Obama health care plan, voters beware

Tuesday, October 21, 2008 | 12:52 p.m. CDT; updated 11:42 a.m. CDT, Thursday, September 3, 2009

Don't be fooled by the promise "You can keep your employer's health insurance" under the Obama plan. Yes, you can, but eventually you won't want to, and ultimately your employer will opt out of providing health insurance to their employees when they are crushed by the competition from the government. Under the guise of increased choice, Obamacare is a cynical slide to socialized, single-payer, government-run medicine.

The proponents of single-payer health care point to the big prize: universal coverage, a generally desirable goal. In reality, universal coverage is impractical.

They ascribe to the socialist philosophy "to each according to their need." In other words the distribution of health benefits should be according to one's needs, not one's wallet. Sounds good, but it fails in practice. Man does a poor job controlling the satisfaction of his needs independent of his wallet.

Old Chinese proverb: As the wallet grows, so do the needs.

New proverb: When it's the government's wallet, spending goes through the roof.

Under the socialist philosophy, health care becomes defined as a right, not a personal responsibility of the individual. When the individual decision maker is absent, the need for a central decision maker or planner is created. At its worst is soviet-style central planning: "Everything is free, but nothing is available," and their famous rationale is "it has never worked because the right people have never been in charge."

Canadians are proud of their universal coverage where poor man and rich manalike receive equitable health care, an argument underlying Obamacare. An underlying assumption is that universal health care will improve the health status of the poor man. Has Canadian universal health care raised the quality of health of the poor man relative to the rich man? An astounding result in a study by David and June O'Neil on the white non-elderly population shows that under the Canadian universal coverage single-payer plan, low-income Canadians are 22 percent more likely to be in poor health than their American counterparts under our fragmented, mainly employer-based medical system.

The single-payer plan abolishes one's individual rights. It denies one the right to self-pay or choose the plan that suits you best. It denies the right to purchase catastrophic insurance, a true insurance plan. In our current employer-based, third-party payer system, constraints interfere with self-pay and true insurance options, but they are still options for many Americans. Under Obamacare these options will be trashed.

Do you have the right to quality care? Screenings for prostate cancer, breast cancer, colon cancer, cervical cancer are less frequent in Canada then here, explaining why cancer mortality rates are up to 25 percent higher. Fewer Canadians receive care for hypertension, asthma, diabetes and coronary heart disease than in the U.S. The U.S. has better blood pressure control than Europe, better quality of life for spinal cord injury patients than in Canada and the UK, and higher dialysis rates than the UK for the same renal disease prevalence. The U.S. has higher use of statins to lower cholesterol and higher use of anti-psychotics for treating schizophrenics.

The list goes on.

In a single-payer system, care is "free," but is it available? When patients overconsume in a single-payer "free" system, care is rationed through waiting and exclusions. Canadians have given up their right to prompt surgical care, waiting an average of 14 weeks. For some surgeries the wait is more than a year. This is after you wait to see a consultant to confirm your need for surgery.

Is cost control superior under a single-payer plan? In a word, no. A recent National Bureau of Economic Research working paper on health care finance, based on data from countries belonging to the Organization of Economic Cooperative Development including all nations commonly touted as models for U.S. health care, concluded that "there has been no consistent and systematic relationship between financing and cost containment."

Is the claim by single-payer system advocates true that the free market system has been a failure? Problems exist, yes, but it hasn't failed. Since the inception of the employer-based system defined benefit health care following WWII, the current so-called "free market" health care delivery system is still untested. To believe otherwise is to deny the pervasive effect that the government has on the current private insurance market.

A Hoover Institution report says an astonishing 80 percent of medical-care pricing is based on government reimbursement rates set by Medicare. Further, regulations imposed on the industry cost more than $330 billion a year.

In the 1990's the government actively promoted managed care, believing it would reign in cost. Did the government vigorously promote Health Savings Accounts? No. That's curious since estimates show that increasing the number of Americans who buy their own health insurance from 17 to 50 million with Health Savings Accounts would reduce health care costs 30 percent from increased market competition alone.

Is it alarming that the government pays for about 60 percent of health care? Medicare costs per capita is more than any other industrial nation's public medical program.

The single-payer system kills the incentive to innovate. For example, recently the Duke Medical Center lowered the cost of treating congestive heart failure patients by 40 percent in one year with innovations that improved patient health. However, Duke lost all the savings created by losing Medicare revenue for hospital stays and doctor visits. Where's the incentive?

Switzerland is perhaps the best example of a universal health care system. Citizens are required to buy their own insurance and pay 32 percent of expenses out-of-pocket. Innovation is stifled by single-payer-style micromanagement of medical care suppliers. Restricting physician access to the latest advances is a disservice.

What is the answer to Obamacare? Here is what Benjamin Zycher of the Manhattan Institute of Policy Research has to say: "A deregulated system not tied to employment, on the other hand, would resemble the markets for life insurance or long-term care insurance. Individuals would have powerful incentives to purchase such policies when young, paying fair premiums, with efficient risk pooling in the insurance market yielding coverage for whatever level of health care expenditures for which individual consumers are willing to pay. The problem of the poor can be addressed in such a system in several straightforward ways, among them the provision of vouchers for the purchase of private insurance plans. A reorientation of the current public debate toward that kind of reform would be salutary."

The AMA Health Care Plan and McCaincare embody the voucher concept. The difference between McCaincare and Obamacare can be thought of this way: McCaincare is a defined contribution plan, while Obamacare is a defined benefit plan. We have already seen retirement plans evolve from the pension, a defined benefit plan, to the 401k plan, a defined contribution plan.

Putting the levers of controlling health care cost in the hands of individuals instead of central planners results in reduced cost. This was shown years ago when the RAND health insurance experiment demonstrated that people who used their own funds to buy health care reduced spending by 30 percent without harming their health.

Fifty years of experience has shown that single-payer systems produce lousy health care at exorbitant cost. Isn't it high time to try something else?

Dale Vaslow is the president of the Boone County Medical Society. This column was first published in the group's monthly newsletter, Prescriptions.

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Charles Dudley Jr October 22, 2008 | 7:47 a.m.

Both have mislead voters:

The real question with only a short time to go is which one is the lesser of the bigger evils.

(Report Comment)
Mike Martin October 22, 2008 | 8:54 a.m.

I, like most of the country, are getting sick and tired of these partisan rants by idiots. yourself a favor and go to John McCain's website and look at his policies...then go to Barack Obama's website and look at his policies...then look at your latest pay stub and figure out who is best for you. Don't listen to bonehead's like Mr. Vaslow here...this is the "Show Me" State decide for yourselves.

I did and I'll choose Obama's Health Care proposal over McCain's any day...but that's just me.

Mr Vaslow's article is pretty much 90% incorrect...the other 10% is lies and innuendo. Kind of like the last 8 years of American History. Find the truth for yourself.

(Report Comment)
otto becker October 22, 2008 | 8:55 a.m.

McCain's intention is to eliminate group insurance plans and make people scrabble with insurance companies. He also plans to let insurance companies base their coverages on states regulations with no oversight. When you are on your own, you lose the benefit of both negotiations for lower prices and for coverages based on numbers of insureds.
McCain's plan is the lobbyist's dream plan, for them. Billions for insurers.

(Report Comment)
Rick Starr October 22, 2008 | 9:00 a.m.

Throwing around the word "socialist" is nonsense. Insurance is inherently "socialist." When you buy homeowner insurance, you are subsidizing the people whose house burns down, even if they are careless. The people who collect on their car insurance are being paid by those who don't have accidents.

It may be that Obama's plan is bad. It's obvious that McCain's plan is worse, as any "free market" advocate should plainly be able to see:

(Report Comment)
otto becker October 22, 2008 | 9:04 a.m.

Health care IS a right. The author is missing the point. If health care IS a right, and we as a people are our brother's keeper, then we can make care of our entire nation's citizens a priority. Right now, health care is a capitalist enterprise, and the state ends up choosing what to do with the poor.
In states bordering Mexico, the state systems are overwhelmed with millions of illegals demanding care that you could have, if the author's self serving ideas do not win the day on Nov 4th. Yes it will be expensive. NO, it will not be as expensive as going to war vs countries that didnt attack us. The perspective is that people here are more important than oil there. Choose. Its really up to you.
The McCain plan is going to put 20 million people OUT of their employer plans and the Obama plan while not the complete plan portrayed by the author, will indeed INSURE 30 to 35 million more people than right now.
Obama says "I am my brother's keeper".
Are you? Christian?.. anyone, anyone, Bueller?
And we can create the end of scarce resources. Not enough doctors in rural areas of Iowa and Minnesota, and Appalachia and monster cities?
No problem. We can start Federal medical schools and place the grads in towns and cities where the authors friends WON'T practice because they cannot make enough to pay off their medical school bills. The fed med grads wont have a school bill. When they leave the federal service, they are free to practice where they choose. More will volunteer. Its about priorities.
Money talks. Love walks in Jesus's shoes. Am I my brother's keeper?
Anyone? Anyone? Bueller?

(Report Comment)
otto becker October 22, 2008 | 9:10 a.m.

This is my favorite part of the article:

In reality, universal coverage is impractical.

Really? For whom? the poor? The insurance companies?
What is impractical about it?

What he really means is that if we cover everyone, we will have to pay more than our share. Who do you think pays for the Mexicans in Los Angeles right now?
They just go to emergency clinics for everything.
OUR TAX DOLLARS pay for the freeloaders already.
If we make a system that take into account our reality and stop letting the rich and famous dictate partial solutions whose benefits accrue only to themselves, we can make a plan that works better than what we have right now. We are all in this together even if the author wishes we would all just blow away and die.

(Report Comment)
Harrelson Stanley October 22, 2008 | 9:15 a.m.

Our third child was born in Japan and had a congenital heart defect. He had full blown open heart surgery at 7 weeks. The bill was $150,000 and our portion was $8.00. If this had happened in the US at the time, I would still be paying for it. I have never seen anyone evaluate the Japanese system. But I can tell you that it is working for the Japanese people and their preventive care is something that should be studied.

Today, our son is a very successful ice hockey player. Without health care insurance he cannot go on the ice. We are now at the lowest tier of our HMO. If things continue the way they are going, he will have to quit hockey, not because of his health rather because of our health care system.

(Report Comment)
Da Mayor October 22, 2008 | 9:17 a.m.

Do you want to wake up the day after the election and ask yourself, "If I only did a little bit more?" I don't. We must spread the truth about Barack Hussein Obama II.

This smooth-talking, "eloquent," and "educated" politician has the support of every major media outlet, Hollywood, and liberal college professors. Despite his "charm," this silver-tongued devil has offered NO policies that will be in the best interest for the United States of America.

He lacks less experience than the oft-maligned Sarah Palin whom has already proven her leadership as Governor of Alaska. He lacks good judgment as demonstrated by his history of associating with questionable characters. He has accomplished NOTHING as a U.S. Senator except FAME.

He avoids answering direct questions and challenges. Rather, he grins like a school child caught with his fingers in the cookie jar. Then, he repeats the mantras of "change," "hope," and "the past eight years have been a mistake."

He claims that he wants the tax system to be "fair." In reality, what he proposes is even less fair than the existing system and will further destroy our economy.

His health care plan will be a huge bureaucratic DISASTER.

Be forewarned: With Barack Obama in the White House and Nancy Pelosi as Speaker of the House in Congress, liberal radicals will gain greater power and YOU will LOSE money and more of your FREEDOMS. Plus, our nation will face greater threats from our enemies.

It does not matter if Obama is far more articulate than George W. Bush. It does not matter if Obama is White or Black. It does not matter if Obama is Christian or Muslim.

The real problems are:




Help save the American Dream. Prevent Obama from getting into the White House. Vote McCain/Palin on November 4.

(Report Comment)
Mike Martin October 22, 2008 | 9:19 a.m.

I publish the Columbia Heart Beat and am NOT the Mike Martin below. It looks like he's from SW Missouri and I live here in Columbia.

The government has screwed up health care so bad that I can't advocate for any plans that involve more government intervention. It doesn't take care of the people who really need it, i.e. low income and disabled folks, especially those with chronic diseases; it's hiked costs for everyone; and made life miserable for most medical practitioners (most of whom, contrary to popular belief, don't make tons of money).

If you want to see how a government run medical system will function, just look at our government run legal system, i.e. the courts. Not a pretty site, frankly.

Mike Martin

(Report Comment)
Jeremy Hegle October 22, 2008 | 9:22 a.m.

Dale Vaslow does a great job of sticking to the Republican message with this article, using the party buzz words of "socialist" and "soviet" to describe the Obama campaign. If you can strip out the bias in the article the real question he poses is "Is health care a right, or a responsibility?".

Mr. Vaslow, we already have socialized medicine. Any time someone goes to the hospital without insurance and are unable to pay, the taxpayers pick up the bill. The issue is that under the current system, the health care provided is too expensive for most and is crushing small business and tax payers alike. Businesses can't afford the increasing cost and decreasing coverage offered by the insurance companies.

Mr. Vaslow-why do you want to continue letting the insurance companies rape the people of Missouri? The insurance industry has been lining the pockets of Republicans everywhere in order to keep their money making empire, while offering less and less to the American people. Why do drugs made in America cost three times more here than they do in Canada? Because the Canadians don’t let the insurance companies over charge the way the Republicans let them here. It’s time we take control of our health care back from the insurance companies. Mr. Vaslow, you aren't by chance profiting off of this too, are you?

(Report Comment)
Gypsy Venna October 22, 2008 | 9:22 a.m.

K, it took me 5 minutes to find some interesting info about this post..

The "cancer mortality rate" link Dale provided is a misguided statement. If you actually read the link, the stats show mortality rates lowering over all. The ACTUAL reason any expected increases of mortality rates are factored in because of population growth.

And I'm sure that since Dale is a physician, he isn't possibly closely tied to the insurance providers... who may be a little freaked right now if Obama wins......... hmm.. just interesting tid bits.

(Report Comment)
Carey Tisdal October 22, 2008 | 9:23 a.m.

The U.S. heathcare system has failed for me. I am in my mid-50's and through a series of unexpected events I do not have health insurance. Last time I checked I could get individual insurance--for $800 per month. I cannot afford that fee. Your article simply shows me that you are a disconnected physician not listening to your own patients and spouting an outdated mantra about socialism polished and refined by the AMA and the hospital/insurance industrial complex. What has failed is corporate medicine. The failure, like that on Wall Street, is due to greed, short sighted decisions, and the amoral and unethical thinking promoted in MBA programs. (Actually, I don't think the greed factor is as high among physicians as it is among the MBAs in hospitals and insurance companies.)

You physicians lost control of your of your own enterprises to hospitals and insurance companies (the blood suckers of our economy). I worked in a hospital, I know, doctors are not in charge. The CEO of the hospital is in charge as marketing departments spend vast amounts of money to entertain physicians and keep them quiet and happy--maybe doctors will not notice the harm done by the system to their patients. In addition, physicians receive perks from the hospital/insurance industrial complex that add to the cost of health care and make certain on the wealthy and obedient be given, not physicians.

And tell me this? How many prospective entreperneurs did NOT start new businesses because of a preexisting condition they had themselves or among their family members? How many unproductive workers stay with jobs they detest to keep health insurance? How do those factors affect the economy? What is the impact on profit potential of millions of American companies from this hospital/insurance industrial complex gone wild with spending on marketing?

Finally, we already have universal health care. People become ill, receive treatment, and go bankrupt. The healthcare and nursing home system simply extracts money from the elderly as they die and makes sure the middle and working class lose all their accumulated wealth each generation. Hey, it keeps people in line working for the wealthy Republican CEO's making millions.

For a physician to write such drivel only shows that you are disconnected from your patient's lives and willfully blind to the deadly, insane nature of the system you are promoting. Shame on you for making a once noble profession into a obedient foot soldiers for the captains of industry! Shame on you for abandoning the practice of medicine for the insane assembly line of 5 minute examinations where symptom are missed, human beings are treated without dignity, and money is spent on marketing costs for drug companies. Shame on you!

(Report Comment)
Christopher Hamilton October 22, 2008 | 9:26 a.m.

Otto: thank you. This is the question, is health care a right or a privilege? It would seem that Mr. Vaslow would like to keep it a privilege. My personal belief that health care is a right implied by "life, liberty, and the pursuit of happiness." He has picked indicators of health that serve his interest. When we look at other indicators compared by the World Health Organization, the U.S. is farther down the list of industrialized countries with universal coverage. He also likes to mix the ideas of coverage and payer, two totally independent components. The other factor to consider in terms of the arguments he is making of the Canadian system is prevention; what is done in terms of prevention and health education starting at a very early age? What do we teach and practice with our youth? What do they do in Canada? Also, no one is saying we need to wholeheartedly adopt the system of another country. Of course the solution in another country is not just ready to go here. We have our own set of challenges and beliefs. What baffles me is how anyone could not want everyone to have health care (and i don't mean walking in to an ER for primary care like now).

(Report Comment)
Don Ashton October 22, 2008 | 9:28 a.m.

You say "Fifty years of experience has shown that single-payer systems produce lousy health care at exorbitant cost." This statement is not true.

The United States spends 15% of our gross domestic product while 20-30% of its population goes uninsured (depending how it is measured). Fifteen percent is more than any other country in the world.

In contrast Japan covers universal coverage but pays only 8% of its gross domestic product for health care, while program enjoys wide public support. People freely choose their care givers and can go to specialists without having to be referred by a primary care giver. Prices are set in negotiations between the government and representatives of the various medical services.

There is no need for us to reinvent the wheel. Let's learn from the successes of other countries, to optimize choice, increase coverage and reduce total cost. Let's not forget that being unable to afford health insurance is a form of rationing. Let's not forget today's insurance clerk's second guessing the doctor is bureaucracy, and that preventative care for all people drastically reduces total costs for that person and society.

Let's also not forget that as long as universal health care isn't the rule, then insurance companies will cover only healthy people at affordable cost. All others will pay 3-5 times the cost for services.

(Report Comment)
david gaertner October 22, 2008 | 9:43 a.m.

How will pro-life people like it when Obamacare pays for optional abortions (non-life threatening) with their taxes? How will pro-abortion people like it when people get into office that they disagree with dictate what health care to provide? I am not agreeing or disagreeing, but I would like to hear how all of you feel about giving what ever health care you have or hope to have over to the political arena. Does anyone think that politicians will not play with health benefits for political gain?

(Report Comment)
John Althoff October 22, 2008 | 9:45 a.m.

Health care really is the biggest issue facing the next President. One-fifth of the population doesn't have any!; "pre-existing" conditions aren't covered on current plans (so there is no portability); Medicare is a more serious financial problem than Social simply cannot be sustained the way it is; the costs of health care are far too high. Can you believe it's cheaper for me to fly to Argentina and have first-rate treatment under a PRIVATE health care plan, with a doctor trained in Europe or the USA, than to obtain treatment here in the USA? This is ridiculous, to say the least!
Many proposal variations will be considered, but 1)the "risk" must be non-existent for the private insurance provider...that is, the role of government should be limited to guaranteeing payment to them (negotiated at a lower rate, of course). The Private insurer will have no risk, thus their fees will have to be lowered accordingly. 2) Medicare, as we know it, would then be absorbed into the new plan. Basically, private health providers would continue to offer their services, but they would NOT take on the "health risk" of the patients...just the treatment!
I'm sure there are differnt ways to look at this, but the core issues are lowering COSTS and eliminating the RISK of PRE-CONDITIONS.

(Report Comment)
Fred D Bartleson Jr October 22, 2008 | 9:48 a.m.

Should only the rich get health care?

(Report Comment)
Ayn Rand October 22, 2008 | 10:07 a.m.

Universal health care is fine by me as long as there are stiff penalties, such as paying a hefty premium, for people who choose to smoke, remain obese, do drugs, water ski, etc. If you live an unhealthy lifestyle, the rest of us should not have to pay for it.

Don't like those rules? Then don't expect me to chip in for your health care.

(Report Comment)
Gareth Collins October 22, 2008 | 10:08 a.m.

Yes, in the US system you have the right to go bankrupt due to medical expenses!

The US with its private healthcare pays twice as much as a percentage of GDP for healthcare as most other industrialized countries, yet falls behind in terms of medical outcomes (i.e. lower life expectancy). I have lived with both systems so I know the single-payer system provides better health care at much, much lower cost.

This guy is just showing his blatant self-interest. He knows that a single-payer system will mean less money for him.

(Report Comment)
Jim Roberts October 22, 2008 | 10:26 a.m.

"Isn't it high time to try something else?"
It is time to try something else... and John McCain is not proposing something that will improve our broken system. McCain's plan will dismantle employer group coverage, which insures many older and unhealthy people. The health insurance companies will benefit by approving only the youngest and healthiest. We will probably see at least 40 million who lose group coverage be denied by medical underwriting and will have to go into high risk pools... or be added to the 47 million who already are uninsured. Americans who have not experienced medical underwriting do not have a clue about how the system works. Anyone in your family overweight? What is your BMI? Any history of asthma, cancer risk, heart problems, diabetes, smokers, substance abuse in your family?? How about any skin conditions? Denials or surcharges run rampant. Are you satisfied with a $10,000 family annual deductible? How far will that tax credit go if someone in your family has to be in the high risk pool? Cindy McCain, Joe Biden, at least one from the Palin family would not be approved by medical underwriting. How about you?? Have you checked the Missouri High Risk Pool coverages and prices? How about a $23,000 annual premium for a couple at age 50? Is that better than your group coverage?? Let's not forget how pre-existing conditions are treated. So the health plan for McCain, Obama and Biden is group coverage... but if the same plan is offered to you, it is socialism? That makes as much sense as calling Obama's tax plan socialism. No doubt... neither McCain nor Palin seem to understand our progressive income tax system anymore than how our healthcare system works.

(Report Comment)
Ayn Rand October 22, 2008 | 10:47 a.m.

How many of you are willing to accepted government-mandated lifestyles in exchange for "free" health care? For example, are you willing to allow the government to ban cigarettes?

(Report Comment)
Deb Lucia October 22, 2008 | 10:53 a.m.

Health care is already available to all Americans. The problem is it's too expensive. In the USA we pay 25%-40% of every dollar to paperwork - the highest cost is for Medicare coding. Obama's plan will add 15% more cost plus add 10 Million illegal immigrants into the system.

We will all be in waiting lines to see doctors. And doctors, there will be less of them as they will not be able to meet patient needs, and will see their income reduced.

We need to stop lawsuits with awards 20 times that of any other nation. We can lower cost. Obama will just burden us with more.

With Obama - Mr. Lawyer - no way to reduce costs.

Only add. And with Mr. Obama we will have given voting control of this country to 49% of the people who pay no taxes. Their demands will be met by those of us that work and we will never be able to eliminate the waste from our governement.

I love this country and fear the sad days ahead.

Our children will never forgive us for following into the trap of "Agent for Change" Yes we will change. Hitler, Chavez they were change too.

(Report Comment)
John Schultz October 22, 2008 | 11:16 a.m.

Regarding the claims that health care is a right, consider the below statement by Neal Boortz:

"You may think, for instance, that you have a right to health care. After all, Hillary said so, didn't she? But you cannot receive health care unless some doctor or health practitioner surrenders some of his time - his life - to you. He may be willing to do this for compensation, but that's his choice. You have no "right" to his time or property. You have no right to his or any other person's life or to any portion thereof."

It follows that taxes will have to be raised to create universal health care. How much that might be is anyone's guess, but it is something most people do not consider. Probably the best solution is to get federal government out of the mess (someone please show me where Medicare and Medicaid are authorized in the Constitution) and let the individual states come up with more local solutions.

I'll also note that I see some incorrect statements about McCain's proposed policy on health care. It would not dismantle group healthcare or eliminate employer-provided insurance. There may be a decline in the usage of those plans if the covered members find better plans in the free market, but I think it will be minimal. Also consider that his $5000 tax credit lets people not be tied to their current employer's insurance by selecting their own private plan. It is also a sizeable decrease in most people's taxes.

(Report Comment)
Gareth Collins October 22, 2008 | 11:16 a.m.

Deb Lucia, Ayn Rand,

Gosh you are brainwashed.

Go to any country with universal coverage (e.g. European countries, Australia, Canada etc.). If given a choice, almost no-one (except those in the health industry that would earn more) wants American-style health care.

They are happy as they know they get better health care for less money. They have the peace of mind that if they have a heart attack/cancer etc., the treatment won't bankrupt them.

Face it - a completely "lassai-faire" health system just doesn't work. The USA has shown that.

(Report Comment)
Donald Peabody October 22, 2008 | 11:25 a.m.

Obama voted FOR Partial-Birth Abortion (the most barbaric "medical" procedure allowed under the law, and AGAINST the Federal Born Alive Infant Protection Act, which prevents babies that survive an abortion attempt from being killed or left to die. He has also stated that he thinks women should have a period of time after a baby is born to decide if they want it killed! What more do you need to know about Obama?

(Report Comment)
John Schultz October 22, 2008 | 11:26 a.m.

Gareth, that would be laissez-faire.

What do you say about stories of Canadians coming to American hospitals for procedures they can't get done in a timely manner? NHS hospitals in the UK saying they can't afford cancer medicine for a patient? Those systems don't seem like health utopia to me, nor to the affected patients.

(Report Comment)
david gaertner October 22, 2008 | 11:28 a.m.

My Mom went to the doctor last year and the nurse saw her blood pressure was so high it prompted immediate action. She was not allowed to leave but instead was put into an ambulance and rushed to the hospital. A few months later, she was visiting England and told her experience to a friend. She said she had something similar happen but was told to go home and call to schedule an appointment. It was scheduled more than 3 months out. I would rather be broke and alive than have a post mortem appointment with a free doctor.

(Report Comment)
Deb Lucia October 22, 2008 | 11:29 a.m.


I would be for a universal health care plan if we first get rid of the waste. That's not whats on the agenda here.

In Europe, Canada the cost of health care paperwork is 4-5%. As I said earlier, in USA it is 25%-40% and it is estimated that Obama's plan will add 15%.

Again, the problem is not that Healthcare is unavailable to everyone, the problem is it's too expensive.

Let's solve the problem.

We have been a great country built on the American dream. Welfare has no place in the America dream.

Helping people improve themselves does. Encouraging people to get a better education does. Letting people see that hard work pays off is something for each of us to strive for. A free handout - only enables people to expect more.

Let's face it. Without big business to provide jobs (they have the best benefits) where is everyone going to work at? We need to create an environment here in the USA that makes companies want to come here. That's how you create jobs. The stock market is down because investors are afraid of an Obama election. They are getting out before he gets in office.

That's not a postive change for us.

(Report Comment)
Ayn Rand October 22, 2008 | 12:04 p.m.

Gareth, you live in a fantasy world, like Harrelson, who believes that a $150,000 surgery cost only $8.00. You pay a lot more for "free" health care in terms of taxes and opportunities lost because of those taxes.

And look at how the feds have screwed up everything from Social Security to FEMA housing trailers. Do you really want those fools controlling your access to health care, too?

(Report Comment)
Doctor R October 22, 2008 | 12:08 p.m.

Vaslow is right! Socialism is Bad!

Let's look at one way socialism has crept into our society.


Fire protection has been set up as a socialist system in this country. Firefighters will put out a fire at ANYBODY's house, regardless of their ability to pay. This is anti-capitalist. People whose houses DON'T burn down are forced to pay for those careless, miscreants who allow their houses to burn down.

This socialist system has created excessive spending on fire protection. Firefighters don't need all that fancy equipment, they could get by with just a hose and buckets. Private firefighting companies could be formed for those who can afford to pay for the extra equipment.

And the WAIT TIMES! As we all know, due to the free, socialized provision of firefighting, sometimes people whose homes are burning need to wait an excessively long time for firefighters to be available.

People think that having firefighters at their home when it is burning is a RIGHT! That is wrongheaded, socialist thinking. Paying for fire protection is a personal responsibility, and if you prefer to spend your money on junk food or heating your home, it is your problem if your house burns down.

Don't accept socialized fire protection. Socialism is always bad, and we must root it out of our society. Here are a few other areas of socialism that we should work on getting rid of as well:

Free education for our children
Highways paid for by YOUR TAX DOLLARS! (If you can't afford a helicopter, TOO BAD! Dirt roads were fine for your great grandparents.)
Subsidized school lunches
Subsidized immunizations
Socialized Law Enforcement. (The police are paid for by your TAX DOLLARS. Private security could provide this service to those who need it and want to pay for it.)
A socialized judicial system. (Judges and the expenses of court rooms are paid for by everyone, and could be replaced by private justice systems that make sure YOU get the justice you pay for.)
Socialized Defense! The Army, Navy, Air Force, etc. (Private defense companies can protect those who pay for it. The rest of you can move to Switzerland if you're so fond of socialism.)

Just a few places to start. Let's rid our country of evil socialism FOREVER!

(Report Comment)
Gareth Collins October 22, 2008 | 12:16 p.m.

Hello John,

You are right. I should have checked my spelling :).

And you are right that in the US, if you have the money you can get the best healthcare in the world. But that is the problem! What is the point having the best healthcare if only a tiny percentage of the population can afford it?

A couple of years ago, I was speaking with a maintenance worker at my office building. He told me he was $100,000 in debt due to a appendicitis operation. Coming from Australia, I almost fell off my chair. And finding a hospital for an appendix operation isn't like buying a TV. You really don't have time to shop around.

An article in the wall street journal mentioned how some hospitals are now asking for upfront $10000/$20000/more payments to be admitted to hospital for critical (but not immediately life threatening) treatment. How do you expect people to pay this?

I am not saying that the government should completely take over health care. I am saying we should have a system like education. The government guarantees every citizen a basic education. If you want something better, you can send your children to a private school. What is wrong with something similar for health?

Deb Lucia - I don't subscribe particularly to Obama's health plan...and I certainly agree that health care in the US needs to become more efficient.

However, I do agree with the principle that access to basic and emergency health care, just like a basic education, should be a right of all citizens. Obama's plan, in a convoluted way, appears to be getting us closer to that.

(Report Comment)
Ayn Rand October 22, 2008 | 12:23 p.m.

Doctor R, if you truly believe in making health care more affordable, will you accept the feds offering incentives to encourage tens of thousands of foreign doctors and nurses to move here? They will work for less, driving down health care salaries and thus helping achieve significant savings.

(Report Comment)
Bad Dad October 22, 2008 | 2:18 p.m.

Mr. Vaslow is your typical conservative hypocrite. He says health care should be the responsibility of the individual.
My 23 year old son has been fighting a brain tumor for 13 years. He is working part time making 8.00 per hour and can't get a job with health insurance because no one will hire him with his health history. He is fully capable of working. Our state allows him to be on my insurance until he is 25 so he is covered now but in two years he won't have health insurance. His last surgery was $90,000. One of his chemo drugs was $5000. How is he supposed to be responsible for his own health insurance???

As with most conservative hypocrites, Mr. Vaslow will change his mind when someone close to him is in this situation.

(Report Comment)
Ayn Rand October 22, 2008 | 2:33 p.m.

Sorry to hear about your son. But are you confident that he would even have had those surgeries and other treatment in time if we had universal health care? Judging by the long waits in countries that do, probably not. Many people in the U.K., Canada, etc. die from prostate cancer simply because the long wait times mean it isn't caught in time.

(Report Comment)
Bad Dad October 22, 2008 | 2:43 p.m.

Yes he would have had the surgeries. I have done some research on what the other countries are doing and long waits used to happen but most countries have eliminated the wait for serious surgeries. Elective surgeries do have longer wait times than we do but I can live with that.

(Report Comment)
Ayn Rand October 22, 2008 | 2:58 p.m.

I'm not so sure:

"And if we measure a health care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50%; the European rate is just 35%. Esophageal carcinoma: 12% in the U.S., 6% in Europe. The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England."


(Report Comment)
david gaertner October 22, 2008 | 3:09 p.m.

How do you go about researching specific medical treatments in foreign countries? I'm not saying you are making anything up but would like to do my own comparisons. My Mom was able to gain a lot of insight into England’s health care system from her friends’ point of view. They seemed pretty ardent that the government doled out care in areas they thought would get the most bang for the buck. For example, older people would not receive timely cancer treatment since they are not paying into the system any longer but a 20 year old kid would get the treatment since he has several decades to put back in. Heck, have you seen their teeth? It’s cheaper to pull than to maintain for the rest of their lives.

(Report Comment)
Gareth Collins October 22, 2008 | 3:24 p.m.

I read your article at ibdeditorials (again by "Gratzer, a physician" who of course has no self-interest here).

He can pick and choose statistics on particular expensive diseases as much as he likes. However he still acknowledges that US has a lower life expectancy (75.3 years) than Canadians (77.3) or the French (76.6) or any other country in Western Europe bar Portugal. If our health care was SO much better (we certainly pay SO much more) we should be way ahead of these "socialized" medicine systems.

(Report Comment)
Ayn Rand October 22, 2008 | 3:28 p.m.

Gareth, you must have missed this part:

"Health care influences life expectancy, of course. But a life can end because of a murder, a fall or a car accident. Such factors aren't academic — homicide rates in the U.S. are much higher than in other countries. In The Business of Health, Robert Ohsfeldt and John Schneider factor out intentional and unintentional injuries from life-expectancy statistics and find that Americans who don't die in car crashes or homicides outlive people in any other Western country."

(Report Comment)
Gareth Collins October 22, 2008 | 4:03 p.m.

I read that too. The same study was quoted in the WSJ a while ago. It shows that if you allowed to discount what you want from the results or (just like the article) if you are allowed to pick and choose specific diseases, you can pretty much prove anything (there are many discussions on the web about the "Business Of Health" results and the way they were calculated).

Even if you do take there results at face value where US is shown to move from a couple of years less from Western Europe to 6 month up, then it still shows the health system is a mess. Double the money for just a few more months is not a good investment!

Perhaps some of that money would be better spent on preventing those accidents and homicides which are spoiling the US statistics.

(Report Comment)
Mike Martin October 22, 2008 | 4:09 p.m.

The SW Missouri one. I have to disagree with my namesake from Columbia and with a few of the posters on here. Look here's the deal no matter how you spin it.

I have an 18 year old highly functioning Autistic son that has also been diagnosed with COPD, a severe respiratory disorder. I currently have probably one of the best insurances in the SW part of the state but even with that my kid's meds cost $300 a month. When my son graduates this year, we have these choices: (A) He goes to college (hopefully) and can continue on my insurance until he's 24. (B) He gets on SS Disability and medicare and the tax payers pay for his care. (C) Or he gets no medical coverage at all and he dies, because there's no way he or I can afford the several thousand dollars a month that his meds cost without insurance. That's they way the system is right now.

McCain's plan is to TAX my now untaxed benefits at both my employer and\or my level. Look at your check...the nontaxable income you now have will move to the taxable column. You don't have to believe me you can look it up on McCain's site. My odds of keeping my employer based coverage are pretty low as my employer is going to have to determine if they can afford to keep their employees insured. If I lose my insurance then we are only left with Options B and C. So either YOU pay for my kid or he dies. That is if McCain doesn't cut Medicare...then we just have option C.

For some of the more repugnant posters out there spouting off about abortion...I guess you are actually Pro-Fetus...because once the kid is born you don't care about life at all.

Under Obama's plan: We still have Option A because my employer based health care doesn't change at all. IN fact the only thing that does change is that eventually my and my employers premiums will go down. Not to mention our costs will also go down. How is that? Well, because the strain on the Medical Economy caused by the uninsured is currently being absorbed by me and YOU. In higher costs of health care. By insuring everyone, those costs go down. Therefore the insurance costs will go down and then the premiums will go down. It's all about the costs, know it...I know it...Barack OBama is the only candidate addressing it.

Also we have an option D under Obama's plan. My kid can opt into the Governmental plan (the same one that saved John McCain's Life) and be covered under it. He can actually pay for his own insurance...imagine that!

People, like I said in my first post. Go find out for are Missourian's and they have historically been wary of taking things at face value. Honor your history. Don't depend on your Church, or the Media, or the Newspaper for the truth. Go out and look for yourselves. No matter who you vote it because you know what's right for you...because you are informed.

(Report Comment)
Jake Sherlock October 22, 2008 | 4:34 p.m.

Here's a comment from Mr. Bob Grossman, of Phoenix, Ariz., who had some problems attaching his comment to the Web site. I offered to post it for him. Here's what he has to say:

I hope to God I can get rid of my company health care plan and opt-in to a government run plan. My company health care plan is horrible - expensive and limited.

Absolutely nothing could be worse than the poor health care coverage we receive in the US. My children are all grown, working and living on their own. None have health care coverage at their jobs.

If Obama has any kind of a plan to scrap this mess and start over, he will get my vote.

(Report Comment)
Harrelson Stanley October 22, 2008 | 4:38 p.m.

I paid into the Japanese health care system for 12 years and my wife and her family paid into the system for many many years. I know what the life saving team cost. I just don't think it's fair to ruin a baby's future before it life gets started. A good national health care system is in everyones best interest

(Report Comment)
John Schultz October 22, 2008 | 4:41 p.m.

John McCain's healthcare proposal will not end employer-provided healthcare. The $5000 tax credit will actually be a tax savings to most people. For instance, if you have employer-provided insurance worth $10000 (to make the math easy) and are in the 25% tax bracket, you'll be taxed at most $2500 on it. For a person with a family plan that gets the full $5000 credit, that would leave $2500 left over to put into a Health Savings Account to pay for other health expenses.

Almost all other benefits provided by employers (company car, life insurance, etc.) is taxed to some degree, so I don't see why once upon a time healthcare was given this sacred exemption. If you have employer-provided health insurance, you pay for that with pre-tax dollars. However someone who carries their own policy isn't so lucky. McCain's tax credit ends that double standard.

(Report Comment)
Ayn Rand October 22, 2008 | 4:47 p.m.

It's a fallacy that insuring everyone will drive down costs. The greatest savings will come only when there are significant disincentives for certain lifestyle choices (e.g., smoking, being a fatty). Are you all prepared to give up certain choices in exchange for health care for you and your fellow man? Or are you willing to pay extra, steep premiums in order to be allowed to live as you wish?

(Report Comment)
Charles Dudley Jr October 22, 2008 | 5:03 p.m.

Ayn Rand look at you claiming to be disabled and in the same part making fun of others who smoke or are fat. How do you know those types do not have underlying psychological disabilities?

The only thing I hate worse than a racists is a bigot and you certainly fill the latter role perfectly.

(Report Comment)
Gareth Collins October 22, 2008 | 5:05 p.m.

Ayn Rand,

At least there is one thing I can agree with you on. On its own insuring everyone, whilst it may redistribute health care cost, will definitely NOT bring down costs.

(Report Comment)
Ayn Rand October 22, 2008 | 5:13 p.m.

Underlying psychological disabilities causing one to smoke? Um, no, other than maybe stupidity or a weak will. Stop making excuses.

(Report Comment)
Charles Dudley Jr October 22, 2008 | 6:05 p.m.

No Ayn Rand you are now showing how uneducated in the matter about disabilities you really are.

Obviously you do not read medical literature on the various subjects concerning the disabled as a whole and their psychological issues they deal with from birth into adulthood or you would not make such a crass statement.

You did not answer my question either on the other thread about the meaning of a "true disability" according to your reasoning.

Oh and Ayn Rand are you going to be here tomorrow:

I would hope to see you there so you can tell me in person what your views of what is a "true disability" are if you are afraid to post your views here. I love to talk shop with people in the community who are Advocates for the disabled or who claim to know so much about the disabled. :)

(Report Comment)
Ayn Rand October 22, 2008 | 6:44 p.m.

Is this the same medical literature that says a father can pass fetal alcohol syndrome to his child?

(Report Comment)
david gaertner October 22, 2008 | 6:53 p.m.

Hey Mike Martin,

I think I am the only one who mentioned abortion so I would like to clarify my question. It is not whether the procedure is right or wrong but about the people who are making the decision to pay for it.

As for pro-life, I adopted and will again so I do care. Try not to assume too much or take questions so personal.

Does anyone here think the politicians will not use covered vs. not covered procedures to pacify their constituency?

Democrats will not always control the legislature, and probably the White House soon. What if there is a major right wing backlash in a dozen years and the health care system is then being administered by the religious right?

I mentioned abortion because those opposed to it do not want to pay for it and it is for the most part an elective procedure. Kind of like Lasik eye surgery, Botox, plastic surgery or penile enlargement only much more volatile in emotion.

Like I said, I just want to know if the Democrats out there want Republicans controlling the purse strings of their health care and vise versa.

(Report Comment)
Charles Dudley Jr October 22, 2008 | 7:02 p.m.

Ayn Rand you are still not answering my earlier question of today "what is a true disability?" Stop dodging the question.

(Report Comment)
jeff lz October 22, 2008 | 7:10 p.m.

McCain backs the insurance companies not patients. His tax credits for health insurance is not the answer to those who can't afford it in any case. Moreover, McCain will do nothing for those with pre-existing conditions. His old idea of creating a high risk pool is already a demonstrated failure. He also wants to tax healthcare benefits from employers indirectly canceling the tax credit. We are the only developed country that does not have healthcare available to all of its citizens without question. We have 47 million people in this country without any healthcare coverage whatsoever. We already have a working model for broad healthcare, it is called Medicare and it does work. We need to expand it to cover everyone. No citizen should ever be denied medical care they need whether or not they unemployed, whether or not they can afford health insurance, whether or not they have cancer or heart disease or asthma or any pre-existing condition! It is a fundamental human right. With no new ideas McCain has his head stuck in the past still spouting free-market slogans (as he did for Wall St.) and protecting the insurers, not the patients.

(Report Comment)
John Schultz October 22, 2008 | 8:40 p.m.

Jeff, you are incorrect about several points of the McCain proposal. See my numbers above about the tax credit and how it would impact a family. Keep in mind it is not a deduction, but a credit. That's a dollar-for-dollar reduction on one's taxes.

The Tax Foundation has said it would be a $1.3 trillion tax cut over 10 years (hopefully if elected McCain would also reduce spending to offset those cuts, but I'm not holding my breath).

Medicare is not a sustainable system. It, along with Social Security and Medicaid, is taking up a larger and larger percentage of federal and state budgets. Get the feds out of healthcare (someone show me in the Constitution where it is authorized) and let the individual states come up with their own solutions.

(Report Comment)
Mike Martin October 22, 2008 | 11:43 p.m.

David, I think we could have a deep discussion about abortion on an abortion related topic. Which this isn't.

I'd like to know how having everyone insured WON'T bring down costs? Several people said that but surely didn't state why that is.

So here's my argument against that presumption. Several factors drive up costs of Medical Care. The largest overriding factor though is people defaulting on bills. I know that some politicians like to say it's malpractice suits but that's NOT the case.

If you took any business (which a Hospital or Clinic is) and half of the people got services and did not much do you think the services would cost? Say it was a Mechanic shop and for every brake job they did they got stiffed on half of them. As a business you'd have to mark up the price of the brake job to recoup your losses. Makes sense.

Hospitals are no different. They are controlled by Boards and many are public companies and have Stock Holders and they have to generate a profit. So how do you do that when (A) you legally have to provide services and (B) you don't get paid for a large percentage of those services? You jack up prices to overcome the loss.

Insuring everyone would give Hospitals and Clinics the ability to garner payment from the insurance company, that they don't have now. Because of this the costs of services will eventually drop. One neighborhood Hospital will compete freely against another to offer it's goods and services at a lesser profit margin to raise the numbers of customers and increase it's revenue. It's called the free market. Costs go down.

Where our medical care has broken down is directly related to the fact that Hospitals and Clinics MUST provide services (rightly so) to ALL regardless of ability to pay. This factor alone, for the last 30 years, has made our nation's health care so expensive. So we broke the Free Market system with that regulation...what we haven't done is address a means for the Hospitals to get paid and provide for the Free Market to bloom again.

Senator Obama is the only candidate who has a proposal to do just that. Sen McCain does not and neither does any third party candidate.

(Report Comment)
david gaertner October 23, 2008 | 7:53 a.m.


You are still missing the point. I DO NOT want to discuss abortion. I want to discuss who will PAY OR DENY PAYMENT for abortion. That is only because it is a hot button procedure (thank you for proving that point already), you can substitute any other mainly elective procedure you wish if that will help you answer the actual question.

I am going to ask you for a third time: Do you want the religious right controlling your health care? How about the far left?

If health care does wind up in the government sector, each of these scenarios WILL HAPPEN sooner or latter. Is anybody comfortable with giving up more control to the self serving politicians? If the health care system is largely taken over by the government, the politicians WILL use this for their own gain rather than what is right for the patient.

Your argument that prices will come down when everybody goes to the doctor doesn’t make sense. You say some people cannot afford to pay so the prices are raised for the rest to make up the difference, I agree with that part. However, the folks who couldn’t pay before still cannot pay and the others who didn’t go at all will be more inclined to go which will ring up many more bills. This money doesn’t just show up from the mint, it comes from our taxes. If you think your health care costs are high now, wait until we are also paying for 47 million more people’s health care who can’t pay now.

(Report Comment)
Ayn Rand October 23, 2008 | 8:10 a.m.

David G, you hit the nail on the head with this statement: "However, the folks who couldn’t pay before still cannot pay and the others who didn’t go at all will be more inclined to go which will ring up many more bills. This money doesn’t just show up from the mint, it comes from our taxes. If you think your health care costs are high now, wait until we are also paying for 47 million more people’s health care who can’t pay now."

(Report Comment)
Gareth Collins October 23, 2008 | 9:06 a.m.


What you personally pay for medical care MAY go down, the country as a whole will be paying more for medical care.

You said so yourself. You are expecting all those uninsured people to now pay more. If these previously uninsured, now insured people are poor this money will come from the government (so you may pay in the end pay more via higher taxes). Also these newly insured people are likely to take more advantage of health care services, pushing prices up even more.

Any real "solution" to the medical insurance crisis must involve controlling costs. Hospitals/health professional salaries/pharmaceutical companies etc. are increasing prices every year. The current insurance companies have failed to wring efficiencies out of the system - they just pass the bill through in higher insurance premiums (and if the government makes it harder not to have private insurance these price hikes will be even easier to pass through).

The market has failed. The market fails because health care is not like buying a plasma TV. If the price of a plasma TV is too high, you can always "walk away". Demand for plasma TVs is elastic. However, demand for life-sustaining medical care is inelastic, and always will be. You will pay whatever it takes to stay alive and so the health industry will charge whatever they like. The only entity that can keep control of cost is government (unfortunately).

(Report Comment)
Bad Dad October 23, 2008 | 9:57 a.m.

David, (from 3:10 yesterday)
I know you want to show how universal health care affects
quality of care and it will probably have some impact but in my son's case it isn't relevant. It doesn't matter what the quality is if he doesn't have access to it because he doesn't have health insurance. In two years he will not have health insurance. He will be eligible for the State plan but the cost will be way too high since he only makes 8.00 per hour.
He wants to work and contribute to society but society won't let him because of the brain tumor. Then, when the brain tumor grows again he will die!

(Report Comment)
Ayn Rand October 23, 2008 | 9:58 a.m.

Costs also must be controlled by creating disincentives for certain lifestyle choices. For example, if you smoke or are obese, you should pay a penalty in the form of a much higher premium.

(Report Comment)
david gaertner October 23, 2008 | 10:17 a.m.

Bad Dad,

That sucks. My heart goes out to you and your family. Are there research opportunities for him to participate in? Many research hospitals and medical schools offer admittance to studies for lower cost and sometimes free. They use government grants to run these studies so they can train other health care facilities. I grew up near Raleigh, NC and the Duke and UNC systems (Wake Forrest is just 70 miles down the road) were/are fantastic.

I am not opposed to government involvement in health care, I just oppose them telling me what I can have and what they may decide to do with my money.

(Report Comment)
david gaertner October 23, 2008 | 10:22 a.m.

By the way, do you have links I could use to do my own research? I would rather not let Mr Vaslow, Sen. Obama or Sen. McCain just tell me to trust their opinions are right.

(Report Comment)
Gareth Collins October 23, 2008 | 10:39 a.m.

Ayn Rand,

Certainly creating disincentives for certain lifestyle choices should be part of the mix (i.e. smokers should pay more)...though this only delays cost (everyone gets sick and dies someday), it doesn't necessarily remove it. As well it has other consequences (e.g. in creating social security, it was initially assumed that people did not live very long after retirement).

The only real solution is to force down the cost of health care, making medicines cheaper, making operations cheaper etc. Either the health industry becomes more efficient or it loses profits.

(Report Comment)
david gaertner October 23, 2008 | 10:43 a.m.

Bad Dad,

This is the information I gleaned from the first three hits out of nearly 1.6 million when I Googled “brain tumor studies.” America is a very generous and giving nation for those who are in need without the government forcing it on us. If anything, I hope this helps your son live a long and happy life.

(Report Comment)
Bad Dad October 23, 2008 | 12:46 p.m.

Thanks for the brain tumor sites. I have looked at some of them. I don't like the government to telling me what I can have either but I also feel everyone has a right to basic health care. I read about a 50 year old man who wanted to start his own business. He quit his job and then found out he couldn't buy health insurance because he had asthma 40 years ago. My son's situation is more serious but you don't have to have a major illness for the insurance companies to write you off. It can happen to anyone! I agree it won't be perfect and
it will be expensive but we are the only industrialized country with out universal health care. PBS had a great program about Universal Health Care. You can watch it online. It tells how it works in other countries.

This shows we can do it too!!!

(Report Comment)
david gaertner October 23, 2008 | 1:34 p.m.

As innovative as our private sector has been in so many areas of industry, I do wonder why health care management seems to lag so far behind. There are just too many layers to that onion for an outsider like me to peal away to the truth. I do not trust politicians who tell everyone what they want to hear and deny everything they do not want to know.

When I was a kid, we had a family doctor. If I was sick, I went in and got what I needed and no insurance company dictated what kind of medicine I should receive. My doctor knew my name, my siblings’ names, what I came in for last. It was an actual patient/doctor relationship. I am afraid those days are gone forever because the bean counters are controlling so much. It’s become a business rather than medical practice and business can be cold.

Someone mentioned Japan’s system. I looked up their tax system and found people making (I’m rounding here) 33k to 69.5k pay 20% income tax plus 10% combined municipal and prefectural tax. If you are a non resident, you pay another 20%. I am not sure if there is a consumption tax but right there is 50% on what would be a solid mid to lower income earner in US. They better pay all but $8 for that $150,000 bill because the taxes would break them before they get sick.

(Report Comment)
Ayn Rand October 24, 2008 | 7:28 a.m.

One example of the tough decisions that will have to be made when the government is in charge of health care:

(Report Comment)
David Humbles February 23, 2010 | 2:29 p.m.

Why does the word 'socialism' have to crop up all the time? I lived most of my life (40 years)in South Africa, where the health system is insurance/employer driven (just like in the US) and (now living in the UK) having the National Health Service is a vast relief. I instinctively don't like socialism or 'big government' but am perfectly happy to make an exception for free healthcare and education. I realise that neither are 'free' but I earn a slightly above average UK salary and my overall tax rate is 24% which includes health and social welfare expenses and that hardly seems excessive to me - I paid a much higher rate in SA. I admit I have no idea what Americans typically pay.

Obviously health is a bit of a lottery but I'm more than happy to chip in with my fellow citizens and the weight off of my shoulders is hard to quantify or explain. Obviously there's some general resentment against fat people, heavy drinkers and smokers but that doesn't change the fact that there's a pretty good system looking after us. The UK doesn't have the best system by all accounts - Canada and France are said to be better - but I'm pretty happy with it personally. If you are well off then private health care is available - I have access to it as part of my salary package but turned it down because I don't see the point - the NHS is that good.

Jibes about British people's snaggleteeth are kind of funny but not really the point either as dentistry is only partially subsidized by the NHS. My experience of UK dentistry has been reasonably good too and the prices are OK.

All of the above has been anecdotal, granted but I feel obliged to defend 'socialist' health care and I really don't understand why people in the US fight something that could be pretty good for them so strenuously. I think you should be careful of propaganda from the private health and insurance industries. If you can afford health care in SA it's like being in an upmarket hotel and so much nicer than in the UK but there's nothing much wrong with NHS care when you really need it and I'll say again - it's wonderful to have the option when you really need it.

(Report Comment)

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