Martin Lewitt (2010.02.19.1659 MST)
[From Rick Marken (2010.02.19.1450)]
Martin Lewitt (2010.02.19.1146 MST)
Rick Marken (2010.02.18.1340)--
Every country in which there is a single payer type system pays less
(as a proportion of GDP) for health care and has better outcomes than
countries that don't have such a system.
If you've been following the healthcare debate in the US, you would have
heard that the US system has better survival rates after diagnosis for most
cancers than Canada.
How much better? And at what cost? If you've been following the
healthcare debate you might also know that the only western industrial
democracy where people are driven into bankruptcy due to illness is
the US. But maybe that plus high infant mortality and worse outcomes
for all other diseases is a price you are willing to pay for slightly
better cancer survival rates.
It is expensive, but people are willing to pay the price. Forget for
the moment that the prices are far higher than they need to be because
of government interference. Compared to what most of humanity faces,
bankruptcy is a minor concern, infant mortality is not a priceborn by
those who are getting the healthcare.
I can't be so dismissive of 3% of the people. My reference level for
fascism may not be zero like Bill P, but it is very low.
I wasn't dismissing the 3% of Canadians who are unhappy with their
health care system. Indeed, I was recognizing that they exist. Their
existence proves that no policy, not matter how good (and 97% positive
seems pretty good) will make everyone happy. The problem is that some
policies only work if everyone cooperates. This is particularly
obvious with health insurance. If healthy people decide not to
cooperate and share in the risk by purchasing insurance then the
insurance becomes prohibitively expensive for the people who are in
the pool (as happened recently here in California with Anthem Blue
Cross). See Krugman's recent column for an explanation of the problem
why, once a policy is agreed on, even if only by a slight majority,
there has to be enforcement for it to work. Most reasonable people
understand this. They may not like to pay their taxes, for example,
but they know that, as Oliver Wendall Holmes once said, taxes are the
price we pay for civilization.
Before coercing people into risk pools, perhaps we should first try to
allow larger multistate voluntary risk pools. Many healthy people do
want insurance, perhaps larger pools, a more competitive environment
and less government interference will result in more affordable
What is reasonable depends on perspective. For someone not identifying
with the national collective, but having an international socialist
perspective, it would be more reasonable not to “waste” healthcare on
the elderly at all, but instead help two orders of magnitude more
people in third world countries for the same cost. Those countries
with single payer systems are just being selfish and coddling the
elderly who have outlived their usefulness.
The US may well be helping more poor and infants by having open
borders, global trade and protecting the sea lanes and by deterring
Do we have an obligation to the national collective? to all humanity?
Should we oppose and demonize the “other”, or the ones who do not want
to cooperate or be our sacrificial lambs? Doesn’t the US have as much
right to tax Canada’s and Norway’s rich as those coutnries do, or do
those countries have an exclusive right to exploit their rich? Is it
wrong for human animals to succumb to their mammalian nature and want
to invest in their own survival and in the reproductive success of
their children, rather than serve the collective?
While the national collectives in Europe and Canada may currently seem
benign, but the same “reasonable” perspective that justifies
sacrificing a few, making the rich and healthy pay, and rationing some
care to the elderly, also justified the most destructive weapon of mass
destruction in history, which laid waste to the world over the last two
centuries … conscription.
Be careful, identification with national collectives has been
demonstrate to interfere with conceptual ability. This from a WWI
Supreme Court case:
“Finally, as we are unable to conceive upon what theory the exaction
by government from the citizen of the performance of his supreme and
noble duty of contributing to the defense of the rights and honor of
the nation as the result of a war declared by the great representative
body of the people can be said to be the imposition of involuntary
servitude in violation of the prohibitions of the Thirteenth Amendment,
we are constrained to the conclusion that the contention to that effect
is refuted by its mere statement.”
A rather selective deficit of conceptual ability. Down with fascism.