September 3, 2007

John Edwards: "you can't choose not to go to the doctor for 20 years."

Edwards' universal health care proposal ignores individual autonomy:
"It requires that everybody be covered. It requires that everybody get preventive care," he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. "If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."...

Edwards said his mandatory health care plan would cover preventive, chronic and long-term health care. The plan would include mental health care as well as dental and vision coverage for all Americans.
So, the mental health check is mandatory too? Why does he not even realize how bad that sounds? He's so warmed up about the generous benefits he's promising that he doesn't even hear the repressiveness in his own statements. I'm sure he won't be able to deliver on these promises. I'm just wondering about a person with so little sensitivity toward personal freedom.

Somehow, this reminds me of a sign I saw the other day:

DSC04517.JPG

For more commentary, start here. And I predict Edwards will, within a day, chide us for misunderstanding what he meant by "require" and that "require" doesn't mean you'll be forced, only that the big bad medical establishment will be required to provide.

ADDED: This idea of screening everyone's mental health reminds me of the proposal we were just talking about to screen military personnel. There was a NYT editorial:
It is an eminently good thing that the anti-suicide measure would require medical specialists to keep track of veterans found to be high risks for suicide. But that’s to care for them as human beings, under that other constitutional right — to life, liberty and the pursuit of happiness.
I'll ignore that goof about the Constitution this time and just quote this reaction of mine:
Why stop at soldiers? Let's have the government come around and check on everyone's sanity and then track those of us who don't meet the standard! To show we care for them as human beings.
That was my sarcasm, but Edwards is talking about really doing it!

MORE: Concurring Opinions has some sort of pincer theory that attacks me. Whatever. The real question is who ought to be worried if the government starts tracking our mental health.

128 comments:

Ruth Anne Adams said...
This comment has been removed by the author.
Bob said...

Oh, it's easy enough to enforce crap laws like that. Just tie it to renewal of driver's licenses, or institute escalating fines for not going to the doctor, and they'll all fall in line quickly enough. Won't apply to the rich, and of course the Congress will exempt itself, like it does with most laws.

Bender said...

It is only a small step from government forcing everyone to receive mental "healthcare," to institutionalizing people in "hospitals" because they are obviously insane for dissenting from the politically correct.

Paddy O. said...

I hear Edwards is also considering mandating clocks be moved ahead a half hour. So as to improve metabolism and productivity.

EnigmatiCore said...

First, I oppose socialized healthcare because it is very inefficient and will lead to worse care for all.

However, IF we are going to have it, then I do want it that if you want the benefits, you have to accept the responsibilities. I do not want to have to pay for the treatment of someone who hasn't gone to the doctor for 20 years and has something that could have been and should have been handled earlier and cheaper.

He said that if they want the free care, they have to go to the doctor regularly. I oppose his health care plan because I oppose socialism. However, if we are going to have socialism, I want the strings attached, both to minimize the costs to me and to make it less likely that people will clamor for more socialism (not wanting the strings).

Bob said...

Guest poster Darleen Click has a great take on this (with government form already designed) on Protein Wisdom:

http://proteinwisdom.com/?p=9713

Bender said...

Personally, I'm waiting for the plan where everyone is required to obtain liability insurance and each and every person in the country is required by law to go see a lawyer every year in order to examine his legal "health," whether he has any legal problems or not.

David said...

Ann: You claim to be a liberal, but then you -- a law professor -- make a big deal about things like personal autonomy even though Bush is a liar.

AlphaLiberal said...

Sounds like Ann's taking his comments our of context or he misspoke. I'm sure he didn't mean compulsory doctor visits.

He probably meant something more like people can't (afford) to skip 20 years of visits. After all, Bush has said we have medical care, just look at all these emergency rooms.

vet66 said...

This is rich coming from Edwards who made his fortune on junk science that was later disproved. It sounds like more make work along the lines of a smog check for your car which generally takes an hour of a citizens time plus the gas burned idling up to the test bay.

The mental health check-up is laughable too. What happens if you flunk for some reason? Are they going to send the misguided soul to rehab somewhere? GOD save us from the east coast Brahmins with excess cash and time on their hands.

EnigmatiCore said...

AlphaLiberal, the exact quote is provided.

"If you are going to be in the system, you can't choose not to go to the doctor for 20 years."

If he had not started with "if you are going to be in the system", then your charitable interpretation would be plausible. However, he was clearly stating that the requirements of the system would be mandatory doctor visits.

Frankly, if we are going to have universal coverage (which I abhor) then I want this. We require people to get their cars inspected regularly, because there is a cost (in terms of risk) that others must bear when an unsafe car is on the road. Right now, if you choose to not go to the doctor, you are putting yourself at risk which does not affect me much at all. I'll be sad if you get sick with something that would have been significantly more treatable if caught early, but I won't otherwise be affected. Under universal care, I would be because I would have to pay for you and for anyone else who had been negligent with their own body. You want my money to pay for your healthcare? You have a responsibility to prevent as much of the costs as possible.

Edwards might crawl back from his statement now, but if there is universal coverage, then what he suggested here is what will actually come to pass. People will demand it, and I will be one of them. Strings will be attached and pulled to maintain costs and to make a healthier world.

Ann Althouse said...

Alpha Liberal is doing Edwards' backtracking for him. I already said he'd backtrack and what he'd say. So what are you adding?

Gahrie said...

Alphaliberal:

If you didn't exist, someone would invent you as performance art.

I'm not entirely certain that they haven't.

AllenS said...

What would the doctor visit consist of? Check for HIV? Sexually transmitted diseases? Then what would happen if you turned up positive? Confinement?

Kirk said...

Well, we've already had compulsory legal checkups suggested as the next step after medical care is socialized. May I propose universal firearms training instead? At least that would have tradition in its favor!

jimbino said...

Americans living overseas, such as students, travelers and retired expatriates will not have to fly back to the USSA for a checkup of course. Hell, their problem is that they will continue to pay taxes to cover the socialized healthcare and drugs that aren't even available to them!

You can't even get Medicare or Medicaid overseas, but you still have to pay Federal income tax.

Dave said...

Anyone who has watched the real world should have established that there are two kinds of people (other than the kind that believes there are two kinds of people and those who don't): Those who want to determine and control your behavior and those who don't. I don't see how anyone could not put Edwards in the first group.

Simon said...

David said...
"Ann: You claim to be a liberal, but then you -- a law professor -- make a big deal about things like personal autonomy even though Bush is a liar."

What a weird post! How does does whether Bush is a liar follow from or relate to whether Ann is (or claims to be a libeal) and whether she "make[s] a big deal about things like personal autonomy"? Are you saying that liberals are opposed to personal autonomy?

Simon said...

Dave - it's the difference between planners and liberals, as elucidated by Hayek before the planners commandeered the word "liberal" (just as, Hayek lamented, they had commandeered the word "planning").

Why is it that kids aren't taught about Hayek in school? Oh ... Wait. That's why.

jane said...

Edwards should stick to what he knows best, as in "you can't choose not to go to a good hairdresser for 20 years."

For a better coiffed America. At least the harm that can be done to hair grows out. Medical state-of-the-art with lots of oops factors, thou shalts and shall nots paternalism, and universal insurance-bureaucratic compromise can be downright dangerous.

Gedaliya said...

Personally, I'm waiting for the plan where everyone is required to obtain liability insurance and each and every person in the country is required by law to go see a lawyer every year in order to examine his legal "health," whether he has any legal problems or not.

The lawyer's full employment act.

EnigmatiCore said...

"there are two kinds of people (other than the kind that believes there are two kinds of people and those who don't): Those who want to determine and control your behavior and those who don't."

There's a third kind. My kind.

The kind that really does not want to determine and control your behavior, unless you are using the government to take my money. You bet your bippie I want to exert control over those living on my dime. You don't want me telling you what to do? Don't be dependent on me.

John said...

Why is it that the left is always yammering about Republicans leading us into Fascism and yet they are the ones who want all these mandatory programs. Presumably if they are mandatory there is some punishment for not complying --- a re-education camp perhaps?

A pox on their house.

Tim said...

"What would the doctor visit consist of? Check for HIV? Sexually transmitted diseases? Then what would happen if you turned up positive? Confinement?

AllenS,

That is an excellent point. Already we've economic incentives in medicine for specialists over primary care providers. Throw in the "pay for performance" and mandatory check requirements, add 15% or more patient demand to (currently) fixed supply of providers, and we'll have more people seeing the same number of docs who have to do more with, wait for it...less time and no more pay.

Many prospective doctors, being as smart or smarter than the average American, will change career paths to more lucrative fields, such as law and finance instead of becoming civil servants in our bright, shiny new health care system for all. We, of course, will then brain drain developing third-world nations like the Philippines, Guatemala, Nigeria and countless others for our docs - and then wonder why there weren't enough docs to stop the next global epidemic from sub-Saharan Africa or East Asia...

Only a smarter-than-everyone-else liberal Socialist Democrat could think up a system in which we'd all have to pay higher taxes, make work miserable for docs, get worse care, and import third-world docs just so the Democrat can nationalize 16% of the nation's economy and keep the "vulnerable" middle-class on the Democrat plantation.

All of that without even talking about the deleterious affect of socialized health care on innovation as capital funds wither away...

Kevin said...

Anne--

I really don't think he's going to backtrack, except maybe on the mental health thing, which may well be misquoted. Edwards is a distant third, and desperate. He needs to roll the dice with a big idea, and playing safe will keep him a distant third.

The Mechanical Eye said...

This is rich coming from Edwards who made his fortune on junk science that was later disproved. It sounds like more make work along the lines of a smog check for your car which generally takes an hour of a citizens time plus the gas burned idling up to the test bay.

As a lifelong resident of Southern California, I'd consider that an awful example of Socialism Not Working.

I was born in 1981, and even then I can recall hot summer days when the LA basin would have days where it was covered in a very thick layer of smog -- it was grossly visible in the skyline and nothing at all like today's worst smoggy days. Local emission controls like Smog Check did a lot to solve that.

This post generated the usual knee-jerk responses against the Stalinesque Tyranny that is socialized medicine while bringing out examples where government intervention actually *worked*

DU

From Inwood said...

Prof A.

Um, depends on what the meaning of "require" is doesn't it?

What happens when a 20 yr old with bad cholesterol readings but in otherwise excellent health is advised to take statins, stop eating a pint of rich ice cream every day, & exercise?

Think that his habits can be changed by a routine physical? Some nannies of the Socialist state think so, tho there's no indication that worldly experience of the failure of Socialism everywhere it's been tried has changed their robotic political habits.

OK, let's mandate a stress test for all 20 yr olds. And oh, that's really not 100% certain, so let's have the one where they inject dye.... For every 20 yr old? What about the costs? Tax the rich.

And if my 20-yr old gets a heart attack at 40 he can sue the system with the help of a tort lawyer!

Brave New World & 1984 here we come.

Michael said...

Ann: So, the mental health check is mandatory too? Why does he not even realize how bad that sounds?

But it takes place in a nice comfy chair in a wonderful room at the ministry of truth!

Now be a good prole and stop questioning the superior wisdom of Ingsoc. It's for your own good, after all.

Mark said...

Meanwhile, in England, the nanny state needs to improve adoption rates for children who have fallen into its care. Solution: seize better (i.e. newbowrn, low-risk) children.

A pregnant woman has been told that her baby will be taken from her at birth because she is deemed capable of "emotional abuse", even though psychiatrists treating her say there is no evidence to suggest that she will harm her child in any way.

Yep, I'm so looking forward to a fully-socialized health care system.

jeff said...

"Local emission controls like Smog Check did a lot to solve that."

Or maybe 27 years later the cars that currently are on the road produce so much less smog that what was on the road back then? What do you suppose the difference in smog output between say a car 10 years old and a car that was on the road 27 years ago? How about a brand new car verse one 10 years old?

downtownlad said...

But if I open a restaurant, Ann wants to force people to serve black people.

That's just a removal of liberty as forcing someone to go to the doctor.

Why is one ok and the other is not?

They are both oppressive and bad for society.

vet66 said...

Mechanical Eye;

I was raised in Compton, California, liveing there from 1952 until 1966. The emissions testing that goes on is so loose as to border on the useless. If your car fails you have it detuned. If it fails again you can get a one-time waiver. It also, as stated above, is superfluous to the boutique gas that is produced and computer controlled engine systems that detune themselves depending on what gas you use. This is busy work to decrease unemployment and slip what really is a tax on everybody driving a car.

The skies are indeed clearer over the L.A. basin. The San Joaquin Valley is another matter entirely. I eagerly await your move from California as you take what little money you have left and leave the welfare Golden (Plated) State and move east following so many of your former neighbors.

There is life after the traffic jams on the 405, 10, 605, 5, 710, and 210 to name but a few.

Fat Man said...

Esposito: From this day on, the official language of San Marcos will be Swedish. Silence! In addition to that, all citizens will be required to change their underwear every half-hour. Underwear will be worn on the outside so we can check. Furthermore, all children under 16 years old are now… 16 years old!Bananas

Cedarford said...

Enigmaticore - First, I oppose socialized healthcare because it is very inefficient and will lead to worse care for all.

Except that it isn't.
Health care costs in France and Germany are 60% that of what we Americans pay, full medical, full dental. They cover everyone. They have 1/3 of the fatal hospital infections and fatal medical errors we do in the States. We also are slipping from 1/7th of the population denied to 1/6th as private companies that now foot much of the care cannot compete with global companies that don't.

It is not a question of "Freedom!!!". All the advanced industrialized nations that are polled on this say they would never abandon universal health care because it would be a loss in the freedom of people to wake up and know they are one injury, one disease away from bankruptcy and family destitution - as was the case in Europe and Asia in the 19th Century.
They see the US system as a disgrace. Exploding health care costs the Asians and Euros avoid, years of admin and legal fights over bills. A million medical bankruptcies a year. Supremely wasteful of health dollars spent, high accident and infection rates, failing the many to heap huge financial rewards in the few.

******************
Edwards is stupid. He doesn't have
to reinvent the wheel - just look at what many other nations have done very well. Go with the century of expertise the Euros acquired in geting the Bismarkian system to function so well, or go with the universal coverage through national insurers system that nations like Japan, Australia, Israel have....and avoid the system flaws of scarcity that the Brits and Canadians occasionally contend with.

If nothing is done, CBO estimates that the American system will continue to break down...lower life expectancy, massively higher costs, more concentration of wealth in an elite of drug companies and health care cabals. By 2025 they see health care costs taking up 25% of the GNP, with degraded emergency room care, more medical error fatalities and infection, and half of America's population outside dental care coverage and 1/4 witho/ut medical insurance.

Something has to be done.

Private enterprise and the "genius of the markets and competition" has failed.

Everyone running for President except the wackball libertarian Paul and Senator Snowflake Kids
(Brownback) recognize we are in a health care crisis and something must change, change urgently. Newt Gingrich agrees with Romney, and Hillary.

Bruce Hayden said...

Edwards is just trying to find some way to get a little traction. Good looking Southern boy made good, with a full Senate term under his belt, and no one takes his candidacy seriously.

He tried "Two Americas" and then he tried environmentalism, preaching that we should all give up our SUVs. And so, what do we find? One picture points to the hypocrisy of both (the picture appears to show four SUVs (circled in red) parked around his mansion).

At this point, anything to get traction is all he wants. He isn't serious about this, just like he wasn't serious about Two Americas or Global Warming. The nomination is what is important, and he will say what it takes to get it (and have his wife with cancer do the same).

lamc said...

Help me out law professor - where is healthcare guaranteed in constitution?

Mark said...

"Mandatory" ... coming from the same Federal Government that brought us the kind-and-gentle folks of the TSA, ATF, and DEA ... managed by Hillary and VP Edwards ... what does that translate to?

Obviously there will be penalties for missing your mandatory GP appointment and your mandatory Psych Eval.

And of course any objection to getting a mandatory psych eval will be seen as a prima-facie proof of "anti-social-disorder" (leaving off the "ist" after the "l") ... treatable by mandatory mind-numbing drugs or other kind-and-gentle therapy in a registered mental health facility (which is not a socialist re-education-facility (really!)).

Missing your medication will be a misdemeanor punishable by fines of not more than $5000, imprisonment for not more than 90 days and forfeiture of your residence and vehicle and bank/brokerage accounts and other assets (this is Hillary after all, using Edward's policy suggestion to further her socialist ends).

Then, medication becomes mandatory in a whole new way ... similar to the "Norplant" device, a medication-release tube will be implanted in an unremovable way to ensure that you incorrigible anti-psych people take your Paxil.

After all, if seeing the doctor is mandatory, so is listening to the doctors orders ... and following them ... under penalty of law (since it's being paid for by federal tax dollars ... following the usual logic of extending Fed penalties wherever Fed dollars flow or they can find commerce-clause reasons to extend their influence).

Of course, if you are overweight and not following your doctor's mandated diet, they will be perfectly nice and kind about helping you follow the diet and exercise plan by putting you into a Fed-Med fat-farm (which is not a socialist re-education-facility (really!)).

For those of you who think the Fed-Med mandate ends at banning smoking, wait will they go after fatty hamburgers, bacon, french fries, trans-fats (Oh, wait ... ).

If you're particularly unlucky, the next Secretary of Health will be a Vegan ... with police enforcement powers.

Then there's the people who avoid doctors because they've been damaged by med accidents, mistakes, malpractice, etc ... oops ... no "choice" anymore ... no medical privacy or control of your physical body.

Then there's the doctor's conversation with parents "your 11-year-old daughter needs to get the HPV vaccine and to be on Norplant/Yaz/Nuvaring/etc" ... the parents ask why, the doctor refuses to answer but tells them she also needs to take these pills and also refuses to answer ... and an 11-year-old's sexual privacy is destroyed, the parents assume she is sleeping around and the doctor is simply following age-guidelines legally mandated by Fed-Med without any specific indicator that _this_ 11yo is sexually active ... and other Fed-Med laws that say he _cannot_ discuss sexually-related matters with parents.

Then eventually the 11yo convinces her parents that she's never had a boyfriend and the parents don't force her on hormones and the next mandatory checkup (at school, for convenience (of course)) doesn't detect the legally required birth control hormones in her urine ... so the Parent-Police (used to be called social services before they dropped the pretense) come and arrest the parents and put the kids up for adoption for law-abiding would-be-parents to raise within the legal requirements.

After all, anything the Fed-Gov pays for, the Feds pass laws to control ... like highway money allowing the Fed mandate for 55mph speed limits nationwide, DeptOfEdu money allowing for federal control over schools, and the commerce clause allowing intrusion into just about everything (wages, legal and illegal drugs, car safety and mileage, OSHA, the environment (pollution crosses state lines)). The next thing you know, we might have Fed-Gov mandates on light bulbs because electricity crosses state lines (oh ... oops (CFLs))

Gahrie said...

Cedarford:


If you were seriously sick or had a serious disease, where would you rather be treated: in a European style nationalized system, or in the US?

We already know what most people think...when they get sick, the ones who can come to the US for treatment as fast as they can.

Bart Hall (Kansas, USA) said...

What strikes me is the proposed cost of $120 billion for the entire nation. What an absolute crock!

The Wisconsin proposal for not quite 6 million people was $15 billion -- about $750 billion for 300 million people.

The Oregon proposal, for a stripped-down program, was $7 billion dollars for a bit more than 3 million people -- about $690 billion for 300 million people.

Since health care nationwide is a $2 Trillion sector of the economy, I fail to see how "universal" coverage can cost one-seventeenth of that amount.

Disingenuous, or clueless. Probably both.

Cedarford said...

Bruce Hayden -

The "Two Americas" speech works very well because it is 90% true.

It doesn't work well with John Edwards giving it because he is the wrong messenger.

The old "Hypocrite!" argument that has infected American politics is gotten even worse over the years.

You can't argue for AIDs patient care when you are such a hypocrite you or family members haven't personally cared for an AIDs patient. You can't argue for America taking military action anywhere unless you were in the military or have sons in the military (amazing how liberals & Lefties dropped the "daughter" part out of military service when people started dying in conflict).

You can't argue for war even if you served - if you served in a cowardly hypocritical spot like the National Guard or "never saw combat"...as assholes shift the goalposts.

And with Edwards...I would prefer someone else to give the speech, just as I wish hypocritical Newt would not come up with good ideas but some "worthy hero-victim". Frankly, it would have been better if a hyocritical lawyer who sever served in combat and was fond of nigger jokes did not deliver the Gettysburg Address.

Barry Dauphin said...

He is saying his plan would require an assessment. But what good is coerced assessment without coerced treatment?

This could be an interesting twist. For years HMOs have been significantly limiting the number of sessions for people who want treatment (in order to save money). Would Edwards propose forcing some sort of mental health treatment upon those who do not wish it, thereby either increasing the cost or furthering limiting the service for those who wish it?

How about the ultimate Orwellian twist--you must have a mental health problem if you do not wish mental health treatment! Edwards '08

Bruce Hayden said...

Not sure whether to believe that the German and French systems work all that much better than ours does. One thing to keep in mind is that the same government that is providing the health care is measuring how well it does.

It is somewhat like a moving target. After years of hearing about how well the Canadian and British systems work, we now find that they don't. Yes, Americans go to Canada to get cheap drugs, but Canadians come down here to get MRIs and have their higher risk babies. One of our Canadian ski guides went to Italy for hip surgery, since if he had waited for the Canadian system, he would have been out of work for two years waiting. And the British system does fine with breast cancer, but apparently puts prostate cancer way down the list, and last I knew, refused to pay for the standard prostate diagnostics that males over 50 here expect. And their hospitals now make ours look antiseptic.

Bender said...

Instead of government running every aspect of our lives, I have a better suggestion --

Let's simply abolish most government payments for routine healthcare, abolish HMOs, etc. and all other types of quasi-socialist healthcare payment systems, and return to a pure and true insurance model that covers only risk?

That is, like in the olden days, people have the option of buying catastrophic major medical, hospitalization, and accident coverage, which would insure against unexpected loss, but pay for routine office visits and other expected everyday care items out of their own pocket. Then folks wouldn't run to the doctor every time they sneeze or get the sniffles and end up taking up limited resources, thereby increasing the cost.

Palladian said...

Cedarford is a good example of why the far left and the far paleo-right find purchase with each other.

"...more concentration of wealth in an elite of drug companies and health care cabals."

You mean the elite drug companies who are actually pushing medicine and medical technology forward?

CedarfordCare™, a lot like socialized medicine except with a difference: better hope you don't get HIV or want to circumcise your child! No health credits for ELITE HOMOS OR JEWS.

Balfegor said...

"It requires that everybody be covered. It requires that everybody get preventive care," he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. "If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."

Honestly, provided there's an opt-out (i.e. so long as "universal" health care isn't actually universal), I don't see the problem with this. It would be reasonable for an insurer to require plan participants to undergo regular checks and preventive care, and it's still reasonable when it's the government. That might force an awful lot of people off the government health care plan, but I don't really have a problem with that, so long as (a) there's an alternative private market for insurance that they can buy into, and (b) they can opt out of paying the taxes to support the government's plan.

I know. I'm living in a fantasy land. Bah!

Re: Gahrie:

We already know what most people think...when they get sick, the ones who can come to the US for treatment as fast as they can.

You can only take that argument so far, though. I know of a number of people who have engaged in medical tourism to places like India so they can get expensive procedures done at affordable rates. Would we conclude therefore that the market has spoken and India offers better health care than the US? Not really -- just better value for the money. And if we're talking about European health care, I'd prefer US health care, naturally, because we have heavy investment in technological gizmos, but I'd feel comfortable with my life in the hands of West European doctors.

Gahrie said...

balfegor:

I know of a number of people who have engaged in medical tourism to places like India so they can get expensive procedures done at affordable rates

I bet if you do a little more inquiry you'll find that these people were actually going to India to get treatment that is illegal or unapproved here in the US.

Pissed Off Hillbilly said...

It's funny that a health care crisis only happens when there is a Republican administration.
We had 8 years of Clinton andwhich thankfully died quickly, there was no mention of a crisis. There was certainly no action on it.

Bruce Hayden said...

Proponents of socialized medicine most often sidestep the basic economics problem with the concept. The best we had so far today is the suggestion that if we spend a century like the French and Germans did, making their Bismarkian systems work, ours can too.

But what is inevitably missed is that goods and services are invariably controlled by the laws of economics, notably supply and demand. In a functioning market, the two will be in equilibrium, with price controlling demand.

But when we talk socialized medicine, the suggestion seems to be that these basic laws of economics don't apply. Somehow, we are supposed to believe that removing cost as counter to spending won't result in runaway spending. But demand unconstrained by cost inevitably ends up with increased, excess, demand.

Meanwhile, supply is dried up, by refusing to spend what it takes to supply it. We see that in reduced incentives for GPs, more patients, less pay, etc., and as one poster above pointed out, more of the best and brightest entering the practice of law where they can sue the doctors instead.

No wonder that HillaryCare turned out to be such a disastrous plan - they knew that the only way they could get it to work would be to jail anyone who tried to game the system (and gaming the system is what most do as a matter of course).

Of course, Edwards won't get into specifics, except that he is promising the moon without bothering to explain how we would pay for it. Primarily, he won't get into specifics because he doesn't know them, but if he did, he still wouldn't because they would scare too many people off.

Don Giannatti said...

I can't believe how much you all miss the point. John Edwards is keeping hope alive. He is an example of America's promise to all of its citizens. He gives us all a glimpse of the American dream. Think about it, a guy this unbelievably stupid, just downright pure unadulteratedly stupid, can become that rich and actually be considered for the presidency... that is amazing and a beacon of hope for anyone with even half a brain. Ya know.

Cedarford said...

Gahrie said...
Cedarford:


If you were seriously sick or had a serious disease, where would you rather be treated: in a European style nationalized system, or in the US?

We already know what most people think...when they get sick, the ones who can come to the US for treatment as fast as they can.


Brainless jingoism along the same lines as "our public schools are the envy of the world, our cars are the best, American workers can out-compete anyone!"

The people who come do not come from advanced industrial nations - they are the dictators, oil sheikhs, plutocrats from 3rd world shitholes that can afford the US costs that 99.5% of their fellow countrymen cannot.

They didn't go to the universal coverage nations because those nations built capacities for their citizens 1st and foremost and - except for a few of the more entrepreneural that craved big bucks 3rd Worlders seeking better care than Ubuntu, the palace witch doctor - did not set up to give a Brazilian cement magnate 1st in line privileges.

Canada used to have a spillover, because they were deaf to certain capacity and waiting line problems until they became big political liability. Same with PHS under Thatcherism.
Now the UK is working through the PHS problems and the spillover has been of Americans going to Canada and Mexico for better prices while our system in turn treats illegal Mexicans for free.

Few Euros or Asians seek US hospitals now - except for a few stellar ones or for cetain specialties...because the chances of dying in a US hospital from error or infection from poor sanitation are higher than in a place like Japan or Italy.

America was once a leader and preferred destination for even 1st Worlders for medical care. Not any more.

Paco Wové said...

"What a weird post! How does does whether Bush is a liar follow from or relate to whether Ann is (or claims to be a libeal) and whether she "make[s] a big deal about things like personal autonomy"?"

Simon: "Dave" is engaging in that mysterious oriental artform known as ... "sarcasm".

Bruce Hayden said...

I alluded to gaming the system in my last post. And that is one of the big problems with any socialist venture. Socialism is inevitably based on Utopian views of man. Of man being willing to sacrifice for his fellow citizens.

But that is not reality. Rather, man is selfish, and the further you get from himself, his family, his community, etc., the more selfish he is. And why shouldn't he be? We are descended from the selfish ones, not the altruistic ones.

So, inevitably, you will have people gaming whatever socialized system you set up. That is just human nature. The conceit is that someone or some group is that much smarter than everyone else, and so can outdesign those who would game the system.

But, of course, that is a conceit, because there is always more, much more, money on the side of those trying to game the system and make their fortunes (or just get the treatment they think they need). So, you will always have more brains on the side of those gaming the system than on the side of those trying to design it. A lot more. The top end will be higher, as well as the numbers involved.

Indeed, we saw what Hillary Clinton, supposedly the smartest woman in the world, ended up having to do to try to prevent gaming of her health care system - throw anyone in jail who even thought about it. So much for altruism and Utopian solutions.

Simon said...

The elephant in the room: is abortion going to be available in this wonderful system Edwards envisages?

Palladian said...

"The elephant in the room: is abortion going to be available in this wonderful system Edwards envisages?"

Mandatory!

If the government is paying for your health care, of course they should dictate how many children you will have!

Bruce Hayden said...

Why is it that the left is always yammering about Republicans leading us into Fascism and yet they are the ones who want all these mandatory programs.

Read Hayek.

The answer is that the real Fascists, Nazis, and Communists were/are all socialists. Hayek was writing from the time when the Nazis were running Germany and the Fascists were running Italy, and it is only through almost Orwellian double think that we have been led to believe they weren't socialists, and that their totalitarianism wasn't primarily to implement their version of a socialist Utopia.

In his "Road to Serfdom", Hayek makes the point that it was socialism that drove the totalitarianism of all these movements, and, indeed, the book can be seen as an argument against socialism on just those grounds.

Tim said...

"Private enterprise and the "genius of the markets and competition" has failed."

Except, of course, thanks to government policies, there is no private enterprise, the genius of markets or competition, in the true sense, in health care in the U.S. About 93% of Americans get their health care coverage from someone else - either their employer or the government. Only about 7% of those with insurance actually buy their own insurance on the market.

Our third-party system results from the Federal government imposing wage controls during WWII; employers attracted employees by offering (substantially cheaper than now) health insurance; the IRS and the Federal Labor Relations Board both deemed the new benefit tax free by regulatory ruling; Congress made these regulatory rulings law in 1954.

All was fine and well until three important things happened - people stop dying because of infectious diseases (say what you will about the broad social benefits of that, but one benefit of early death due to infectious diseases is that aggregate health care costs are low); as we cured infectious diseases, people aged and became sick due to chronic diseases (primarily); and health care technology exploded, both in pharmaceuticals and devices. Consequently, health care expenses exploded.

You are right, of course, to point out lower aggregate costs and lower hospital-borne infectious disease and other relative quality rates - but it does come at cost. Many don't get expensive end-of-life care; many have to wait for routine (in the U.S.) cancer treatments such that by the time they do, it's too late. Also, you cannot ignore the four decades of deferred maintenance in the U.K. NHS hospitals such that Blair was forced to impose a massive tax increase to rehab decrepit hospitals in 1997; nor can you overlook what would happen in the private investment markets for medicines and devices, unless, or course, you're satisfied with the level of treatments available for numerous cancers, strokes, heart disease, Parkinson's, Alzheimer's, Multiple Sclerosis, Lupus, etc., etc., etc.

Simon said...

Just to clarify Bruce's point (and my earlier one) about Hayek, Hayek's point was that the only meaningful distinction is between liberalism and planning - that is, between a philosophy that emphasizes personal freedom and individual action, on the one hand, and various philosophies that, no matter what they call themselves -- communism, socialism, fascism, nazism, and I'm sure he'd have added progressivism and (modern) liberalism -- impose their own designs and plans, from which deviation isn't permissable.

In short, the choice is between freedom and opression, and it's no answer to say that the Democratic Party don't think of themselves as fascists (and most of them don't think of themselves as socialists, either) - that's why it's a road to serfdom. As I've said before, while "[t]he first step is a long way from the last, ... [t]he first step on the path of that irresistable logic is this: 'We're going to take things away from you on behalf of the common good.' That is the mindset that underlies the [planner's] enterprise. ... [A]s Daniel Webster once warned, there are people among us who would rule us, and while they mean to rule well, they mean to rule."

EnigmatiCore said...

Cedarford--

"Except that it isn't."

An anti-semite who favors socialism.

How are you about nationalism?

Hmm. Just... hmm.

imsoco said...

Enforcing everyone to see a doctor is only the first step. Next it will be a violation of the new "health care laws", soon to follow, that everyone must take the prescribed medication. And that has been the topic of many sci fi movies depicting control of the race for the "good of mankind". Once the pharmaco's are capable of proiducing a drug zombifies a person without the mass murdered side effect (VT, Columbine, etc); you can be assured mass forced medication for your own good will follow.
Watch this online movie http://www.zeitgeistmovie.com/
to learn more about the who.

Cedarford said...

Hayden -

Proponents of socialized medicine most often sidestep the basic economics problem with the concept.

No, the reverse is true. Because of administration, insurance provider overhead, lawyer-induced 19th Century paperwork bureaucracy, duplication of services, and cabals like the AMA keeping the supply of nurses and MDs artificially constrained --

America pays 50% to 80% more per capita on health care than nations that cover all of their people and who have higher life expectancies. Without the million medical bankruptcies and high error and infection fatality rate America has.

The best we had so far today is the suggestion that if we spend a century like the French and Germans did, making their Bismarkian systems work, ours can too.

Hayden's argument presumes that it will take any nation that sees a successful technology or system at work elsewhere an equal amount of time to duplicate it. Thus it took Meiji Japan 300 years to adapt the successful British-Dutch banking and insurance system for international trade, like it took the Brits and Dutch in fits and starts to invent. That once Euros had spent 30 years getting radial tires to be reliable and inexpensive by the mid-sixties, it took America 30 years to make their own product as good.
Indeed, people like Gingrich and Buffett believe that America can do better if we build on the French or Japanese model as we move past our 19th Century system, just as they think they out-did the Bismarkian model.

But what is inevitably missed is that goods and services are invariably controlled by the laws of economics, notably supply and demand. In a functioning market, the two will be in equilibrium, with price controlling demand.

That is not how US Healthcare works. It is a system hobbled by laws, lawsuits, anticompetitive regulations, crushing financial paperwork, cabals controlling services and product supply, a captive consumer market with insurers, drug companies, doctors not willing to let consumers shop globally - and all those inefficiencies add up to the nation paying twice as much for lower overall health care than the Dutch get.

It is a system that pits individuals against major corporations and health businesses on who pays.
And adds even more cost in terms of the economic fear, uncertainty, and paperwork burden that is slapped on families and estates of ill and deceased Americans.
I was executor for my Aunt, who had cancer then had a bad car accident that finished her after a 10-day fight. The estate was a nightmare of hospital and insurers bills, claims, counterclaims. False bills, stuff we found she never got in treatment - insurer run-arounds where lawyers billed for hours of work to get valid claims settled after the family was stonewalled. It was 3 years and hundreds of hours I worked before the estate was settled - and the "medical part" of it was 70% of the delay and estate admin costs..It was disgraceful. But, then again, I was lucky as an American it wasn't worse - like the destitution and wipeout of family savings and property that other families in the millions have been hit with.

The other matter Hayden doesn't mention is health care costs have exploded from what private businesses now facing backruptcy on retiree benefits and considering dropping employee haelth care coverage say are forces independent of supply and demand.

The "American Health Care System" is less tenable now, financially, than the "State Systems" at work elsewhere.
And not just Democrats, but Centrist Republicans agree that the system is broken and the American people (except those at the top, bottom, and young libertarians) demand major change.

Cedarford said...

EnigmatiCore said...
Cedarford--

"Except that it isn't."

An anti-semite who favors socialism.

How are you about nationalism?


I'm no anti-Semite. I just believe that Jews can be criticized like any other ethnic group.

For those that believe Jews somehow merit an absolute immunity from criticism not given to other ethnicities regarding matters they are involved in - explain why..

The longer a group seeks to stifle reasonable criticism, the more pungent that criticism tends to be when the taboo they impose on others is broken.

Tully said...

Let's get this right. It won't be the Ministry of Truth, but the Ministry of Health. MiniHealth! How appropriate...

America pays 50% to 80% more per capita on health care than nations that cover all of their people and who have higher life expectancies

Beware of cross-national comparisons. The "same" stats are quite often measured in very different ways, leading to apples-to-oranges problems. Some nations (such as Cuba) have even been known to (gasp!) fake their reporting.

Personally I think all of you are sounding a bit unbalanced. The proctors will be by in the morning to make sure you get to your mandatory mental health exams on time. Don't worry, if they find anything out of tune we have a lovely place for you to stay while we get you all sorted out!

EnigmatiCore said...

I think people can make up their own mind.

Gedaliya said...

For those that believe Jews somehow merit an absolute immunity from criticism not given to other ethnicities regarding matters they are involved in - explain why..

What other "ethnic groups" do you "criticize"?

Conserve Liberty said...

John said: Why is it that the left is always yammering about Republicans leading us into Fascism and yet they are the ones who want all these mandatory programs. Presumably if they are mandatory there is some punishment for not complying --- a re-education camp perhaps.

The context of political debate should not be binary.

There are controlling liberals and controlling conservatives.

There are non-controlling liberals and non-controlling conservatives.

Very (way too) simple statements ->

Controllers wish to order your life - liberals using government, conservatives using business.

Non-controllers wish to allow you freedom of choice - liberals from corporate greed, conservatives from government mandates.

Go to Political Compass to read more .

Simon Kenton said...

Once you get the mandatory doctor checks, you are also going to get the restrictions for your own good. Bruce Hayden will get to kiss skiing goodbye. While you may be compelled to exercise, it won't be by bicycle. Once 'we' recognize how badly motorcyclists hammer their kidneys and their hearing, they'll go the way of sky-divers. The current attempt to search out and destroy smokers will be mild in comparison with the Edwards ninny-state.

M. Simon said...

C4,

If you take out the illegals and 2 lb. preemies (not counted in most places) neither our life expectancy nor costs are out of line with the rest of the world.

Frank said...

There is a "left" critique of a duty to be healthy, too:
http://www.concurringopinions.com/archives/2007/05/three_critiques.html

But my sense is that Edwards is mainly pushing this idea to counter the libertarian insistence that "we responsible people" shouldn't have to care for "those undeserving, careless people."

In other words, it's the politics of compassionlessness that provoke the embrace of surveillance.

Frank said...

oops, this got cut off:

http://www.concurringopinions.com/archives/2007/05/
three_critiques.html

EnigmatiCore said...
This comment has been removed by the author.
EnigmatiCore said...

"Go to Political Compass to read more ."

I've seen those kind of tests before, but that one is... something else, I have to tell you.

Not only am I to the left of, and less authoritarian than, every single candidate of both parties, excepting Gravel and Kucinich, all candidates except those two are in the 'authoritarian right' quadrant.

In other words, when it comes to US politics, that compass needs calibration, very badly.

Although I suppose I should be flattered by the fact that it deems me to be closer to the center than any of them, including Gravel and Kucinich.

Mortimer Brezny said...

Sounds like Ann's taking his comments our of context or he misspoke. I'm sure he didn't mean compulsory doctor visits.

Wait, but NO.

I read the article myself. Before I saw this post. Edwrads really said it and really meant what he said.

There is no backtracking from this.

He meant compulsory doctor visits for preventive care (that's the nuance; you still get control over actual medical procedures, but you have to be screened). Now, that's not such a crazy position if we're talking about regular doctor visits "manadatory check-up that you want but cannot otherwise afford!" -- obviously it makes sense that if the government is paying for it, you have to use it so there isn't any waste. But it gets crazy, as Ann pointed out, once you get to mental health-land: Why would we enable the government to mandate that people are officially crazy?

That is nutballs crazytime.

docweasel said...

What happened to "My body, my choice" or "I don't want some white men in Washington telling me what to do with my body" or "Politicians, hands off my uterus (or testes, in my case)" "A (wo)man's right to choose in matters of her own health!" etc.

I guess that's only for killing babies.

Simon said...

What Docweasal said.

Also -

Conserve Liberty said...
"Non-controllers wish to allow you freedom of choice - liberals from corporate greed, conservatives from government mandates."

That's a false dichotomy. How would liberals preserve "freedom of choice ... from corporate greed" (assuming arguendo that such a statement has any coherent content) other than by "government mandates" and regulations on what corporations - which are run by and composed of people - can and can't do?

jimbino said...

Fixing Amerikan healthcare is simple. The young libertarian would favor free-market policies that:

Kill off certification of healthcare professionals and facilities.

Kill off state meddling in the education of healthcare professionals.

Kill off the requirement of prescriptions for medication.

Kill off the tax break for employer-subsidized healthcare.

Kill off Medicare.

Kill off any requirement that anyone insure against risk to his own body or health.

The bleeding-heart libertarian might favor government intervention in the market to:

Expand Medicaid to cover poor retirees, allowing them to spend their Medicaid dollars overseas.

Require that all healthcare providers publish their rates, referring to published CD-9 diagnostic codes and CPT codes, and refrain from price discrimination.

MadisonMan said...

Why not use economic incentives? You show up at the Doctor's with stage IV cancer that was easily treatable if caught early by a simple test two years ago, but you couldn't bother to show up? Tough -- you'll pay for all your treatment. But the person who showed up early and had the cancer caught early? Full coverage.

Moe Szyslak said...

Ann's against mental health testing, huh? No surprise there.

Ross MacLochness said...

So Edwards proposes to take us in this direction:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/08/26/nbaby126.xml

THIS is why we have a Second Amendment.

Seven Machos said...

Madison Man -- That's compassion, man. Health care is a right, man, an unadulterated right, on a par with suffrage and freedom of assembly and a fair trial...unless you wait too long to go to the doctor.

I also point out that Cedarford, as usual these days, is wrong when he says that there is a health care "crisis."

First of all, why is everyone living so long and why are common scourges like mumps a thing of the past?

Second, the only reasons health care is so expensive here are (a) because the costs are not hidden as public works and (b) because as any fool, except you, intuitively understands, massive subsidies lead directly to massive price increases.

I'm sure the Jews are to blame. Jews and drug companies, those twin evils of our time.

Seven Machos said...

Moe -- If only we could get the proper help for the few troublesome types who are clearly crazy because they don't accept the scientific principles we have demonstrated, then the workers' paradise would be achievable after one five-year plan.

Peter Palladas said...

So long as I'm not obliged to see a dentist for fifty years I won't object.

Cassandra said...

The Soviets perfected the CRYOGENIC CURE for mental illness - Siberia.

Tully said...

They also had some wonderful curative institutions, as I linked upthread. Need to make those links more blatant maybe.

Cassandra said...

Lest we forget, the Soviets perfected the CRYOGENIC CURE for mental illness - SIBERIA. Mental illness became a very convenient diagnosis, applied to those who opposed authority. The vigilant who love liberty remain an enduring obstacle to aspiring authoritarian hairmodels.

Seven Machos said...

It's not like Edwards would be taking your liberty away. He just wants to use the power of the State to force you to go to the doctor. Big whoop.

And if you are found to be a little crazy, to think a little funny, well, we'll get you the help you need, in a place where you can really focus on thinking correctly.

dick said...

Madison Man,

I would think that was unconstitutional.

Seven Machos said...

Some further thoughts...

1. I can't imagine that it's not unconstitutional to force doctor visits on people. I mean, seriously, that's got to be all over the penumbra, if nothing else.

2. I went over to democratsunderground, and they are against this proposal, either on principle or for pragmatic reasons.

3. I really do bet that Edwards's plan is that people can opt out by not going to the doctor. It's not a terrible idea insofar as it goes, in the same way that socialism is not a terrible idea. However, like socialism, it won't work and it certainly isn't going to fly in the United States.

Simon said...

Dick and Seven - I think you'd have to reach fairly deeply into the legal liberal hat to pull that rabbit out of the hat. The best Constitutional argument you could make would be that the proram exceeded federal power vis-a-vis the states, not that a particular aspect of it abridged people's substantive rights.

Dr Zen said...

Fucksake. If you want the coverage, you have to see the doctor from time to time. Big fucking deal. It's a very small quid pro quo.

Why you are worried, Ann, is a mystery to me. You have insurance, and don't need to fear that your woeful mental health will be exposed.

Christy said...

Do I remember correctly that Mrs. John Edwards 3 years ago delayed going to the doctor because she was caught up in the election? He could have simply been speaking from the pain in his heart.

BTW, the Blues have catastrophic coverage available. You pay routine costs, they cover the crisis stuff.

Seven Machos said...

Zen -- The issue is that, in this country, it's a problem for a lot of people when the government tries to force you to do something. It's one thing to outlaw something. It's quite another to compel an action.

Christy said...

Insty is linking to this Telegraph article. The government in the UK plans to take a child away as soon as she is born because, based upon the mother's previous successful mental health treatment, one doctor who has never seen her thinks the mother may turn out to suffer from Munchausen by Proxy. So much for my thinking this stuff just wouldn't happen.

Eric said...

Cedarford:
Health care costs in France and Germany are 60% that of what we Americans pay, full medical, full dental. They cover everyone.

Hmmmmm, this is a result of selective studies, at best. First, I notice you chose not to cite Canada or the UK, yet they also have socialized healthcare. Why is that?

Second, the cost of healthcare in France, Germany, the UK, Canada, etc. is not fully disclosed. There is tremendous subsidy that is not included in the so-called costs.

Third, no one in those countries, except the wealthy, can gain access to a specialist or life saving procedures as quickly as the poorest uninsured person can in the USA. So, is your goal to improve access to healthcare? Bear in mind that the typical wait for a specialist in Canada is 18 weeks. That is average, not the high end. Do you want to wait that long?

Fourth, we do not have a free market healthcare system in the USA. We have a heavily subsidized and controlled healthcare system.

Fifth, the US healthcare system ensures that the consumer of healthcare will not be the payer of healthcare, completely breaking the supply and demand model of a market driven system. The only reason that we have qualitatively better healthcare is that the tertiary nature of our system enables a certain amount of market forces to be in play. However, the high cost of care is almost entirely due to the fact that supply and demand plays no part in the consumption of healthcare.

We, in fact, already have a semi-socialized healthcare system. This has created some really bad situations, but still none as bad as we find in true socialized systems.

There's another outcome of completely socializing healthcare. The government will now control access to a service absolutely necessary to your right to life, and will make decisions about what care you need or don't need. The same government that progressives whine about favoring the rich all the time. What makes you think this time will be different?

Finally some comments on economics, including a study from some Swedish economists that points out the discrepancy between EU states, with socialized, Bismarkian systems, and the USA, with a somewhat free market. It should be pointed out that the countries you tout would barely qualify as being amongst the poorest states in the USA, in terms of wealth and productivity. This is the outcome of the Bismarkian system you think so highly of. Using data from Heritage Institute, we see that the US economy has grown year over year for 22 straight years now, and has grown year over year for 27 of the past 30 years (using 2004 data).

Although I do not have data readily available for EU economies, I know the picture is not nearly as rosy for them. Less year over year growth and more years of contracting economies. Further, the typical middle class European does not live as well as the typical poor American. Poor Americans have more living space in their homes, are more likely to own their home, own a car, a TV, have Internet access and access to healthcare than middle class Europeans.

So much for the wonderful European approach. And mandatory healthcare checkups. Edwards and Hillary and the rest are socialists who haven't learned the lesson that Bismarkian socialism is a dismal failure that barely sustains its population.

Last thought. I've lived and travelled in Europe, I wonder if the folks that want to follow the EU model have? Lovely places to be a visitor, but I have no desire to live there. None.

Conserve Liberty said...

Simon said: That's a false dichotomy. How would liberals preserve "freedom of choice ... from corporate greed" (assuming arguendo that such a statement has any coherent content) other than by "government mandates" and regulations on what corporations - which are run by and composed of people - can and can't do?

I have to confess, Simon, that I don't fully comprehend the Libertarian Liberal quadrant myself. Without completing the reading list (I should) I believe many of them are anarchists.

Substitute Libertarian for non-controlling.

enigmaticore said: I've seen those kind of tests before, but that one is... something else, I have to tell you

I'm more interested in the thinking and the reading lists than in the actual questionnaire - so conforting to be able to label oneself in 3 - 5 minutes /s

FWIW, I come out right on top of John Kenneth Galbraith, which seems about right

CL

Fen said...

Eric: I notice you chose not to cite Canada or the UK, yet they also have socialized healthcare. Why is that?

Perhaps because the UK has run so many of it own doctors out business that they must import medical labor from India, Pakistan, etc. With startling results - such as imported Muslim doctors recently attempting to blow up an airport terminal.

Sure, lets have some of that here... I'd love to be treated by a recent immigrant with substandard training who may or may not blow me up afterwards...

Ann Althouse said...

Anyone who thinks my political opinion on this is based on how it affects me is... cahrayzeee. You should get tested. And tracked.

Eric said...

Cedarford (again):
The "American Health Care System" is less tenable now, financially, than the "State Systems" at work elsewhere.
And not just Democrats, but Centrist Republicans agree that the system is broken and the American people (except those at the top, bottom, and young libertarians) demand major change.


Well, you've recognized the problem succinctly. Healthcare in the USA is not a free market.Interestingly, you claim that the free market has failed, but then you point out all the things that makes healthcare here not free market.

Now that you've recognized it, you propose to replace it with socialism, something that also does not work unless you continuously prop it up.

Have you seen the difference between an American hospital, in terms of size, cleanliness, crowding, customer service of the staff, capabilities, and so forth, and a typical European hospital? I have. You're smoking crack if you would rather be treated in the UK, Canada, Germany, France, etc. or the United States.

Oh, by the way, most would describe me as libertarian and "on top", although I am not actually a libertarian in the sense you mean it. I must admit that I am "on top" in the class warfare sense that you meant, though. Of course, 20 years ago I wasn't. Another issue, for another day, though. That said, just because I argue against your socialized utopia does not mean I don't want change. I do, just not your change. And, in fact, most that you label as libertarians, young or old, want change. You just refuse to see that because it isn't your approved change that they want.

EnigmatiCore said...

"I believe many of them are anarchists."

You have almost figured that out?

Simon said...

I'm just laughing my ass off at Frank's suggestion that Althouse is part of - of all things - a libertarian conspiracy.

dick said...

Madison Man,

My point was that you were opening up benefits to all people and then you were going to ration them on an artificial basis. I am not sure that is legal.

Gary Rosen said...

"I'm no anti-Semite. I just believe that Jews can be criticized like any other ethnic group."

In C-Fudd's case, "criticism" means obsessively dragging in Jews into debates completely gratuitously and irrelevantly, solid proof of his neurotic obsession. While he didn't do it in this thread, there are dozens of other examples both in Althouse and elsewhere.

Fudd, you claim you actually lived in NYC. How could you stand it, surrounded by all those Joooos? Did you hunker down in your flophouse room, eating your beefaroni dinners before retiring with your collection of "Yank" tabloids?

Eli Blake said...

So I supposed you'd prefer the approach that we've had for the past fifteen years, with the 'market' taking care of everything so those who can pay top dollar have great health care while those who have no insurance and can't pay get dumped out of a van onto skid row in L.A. with nothing but a broken colostomy bag hanging out of them?

It's fine to criticize John Edwards' or anyone else's proposal, but let's be honest here-- what we have today is what we got after 'Hillarycare' lost-- and what we have today sucks.

Simon said...

Eli, like Frank, you assume three premises: that healthcare in America has a problem, that government ought to solve that problem, and that the federal government particularly both has the power to and is the proper government to resolve that issue. If Edwards wants to "solve" healthcare, have him run for Governor some place. Such questions have no place at all in the Presidential race.

dick said...

eli,

Try to imagine what healthcare will be like under Hillarycare. You need an operation, some bureaucrat who does not know your specific case will decide if you can have the operation or not. If you want anything done you have to fill out all the forms in triplicate and hope some federal employee is some location somewhere acts upon it. Your doctors are underpaid and overworked even more than they are now.

Imagine the resources that would be needed to implement this boondoggle. When you look at what SSA takes and then you multiply that a factor of say 6, you might come close to the resources used up. Then you add in the training to get this mess moving, the paperwork analysis to get that set up, all the office space to house this group. Then add in dealing with the mobility of the population and getting the right paperwork to the right offices and getting you set up with your new doctor and facilities. And that is just for starters. Add in your hypochondriacs and your other patients who need specific instructions in how to administer the required medications and check the timing involved.

Then make sure you have all the equipment you need where you need it. After all, look at that Canadian woman who had to leave her home in a city of a million people because they did not have the facilities to handle her and go to a small town in Montana which could have handled 6 more cases like hers. Then try to make sure that you don't have patients who have to wait too long for care and they die or patients who can't get treated so they go elsewhere and then sue for repayment (this happened in Britain - the woman would have had to wait 3 years to get treatment in Britain so she went to Belgium privately, got treated, then sued and won against the NHS and they had to pay all her fees and then an amount above that for stress). I want nothing to do with socialized medicine. We hear how wonderful it is and yet remember just a couple of years ago when all those old people in France died because the health service didn't bother to checkup on them during a heat wave while their families were on vacation. Just what I would want for my family.

BTW almost anyone can get free care at an emergency room no matter their financial situation. Your case of the guy with the colostomy bag is because he did not follow his instructions, not because he could not get care.

Cedarford said...

M Simon - C4,

If you take out the illegals and 2 lb. preemies (not counted in most places) neither our life expectancy nor costs are out of line with the rest of the world.


I agree that the life expectancy differences are narrow, but they are advanced in argument because they are the quickest rebuttal to people conditioned to believe that people die like flies under the "Communist Care" all the other advanced indistrial nations have.

It is a better argument, coupled with the fact the systems cover everybody and are 50% cheaper than America's societal burden, to rebut a typical "Hayek is God" book-waver.

Better than other arguments of the tremendous loss in efficiency to society all the medical paperwork and bill fights cause, the fact that we alone of nations have millions of medical bankruptcies, and fail to cover what was 1/7th now approaching 1/6th of the population.

Because all too many Americans are in a "my benefits are fine, God Bless America and our Perfect system, and fuck anyone who doesn't get the benefits I get," mode of thinking.

(Beacuse they ignore that with globalization, private firms cannot compete with private firms elsewhere that have no health care costs. They ignore we have the greatest healthcare unfunded liability per capita of any nation, with a sum of 27 trillion dollars obligated to baby boomer health care, and we have the fastest rising health care costs of any nation we compete with)

I personally prefer the Japanese/Singapore system that keeps some free market system elements, drives for cheaper and better care - but requires the nation to come up with insurers that will cover everyone, requires a co-pay to discourage excessive use.
And some of the Asian/French innovations on going electronic.

Romney's Plan is a start. There should be some room for states to innovate, but we need an overall national health care system that seeks both good care and cost management like our global peers have achieved better than us...

From Inwood said...

P. J. O'Rourke once said:

"If you think medical care is expensive now, wait 'til it's free."

Bob @ 10:11.

Thanks for the tip about the faux from for enforcement. If this crap gets enacted, this faux form will become the basis of the real form. I say basis because no Fed form could be that short.

Eli Blake

I agree with what Dick said at 10:50 PM.

You're confusing the mentally ill with the non-mentally ill poor. The later can & do go to emergency rooms & there's no van or black helicopter waiting to remove them & dump them somewhere.

docweasel

A women's right to control her own body? It's the Nina Totenberg effect. She'll suspend that right in this case as long as socialism can be put into effect with real penalties for avoiding the common good as decided by the Best & the Brightest.


Gary Rosen

Cedarford (12:45 PM) is now attacking Abe Lincoln. Wait, I get it, "Abe".

Michael said...

lamc: Help me out law professor - where is healthcare guaranteed in constitution?

Good question. Even better - where, in the constitution, is the federal government empowered to lay and collect taxes in order to pay for health care?

Gary Carson said...

The agitator has a post up today about sending a SWAT team in response to a 911 call seeking help for someone thinking about suicide.

I made a post this morning about a high speed police chase because they suspected someone had earlier thought about jumping off a bridge.

It seemed clear to me from all the nonsense that was written about that Va. Tech shooting that most people think the function of mental health services is to protect the public from some possible out of line behavior from a nutcase. So, I think the concept Edwards is expressing is very much in line with what the public wants and expects from the government.

Michael said...

What kind of person screams bloody murder over the federal government possibly gaining access to your public library records, yet thinks it's a great idea for that very same federal government to posess everyone's medical records?

Gary Rosen said...

Inwood:

Lincoln, Shmincoln. His real name was Abie ben-Lincolnsteinbergbaumfeld, another Jooo, I mean hook-nosed cosmopolitan trotskyist neocon zionist wire-puller.

Tom Perkins said...

Cedarford wrote:

Brainless jingoism along the same lines as "our public schools are the envy of the world, our cars are the best, American workers can out-compete anyone!"

Except two of my colleagues are ex-Europeans who came here because they could transfer to American positions within the multi-national conglomerate we work for, and the prognosis they were given was that it wasn't cost effective to treat them, and they had on (or two) years. They moved here respectively 6 and 4 years ago, and the US healthcare system did a much better job than the UK and Dutch doctors thought they had the resources to do.

If we have universal taxpayer underwritten/provided healthcare, the overall quality of care and availability of treatment for the more obscure diseases will decrease, as will medical innovation.

I know this because it is what has happened elsewhere where the govt provides medicine at taxpayer expense.

Tom Perkins said...

Cedarford wrote:


I agree that the life expectancy differences are narrow, but they are advanced in argument because they are the quickest rebuttal to people conditioned to believe that people die like flies under the "Communist Care" all the other advanced indistrial nations have.

Tom Perkins said...

Continued from the C4 quote above:

If we are not comparing stats with quite similar criteria, then it is no rebuttal at all.

From what I've heard you say, your quiver was empty when you got here.

Simon said...

Re Dick's comment, it doesn't require any stretch of the imagination to work out what state-run healthcare will be like. Just look at the public school system: if you think that's a glealming model of efficiency, a shining beacon of how education should be, you go ahead and advocate state-run healthcare. Check yourself in for a psych exam on the way. ;)

Roger said...

A quick note on "life expectancy." You have to disaggregate the various ethnic groups and compare common denominators and numerators. The US population is multiethnic. Most european nations are considerably more homogeneous. A better measure of the performance of the health care system is the length of life expectancy following treatment of disease. The US ranks first in all except diabetes care for longevevity of life following medical intervention. Japan has us beat for diabetes.

Bruce Hayden said...

So I supposed you'd prefer the approach that we've had for the past fifteen years, with the 'market' taking care of everything so those who can pay top dollar have great health care while those who have no insurance and can't pay get dumped out of a van onto skid row in L.A. with nothing but a broken colostomy bag hanging out of them?

It's fine to criticize John Edwards' or anyone else's proposal, but let's be honest here-- what we have today is what we got after 'Hillarycare' lost-- and what we have today sucks.


Others above have pointed out that the poor here do get essentially free health care, whether it be Medicaid, or emergency room visits.

But as importantly, you seem to be suggesting that any plan is better than no plan, but then forget that Edwards doesn't have a plan, just aspirational goals. And the devil is always in the details. Hillary at least had a plan, and when she laid it out, we were able to see what we would give up in freedom, etc. to get to her promised land.

Without the details, we are left with just the warm feeling that John Edwards truly feels for us. Or, at least those who wouldn't pay for his mandatory healthcare.

Where is the money going to come from? Is this the typical smoke and mirrors that we most often see in this sort of situation?

How does he plan to make sure that we increase, not decrease, our supply of primary care physicians? How about innovation (including drug research)? Will his plan increase or decrease that? And is it plausible?

If someone is going to seriously propose socialized medicine, instead of just waiving it around like Edwards is doing, I want to see what the economists and physicians say about it (Hillary solved that problem by cutting both of them out of the process).

But a former contingency fee medical malpractice attorney has little if any credibility on his own in designing a nationalized health care system.

So, as I suggested above, the devil is in the details, and I just don't trust Edwards on this without seeing his details.

Simon said...

Bruce said...
"But as importantly, [Eli] seem[s] to be suggesting that any plan is better than no plan, but then forget[s] that Edwards doesn't have a plan, just aspirational goals."

He's also forgetting that retaining the current system is a plan. The burden lies on those who advocate change "to identify clear and compelling problems with current practice ... and then link those problems to a solution that offers substantial improvement on current practice, one closely enough tailored as to pose little (or at least acceptably limited) risk of unforeseen and deleterious consequences." The tie goes to the status quo, a fortiori when the status quo clearly works.

Michael said...

Simon: Re Dick's comment, it doesn't require any stretch of the imagination to work out what state-run healthcare will be like.

It doesn't require any imagination at all. The Veterans Administration Hospital system is a state-run health care system - the same health care system Democrats were knocking not that long ago.

Tully said...

If we are not comparing stats with quite similar criteria, then it is no rebuttal at all.

Exactly, Tom. The disconnect between the figures starts as far back as infant mortality stats, which are measured differently in EVERY nation. Example: In the US, a 14-oz stillborn preemie is counted as an infant mortality if the birth occurs at a hospital. In Russia, it's not an "infant mortality" unless the child fails to make it to one year of age.

Does anyone seriously believe that, say, Cuba accurately reports all the disappearances of dissidents as mortalities? That Mynamar accurately reports the incidience of perinatal mortality?

Apples and oranges. I've ranted about the continual misrepresentation of this "factoid" before.

Tully said...

Correction "In Russia, it's not an "infant mortality" unless the child fails to make it to one year of age" should read "unless a child born alive"

And in many of the "enlightened" Euro-nations, somehow a child born alive with birth defects often fails to leave the delivery room alive though born in stable condition. And that's counted as a perinatal mortality, not an infant mortality.

Roger said...

Tully--add to your points about the use of "infant mortality" and "life expectancy," the inanity of using ordinal measures where the differences between, say numbers 5 and 25 is usually statistically insignificant. These factoids are only useful for those (1)without the remotest idea of epidemiology; and (2)who are peddling a single payer or other government run program.

PatCA said...

I wish I had time to read the whole thread but I will say this: it continues to strike me that the left continues to propose draconian measures to protect us against minute threats like transfats, secondhand smoke, restless leg syndrome. We all wear our helmets outside--god forbid we should fall and hurt ourselves--yet we are urged to studiously ignore real threats made by real people, like radical Islamists. Just odd.

Theirs is the real nefarious "culture of fear."

Fen said...

The Veterans Administration Hospital system is a state-run health care system

And I would shoot myself rather than be placed long-term in any VA Hospital. Its the Seventh Circle of Hell.

Original Mike said...

I have grown skeptical of the universally held believe that regular doctor visits saves money by finding things early. It seems logical, but so much that does turns out, upon inspection, to not be so. And I'm sure it's different for different disease. So, can anybody point to hard evidence to back up this perceived wisdom?

Bryan said...

He won't revise the "require" part because that's exactly what he means. You have the option to opt out of the program, but if you want the coverage, you have to accept some responsibility. Like any other public health issue, cost drives this decision. People are forced to immunize their kids--but only if you want them to be able to attend public school. Does Edwards (or anyone else outside your circle of family and friends) care if you don't go to the doctor? No. Do we care if you cost us money? Yes. So to keep costs down over the long term, you have to go or get out.

Balfegor said...

I bet if you do a little more inquiry you'll find that these people were actually going to India to get treatment that is illegal or unapproved here in the US.

Mmm. No, not so far as I can tell. They're treatments available in the US, but not covered by their insurance packages, so they're going abroad, since they can't afford it here in the US.

Robohobo said...

EnigmatiCore or whatever your handle is......

I am sure you will make a good "Special Detachment" member in the reeducation camps. Or perhaps you will prefer Einsatzkommando?

serket said...

Are you able to opt out of government care under this program and just use private care. I think the psychological evaluation part is scary since Dr. Helen has mentioned how left-wing the psych community is. I really don't think he will be the next president (and I also don't think a Democrat will win), but I did hear he might do well in one of the state primaries which will boose his campaign (was it Iowa?).