and needs care, the mother may expect the need to be taken care of! She needs to be taught that nobody owes anyone a living! Tell her she got what was coming to her and let the brat die!

OK, I'm going over the top a bit here, but do you see how the same situation can be presented in two completely different lights depending on the point you want to make at the time, or even the mood you happen to be in?

Rolfe.

[Francesca R]

Originally Posted by Rolfe

Remember, we spend 7.7% of GDP to cover everyone, you spend 14.8% of GDP not to cover everyone.

Originally Posted by DaN K. StAnLeY

Could this have anything to do with our per capita income being higher? [ . . . ] My reasoning here is that since we make more money, we are more inclined to spend it on our health care.

Well that would explain it if healthcare was a luxury good, which is the type of good that people don't buy at all if they are dirt poor, and spend an increasing proportion of their income on as they get richer. Typically that is the case for Gucci handbags, caviar, yachts and country mansions.

Except that this is about government spending on health not individual spending. So that would be the US government deciding that health is a luxury not for the poor.

The alternative explanation is that the US has been suckered badly into myriad market failures and path-dependent policy stasis.

[Rolfe]

Originally Posted by DaN K. StAnLeY

If everything is truly like you say it is, it sounds like a great system. I don't have a new position, just a couple questions.

Look, it's not perfect. Stuff goes wrong. Right-wing politicians like to promise tax cuts, then underfund the system. A huge, monolithic bureaucracy can make some absolutely stonking big mistakes - like commissioning IT systems that cost millions and don't work. Internal bureaucracy can result in the tail wagging the dog, and administrators having too much power to tell consultants what to do. It's not a panacea for utopia.

Bear in mind that the NHS, which is what most people here are talking about because we speak the same language and that's what we're familiar with, isn't even the best system based on international evaluation criteria. Nevertheless, everyone will close ranks and agree wholeheartedly that whatever its faults, it's so massively better that the situation in the US that we go hot and cold all over at the very thought of having to put up with what goes on in the USA.

Rolfe.

[DaN K. StAnLeY]

Quote:

Well that would explain it if healthcare was a luxury good, which is the type of good that people don't buy at all if they are dirt poor, and spend an increasing proportion of their income on as they get richer. Typically that is the case for Gucci handbags, caviar, yachts and country mansions.

Except that this is about government spending on health not individual spending. So that would be the US government deciding that health is a luxury not for the poor.

The alternative explanation is that the US has been suckered badly into myriad market failures and path-dependent policy stasis.

What about a procedure like gastric bypass? It would seem like this type of procedure would be more common in the US and would be more likely to be performed on someone with good insurance or extra cash. I'm not saying gastric bypass is the entire reason, just one example.

[Francesca R]

If you catch your government admitting that it wants to spend a bigger chunk of taxed national income on health than other governments do because it wants to give luxury treatments to the richer ones and nothing much to the poorest, let the thread know.

[Darat]

Originally Posted by DaN K. StAnLeY

What about a procedure like gastric bypass? It would seem like this type of procedure would be more common in the US and would be more likely to be performed on someone with good insurance or extra cash. I'm not saying gastric bypass is the entire reason, just one example.

Why is that an example - as far as I understood a gastric bypass is usually carried out for medical reasons?

[Francesca R]

I dunno, I was thinking of getting one just for status depending on next year's bonus.

[Rolfe]

Originally Posted by DaN K. StAnLeY

I don't see what good it would really do if it also said this:

Quote:

CoverTN plan benefits are very limited compared to traditional insurance. For instance, these plans do not have an out-of-pocket maximum, so they do not protect against the potential of catastrophic medical costs. In other words, there is no limit to the amount of medical bills a member might have to pay for a major illness or injury, such as disease treatment, or injuries sustained in an automobile accident for example.

That's a very interesting plan KellyB refers to. Like so much of what has been brought up in this discussion (including a couple of Stossel's suggestions), it's a clear improvement for US citizens on what they have at the moment, but at the same time it still leaves them massively worse off than people with universal healthcare entitlement.

It probably would benefit a lot of people. I think Dan would be mad not to take something like that if he left his job to set up his own business. The problem is that it still leaves fairly obvious cracks that some people will slip through. And you don't know if it's going to be you.

I note that it says the cover continues during brief periods of unemployment. So you better not be out of the job market for too long by the sound of that.

If you have a catastrophic event while you're on the plan, you're screwed, then and there. And this is going to happen to some people, guaranteed.

Perhaps worst of all, it seems to leave people wide open to the trap that caught the woman in the Stossel film. Young, healthy, expecting to go on and earn more, and be able to afford a better health plan - then she gets something catastrophic that leaves her uninsurable. The limited cover she had was never designed to deal with something like that, and doesn't. And now she has it, she can't insure against it.

It's better than nothing, and it's going to make life a lot easier for people who don't have catastrophic health events. But it's still going to leave a minority in a very bad place.

Rationally, the best cover for all eventualities is something with no (or a very high) ceiling. The trouble is that such plans tend to have very high premiums. And the only way to mitigate that is to accept a very high excess. So you end up still having to budget for all realtively routine items to be paid for out of pocket, and the cost of the premiums. A bit like Stossel's preferred insurance plan. It's life, Jim, but not as we know it.

Rolfe.

[Darat]

Originally Posted by Francesca R

I dunno, I was thinking of getting one just for status depending on next year's bonus.

Diamond encrusted?

[Rolfe]

Originally Posted by DaN K. StAnLeY

It will be interesting to see what happens in the next 10 years with this issue. I wonder how it will be to revisit this thread after living under a soc-UHC system. I'm sure that it's going to be tried soon and I think I remember hearing someone suggesting it would be done on the state level first.

I think there's a lot to be said for a country as large as the USA operating UHC on a state-by-state basis. You should still benefit from good economies of scale, and there's a limit to how big you want one employer or one bureaucracy to get. Arguably, the NHS as it stands is too big. You can then implement complete reciprocity, in a similar way to Europe, so that all citizens are covered.

You might also benefit from competition or rivalry between states. If one state provides a crap system, there will be political pressure to do better from citizens who see that friends and relatives in other states are getting a better deal. If one state tries out something a bit off-the-wall and it works out, it will be easy for others to implement it, with the trial run example before them. If on the other hand it doesn't work out, then the cost/damage of the unsuccessful experiment will be limited to one state. And the people whose baby it was are unlikely to be able to hang on to the failed initiative if the examples of neighbouring states are showing it up for the daft idea it is.

Should be interesting to watch!

Rolfe.

[Darat]

I suspect in the USA one of the changes would be the power balance between employees and employers shifting in favour of the employees.

[Francesca R]

Erm, now??

(Jobless rate)

[Darat]

It is very unlikely that the USA will be going over to a universal system overnight.

[Francesca R]

I'll check tomorrow.

[DaN K. StAnLeY]

Quote:

Just returning to this one. Excellent. Truly civilised. Sounds terrific.

Except - this is "soc HC"!! This is compelling you and others to pay for someone else's healthcare! Goodness, the mother may have been improvident!

Okay, there isn't going to realistic way to completely eliminate the need for programs for low income people and the disabled and elderly. I think the US recognizes the need to provide at least some services to everyone, but a lot can be done to minimalize the expenses in a soc program like medicare/caid. Thats why we have the post office, public school, etc. The alternatives would be worse than a semi-soc system. The thing that has worked for us is free-market choices, with a semi-soc way to provide for all.

In a perfect world nobody would ever lose their job or get cancer, and saying 100% any type system (capitalist,socialist,etc)

[Rolfe]

Originally Posted by DaN K. StAnLeY

What about a procedure like gastric bypass? It would seem like this type of procedure would be more common in the US and would be more likely to be performed on someone with good insurance or extra cash. I'm not saying gastric bypass is the entire reason, just one example.

Actually, that's an interesting example. We have tons of reality TV shows following the progress of the morbidly obese trying to get their lives back. The World's Fattest Teenager. Three Ton Mom. The Heaviest Man in the World. Stuff like that. And about 90% of them are US imports.

In nearly every case, they end up getting bariatric surgery. All very interesting. And we see the hospitals where they are treated, and we hear from the surgeons who specialise in the operations, and not once does anyone mention how any of this is being paid for.

But these are people who are so obese they can't get out of bed. The Fire Department have to come along and take a window out of the house to get them into the fire truck to take them to hospital. They are clearly close to the poverty line, usually with only the small income of a spouse supporting the family. There's no way at all they can be paying for that surgery themselves, and I'd be fairly surprised if there was insurance cover paying for it. (The spouses never look as if they have the sort of job that would have a health plan that would pay for bariatric surgery for a chronically, morbidly obese other half.)

I can only assume Medicaid is paying.

And given that (another wild generalisation coming up here) morbidly obese people tend to be both dimmer and in a lower earning bracket than the general population, I'd guess that most of these surgeries are Medicaid jobs.

I suppose it's possible that a chubby high-earner might choose to demand bariatric surgery paid for on insurance (or even self-paid), at a point where medical need maybe wouldn't advocate it. But I have enormous trouble imagining that increased demand for elective bariatric surgery buy the well-heeled who can't stick to a diet is enough of a pressure to show up in the statistics on healthcare spending, even at the third decimal point.

Rolfe.

[Toke]

Originally Posted by Darat

I suspect in the USA one of the changes would be the power balance between employees and employers shifting in favour of the employees.

Or employers and insurance companies will team up against it.

Unless the employers think the cost of employee insurance does not outweigh the hold it gives on employees.

[DaN K. StAnLeY]

Quote:

Why is that an example - as far as I understood a gastric bypass is usually carried out for medical reasons?

Sorry, I'm not reading you. Can you rephrase?

[DaN K. StAnLeY]

Quote:

I suppose it's possible that a chubby high-earner might choose to demand bariatric surgery paid for on insurance (or even self-paid), at a point where medical need maybe wouldn't advocate it. But I have enormous trouble imagining that increased demand for elective bariatric surgery buy the well-heeled who can't stick to a diet is enough of a pressure to show up in the statistics on healthcare spending, even at the third decimal point.

I know four people personally (see them regularly) that have had this surgery paid for by insurance because they wanted to look skinnier. If you have any medical condition (including high blood pressure) you can get your insurance company to pay for it most times. I don't want to make a huge thing out of one example but it was just something that came into my mind that might be more of an issue here than in other places.

[Rolfe]

Originally Posted by DaN K. StAnLeY

Okay, there isn't going to realistic way to completely eliminate the need for programs for low income people and the disabled and elderly. I think the US recognizes the need to provide at least some services to everyone, but a lot can be done to minimalize the expenses in a soc program like medicare/caid. Thats why we have the post office, public school, etc. The alternatives would be worse than a semi-soc system. The thing that has worked for us is free-market choices, with a semi-soc way to provide for all.

In a perfect world nobody would ever lose their job or get cancer, and saying 100% any type system (capitalist,socialist,etc)

False analogy alert! Everyone can use the Post Office. Everyone can send their children to a public school. These aren't "semi-soc". But publicly-funded healthcare is off-limits to all but "low income people and the disabled and elderly". Not the same!

If you want to use education as an analogy (and it has its uses), then you have a publicly-funded system that is open to all and to which everybody contributes, and you permit private providers to offer alternative services for sale as well. That is what many people would call "semi-soc". That provides a free market choice, and the publicly-funded system has to compete on quality in that free market or else the better-off just vote with their wallets.

In a perfect world nobody would ever lose their job or get cancer. Agreed. But it isn't a perfect world. And yet, the US system seems to be set up on the assumption that it is, and those who are above the level of entitlement to the publicly-funded system will never suffer a catastrophe that they can't cope with. So if they do, then they have to beggar themselves and see their lifestyle (and their family's lifestyle) destroyed before they are eligible to access the publicly-funded system.

I feel a post coming on about the poverty trap, although Francesca probably knows more about this than me.

Rolfe.

[DaN K. StAnLeY]

Semi-soc in the sense that there are many private alternatives.

[DaN K. StAnLeY]

RQ, going back to the Abagail story. If I remember right, someone was trying to give Germany all the credit for the innovation of that. I'm reading that it is a more advanced version of a artificial heart invented here in the US and perfected here in TGS of Texas:

Quote:

[edit] First clinical implantation of a total artificial heart
In the morning of April 4, 1969 Domingo Liotta and Denton A. Cooley replaced a dying man’s heart with a mechanical heart inside the chest at the Texas Heart Institute in Houston as a bridge for a transplant. The patient woke up and recovered well. After 64 hours the pneumatic powered artificial heart was removed and replaced by a donor heart. Replacing the artificial heart proved to be a bad decision, however; thirty-two hours after transplantation the patient died of what was later proved to be an acute pulmonary infection, extended to both lungs, caused by fungi, most likely caused by an immunosuppressive drugs complication. If they had left the artificial heart in place the patient may have lived longer.[14]

Just keepin ya'll honest

[DaN K. StAnLeY]

Here's another perspective on UHC from our former landlords across the pond:

http://www.heritage.org/Research/HealthCare/bg2239.cfm

This doctor seems to think the NHS is in worse shape than Amy Winehouse

Quote:

Comparative Effectiveness: The Rationale

In recent decades, health care has advanced in significant ways. Across the developed world, not only has medical knowledge progressed, but investment in equipment and drugs has delivered unprecedented gains. Treatments are safer and more effective than ever before. Quality of life and life expectancy have been enhanced. Alongside aging populations has come the world of ever-increasing consumer expectations.

...snip...

Edited by Darat:

Breach of Rule 4 removed.

She also seems to have beef with the NHS:

Quote:

How Comparative Effectiveness Works in Europe

According to the International Network of Agencies for Health Technology Assessments (INAHTA),[17] many industrialized countries have bodies that are charged with health technology assessments or comparative effectiveness studies. Despite this, the evolution of these bodies and their responsibilities at the national decision-making level has been far from uniform....snip...

Edited by Darat:

Breach of Rule 4 removed.

I'm just wondering if the are any lies, cherry pickings, or misrepresentations in this critique of the UHC systems in Europe and in general. I also thought the Stossel thread was getting a little long.

[Architect]

As a sceptic it woe-betide me to attack the messenger rather than the message, however be aware that Ms. Evans has a particular area of focus/outlook which is unlikely to be widely represented across the wider healthcare community in the UK:

http://www.biggovhealth.org/testimon...s/helen-evans/

She's not a medical doctor, by the way, hence I'm no more inclined to attach weight to the title than I am to my old professor (PHD in architectural history, used the "doctor" every day).

Nurses For Reform, for example, has a very clear agenda:

Quote:

Above all else, NFR believes that greater partnership with the private sector is to be actively welcomed and that this sector’s contributions are good news for patients and healthcare professionals alike.

The final thing I find of interest is that the organisation has had, as far as I can see on a quick google, very little UK exposure - which is unusual for an issue such as this. The BMA and RCN are in the press all the time whenever there are problems.

So, to summarise, two issues:

1. The accuracy of the points made, once we strip down the polemic and hyperbole (I'll leave this to those more expert than myself)

2. The extent to whjich her views and those of NFR are representative of the wider views of healthcare professionals in the UK, in the same way that Richard Gage isn't representative of the AIA over on the conspiracy threads.

[DaN K. StAnLeY]

Quote:

She's not a medical doctor, by the way, hence I'm no more inclined to attach weight to the title than I am to my old professor (PHD in architectural history, used the "doctor" every day).

I'll see if I can ask to edit the title again, LOL!

[DaN K. StAnLeY]

Quote:

2. The extent to whjich her views and those of NFR are representative of the wider views of healthcare professionals in the UK, in the same way that Richard Gage isn't representative of the AIA over on the conspiracy threads.

So, she believes therm*te is responsible for the collapse of the health care system in the US??? hehehe

[DaN K. StAnLeY]

Quote:

The BMA and RCN are in the press all the time whenever there are problems.

I'm sorry, what are those acros for?

Quote:

As a sceptic it woe-betide me to attack the messenger rather than the message, however be aware that Ms. Evans has a particular area of focus/outlook which is unlikely to be widely represented across the wider healthcare community in the UK:

http://www.biggovhealth.org/testimon...s/helen-evans/

Found this video with that link you gave: http://vimeo.com/1390455?pg=embed&sec=1390455

Sad story.

[Professor Yaffle]

Originally Posted by DaN K. StAnLeY

I'm sorry, what are those acros for?

BMA = British Medical Association
RCN = Royal College of Nursing

[DaN K. StAnLeY]

This poor neck-less man seems to really despise the NHS: http://vimeo.com/1189814

Quote:

BMA = British Medical Association
RCN = Royal College of Nursing

tyvm.

[DaN K. StAnLeY]

Darat, why did the post get merged? Just so I don't make the same mistake again?

[Rolfe]

Originally Posted by DaN K. StAnLeY

RQ, going back to the Abagail story. If I remember right, someone was trying to give Germany all the credit for the innovation of that. I'm reading that it is a more advanced version of a artificial heart invented here in the US and perfected here in TGS of Texas:

Just keepin ya'll honest

Not being dishonest. There are many different types of artificial heart, and the original design has been modified and improved on in many ways. Just because the automobile was originally invented in the USA (no idea if it was, actually!), doesn't mean that no other country is due any credit for advances in automobile technology.

The point about it being the "Berlin heart" that Abigail got was a response to your suggestion that countries with universal healthcare systems don't innovate in healthcare technology. This artificial heart was just a handy example to demonstrate that they do.

Did you look at the web site of the Wellcome Trust that I linked to earlier? This is a British charitable foundation.

Quote:

The world's largest medical research charity funding research into human and animal health.

Have a look round that site, see what they do. This bunch are probably the largest source of funding for medical research in Britain, and they have a high international profile too. They have absolutely bugger-all to do with the government.

There is a government supported research council too, and quite right, the government should bloody well pitch in, but it's only part of the overall medical research scene in Britain. This is why Stossel was able to say that only a small fraction of medical research is government-funded. The vast bulk is funded by chartiable trusts (like Wellcome), and by pharmaceutical companies (you know, private capitalist outfits).

Stossel was dishonestly implying that in countries with universal healthcare systems, all the medical research in these countries is government-funded, and then pointing to the small fraction that actually is to suggest that such countries do not engage in medical research to a significant degree. Well, of course that's simply not true. The existence of universal healthcare provision doesn't for a second imply that the government takes over medical research. It's got nothing to do with it. The government remains a part of an overall research effort that is largely non-government-funded.

Now, talking of keeping people honest, why do you think that Stossel (implicitly) lied about this?

A little bit more about Wellcome. This lot have more money than God. They are responsible for the fact that the human genome is a free-access public good, and was not patented for profit.

(Sorry, doing this from memory, source is a book called "Backroom Boys" by Francis Spufford.) In the 1990s there was a public project to sequence the human genome and make the results freely available to any researchers, with the aim of the advancement of science. It had wide support and was generally agreed to be a Good Thing. However, one or a small group of US researchers decided to rock the boat and hijack the effort for their own profit.

They announced that they had funding to buy a lot of equipment, and in addition they were going to skip a time-consuming but hitherto essential step in the process so that they could get results faster than the public project. And that they would patent the results and people who wanted access would have to pay.

The real killer here is that there is a law in the US which forbids the government from doing anything that competes with a private company. This still applies even if the government were doing it first. The result was that the US government was legally obliged to withdraw its funding for the public effort.

The private entrepreneurs behaved as if the US government contribution was the entire public project, and started talking about the researchers in that sector moving over to sequence the mouse genome instead. They were confident that the US law meant that they had a completely free run.

They forgot that it was an international effort, and there were other countries conrtibuting.

The British researchers went to the Wellcome Trust, who were funding the British section of the project, and explained all. They were at first worried that Wellcome would simply see this as a reason to withdraw funding and allocate its money elsewhere. However, the Wellcome trustees got cross. They all went to a meeting in the US where all the talk was already about disappointed scientists having to switch to mouse research, and announced that they were going to increase their funding to cover a much higher percentage of the total effort. They also made it clear that this was not a ceiling on their potential contribution, and that they were prepared to fund 100% of the public effort if need be. They would put the entire assets of the Trust behind it (capital of $25 billion was mentioned I think).

So the public effort speeded up, and stayed ahead of the private project, and managed to get enough of the genome into the public domain that the private company folded. Or that's how the story is told.

Google The Human Genome Project and Celera Corporation for more information.

Now there are two views which may be taken on this (or maybe more than two!). Maybe Venter was hard-done-by, and should have been left in peace to patent the human DNA sequence. Maybe (actually, not maybe, he did) he spurred the public effort to move faster and complete the project earlier. Maybe it would be better if a private company had the patent on our genes and was able to profit from every research project that needs the information.

But whichever line you take, remember that the funding and the impetus for the ultimately successful public project came from Britain, and came from a completely private, non-government source, able to act without political or vested-interest interference.

In a country with one of the most centralised universal healthcare systems in the world.

Rolfe.

[ponderingturtle]

Originally Posted by Rolfe

Actually, that's an interesting example. We have tons of reality TV shows following the progress of the morbidly obese trying to get their lives back. The World's Fattest Teenager. Three Ton Mom. The Heaviest Man in the World. Stuff like that. And about 90% of them are US imports.

In nearly every case, they end up getting bariatric surgery. All very interesting. And we see the hospitals where they are treated, and we hear from the surgeons who specialise in the operations, and not once does anyone mention how any of this is being paid for.

But these are people who are so obese they can't get out of bed. The Fire Department have to come along and take a window out of the house to get them into the fire truck to take them to hospital. They are clearly close to the poverty line, usually with only the small income of a spouse supporting the family. There's no way at all they can be paying for that surgery themselves, and I'd be fairly surprised if there was insurance cover paying for it. (The spouses never look as if they have the sort of job that would have a health plan that would pay for bariatric surgery for a chronically, morbidly obese other half.)

I can only assume Medicaid is paying.

The TV producers might be paying. Makes a good show.

[Rolfe]

Originally Posted by DaN K. StAnLeY

I know four people personally (see them regularly) that have had this surgery paid for by insurance because they wanted to look skinnier. If you have any medical condition (including high blood pressure) you can get your insurance company to pay for it most times. I don't want to make a huge thing out of one example but it was just something that came into my mind that might be more of an issue here than in other places.

Could be. I think the NHS is relatively reluctant to start slicing people up just because they want to look skinnier. It may be easier to get an insurance company to pony up. But as I said in my original post, I'd be very surprised if the extent of this was enough to influence the overall healthcare spending statistics above the third decimal point.

Rolfe.

ETA: Yes, I suppose the TV might be paying for the ones they film. The scenes in the hospitals suggested they were just individual examples of a sizeable group of patients though.

[Rolfe]

Originally Posted by DaN K. StAnLeY

Here's another perspective on UHC from our former landlords across the pond:

http://www.heritage.org/Research/HealthCare/bg2239.cfm

This doctor seems to think the NHS is in worse shape than Amy Winehouse

She also seems to have beef with the NHS:

I'm just wondering if the are any lies, cherry pickings, or misrepresentations in this critique of the UHC systems in Europe and in general. I also thought the Stossel thread was getting a little long.

Never heard of the woman. As Architect remarked, she's not a doctor within the meaning of this discussion - she's a nurse with a PhD. And she has issues with the NHS, and she's making a fuss.

I'd hesitate to say she's a minority of one, because complaining about the NHS is almost a national sport in Britain. But she certainly doesn't represent a consitiuency of any size. I don't have time right now to read that long article, but I note that it's an article written for the US, to support a private-enterprise view of healthcare. I'd have to read it to see just how analytical she really is, but at the moment I'm inclined to treat it as "one woman's opinion".

We have rabid freemarketeers in this country too, you know.

I'd ask something else, too. I note from Architect's quote that she's talking about "partnership" with the private sector. Is she then talking about the government buying more of its national healthcare from independent private companies as opposed to the NHS being a relatively monolithic institution, or is she talking about actually removing the universal right to healthcare in Britain?

I suspect it's the former. I suspect she wants to keep universal healthcare, but believes that its delivery can be vastly improved by involving the private sector. (I, on the other hand worry that such "partnership" may lead to a decrease in service as the private company cuts corners to improve shareholder returns. Who knows who's right.) I suspect she's a proponent of a different sort of universal healthcare.

If she's actually advocating that Britain should abandon the principle of universal access to healthcare, and move to a US system of basic charity safety-net under a wildly expensive and incomplete insurance-funded provision for everyone not on the bread-line, I'd like to hear her stand for public office on that platform!

Rolfe.

[Rolfe]

Originally Posted by DaN K. StAnLeY

Found this video with that link you gave: http://vimeo.com/1390455?pg=embed&sec=1390455

Sad story.

Originally Posted by DaN K. StAnLeY

This poor neck-less man seems to really despise the NHS: http://vimeo.com/1189814.

Sorry, can't watch these on the computer I'm on at the moment. I see one example is from Canada and the other from England, that's all.

And can we really not find any sad stories form the USA? Seems to me that Stossel, for example, had an easier time finding people genuinely harmed by the US system than he did with even the Canadian system, which seems to have particular problems.

Originally Posted by Rolfe

Look, it's not perfect. Stuff goes wrong. Right-wing politicians like to promise tax cuts, then underfund the system. A huge, monolithic bureaucracy can make some absolutely stonking big mistakes - like commissioning IT systems that cost millions and don't work. Internal bureaucracy can result in the tail wagging the dog, and administrators having too much power to tell consultants what to do. It's not a panacea for utopia.

Bear in mind that the NHS, which is what most people here are talking about because we speak the same language and that's what we're familiar with, isn't even the best system based on international evaluation criteria. Nevertheless, everyone will close ranks and agree wholeheartedly that whatever its faults, it's so massively better that the situation in the US that we go hot and cold all over at the very thought of having to put up with what goes on in the USA.

I'll think you'll find that I've consistently said that the NHS is not perfect, and that if you look you'll find stories of people let down by the system, or by particular people within the system. They tend to make the news more easily that the squillions of people who just get the care they need and go away and get on with their lives, after all.

The difference, as I again have consistently pointed out, is that the British horror stories do not involve lack of entitlement. They are all about people who, for whatever reason, didn't get what they were actually entitled to. In contrast to the US horror stories, which seem almost always to be about people left stranded because for some reason or another, they have no entitlement.

Removing universal healthcare is about removing that entitlement from a country's citizens. How is it better to go from a situation where the ordinary citizen might be let down by the system that is supposed to care for him, to one where the system is no longer expected to care for him?

Consider this. I've no idea what happened to the poor guy with no neck. However, if such horror stories were at all common in the NHS, you simply would not find that all the British posters here were talking so positively about the system.

Any medical service can let people down. You'll always be able to find anecdotal stories of individuals who got a bad deal. I expect you'll find some in the US too.

What were're talking about here is entitlement to access to healthcare. Individual examples of people who were entitled to healthcare but who then got the rifle dropped on them are actually not especially relevant.

Rolfe.