Socialized Medical Care for Veterans:
If private companies had mismanaged outpatient care for veterans the way the V.A. system has, there would be strong calls from all the usual quarters for a government takeover, and proclamations of how we can't trust "greedy" for-profit companies to take care of veterans. Funny how this thought process doesn't seem to work in reverse, except among "free market ideologues," who have been criticizing the V.A. for years.
Related Posts (on one page):
- "People Who Don't Believe in Government Do a Bad Job of Running It":
- Socialized Medical Care for Veterans:
The only good thing the VA gave me was a veteran's ID, which gets me out of most speeding tickets.
Here's John Cole's piece, refuting:
http://www.balloon-juice.com/?p=7939
The real lesson of the VA scandal isn't that this proves that the GOP is right. It's that it proves that the GOP is incompetent.
It's like the sound of one hand clapping.
Today's Army Times reports: "The committee wants to learn more about a letter written in September by Garrison Commander Peter Garibaldi to Weightman. The memorandum 'describes how the Army's decision to privatize support services at Walter Reed Army Medical Center was causing an exodus of 'highly skilled and experienced personnel,'' the committee's letter states. 'According to multiple sources, the decision to privatize support services at Walter Reed led to a precipitous drop in support personnel at Walter Reed.' The letter said Walter Reed also awarded a five-year, $120-million contract to IAP Worldwide Services, which is run by Al Neffgen, a former senior Halliburton official." Fancy that: a former senior Halliburton official.
I would advise y'all holding off yet on exactly *what* the Walter Reed mess is an example of.
So the biggest problem may in fact be political: as the situation at Walter Reed shows, the VA system, and the executive branch in general, has a strong motivation to understate the strains on the military health care system, leading Congress to be underinformed, leading Congress to underallocate resources.
Let us forget whether this tells us something about free market versus government for just a moment. My understanding is that Walter Reed formerly provided excellent care. Just as plausible of an explanation, is that the Bush administration cannot do anything right, because it is run by people like David Bernstein who do not believe in government. It is hard to run something well, when you fundamentally despise the existence of the organization you run. It is kind of like criticizing the idea of FEMA because the current director of FEMA is an idiot Republican more interested in image than results. There is only one conclusion that can be honestly made. This sort of scandal is not all that informative to the larger debate, since it is hard to seperate specific (i.e. Republican) incompetance from theoretically existent systematic failures.
It should also be noted that when corporations are run badly, you don't see a whole lot of conservatives running out demanding an expanded government role. When corporations screw up, conservatives see it as an isolated incident. (Enron and its ilk are "bad apples," nothing more) But if there is a similar screw up in the government, this is evidence of how government is always destined to fail. Does this seem slightly self-serving to anyone else?
Okay. So liberals are probably guilty of their own self serving biases too. (To a liberal, Enron is no mere bad apple, but an example of everything that is wrong with greedy corporations with little accountability.)
But what amuses me, is that conservative/libertarians like Bernstein can only see bias in others. He fails to see it in himself. As when he tries to exploit this incident to advance his free market ideology, when any intellectually honest person would have to say that it is not that informative one way or another. Just as any intellectually honest person would have to say that Enron is not that informative one way or another.
But really, how many times in a day, week, or year do you think someone like David Bernstein questions the superiority of markets for all things? This is a guy who does not believe there should be public universities, even though he works for one. Overall, I do not think we should give much weight to the ideas of people on the left or the right who seem to hold their ideas with a religious fervor. Obviously, when they find "evidence" for their views, their conclusions (though not their evidence) should be dismissed. They always see the evidence for their views, never the evidence against.
Does it not tell us everything we need to know about confirmation bias that Bernstein did not need to investigate this actual incident before suggesting that the problem was obviously one of too few markets?
Exhibit 1A on why ideologues of any type cannot be trusted.
That may very well be one of the worst legacies of the Bush Administration: giving its opponents the impression that only incompetent administration produces governmental incompetence and that competent administration is sufficient to overcome all the inherent inefficiencies of a government monopoly. That's a frightening delusion.
Your right. And for the same reason, we should abolish corporations. You never know when some incompetant will manage to get his or her hands on the steering wheel of a corporation.
In fact, I think the mere possibility of incompetance is reason enough for us to discontinue all activities and hide under our beds.
Brilliant argument. Simply brilliant.
I do wish the GOP would make this one, though.
New GOP slogan:
If the first two points are true - and if we ignore efficiency arguments - they still point to the fundamental problem with a socialist (i.e. single payer) system: it is entirely and absolutely reliant on the single payer's political will to fund the program properly. In a perfect world, governed by Platonic Guardians gifted with omniscience, omnipotence, and the morality and incorruptibility of saints, such programs would always receive the perfect amount of funding to maintain the proper level of services. But in the real world, to borrow Oscar Wilde's bon mot, predicating the success of a program on the appearance of such Guardians represents the triumph of hope over experience. Instead, history and common sense teach us that politicians are corruptible, fallible, prone to misjudgment, and focused on their personal interests which rarely coincide for any time with those of vulnerable constituents. Squeaky wheels get the grease, and I doubt not that the VA and associated medical systems will benefit from this negative publicity with a temporary injection of funds (although, as with all political quick-fixes, the "solution" rarely bears much interest to a program's actual needs), but the essential problem remains: the program remains entirely dependent on the good will and omnicompetence of politicians. In short, the problem is one of monopoly (or monopsony, technically), but in this case the monopoly has the power of government.
In multi-payer systems, where (preferably) consumers themselves, or (less preferably) private companies pay for services from competing service providers, the spirit of competition improves efficiency and (more importantly, from the patients' standpoint) offers patients their own choice among service providers, enabling them to flee to another provider when problems like those at Walter Reed appear.
In short, the original post has it exactly right: the problems at Walter Reed would inevitably crop up in most places under a universal single-payer system. That is to say, private entities are not immune from creating such problems on their own, and private companies are equally (or even more) fallible than the government, and all systems are self-correcting to the needs or preferences of those who foot the bills. Where patients foot the bill, the service providers will endeavor to meet their needs - especially where the consumers have a choice of providers. Where governments or monopolistic private entities foot the billl, however, the service providers care only for the stated preferences of those payers, and needs of patients are recognized by the service provider only to the extent that the payers (government or monopolistic private payer) chooses to pass on patients' complaints and concerns. Those who pay the piper call the tune.
It is a big mistake to think that the Walter Reed problems illustrate the inherent incompetence of government and superiority of markets, as many commenters have rightly pointed out.
Sheesh. Where to begin? You may have noted that Enron failed; it's bankrupt, gone, kaput. When a corporation is run badly, people suffer, yes, but it's a limited number of people, and one generally has other options. Ford and GM may suck, but there's always Toyota, Honda, and Subaru. When the Soviet Union had a state monopoly on automobiles and they sucked, everyone suffered.
The point is the irony that those in favor of government tend to call for further government oversight even when competitors may have avoided (or competition may encourage other firms to avoid) the very behavior/conditions that prompted the call for government oversight in the first place, but a market response is hardly ever countenanced on the left to failures by government providers, even where doing so might produce its own efficiencies and/or expose fewer people to the caprice of the (albeit government) monopolist (see, e.g., school vouchers).
See my post at 10:32. The risks you cite (as best I can decipher them) is largely avoided by (1) a diversified investment portfolio, (2) a plethora of competitors (even in retail--I haven't shopped at a Walmart in goodness knows how long), and (3) tort actions. I've never seen a government program that offers the same three brakes on abuses of the government's monopoly power.
That said, this comment thread is off to a terrible start WRT the conflation of Army and VA hospitals, discussion of the quality of medical treatment when the issue is apparantly facilities maintenance and bureaucracy, etc. I'm guessing not many of us understand the organizations involved here and that it would behoove us all to do research before talking too much about it.
True, which is why the thought of single-payer health care scares the s**t out of me--indeed almost as much as truly socialized medicine does.
I guess the theory is that if the government is basically giving consumers the money with which to buy medical services. That allows for a market to exist. It's in that way preferable to the government simply providing all services.
I know that sounds very much like redistribution (which I imagine I'm more sympathetic to than you), but I think the important difference is the insurance mechanism -- it's redistribution based on illness, rather than based on poorness.
But of course, in this case we are never (I hope to God) going to ask the patients to foot the bill. David is suggesting we turn the military medical care system over to private entities because they will presumably be able to provide care more efficiently and also a superior product. He doesn't explain how this will this will occur, just that it would be. The government would still be paying the bills, and the private companies' first priority would still be profits, not delivering quality care. No matter how much he bitches about government healthcare, the simple fact remains that overhead on government healthcare programs are generally much lower than on private programs.
Yes and no. If a corporation providing you health care screws up, you may not have other options. But in other cases, you are right.
However, in general, government failures, like market failures, are corrected. If those in control do not take action to correct problems, they will be voted out of office. Also, most government failures affect a limited number of people, and one often has other options. If you don't like a particular public university, go to another university, public or private. If you do not like a particular public school, go to another, public or private. If you don't like the post office, use fed ex. If you don't like the DMV, take the bus. Just as in the private sector, you usually have other options. Just as in the private sector, those other options may or may not be attractive to you, assuming you can afford them. Your distinction here, while not totally meaningless, is overwrought.
We have a political process to keep government accountable.
This point is nonsensical. There is competition within government, just as there is competition within markets. Note that the Walter Reed scandal has destroyed the career of a 2 star general and the Secretary of the Army has resigned. They will be replaced by competitors.
It would be as if I complained that when companies like Enron were involved in scandal, that conservatives call "for further market oversight" instead of having the function in question taken over by government. It is an empty criticism, because the market actor exercising "oversight" is different. Likewise, your criticism about "further government oversight" is meaningless, because the government actor exercising oversight is different.
Competition is not the exclusive province of the private sector. Especially at the higher levels of government.
There are advantages and disadvantages to different structures, whether government or market, for different situations. But I don't expect "free market ideologues" to recognize this anytime soon. They will, instead, say that market solutions are always or nearly always superior. And as I said, for anyone who is intellectually honest, their conclusions (though not their evidence) should be discarded and ignored, because they are ideological in nature, and typically not subject to reasoned discourse.
Well, if the alternative is a system that spends 50% more on health care, delivers inferior care and still leaves one in six people completely without health insurance, single payer begins to look like a more rational choice.
It must be very reassuring to be a right-winger/libertarian. You endorse or push through certain policies: the Iraq war, privitization schemes, whatever. Then, if they work, great; it shows you were right because your side had the best policies. If they don't work, you were still right because you knew all along government couldn't accomplish anything.
Several posters have pointed out the Bush administration's peculiar incompetence already. I'll just add that this incompetence isn't accidental. The Bush admin., more than any other I know of, has made it an intentional policy in staffing and running federal agencies, to stress political loyalty over expertise.
The FEMA/Brown scandal was only the tip of the iceberg. That sort of thing is going on all through government, and it's a conscious policy. Read some turn of the 21st Century Heritage Foundation publications explicitly urging loyalty over expertise in federal personnel matters. The most recent example? Look what's happening to U.S. District Attorneys. Then, after competent DAs are fired for making the mistake of prosecuting political allies of the administration and replaced by loyal cronies, look forward to future posts on this blog about how government can't do criminal justice effectively.
inefficient health care is better than no health care.
My wife asked me if Paul Krugman had chimed in on the Walter Reed fisasco.
Actually, it isn't: as I pointed out, many of the facilities referenced in the article are Army not VA. It's not clear to me that the reporters on the piece (one of whom is Dana Priest, who is generally a very good reporter) understand the difference.
Where is the admission that you failed to consider that privatizing support services might have contributed to this fiasco and that you failed to consider that in your initial post, before going off on how this was proof of the need for markets to take over this particular function?
And when the government sector screws up, the usual suspsects call for privatization. When the private sector screws up, the usual suspect say that this is just an example of a "bad apple" and replacing/punishing the particular private sector actor in question is enough.
What I find interesting is not that you have identified a bias in others, but rather, that you fail to see it elsewhere as well. You appear biased in your ability to detect bias.
And if the "socialized" sector does really well, as the VA system has, then we hear the crickets chirping.
Trying to wedge this into a "free-market versus socialization" ECONOMIC question WILLFULLY OBSCURES a searing, and very simple, MORAL question: Our government sent these men and women to war; shouldn't our government take care of them when they return?
Why are so few people from the right asking that very simple question? Why has there been so little gut outrage from the right over the Walter Reed issue? It's because it exposes, so blindingly, the utter emptiness and mendacity of their "support the troops" mantra.
Except that many, if not most, Americans without health insurance receive completely adequate health care when they really need it. Nevertheless, even if you're correct, I'm not sure whether this is a point you want to advertise in the campaign to persuade Americans to follow Canada down the road to socialized medicine: "Vote socialized health care. It'll be an improvement for the 15% of Americans who lack health insurance. For the remaining 85% of you, sure, you'll see a decline in efficiency, but that's a small price to pay, eh?"
Jokes like W's are only funny if they're true. No matter what one labels him/herself, everyone should be disgusted by this administration's raid of the treasury for the benefit of the few.
Some other folks here that engage in not-so-benign neglect here include IAP Worldwide Services, a private corporation that took over operations at Walter Reed last year (same one that couldn't seem to get enough ice after Katrina) and gutted the staff of experienced workers, resulting in "a risk of mission failure" according to an Army Medical Command memo. Its actually far worse than not-so-benign neglect in this case. Its a systematic dismantling of services, driven by the ideology of profit.
Here again, the fundamental lack of moral concern in your response is truly telling.
Depending on your definition of the italicized part of your statement, I call shenanigans. Either people like Deamonte Driver are obtaining "completely adequate" health care under your definition, or your empirical argument is false.
Those of us near the Canadian border can disabuse you of that. Our hospitals have all sorts of Canadian patients, crossing the border to pay for what is supposedly free (but unavailable) for them at home.
Re veteran benefits: "The amounts have gotten to the point where they are hurtful. They are taking away from the nation's ability to defend itself.”
Re veteran retiree benefits: "Benefits that apply mainly to retirees and their families are making it harder for the Pentagon to afford financial incentives for today's military…”
“(Retiree benefits) are starting to crowd out two things: First, our ability to reward the person who is bearing the burden right now in Iraq or Afghanistan. Second, they are undercutting our ability to finance the new gear that is going to make that military person successful five, ten 15 years from now."
So, apparently, our priority is in funding new wars OVER caring for those who fought the old ones.
Whose report is this? Those commies over at Business Week.
Good point -- many seem to. However, the economics on which the "conservative" claims are based is simple and clear: When corporations screw up, their failures are caused by the same forces which will cause similar failures in governments.
Governments have all the same failure modes as corporations, plus unique ones caused by their unique ability to use force. The worst failure modes of corporations -- for example, internal politics -- are amplified in governments. Finally, governments tend not to have the financial negative feedback that corporations necessarily have (however suppressed that feedback might be for a megacorporation).
Too many people in this debate (liberals especially) seem not to realize that governments aren't special. "Market failure" is a concept that applies to government as well as private industry.
Not that this will make an impression on the populist types, but the accusation of 'willful indifference from the President on down' is at least as big a leap as summarily blaming 'government-run healthcare'.
And Micheal Moore isn't the leftwing Ann Coulter, Markos Moulitsas is.
Speaking of Kiley, here's some interesting and relevant observations about him from an article in today's Washington Post: "In interviews, some said he was a deft leader, but others criticized his apparent desire to stick to the budget and increase productivity while sacrificing care.
"His last concern was his concern for the patient," said retired Col. Robert M. Tabachnikoff, chief of obstetrics and gynecology under Kiley at Landstuhl in the mid-1990s. Tabachnikoff said Kiley wanted to discharge new mothers within 24 hours of delivery to keep beds free and counted phone calls as office visits. "
All about the bottom line.
Again, I take it your point is "Vote for nationalized health care, and hope to God the Democrats stay in power. Perpetually. 'Cause otherwise you're screwed." As I commented earlier, even if I grant the difference between highly efficient, expertise Dem bureaucrats and incompetent Republican ones, your argument gives me little cause for comfort at the prospect of expanding government's monopoly power over ever larger sectors of our economy.
And, the name of the magazine notwithstanding, BusinessWeek is no Wall Street Journal, editorially speaking.
All of our Congressional Representatives and Senators should quit posturing and authorize immediately the following:
Include any member of the armed services serving in Iraq and Afghanistan who has been injured or contracted an illness in the line of duty in the Congressional Health Care Program; and
Provide each such member with a volunteer advocate who is an experienced attorney, trained in healthcare law who can help the member steer through any remaining bureaucratic bullsh**.
My legal foundation is now recruiting volunteers for the advocacy program, whether or not Congress acts on the first part of this suggestion.
Please let me know by email or comment if you are willing to help by publicizing this idea or otherwise.
As our underinsured and elderly cross over the Canadian border to get cheap prescription drugs.
Would that include that peculiar religion known as "belief in government"?
And if the "socialized" sector does really well, as the VA system has, then we hear the crickets chirping.
No, that's the sound of tapping feet. Socialized systems fail because they are socialized -- that's their basic flaw -- and they cannot keep "doing well" for long.
inefficient health care is better than no health care.
David, there is the source of your "ratchet". Once the government nationalizes something and the inevitable disaster starts happening, the left keeps in in place by intoning that if the government doesn't provide "X", then there will be no "X". If it weren't for the government, then we'd have no roads, no schools etc.
A milder version of that, used for the slightly more aware voter, is that "only the rich" would have X.... but it's the same kind of willful ignorance of free markets.
Trying to wedge this into a "free-market versus socialization" ECONOMIC question WILLFULLY OBSCURES a searing, and very simple, MORAL question
Free markets versus socialization IS a searing and very simple moral question: freedom versus tyranny. The "free" in free markets and the "free" in freedom are one and the same.
Those of us near the Canadian border can disabuse you of that. Our hospitals have all sorts of Canadian patients, crossing the border to pay for what is supposedly free (but unavailable) for them at home.
When I emigrated to the US from Canada in 1997, I was struck by the carefully maintained ignorance of what was happening in Canada, by American advocates of socialized medicine, especially with the ease of access to Canadian news via the Internet. I made a habit on Usenet of linking to articles on globeandmail.com and thestar.com with hardly any commentary of my own, to greater effect than most argumentative posts, even those operating from valid principles. If I had the time, I'd buold a network of Canadian correspondents and start a blog documenting the continuing failure of the Canadian system.
I'll say it again: socialized systems of any kind fail because they are socialized. Period.
Oh I see willful neglect and lousy management, I just don't follow you in raising it to some sort of conspiracy in the White House to squeeze a few bucks out by making childbirth an outpatient procedure. The guilty parties are lower down the totem pole, and while we can legitimately worry that the administration won't hold those folks accountable, this isn't the kind of thing that the President should fall on his sword over. Chances are that the system worked alright until casualties with long term care needs started to build up, but we're not going to know for sure until an investigation takes place.
The only thing this event demonstrates is that there were some problems in a bueaurocracy. Earthshaking, that.
This isn't an indictment of military hospitals, the VA, the President, Democrats, anybody but the hosptial administrator. This is a single point in space, not an obvious line (up or down). It's an issue because it was made into an issue. Hell, I'm not even blaming our idiotic, generally incompetent press... it's just the event dejeure. I do resent those that are opposed to the war using this as an example of how they really do care about and support the troops, but the Walter Reed Disaster has no real substance at all. It might be the starting point for addressing issues (you know, fixing problems, not blame), and certainly a wake-up call for other facilities to get their houses in order. Those are good things. But indicting (or supporting) any system based on this is kind of stupid (IMHO).
My father in law died of bladder cancer at the hands of the VA. Being an unaccountable government institution; they just didn't care whether the patients improved or not. When he finally got out and into the private sector they diagnosed and treated him quickly but it was too late.
Maybe we would have less of that if the Republicans, from the top leadership on down, hadn't made it a repeated talking point that liberals, war opponents, and Democrats in general really don't care about or support the troops.
Our government sent these men and women to war; shouldn't our government take care of them when they return?
Or should that, too, be left up to the market?
Its easy for free-market conservatives to make abstract, circular pronouncements ("socialized systems fail because they are socialized"). But when it comes to addressing (or even thinking about ) on-the-ground realities of health care for war veterans today (a system that is failing in large part BECAUSE of a privatizing, profit-driven approach to health care prevalent in this administration) - there doesn't seem much appetite for discussion.
No one's talking about conspiracies. We're talking about an ideology of warfare that neglects those who actually fight the war.
You say: "Chances are that the system worked alright until casualties with long term care needs started to build up, but we're not going to know for sure until an investigation takes place."
If the system can't anticipate long-term casualties in a time of war, then there's a problem. The larger meaning here - which is the right wing's utterly disingenuous approach to this entire war - is "How were we to know?" "How were we supposed to prepare for - gasp - long-term casualties?" Please. Its a war! Its the exact same do-it-on-the-cheap approach to health care that Rumsfeld had to warfare.
And again, who pays the price? And again, why aren't the "support the troops" right-wingers paying any attention to this? It's not just Walter Reed, by the way, veterans' health care is a mounting disaster everywhere. Does the right wing "support the troops" only when they go off to die, and not when they come home to recover?
Seerak: is it your position that the freer the market, the freer the society and we the people? If not, I apologize for the mistake and please clarify this point if you will. If so, I strongly disagree.
Coincidentally, I just heard today a report of a study revealing a list of the freest markets in the world. The only ones I heard were nos. 1 &2: Hong Kong and Singapore. Nuff said.
The govt has the army, not private enterprise, owned by a stockholding goup. Are you suggesting we privatize the military? Instapundit merely cites your post of an example to claim that if this were private (the Reed Hospital), the Left would say it ought to be taken over by the govt. In fact, if it were private it would get (1) get away with it (2) get govt subsidies, (3) get swallowed up by another big organization. Now it is nice to think all things can be viewed from a Libertarian perspeictive, but either you want the govt to have a military or you do not. The issue here is that the govt, under Bush, has screwed up the very gujys that have served us so faithfully (I don'[t even get into VA budget cuts), .
Stacy claims that the Right bloggerfs are not ignoring this issue. Oh? Reread Instapundit and note how he shifts the arguement to another issue., refusing to fault the guy and the placw where the buck is supposed to stop Pardon ref to a Democrat).
What is the metric you're relying on here? Certainly, our medical system may not be sufficient to overcome the deleterious effects of our gluttony and aversion to exercise on our longevity stats, but certainly there are far too many factors involved to make that an accurate indication of the quality of the product. Indeed, it's almost as absurd as arguing that the level of traffic congestion justifies nationalizing the automobile industry.
As with the auto industry, I would think we'd be looking at the quality and efficiency of the goods and services that are actually delivered. My Canadian friends would certainly envy me for my ability to schedule an MRI and a sleep study within two weeks of seeing a neurologist (with whom I made an appointment the day before); I suspect they'd've been put on a wait list of several months, at the very least. I'm not sure how this qualifies as an inferior product, but it's one I'm more than happy to pay a 30-40% premium for, thank you very much.
Halliburton... Halliburton, where have I heard that name before? Further, they're implying that it's being covered up:
I don't know, maybe the Army Times is well known for its liberal bias and doesn't really support our troops.
I spent six years in a state ICF/MR (long term care) and ten plus years in the IHS (federal Indian hospitals). They all had the same problems: Red tape and pressure to stay within the budget. And, in contrast to private care, the physical plant is ugly,(ugly concrete walls, ugly furniture, ugly linoleum or carpet) the waits for non emergency care is long due to lack of personnel, and the hiring system to get more personnel is slow.
You have limited physician choice (many foreign docs) and limited medicines. The physical plant can be fixed, but requires a long paper trail of proposal, approval, contract bids, and then it might be done.
If you need open heart surgery, it's great. They will send you to a center that does it or subcontract. If you need less acute care it's not. You wait. Priorities, you know.
Another thing to remember: Walter Reed was so old it had been scheduled to be shut down; I suspect many problems simply weren't fixed.
My solution? Approve vouchers for the non emergency care. That can be done faster than trying to work thru the system.
Alkali, if I mistakenly relied on misrepresentations by the Post reporters, I stand correct. HOWEVER, if we substitute "VA system" for "Army-run hospitals," the point is exactly teh same: when the private sector screws up, the usual suspects call for socialization; when the socalized sector screws up, the usual suspects do some combination of calling for throwing more money at the problem, and claiming that it's all about the incompetence of particular individuals, not the system itself.
Except in the case of the private company running Florida's post-sentence sex offender commitment program, described in part two of a three-part series in today's New York Times. It's screwed up and it's calling for throwing more money at the problem and claiming it's about the incompetence of the system itself, not the individuals who staff it.
It's nice that you can get it immediately, assuming of course it is covered by your insurance or you can afford it out of pocket. And that is the difference. Although 100% of Canadians might have to wait a couple months for a non-emergency MRI, maybe the 70% of the Americans with good insurance can walk right in (actually even we have to wait a week or two for our insurance companies to approve it) and get the MRI. The other 90 or 100 million Americans who would benefit from a non-emergency MRI (and I bet a good number who go to an emergency room who probably should get an MRI but who have lousy or no insurance who need an MRI) are SOL.
are the socialized health care systems "better". how long do you have to wait for diagnostic testing? surgery? what medicines have been developed there as opposed to here? when you make a blanket statement and still don't answer the simple question of what you are willing to sacrifice in the quest to cover that 15% figure you like to throw around,your argument becomes irrelevant and whiny.
The way you judge anything, by results. Infant mortality, heart disease, life expectancy, any measure of health you care to use. The numbers in this country are at best middling. Yet we spend around 15% of our GDP on health care, while the next closest country spends around 11%.
I don't see how this is supposed to represent a failing of the privatization effort. To me it seems the intended outcome. Let's say I run a small business and have a night staff who come in and clean up but I think I am spending too much on them. I find a private company that can do a better job for less money than I spend on my own employees. So I hire the new company to do the cleaning. Would anyone be surprised to find that this was causing "an exodus of highly skilled and experienced personnel" among my janatorial staff? Or that the new contract cleaners were leading to "a precipitous drop in [janatorial] support personnel" at my company?
It seems to me that those are loaded phrases chosen specifically to make it appear that something alarming was happening, when reducing staff support personnel and replacing them with less expensive contractors was the goal all along. I don't see it as an example of a failing privatization effort at all as some here have painted it.
The infant survival rate in this country is better than most any other country in the world. The numbers are inflated in terms of mortality in that premature babies that live only a few hours would be reported as stillbirths in other countries but are reported as live births here. You need look no further than the recent example of Amillia Taylor who was delivered at 22 weeks gestation in Miami. After intensive support she was released from the hospital. That would not have happened in many other countries that have a less aggressive approach to premature infants.
One thing to keep in mind with your MRI example is that the demographic that presumably uses the most MRIs per capita is also the demographic that is covered by socialized medicine in this country, i.e. Medicare.
The other thing is that you seem to be unestimating some of the wait times. We go to Canada most years on a male bonding ski trip. One of our usual guides needed hip surgery or he would be out of work. The Canadian system put him on a waiting list, and he was told it would take 3-4 years. All of course, without pay, since that was his livlihood. So, he flew to India, paid cash, and was back home w/i a week, and on skis w/i a month.
Our attempts to have his records forwarded down from the VA, where he insisted on being treated before, were met with indifference. After I finally created enough of a stir, they agreed to fax them down late in the day. Nothing was legible. The person on the other end made no effort to take the slightest care in providing us with what might have been critical information at that moment.
My father died soon after. I can't say with certainty that the VA contributed to his death but they certainly did not contribute to his health.
It is a national disgrace that the men and women who make the greatest sacrifices for our country are so badly treated.
What, he didn't go to the U.S.?
And on the other hand I tore my ACL skiing at Whistler. My total ER bill, including X-Rays, crutches, and a knee brace was CN $400. A prescription for Tylenol 3 filled at the pharmacy across the street was CN $5. (I presume that if I was a Candian citizen it would have all been free.) A similar ER visit 8 months later in the U.S. for stitches was $2000 (U.S.).
I'm curious, what exactly do these policies cover? Would they pay for an ACL repair? Mine, ten years ago now, cost $25,000, and that was without any meniscus or secondary damage at all.
My parents and brother live in the UK (my family emigrated to the U.S. when I was a baby and my parents returned there when I was in college).
My niece (who is now 14) was born almost three months premature. She is happy and healthy. Her birth weight was just over two lbs and she spent the first three months of her life in a neonatal ICU in the UK in the care of the dreaded NHS. My sister-in-law is from New Jersey and her parents went over and kept insisting that they would help pay for the medical bills. They just couldn't wrap their minds around the fact that all that top notch care wasn't going to cost a penny.
Part of the problem at Walter Read were the very units that were "privatized."
All the rest is simply ideology place on top of a reality that does not conform.
But if private free enterprise is the only way out of this mess, then I suggest that every single taxpayer dollar that is used in any hospital for research or otherwise be immediately re-directed into health bucks. And in the end when all of the health bucks have been spent and there are still poor and untreated sick veterans languishing, please then tell me how your wonderful theories are providing those who have served our country with anything useful.
If government sucks because of the bureaucracy, why do we trust our national security on one of the largest and mot inefficient groups known to man? Why not just hire a private army?
At some point all of the "originalists" and conservatives and "libertarians" have to decide which is their actual deity: our constitutional democracy or "free market capitalism" because capitalism certainly does not care about the commonwealth of our nation.
But of course, let us not blame our fearless "war" leaders. Some sacrifices must be made and anyway this provides a perfect illustration for all of the liberals about why the government sucks.
This is intellectual dishonesty at its highest and I am personally affronted that it is being propounded by someone who has been licensed by the state to teach our youth about law and justice. Bravo.
HILARIOUS. Given the current situation, it's most likely true too
That's ridiculous. Healthcare is an excludeable private good that's in demand. If it's not profitable to provide it, that's because some deus ex machina makes it so. The biggest item ex fee-for-service healthcare is insurance. In effect there is no private healthcare because the person recieving the care rarely or never is the one holding the purse strings.
Decoupling health insurance from employers and eliminating any extant legal requirements for people to be insured would be a good first step towards introducing market forces into healthcare. Nationalizing healthcare providers would be about twenty steps backwards into a situation with even less connection (if that's possible) between service providers and customers.