Lying Worthless Political Hack Calls Opponents of ObamaCare Nazis

Thursday, August 6, AD 2009

I must say, although I have never been a fan of the Lying Worthless Political Hack, I was surprised at this latest example of the depths of her political ineptitude and detachment from reality.  As to her comment about “astroturfing” ( creating a fake, rather than a real, grassroots movement), David Axlerod, the campaign manager of Obama, built a large fortune by mastering the techniques of astroturfing as this article here relates.  Alas for the Lying Worthless Political Hack, as the polls amply indicate, the opposition to ObamaCare is real and growing.

Update: The indispensable Iowahawk has the White House Under Minister for Truth, former ABC and CBS reporter Linda Douglass, explaining here all about those evil townhall mob agitators!

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22 Responses to Lying Worthless Political Hack Calls Opponents of ObamaCare Nazis

Post Office Going Broke

Tuesday, August 4, AD 2009

snail mail

As this story indicates here, the Post Office, in spite of a rate increase, is in deep financial trouble.  Unwilling to adapt to a changing market, the wranglers of snail mail no doubt will be the recipient of a massive bailout in the next few months to “save the local post office”.  Something to keep in mind before the government is put in charge of our health care.

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6 Responses to Post Office Going Broke

  • If the Post Office isn’t able to meet its mandate to provide affordable mail service across the U.S., we might consider repealing the mail monopoly it is granted, at least in those areas and times in which it is no longer offering service.

    Just a thought.

  • Having a nation-wide way of getting mail around is very important…biggest problem with the post office is that it’s run by, well, the gov’t.

    There’s a HUGE post office about three blocks away from where I set, to the north. About two miles from that, west, is another– also huge, mostly empty. To the south, about a half-mile and then one mile in either direction, are two more. (slightly smaller)

    Every time I’ve gone in the big office there have been at least two folks in the back desks, and one or two at the front. So far as I can tell, 90% of the front-desk-work could be done by anyone bright enough to graduate high school, since you set a box on the scale, type in the address, read off the options and then push a button to get a print-out of the address with cost. Anyone that can manage a fast food job could do that… somehow, I doubt they’re getting minimum wage.

    If the post office were run more like a private business, with the exception that they still had to offer nation-wide, everyone-can-use-it service in return for their monopoly, it would probably do better….

  • Why not

    1. Transfer the Postal Inspection Service to the Department of Justice or Homeland Security;

    2. Articulate Postal pension and medical benefits into two components: a stream they would receive were such programs actuarially sound, and the subsidy thereto; the obligations of the latter would be assumed by the U.S.Treasury and be vestigial, trending to nil over a run of decades;

    3. Put the corporation that is the United States Postal Service on the auction bloc, selling it in an initial public offering and allowing it to claim the term ‘Post Office’ as a trademark;

    4. Assemble every six years extant postal companies (USPS, UPS, FedEx, &c.) and have them bid on a standard contract for mail delivery in the deep country – rates and loci specified. Low bidder gets the contract. The other companies can deliver to these routes, they just do not get paid by the U.S. Treasury to do so and can charge what they please.

  • You folks are obviously spreading malicious lies and misinformation. Our beloved leader has told us that by removing the profit motive and cutting down on overhead, the government will provide savings over private industry- ergo, the United States Postal Service cannot be in trouble. If it had been in trouble, he would have fixed it with his pouch of fairy dust, and it would be more profitable than FedEx and UPS combined. You are just trying to shake the faith of His loyal subjects in the cost cutting prowess of the federal bureaucracy which is going to bend the ‘cost curve’ and save the economy without reducing services. I am now obliged to report you to the Executive Branch office of ‘Saying Naughty Things About His Highness’.

  • [youtube=http://www.youtube.com/watch?v=pj73rqEpr1A&hl=en&fs=1&rel=0&border=1]

  • Ummm… who do I inform on him to?

It Couldn't Happen to a Nicer Guy and Gal

Tuesday, August 4, AD 2009

Ah, it does my heart good to see Senator Arlen Specter (D.Pa) and Kathleen Sebelius, Secretary of Health and Human Services exposed to the verbal anger of the public!  Now why is that?

Well as to Snarlin’ Arlen, he was for decades a pro-abort Republican and now is a pro-abort Democrat.  My reaction when he jumped parties earlier this year was good riddance.  He jumped parties of course because he was an almost certain loser to pro-life Pat Toomey in the Republican primary.  The hilarious thing is that Specter will face a Democrat primary challenge from Congressman Joe Sestak who announced his candidacy yesterday.  If he survives the primary challenge he faces an up-hill fight against Toomey.  In a Quinnipiac poll on July 22, Specter leads Toomey by a single percentage point 45%-44%.  This is a devastating poll for an incumbent facing a well-known challenger.

As for Sebelius, she is a fanatic pro-abort, as I detailed here, and a close political ally of the late Tiller the Killer.  Just before her confirmation it came out that she had received three times the donations from Tiller than she had claimed.    Of course this is only the tip of a large ice berg of campaign funds that Tiller used to aid Sebelius as this letter here from Tiller indicates.  Her ties to Tiller were outlined by Bob Novak last year here. When confronted about Tiller she was always in full ” Tiller?” mode:

Yep, I can watch these two being booed with a fine enjoyment!  Schadenfreude?  Indeed!

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36 Responses to It Couldn't Happen to a Nicer Guy and Gal

  • I too take some comfort in knowing the likes of Specter and Sebelius are being challenged. However, my real delight was in the substance of those two clips from the town hall meeting. They demonstrate the common sense of the common man, and the futility of trying to stump it. The common man may not be slick or sophisticated like those who desire to lord over them, but he is far wiser because he chooses to deal with reality rather than delude himself.

  • Agreed Rick. This was the classic case of two con artists suddenly learning to their dismay that “the marks” of their con weren’t quite the rubes they thought!

  • Like Hitler watching the Reichstag.

  • I’m confused… Your theory is that Donald will burn down the administration and then get himself elected chancellor of the US in a tight three way election?

    Or is it some sort of vague aspersion that although the Democrats may be bad, the Republicans are infinitely worse?

  • It’s funny that MZ is getting his “talking points” from a website where the main contributor (Marshall) in 2005 openly stated that the social security reform package should be “demagogued” to death. So now it’s four years later and suddenly the left is upset about passionate rhetoric and instilling fear as a method of squashing reform. Convenient.

  • That being said, the comparison to Hitler in this context is revolting, but it’s MZ so it’s not surprising that he said something intentionally inflammatory. His hair shirt has to be chafing.

  • I could be wrong, but didn’t M.Z. vote for Obama?

    Also remember that when people start comparing Republicans or Conservatives to anything Nazi or Hitler, that’s a strong indication that they are losing (or have lost) the argument.

  • Oh, I get it… The point is supposed to be that the booing is orchestrated and therefore doesn’t count. (And the Nazis are simply thrown in for extra rhetorical spice.)

    Of course, the booing could be orchestrated. These things happen. Goodness knowns, given the much greater preponderance of bored students on the liberal side of the aisle we’ve been dealing with this for decades. But given that support for the health plan has dropped solidly in the polls, it’s hardly surprising if adverse reactions are seen regardless of whether they’re orchestrated or not.

  • Does that mean we can call liberals communists when they use the same tactics?

  • I thought that’s how you say communist in American?

  • We have no idea whether or not the lady in the audience who spoke up was there to be a disruption or was there due to her own concern. Nothing in what she said would indicate that she was trying to be a trouble maker – unless of course, one considers challenging the wisdom of the ruling elite as being such.

    Oddly enough it was Specter’s own words, voluntarily given, that were damning. Anyone who thinks it is good or appropriate to ram through legislation of such magnitude without studying what effects it may have or to do it so it can’t be scrutinized really has no business making such decisions. Alas, I know we elected them, but it doesn’t mean we shouldn’t try to keep them in check.

    Personally, I’m suspect of any decision made by someone who would classify abortion as health care. Even if the proposed reform was mostly a good and workable idea, I’d be against it because of the inclusion of abortion. One absolute mandate of the justification of the state is to defend innocent life – not take it. While the state has a duty to the common good, properly understood, forcing people to buy health insurance and creating alternative insurance organizations is not mandatory – especially when the state considers abortion health care and a right and starving the infirm to be a private matter. These moral and intellectual faults make for horrible foundation to build “health care” upon. It is easy to see how euthanasia and the disabled could easily become marginalized by these people.

  • Hey, what ever happened to dissent being patriotic?

  • Phillip,

    It’s ok to dissent if you’re an extremist liberal. It’s not ok if you’re an ordinary American.

  • I encourage people on the Left to engage in the fantasy that these eruptions of citizen rage taking place at townhall meetings are simply the work of some grand right-wing conspiracy. Reassure yourselves that all is well, that Obama and the Democrats in Congress are on the right course, and that there is absolutely no chance that in 2010 angry voters will be clambering over each other to register their displeasure at the polls.

  • I seem to remember that just last week at VN they were claiming that conspiracy theories are a characteristic of the right but not the left. Huh.

  • Like Hitler watching the Reichstag.

    It’s a bit early in the day for the sauce, MZ.

  • Art Deco,

    M.Z.’s a teetoler, he drinks only Kool-Ade.

  • Donald,

    There is absolutely no chance of any change™ occurring in 2010.

    For example, ACORN at this time are combing cemetery’s to register new voters in order to prevent change™ from happening.

    They’ve even began discrediting Tea Party protesters as ‘right-wing-tea-baggers’ with Janeane Garofalo leading the cheers.

    What next? Cow-towing to dictatorships that imprison innocent Americans such as the two journalists in North Korea or the three hikers in Iran? So we can be sensitive to our enemies, but damn American voters for voicing their disagreement with government run health care?

  • It was a stupid comment, but let’s not go overboard on the inside baseball jibes.

  • I’m actually enjoying all the comments. True, I’m saddened for our nation and what’s left of the right.

  • Darwin,

    This gentleman’s explanation you may find more persuasive.

  • Consider it community organizing.

  • True, I’m saddened for our nation and what’s left of the right.

    We know, MZ. All those uppity people speaking back to their superiors. They should know better.

  • MZ,

    Not really.

    All,

    My apologies. Resume pummelling.

  • On a side note, I’m amused that some on the progressive side are claiming to be shocked (shocked!) that criticisms voiced at “town hall meetings” are not sufficiently learned from their point of view.

    Does anyone really imagine that getting a bunch of random voters to ask politicians questions about a complex and contentious topic will produce learned questions — or answers for that matter? “Town hall” meetings to discuss anything other than how to run a local town are unlikely to result in deep analysis from either the citizens or the politicians involved. To get upset that it’s not your pat and simplistic arguments being aired seems odd.

  • Are you pawning yourself off Paul as the everyman?

  • MZ:

    Yes, MZ. Clearly walking by the SEIU headquarters every day on my lunch break is finally getting to me.

  • The rift between the common people and the know-it-all’s widens…

  • From the comment MZ linked to:

    “These town hall shut downs have been orchestrated by the same Washington lobbying firm that was behind the tea parties. I assume those of who who don’t depend on Fox know that by now.”

    I rejoice that such a complete misreading of the current situation is what passes for analysis on the Left. Of course the proposals of Obama and the Democrats in Congress can’t really be unpopular with the public; this all has to be orchestrated by a sinister right wing cabal.

  • Hillary Clinton nailed it over 15 years ago as a “vast right-wing conspiracy” Donald.

    Why people are incapable of making up their own minds without help from “others”.

    Frankly, if this is what the White House offers as an objective analysis, then President Obama is in for a real awakening come 2010.

  • Hmmm Republicans lead by 5 points on the Rasmussen generic Congressional ballot:

    “Support for Republican congressional candidates has risen to its highest level in recent years, giving the GOP a five-point lead over Democrats in the latest Congressional Ballot and stretching the out-of-power party’s lead to six weeks in a row.
    The latest Rasmussen Reports national telephone survey shows that 43% would vote for their district’s Republican congressional candidate while 38% would opt for his or her Democratic opponent.

    Democrats held a six- or seven-point lead on the ballot for the first few weeks of 2009. That began to slip in early February, and from mid-April through June the two political parties were roughly even. Republicans have held a lead on the ballot since the last week in June, the first time they’d been on top in well over a year.

    Women who have consistently favored Democrats now prefer the GOP by a 40% to 39% margin. Men continue to favor Republicans over Democrats 47% to 36%.

    Voters not affiliated with either party prefer Republicans two-to-one – 43% to 22%.”

    Well Rasmussen must obviously be in the pay of the Vast Right-Wing Conspiracy. Of course that doesn’t explain why NPR shows Republicans ahead on their generic Congressional ballot poll by one point. Even the full mooners of the Left will have some difficulty portraying National Public Radio as in any sense right-wing.

    There is a long way to go of course until November 2010, but this is a crucial time for recruiting candidates and raising war chests, and this type of news gives a big boost to the GOP and a big problem for the Democrats.

  • Oh, I’m sure Toomey’s campaign manager danced a jig around the office when he (or she) saw that clip. PA voters are going to see the sound bite helpfully provided by Arlen “I don’t actually read the bills” Spector over and over in the fall.

    Look, in your own personal life you know you’re a darn fool if you don’t bother to read important documents you put your name to, whether they’re mortgages, leases, wills, insurance policies or what have you. Every responsible adult understands that what’s in the fine print might come back to bite you. And yet we have the surreal spectacle of our lawmakers pushing for a momentous change – and yet they haven’t even read the bill (or else it hasn’t been written yet, so they don’t know the specifics.) And yet we’re just supposed to trust them to do the right thing? This is ridiculous.

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So….What About the Other 10 Million?

Monday, August 3, AD 2009

By this stage in the health care debates, most people are aware that roughly 47 million individuals in America do not have health insurance. And many people are further aware that the 47 million statistic is misleading, because roughly 14 million of these individuals are already eligible for (but have not enrolled in) existing government programs, 9 million have incomes over $75,000 and choose not to purchase private insurance, 3-5 million are only temporarily uninsured between jobs, and roughly 10 million do not have the legal right to reside in the country. In the end, this means roughly 10 million U.S. citizens lack meaningful access to health insurance.  It has been noted elsewhere that insuring these individuals would cost a lot less than the $1 trillion proposal currently under consideration in Congress, and further that it would not require a dramatic (and costly) restructuring of the U.S. health care system.

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11 Responses to So….What About the Other 10 Million?

  • If you could come up with some alternative to ObamaCare that would really stay limited to that ten million or so people in question then I would support it. Even within that ten million, however, there are a lot of people who could afford health care without undergoing serious hardship but who don’t do so because they would rather spend the money on something else (i.e. people who are young and healthy). As to that group my thoughts are similar to those of Megan McArdle: “If you could reasonably afford health insurance by dropping down to a lower-priced cell phone plan and cutting back on your bar tab, you are not a national emergency.”

  • If we’re talking something fairly heavily means-tested, I have nothing in particular against putting something out there to cover that “other ten million”.

    If that could be packaged with means-testing medicare and social security, I’d become downright enthusiastic.

    For me, at least, the big objection is when you start trying to use the predicament of a small number of people to justify putting _everyone_ into some big program.

  • I would suggest a subsidy of some sort, probably tagged on to the earned income tax credit, to allow people who simply can’t afford health insurance to purchase it. I, like Blackadder, do agree with Ms. McArdle however. In my bankruptcy practice I do find quite a few debtors, most without much in the way of medical bills, who have run up high tabs on self phones and drive far more expensive vehicles than I drive, and who could easily afford health insurance but simply prefer to spend their funds in other ways.

  • Health care is a basic human right? Health care is something I’m owed simply by virtue of being a human being? Who’s responsibility is it to see that this “basic” right is not denied to me? Where is that person’s obligation in the natural law? What kind of health care am I owed? What is it’s extent? What does the term even mean?

  • Please delete my brief rant if you think it’s not sufficiently related to, or will only distract from, the point of the post.

    FWIW, if universal coverage is really the goal, then I think the best way to achieve that is to make it affordable for everyone. Because of the way our economy works, the only way this is really possible is through competition and deregulation. This is obviously a very general prescription, but it’s all I’m really capable of:)

  • Well, there seems to be general agreement (Zach excepted) that an expansion of government-provided health care is desirable here (even if not the best of all possible solutions). Apologies for the caricature in the post if that’s how it came across. I have a few more thoughts I’ll throw out just to be contrary:

    BA – Since we agree on the larger point here, I suppose it’s just quibbling, but I think Ms. McArdle’s ‘unsympathetic recipient’ illustration is somewhat beside the point, both because a hypothetical (or actual) ‘sympathetic recipient’ could just as easily be produced, and because over and under-inclusiveness are a necessary consequence of every expansion or reduction in government services. The relevant question to my mind is: “what is the best way to serve the common good here?” A substantial over-inclusiveness problem obviously harms the common good because it is a wasteful use of resources, but we don’t have evidence of substantially over-inclusive public health care benefits with regard to these individuals. If anything, the data suggests we have the opposite problem.

    DC – I think we’re in basic agreement. It still amazes me that Social security and Medicaid aren’t means-tested. Everyone seems to agree it should be done, but politicians in both parties seem to be terrified of the political consequences. At some point, hopefully, sanity will prevail, but I’m not holding my breath. As they say in finance, the market (and politicians) can stay irrational longer than you (or the government) can stay solvent.

    Zach – I left your comments undisturbed (although you are certainly free as a contributor to modify or delete them if you would like). I think your underlying concern about the ambiguities of rights language has some validity, particularly when the ‘right’ involved is, more properly speaking, a duty imposed on other citizens that evolves and takes different forms as a society becomes more prosperous. Nevertheless, it seems clear to me that the underlying concept of the preferential option for the poor is soundly rooted in the teachings of the Church throughout the centuries and the Gospels.

  • I think it would be best to forego this until the banking system is arighted and the public sector deficit extinguished. For flusher times, i’ll offer the following suggestions; those of you more sophisticated about the technics of tax collection and accounting and who have consulted some academic literature on insurance and medical economics can tell me where I have gone astray:

    1. Equalitarian tax reform:

    a. Abolition of property taxes and general sales taxes.

    b. Generous use of tolls and fees on public services.

    c. Conversion of corporate taxes to a flat rate on net profits, without deductions exemptions allowances, &c.

    d. Abolition of the current portfolio of payroll taxes

    e. Replacement of estate taxes with a tax on gifts and bequests received over and above a lifetime deductable. The deductable should be calculated such that these sort of taxes are limited to about 4% of the population with serious assets.

    f. Establishment of a policy that imposts and excises are to be used as instruments of trade negotiations and to change relative prices and induce ‘substitution effects’, not raise revenue. This can be done by distributing the receivables on a roughly per capita basis as a credit against one’s income tax liability.

    g. Define ‘capital gains’ as any increase over and above the increase in the GNP deflator since the base year.

    h. Rely on completely unadorned income taxes for about nine-tenths of public revenue. Calculate them as follows:

    (r x income in cash and kind from ALL sources) – (sum of credits)
    [a dollar value credit for yourself and each dependant]

    Fix the rate and the dollar value of the various credits such that revenues meet expenditures and that about 20% or 25% of the public pays no taxes but receives a net rebate. The net rebate for each head of household would, however, be constrained by a ceiling calculated as a percentage of his earned income; the ceiling could be relaxed for the elderly and disabled.

    2. Scrap public subsidies and provision for commodities for which household expenditures are regular, predictable, and subject to adjustment for amenity (food, rent, mortgage payments, utilities, etc). Turn interstitial social services (the Office for the Aging, the midnight basketball, &c. over to philanthropies).

    3. Incorporate philanthropic foundations to assume ownership and management of all public hospitals, clinics, and homes. Members of the foundation would include those on the attending lists of the hospitals, donors, members of the local chapters of the American Legion and the VFW, those on tribal rolls, &c.

    4. Gradually discontinue state funding of medical research, bar that in the realm of public health.

    5. Consider removing the adjudication of malpractice claims to administrative tribunals who issue awards from a stereotyped compensation schedule, derived from a state fund collected from an annual assessment on practitioners.

    6. Systematize extant schemes in place for extending services to undesirable loci by creating an ROTC-like program for medical students and residents at the end of which they would put in five years with the Commissioned Corps of the Public Health Service, accepting deployments to Indian reservations, &c.

    7. Enforced savings: each family would have two bequeathable savings accounts, one devoted to medical care and the other devoted to custodial care. The state would make a flat monthly assessment of one’s income with a portion destined for each account. One would be permitted to draw on one or the other to pay for care, and would be permitted each quarter to withdraw for use at one’s discretion any amount over legislated minimum balances. (These minimum balances I would think be fairly high).

    8. Public insurance:

    a. Each state government defines by legislation a standard insurance contract. The contract would provide for the re-imbursement of providers once the individual has exhausted the contents of his savings account (or exhausted the legislated minimum balance, whichever is lesser). The state government would divide the territory of the state into catchments on which demographic information would be available and with regard to which insurers could do their own research. The state would then assemble qualified insurers every few years to submit sealed bids to be the insurer for the catchment. Low bid wins, and the state government acts as the bag man for the insurance company in question, collecting the community premium by assessing a surcharge of a certain percentage on the state income tax bill of each family in the catchment.

    b. The state government would do the same for the provision of insurance for custodial care.

    c. The federal government would enact a parallel plans much like the above to cover medical benefits and custodial care of certain clientele (e.g. military families and others in itinerant occupations) and those who have moved into a state in the last three years.

    9. Grandfather clauses:

    The federal government would add balances to the medical and custodial savings of the elderly, the disabled, and in-theater war veterans for some decades to hold harmless people whose financial planning was dependent on a certain benefits configuration.

    10. Private insurance could be purchased at the discretion of the head of household to supplement or supplant benefits in the state’s standard contract. He still has to pay his surcharges, though.

    11. State insurance funds derived from assessments on private insurers, to compensate hospitals for emergency care delivered to patients who use insurers with which that particular hospital does not do business.

    12. Philanthropy of the formal and informal sort.

  • On McArdle’s unsympathetic recipient — if one was willing to come up with some reasonable means-testing and stick to it, I think that could mostly alleviate that problem. Assign a subsidy or possibly public coverage ala Medicare to those in that ten million, but only to those who meet a certain threshold of need.

    If people don’t have the stomach to leave those who can cover themselves but refuse to out in the cold, one could allow them use of the same program as those who meet the means test, but then dun them for payment via the IRS.

    Now, I’ll say, I’m not crazy about public subsidies (for people or enterprise) in general, but I think given the society we find ourselves in at this time we’re probably stuck with using that as a way out of certain problem. I admire groups like the Amish who accept neither social security nor medicare nor insurance because they believe in relying on one another — but we clearly don’t have that kind of community cohesion so there’s no point in cutting our legs out from under us based on the ideal.

  • I do not care for subsidies for private goods, either. What is (among other things) characteristic of medical care, custodial care, and legal counsel is that over the course of your life you suffer somewhat unpredictable spikes in your demand for these services. If we are being admonished to place the interests of the poor front-and-center it ought be acknowledged that the information deficits in the purchase of these sorts of services tend to be more acute the more impecunious the recipient and that trouble with time horizons is inversely correllated with income. Legal counsel and common schooling are also a facility for taking your place as a citizen and common schooling and mass transit are a facility for entering the workforce. Ergo, there is a case to be made for redistribution taking the form of common provision of a modest selection of purchasable services. What is mad about our current welfare system is that policy is generally to subsidize the purchase of frequently replenished goods of which consumption varies according to consideration of amenity. We can ‘pay’ for the collective consumption of certain services in part by erasing the unnecessary subsidies as well as certain baleful income transfer programs (TANF, for example), as well as targeting the role of public agencies in heath to public health measures and the provision of care, not to academic pork barrel. Concern about ‘cost control’ is somewhat misplaced. What should concern us is that public expenditure not be put on autopilot, which we can accomplish by adjusting a deductable upward every few years in order to maintain the committment of the state in the realm of medical and custodial care somewhere in the neighborhood of 8% of GDP.

  • John,

    Nevertheless, it seems clear to me that the underlying concept of the preferential option for the poor is soundly rooted in the teachings of the Church throughout the centuries and the Gospels.

    Does the preferential option for the poor entail a right to health care? What does the option entail? I don’t believe this has ever been spelled out in any specifics in terms of policies. I think it means political leaders and leaders of communities should consider the poor in all that they do.

  • Based on Darwin’s estimate of $4-6K for 1yr of insurance, I’d think that we could just buy ordinary insurance for those folks at a cost of $50B/yr. (And I assume that merely adding those people to medicaid would be less expensive than $5K/yr.)

    According to this story,

    http://www.cbsnews.com/stories/2009/08/10/business/moneywatch/main5230656.shtml

    the reform plan will cost $90-100B/yr over the next ten years. According to the same story, we could make up that amount either by raising taxes for individuals making over $280,000 and families with income over $350,000 or by taxing employer provided health insurance as income. I think that either of these would be fair ways to pay the tab for the extra 10M uninsured.

    QUESTION: What is the source of the 10M figure? I’ve seen George Will’s column…

    http://www.washingtonpost.com/wp-dyn/content/article/2009/06/19/AR2009061902334.html

    but that gives 9.7M illegals and 9.1 over $75K income, for a total of 18.8M not to include so far.
    Then he says that there are AS MANY AS 14M who are already eligible (which implies that there are likely <14M) and that there are many who are uninsured for 6 months or less (but states no figure). He ends up suggesting that there may be 20M remaining, not 10M. In other words he is sure that at least 25.7M can be excluded. That would mean that the figure for the already eligible plus the 6 monthers may add up to as little as 6.9M Moreover, his starting figure was 45.7M and not 47M, which would mean adding a possible 1.3M

    To me, that implies that there may be as many as 21.3M chronically uninsured, unless there is another source for the 14M which does not use it as an upper limit and another source for the 3-5M figure. (Daylightsmark gives no sources, and the 3-5M seems to come from there.)

    The two sources of funding I mentioned above, when combined, would still accommodate the larger estimate of uninsured.

Canada Has Its Own Health Care Debate

Monday, August 3, AD 2009

Hattip to Ed Morrissey at Hot Air. John Stossel is an anomaly:  he is a libertarian in a profession, journalism, dominated by liberal democrats.  Here is a column he wrote which summarizes the video, which spent quite a bit of time discussing the shortcomings of Canadian health care.

The experience of Canada under national health care is intriguing.  A battle is raging over the net with opponents of ObamaCare pointing out its shortcomings and proponents rallying to the defense of  the Canadian system.  One often overlooked feature is the role of private medical clinics in Canada.   Recently such clinics have been made legal based upon a Canadian Supreme Court decision and are becoming increasingly popular.  A good article on the subject is here Here is another article on the clinics.

I found this quote from the last article linked to curious.

“It’s obviously extra billing and queue jumping,” says David Eggen, executive director of Friends of Medicare. “If this goes on unregulated, it’ll spread like wildfire and we can see it, even in a recession, starting to expand here in Alberta.”

Now why would these clinics spread like wildfire if the Canadians are as enamored of their national health care system as the proponents of ObamaCare say they are?  Here is a story from 2006 on the subject which appeared in that notorious right-wing rag The New York Times.   As we debate changing our health care system to something approaching that of the Canadian system, we should also understand that there is a debate in Canada about broadening the availability of private pay health care.

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5 Responses to Canada Has Its Own Health Care Debate

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  • But..but..you’re just pointing out the inefficiencies and poor care because you’re already against government control of health care. Just like when you railed against GovMed because it will cover abortion and most likely euthanasia. These are small things, the important thing is that we have the honorable and intelligent people in congress give everyone free health care. Where’s the hope, people?!?

  • I also found this interesting. I wonder why this is happening?

    “While proponents of private clinics say they will shorten waiting lists and quicken service at public institutions, critics warn that they will drain the public system of doctors and nurses. Canada has a national doctor shortage already, with 1.4 million people in the province of Ontario alone without the services of a family doctor.

    “If anesthetists go to work in a private clinic,” Manitoba’s health minister, Tim Sale, argued recently, “the work that they were doing in the public sector is spread among fewer and fewer people.”

    But most Canadians agree that current wait times are not acceptable.

    The median wait time between a referral by a family doctor and an appointment with a specialist has increased to 8.3 weeks last year from 3.7 weeks in 1993, according to a recent study by The Fraser Institute, a conservative research group. Meanwhile the median wait between an appointment with a specialist and treatment has increased to 9.4 weeks from 5.6 weeks over the same period.

    Average wait times between referral by a family doctor and treatment range from 5.5 weeks for oncology to 40 weeks for orthopedic surgery, according to the study.”

  • Rick,
    You invoke the virtue of Hope in the same paragraph you call Abortion and Euthanasia “small things”. In our creators eyes abortion is the modern day Holocaust. Hope is the virtue that makes the Christian Crave for the Kingdom of God and to place his trust in the promises of Jesus to get us there. Your insensitivity, to the point of trivialization, of the dignity of life clearly reflects your lack of Hope. Whenever a virtue whether Hope, Charity, Justice, etc are invoked without regard for it’s origin in divinity you have Nothing.

  • Sorry, Ray. I was being sarcastic and mocking a type of argument that is offered by some in these parts. The really sad thing about it is that I didn’t need to take much creative license to do it. Nevertheless, I should have written something at the end to indicate that I was being snarky.

Congress Feeling the Heat

Sunday, August 2, AD 2009

town-hall-2

Hattip to Instapundit. Democrat Congress beings are reporting here that they are encountering angry constituents at their townhall meetings.  Now why would their constituents be so angry?

red-ink

Oh yeah.

There is a political storm brewing in this country of immense proportions.  If some members of Congress aren’t aware of it yet, they will be after they return from the August recess.

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11 Responses to Congress Feeling the Heat

  • I’m sorry that the storm is brewing up over the cost of the proposal rather than over some of the specifics in it. No matter how the proposed program is funded, it seems likely that “universal health care” will make abortion available without restriction or cost throughout America in the near future. In fact, I understand that is the upshot of the Capps amendment included in the version that just came out of committee in the House. Sadly, an increasingly number of Catholic commentators (at America, Commonweal, and Vox Nova, among others) seem to agree that the only possible curb on abortion in the future will have come in the form of increased social services for women who decide against it.

  • The news is overwhelmingly bad and getting worse… But the recession is almost over according to the White House and controlling the deficit is the Administrations #1 concern once the “economy is on track.”

    What is it about the commonsense approach to fiscal responsibility that Washington thinks doesn’t apply?

    I’m not saying that this is “simple” but only that some basic principles strongly recommend themselves:

    1) Stop digging the hole. If you are in debt, don’t contract more debt and suspend the growth on contracted debts by renegotiating where you can.

    2) Shed unused assets, particularly those that have ancillary costs, and apply the recovered cash to the debts with the highest effective cost.

    3) Suspend gifts and donations that are absolutely necessary. This is to say that the 3rd World will have to do without us for a while as we get the economy back on track. Sure it will hurt but it will hurt a lot less than bankrupting the only large-scale donor on the planet.

    4) Reduce taxes where it will have a real positive impact on spending.

    5) Reduce or eliminate taxes on business income for small businesses.

    I am sure there are lots of other choices that people much smarter than me would make. However, the Vice President sounds insane when he suggests that the best way to avoid national bankruptcy is to continue to feed the growing debt. I am equally certain that those statements are utterly incompatible with the President’s assertion that reducing America’s debt is critical to the nation’s sustained prosperity.

    In short, were the Legislature or the Executive Branches serious about the economy, they would not be extending unemployment benefits, contemplating new social programs, or offering $4,500 to Americans to give a short-term spike to the auto markets. These are the acts of persons who have thrown in the towel, the acts which, if done by a person rather than a government, would be a pre-curser to filing for Bankruptcy, not one who expected to avoid it.

  • Ron, don’t underestimate the anger being generated about abortions being funded. Just last week I was approached by a fairly apolitical acquaintance who told me he was livid about the prospect of National Health Care paying for abortions. Paying for abortions has always been a 70-30 split with 70% of the country against using any government funds to pay for abortions. The CongressCritters will be hearing a lot on this issue during the recess.

  • According to the Politico article — if I read it correctly — all the anger seems to be directed at Democratic Congresscritters. Surely Republicans are hearing the same concerns as well?

  • Are you referring to the staged protests occurring, many of which are manned by bussed in operatives?

  • No Mr. DeFrancisis these are not Acorn style faked protests that the Left has specialized in for decades in this country. This is the rage felt by the public against the woeful incompetence of the Obama administration and the Democrats in Congress. However, please do your best to convince yourself and your colleagues on the Left that these are staged protests and that they have nothing to worry about in the 2010 elections.

  • Mr. DeFrancisis,

    My wife and I attended a Tea Party in June. Neither of us had been to a protest before.

    While there, we ran into many people from our places of work, our church, and our children’s schools. None of them had ever been to a protest before either.

    I make no prediction as to the effect of such protests since the Speaker and the President are hell bent on dragging our country into this no matter what we say or do. However, my personal experience suggests that they have sparked a visceral response that will not easily be set aside. The fantasy that this is all a conspiracy – some sort of a plot by business – is laughable at best and utterly corrupt at worst.

    Where was all of this skepticism of protests during the Bush years? Where was the indignation at the suggestion that our President was a liar, the Congress a bunch of corrupt lackeys, and our nation a bunch of sheep?

    No… Those struggling to defend the lies of the Obama Administration and of Pelosi’s Congress are a hypocritical lot, concerned more with maintaining political power than doing what is good for our country.

  • What must really be causing cognitive dissonance on the left is the fact that these tea parties are not only growing, they’re also taking place in blue states like New York. If they were limited to the South and rural areas, the liberals could continue to snicker and sneer about rednecks and sore losers. But there have been tea parties in deep blue states, in places like Long Island and (fittingly) Boston. Lefties see that and conclude that these people must have been bussed in from somewhere else because it’s unthinkable that anyone in Long Island could be possibly upset about government spending.

    There were a lot of anti-war protests in my neighborhood back in the day (2003-2008. There’s still a war on and things are heating up in Afghanistan and yet, amazingly, I haven’t seen a single anti-war protest this summer. Hmmmm, what could possibly be different?) So I know what a professional protestor – a leftist cause junkie – looks like. These tea party folks are amateurish by comparison – no Move On folks passing out slick manufactured signs.

    P.J. O’Rourke once noted that normally lefty marches and rallies are far bigger than conservative protests because “we have jobs.” When Mrs. Jones the store manager and Mr. Smith the surgical tech get angry enough to take off from work so they can go to a rally holding a homemade cardboard sign – well, if I were on the Left, that would make me very uneasy indeed.

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ObamaCare: A Pre-Mortem

Wednesday, July 29, AD 2009

ObamaCareChart

Barring some political miracle, National Health Care is dead. Many  current polls indicate that a majority of the public is now against it.  There is no chance of having a vote in either chamber of Congress before the August recess.  Considering the high popularity numbers that Obama had coming into office, and the wide majorities that the Democrats enjoy in Congress this is astounding.  What caused this debacle?  A few thoughts.

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31 Responses to ObamaCare: A Pre-Mortem

  • You mention the “stimulus” bill and the budget, but I think this needs to be emphasized:

    By essentially wasting $ 1 trillion on a pork bill that did absolutely nothing to stimulate the economy and put no money in the pockets of most voters (at least our family got $2400 under Bush, which helped pay for my kids’ Catholic school), the Democrats completely blew up the budget and used up what little political (and actual) capital there might have been for enacting a health care plan.

  • Technically, we are getting up to $800 per couple under the so-called stimulus package.

    But IIRC it’s being done through a remittance of payroll taxes in each paycheck, so I can’t blame you for not missing it.

    However, you nailed it on the source of the skepticism: the administration shredded its credibility by pushing through an ineffective spending bill that has come nowhere near to doing what its proponents asserted it would.

    Had there been a lot more infrastructure spending and a lot less wish-listing, I think there would still be a reservoir of good will. Instead, we have revelations like this, which make skeptics out of anyone who isn’t a daily pom-pon shaker for the administration:

    http://news.yahoo.com/s/ap/20090728/ap_on_re_us/us_stimulus_counting_jobs

  • Leaving aside a prudent distrust of politicians and a party that are beholden to special interests, love power, harbor contempt for the common man, and have no sense of fiscal sanity, why would any sane person want people who consider killing societies weakest “health care”?

    A link to a bigger version of that chart.

    http://www.rollcall.com/pdfs/healthchart072309.pdf

  • Ugh, should have been “society’s”. Combat illiteracy – it’s killing me. 😉

  • It strikes me that ObamaCare (like ClintonCare and Bush’s attempted reform of social security) is suffering from the fact that it either could not be or simply was not explained in a manner such as to gain the support of a significant portion of the population.

    One thing that is hard to get used to in the corporate world is that it doesn’t matter how good your ideas are if you can’t present them to decision makers in a way that convinces them to let you act on them. What political parties seem to have some difficulty grasping is that on a sufficiently big change in civic structures, the entire voting population counts as the decison makers. So if they can’t package something in a way that voters can understand its benefits, it will run aground unless the politician has enough capital to pull off the “trust me on this one” approach.

  • Jay simply asserts without argument. Well, here is the argument for the stimulus: we have seen an enormous decline in private demand. the only reason why we have not seen a similar collapse in overall economic activity is because it was cushioned by a large increase in public demand. See Krugman: http://krugman.blogs.nytimes.com/2009/07/15/deficits-saved-the-world/

    Much of this has been through automatic stabilizers, not stimulus, but automatic stabilizers are far lower in the US than in Europe (income tax is less progressive, social safety nets are smaller), meaning that discretionary stimulus needs to be larger. Of course, given capacity constraints, much of the money hasn’t been spent yet. But in countries where it has been spent quickly, and where automatic stabilizers are similarly small, fiscal stimulus has been a huge boon for growth. I’m talking mainly about China.

    Now, on the composition. As any economist will tell you, multipliers are larger for spending than for taxes. The tax cut component of the US stimulus was, I believe, too large. If you want the most bang-for-back, you’ll go where the multipliers are largest, and that’s on the spending side, espcially capital spending.

    The economic illiteracy on display in public circles is simply staggering. Quite aside from the laissez-faire small government ideology (stop exempting the military, and we’ll talk), you have pundits railing against “pork”. Well, sorry, but that is precisely the point. When you have a major across-the-board collapse in aggregate demand, and when monetary policy has reached its limits (interest rates at the lower bound), then you need government spending. It is an extreme response to extreme circumstances. You are *supposed* to spend more in times like this, and spend less when times are good. But the pundits just don’t get this.

  • Complexity? what this chart fails to note is that the current system is even more complex. What I find highly frustrating, as somebody who has been following healthcare wonkery for years, is the sheer ignorance out there about what this reform does and does not do. I would actually fault its timidity, for not doing enough to curb the bad behavior of the private insurance companies. It changes too little, not too much.

    But look at the rhetoric. We are suddenly moving to “government” healthcare. Of course, if you actually looked at the proposals, you would see the public option limited to those who can participate in health insurance exchanges, which in turn is limited to the unemployed, the self-employed and small businesses. The CBO thinks that only 27 million would be in the exchange by 2019, and only a small portion of these would be in the public option. For everybody else, it’s old-style employer insurance.

    And then there are the people who rail against the *costs* of government healthcare, oblivious to the fact that costs are rising substantially more slowly in medicare and medicaid than in private insurance (7.3 percent verus 4.6 percent for the average annual increase in premiums). And then there is the widely circulating story at the guy at sme town hall meeting who yelled out “keep your government hands off my Medicare”. We might smile, but this kind of delusion is only mildly hyperbolic.

    Of course, this is what the opponents of reform want. They don’t want people actually trying to understand what is going on. They want slogans and scaremongering. Because there is a lot of financial interests at stake here. And God forbid we reduce the profitability of the private insurance companies.

    Ezra Klein sums up my feelings completely; “what has kept health-care reform at the forefront of liberal politics for decades is moral outrage that 47 million of our friends and neighbors are uninsured. That medical costs are one of the leading causes of bankruptcy in the United States. That an unemployed machinist gets screwed by fly-by-night insurance schemes while a comfortably employed banker need never worry. That the working class ends up in emergency rooms with crushing chest pains because they didn’t have health insurance and didn’t get prescribed cheap blood pressure medications five years before.”

    As the Church would say, health care is a human right. Let’s treat it that way.

  • Jay:

    Ten days ago, I posted Robert Samuelson’s very fine post-mortem on the stimulus bust in the Washington Post 10 days ago. He argues convincingly that there was a need for the stimulus, but notes that what was enacted was an underpowered failure, misconceived from the start:

    On humanitarian grounds, hardly anyone should object to parts of the stimulus package: longer and (slightly) higher unemployment benefits; subsidies for job losers to extend their health insurance; expanded food stamps. Obama was politically obligated to enact a campaign proposal providing tax cuts to most workers — up to $400 for individuals and $800 for married couples. But beyond these basics, the stimulus plan became an orgy of politically appealing spending increases and tax breaks.

    More than 50 million retirees and veterans got $250 checks (cost: $14 billion). Businesses received liberalized depreciation allowances ($5 billion). Health-care information technology was promoted ($19 billion). High-speed rail was encouraged ($8 billion). Whatever the virtues of these programs, the effects are diluted and delayed. The CBO estimated that nearly 30 percent of the economic effects would occur after 2010. Ignored was any concerted effort to improve consumer and business confidence by resuscitating the most distressed economic sectors.

    Vehicle sales are running 35 percent behind year-earlier levels; frightened consumers recoil from big-ticket purchases. Falling house prices deter home buying. Why buy today if the price will be lower tomorrow? States suffer from steep drops in tax revenue and face legal requirements to balance their budgets. This means raising taxes or cutting spending — precisely the wrong steps in a severe slump. Yet the stimulus package barely addressed these problems.

    To promote car sales and home buying, Congress could have provided temporary but generous tax breaks. It didn’t. The housing tax credit applied to a fraction of first-time buyers; the car tax break permitted federal tax deductions for state sales and excise taxes on vehicle purchases. The effects are trivial. The recently signed “cash for clunkers” tax credit is similarly stunted; Macroeconomic Advisers estimates it might advance a mere 130,000 vehicle sales. States fared better. They received $135 billion in largely unfettered funds. But even with this money, economists at Goldman Sachs estimate that states face up to a $100 billion budget gap in the next year. Already, 28 states have increased taxes and 40 have reduced spending, reports the Office of Management and Budget.

    There are growing demands for another Obama “stimulus” on the grounds that the first was too small. Wrong. The problem with the first stimulus was more its composition than its size. With budget deficits for 2009 and 2010 estimated by the CBO at $1.8 trillion and $1.4 trillion (respectively, 13 and 9.9 percent of gross domestic product), it’s hard to argue they’re too tiny. Obama and congressional Democrats sacrificed real economic stimulus to promote parochial political interests. Any new “stimulus” should be financed by culling some of the old.

    http://tinyurl.com/lebua3

    While I don’t think he’d agree that it does “absolutely nothing to stimulate the economy,” he’d certainly concur that what was enacted had no prospect of doing what its proponents said it would.

  • Did I mention that I posted it ten days ago?

    Sigh….

  • Minion:

    Jay did not say that we shouldn’t have spent the stimulus money; he said the way the stimulus money was spent was retarded. Considering most of the money won’t be spent yet, while France has spent most of theirs, that’s a fair argument.

    Second, current system = bad does not lead to proposed system = good.

    Third, how on earth is one supposed to what the reform does? It changes daily! I’ve tried to keep up and I’ve had no chance; I can’t imagine what most Americans think!

    And finally, health care = right. Obamacare, however, is not a right and Obamacare does NOT = Church envisioned health care.

  • No, seriously. Does anyone else hear that sound (like an annoying gnat that won’t go away)? If you listen close enough it sounds like “I luvzzzzzzz me sommmmmmme Obbbbbbammmmmmma.”

  • Jay:

    You need to be drinking more Kool-Aid so that the “annoying gnat noise” in your ear turns into a beautiful song that you sing loudly every day.

  • Guys,

    While I agree that MM’s mixture of bow-before-my-authority expert posing and loud moral indignation is very annoying, let’s try to tread the line of not stooping lower in responding to it.

    MM,

    Ezra Klein sums up my feelings completely; “what has kept health-care reform at the forefront of liberal politics for decades is moral outrage that 47 million of our friends and neighbors are uninsured. That medical costs are one of the leading causes of bankruptcy in the United States. That an unemployed machinist gets screwed by fly-by-night insurance schemes while a comfortably employed banker need never worry. That the working class ends up in emergency rooms with crushing chest pains because they didn’t have health insurance and didn’t get prescribed cheap blood pressure medications five years before.”

    As the Church would say, health care is a human right. Let’s treat it that way.

    See, here’s the thing, MM. I could take the moral indignation a lot more seriously if it didn’t seem to only be trotted out in efforts to come up with systems designed to bring the electoral gold of the middle class into a government run health care system. The interest in reducing costs in the current system, making incremental changes to allow primary care to be more affordable for the uninsured, or setting up more efficient programs specifically to help those who cannot afford coverage or care seems to be rather sparse in the liberal camp. The interest is almost exclusively in finding a way to work towards a large government run program which the vast majority of Americans would eventually participate in — something which would represent a significant power increase for the people pushing it.

    Why the lack of interest in attacking the real problem (high costs and inability of some people to afford health care they need) when not associated wish the large government solution which has been on the progressive wish list for so long? It seems to suggest that the motives are rather less sterling than you present.

  • My. I am surprised by the behavior of some commenters here, especially those who usually demoan the mean-spiritedness of their imagined ideological counterparts in commenr boxes.

    I guess it depends on what side you stand on on your imagined ideeological divide.

  • Was I responding to someone? What? Did somebody say something?

  • Jay is an example of everything I am talking about. If somebody comes along with facts and arguments that go against cherished talking points, lets just change the subject to taunts and slogans. Hmmmm, doesn’t that sound familiar?

  • Darwin,

    Moral indignation? That would be righteous moral indignation!

    “sytems designed to bring the electoral gold of the middle class into a government run health care system”. What in God’s name does this mean?

    Did you read what I wrote? Let’s start at the basics. “Government run” health care means precisely that – the governmment employs and pays the healthcare workers and owns the facilities. Think of the UK. I personally support single payer which is NOT THIS. Single payer basically means a single insurance agent to leverage economies of scale, cover everybody, don’t try to weed out people for profit purposes, and use monopsony power to get better deals from suppliers.

    I support single payer not on ideological grounds, but on pragmatic grounds — it seems emprically the best way to contain costs and deliver superior outcomes. It’s gives good bang for buck. Of course, this is not the only way to do it. As I said elsewhere, the core principles of reform include community rating and the individual mandate, and this can be done with regulated private markets.

    The proposed reforms are a mere timid step in this direction. For people with employer converage, nothing much will change. Others can join the regulated exchanges. To me, this is exactly the kind of “incremental change” we need. It’s far less radical than previous proposals, including Nixon’s. It represents the best way of increasing coverage and reducing costs. Unless of course, like the GOP, you have a vested interest in protecting the balance sheets of the insurance companies.

  • Unless of course, like the GOP, you have a vested interest in protecting the balance sheets of the insurance companies,

    One might argue that the absence of tort reform is due to the Democrats’ vested interest in protecting the balance sheets of plaintiff attorneys instead of actually cutting costs.

  • I support single payer not on ideological grounds, but on pragmatic grounds — it seems emprically the best way to contain costs and deliver superior outcomes.

    Per a prior conversation, did you ever look into Singapore’s health care system?

  • Blackadder, ever an optimist, seems to think that he’s talking to someone who has any interest in learning new facts and evidence, as opposed to cutting-and-pasting one of his four blogging scripts (“prolifers are bad,” “Americans are Calvinists,” “Obama is good,” “single-payer is good”) into every discussion.

  • Singapore — yes, has some good aspects, but does a lousy job dealing with tail risks. As I keep saying, my preference is based on pragmatism. A private system based on community rating, the universal mandate, and subsidies for the poor would be a very good start. It just not would be as efficient as a public system.

    Michael — I have no problem with tort reform. Unfortunately, the costs of insurance and defensive medicine represent an insignificant part of healthcare costs.

  • Did you read what I wrote? Let’s start at the basics. “Government run” health care means precisely that – the governmment employs and pays the healthcare workers and owns the facilities. Think of the UK. I personally support single payer which is NOT THIS.

    I did not think that you were talking about single provider health care, nor was I addressing the question. I’m not sure why you like to try to shoe-horn your oponents into positions they don’t hold, but it doesn’t get conversation far.

    I support single payer not on ideological grounds, but on pragmatic grounds — it seems emprically the best way to contain costs and deliver superior outcomes.

    So you keep saying — even when people point to non-single-payer systems which work better than the single payer ones. (Heck, even the much vaunted French system is not actually a true single payer system.)

    And although you say your support is non-ideological, I can’t help seeing it as awfully convenient that a statist technocrat cries foul at any suggestion, however helpful it might be, which does not increase the amount of statist technocrat control over health care in the US — and supports programs other than his preferred one so long as they expand the reach of government.

    I will agree with your later comments thus far, however: It’s true that the proposed reforms are a timid step, delivering much complication and little improvement by anyone’s standards. Of course, that leaves me wondering why you’re so fiercely supportive. Why not hold out for what you think would actually solve the problem? Or, should we perhaps take that as a sign that you see the currently proposed legislation as being a clear step in the direction of a single payer system?

  • If somebody comes along with facts and arguments that go against cherished talking points, lets just change the subject to taunts and slogans. Hmmmm, doesn’t that sound familiar?

    Indeed —

    His name, or rather alias, happens to be Morning’s Minion!

  • As any economist will tell you, multipliers are larger for spending than for taxes.

    The size of the multiplier is precisely what has been disputed by Casey Mulligan, Gregory Mankiw, among other ‘economic illiterates’

  • Art, my wise friend, why aren’t you following the sage advice you gave me just yesterday? 😉

  • Guess I can’t resist, sometimes.

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How to Get There from Here

Tuesday, July 28, AD 2009

There’s been much discussion of late about what other country’s health care apparatus the US should consider emulating, and in such discussions France is often mentioned. Now, all cheerful ribbing against the French aside, their health care system is not nearly as “socialized” or nearly as afflicted by treatment denials and waiting lists as those of the UK or Canada. It is also rather more like the system that the US already has, in that it is a hybrid public/private system, though in their case there is a guaranteed base level of coverage everyone has through the government (funded via a hefty payroll tax — not unlike Medicare) which most people supplement with private coverage. Most doctors are in private practice, and 25% do not even accept the public plan, just as some practices in the US do not accept Medicare. However, everyone does have that minimum level of coverage, and the French spend a lower percentage of their GDP on health care than the US (11% versus 16%) which when you take into account that France’s GDP per capita is a good deal smaller than that of the US (which is the polite, economist way of saying it’s a poorer country) works out to the US spending about twice as many dollars per person on health care, while still not having universal coverage.

So what are we waiting for? Why don’t we go enact the French system here right now? Why doesn’t Obama put on a jaunty beret, dangle a cigarette coolly from the corner of his mouth, hoist a glass of wine, and just say, “Oui, nous pouvons.”

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9 Responses to How to Get There from Here

  • Well done Darwin,

    Many factors in health care. One is physician salaries as pointed out in other posts. Many factors in physican salaries as you point out including the high cost of medical school and indirect malpractice costs. If those aren’t addressed while cutting physician salaries, problems will most certainly follow.

  • Dear God… someone finally stopped talking about British and Canadian health care and realized that are quite a number of schemes to reach universal coverage and single-payer systems aside (I don’t feel like having that go-round), France is a pretty good model.

    Moreover, I think if we attacked education (costs) and provided greater assistance to medical students (not just with public funds), we could slightly lessen doctor salaries — as health care costs go down and depending on their specialty.

  • And by ‘lessen’ I don’t mean put caps on it via legislation.

  • Related to this but in a more general sense: I think that dealing with a situation like this (in which it becomes necessary to drive a group of people’s income down for the common good) the impersonal nature of markets is generally more socially acceptable than government action. I don’t think anyone would tolerate reducing doctor pay 30-40% by fiat, even when they generally make a lot of money. But creating the conditions for it to gradually reduce due to market pressure doesn’t have the same antagonistic edge.

    Just had to get the market plug in. 🙂

  • 30 – 40% again seems not to take into account malpractice costs let alone medical school. Maybe your figures take into account malpractice costs. But if not, using your figures, a specialist in the US averages 230k vs 149k in France. Subtract the average 55k for malpractice and you get a difference of 175 vs 149. Excluding medical school costs you’re now talking about a 14% difference, not 30 – 40.

    What’s the average malpractic attorney’s pay?

  • Actually just Googled it. In 2006 it was 100k.

  • I guess, I’m not sure how stuff like malpractice insurance is usually accounted for. Do doctors always have to pay it out of pocket (thus out of their personal pay) or is it often payed by their practice as a business expense?

    Either way, significantly reducing the malpractice lottery would have a salient effect on health care prices — not just in allowing for health care providers to charge less, but also reducing the number of extra procedures which are done for tail covering purposes rather than medical effect.

  • Depends on the practice. Those that are stand alone pay out of their own pocket. Those in large practices or hospital based practices get it paid for. But that will be considered part of compensation and usually salaries are lower to reflect that. Either way, there is a cost to income from malpractice premiums.

  • The cost of malpractice insurance is inflated by insurance companies, just as insurance companies inflate the cost of medical insurance. But the big issue is that usa doctors and hospitals do not like to be held accountable for their bad medical practices and poor outcomes. Their private for profit medicine ranks 37th in outcomes compared to other countries, which rank muych better using national health programs. Malpractice costs would clearly go down if usa outcome rankings improved. The fact that france ranks number one, having the best outcomes, while paying their doctors much less, is all just a further indictment of our private medical system in the usa.