I Get Mail/Not the Ducks! – Alex C – A Response – The Quackening


This one is from Alex C from the Suzanne Somers post on how Canada is evil and killing the elderly.

> Oh noes! It’s Socialism! Except it isn’t. It’s a government insurance scheme
> where the price is kept low by running it at cost.

Except it is! That’s exactly what economic socialism (of the Marxist variety)
is. Euphemistically calling it a ‘mixed-economy’ (such as in india) does not
make it *not* Socialist.

You mean like what the USA already had? A system where the poorest people and indeed many middle class people and the private healthcare system used and abused the emergency medical system to the tune of effectively DOUBLING the healthcare cost of the average american while providing and inferior penetration of care?

And you think that the way to fix that is to simply toss the poorest people out on the street DESPITE me pointing out that the USA’s housing boom and economic collapse of major companies such as GM effectively boiled down to healthcare.

The real joke here is that had the US government actually properly socialised it’s medical system a la UK Or Canada or France then the USA’s medical system would be just as good and cost half as much to the tax payer. A saving in effect of 300 BILLION dollars and a unified system of care where care across the USA is held to the same standard and a system by which you can integrate healthcare with social health and encourage ideas such as healthy eating and nutritional supplementation.

You want to see what socialised medicine is like? Check out the Finnish Baby Box. Simple, Elegant Usage of Public Wealth to Stop Disease and Death.

Your argument is that somehow eliminating the one safety net for the poorest that the private sector will somehow pull through and be super cheap and everyone will be incredibly healthy. Not that emergency medicine as a field will effectively tank since you have to do wallet biopsies and the poorest Americans in effect will always be saddled with debts the moment they fall ill which they are more likely to since they work in more undesirable jobs, eat worse food and it’s a deadly cycle.

The main attraction of Socialism for rationalists is that it *claims* to
promote efficiency, leading to lower overall costs. However, decades of bitter
experience of failure in other fields (railways, telecom, electricity, you
name it) naturally leads one to be circumspect about its efficacy in this
instance.

Except Healthcare has repeatedly demonstrated how effective it is. Even the complaints about the NHS bloat still make the system MORE effective than what the USA’s got. If the bloated wallowing behmoth that is the NHS is some sort of failure then it’s less of one than the US healthcare system. At a cost of 50% of the USA it provides a healthcare system comparable to the american private sector without having to worry about a wallet biopsy.

It can be made more effective and that can be done by actually training some doctors in management rather than using businessmen who don’t understand how hospitals run. In fact it’s problem is that the NHS has sectors of it’s work privatised leading to ineffectiveness.

Once there were matrons who controlled cleanliness. Now? It’s a private company. Once there was an NHS catering service and the NHS actively bargained for food and could control quality. The sterilisation and waste disposal? Once were NHS? Again privatised. These are all places where costs went up and efficiency went down. People began treating the NHS as some sort of goal machine rather than something that treats people and that is where you FORGET how to be a health system.

The USA’s health system is one part health machine and 99 parts goal related. And that goal is the  worst of all.

Money.

That is, only if one isn’t a red pom-pom waving blatant Socialist cheerleader
like you.

And also living in the real world.

In both child mortality and life expectancy socialised medicine actually “wins”. So I don’t know what scale of achievement you are using but universal healthcare beats treating only those who can afford it. Because most people cannot afford it and unfortunately reality requires “most people” to exist to keep it working.

The many misdirections and slanders employed by your rebuttal to Ms Somers’
rhetoric make your argument even less credible than hers (if that is even
possible). To think that I came to this page looking for a good response to MS
Somers. Pshaw!

Good bye, sir, and good riddance!

What misdirection? She’s an actress. I am a medic. If you asked me to wire up your house then prepare to be disappointed as your house goes up in flames. IMHO she’s a worse at medical advice than my dog since my dog isn’t running around on the Internet telling people to diet their cancer away.

Do you need me to explain to you how cancer cells are effectively “99..999% Our Cells” and anything that kills them kills us too and how therapy is about effectively removing the cancer cells or destroying them focally? And that diet has bugger all to do with fighting “Cancer”?

Or that she is pushing for a branch of “alternative” medicine that is widely regarded as quackery since it has absolutely no basis in reality or any scientific backing?

Do you need me to point out that her statements in effect contribute to a small percentage of treatable cancer sufferers dying due to poor adherence to medicine and refusal to use real medical care or doing things that effectively hasten their demise?

No. Because we know all of this. You want to argue that universal healthcare is worse than what America has? Then evidence. Every single statistic shows Universal Healthcare to be superior and every single statistic shows that public Universal Healthcare schemes beat privatised ones in cost and effectiveness.

Unless the WHO doesn’t know anything about healthcare and life expectancy and infant mortality rare not valid determinants of quality of healthcare or availability. In which case we should just determine who has the best healthcare system by the broodiness of it’s tall, dark and handsome doctors who happen to have blogs and are bald.

If that’s the case then I am a shoe in…. (maybe may need some platform shoes).

Comments

  1. maudell says

    Canada’s health care system is getting costlier than it used to be since parts of it have been privatized (profits are privatized while risks/costs are public in some provinces). It’s still way better than the US, on government costs and on the vast majority of care (especially prevention). When I go to the hospital, the wait is usually quite short in metro areas (30-40 minutes on average, except for Quebec since it has a different type of system). I have a doctor that I can see when I need to. It’s not the case in every region of Canada, but I have yet to meet a Canadian who wishes we had an American system (insurance tied to work? Wtf?) Yes, you can find someone who needs a rare and costly procedure and they will have to wait in line with the poor people. Yes, you can find rich people who go to the US to skip the line. And yes, you can find many Americans who come to Canada to buy their medicine, since costs are less out of control (the good old Republican advice to seniors in the 2000s). Good work with the 20$ 200g ibuprofen pill in hospitals, guys. I’m sure it is the best ibuprofen money can buy.
    Canada is still one of the most expensive systems in the world. Still, the US spends twice as much per capita on health care. Over $8,000 per capita/year. That’s insane, and that’s not small government by any measure. Also, there are *less* hospital beds per capita in the US than in Canada. Keep in mind that about everything is costlier in Canada due to a smaller population in a large territory (larger than the US, but less inhabitable). Cold climate is also costlier.

    About public hydro: Hydro-Quebec is one of the largest assets in the province, one of the reasons why the economy isn’t in the tank and that the government is able to offer things like $7 daycare, helping low revenue families to work (in other provinces, daycare can be more expensive than a day’s wage). There are many problems with HQ, but no one who knows a bit about its history would argue that going public in the 1960s was a bad move. There is a debate for privatization now, but even its supporters agree that the move to public was beneficial economically.

  2. AsqJames says

    However, decades of bitter experience of failure in other fields (railways, telecom, electricity, you name it) naturally leads one to be circumspect about its efficacy in this instance.

    I’ll accept that the privatisation of telecoms in the UK has mostly been a success (although it could be argued the same improvements might have been achieved by removing BT’s monopoly without privatising it), but whoever wrote this knows next to nothing of what’s happened to the railways and the privatised utilities (water, electricity & gas).

    The only rail franchise currently running without a subsidy is owned and managed (at arms length) by HMG. The previous (private) operator walked away when they couldn’t make a profit. Many of the others are fully or partly owned by foreign state-owned rail companies (SNCF, DeutscheBahn, etc), and they all receive heavy subsidies from the taxpayer. More even than British rail was losing before it was broken up and sold off. And it’s not as if those subsidies have kept fares low, they’ve rocketed way faster than inflation and if they’re not the highest in Europe, they’re certainly among the highest.

    The franchise system also killed the train manufacturing industry in the UK.

    In the utilities, investment in infrastructure plummeted after privatisation, but once again price rises outpaced inflation. And here too foreign state-owned companies bought into the private market and the profits go offshore to subsidise power or water in other countries or via tax havens to private companies and individuals.

    So now that private enterprise has failed to build enough generating capacity the government are so desperate to prevent the lights going out they’re guaranteed the French state owned EDF and their Chinese state investors 35 years of double the current wholesale price for electricity if they’ll just build us a power station.

    You’ll forgive me if I’m somewhat circumspect regarding the efficacy of private enterprise in providing essential services as my experience has not been without bitterness.

  3. angharad says

    I live in a country with the second highest life expectancy in the world, after Japan. And…yes, socialised medicine. And in our case, it’s unlikely to be healthy lifestyles contributing to that life expectancy – we are nearly on par with the USA in terms of obesity, and due to environmental factors have very high rates of certain cancers and dust related illnesses.

    In my case socialised medicine is probably a substantially contributor to the fact that the auto-immune disease I acquired as an impoverished student has not stopped me from entering the workforce, earning a large income and contributing a lot to the economy.

  4. Alex C. says

    Thank you for unfurling your true colours (Red), and admitting forthright that
    this *is*, in fact, socialised medicine. Ms Somers and you now agree on at
    least one point. Here is a brief recap of your dramatic about turn
    (misdirection):

    SS: First of all, let’s call affordable health care what it really is: It’s
    socialized medicine.
    Av: Except it isn’t. It’s a government insurance scheme where the price is kept
    low by running it at cost.
    «Anti-American-Pro-Communist propaganda deleted»
    Three paragraphs later:
    Av: Socialised medicine just means you pay insurance to the government which
    acts like an insurance company.

    Which is what she was claiming in the first place! Note your two contradictory
    statements.

    Continuing in the present article:

    Yes, the present healthcare/social security system in the USA is socialised
    (Medicaid/Medicare), and its failings are well known. This means they have to
    implement a better system, possibly jettisoning the socialist baggage.
    However, that is highly unlikely, given the large number of immediate
    beneficiaries this would damage. What this does NOT imply, is that the
    Government needs to impose an even MORE onerous system.

    It is disingenuous to claim
    “A saving in effect of 300 BILLION dollars”
    on the one hand when your primary antagonism is with
    “ …the worst of all. Money.”
    on the other.

    I do not care if $300 billion are saved. At the rate the Government burns
    through (paper and essentially worthless) money, this is an irrelevant saving.
    There is something worse than money: theft—the fundamental basis of Socialism.
    Life (first) and Property (next) are worth more than $300 billion, and Freedom
    is worth more than any of those.

    Do NOT try to give this discourse the ridiculous Rich vs Poor turn. This
    stupidity should have died out with the Soviet Union, yet it perseveres.
    Everyone will NOT be healthy, ever. There will always be people for whom
    medical services are necessary. Those people will be either able to pay for
    those services, or not. The people who can’t pay for their treatment, of
    course, need to be helped, just as people who can’t afford food need to be
    fed. This is basic human charity. But curtailing or delaying availability of
    certain techniques, procedures, or qualified providers to those who *can* pay
    for it is not only wrong, it is criminal. Feeding the hungry should NOT imply
    rationing of food for all. There is no dearth of food, neither is there a
    dearth of medicines or doctors in the US (unlike India). Guaranteeing the
    basic minimum care to support productive life is different from preventing
    advanced techniques to some on the grounds that they are unnecessary. Who’s to
    decide what’s necessary, if not the patient themselves? Certainly not doctors,
    and most assuredly not bureaucrats.

    I refuse to comment on your dragging the NHS into this slime pit. If the
    doctors and other professionals involved with the NHS are happy and content,
    if the public of Great Britain and Ireland sees nothing better, who am I to
    judge them? In their culture, it is normal, just like in Saudi Arabia, no
    citizenship for women is normal (I hear they can drive now).

    No need for the rant on Ms Somers. She deserves most of it (especially due to
    her cancer claims), but she is right on this one (for the wrong reasons). Does
    your being a medic imply you have better brains than her, or should it? Are
    all actors equally stupid?… Here’s another misdirection. You’re shifting
    focus from your bad writing (again) to Ms Somers’ Cancer straw man, which we
    both agree is wrong and dangerous.

    No need, also, for the appeal to WHO’s authority. It does not cover one
    important aspect of healthcare: Patient Satisfaction. This is the most
    important goal for a physician, after honesty. WHO is not concerned with
    either of those goals, so please leave it out of this. This is a social and
    professional issue.

    I’m not too keen on platform shoes, but a good pair of 1″ heeled boots should
    do fine, or even try 2″ Cubans! (forgive the possible infraction any actual
    Cuban folks reading this).

    Good bye!

  5. Alex C. says

    @AsqJames:

    Its good to know we agree on telecom.

    As for Railways, if they are so unprofitable that both a private operator (of
    unknown competence) and the Government (of known incompetence) have failed to
    realise profit, pray tell me why the railway is still running in the first
    place? It does not serve hinterland areas (branch lines sadly removed by the
    Government, oh!), uses hugely expensive diesel and electricity (!) to run
    passengerless trains, the once legendary punctuality gone… Why is this
    zombie operation still running? To think that Railways have been so
    spectacularly destroyed in the country that gave us Rocket and Mallard to the
    Deltic is really pathetic.

    Please remember that privatisation is not magic pixie dust that can turn
    around a destroyed, unprofitable enterprise overnight. Especially not in the
    sad case of BR. Please also remember that goods transport is the backbone of
    any railway system, and when a country has a blighted and declining industrial
    infrastructure, Railways are very difficult to run profitably indeed. Don’t
    just focus on the loss-making passenger side.

    A simple suggestion: stop paying the subsidies. Let SNCF and DB go to hell.
    Let the customers this Railway serves stand up and be counted, and decide
    whether they’re willing to pay the actual price of Rail travel. As a die-hard
    railfan, I’m only acutely aware that the State sponsored highway system is
    largely responsible for decline in passenger rail traffic, but let’s leave
    that issue elsewhere.

    Rail-system manufacturing was killed by the Government when it decided to
    import major components. Not that I disagree with their decision, but that’s
    how it is. The rest was inevitable.

    Regarding utilities, how is it that the profits from British utilities are so
    substantial that they can subsidise power and water in other countries
    (France?), but these immense profits were realised only AFTER the foreign
    communists bought into them? Was the UK Government fixing prices earlier so
    that it was impossible for a UK firm to make this level of profit? Why can the
    Govt. guarantee foreign entities such ridiculous terms? What’s stopping the
    major consumers of electricity, such as the Railways (oops!) and industry
    (oops!) from setting up their own power plants, just like the old days? Oh, I
    remember, the Socialist Grid. You can’t make your own power. Oops again. Can
    it be that the communists in UK Govt. have effectively handed over their
    utilities to their French brethren and their Chinese masters?

    It is rather sad for me to hear someone from the birthplace of Capitalism
    blame the Government’s sins on private enterprise. Napoleon might have been
    right after all.

  6. Alex C. says

    @angharad:

    More power to you! I will not comment on your (unknown) country of health and
    long life, as I myself live in hell compared to that Socialised paradise. If
    all your countrymen are Socialists, so be it!

    Just one question: would you have turned out different if you had been a
    recipient of a benefactor’s charity?

  7. Ysanne says

    However, decades of bitter
    experience of failure in other fields (railways, telecom, electricity, you
    name it) naturally leads one to be circumspect about its efficacy in this
    instance.

    HAHAHA. That was good.
    Railways: The UK rail system is known as one of the best examples of how hacking a large public asset into small private pieces can be absolutely catastrophic. Germany is also a great example; basically since rail was privatised there, tickets have become more expensive, local services less accessible, reliability is down the toilet (the high-speed trains regularly fail in summer because they can’t deal with temperatures above 36C, and in winter because their brakes freeze, and let’s not start about how safety-critical stuff fails because buying cheapo parts and extending maintenance intervals does not go together), and the whole operation still eats millions and millions of tax money… except now that’s contributing to shareholders’ profits instead of service.
    So, yeah, railways: A good example why not everything lends itself to privatisation.

    Same with electricity (in Germany, local governments are starting to buy back assets for good reasons) and other public infrastructure (rubbish collection, water).

    Telecom is basically the only example on this list that didn’t go horribly wrong, and last time I checked, all the fantastic achievements of the “free market” hadn’t managed to make telecom companies’ service particularly customer-friendly or at least reasonably priced. (Regulation against price-gouging and cheating on bills, in contrast, did help.)

  8. Rich Woods says

    @Alex C #4:

    But curtailing or delaying availability of
    certain techniques, procedures, or qualified providers to those who *can* pay
    for it is not only wrong, it is criminal.

    Even here in the Socialist hell known as the UK, people who want to buy private healthcare are free to do so, and have been both since and before the NHS came into existence. The NHS won’t fund certain treatments for which there is not yet enough evidence of cost-effectiveness, but then neither will the profit-driven insurance companies who control the freedom-loving healthcare in that Capitalist heaven known as the USA.

    Get your facts straight, death panellist.

  9. otranreg says

    Oof, ‘Socialist’ as a pejorative is a sure sign of tossery. Go have a wank, matey, the invisible hand might help you with that.

  10. Alex C. says

    @Rich Woods
    That comment was not about the NHS. Re-read the section below that. I refuse to discuss the NHS—if Kingdomites and their doctors are happy with it, who am I to judge them? Also, it would be better to avoid digging up dead slanders like the infamous “death panel” stupidity.

  11. AsqJames says

    @Alex C #5,

    You’re ignorance and/or inability to read is showing again.

    I wrote:

    The only rail franchise currently running without a subsidy is owned and managed (at arms length) by HMG. The previous (private) operator walked away when they couldn’t make a profit.

    And you reply with:

    As for Railways, if they are so unprofitable that both a private operator (of unknown competence) and the Government (of known incompetence) have failed to realise profit

    There is currently one rail franchise in the UK owned and operated by the state. It is the only one which does not require a taxpayer subsidy. In fact it pays money back to HM Treasury. How’s that for “known incompetence”. If the other franchises were run the same way, maybe they’d all be making a profit for the treasury instead of receiving subsidies.

    Let me repeat: There is one franchise operator contributing cash to the exchequer. It is state owned. All the others are privately owned and receive money from the exchequer. Tell me again how private enterprise always outperforms the government?

    Rail-system manufacturing was killed by the Government when it decided to import major components.

    Wrong. This is more ignorance. I could give you an economics history lesson on how the franchise system of TOCs and TLCs has led to short-termism and the purchase of the cheapest possible rolling stock from abroad, but on the current evidence it would be wasted on you.

    Was the UK Government fixing prices earlier so that it was impossible for a UK firm to make this level of profit?

    Um, when the utilities were publicly owned there were no private firms to have their profits restricted by government fixing their prices. They were government owned and run because they are natural monopolies. It makes no sense to have several different companies lay water pipes or gas pipes or electricity lines to every business and dwelling to allow a true market in which those companies can compete for business.

    Almost all of the cost of providing those utilities was paid by the consumers directly with a very small proportion coming from general taxation. For that small contribution, taxpayers got lower prices overall, more investment in long-term infrastructure and a guarantee that they could move anywhere in the country and receive the same quality of water and sewerage service, etc.

    Why can the Govt. guarantee foreign entities such ridiculous terms? What’s stopping the major consumers of electricity, such as the Railways (oops!) and industry (oops!) from setting up their own power plants, just like the old days? Oh, I remember, the Socialist Grid. You can’t make your own power.

    Wrong again. Nobody is stopping any private business from generating their own electricity. In fact feed in tariffs for renewables have encouraged individuals and businesses to do so. But large scale power plants are huge and long-term investments. Power stations typically expect to operate for 50-75 years. No private enterprise is willing to invests the billions of pounds needed, because they can’t guarantee they will be around that long or that they will make a profit even if they are.

    But governments know that the country will still be around then. They know there will be houses and businesses which will need that power. Again, just like natural monopolies, this is an area in which it makes sense for the state to act. That’s not to say there is any one absolutely correct way for the state to get involved – it may be best to build and operate power stations, or it may be best to involve private enterprises to some greater or lesser degree. But I’m afraid it is a fact of life that the scale, in terms of cost and longevity, mean such things cannot be left entirely to the short-termist, quick-profit driven market.

    Can it be that the communists in UK Govt. have effectively handed over their utilities to their French brethren and their Chinese masters?

    Communists in the UK government? You mean the free-market ideologues in the Conservative Party?

    No. Their ideology (private enterprise always outperforms the state) has clashed with market reality, and they had to provide a huge bribe of guaranteed profit before anyone would come in and do what the government knew was needed for the long-term energy security of the nation. That the firms involved are foreign state owned only shows that such state enterprises have the size and credit rating to tackle such large projects more cheaply than their private competitors. A fact which would also have applied to similar companies owned and operated by the British state had Thatcher and Major not sold them all off for a fraction of their value.

  12. Alex C. says

    @Ysanne
    You forget that the UK Rail System was also the best example of how
    consolidating multiple private enterprises into a large Socialist asset is
    catastrophic. Ill-gotten wealth deserves ruin, as equally to Government as to
    robber barons. All the more as the British Govt. thoroughly milked the Railcos
    for their doomed war effort, which they themselves were responsible for
    creating through political incompetence. LNER, SR, LMS, GWR, Metro. All
    swallowed up by the rapacious jaws of the Socialists.

    Germany, nothing but sympathy for a people that never *had* any freedom, as
    opposed to UK which had their chance but blew it. Right from the Prussian
    hegemony to Imperialism under the Kaiser to successive Fascist states to
    partition with authoritarian patriarchs on both sides (Emperor Adenauer on one
    side and Comrade Honnecker on the other). The real German history only begins
    after 1989, and as such the people have done well with what they inherited.
    Sadly, Austria has remained a different country despite cultural uniformity
    within Germany, due to the historical accident called Anschluss. The real test
    for Germany is if they manage to somehow throw out the Christian Left and the
    Socialist Left, which seems highly unlikely given the deeply religious and
    socialist population. Just like in the US, Reds and Robber barons seem to
    have entered into unholy matrimony (Volkswagen, Daimler, ThyssenKrupp,
    etc. etc.)

  13. dianne says

    Canada is still one of the most expensive systems in the world. Still, the US spends twice as much per capita on health care. Over $8,000 per capita/year. That’s insane, and that’s not small government by any measure.

    It’s not “small government” but why is it “insane”? The US’s economy is not stupendous, but it’s not notably worse than the economy of Canada or most parts of Europe, so clearly the health care spending is not destroying the economy (in fact, it may be helping given that personnel are a major health care expense and more personnel=lower unemployment). Disease is a major threat to the safety of the citizens of the US. Far more people die of, say, heart disease, COPD, cancer, and HIV in the US than die of terrorist attacks, much less invasion by foreign armies. Shouldn’t we spend a lot to protect our citizens from the worst threats?

    My claim is that the US isn’t overspending on health care. It is spending on the wrong things, it’s inefficient, but in terms of sheer amount of money going into the health care system, it’s not wrong. Canada, Britain, etc are spending too little. Until you have people living 500 years and disease is totally unknown, you’re not spending too much on health care. Spend more. Hire more people. Tax your rich people more. I don’t see any insanity in it.

  14. dianne says

    There is no dearth of food, neither is there a dearth of medicines or doctors in the US

    Actually, there is. The US has notoriously had an issue with drug shortages, mostly generic drugs, frequently chemotherapy, in the past decade or so. The problem has been mitigated by Obama who has made some (oh, no, government intrusion on private companies!) changes to regulations that encourage companies to keep making generics, but it’s hardly a solved problem.

    As to doctors, the US imports doctors from…anywhere it can. Because there’s a shortage! Especially in primary care. I used to live in NYC, probably the place in the US with the highest concentration of doctors anywhere. I couldn’t get an appointment with a PCP for 2 months. I was considering taking the publicly subsidized train to Canada and seeing if I could get in sooner there. Recently, I couldn’t get an appointment with a gastroenterologist in my own institution for 3 months. And I still live on the eastern seaboard in an extremely doctor-rich environment. Yet not a week goes by that I don’t call a colleague asking them if they could PLEASE squeeze just this one urgent patient in…and/or getting the same call from a colleague.

    In short, I wonder if you actually know anything about the US which you seem to be idealizing.

  15. dianne says

    Germany, nothing but sympathy for a people that never *had* any freedom, as
    opposed to UK

    Anecdote caution, but…I’ve lived in Germany and I’ve at least visited the UK. There’s no comparison in terms of freedom: Germany wins by a landslide! Getting into the UK in the first places is like, well, like getting into the US: Long customs lines, suspicious officials, multiple harassing forms, the occasional search. In comparison, getting into Germany is quick and efficient. Heck, I’ve snarked at customs officials in Germany and not gotten into trouble. I don’t know how it is for, say, Turkish people, but at least coming from the US, there was no problem.

    Then there’s the situation once you’re there. In Britain there are cameras everywhere. Constant observation by everyone from the state to the store you’re in. None of that in Germany, at least not in the little town I was in. I’ve never seen a truck saying “hey, foreigners: get out or get arrested” in Germany. Or been stopped and had my ID demanded (though admittedly I’m naturally invisible, being a middle aged woman). So not sure how you’re coming to the conclusion that people in Germany have “never had freedom” because they certainly seem to have it now. More, arguably, than in the US or Britain.

  16. smrnda says

    In Germany, it is not a crime to break out of jail. The police will try to apprehend you, and if you are out for a month a month will be added to your sentence, but you will not get an additional 8-10 years like in the US, because in Germany, it is considered a human right to want to be free.

    I also hear (Germans, can you verify?) that the name of a person accused of a crime cannot be publicized, nor their picture, until they are actually convicted.

    Homeschooling is outlawed in Germany, which means that children are not denied the right to education and denied access to ideas based on their parents’ desire to raise them to be isolated members of a cult.

    **

    Alex, do you oppose socialized health care because it does not work, or because you don’t think it’s a function government should do? By bringing up the USSR it *seems* like you’re trying to argue that it doesn’t work, but with health care outcomes being far better than in the US in many countries with socialized medicine, saying it doesn’t work is contradicted by actual data.

    Alex, do you oppose publicly funded roads? Police? Fire departments? Public education? If you oppose these, then you simply oppose civilization, since the idea that these functions will be served by private vendors is laughable. If your argument is that all taxation is theft, how exactly do you expect a government to function?

    If wealthy people get denied treatment by government health care, they are free to purchase this from private vendor. It’s the same as you can send your kids to school, but choose to enroll them in private tutoring, or that I am free to use the library, but I can also choose to buy my own books. I also find it a bit odd that your sympathy is for wealthy people who can pay rather than people who, being poor through no fault of their own (upward mobility isn’t really a thing in the US) cannot.

    On ‘rich vs. poor’ nations in Europe handle this better than the US without falling apart, so the ‘nonsense’ you think should have died out with the USSR is clearly not nonsense. Inequality is a problem you can fix through smart government. Nations with better welfare states which retain private industry do alright. If your opinion is that the sanctity of property is worth more than that, then I just think that you, effectively, believe in feudalism, with those with property being unquestioned feudal lords – property is a social construct, and taxes are a part of life, and I get sick of the entitled whining. Freedom comes, a great degree, FROM government, because getting pissed and shat on by employers is par for the course for most people. Are you one of those libertarians who think that it’s FREEDOM for an employer to refuse to let a pregnant worker go to the bathroom when she feels nauseous, and then fire her for throwing up? If that’s freedom, then I do not want what you call *freedom* since it’s clearly only freedom for the privileged. In European nations, with greater restrictions on employers, there is more freedom.

    As far as governments go, they exist by consent of those governed by it. There will not be 100% agreement on the necessary role of government, so what government does is mostly a compromise. You, and other ‘limited government’ proponents seem to believe that no matter what people want, government should be restricted to doing only what YOU want it to do, so that everybody MUST submit to a government which does not represent their interests because YOUR idea of government is the only right one.

    Also, please use words correctly. Given the fact that there is still plenty of private control of industry, no country on earth is communist, so quit throwing labels around where they don’t apply. By your standards, a government that funds roads is communist, so every nation but Somalia is now communist. I prefer words be used correctly to avoid confusion and because I prefer meaningful, rather than meaningless discourse.

  17. Alex C. says

    @AsqJames #11,

    Thanks for your detailed rebuttal. It would be even better if you could do it
    without opening with childish attacks.

    I feel we have a misunderstanding on the Rail franchises. My “stop paying
    subsidies” argument was directed at the franchises that *do* receive subsidies,
    not at the one franchise that doesn’t. My allegation of Govt. incompetence was
    aimed at the exploitation, amalgamation, nationalisation leading to the
    formation of BR, and its subsequent running into the ground. The fact that one
    franchise is able to make a profit while several others are not, points to
    either better railwaymen in that franchise, or less customers in the others.
    Either way, it is an argument against amalgamation. Maybe there are no more
    people in Britain interested in running railways. Overall, privatisation of
    railways is a step in the right direction, though undertaken under tremendous
    pressure of socialists. That it was conducted in a largely incompetent and
    possibly corrupt manner is another beast altogether. Rail franchising to
    essentially asset-less TOCs was bad, and the entire privatisation process has
    been a train-wreck (forgive the pun!), involving too many companies and
    unnecessary complexity.

    To repeat, I’m not saying the privatisation process has been good. Please do not
    divert attention from the ills of BR to the ills of privatisation. As I said
    earlier, privatisation is not magic pixie dust that can turn around a blighted
    firm overnight (with apologies to Jamie Zawinsky). However, as an attempt to
    correct historical wrongs, it is commendable.

    Regarding natural monopolies, your fatuous claim that “they were government
    owned and run because they are natural monopolies” is devoid of truth. There is
    nothing about natural monopolies that requires them to be run by the Government.
    The same logic used to be employed for telcos until it was shown to be false.
    Regulation by local bodies, yes. Government ownership, no. Remember, the
    opposite of communism is not robber barons that bleed you dry. This seems to be
    the case in UK, but it doesn’t have to be. Again, the immediate goal is not
    lower prices overall. That comes later. A chronically underfunded utility does
    not transform overnight after privatisation. As an aside, why should anyone
    expect to “move anywhere in the country and receive the same quality of water
    and sewerage service, etc.” Classic Red line. It should actually read
    “…receive the same *minimum* quality of water and sewerage service…” Some
    areas will always be better than others, just as they always have, due to their
    residents caring more about some things than others. To claim otherwise is
    false, to enforce such claims is criminal, sorry, Communism.

    If the UK Government is prepared to offer long term guarantees to foreign
    corporations, why can’t it offer the same to UK firms? The people vote with
    their money, and that nobody is prepared to invest large amounts for the long
    term says a lot about the lack of investor confidence in the future of British
    economy and people. The short-termist swindler is king because no one really
    believes there *is* any long term in UK.

    If you think the Conservatives are free-market ideologues, there is no help for
    you. Maybe from the Red land you live in they seem like White stars, but they’re
    not. Private enterprise does not always outperform the state. *Competitive*
    private enterprise is the key. A private monopoly is no better than a state
    monopoly, and possibly worse.

    Enough off-topic discussion on this page. I’m not trying to convince you of
    anything, I’m only reminding you that Socialism has not won the day yet.

  18. dianne says

    I also hear (Germans, can you verify?) that the name of a person accused of a crime cannot be publicized, nor their picture, until they are actually convicted.

    Not German, but from what I’ve seen in the German media, the person will typically be identified by first name and last initial if accused but not convicted. So, if, say, Angela Merkel were accused of breaking into a cell phone store and jumping up and down on the phones, they might say, “Angela M was accused of breaking into a store selling US-based Verizon phones and jumping up and down on several phones”. So the “not identified” can be quite fig leafish at times, but there is at least an attempt to prevent disclosure.

  19. dianne says

    they seem like White stars

    The (private) White Star Line was nothing to hold up as an example of efficiency and safety, you know…

  20. Alex C. says

    @dianne #14

    The drug industry in the US is notoriously dependent upon the broken patent
    system, which is exploitative, monopolistic, outmoded and anti-liberal to the
    core. I fully agree with you that it needs to be reformed. However, the
    shortages of medicines are artifacts of a broken system put in place by robber
    barons, rather than an intrinsic shortage of materials, persons, skills, or
    finances.

    As for doctors, it is not so much as the US importing doctors as doctors from
    around the world making a bee-line for the US. The perceived need of patients
    is considerably more in the US compared to other countries, and doctors from
    around the world are coming in to satisfy them. The solution is more doctors
    and easier immigration. Nothing to do with the thrust of this article.

    #15

    You and I are in good agreement about Germany. For a country that tasted
    freedom in 1989, Germans have done well with what they inherited (as I said
    previously). Now if they can only move away from the Christian Left and the
    Social Left…

  21. dianne says

    As for doctors, it is not so much as the US importing doctors as doctors from around the world making a bee-line for the US.

    Not obviously. We’ve got some people from India, China, a few eastern Europeans, some South Americans but nobody showing up these days from western Europe. Certainly not from the other rich English speaking countries. NZ was recruiting for a while, but they seem to have settled down. This is just impression, though: I don’t know what the numbers look like.

  22. Alex C. says

    @smrnda

    Thanks for your considered, non-confrontational response. If only others
    were able to put forward their views as easily! I disagree with you, but I
    admire your style. A refreshing change from the author of this blog and
    several commentators.

    Let me try to state my position just as clearly as you have stated
    yours.

    1. I oppose socialised health care because people’s life and health are
    too valuable to trust Government with. That it failed (among other
    things) in the U.S.S.R. is merely co-incidental. For example,
    women’s rights were greatly advanced in the Soviet Union, as were
    minorities’, for a time. Who can forget the monumental Socialist
    Realist art, International Style architecture, or the pioneering
    space program? That these things happened in the Soviet Union are
    immaterial—they served as inspiration for social change around the
    world. That does not, however, wash off the many sins of the Soviet
    Empire.

    2. Health outcomes have no regard for Patient Satisfaction, which is
    the most important goal for a physician (after honesty). Health
    indices are tools to measure progress, not goals to be worked for
    exclusive of everything else.

    3. Do I oppose:
    i) Publicly funded roads: Yes. In the US, they were responsible
    for destroying passenger Railway economies, and set back
    that most efficient form of transport in favour of the
    automobile epidemic that we have today.
    ii) Police: Yes. Especially in the past few years, police have
    metamorphosed from preventive, safety-focussed organisations
    into crime-investigators and a Government-sanctioned
    paramilitary oppressive force. I say bring back community
    policing.
    iii) Fire departments: Many fire departments are already volunteer
    staffed, or running under local self government. It would
    not take much effort to switch them completely to this mode.
    Firefighting tools and equipment should be supplied by
    private manufacturers, as they are today. All in all,
    current US Fire Deptts are among the most liberal of all
    quasi-Government organisations, and have done stellar work.
    iv) Public Education: A tough one. I have no stand on this as there
    are good and bad implementations. I’m, in principle,
    supportive of homeschooling. This may change when I have
    closely observed the German schooling system. On the other
    hand, I also realise the potential of homeschooling to turn
    children into mini cultists, and oppose religious
    segregation and schooling on these grounds.
    v) The idea that these functions will be served by private vendors
    is laughable: Private schools in India are laughing all the
    way to their banks.

    4. If people get denied healthcare that they have already *paid*for*
    then something is wrong. They may naturally expect not to have to
    pay for a service that does not satisfy them. You buy a poor product
    only once. You should not have to pay for a sub-standard school
    whose stupidity you have to wash off by private tutoring. Public
    libraries make sense because the vast majority of books do not need
    to be bought to benefit from them. You can never, ever, have a
    sub-standard library in the way you can have sub-standard
    healthcare. That said, libraries should be co-operative, in that the
    cost of books is distributed among the readers.

    5. Inequality is not the problem. Unequal opportunity and lack of
    upward mobility are. Property is a social construct, and it is second
    to Life, I agree. Taxes are a part of life, I also agree. But the
    Freedom to claim your money’s worth for the taxes you give is worth
    more.

    6. I would say “getting pissed and shat on” by Government (police, FBI, NSA,
    DMV, take your pick) is also par for the course. Do not mix labour rights
    with Socialist propaganda. Just because I’m a supporter of limited
    Government does not mean I’m ready to trample upon workers’ rights (or
    women’s or minorities’, etc.).

    7. You say, “As far as governments go, they exist by consent of those
    governed by it.” I say bollocks. They have my consent to prevent
    rape, pillage and murder, but that’s about it. They do not have my
    consent for deciding whether I may marry (or who), how I raise my
    children (provided I do a competent job of it), or whether I want to
    travel by road or rail.

    8. Please do not club me with proponents of ‘limited Government’ in the
    US, as they are mostly Conservative Christians hiding under the
    “Libertarian” label. Of course, Socialists in the US have hijacked
    the “Liberal” moniker, but I say Down with Them!

    9. You say, I “…believe that no matter what people want, government
    should be restricted to doing only what YOU want it to do, so that
    everybody MUST submit to a government which does not represent their
    interests because YOUR idea of government is the only right one.” I
    say take thy own medicine, O Healer! This is exactly my argument
    against Socialists. Unfortunately, there is no possibility of an
    easy solution, short of Rand-esque stupidity involving the formation
    of a new nation, that can only work in fiction. There was a sort of
    compromise status-quo in the US, but Socialism marches relentlessly
    forward, and for them, no Government is Big enough. I may or may not
    have a voice loud enough to be heard over their massed cacophony,
    but damned if I’m going to sit silently while they roll over me.

    10. Socialism, even if not in the all-encompassing totalitarian format
    as the Soviet Union, is still with us, unfortunately. I’ll stop
    calling out the Socialists if and when they stop labelling
    themselves “Liberals” while opposing Liberalism tooth and nail.

  23. Alex C. says

    @dianne #22

    >> As for doctors, it is not so much as the US importing doctors as doctors
    >> from around the world making a bee-line for the US.

    > Not obviously. We’ve got some people from India, China, a few eastern
    > Europeans, some South Americans but nobody showing up these days from
    > western Europe. Certainly not from the other rich English speaking
    > countries. NZ was recruiting for a while, but they seem to have settled
    > down. This is just impression, though: I don’t know what the numbers look
    > like.

    Methinks you’ve got a LOT of doctors from India. Moving from Western Europe to
    the US makes little sense due to the language barrier and similar economic
    levels. Most of the Western Europeans who desired to move to the US have
    already done so over the past centuries.

    Anyone from a “rich, English speaking country” would find no reason to move to
    the US, as there are similar levels of Socialism. Unlike Indians and Chinese
    and East Europeans, who deal with onerous Socialism every day. USA does not
    have an “Import Doctors” policy. Rather, these foreign doctors are desperate
    to get into the US.

    Unlike Western Europe, however, the US is markedly less secular, where any
    loony group can get together and claim Freedom of Religion for whatever they
    want to do as long as they don’t mess with the Government. Any *other* loony
    group is violently dealt with by the Government militia masquerading as
    police.

  24. smrnda says

    Alex

    2. If you are making patient satisfaction the goal, then I would say the US would have some of the lowest rates of satisfaction you can find because people without access to health care will be unsatisfied. All the stats I see indicate higher level of patient satisfaction elsewhere, along with better health outcomes. I also believe that all people should get health care, and if this comes at the cost of taxation which some people object to, I do not give a shit. There are some things governments should not do regardless of popular opinion (restrict marriage based on religious teachings ) and other things that it should. Government action or involvement is neither good nor bad in and of itself.

    “But the
    Freedom to claim your money’s worth for the taxes you give is worth
    more.”

    There will always be disagreements on this because people value different things. You have told me what you oppose, and I guess we disagree on health care. I’d like to see many negative things connected with US imperialism and the police state defunded, but I also think that health care should be made available to all.

    ” I
    say take thy own medicine, O Healer! This is exactly my argument
    against Socialists. Unfortunately, there is no possibility of an
    easy solution, short of Rand-esque stupidity involving the formation
    of a new nation, that can only work in fiction. There was a sort of
    compromise status-quo in the US, but Socialism marches relentlessly
    forward, and for them, no Government is Big enough. I may or may not
    have a voice loud enough to be heard over their massed cacophony,
    but damned if I’m going to sit silently while they roll over me.”

    Well, I guess we disagree then. I will not sit idly by while in the defense of the abstract virtue of ‘small government’ people prevent others from access to health care. Given that you openly state that there i no easy solution, and you agree the notion of forming a new nation is stupidity, we’re stuck with the condition we have now – that we will not always agree on the proper function of government and that neither of us will get a government exactly how we want. You just see the trends to be, generally, opposed to what you like, and I see some more to my liking.

    If this make you feel like someone is rolling over you, it just seems like entitled privileged whining to me. Just because you feel like you’re being ‘rolled over’ doesn’t mean you have any legitimate complaints, nor does it mean you are really suffering. Just the fact that you want to whine about ‘socialism’ doesn’t mean I should listen to you. I’ve seen too much suffering caused by ‘limited government’ and no national health care for me to take your complaints as anything worth listening to.

    I also understand that historically, ‘liberalism’ means small government, but small government means the Company Town, Child Labor, blacklists and racial discrimination in hiring. Liberalism looked like a big move back when monarchies were being toppled, but then people found out there were forms of power other than political ones. The notion that you can separate worker’s rights from government regulation of employers is laughable to me – gains won by unions were often short-lived and required a massive amount of effort on the part of workers – transferring some of the work of gaining worker’s rights to the government was simply a natural move to make the gains more permanent and harder to take away.

    You have not addressed my points that Western Europeans have greater freedom, mostly because of more government programs and regulations. To me, their governments are not superior to the US government because they are bigger, but because they *don’t do* certain bad things, and *do do* certain good things.

    Also, given that at least some members of the Austrian economic school advocated for some type of payment to be made to people, from government money, in the event of their losing their jobs or other economic hardship, is EVERYBODY a socialist now?

    On onerous socialism, I deal with onerous ‘free market’ ideology every day.

  25. smrnda says

    Alex, a few more questions:

    1. Are you opposed to what you call ‘socialism’ because it does not work, or are you even opposed to it if it does? If a socialized health care system delivered better results, are you still opposed to it?

    2. If you state that *any* amount of socialism is bad either because of the the USSR OR because you find it ‘onerous’ what is your response to people who point out failures under capitalism (Triangle Garment Factory Fire? Life in the “company town?” A pregnant woman fired for being pregnant?) or by people stating that they find life under non-socialism ‘onerous?’

    3. It seems that, in the end, we simply disagree on whether or not 1 function (health care) should be handled by government. Governments always end up imposing conditions that some people don’t like, and by all means, fight what you don’t like, but expect others to fight against you. If that’s the case, then there’s no point in our discussing the merits of socialized medicine – you simply are against it on principle, and I am for it for pragmatic reasons. Currently I have fairly good health care, but I would support a system that put a few more impositions on me because others need access.

    4. I did not respond to your point about how the presence of hunger should not imply food rationing for all. The fact that people lack food even when food is abundant is a consequence of the fact that food is grown to make $$$, not to feed people. So in the US at least, enough food for all (and then some) is possible without any meaningful rationing of food, but not without taxes being levied to supply $ to buy food for those who cannot afford it, who OFTEN ARE THE PEOPLE WHO WORK THE HARDEST. However, if there is not enough food for everyone, then I support rationing. Between life and property, I must privilege life above property rights, all the time.

  26. Alex C. says

    g`”
    > …entitled privileged whining…

    Entitled. Privileged. Whining. Hmm… Do I detect leftist smoke and mirrors?
    Socialist thieves’ parting me from my money (which is deplorably small anyway)
    is right, while my protesting loudly is whining? It seems I am your Privileged
    Class Enemy Comrade! Better get the bayonets before I cry out too loudly.

    I was wrong when I said there was no easy solution. There is: YOU pay for
    whatever it is YOU want YOUR Government to do. Leave ME out of this. The US
    Federal system allows much leeway. Use it. Don’t waste your time listening to
    me, and remember it is as distasteful for me as it is (probably) for you.

    Congratulations on resorting to Communist propaganda like the Company Town
    and all. Oh, you forgot to mention the Top Hat-wearing monocled Capitalist who
    slept with workers’ virgin newly-wed wives, or the evil Vampire they call
    President, or that they’re lynching negroes! Thus, opposing Socialism is
    equivalent to labour exploitation, monopolistic trade, child labour, and
    racism, as if somehow these are the result of Capitalism and not due to
    pre-existing social biases dating from Imperial times. Which has nothing to
    do with the subject matter at hand. Thank you for unfurling your Red flag as
    well.

    A relevant joke from Wikipedia (https://en.wikipedia.org/wiki/And_you_are_lynching_Negroes):
    An American and a Soviet car salesman argue which country makes better cars.
    Finally, the American asks: “How many decades does it take an average Soviet
    man to earn enough money to buy a Soviet car?” After a thoughtful pause, the
    Soviet replies: “And you are lynching Negroes!”

    Also, it is only in the US that Liberalism means anything other than ‘small
    Government.’ That’s because the cowards in the Socialist camp are too scared
    to declare themselves—preferring to hide behind “Liberal.” Everywhere else, in
    Britain, France, Germany, even India, Liberalism means what it has always
    meant. Nothing historical about it. Just regional myopia caused by Socialists’
    successful camouflage.

    *Some* Western Europeans (maybe not Czech Republic—is it even Western?) feel
    they have greater freedom. Remember, even France may not stay Socialist
    forever. However, even if they are Socialists and feel happy about it, so be
    it! It is their country and they have every right to burn it if they wish. I
    have no desire to engage or try to convince those who have purposely blinded
    themselves to honesty and fairness. If any in those countries do not feel as
    cheerful as others, let them speak up! I am in no position to judge them, as
    evidently, you are. However, I AM in a position to judge what I’m going to do
    with MY money, and giving it to the Government is certainly not what it is.

    As for the reference to the Austrian school, I should remind you that I’m not
    a religious dogmatist to sway whom you have to invoke some Scriptural words or
    Prophecies. There are even theories floating around that advocate Free Money
    for All, but they are not relevant to this discussion. Some type of payment to
    the recently unemployed or troubled is Social Security. There are a variety of
    means of ensuring this apart from high taxes. Do not imply that being
    pro-small-Government is the same as being uncharitable. Altruism is not
    Socialism, but FORCED “altruism” is loot.

    A few answers to your second post:

    1. What I call Socialism: Looting my money. Always opposed, unfortunately.
    Socialised health care? See above.
    How are the poor going to get treated? Charity. Not Doles. Charity.
    What can the middle class do? Get Socialists out of Congress.
    What can the rich do? Charity. Remember, the Red Army is at your doorstep.
    The middle class will go first, but you will not escape either.
    What can a Red do? Go to Hell.

    2. More Communist propaganda. Labour exploitation, Child Labour, Racism, and
    poor respect for Women’s and minorities’ rights are not caused by
    Capitalism itself, but by deep rooted social biases existing from
    Classical times and before. If you were a real Liberal (rather than a
    closeted Socialist) you would know that Social Liberalism is all about
    removing these biases and forming an æquitarian society. Perhaps you have
    been blinded by the glare of US Conservatives who champion a regressive
    social agenda while singing pæns to Economic Liberalism (you’d know
    them—they call themselves ‘Libertarians.’)

    3. You are most WELCOME to support a “system that put a few more impositions
    on (you) because others need access”. What you’re not welcome is to
    support those impositions on ME. I’m acutely aware of the problems with
    the US healthcare systems, and this is not the way to go to treat them.
    Focus should be on reducing the cost of the system first, starting with
    the ridiculous and outdated patent regime. Reducing the cost of the system
    automatically enables many more people to afford it. Artificial shortages
    of medicines should be unthinkable. But you won’t support it. Would you?
    After all, won’t it affect the Crony Capitalists (Crapitalists?) whose
    money the Socialists are so dependent on for running their political
    machine? Concentration of Political Power and the Means of Production in
    the same hands was the major fault of the Soviet Union, and it is slowly
    happening in the US as well, though by another route.

    4. Do not speak lightly of the Byzantine web of subsidies that is US (and
    European) agriculture. Wherever else the market may be free, in Food it
    certainly is not. Brazil and India have been protesting this in WTO for
    years without any result. As to my earlier argument, you are twisting it.
    I claim that *when*there*is*no*dearth*of*food* then a food rationing
    scheme is wrong. You agree with this, and then introduce the facetious
    case of “if there is not enough food for everyone.” I’ll repeat what I
    said earlier. Maybe you missed it: “Life (first) and Property (next) are
    worth more than $300 billion, and Freedom is worth more than any of
    those.” Of course I value Life above Property! Even others’ Life over my
    Property! At last, we are in perfect agreement.

    On this happy note,

    Good bye!

  27. Alex C. says

    I beg pardon. My reply above (#27) was directed at smrnda (#25, #26). I failed to mention this in that post.

  28. dianne says

    Moving from Western Europe to the US makes little sense due to the language barrier and similar economic
    levels.

    Much less than moving the opposite direction. English is the language of medicine and most medical journals and medical conferences are in English. And the dreaded socialized medicine is used throughout western Europe (and Canada, Britain, etc) so if it really made doctors miserable, there’d be quite a lot of desire to move to the US. There’s not. Somewhat the opposite: it’s nearly impossible for doctors in the US to move to Europe, even if they have adequate language skills because, well, there’s just no need.

    Anyone from a “rich, English speaking country” would find no reason to move to the US, as there are similar levels of Socialism.

    Not in medicine. Doctors in Canada must work on the Canadian health insurance system or not work. There is no alternative. Doctors in Britain can be private, but it’s considered both challenging and pointless (at least among oncologists.) I know less about NZ and Australia but get the impression of a similar situation there. It’s relatively simple to ignore “socialized medicine” altogether in the US. One can work for cash only or refuse to take Medicare/Medicaid or refuse any but the most high priced private insurances. I suppose someone who found the US’s “socialized medicine” onerous could move to South Africa where I’ve heard it’s all private, but I don’t see many people clamoring to do that.

  29. angharad says

    @Alex C:

    Just one question: would you have turned out different if you had been a
    recipient of a benefactor’s charity?

    Really? Seriously? I mean, sure there might have been no functional difference, but the very idea gives me the heebie-jeebies. My continuing good health and capacity to function like a normal person (including having children) should be dependent on the whim of a single person? I should point out that, while my condition did require some fairly intensive medical intervention when it was first diagnosed, it also requires ongoing monitoring and medication for the rest of my life. Yes, I could probably afford to pay for it myself these days, but for most of the last fifteen years, not so much. So for all that time I might be dependent on this person and their willingness or capacity to pay for me.

    And yes, I realise you could argue that I’m dependent on the government instead, but that really doesn’t feel like the same thing. The government, whatever else its failings, is impartial. It will not refuse me healthcare because of my relationships, or my citizenship status, or my political leanings. It won’t turn me away if I have a criminal record or if I smoke or am obese. It will treat me even if there is no chance that I will recover sufficiently to become a ‘productive’ member of society.

    Nor does this seem like a more efficient process. Let’s suppose I had to haul myself out of my sick bed and fill in a bunch of forms at Mrs MacRichie’s Benevolent Fund for the Poor and Sick. And then wait for approval. And then find a doctor who charged a rate Mrs MacRichie was willing to pay. All the while getting sicker, and not being able to study or work. Or you know, I could do what I actually did, which was go to the nearest doctor.

    I live in Australia BTW, if you actually want to go and look up our stats on life expectancy etc

  30. Alex C. says

    @dianne #29

    Thank you for your enlightening words. Your comments have expanded my
    understanding of some international medical systems.

    So, as I understand, in Germany, for example, it is impossible for US doctors
    to thrive, even despite the language barrier, because the local market is
    flush with young German doctors willing to work for peanuts. Great!

    Now I get the thrust of this article:

    http://www.spiegel.de/international/german-brain-drain-sick-of-bad-pay-doctors-flee-germany-a-399537.html

    and this one about South Africa:

    http://www.thoughtleader.co.za/martinyoung/2013/08/14/why-should-you-be-concerned-if-your-doctor-is-a-designated-service-provider-5/

    US “socialised medicine” is not onerous at all compared to what the Fearless
    Leaders have in store. As I said, the compromise status-quo is not Red enough
    for some.

    Thanks especially for the heads up on Canada. That doctors willingly and
    happily choose to work in this system is indeed a testament to human
    forbearance. I’m sure Soviet Comrades were as content right until the system
    collapsed. Anyway, more power to them!

  31. Alex C. says

    @angharad #30

    Not the whim of a single person, but the endowment of a Foundation (as you
    yourself correctly surmise later). Big difference. The endowment commits to
    your treatment with a full grasp of the cost and duration involved.

    Efficiency does not factor into this. Relentless pursuit of efficiency is what
    gets terminally ill, unproductive people killed, oops, euthanised. You should
    be thankful “efficiency” is not the overriding requirement, whatever it means.
    Life (first) and Property (next) are more important than “efficiency”

    So if it isn’t just Mrs. MacRichie’s Benevolent Fund for the Poor and Sick
    (nice!), but having income below a certain threshold automatically enables you
    for endowment and you have to fill out a single form, would you then prefer
    it? Would you take the money Mrs. MacRichie is effectively (and efficiently,
    of course, no-one likes vast intermediary bureaucracies, least of all me)
    *giving* you and be thankful for it?

  32. says

    @Alex C

    1. Patient satisfaction is higher across the board in socialised medical care systems in first world nations. I pointed out that 60% of all personal bankruptcy and 25% of youth debt is related to medical expenses. Want to know something good? Personal Debt in the Most Spendhappy Group Of People Hammers Down Economic Flow of Money. In any economy the money must move and poor people don’t move money if they are in debt because they have to pay off debts. So they spend less and less and less money goes around. Your entire system hammers the poorest. There are a lot more poor people in the USA. Remember those foreclosures that tanked the global economy due to unrestricted free market trade in securities instead of regulating such a blatantly stupid practice? Biggest cause was healthcare related cost. Are you seriously telling me that poor americans are thrilled to bankrupt themselves or place themselves in titanic amounts of debt to survive? What’s the point saying “well I got seen immediately and my doctor was super friendly but now I live in a cardboard box and so will my kids?

    2. Euthanasia? Is that why the UK’s life expectancy is 1.2 years higher than the USA? Funny that. Canada? It’s 1.8 years higher. Ah! It must be socialism! Those euthanasia monkeys are so bad at their job that people are actually living longer! Ineffective!

    3. The AVERAGE physician’s salary in the USA is around 100,000 dollars. Big whoop. UK Average salary is 60,000 quid which is around 96,000 dollars. I don’t know about you but 4,000 dollars is hardly a reason for me to up sticks from my dark island to the Land of the Free (Market) EXCEPT we know one thing. The HIGHEST salary for a doctor in the UK is obviously a lot lot lower but doctors in the USA start off poor. They don’t in the UK. The NHS pays a living wage. Not the 22,000 dollar nonsense that the medical student has to live on considering many have major loans to pay off. And remember, not every doctor earns the 400,000 dollars a year that the spinal orthopaedic surgeon (the highest paid speciality btw) earns. Most earn a rather tame 200,000 dollars which works out roughly the equivalent of our highest salaries for GPs and there is a private sector in the UK where if you so chose, you can go strike out on your own.

    4. The AVERAGE earning of doctors in Canada is actually higher than the USA. Oh the maximum is lower I will grant you that but you seem to think all doctors reach the maximum. No. I am afraid most doctors will be around the Average mark when it comes to earning money.

    5. I repeat. In every single factor apart from “time taken to be seen” a socialised medical system beats the living daylights out of yours. Hands down. There is no contest. To match a level of care in a western nation the US has to haemorrhage money. 300 billion is small potatoes? It’s a saving of 50% on current healthcare expenditure if the USA actually adopted a proper medical system rather than this vampirical system of middle men who’s sole job is to get fat on disease. This is without the follow through issues of harming small business owners by forcing them to worry about employee insurance and the poor. No I am afraid universal healthcare wins hands down. The statistics are crystal clear on superior outcomes.

    And the joke is you claim you aren’t rich and somehow you can afford privatised medical care?

    Universal healthcare effectively means the government is your policy holder and has no limitations on what care you get unless the healthcare outcome is inferior. Doctors who want “money” come to the USA because they can make a lot but honestly? Healthcare doesn’t exist for the doctor. That’s like suggesting that Wallmart exists to give teenagers something to do.

  33. Alex C. says

    @Avicenna

    Spendthrift. “Spendhappy” isn’t even a word. ;)

    Anyway, I agree that the cost of treatment (medicines and procedures both) in
    the US is very high. As I’ve repeatedly said, if the cost can be reduced,
    healthcare becomes automatically more affordable to a lot more people. That
    high medicine prices are sustained by a monopolistic patent system, and high
    medical costs related to fear of malpractice lawsuits by the over-litigious US
    population, have NOTHING to do with poverty, and attempting to solve these
    inherent problems with MORE Government loot cannot be good for anyone. Again,
    the role of Government is to prevent and/or punish dishonest business
    dealings, which it spectacularly failed to do in the financial crisis, and the
    later shameful bailout money given to the criminals responsible. I’ll also not
    buy GM or Chrysler again until they pay back the people’s money with interest
    and apologise (fat chance). If you think, as a doctor, that seeing patients
    immediately and being super friendly is not a worthy goal, I don’t know what
    kind of doctor you are, but I do know that you wouldn’t survive in private
    practice at all without some fancy-shmancy specialty that practically brings
    your patients to you. The No. 1 complaint of patients in a “system” is that
    doctors are either not available, or not interested in their problems when
    they *are* available. Patients (customers?) are prepared to spend a LOT of
    money indeed if you only LISTEN to them, and then do only what you would
    otherwise have done. But a holier-than-thou bureaucrat knows better than the
    patient themselves right? I say GIVE the people what they want—white coats,
    modest manner and a patient ear. That’s only what is required of a doctor. The
    rest is science. And then you wonder why quacks are stealing so many patients.

    Do not twist the euthanasia quote around. The sort of “relentless drive for
    efficiency” that leads to murder euthanasia has, thankfully,
    not been seen for decades, and it probably never was implemented in Western
    Europe (except, you know, the usual Germany, France, Italy, etc.) or the US.
    I’m saying that the Life of a person is more valuable than any billions of
    dollars you may save through efficiency, even if that person is not able to
    pay for any treatment, and especially if they are. You may decide what they
    actually “need”, but you *should* also give them what they *want*, if it does
    not actually harm them, and explain to them why thoroughly, if it can.

    As for the average salary jibe: I’m well aware that doctors in the US are not
    considerably better off financially than their UK counterparts, on the
    average. That is nowhere related to the extravagant cost of medical education
    (actually, ALL professional education) in the US, or to the professional
    slavery that is the Residency system (also in, for example, India). The
    private sector in the UK is hobbled by the mass of NHS doctors, who are
    willing to work for less. Free market in action, this is not, it is the
    distortion of the labour market of physicians. Private practitioners are
    practically *forced* to move up the value chain to areas not covered by the
    NHS. Leaving the middle-class people dependent upon the NHS at the mercy of
    people who know what they “need” are are willing to ignore everything they
    say. (Aside: Dark Island? Really? :))

    Again harping on the high cost of the US healthcare system (due to causes,
    some of which I enumerated earlier) is no defence of Socialism. Again, I’m one
    of those people who believe that saving $300 billion at the cost of patient
    satisfaction is not worth it, while $1 spent on fuel for a bureaucrat’s car so
    she can move half a mile to her office is one dollar too many, to say nothing
    of the untold trillions spent on foreign policy (!). The defective medical
    system needs to be corrected at the source that is high cost: applying
    Socialist Band-Aid is NOT the solution.

    My not being rich (by any definition of the term), and being barely
    middle-class may be a joke to you, O Champion of the Poor Masses, but I’m not
    willing to loot others.

    I say no healthcare is worth it if you don’t feel you get your money’s worth.
    Even if the outcome (measured by quantitative indices) is favourable. This is
    why quackery is so successful. Doctors need to climb down from ivory towers
    and simply LISTEN to what patients have to say. They’re willing to pay (a lot)
    for it!

    I would modify your later statement to read “Doctors who want *honest* money
    come to the US”. Money that the patient actually *gives* them and goes home
    happy feeling that money was well spent. Insurance fraudsters can get rich in
    any country, Socialist or not. If medicine and doctors’ liability costs were
    lower, and they can be—after simplifying the Byzantine US Patent and Liability
    Law, then patients would spend a lot less, while doctors would earn about the
    same. “Healthcare doesn’t exist for the doctor,” unless that doctor is from
    the Govt. and knows what you REALLY need, right?

  34. Holms says

    If you think, as a doctor, that seeing patients
    immediately and being super friendly is not a worthy goal, I don’t know what
    kind of doctor you are, but I do know that you wouldn’t survive in private
    practice at all without some fancy-shmancy specialty that practically brings
    your patients to you.

    In which a non-doctor tries to tell a doctor how to be a doctor and gets laughed at.

  35. dianne says

    US “socialised medicine” is not onerous at all compared to what the Fearless Leaders have in store.

    It’s true that they have yet another damned insurance system in mind and that this does not make me particularly happy. The US has a perfectly good universal medical insurance system already in place. It’s called “Medicare”. Why not just expand it to cover younger people as well?

    Incidentally, if you look at cancer survival in the US versus much of western Europe, the US does reasonably, better in some cancers, worse in others. It does notably worse in what I like to call the “treatment cancers”, i.e. cancers that are curable, even in advanced stages, but only with intensive treatment. In other words, hematologic malignancies. The US tends to have lower survival rates in hematologic malignancies, especially acute leukemia. However, there is an exception: patients older than 65. After 65, the US suddenly looks great-better, even, than some western European countries. What happens at age 65? Hmm…I wonder…

    Also, you may want to update your sources. Your article from Der Spiegel is from 2006.

  36. dianne says

    I say GIVE the people what they want

    Unfortunately, it appears that if you give people what they want, quality of care suffers. Yep. High patient satisfaction is INVERSELY correlated with good care. This makes sense on some level: patients don’t generally know a lot about medicine and therefore don’t have a lot to judge by except things like promptness of appointment and how charming the staff is. But that doesn’t correlate with actual competence. And giving the patient what they want is not always good medicine in general. Suppose, for example, they want the latest drug they saw advertized on TV? It might be wildly inappropriate for them but telling them this is likely to result in lower satisfaction than just giving it to them. They might want high dose narcotics or benzos (without having any indication for them besides a desire to use them recreationally.) Deny them and your satisfaction score goes through the floor.

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