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Conservative Breaks the Crazy Frame

Rod Dreher is one of the few intellectually honest and relatively non-partisan conservatives. He’s willing to call out the wingnuts for their often crazed rhetoric, including the “ZOMG, health care reform is communism/socialism/fascism” nonsense. He says this on the mandate ruling:

A couple of days ago I heard a self-identified Tea Party member interviewed on NPR about the decision, and she was on the brink of tears, saying that freedom in America is over and done with. I suppose I can perfectly well understand the belief that this is a bad ruling — I know people who really do understand health care policy who say this — but some of the reaction from the Right to the decision has been completely hysterical. All the major European democracies have some advanced form of socialized health care. I do not think they are behind the Iron Hospital Gown.

This is obviously true. Universal healthcare is a harbinger of creeping communism or fascism, even if it’s nothing more than subsidized private insurance? Seriously? Canada has genuine nationalized medical care; are they a communist dystopia as a result? Is England? Or Israel? Or every other Western democratic nation, for that matter? Of course not. The fact that the right throws around such deranged bullshit, and that so many of their followers actually believe it, tells you just how out of touch with reality they are. They couldn’t see sanity from Sarah Palin’s house at this point.

Dreher also points out that keeping the old health care system in America is neither practical nor moral:

Anyway, it seems to me, and has for a long time, that the way we handle health care in our country is pretty irrational. I haven’t thought much about it because I’m not the sort of person who has a mind for policy, and, to be honest, I have always had good private insurance through my employer, and haven’t really needed to use it for anything very costly. If I lost my job tomorrow and suddenly didn’t have insurance for my family, and couldn’t afford COBRA (which doesn’t last forever, anyway), I would be consumed by anxiety over the vulnerability my wife and kids would be facing. Again, I suppose they could be treated at the charity hospital if it got that bad, but that is a far from ideal solution.

Besides, what kind of system pays for the poor and uninsured to receive some level of care, but does so partially by indirectly passing on the costs to those with private insurance (via things like the $25 aspirin)? Even though I’m not a policy guy, this doesn’t make sense to me. And, as a practicing Christian, I find it hard to justify a society as well-off as ours tolerating a situation in which so many people lack affordable, decent health care. Back when Congress was debating Obamacare, I was prepared to believe that Obama’s proposal was unacceptable, but it bothered me a lot that the Republicans had nothing to offer in its place. It seemed to me that they were implicitly denying that affordable health care was a problem.

And they are. As Mitch McConnell said on Fox News the other day, millions of uninsured people just “aren’t the issue.” They don’t care. But not caring isn’t just hurting those who lack health insurance, it’s hurting everyone else too. It’s the principal reason why the U.S. spends far more on health care than any other modern nation while getting far less for it, because millions of people going to the hospital only when they get seriously ill, without the ability to pay for it, costs far more than having those people get consistent and preventative health care from a family doctor. I don’t think what we ended up with in the bill Obama signed is a particularly good solution to that problem, but it’s at least a step in the right direction. The Republicans clearly don’t care to fix the problem at all.

Comments

  1. jamessweet says

    I don’t think what we ended up with in the bill Obama signed is a particularly good solution to that problem, but it’s at least a step in the right direction.

    Not only a step in the right direction, but once we hit Jan 1st 2014 and (effectively) everyone in the US has health insurance, it will become politically untenable to make any proposal which takes that away. The same people who are demanding that the government “keep its hands off my Medicare!” will be livid if any lawmaker so much as suggests a plan that would result in less than universal coverage.

    At that point, getting a good policy in place should be less of a challenge, because we can use “everybody should have decent and affordable coverage” as a BASELINE, instead of fighting tooth and nail just to get to that modest concession.

  2. jerthebarbarian says

    Back when Congress was debating Obamacare, I was prepared to believe that Obama’s proposal was unacceptable, but it bothered me a lot that the Republicans had nothing to offer in its place. It seemed to me that they were implicitly denying that affordable health care was a problem.

    Head*Desk – Head*Desk – Head*Desk – Head*Desk.

    If Dreher did even a modicum of research he would find out that a good-sized chunk of the PPACA that is now known as “Obamacare” started out as a freaking Heritage Foundation plan that was a conservative alternative to single payer back in the 90s. The “individual mandate” – the least popular part of the PPACA when each piece is polled – was called the “individual responsibility mandate” and was the centerpiece of the Heritage plan for controlling costs.

    Of course Republicans didn’t have an alternative to offer – they WON the Grod-damn ideological argument (at least for the near term). We did it the conservative way – the way that keeps the health insurance system as intact as possible and essentially saves it from itself. In a sane political system they’d be crowing about a victory this year instead of screaming about a loss.

  3. chiel says

    As someone who’s lived with a “Socalised” medical system all his life here in the UK, can somone PLEASE help me understand the thinking behind the state of medicine in America ..

    I like to think I’m resonably well informed as to US politics but the belief tht state involvement in medicine is somehow the start of some vast left wing conspiracy baffles me …

    Long before I was beorn so family legend has it, one of my relatives died of a burt appendix, simply because in those days , pre NHS there was no money for treatment.. please tell me that isn’t that the right have in mind for US uninsured?

  4. Johnny Vector says

    Not only a step in the right direction, but once we hit Jan 1st 2014 and (effectively) everyone in the US has health insurance, it will become politically untenable to make any proposal which takes that away

    At which point the conservatives will switch to “The present system was proposed by conservatives, and first implemented by conservatives, and it was the Democrat Party that was against it, and any further improvements to it would be Communism and fascism and and Islamic atheistic argle bargle morble whoosh.”

  5. ImaginesABeach says

    please tell me that isn’t what the right have in mind for US uninsured

    Yes.

  6. Ben P says

    Not only a step in the right direction, but once we hit Jan 1st 2014 and (effectively) everyone in the US has health insurance, it will become politically untenable to make any proposal which takes that away.

    I disagree to a certain extent because I think you’re overestimating the impact of the legislation.

    There’ll be the mandate to get health insurance, with subsidies for the poor to purchase this insurance on the exchanges, and a mandate that more employers offer minimum levels of health insurance, but the latter has a lot of exceptions.

    As far as most people are concerned, however, it’ll basically be the status quo. You’ll still get insurance through your employer, and you’ll probably still pay for it. This isn’t quite a benefits program like medicare or medicaid or social security that provides people direct care that they can easily see.

  7. says

    The GOP hasn’t offered a replacement because there’s nothing comprehensive to the right of it. It was a conservative solution cooked up by the Heritage Foundation and other rightwing think-tanks and implemented by Republican Gov Romney. The only way it is replaced with anything substantial and equally conservative is to pass the same ledge and call it something else.

  8. eric says

    But not caring isn’t just hurting those who lack health insurance, it’s hurting everyone else too. It’s the principal reason why the U.S. spends far more on health care than any other modern nation while getting far less for it, because millions of people going to the hospital only when they get seriously ill, without the ability to pay for it, costs far more than having those people get consistent and preventative health care from a family doctor.

    I agree, but I don’t think you’re going to convince anyone using that logic.

    Let’s face it, when the GOP rejects a democratic President’s plan designed by the Heritage foundation and implemented at the state level by their own presidential candidate, the issue has completely ceased to be about good policy or even compromise policy. At that point, it has become straight-up party control politics. They want it to fail because a failure by the democrats may let them pick up more votes and seats, and content of the bill is largely irrelevant.

  9. Alverant says

    On a related note I found this on Raw Story this morning:
    http://www.rawstory.com/rs/2012/07/06/reagan-appointed-judge-republican-lunatics-made-me-less-conservative/

    I agree that the current health care system is fundamentally immoral because it is profit-motivated. It’s an insurance company’s responsibility to give out money. It’s a regular company’s responsibility to keep as much money as possible. Those are two contradicting goals that have led to legit claims being rejected because they would cost too much. The only way to get real health care reform is to take the profit aspect out of it.

  10. birgerjohansson says

    In regard to rethoric scaring people, I know a sweet elderly guy (who is into adopting abandoned animals, not at all the kind of Gordon Gekko clones who run the Republicans) and he has been scared by the coverage in Fox News etc.

    (I enclose an excerpt from his message three paragraphs below)
    .
    I am concerned about the part about “Seniors with … Medicare advantage plans, and they will be done away with so that the 100.00 I am paying per month will now go to a medicare supplement plan that will cost me 230.00 per month”
    .
    I am an ocean away so I have no way of checking if this would be correct. Is this part correct, or is it all Fox News/ bogus chain mails going “Death Panel” again?
    Yours Birger J.
    .

    Excerpt: “SOME OF THE PROBLEMS THAT YOU MAY NOT BE AWARE OF IS THE LIAR IN CHIEF HAS ALWAYS SAID THAT IF YOU LIKE YOUR INSURANCE YOU WILL BE ABLE TO KEEP IT. THAT IS NOT TRUE THERE ARE MILLIONS OF SENIORS WITH INSURANCE CALLED MEDICARE ADVANTAGE PLANS AND THEY WILL BE DONE AWAY WITH SO THAT BY PAYING THE 100.00 PER MONTH I PAY NOW WILL HAVE TO GO TO A MEDICARE SUPPLEMENT PLAN THAT WILL COST ME 230.00 PER MONTH, AND THE ARE NUMEROUS OTHER THINGS THAT WILL CHANGE REGARDLESS OF WHAT THE LIAR HAS AND WILL CONTINUE TO SAY.”
    …” THEY ALREADY HAVE ANNOUNCED THEY HAVE TO HIRE THOUSANDS MORE EMPLOYEES TO THE IRS IN ORDER TO CHECK ON AND COLLECT THE NEW TAXES AND HAVE WRITTEN OVER 15,000 PAGES OF NEW REGULATIONS TO GO WITH ;THE IMPLEMENTATION OF THE LAW.”

  11. Trebuchet says

    …some of the reaction from the Right to the decision has been completely hysterical.

    Some? Seriously? Unless he means that “some” has been hysterical and the rest is batshit insane!

  12. eric says

    chiel @4:

    can somone PLEASE help me understand the thinking behind the state of medicine in America

    The ‘above board’ GOP answer: my health is my own responsibility, your health is your responsibility, and so on. Every American should be free to choose the health care plan that best fits them – including the “no health care” plan. The citizenry, not the government, knows best what they need, and they should not be forced by the government into paying for something that, in their best judgement, they don’t want or need.

    The ‘below board answer’: this is proposed by a black Democratic president, and because of that we wouldn’t support it even if it was a save-puppies-from-unnecessary-torture bill. If he writes a bill that says ‘the sky is blue,’ we’d still find a way to object to it.

  13. chrisdevries says

    Gotta hand it to all of these socially conservative, Christian bubble-dwellers, bringin’ the JesusLove (TM) to their fellow Americans!

    But seriously, the right-wing fungelicals have been systematically (and with astounding success) dismantling all of the programs provided by the government that result in social mobility and economic success for those who start out with nothing. Education? Funds decimated. Welfare? Becomes workfare. Regulations on lending practices (designed to protect the borrower)? Gone. This kind of perverse social Darwinism has allowed a small minority of Americans to screw everyone else, and while they’re laughing, the stability and prosperity that the middle class once enjoyed has all but vanished. Democracy requires both transparency of government and an educated citizenry capable of telling truth from lies most of the time. But economic instability and growing poverty tend to lead to people striving for meaning and comfort, which is handily provided by local purveyors of irrationality at the nearest church. And as we’ve seen in the past, when religions are society’s power center, bad shit happens.

    I cannot tell you how glad I am to be a Canadian; yes, we have our own problems, but at least our political conversations don’t involve accusing Stephen Harper of being a Muslim or comparing an unpopular new law to fascist rule in 1930s Germany. At least our politically-active crazies are a small enough minority that they try to avoid attention being paid to their delusions in the public sphere, rather than wallowing in them as if anti-intellectualism was a new fad. Republicans don’t even make lame attempts to appeal to the middle anymore; everyone has been so overwhelmed by the stoopid that it has, in a way, become normalized.

    The only way out of the problem, as I see it, is to reverse the damage done. Decimate military funding. Make education outcomes more rigorous, and ensure that students are taught to question authority, to think critically. Raise taxes on the wealthy and create free or highly subsidized job training programs for the unemployed. Amend or withdraw from global free trade agreements to ensure more Americans are making American consumables. And seriously redraw the laissez-faire economic model that has caused most of the damage to both protect the powerless and include all costs (including human and environmental) in the manufacturing of products and the provision of services. If people have to pay the real price, that which is required to pay workers fair wages, that which takes into account the impact of the entire manufacturing process on the environment (i.e. the cost to do it right, without a mess, or to restore screwed-up areas to their original condition), they will think twice before buying something they don’t need. The system has been deliberately broken, and if it’s not put together again, the power of patriarchal, authoritarian religiosity will grow stronger yet as people struggle to cope with the brave new world.

  14. abb3w says

    The phrase “The Iron Hospital Gown” seems a meme really worth trying to infect the right with.

  15. says

    “Not only a step in the right direction, but once we hit Jan 1st 2014 and (effectively) everyone in the US has health insurance, it will become politically untenable to make any proposal which takes that away.”

    That is precisely why the GOP is trying to shoot it down now. It’s like the Church not wanting people to learn how to read, or think critically, because once they start they won’t stop. So too with this; once they have it they won’t give it up.

  16. says

    And they are. As Mitch McConnell said on Fox News the other day, millions of uninsured people just “aren’t the issue.” They don’t care.

    Unfortunately, they do care. Over the last few years I’ve come to the unhappy conclusion that conservatives not only find the suffering of others tolerable, they find it desirable. These are very hierarchical people; they see the lowly as deserving of their low status, and their deprivation as the means by which they are reminded of who they are, and by which the elite are reminded of how much better they are. If everyone gets equal access to health care, gosh darnit, you’re upsetting the natural order of things.

    What we have to contend with here is not simply a difference of opinion as to how best to improve health care (or pick any policy). It’s a matter of those who want to improve the system for the betterment of human welfare versus those who are terrified that the proles might get something they don’t deserve.

  17. John Hinkle says

    The Republicans clearly don’t care to fix the problem at all.

    Well, c’mon. Perhaps you haven’t been keeping up with current events, but there’s this entity thingy called the free markets? The health care problem will take care of itself in the fullness of time, and everyone will reap the benefits. Sure, a few people might needlessly die in the interim, but that’s a small sacrifice when looking at the Big Picture of Totally Free Markets.

  18. says

    It’s the principal reason why the U.S. spends far more on health care than any other modern nation while getting far less for it, because millions of people going to the hospital only when they get seriously ill, without the ability to pay for it, costs far more than having those people get consistent and preventative health care from a family doctor.

    For what it’s worth, I do not believe this is the principal (or even a major) reason why we spend roughly twice as much per capita as other developed nations.

    We have a serious over-utilization problem. Doctors and hospitals are rewarded for ordering up as many tests and procedures as possible, many of which have never been shown to be useful, and patients go along with it because the doctor is an authority figure and the patient isn’t a medical specialist. The insurance industry is supposed to act as a break on this behavior but for various reasons it doesn’t. Attempts at “consumer driven” health care have failed because there is no price transparency, consumers don’t know what they’re getting, and there is no provider accountability.

    There are solutions to these problems. Reward doctors for patient outcomes and not for the number of procedures they perform. Rigorously study procedures that have been used for years and find out if they actually work; stop covering those that clearly don’t. And yes, make sure everyone has access to preventative care. The list goes on.

    Sadly, you will not be getting the Republicans on board with any of this stuff. Aside from their reflexive obstruction to anything that might make the world a better place, getting health care costs under control ultimately requires reigning in the providers, who are ripping us all off. You can count on the Republicans to side with the providers and against the consumers every single time.

  19. says

    The GOP hasn’t offered a replacement because there’s nothing comprehensive to the right of it.

    Their comprehensive alternative health plan is to make Lubbock the capital of the United States.

  20. jolo5309 says

    @eric #13
    I thought the above board was “If you worked harder you would be able to afford it” and the below board was “Fuck you, I have mine”.

  21. chiel says

    Eric & others – many thanks for that ..

    If I could ask a GOP supporter one question , it would be Why is it that every western country , except yours regards the provision of state support in all aspects of health care as essential and you don’t?,

  22. says

    As someone who’s lived with a “Socalised” medical system all his life here in the UK, can somone PLEASE help me understand the thinking behind the state of medicine in America ..

    I like to think I’m resonably well informed as to US politics but the belief tht state involvement in medicine is somehow the start of some vast left wing conspiracy baffles me

    You have to understand that many conservative Americans have a strong libertarian streak when it comes to anything that might impact their finances. This is what has enabled the completely insane default Republican position that anything that tax-related change in the law that increases revenue for the federal government is considered a tax increase (i.e. even closing accidental and ill-considered loopholes) and must be opposed at all costs.

    Personal responsibility is the clarion call, but it’s a disingenuous one at best. Try proposing the legalization of sports betting or online poker and suddenly personal responsibility takes a back seat. It’s really all to do with “I’ve got mine” and if you don’t have yours, then tough, you can’t have anything of mine.

    This has led to all kinds of insane policies like the complete rejection of any serious reform to healthcare, the ever increasing insistence on longer and harsher sentencing, resulting in America having by far the largest prison population in the world, and the insistence (in the face of all the evidence against) that less regulation of the financial markets will fix the problems that caused the recent financial crisis.

    To compound all this, most low information conservatives (most of them, apparently) have a totally distorted view of what’s happening in other countries. According to them, in Britan, the NHS is the only game in town (i.e. you are forced to use them), people have to wait two years for life-saving operations, they will be denied necessary drugs and treatment on a regular basis, and loads of Brits are flocking to the US for their medical care.

    To sum up, the opposition to healthcare reform is not based on rational arguments but on rationalizations designed to obfuscate the fact that they really don’t want anything that might force them to pay more out of their pay packet. (This, in spite of the fact that universal health care would likely reduce their overall outlay.)

  23. eric says

    chiel – I don’t know, but I suspect the might be something along the lines of: its not a coincidence we are the economic superpower and you aren’t. Your socialized medicine is not giving you the prosperity you think it is.

    (For the record, I disagree with that; I’m just playing devil’s advocate)

  24. says

    If I could ask a GOP supporter one question , it would be Why is it that every western country , except yours regards the provision of state support in all aspects of health care as essential and you don’t?,

    Believe me, we’ve tried, but they refuse to hear it. As I mention in my previous comment, the response is usually a litany of gross distortions about the quality of those other healthcare systems based on the worst cases (and they all have them) where people have died or been seriously hurt through cost-restrictions or neglect. (e.g. “death panels”)

    I’ve described, time-and-again, how all my elderly relatives (I’m British) have received wonderful care (not every time, but most) at the hands of the NHS, even (in one case) when the prognosis was terminal — an in-law still received expensive radiotherapy even though it was only to extend quality of life by several months.

    But it goes in one ear and out the other. As does the novel idea that everyone has the freedom to change jobs or start their own business without the slightest risk to the healthcare of their families (many of my American friend live with the fear of losing their health insurance almost every day). And they can’t get their heads around the fact that British people don’t swamp the NHS with their desire to get free healthcare even when I tell them that one of the biggest problems NHS family doctors face is people not showing up for their appointments!).

    It’s as though the rest of the democratic world doesn’t exist. Any appeal to international laws or policies is decried as socialist or anti-America, even when they are clearly superior to the American counterparts.

    Many conservatives seem to believe that *any* (further) implementation of liberal or even moderate policy will mean the end of America as a nation, even though there are dozens of nations doing very nicely under far more liberal laws and policies.

    And on the off-chance you manage to get one of them to accept that devil’s-spawn nations like Sweden and Denmark (they’re full of atheists, doncha know) are doing well under far more socialist policies than the US will ever have, they just mutter darkly about God judgement will not be rushed (i.e. they’ll get what’s coming to them, one day).

    As I said before, you simply can’t use rational arguments with these people.

  25. birgerjohansson says

    d cwilson,
    Thank you,
    I will link to the article and tell him he is not going to be robbed. ;-)

  26. Ben P says

    I agree that the current health care system is fundamentally immoral because it is profit-motivated. It’s an insurance company’s responsibility to give out money. It’s a regular company’s responsibility to keep as much money as possible. Those are two contradicting goals that have led to legit claims being rejected because they would cost too much. The only way to get real health care reform is to take the profit aspect out of it.

    You can call me a heartless bastard, but I find this argument utterly unconvincing. IMO a universal healthcare system stands or fails based on policy grounds.

    In short, healthcare is most often something that someone else provides for you, and that you don’t have the capability of providing for yourself.

    I don’t believe you ever have a fundamental right to have some other person provide services to you, because then that right exists independently of any compensation. Flipped around the *right* of someone to receive healthcare becomes the legal obligation of a medical professional to give up their own specialized knowledge and time without compensation, and that infringes on the rights of the doctor.

    Now, don’t get me wrong. I think the government absolutely should have in place a system where people are not denied medical care based on ability to pay, and I think that on policy grounds some level of universal healthcare brings a great benefit to society.

    But I don’t base any of that on the idea that there’s a fundamental right to healthcare.

  27. says

    But I don’t base any of that on the idea that there’s a fundamental right to healthcare.

    In that case, defining almost anything as a “fundamental right” is fraught with difficulty.

    But let’s take a look at the “right to water” as defined by Wikipedia:

    When taken as human right, the right to water places certain responsibilities upon governments to ensure that people can enjoy “sufficient, safe, accessible and affordable water, without discrimination” (cf. GC 15, below).

    Now, substitute “health care” for “water” and you have a not unreasonable basis for implementing some form of universal health care system. They key word here is “affordable” which strongly implies that those providing the service will be compensated for their time and skills.

    Does that make it a fundamental right? I don’t know. If they don’t have any money, is leaving a sick person dying on the street any less objectionable than refusing to give a man dying of thirst a drink? Does the difference in the cost of the life-saving measure change anything in a nation that could easily afford both?

    In practical terms, we’re almost there anyway. We require hospitals to treat those who show up with actute life threatening injuries and illnesses (we can’t have people dropping dead in public after all), and we have already decided that we can’t allow the elderly, and children, and veterans to go without solely because they don’t have the funds to pay for it.

    If calling health care a right, or even a fundamental right helps gets us the rest of the way, then I’m fine with that.

  28. Michael Heath says

    tacitus, there is any easy way to distinguish rights.

    We of course have a right to health care and that right is fundamental. Our rights are both inalienable and uncountably many. But that fundamental right doesn’t extend to compelling other individuals to limit the exercise of their rights so we can enjoy consuming health care. For example, our right to health care doesn’t as a matter of rights alone require an increase in others’ taxes in order for us to enjoy the exercise of that right. So from this perspective our right to health care is a negative [fundamental] right.

    Liberal FDR argued all the way through to liberal Nancy Pelosi, that Americans have a right to access health care even if they can’t pay for it. Even millions of non-liberals agree we should institute policies to create and secure the practice of this right. But this is a debate about policy, not about rights except in the context of promoting legislation to create a positive right. A positive right is a right some enjoy at the expense of others.

    I happen to think we should create a positive right to access and consume health care, but we should never falsely conflate this positive right with a fundamental [negative] right. Largely because positive rights require us to win by way of legislation which demands our focused attention and energy. From this perspective if we achieve universal access to health care, we should be even prouder of ourselves for having done so because the creation of positive rights through prudent policy in today’s U.S. is so much more difficult to achieve than the protection of our negative rights.

  29. jesse says

    @Area Man et al

    THe reason health care costs a ton in the US — and why we spend so much are partly what you say — rewards for more procedures rather than outcome. But there are a couple of other twists.

    Over-utilization isn’t just that hospitals get paid (indirectly) for procedures — it’s that health, unlike other kinds of goods, is cheaper when people use it more often. That is, if we had some system in which doctor visits were free (hmmm….) and there was no worry about visiting one, then even though a few hypochondriacs would waste a lot of time, most people would be cheaper to treat. Why? It is far cheaper to treat just about any disease early than late. Just look at the numbers for TB: the initial prophylaxis is pennies per patient. Treating you when your lungs are bleeding is tens of thousands. Heart disease? Go to a doc who says “you know, lay off the cream cheese bagel for a few months and we’ll look at you again” is a lot cheaper than treating a heart attack. This holds true even in a regime where there is a lot of over-testing.

    It’s also worth saying that cost controls can happen in a number of ways. One is denying service. The other is efficiency. Economists bitch about price controls but they can be used effectively as a way to see who is more efficient. This is what they do with health insurance in Switzerland and Germany (I think– the German system is a bit more complex). If you say, “you can charge $X for this service, and you must provide the following minimum standards” an insurance company has to make more profits by boosting efficiency, and compete by offering better service. We see this phenomenon with many commoditized goods — ones where the price tends to fall to a certain level and there’s no way to differentiate based on the product itself. Food, for instance– you go to a supermarket based on selection, based on convenience, a load of other things because the price for a lot of stuff isn’t going to differ a ton. With health care the issue is that one side in the transaction has basically infinite pricing power on a good that you can’t shop around for the way you can for a blue light special on bananas. Prince controls a la Switzerland force that a bit.

    There are other things as well: insurance companies are basically rewarded (profit) by being less efficient under the US system. Insurers make no money at all when they pay a claim. So they employ thousands of people whose job is to find a reason to deny funding. It is cheaper to pay a bunch of temp drones $20 per hour and have them work all year than it is to pay out a few claims for major surgery. Patient dies? So what. (And yes, this kind of thing has happened. The insurer will find a reason not to fund something and dick you around until you die or give up and pay out of pocket).

    This is one reason why technologically speaking the US us pretty good, but outcomes-wise we are not so hot. Our infant mortality rate compares well with places in the developing world (though Costa Rica’s is better IIRC). Break it down by which areas are poor (like West Virgina, Arkansas) and we look even worse.

    To me, the simplest and most efficient solution is Medicare expansion. Medicare operates pretty efficiently. It has its problems, but it works. And because the pool of people is larger it’s more cost-efficient. Absent price controls you want more people in any pool of insured. Wyden proposed this but the Democratic leadership made sure he was ignored.

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