Writes Nicholas D. Kristof in a column Obama's health care reform that's topped the NYT most-emailed list for the last couple days.
Somehow, in the Clinton era, we as a nation freaked out about heath care reform, but this time — this time — we'll swallow our government-dosed medicine.
Kristof is all: "In 1993, the 'Harry and Louise' commercials frightened Americans into abandoning health reform. Let’s ensure those scare tactics don’t work this time." Well, what about lull tactics? If those work, there's no do-over.
June 12, 2009
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Whew. I was a bit worried, but feel all better now after reading Kristof's fluffy-bunny anecdotes about Canadian health care.
Where do I sign up?
I see a lot of merit in Virginia Postrel's argument.
Think about this for a moment. Medicare is a huge, single-payer, government-run program. It ought to provide the perfect environment for experimentation. If more-efficient government management can slash health-care costs by addressing all these problems, why not start with Medicare? Let's see what "better management" looks like applied to Medicare before we roll it out to the rest of the country.
The American Medical Association has already come out against inclusion of a public plan in any reform. While there are reasonable changes which will make marginal improvements, any reform which does not start with the entire structure of the system will only give us more of the same for more money. This reform, which clearly does not go to the crux of the problem, namely that there cannot be a real free market for a commodity with inelastic demand and numerous monopolies throughout the system, is DOA. It is more like electricity or water than televisions. The providers are getting squeezed the patients are paying way too much and the insurance companies are raking in the money. The hospital corporations are taking 30% of the dollars and putting it in their pockets. Even as non-profits, they just pay many executive types enormous salaries to use all the money and thus have no profit. The attempt will ultimately crash and burn.
Even the potential bill of Freaking Huge Proportions (FHP) from nationalized health care won't scare us.
Especially because the Democrats plan to hide it, refusing to use CBO estimates if they don't account for supposed "savings" from preventive care.
Right now, the American public will swallow any pill they're given. We'll swallow, bend over, lick, bite, grovel, spread, roll over, beg, fetch drinks, and pretty much do whatever we're goddamned told. NTTAWWT.
Telling property rights to 'go screw' is pretty popular right now, too. And Althouse is right; there's no do-overs here.
As things are not getting better economically, rolling out universal health care is going to be a hill Obama (thankfully) is not going to be able to take.
But if he could take on Medicare and fix that--that would be a good thing. Personally I think the way to fix it is to roll it back and restrict benefits by age so it is financially viable
Obama was out on the stump telling everyone we're not getting socialized health care and you can go to the doctor your want and keep the health care plan you have.
What he didnt' talk about is 1) how much it's going to cost and 2) how are we going to pay for it.
Sounds to me like if I like my current health care I can continue forking over premiums for that and as an added bonus I can fork over more in tax money to pay for someone else's health care too.
I love how that editorial hints that there are problems with the Canadian system, but then boldly glosses over them. It's not even subtle. There should be all sorts of alarm bells going off for anyone who thinks they like the idea of Government Healthcare.
And anyone with a brain knows that misleading and vague statistics like these:
our infant mortality rate is 40 percent higher than Canada’s, and American mothers are 57 percent more likely to die in childbirth...
...are used all the time to make socialized systems appear better than the alternative. You can make your infant mortality rate look really great, if you don't count babies under 6 months old.
Obama's knowledge of the health care industry, probably comes from the wisdom that his wife, Michelle, learned from working in the Chicago hospital. I'm sure that her job was something that made the cost of the visit cheaper. Or maybe not.
we'll swallow our government-dosed medicine.
Socialized medicine, oh no! How scary! Except ... that's not the plan.
Obama was out on the stump telling everyone we're not getting socialized health care and you can go to the doctor your want and keep the health care plan you have.
Kristof can't seem to make up his mind whether or not he believes this. He repeats the Obama sales pitch about how we're only going to be adding a public option to our private insurance system-- but then what has Canada got to do with anything?
Here is a very good summary of the issues facing the Obama administration--it is published in the Annals of Internal Medicine with a wealth of links to supporting information: http://www.annals.org/cgi/content/full/0000605-200904070-00114v1
Kids, this is the dawning of the TSA of health care.
Thousands Standing Around waiting for substandard healthcare. We're going to implement what is the standard American solution for this - make *everyone* suffer, and reduce the experience to the absolute minimum*.
*"Now with more paperwork!"
Fabulous!
I get scared reading a proponent claim that country X's infant mortality rate is lower and ours, and country Y's mother childbirth death rate is lower than ours, but never telling us what is causing the difference, and why our medical professionals haven't figured it out.
They have figured it out, but would prefer not to talk about it. It has to do with demographics.
I get scared reading a proponent claim that country X's infant mortality rate is lower and ours, and country Y's mother childbirth death rate is lower than ours, but never telling us what is causing the difference, and why our medical professionals haven't figured it out.
Which only begs the question: Is that really the case? Are our doctors too stupid to know why mothers are dying less somewhere else and to make changes to how we do it here?
And before you try to argue that "our private, profiteering insurance companies prevent doctors from doing it the best way", you are going to have to tell me why insurance companies would think it more profitable for their premium paying customer's die.
And you are going to have to tell me how the government's cost reduction motives will be less impact on a doctor's decisions than an insurance company's private profit motives.
And I could go on and on with thing we, the public, just don't know but need to know before we can make any rational decisions on this issue.
So, I'm scared just by the fact that the Obama's proponents claim to have all the answers yet don't appear to even know all the questions.
I deal with medicare and medicaid every day. it is so harsh many businesses can't even afford to provide it.
I'll make a deal with Obama. if he can make medicaid and medicare really work, and not barely work, then i will think about him forcing me onto his program.
And believe you me, we are talking about force. Obama's proposals, if actually enacted, would bankrupt the health care insurance industry in a year, max.
Supposedly, the government system is intended to act as "competition" for private insurer's to, in the President's words, "keep them honest".
If that is the case, why does his legislation have sections letting it mandate private insurance billing practices? Doesn't that kind of tilt the playing field in the governments favor? Doesn't that count as unfair "competition"?
And if that's the case, shouldn't we be calling the President a liar?
From JAC's link: It's a hybrid system.... It will, in other words, be a uniquely American system, and hard to describe with a single epithet..
I'll take a shot. How about unfucking affordable?
We're already spending $450 billion annually on 42 million Medicare beneficiaries and is project to be insolvent by 2018 unless servcies are curtailed or Medicare taxes significantly raised. Yet now we're going to add in another massive health care program and again, haven't heard word one on how we're going to pay for it.
Yes yes I know Bush doubled the debt and left Obama with a deficit. So the sensible thing is not to ease off the accelerator but slam on the gas pedal and do a Thelma and Louise to the nation.
Socialized medicine, oh no! How scary!
More proof (if any were needed) that sons never listen to their mothers. Of course "our government-dosed medicine" isn't literally medicine; it's a metaphor for whatever plan the government ends up imposing.
The two points of health care reform are to *reduce* costs and to ensure universal coverage. Complaining that reform will cost more makes as about as much sense as complaining that it will lead to fewer people being insured.
It should also be noted that the only way any single payer system will work is with some form of rationing. This means that percentage of the population who is used to good health care will realize a net loss in what they get at an effectively higher price, due to the inevitable supplemental health care plans that people with wind up buying.
I don't think any country studied with a culture resembling the US has any level of satisfaction with their system. They stick with them merely because there are no alternatives that normal people can afford.
Which is where we'll be in 10 years, I'm sure...
Quayle: re aggregate measures such as life expectancy and infant mortality: From a standpoint of statistical validity you can only compare like subgroups of populations; eg, life expectancy of mexican-americans versus life expectancy of mexicans.
Infant mortality stats assume that all repeorting states use the World Health Organization's definition of "live birth," which can be met with preemies as young as 7 months in utero (a gasp or any other sign of life on delivery). Not all reporting states adhere to this definition.
There are stresses within any system that pays for services creatively ordered by one person and billed to another. Have you ever looked over a Teenage son's credit card charges that you pay? Over use and fraud are always persent in these systems. However there is real medical care being marketed to people in real need. Once Obamacare sweeps away the market system, then there will be a pretense of care given to people who have no way to know that they are not getting the care they need when they need it.
Obama really does not like anything about this country. He has lived in a liberal cocoon all his adult life.
Complaining that reform will cost more makes as about as much sense as complaining that it will lead to fewer people being insured.
Complaining that reform will cost more is complaining that it will fail to meet one of its goals. Surely this is a possibility?
Can't speak for Canada, but I lived under La Secu in France.
What I learned is that I'll take expensive and rising but excellent over free, generally unavailable, and incompetent when available every time.
Problem with Kristof's column is that anecdotal stories are ok to share but really do not prove anything: "“An emergency room doctor met me at the door, and they took me straight upstairs to the CT scan,” she recalled. A neurologist explained that she had suffered a stroke.
Ms. Tucker spent a week at the hospital. “The doctors were great, although there were also a couple of jerks,” she said. “The nursing staff was wonderful.” "
What is missing here is WHAT EXACTLY WAS DONE IN THE CANADIAN HOSPITAL TO TREAT MS. TUCKER'S STROKE? Was she put in the slightly crowded hospital room and left to recuperate or was she treated with state-of-the-art treatment? Some stroke victims recover with minimal sequelae without medical intervention. Some don't. Should I have a stroke (or an epidural bleed --remember Natasha Richardson!)--I would prefer to be taken to a hospital in the United States. At least now, before Obamacare takes over, I would stand a better chance for full recovery in a hospital in the United States.
"Socialized medicine, oh no! How scary! Except ... that's not the plan."
It won't be socialized medicine because we won't call it socialized! That's how it works! In related news I have a sixteen page dissertation on how Gullible really means highly educated intellectual of leftward political leaning.
Socialized medicine, oh no! How scary!
I couldn't be more sick of the Jon Stewart, snarky pose adopted by so many people.
we'll swallow our government-dosed medicine.
Socialized medicine, oh no! How scary! Except ... that's not the plan.
And this is when the law of unintended consequences kick in.
Can you provide a single reason why a single company would pay for their insurance if the gov't will do it for them?
There will be no private insurance left.
So, it'll be VA FOR ALL OF US!!! Yay!!!!
I mean, Bush's Medicare Drug Benefit cost how much more than it was supposed to cost? And we're going to spread that over for the entire health care industry?
As asked --- why should 85% pay to subsidize the 15% of the population too lazy to afford their own coverage?
Obama was out on the stump telling everyone we're not getting socialized health care
Which, of course, means absolutely nothing. He said he didn't want to run car companies. . .before firing the CEO of GM, deciding where the HQ was going to be and who was going to buy Chrysler, and what sorts of cars they would build. But other than that, he was completely honest!
I think it's fair to say that whatever The One (PBUH) says, you can assume the opposite is true.
Funny, when I read the title of the post, I assumed he was talking about how we were all scared into accepting the stimulus, and that this time we won't let a flawed and unexamined plan be shoved down our throats out of fear of what will happen if we don't.
When lefties say that a person shouldn't have to go bankrupt to get healthcare, I remind them that it used to be that people didn't go bankrupt, they died.
They would get sick and no amount of money could help.
Now they are paying for a system that keeps them alive, but costs a lot.
I assumed he was talking about how we were all scared into accepting the stimulus, and that this time we won't let a flawed and unexamined plan be shoved down our throats out of fear of what will happen if we don't.
No, we're talking about how we'll let a flawed and enexamined plan be shoved down our throats out of fear that 'infants and children are dying.'
Then again, the price was right.
But what did it cost the system?
Ms. Tucker did, in fact, have insurance, but she was told she would have to pay herself and seek reimbursement.
Was it Canadian insurance?
Will a US Citizen visiting Canada receive free health-care?
I don't know how authoritative the answers but basically the answer is 'no' and that a US citizen would be billed.
....he was put in a free two-year program emphasizing an improved diet and lifestyle...
Nothing is FREE
When lefties say that a person shouldn't have to go bankrupt to get healthcare, I remind them that it used to be that people didn't go bankrupt, they died..
I also don't buy the canard that people have to go bankrupt either.
There was a news special here a few days ago ( I missed it but was brought up to speed by a co-worker) about this guy who had a rare form of cancer, had insurance but it would not cover the total cost of care. End result he's cured but filed bankruptcy and his family lost everything.
Did he try and work with the hospital? Dunno she says, it didn't say. Well I would have tried because you know what, when you file a Chapter 7 95% of creditors get squat. I'll bet dollars to donuts that the hospital and providers would have
worked out a plan to accomodate because better to get something than nothing. I mean the hospitals write off total costs with the 'undocumented American' community which go through our hospitals like I go through underwear.
I can recite numerous examples of people I know personally who have worked with thier providers in arranging payment for services that insurance doesn't cover. It just takes some effort.
Complaining that reform will cost more is complaining that it will fail to meet one of its goals. Surely this is a possibility?
Without some meaningful discussion of why or how it might fail it's just FUD.
Will a US Citizen visiting Canada receive free health-care?.
Here is a better question: Will the American taxpayer have to foot the health care bill for the estimated 10-15 million illegal immigrants as well?
So much distrust of our political establishment is eroding our nation's self-confidence. After 8 years of Bush - 8 years not knowing what it might mean if we got that knock at the door at 3 a.m. - we have given an overwhelming mandate to our President and to the Democrats.
We spoke truth to power. We exercised the highest form of patriotism through political dissent and opposition to Bush. We have done our jobs, and we won. Now is the time for us to trust our leaders; let us go blindly into that good night, confident that we have placed in power those who have the good common sense to make these difficult decisions for us.
Economics for Beginners: Why Ezra Klein is full of shit because he doesn't know The Difference Between Socialized Medicine, Single-Payer Health Care, and What We'll Be Getting
Capitalism: Society flows on the basis of private ownership of the means of production and results according to the liberty inherent in a free market
Socialism: Society arranged by an elite few on the basis of public ownership of the means of production and distribution by a bureaucracy.
Von Mises: "It is the aim of Socialism to transfer the means of production from private ownership to the ownership of organized society, to the State. The socialistic State owns all material factors of production and thus directs it. This transfer need not be carried out with due observance of the formalities elaborated for property transfers according to the law set up in the historical epoch which is based on private property in the means of production. Still less important in such a process of transfer is the traditional terminology of Law.
Ownership is power of disposal, and when this power of disposal is divorced from its traditional name and handed over to a legal institution which bears a new name, the old terminology is essentially unimportant in the matter. Not the word but the thing must be considered. Limitation of the rights of owners as well as formal transference is a means of socialization. If the State takes the power of disposal from the owner piecemeal, by extending its influence over production; if its power to determine what direction production shall take and what kind of production there shall be, is increased, then the owner is left at last with nothing except the empty name of ownership, and property has passed into the hands of the State."
______________________________
It is in fact socialism to have the State tell you exactly what you can charge and what services you can offer.
But what exactly is wrong with socialism, Ezra Klein and John Althouse Cohen?
Why would socialism be such a bad thing that you are trying to say this is not in fact socialism?
There must be a trance-like affect that takes over the brains of resonably smart people like JAC and his idol, Ezra.
They think these vague, big govt ideas are excellent "just because".
Tiny Jones could teach Treacle a thing or two about sarcasm.
Socialized medicine, oh no! How scary!
I couldn't be more sick of the Jon Stewart, snarky pose adopted by so many people.
Word, Knox. Also, just asserting that it’s not socialized medicine…that is not an argument. And even if it's not "socialized" medicine, that doesn't make it a good plan! Make an argument with some substance, for heavens sake!
I predict my own (self-employed) heath insurance premiums will double under ODUMACARE within 4 years.
I mean, it's not as if we're alcoholics, and we've taken enough drinks that fully 60% of US health care involves government spending, including the 47% that goes to Medicare/Medicaid/VA hospitals, and we need just one more Big Fucking Drink (BFD) before we're goin'straight, and we really mean it this time, cross our hearts.
And Medicare isn't really socialism, it's corporate fascism, which is much better because you get to wear shiny black boots. NTTAWWT.
Does anyone really believe that when they have their "competition" in place, they won't use the power of the state to run their competition (the private insurers) out of business?
Have John Althouse Cohen and Ezra Klein ever had real jobs? Seems like Ezra Klein went straight from preschool to writing for The American Prospect (admittedly that seems to be the requisite educational requirement).
These are the people that are running our country. Baby Geniuses with lots of Ivy-covered degrees and the wisdom and foresight of denizens of comfy, organic-cotton lined cribs. And now our country is their playpen.
Me, sarcastic? Me, in need of sarcasm lessons? Bah.
Whether the public option will drive private insurers from the market will depend mainly on how a big a subsidy it gets. Since the public plan is supposed to use modified community rating (read: bad deal for the low-risk population) it will have to be subsidized to some extent or adverse selection will kill it off. While it might not be a bad thing if government were to become insurer of last resort (though a means test would be nice), the size of the subsidy is apparently going to be in the hands of people who would impose a single-payer system openly if they thought they could get away with it.
I lived in a country for several years that had public health provision supplemented with private insurance for those who could afford it.
The public portion worked pretty well, particularly for injuries.
Of course, if you had cancer, or were over 65 and needed dialysis or any of a number of types of expensive, life-saving surgery, you weren't called a "patient." You were called "dead."
Remember Democratic Colorado Governor Richard Lamm? He said:
"We've got a duty to die and get out of the way."
The new National Medicare slogan, no doubt.
Hey, he was born in Madison, Wisconsin.
Big surprise.
In other news today, Obama appointed a new "Cost of Wellness" Czar to head up the office of setting prices for getting well.
In making the appointment today, President Obama laid out his ambitious plan for lowering the cost of treating sicknesses.
"Every expert agrees that the cost of fighting and beating some forms of cancer can be up to $400,000. Some forms cost over $1M. These costs are inconsistent with the principles on which this great country was founded, and the objectives for which you placed me in this high office.”
“Therefore, I have instructed Ms. Barnard to immediately cut the cost of treating rare forms of brain cancer to $237.50 and to complete the task of similarly cutting all other costs of treatment in one year." The President said.
"Some will say that this is too much cutting too fast, and that we should go slowly and take baby steps."
"But I refuse to believe that we need to surrender our hard earned dollars in order to fight cancer."
"In fact, I believe that surrendering our dollars to fight cancer actually emboldens cancer and makes in more prevalent in our society."
Details of the President's plan are still being worked out.
When we return, the Administration has announced its intentions to suspend the second law of thermodynamics in an effort to solve the energy crisis, and, a debate is heating up on whether Microsoft’s Excel is actually ruining the public’s ability to understand government programs.
In politics, the less scare you are, the harder you fall.
Everything free!
Nothing readily available!
Speaking of scare-mongering Mr. Kristof,what about Dr. Steven Hatfill? Nice work on that.
Other people lose their jobs
Maybe you and your wealthy friends won't scare, Mr Kristof. After all, what do you have to be scared of? You're buttering the government's bread and writing for the New York Times (but I repeat myself). You don't have to be scared of what will happen to your health care. You'll still be going to your doctor on Park Avenue or off of 5th in the East 60s.
But the rest of us are scared. In fact, the less scared you and your type are, the more scared the rest of us should be.
Well, for the past 16 years, we've had private insurance bureaucrats telling us which treatments we can have and which ones we can't, and which doctors we can see and which doctors we can't.
I think we should all convert to Christian Scientists. Health care problem solved.
Should I read "scare tactics" as anything other than "pointing out things he doesn't like pointed out"?
@JAC
In my sentence that you quoted, "medicine" = the health care reform. It's a metaphor.
"Well, for the past 16 years, we've had private insurance bureaucrats telling us which treatments we can have and which ones we can't, and which doctors we can see and which doctors we can't."
... so why not let unaccountable government bureaucrats do the same, except with the power of the State to back them up?!
Quayle said...
I get scared reading a proponent claim that country X's infant mortality rate is lower and ours, and country Y's mother childbirth death rate is lower than ours, but never telling us what is causing the difference, and why our medical professionals haven't figured it out..
They pretty well know why the US has a lower life expectancy The top reason is that we have a huge disparity in death rates of the working poor and those with inadequate insurance (1/6th and 1/5th the population, respectively) - and those with adequate insurance or who get free care as "wards of the state".
The second big reason is our American lifestyle, paticularly in dysfunctional minorities - is worse for not only "birthin' healthy chilluns", but long-term cardiovascular and diabetes and cancer-free odds. (A Spaniard visiting us with his family, that we made friends with in Barcelona years back was amazed when he and his wife checked out a huge supermarket. Not at the wares and produce - but coming back and saying "El Gordo City!" - almost a dozen huge fat people shopping while in motorized golf carts trailed by their spouse or obese kids. "In our lives, never such a sight en Espania!")
We also have a 3rd reason - deaths by "medical misadventures" - hospital errors& infections, prescription errors, dosage screw ups by patients. 3 times what happen in Japan or France.
About 4th on the list is difference in childhood mortality stats. Other nations don't record doomed premiees and the genetically defective doomed to die in hours or days as actual deaths in their society's vital statistics.
We are becoming a country where elected officials don't contribute much of their own money to worthy charities until after it is disclosed publicly that they have been cheap, stingy bastards [for background just google tax return info for Joe Biden and Barack Obama].
These same officials are however quick to take our hard-earned money and give to the 5%-10% of the country who are too lazy or f-ed up to help themselves.
Palladian- While Mr. Kristof thinks he is immune, he is not. In the UK it is illegal to provide or receive health care outside of the system. He will have to go to some Banana Republic where his MD has gone to get any care, or wait in line with the rest of us, and regular folks are so yukky!
Elliott:
Do you believe that Margaret Thatcher or Tony Blair waited in line with the rest of us? If not, at what level of elite and special people do you think the special access ends?
Does the special access end after Parliament members or do their familes get special access too? How about people who work for Parliament members? How about the Buckingham Palace guards?
http://voices.washingtonpost.com/ezra-klein/2009/06/has_kent_conrad_solved_the_pub.html?hpid=topnews
Per Ezra Klein's interview with Kent Conrad, Kristof's column is already moot. We ain't going Canada style.
AJ Lynch,
I read an article about the woman who pushed so hard for the Canadian healthcare system. She developed breast cancer. In Canada she would have had to wait 2 years to get the treatment she needed. She flew to California and got it immediately and paid for it. If she had waited in Canada, she would have died.
I also remember about that multiple birth in the Calgary area. The whole province did not have enough incubators to handle the babies. She came to a town in Montana with a population of 50K and there were more incubators in that city that in the whole province in Canada.
That is something that needs to be addressed before this whole mess gets put into action. How are you going to keep the treatments up to date. Until you can besure to provice the treatments that are needed in a timely manner, then the whole concept of single payer federal health care should be moot.
Dick:
Good stuff I agree. Obama and his minions see 5-10% who bitch, gripe and some who have been unlucky. So they want to tweak everyone's plan.
They are using the growth in healthcare costs as their mantra and excuse to move forward with drastic, sweeping and untested changes to the entire system.
For every doctor whose income they destroy, they will add at least one new bureaucrat who makes $100K or more. I guarantee it!
Dr. Sanity unleashes a torrent of anger worthy of Howard Beale (or Arthur Jensen) from Network.
That movie was an odd duck; there's no one for me to root for. Turns out the left was in favor of globalization by political superstate, not by free trade, go figure.
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