47 thoughts on “Practice What You Preach”

  1. The “Practice what you preach” commentary seems to me to be in the same family as the chicken hawk fallacy you rightly revile.

    No doubt Ted Kennedy will seek the best care he can afford. The Democratic party’s health care proposals seek to make sure that everyone can afford good care, but, as I understand it, the proposals (or at least Obama’s proposal) will not limit anyone from seeking the best care they can afford. If someone understands differently, please explain it me (or refer me to a good reference.)

  2. If we had a draft, you might have a point about the chickenhawk argument, but I don’t think so. Since we don’t, there really is no parallel at all. Proposing universal “health care” and advocating a war are two entirely different categories of things, for many reasons.

  3. Ah. Well, I’m happy to drop the chicken hawk aspect in favor of the more interesting question: whether or not the health care plans of Canada and the UK (and Cuba, if you insist) are in an “entirely different category” from the health care plans endorsed by Senator Kennedy? In particular, isn’t it true that Obama’s plan would allow Senator Kennedy to do exactly what he is no doubt going to do under the current system, which is to seek the best care he can afford? In other words: isn’t what he is practicing consistent with what he is preaching?

  4. I particularly liked the helicopter flight from his local hospital to Mass General. Very proletarian.

  5. In particular, isn’t it true that Obama’s plan would allow Senator Kennedy to do exactly what he is no doubt going to do under the current system, which is to seek the best care he can afford? In other words: isn’t what he is practicing consistent with what he is preaching?

    I didn’t say anything about Obama’s health plan. Paul and I were referring to what Kennedy has been preaching all of his life. He continually lauds places like Canada and Cuba for their health plans, and has expressed the desire for ours to be more like theirs. He also (I think) supported Hillary!s plan in 1993, which essentially made it illegal to provide private medical service for pay.

  6. From Barack’s website:

    Tackle disparities in health care. Obama will tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health, both of which play a major role in addressing disparities. He will also challenge the medical system to eliminate inequities in health care through quality measurement and reporting, implementation of effective interventions such as patient navigation programs, and diversification of the health workforce.

    The only equality is at some common denominator that is typically lower than any population mean.

    BTW, I know a of a situation in which a doctor volunteered to provide critical eye surgery on a young child to restore that child’s vision. Medicare prevented the doctor from providing the services free of charge, because Medicare required that if a doctor received patients using Medicare, then he must charge those patients at his lowest fee. In other words, if he gave a child free surgery, then he would have to give free surgery to everyone else. Fortunately for the child, private charities raised the funds to pay the doctors nominal fee. Fortunately for medicare patients, the doctor didn’t (as many other doctors have) refuse to no longer see Medicare patients, so that they could pay for quality service.

  7. Ted Kennedy was the author of the first HMO bill to pass the Senate. I wonder if he believes in HMOs enough to let them take care of his family’s health care. I rather doubt it.

    “As the author of the first HMO bill ever to pass the Senate, I find this spreading support for HMOs truly gratifying. Just a few years ago, proponents of health maintenance organizations faced bitter opposition from organized medicine. And just a few years ago, congressional advocates of HMOs faced an administration which was long on HMO rhetoric, but very short on action.

    “The current revival of the HMO movement should come as no surprise. HMOs have proven themselves again and again to be effective and efficient mechanisms for delivering health care of the highest quality. HMOs cut hospital utilization by an average of 20 to 25 percent compared to the fee-for-service sector. They cut the total cost of health care by anywhere from 10 to 30 percent. And they accomplish these savings without compromising the quality of care they provide their members.

    “In fact, many medical experts argue that the peer review built into group practice in the HMO setting promotes a quality of care superior to that found in the traditional health care system…. “In our enthusiasm to see HMOs proliferate throughout this country we should not lose sight of the need to guarantee the quality and integrity of the prepaid plans we create.”

    I wish no ill on him as a man even though I oppose just about everything he stands for politically. Unlike the Kos crowd, I take no satisfaction in the misfortune of political opponents.

  8. I wonder which country with morally superior “universal health care” he’ll go to for his treatment? Will it be Canada, the UK, or Cuba?

    He will go to the United States, because members of Congress, like all federal employees, already have guaranteed health care. Now you can make an argument that if you can’t afford brain cancer, you should die like a dog without treatment. But obviously Kennedy disagrees and he is practicing what he preaches.

    What I wonder is when you’re eligible for Medicare, will you practice what you preach and turn it down? Frankly I don’t think that you should stick to principle at the risk of bankruptcy. But I also don’t think that you will.

  9. Of course as a member of an extremely rich family and a wealthy individual in his own right I would expect him to seek the best treatment money can offer, which is a built in factor of the British NHS.

    He would naturally not complain that his tax money had also been spent on providing a, probably, lower standard for everybody who were not as lucky as he.

  10. He would naturally not complain that his tax money had also been spent on providing a, probably, lower standard for everybody who were not as lucky as he.

    While I agree with your characterization of Ted Kennedy, not everyone who is rich (at least in the US) is “lucky.”

  11. I still don’t really understand the logic of this thread. If someone wants to raise a minimum standard, they ought to experience the minimum themselves, even if they can afford to do better?

  12. I think your point is that if Kennedy wanted to impose evil collectivist solutions on the public, he should impose them on himself as well. Fair enough, but I don’t think he wanted to do that.

    He also (I think) supported Hillary!s plan in 1993, which essentially made it illegal to provide private medical service for pay.

    I don’t understand how that could work (and so I, admittedly ignorant, am skeptical that this was in Hillary’s plan). Leland’s story showed how a contractual system could prevent a doctor from offering services outside the system. But if a doctor (or a private hospital) decides to work outside the contractual system in the first place, I can’t think of any constitutional basis for preventing it from offering private medical service for pay.

  13. He also (I think) supported Hillary!s plan in 1993, which essentially made it illegal to provide private medical service for pay.

    This blog has an amazing attraction to counterfactualism. No, Clinton’s 1993 health care plan did not ban private medical service for pay, essentially or otherwise. Read this detailed hostile review by the Heritage Foundation. They trot out every plausible argument against the 1993 Clinton plan and then some. But when they finally get to private medical service for pay, they say the opposite: “To be sure, anyone will have the right to consult any doctor outside the system if they pay for the visit and treatment out of their own pocket.”

  14. I can’t think of any constitutional basis for preventing it from offering private medical service for pay.

    I can’t either. But what does the Constitution have to do with this, given that none of the three presidential candidates give a damn about it? At least as written…

  15. To be sure, anyone will have the right to consult any doctor outside the system if they pay for the visit and treatment out of their own pocket.

    What you’re forgetting is that the massive system of price fixing and income redistribution and strange tax subsidies proposed would hideously distort the prices of things, so that this “right” becomes meaningless.

    Actually, it already has. You can go to an ER and pay for it yourself, but what you’ll notice is that the hospital bills you from 2 to 10 times more for the exact same service as they would if your health plan was paying. What’s up with that? Well, the system already in place massively distorts the pricing system, and it turns out to be beneficial for hospitals to wildly overcharge for “a la carte” service.

    There are ways to get out of it. Google “cash only physician” for some interesting results. Some physicians just go off the system, refuse to take any insurance, and only deal in cash directly with their patients. To the surprise of a brain-dead advocate of socialized medicine (yes I know the adjective is redundant), it turns out this ends up being profitable for both physicians and patients. Physicians make more money charging less, with obvious benefits to the patients.

    The only problem, the only thing missing, is some form of catastrophe insurance, some way to account for the occasional piece of really bad luck for which no one individual can possibly save up. Add that, and subtract all the other happy horseshit Obambi and The Hill peddle, as well as the current uberupgefucked system, and you’d have something that might do very well indeed.

  16. Having lived in Canada for nearly all my life, I can tell you exactly what sort of treatement Kennedy would have received there. He would have been told that the waiting list for an MRI is eight months – and like so many other Canadians who can afford it, would have hopped the first plane for the US to get his MRI the next day.

    If he couldn’t afford it, well then he’d get in the queue, and they’d discover his brain cancer during the autopsy.

  17. If someone wants to raise a minimum standard

    Perhaps you misunderstand equality. As you raise the minimum to some common standard for equal health coverage, then you also must lower the maximum to that common standard. That’s equality. Otherwise, the disparity (Obama uses the word inequities) you sought to correct still exists. The poor still can only get the lowest standard, and the rich can pay for the higher. You could argue some morality to rising the standard, but my rebuttal is show me a decade in which the minimum standard for medical care in the US hasn’t been raised. We haven’t needed universal healthcare before to raise the bar, what makes it essential now?

  18. I can tell you exactly what sort of treatement Kennedy would have received there. He would have been told that the waiting list for an MRI is eight months – and like so many other Canadians who can afford it, would have hopped the first plane for the US to get his MRI the next day.

    Again, this thread (like several others on topics such as global warming) has this weird attraction to counterfactualism. That is, yes, if Kennedy were Canadian someone could tell him that the waiting time for an MRI is eight months, but it would not be true. Kennedy had an emergency MRI, while the waiting lists are only for non-emergency MRIs. Moreover, the median wait time for non-emergency MRIs, CTs, and angiographies in 2005 was actually three weeks, not eight months. Maybe there are examples of non-emergency MRIs that take eight months, but it is not what happens usually.

    Besides, many American patients have to wait a long time for insurance approval before getting treatment. That’s pretty equivalent to medical delays in Canada, except that the US does less to keep track of it. An even bigger problem is American patients whose coverage collapses in the middle of long-term treatment; then they are trapped with an existing condition and can’t get coverage at any price.

  19. Maybe I’m getting my health security acts confused, but here is a link to S.491, “American Health Security Act of 1993”. This is the Senate version of HillaryCare.

    http://thomas.loc.gov/cgi-bin/query/F?c103:1:./temp/~c103bUIATM:e9833:

    [If this link doesn’t work, just search

    http://thomas.loc.gov/home/c103query.html

    for “Health Security Act of 1993”. That will also turn up the House versions of the bill.]

    If you scroll down to Section 631 (you have to click “This document, Forward”) you will see

    “SEC. 631. MANDATORY ASSIGNMENT.

    ” (a) NO BALANCE BILLING- Payments for benefits under this Act shall constitute payment in full for such benefits and the entity furnishing an item or service for which payment is made under this Act shall accept such payment as payment in full for the item or service and may not accept any payment or impose any charge for any such item or service other than accepting payment from the State health security program in accordance with this Act.

    ” (b) ENFORCEMENT- If an entity knowingly and willfully bills for an item or service or accepts payment in violation of subsection (a), the Board may apply sanctions against the entity in the same manner as sanctions could have been imposed under section 1842(j)(2) of the Social Security Act for a violation of section 1842(j)(1) of such Act. Such sanctions are in addition to any sanctions that a State may impose under its State health security program.”

    Inasmuch as there is no opt-out provision (see Sec 102 & 103 — under HillaryCare, everyone was forced to be covered), it seems to me this “essentially made it illegal to provide private medical service for pay,” as Rand has alluded. Perhaps Robert can explain how we are misinterpreting this section or the history of this legislation.

    BBB

  20. Leland, the minimum standard being raised in this case is the amount of health care affordable by poor people. What maximum would decrease, and what would be the mechanism which decreases it?

    BBB, that’s interesting. Why would receiving private medical care constitute receiving a benefit under the health security act? Doesn’t it work like any other insurance policy? Doesn’t the insurance policy have to be invoked before it can take effect?

    For example, my homeowner’s insurance policy covers me in case an animal chews a hole through my roof, but I only intend to invoke my insurance policy for a catastrophic loss. If I find a hole in my roof, pay a carpenter to fix the hole, and never contact my insurance company about the event, why would the carpenter’s payment be a payment for a benefit in my homeowner’s policy? The hole was covered, I had already paid for the coverage, but I chose not to invoke my coverage. Although I was covered, I don’t see how anyone could argue that the insurance company was involved.

    Furthermore, you might be seeking private medical care because you wanted something that wasn’t even covered by the Health Security Act, and in that case, Section 531 wouldn’t apply.

  21. the minimum standard being raised in this case is the amount of health care affordable by poor people. What maximum would decrease, and what would be the mechanism which decreases it?

    I’m not sure how Obama will lower the maximum. A couple of things:

    First, Obama is using the words inequity. What is unfair about health care costs besides poor people having less access than rich people? You cannot give poor people more access to a limited product and expect more availability of it. Demand goes up, supply remains the same, then costs go up (except costs would be controlled to again allow access to poor). If cost can’t go up, then typically quality suffers.

    Second, in the originally Clinton proposal in the early 90’s, Government would set prices on healthcare services. To assure fair distribution of services, government would control service queues. If a doctor offerred additional services on the side (e.g. after working the mandated 8 cases a day, a doctor offers to take you as a 9th case if you paid him extra for doing so), then he could face penalties that included fines and jail time. Jail is an effective mechanism.

    Third, there is a larger economic discussion of the negative effects of price controls in general and ripple effects. I recently explained this in another thread, so I won’t repeat it again.

  22. Leland, I probably shouldn’t say anything late at night, but a) thanks for your reply and b) As demand rises, why can’t the supply of health care services rise too? After all, now there will be more people with a guaranteed ability to pay for services.

  23. Robert said:
    “I still don’t really understand the logic of this thread. If someone wants to raise a minimum standard, they ought to experience the minimum themselves, even if they can afford to do better?”

    Here’s the deal: the “rich” will be able to afford whatever they need, healthcare-wise (and are pretty sure to be able to leave themselves loopholes, although Hillarycare did its best to close them).
    The people who get screwed in “raising the minimum” are those in the middle. They are the people whose insurance is actually pretty good (just not magically “free” {roll eyes}) the way things are. Of course that not to say there’s not room for improvement, but most of what passes for reform will inevitably lead to rationing & cutbacks, longer waits, etc — and the people in the middle will not be able to afford to just whip out the checkbook and do an end-run on the system. *They* suffer a net loss.

    FWIW I don;t understand *your* blindspot about efforts to block people going outside the system, going private. Of *course* its wrong and absurd on the face of it, but the fact is the government has the power to try to do what it wants, and the Dems typically what to give it to them. Just because something is wrong does not in any way mean the government can’t trample our rights (with the right progressive judges to gieve ’em a pass for our own good.)

  24. As demand rises, why can’t the supply of health care services rise too? After all, now there will be more people with a guaranteed ability to pay for services.

    Partly because of the medical school cartel, which artificially restricts it.

  25. > He will go to the United States, because members of Congress, like all federal employees, already have guaranteed health care.

    Their health care does not have the benefits that advocates of govt health care claim.

    The US spends about 15% of GDP on health care. The single payer folks claim that they’d drop that number to 10%.

    Govt health care already covers about half of the population, private the other half. Interestingly enough, both spend about the same amount of money.

    Let’s give govt the benefit of the doubt and say that it spends 7% now and covers half the population. (Both numbers are low.)

    If the single payer folks are correct, we can double the number of folks getting govt healthcare for less than 50% more money. (10-7 is 3 and 3 is less than half of 7.)

    I’m perfectly willing to believe that govt can spend more efficiently on health care than it does today, but that doesn’t mean that it will.

    Why aren’t the single payer advocates fixing govt healthcare so it works as they insist that it will? Once they do, they can kill private health care by opening up govt health care at cost.

    Curiously, govt health care advocates are never willing to make govt healthcare work as they insist that it will. They often get abusive when one suggests that the possibility.

  26. You might also want to check the salaries of health care workers in many countries that have socialized medicine. Quite often, they aren’t all that great. When government controls all aspects of health care, it isn’t long before cost constraints begin to cut into salaries. That tends to reduce the pool of people who choose to pursue a career like a doctor that takes many years to become fully qualified.

    Case in point: I was a substitute teacher in 1984. One of my students was an exceptional young man who was a sophomore at the time. He graduated high school in 1986 and premed in 1990. He graduated medical school in 1995, finished a 7 year general surgery residency in 2002, and 2 more years to become a thoracic surgeon. From 1986 to 2004 is 18 years. That’s a long time to become a fully qualified thoracic surgeon. He’s now an Assistant Professor at the University of Michigan Medical School.

  27. Govt health care already covers about half of the population, private the other half. Interestingly enough, both spend about the same amount of money.

    This isn’t quite counterfactual, but it’s close, because health costs aren’t per person, they’re per disease. The government covers everyone over age 65, veterans are also older than average, and disability is a direct eligibility criterion for Medicaid. So the government is covering rather more than half of the sick people in the country. In fact, private health insurance partly compete on their ability to find healthy subscribers and avoid or dump sick subscribers. The government does the opposite.

    You might also want to check the salaries of health care workers in many countries that have socialized medicine. Quite often, they aren’t all that great.

    Whereas in the US, doctors’ salaries are fabulous, but people aren’t all that healthy.

  28. Jim Harris: perhaps you should have read the whole article to which you linked. According to that article, Kennedy could have waited three months or more to see a specialist, and then four months or more to get his MRI (88% within three months and 90% within four months respectively… 1 in 8 don’t get to see a specialist within three months, and then 1 in ten have to wait more than four months for the diagnostic). Want to bet that the numbers are even worse for specialties like neurosurgury? My eight month figure is far closer than your magical three week figure. Maybe that’s because I actually lived in Canada for 36 years, and you are simply blowing smoke out your ass as usual.

  29. Robert said:
    BBB, that’s interesting. Why would receiving private medical care constitute receiving a benefit under the health security act? Doesn’t it work like any other insurance policy? Doesn’t the insurance policy have to be invoked before it can take effect?

    No, it doesn’t work like other insurance policies.

    I think you are not grasping the fundamental tension in the debate over health care in this country. Despite Democrat talking points, the debate is not between those who want everyone to have at least a minimum standard of care (D) and those who want poor people to pay for their sins (R). The struggle is over whether we will have a collectivized health care distribution system or whether we will have one that preserves freedom and market incentives (which necessarily implies a spread of access and outcomes). At the moment we have neither and the debate is really about where to set the balance. But fundamentally it really is about equality versus freedom (and the high quality that freedom generates), which is why O’Bama’s health care plan addresses “disparities” in care, not minimums of care, and why HillaryCare forced everyone into the same government health care program, and didn’t just provide for government to be the “insurer of last resort.” I don’t know where you got the idea that HillaryCare and the other plans are just about expanding Medicaid a little bit. I can see this is the root of your confusion.

    You have repeatedly suggested that the collectivists like Kennedy and Clinton merely want to raise minimum standards, which indicates to me that you just don’t get it. In the collectivist model, “inequality” is a social evil to be eradicated. They literally want everyone to have the same standard of care, be they Bill Gates or a debt-laden Princeton grad like Michelle Obama or a homeless man in Union Square. That is why they look to countries like Canada (where AIUI it is illegal to procure medical care outside the national health care system) and Cuba (ditto) for their paradigms of health care.

    “Inconceivable!” — Vizzini.

    For an introduction to the collectivist mindset, I suggest you pick up a copy of Thomas More’s “Utopia.” People generally fall into two categories about this book. Some folks are utterly repelled by the ant-like communism that More proposes, in which everyone wears the same clothes and lives in the same houses and has the same work schedule — and dissidents are executed. Others are enthralled by the vision of a society with no wasteful luxuries, where everyone who obeys the rules will have a decent life and everything is shared like a big family. I guess there is a third category — people who fall asleep before finishing the book….

    Regards
    BBB

  30. Leland wrote:
    >> BTW, I know a of a situation in which a doctor volunteered to provide critical eye surgery on a young child to restore that child’s vision. Medicare prevented the doctor from providing the services free of charge, because Medicare required that if a doctor received patients using Medicare, then he must charge those patients at his lowest fee.

    Sharing that tale, I had the accuracy challenged. Could you cite a reference for us?

  31. Rand said: Partly because of the medical school cartel, which artificially restricts it.

    Rand, The medical school cartel sounds like an easy opponent. There are no trade secrets, and we know how to teach. There is no shortage of smart people in the world. The med school cartel is hardly controlling a rare resource.

    Ed, I don’t see what you are seeing in the article Jim supplied. The article clearly states the wait time depends on what kind of patient you are. The article says ” one in three patients requiring a CT exam are referred while in a hospital emergency department or inpatient bed. This group typically will have their exam on the day it was requested or the next day.” The article doesn’t say how long Canadians who are referred while in the hospital or during an emergency have to wait for an MRI, it only refers to CT scans. But you seem to be saying that Kennedy wouldn’t have been treated on an emergency basis in Canada and wouldn’t have gotten a diagnostic scan within a day. I don’t believe it.

    Newscaper & BBB, you explained your concerns, but you didn’t explain why you think what you are concerned about would actually occur. As for my supposed blindspot, as a mainstream Democrat, I’m not ideologically opposed to economic inequality. I want people to strive to get rich. I’m ideologically opposed to Americans having no health care (or ER-only care, or sell-the-house-to-save-your-child’s-life care). When I read that Obama wants to eliminate inequities, I don’t think that means imposing some Harrison Bergeron scheme on the good parts of the system, which includes having the freedom to go buy the best care you can afford. Just call me a crazy freedom-loving Democrat!

    Trading ideological viewpoints is silly — I don’t have the facts, but you aren’t supplying them. Why is HillaryCare (and, much much more relevantly, Obama’s current plan) different than an ordinary insurance policy? Just asserting it and talking about collectivism doesn’t make it so. I am openly ignorant and willing to learn.

  32. Ed Minchau: According to that article, Kennedy could have waited three months or more to see a specialist, and then four months or more to get his MRI (88% within three months and 90% within four months respectively

    First you said “would”, now you say “could”. That sort of word substitution is already counterfactual. It’s also counterfactual to add up the worst cases and talk as if the sum is a common risk. Yes, it could take you a week to fly from Atlanta to Dallas, if there’s a storm at each end. It’s just not nearly as likely as a storm at just one end.

    The other error in your account is that the wait lists are only for non-emergency care. A patient hospitalized with a massive seizure is a clear medical emergency, and he can get an MRI immediately in either the US or Canada. Someone like you or Mark Steyn might tell him that he has to wait eight months, but it would not be true.

    I actually lived in Canada for 36 years

    “I lived in Canada, therefore I speak for Canadians. I don’t need to cite any source other than myself.”

  33. I actually lived in Canada for 36 years

    “I lived in Canada, therefore I speak for Canadians. I don’t need to cite any source other than myself.”

    No, it means he know more about health care in Canada than you do. Likewise, we probably know more about health care in America than he does.

  34. A Canadian wouldn’t wait 8 months for an MRI in an acute situation. After a bicycle accident last year (yes, I’m a liberal, and I ride a bike – laugh it up) I waited about 4 hours for a scan, and I only waited that long because I didn’t have any symptoms except blood on my forehead. I only had to show my health care card, and didn’t pay anything, do any paperwork, or confront any bureaucracy.

    Also, Kennedy isn’t entitled to health care in Canada, the UK, or Cuba, because as far as I know, he hasn’t paid any taxes there. I thought the most disgusting part of Michael Moore’s “Sicko” was the Americans sneaking into France and Canada to abuse the system.

  35. A brain tumor can exist for years before detection. They can affect reasoning and thought patterns. What if….
    .
    .
    .
    deet, da, deet, deet, deet, da, deet, deet, deet …dateline Boston….AP Wire says, this morning after completing his final brain tumor treatments and having been given a clean bill of health by his oncologist, MA Senator Ted Kennedy announced that he is fit, healthy and he is thinking clearly. The Senator apologized to President George Bush, retracted his endorsement of Sen Obama, outted Senator Clinton and Speaker of the House Pelosi as lesbian lovers, announced he was changing parties, and endorsed Senator John McCain.

    “I’m telling you, that it’s like a veil has been lifted from my eyes”, Sen Kennedy told reporters.

    “Oh, and thank God that all those stupid nationalized health care plans were defeated!! I coulda’ been a goner.”
    .
    .
    .
    Seriously though, my maternal grandmother, my sister, my mother-in-law and my wifes paternal grandfather died of cancer. As Sean Conney says in “Medicine Man”, cancer is the plague of the 20th Century.

    I’ve got too much time dealing with this disease, and the familial fallout from it, to make hay at Kennedy’s expense. I’m too much a believer to not pray for him and his family.

  36. A brain tumor can exist for years before detection. They can affect reasoning and thought patterns.

    That kind of reminds me of that dumb (and unintentionally hilarious) Harrison Ford movie, in which he gets lobotomized with a 38 bullet, and becomes a liberal.

  37. Robert wrote: you explained your concerns, but you didn’t explain why you think what you are concerned about would actually occur.

    Umm, because this nightmarish overhaul and collectivization of medical care was almost enacted by Congress in 1993? And because the same people are running the Democrat party today? And because the same Democrats with the same idiotic conception of how economies work are likely to win keep both houses of Congress as well as the Presidency this year?

    As for my supposed blindspot, as a mainstream Democrat, I’m not ideologically opposed to economic inequality. I want people to strive to get rich.

    Good for you. From what I can tell, you are a minority in the Democrat party.

    I’m ideologically opposed to Americans having no health care (or ER-only care, or sell-the-house-to-save-your-child’s-life care).

    So… it’s okay in your book to take my paycheck and buy health insurance for someone else? This doesn’t sound like “how any other insurance policy would work”.

    Another scary way these federal health care plans differ from Blue Cross is that the federal meddlers think that it is within their purview to dictate constraints on medical practice and education far beyond what sane people think appropriate. Hillary proposed to establish an American Health Security Standards Board that had a much larger charter than, say, the folks at Blue Cross who set premiums and invent charging codes. One version of HillaryCare (the 1400-page draft that was released in 1993) empowered the AHSSB to set racial quotas for incoming medical students. The AHSSB would also have dictated the proportion of medical school graduates that were to become primary care doctors (as opposed to specialists). The idea that the federal government can wave a wand and establish the market balance for, say, doubling the number of primary care doctors and halving the number of specialists is absurd. Soviet-style central control of markets is always an abysmal failure. So why am I worried about it? Because the leaders of your political party are powerful idiots. Teddy Kennedy (remember him? there’s a thread about Ted…) is a prime example of a powerful politician who never understood why central planning doesn’t work.

    Regards
    BBB

  38. So… it’s okay in your book to take my paycheck and buy health insurance for someone else?

    In principle yes. No more so than its ok to take my paycheck and buy a bunch of other things that the kind of society I want to live in needs.

    There’s plenty of places where there’s effectively no government nor taxes but I hear Somolia is a tad warm this time of year.

    I hear they’re proposing a Libertarian colony again. You could give that a go.

  39. Daveon:

    Now we get to the crux of the issue. Why is Ted Kennedy’s health care your responsibility? Why is Rand Simberg’s health care your responsibility?

    Why is anyone’s health care the government’s responsibility?

    BTW, to compare the US Government following the constitution and not being involved in healthcare to the situation in Somalia is pure asshattery.

  40. Daveon wrote: In principle yes. No more so than its ok to take my paycheck and buy a bunch of other things that the kind of society I want to live in needs.

    Well, this view of unlimited government power promises little better than Somalia. Fortunately, that’s not actually the way things work (or at least, have worked in the past) in this country, where the Constitution limits government to a set of enumerated powers. You should look into this.

    BBB

  41. > I wonder which country with morally superior “universal health care” he’ll go to for his treatment? Will it be Canada, the UK, or Cuba?

    Nice. LOL. I predict option “d — none of the above”.

  42. > I take no satisfaction in the misfortune of political opponents.

    I do, but I don’t inhale.

    (This limits my time to snicker substantially, keeping it to a healthy minimum)
    :o)

  43. > The only problem, the only thing missing, is some form of catastrophe insurance, some way to account for the occasional piece of really bad luck for which no one individual can possibly save up.

    This, in fact, is what insurance is really supposed to be all about — the insurance companies use statistics to average out all the unplannable catastrophes to reduce and distribute the expense at a manageable level to policy holders (yes, ignore the “act of God” provisions of most policies, that’s the insurance companies’ out for the equivalent on a widescale level).

    Health insurance is no longer about managing catastrophic expenses but distributing ALL healthcare expenses — which penalizes the healthy to the benefit of the sickly — because the healthy can’t really obtain “catastrophe” health insurance.

  44. > Besides, many American patients have to wait a long time for insurance approval before getting treatment.

    Considering that I’ve gotten two MRIs and a CT **without health insurance** in the ER (three different visits with back spasms over the course of 5 years), this seems relatively improbable. A fourth visit involved an EKG (some people interpret a heart attack as back issues), noting another, unrelated issue with my heart, resulting in short-term hospitalization and heart catheterization to determine the nature of the problem (reduced ejection fraction, at 35% instead of the normal 65-70%).

    All with no insurance.

    Yeah, I’ll vote for government-mandated healthcare.

    Sure. I’d love to have it work like it does in Canada and the UK, where people are known to die on waiting lists for *medically-required* surgeries.

    ‘Sicko’: Heavily Doctored
    http://www.mtv.com/movies/news/articles/1563758/story.jhtml

  45. > The medical school cartel sounds like an easy opponent. There are no trade secrets, and we know how to teach. There is no shortage of smart people in the world. The med school cartel is hardly controlling a rare resource.

    It’s not a cartel. It’s a **guild**, and one of the most powerful ones in the USA. Probably the only one which manages to actually control membership directly.

    You do not practice medicine without a license. Who defines the criteria for getting a license?

    Members of the Guild, that’s who.

    Just try and change the requirements for getting a license. They don’t even let you move easily from state to state and re-locate a practice.

    We need to reverse the law school-med school rules. If we had lawyers like we have doctors and doctors like we have lawyers, the whole system would probably right itself within a decade or so.

  46. Usually in a socialist country, there is an entirely separate healthcare system for the ‘leaders’. So what happens in Canada if a high-up government official decides that he needs healthcare? I can see three possibilities: 1. He gets treated the same as anybody else? 2. He keeps it quiet but takes a brief vacation to the US? 3. He uses the same facilities as anbody else, but the waiting times don’t apply? Anybody with experience to suggest how it works?

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