The US is one of the better off developing nations

If you make a ranked list among developed nations on how well the US is doing in health care, we are towards the top of the list. If you hold the list upside down:

Americans live shorter lives than citizens of almost every other developed nation, according to a report from several US charities.

The report found that the US ranked 42nd in the world for life expectancy despite spending more on health care per person than any other country.

Overall, the American Human Development Report ranked the world's richest country 12th for human development.

The study looked at US government data on health, education and income.

The report was funded by Oxfam America, the Rockefeller Foundation and the Conrad Hilton Foundation.

The report combines measurements of health, education and income into one measurement - the human development index - based on that used by the United Nations.
Health insurance. (BBC, h/t reader "slovenia")

The US has higher infant mortality than most developed countries and within the US there are substantial gaps. We've come to expect southern states like Mississippi and Alabama to be more like third world countries in all kinds of human services, including health care, and indeed as states they are down near the bottom. But it's not just the usual suspects. Ranking the human development level (income, quality of life, health) in 436 congressional districts, the bottom slot is held down by Fresno, California. Their income is only a third of the top district. Among rich nations, the US has more children living in poverty than any other (15%). And, of course, we have more people in prison.

Health experts have suggested at least two reasons for the poor health indices of the US population. One is obesity. I'm not sure about that one, although some data from CDC just released are at least congruent with that idea. Mississippi holds down the bottom spot for states (as opposed to congressional districts) and it also is the fattest state (Alabama and Tennessee are almost as bad; all have more than 30% of their population with BMIs over 30, the CDC definition of obesity). The other is lack of adequate health care because of inadequate health insurance or access to medical care. Every other wealthy nation has universal health care. And they have healthier people.

But maybe there's no connection. After all, as we are always reminded, correlation isn't causation. Right.

More like this

by Kim Krisberg When it comes to good health, America is far from top dog. Yes, we may spend the most, we may have some of the most advanced medical technologies and we may produce some of the best doctors. But when it comes to the ultimate measure of a health care system's success — the health of…
[Another post from two years ago. Everybody is talking universal health care now. Two years ago, nada. Well, almost nada. Below is what we said then (and continue to say, now). But first this, to show the original post is still current: Americans are living longer than ever, but not as long as…
To start off some balanced discussions of what universal health care looks like around the world, I thought I would begin with Australia, a system that we could learn a great deal from. In the US system, we do not have universal healthcare, we have mostly employer-subsidized healthcare, private…
It's a myth that's hard to bust. The one that says the United States, the country that spends more on health care than any other, has the best medical care in the world to go with it. It hasn't been true for a long time. It doesn't. But it is part of the core belief of most Americans. I wonder who…


How much does demographics (age, race, gender, and income of population, say) affect this? I honestly can't see any way that would radically change the picture, but I imagine it could have some effect. (But aren't most other first-world nations graying at about the same rate we are?)

I am curious how much of this is about our healthcare system, and how much is about all kinds of other stuff (we have more gun crime and more prisoners, frex).

By albatross (not verified) on 18 Jul 2008 #permalink

albatross: Good questions, but as to the last, I think the prisons are stuffed mainly because of our insane drug laws.

Do you know if the actual results are available, or just the media blurb? I found (which seems to be the source for the BBC report you link to) but it's $16 for the whole thing, and the only seem to offer "executive summaries" and so on online. I'd be interested in their methodology, as well as the detailed comparisons.

(Certainly their conclusions are entirely in line with many previous studies on American health care compared to other countries, but as Darwin said, it's the conclusions you agree with that you should look hardest at.)

We spend more money on health care than other countries, but don't have a lot to show for it. From Gerard Anderson and Kalipso Chalkidous's May 2008 JAMA editorial: "Most analyses at the institutional level have reached similar
conclusions. One study found that while expenditures
varied by up to 60% across academic medical centers,higher spending did not necessarily lead to improved health outcomes. Analyses at the individual physician level often reach the same conclusion. For example, increased spending by individual intensivists caring for critically ill patients does not correlate with better mortality rates or shorter stays in the intensive care unit."

We are wasteful and our efficiencies are terrible.

That's what you get when you let the "system" optimize profit rather than health outcomes. We need to tell our legislators to quit worshipping at the Church of the Chicago School of Economics when it comes to taking care of the sick. Free enterprise works fine most anywhere else. In health care, not so much.

No need to jerk the quadriceps here, you can run a health care system in the non-profit sector, with publicly negotiated rules. The only role of government is to make the rules legally binding and enforce them.

By dubiquiabs (not verified) on 18 Jul 2008 #permalink

One thing to keep in mind here folks is that this whole report is very slanted to the far left as it was perpared by a socialist organization.

That said it does have some good points that it makes. Our society does have a lot of obese folks. We have an advertising industry that promotes junk food and food that makes you hungry for more of it. These formulated foods that trick your brain and system into wanting to eat more are engineered by chemists in the food industry to taste great and also to make you feel less full and to want more of them. They are very high in calories usually and they make you pack on the pounds. Buyer beware.

Our prisons are packed full of people that are there for breaking drug laws. We as a society have the government and the courts telling us that these drugs laws must be enforced to protect society. Yet, there is a constant supply of drugs and a a constant supply of drug use violators in society. Drugs are cheap and there are millions of drug users and there are hundreds of thousands of drug sellers. This is somethng that is not going away and half of the people in prisions are there because of drug laws that they violated. If you had no people in prison for drug laws, then the whole picture changes. The U.S. would not have the most people in prison. The only people in prison would be the violent offenders and the thiefs. Then again, does society want to condone the open and free use of drugs in all forms? This is the trade off to reduce crime, but you will have a lot of overdose deaths if you go this route.

The cost of health care is out of hand. I have seen what the imported cost of some of the items that hospitals use. Some of these companies make their stuff in Mexico for $3.00 to $5.00 and turn around and sell it to the hospitals for $50.00 to $100.00. Then the hospital marks it up another 50% when you get your hospital bill. That is pure greed and that is what is driving the cost up. The doctors have high costs because they have to pay off student loans that cost them in the hundreds of thousands of dollars for 8-10 years of school to get their degree and training, then they have malpractice insurance that is astronomical, plus add on association fees, office expenses, rent, staff fees, etc. You think they don't earn their $200.00 to $300.00 an hour? They're professionals like anyone else and they earn they're money honestly. At least most do. The health care industry works and is good, maybe is one of the best in the world in my opinion. Access to it is another thing.

Having health care insurance is a wonderful thing and having good job that gives you this insurance is a wonderful thing. I am lucky and have this now. I have been in a position before of not having any insurance at all. I do not believe the government and the taxpayers should provide universal healthcare. All this cradle to grave crap that the socialists want the government to provide is making people dependant on the government and making their souls weak. Free money, free food, free place to live or reduced rent, free health care, ("oh please take care of me big government, I'm so helpless"), makes a weak society ready for the communists to take over or a tyrant to take over. No, I believe in the independent spirit and doing things for yourself. I don't need handouts and weak kneed people around me. Universal healthcare is bad for America as it is the next step to our downfall as a society. We need to start fixing our messes instead of adding to them.

By bigdudeisme (not verified) on 18 Jul 2008 #permalink

bigdude: Which of the three is "socialist" and why? (not that it matters to me, as I am a Democratic Socialist, but just wondering what your criteria were and what difference it makes). But I agree about not wanting to pay for the military.

All this cradle to grave crap that the socialists want the government to provide is making people dependant on the government and making their souls weak.

Yeah, losing your house in order to pay medical bills after an auto accident, or cancer, or a stroke is good for the soul, alright. I can feel myself getting more masculine and vigorous just thinking about it.

It's nice that you're "lucky" enough to have healthcare. But luck doesn't seem like a very good basis for apportioning medical treatment in a civilized society.

So God didn't give you medical care when you came out of the womb you sick cry baby? How about going out and getting some yourself! That is my point. I have had no health care before and it is not a good thing when you do have a problem like when I rolled my car. I thank God for health insurance now. I got myself a job with health care. I didn't ask society to provide me with health care. I don't expect big brother to hand me a package of health care. I got off of my ass and went out to work and found a job that gave me health insurance. I am lucky only because I made it happen buddy.

Now Revere, I think I am answering your question in "what one of the three is socialist"? I think I rattled off four to be exact. " Free money, free food, free place to live or reduced rent, free health care". But, we were talking free health care now were we not? Thgat is a socialist agenda item these days, all wrapped up in the "Universal Healthcare" mantra. Chant with us now.

All well and good if you want to wait forever for your operation to happen like up in Canada where you have to wait for 3 to 6 months for an operation that you get on a list that takes 7 to 10 days here in the United States. Heck, you could die in 3 to 6 months from complications. That is why a lot of Canadians do their surgery here in the United States and just pay for it out of pocket. Socialist medicine can kill you if you just wait around long enough.

By bigdudeisme (not verified) on 18 Jul 2008 #permalink

Are these guys Oxfam America, the Rockefeller Foundation and the Conrad Hilton Foundation part of the "Think Tank" bozo's?

bigdudeisme: Agree with you on the health care issue however, disagree with "but you will have a lot of overdose deaths if you go this route".

This will only last for a one or two year period and then the initial motion will back down. On the other hand, there are tons and tons of responsible user's.

As far as the obese thing in America, it is the poor quality of food but it's also that many American's are depressed (and don't have the nerve to admit it).
Yes, depression will add to weight gain.

Lea: No, they are three (quite famous and reputable) charities.

bigdude: I'm glad you have health insurance, although I have a bit of a problem. I don't know whom you work for, but if I use the services of your company or buy any of its products I am paying for your health insurance, which I object to on principle. It is essentially a sales tax on me which I do not wish to pay. Since your company probably has competitors, they may soon dump your insurance benefits anyway, and I'll be happy because the price will be lowered. Until then, though, they and you are screwing me and all the customers. That doesn't seem fair, does it?

Bigdude: if you're so keen to pay your own way, why are you paying into insurance at all? Shouldn't you save, invest, and pay for procedures as they come up?

Insurance *is* socialised. You all support each other with your contributions. You are already subsidising the sicker people who use your insurance company, just as healthier people in that company are subsidising your own care.

The difference is that you are excluding people on lower incomes. I can only guess you hope to have better outcomes by keeping the medical resources to yourself. In effect, you are expecting a better outcome by letting others die.

When did honour and dignity leave America? When did idealism become a dirty word?

In any case, unless you are on a very high income you are still screwing yourself - universal health care is cheaper per person, and gives a better outcome. So not only are supporters of the present "free market" system acting in a contemptible manner, they are acting contrary to their own best interests, and even damaging their country! The massive waste that the present system represents over a UHC is nothing but a drain on the economy. It could be better spent on, say, more wars. Or whatever.

bigdude said:
"...this whole report is very slanted to the far left as it was perpared by a socialist organization."

revere said:
"bigdude: Which of the three is "socialist" and why?"

bigdude said:
"Free money, free food, free place to live or reduced rent, free health care."

bigdude, I might be wrong, but I don't think that's what revere asked. You claim that the American Human Development Report is a Socialist organization. It is in fact funded by at least the three organizations revere mentioned above. It looks to me like revere is suggesting that implicit in your claim is an accusation that at least one of these three organizations is a Socialist organization as well. Is this true and why?

From Ron Paul's book The Revolution A Manifesto: In "From Mutual Aid to Welfare State: Fraternal Societies and Social Services", 1890-1967, historian David Beito uncovered some of the story of how people once cared for their needs in the absence of massive bureaucracies and the financial chaos and moral hazard they inevitably cause. Beito focuses particular attention on fraternal organizations, which in decades past provided all kinds of services for their members that we now assume must be handled by government. With strength in numbers, such organizations were able to negotiate with doctors and get very inexpensive health care as well.
On the other hand, just about everyone is unhappy with the health care system we have now, a system some people wrongly blame on the free market. To the contrary, our system is shot through with government intervention, regulation, mandates, and other distortions that have put us in this unenviable situation.

"...massive bureaucracies and the financial chaos and moral hazard they inevitably cause."

Inevitably? How do you measure it when you've got many examples of working, efficient "socialised" healthcare systems operating around the world, but - apparently - no true free market system to compare it with? I can see how you might be able to suggest that a free-market system might be able to work better - I'd disagree, but it's a valid argument. But how you can be so sure is a bit beyond me. UHC systems are already pretty efficient compared with other industries, and wildly more efficient when compared with the present US system. How can we be so sure that a more free market system will be more efficient again?

Free market principles don't really apply to basic healthcare, because no-one chooses the option that means they get to watch their kid die, no matter how much money they save. "Free market" healthcare is either a means test or a crap shoot. Pretty much everyone automatically gets the best healthcare they can afford, and anyone who chooses to save money on it does so in the hope they won't suffer for it - they gamble.

How many proponents of the free market want to reduce their cover, but can't? None? People don't want to be more exposed. No-one wants that.

Further, there are no "acceptable" compromises in basic healthcare - there is either the scientifically determined best practice, or there is sub-standard care that risks lives. I can buy the cheap brand of tuna because I don't mind the taste. I can get a cheap car because it suits my needs. But all human bodies have the same needs when it comes to healthcare. If you need a heart transplant, you can't buy a cheapo dog heart and do it at home. You can't get your tonsils out instead.

In healthcare you don't save money by getting a different colour. You don't get a different operation to fix something cheaper. You don't get to put off life-saving procedures while you save up for them, or wait for the procedure to get cheaper, because the risk you are taking is death. You can't buy a second-hand operation, or a slightly damaged one from a discount store.

An operation should be exactly the same for everyone - there is one, and only one, best option, and we all have the same organs, the same diseases, and the same desire to live. The only areas regular competition is valid is in elective surgery and "comfort" - areas where you have real choices.

And that's the system we have in Australia. The UHC covers life-saving stuff. We all pay into the fund, and we all get the same level of care. Note that this is at a higher level than the US for a much lower cost. No-one has to worry about losing their life savings - open heart surgery costs not one cent.

We then have a parallel private system - if you want to skip the queue for elective surgery, you either have "insurance" or you pay directly to the hospital. These costs are still mostly covered by the UHC (since you would have got the treatment anyway, you're just paying extra to skip the queue and to get better food, nicer rooms, etc).

Life saving stuff, though, has to have the same outcomes for both systems. You can't "pay" to live when some low-income person would have died. And I honestly cannot understand how anyone would think that is an acceptible situation. Are we equal, or not?

Absolutely no disrepect meant whatsoever, it amazes me how someone from Australia thinks they know what is best for our country. (Ignore that comment Victoria).

This is what I say to American's; settle for your typical Democrat or Republican, just like the ones the oligarchys have selected this time around, AGAIN, and let's see how far health care changes in the US these next few years. If it does change it certainly won't be for the benefit of the majority, just the benefit of the rich.

in Canada where you have to wait for 3 to 6 months for an operation that you get on a list that takes 7 to 10 days here in the United States

bigdudeisme: That's simply wrong. There are many comparisons of waiting times in the US vs. Canada, and in almost all cases they're comparable. Business Week (maybe you'll call that a socialist organization too?) said that "American people are already waiting as long or longer than patients living with universal health-care systems" (June '07). Aetna Health Care says that in the US "people are waiting an average of about 70 days to see a provider. ... In many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable."

Some operations do have longer waits in Canada than the US (hip replacements; cataract surgery; MRIs were a huge problem for a while, and I don't know if that's completely resolved yet); but you don't waltz in for a hip replacement in 7 to 10 days in the US.

This is all supported by the simple fact that, disease for disease, outcomes in Canada are virtually identical to (or better than) those in the USA.

There are pros and cons to the Canadian health care system; parroting propaganda that's long since been disproven is no way to make your case.

This may be a bit roundabout, but here goes...

Nouriel Roubini, an Economics professor who was one of the most vocal Cassandras of the current Housing bubble had an interesting article regarding Fanny Mae and Freddy Mac. (Article is here, but requires a subscription. I read this through another blog, but cannot find the post now. =P )

The article suggested a metod by which Fannie Mae and Freddie Mac could be salvaged without the collapse of the banking system, or the "Mother of all Moral Hazards" caused by socializing the risks and privatizing the profits. He suggested that the US government was practicing the most dishonest form of socialism by doing this. His solution, by the way, was by nationalizing the programs, and ensuring the loss to shareholders would be much less than the potential destruction the two financing firms are currently facing.

It made me wonder just how many "socialist" systems in the united States have wound up with this "Dishonest Socialism". How many branches of government have been farmed out to for-profit industries with crony appointments and unfettered monopolies? Our healthcare system easily fits into this category, as does the modern military with it's endless civilian contractors like Blackwater.

Part of me wonders if this cultural fear of socialism in America is partly because of the modern exposure to this sort of crony capitalism socialism that has largely replaced the old New Deal structures over the past 30 years.

What difference does it make? When every other developed nation on earth does it better than you, maybe it's time to ask them how. Instead I see so often in American debates the belief that it "can't possibly work", while the rest of the world points to it working and says "LOOK!" To which you answer "who the hell are you?"

Insular much?

But feel free to explain why an American's liver is different to an Australian's. I mean, the commonality of all people was kinda the point of my post, which your response spectacularly ignored. Was it intended as irony?

Australia is an especially good example because we have such a similar system of government - since when we federated we stole a big chunk of your system (ie looked outside our own country for ideas - ZOMG!). So ours is built around a Federal government providing funds to independent state governments, with their own systems and budgets, just as in the US. If it works for us, it should work for you.

But of course you have reasons for enjoying the knowledge that your countrymen are suffering unnecessarily. It's a cultural difference. Of course! Foolish foreigner. What could I know of human misery? Of decency or compassion or simple fairness? Those are words owned and patented by the US, right? And America has perfected the secret method for making an inefficient, failed system, littered with fiscal waste and ruined lives, a BENEFIT to the economy.

If only I'd known.

Err, sorry, my post above in response to: Absolutely no disrepect meant whatsoever, it amazes me how someone from Australia thinks they know what is best for our country. (Ignore that comment Victoria). which I chose to find disrespect anyway.

Having a bad day are you Magpie? Geez-ohs.

Ludwig von Mises once said: government interventions create unintended consequences that lead to calls for further intervention, and so on into a destructive spiral of more and more government control.

The most obvious way to break this cycle is to get the government out of the business of meddling in health care, which was far more affordable and accessible before government got involved.

Ron Paul shares in his book (same as listed above): I had a chance to meet Dr. Robert Berry, who had come to Washington to offer testimony before the congressional Joint Economic Committee, of which I am a member, Dr. Berry had opened a low-cost health clinic in rural Tennessee. The clinic does not accept insurance, Medicare, or Medicaid, a policy that allows Dr. Berry to treat patients without interference from third-party government bureaucrats or HMO administrators. He and his patients can therefore decide for themselves on appropriate treatments.

In other words, Dr. Berry practices medicine as most doctors did 40 years ago, when patients paid cash for ordinary services and had inexpensive catastrophic insurance for serious injuries or illnesses. Doing so affords him additional advantages as well.

Freed from the bureaucracies of HMO's or government, he can focus on medicine rather than billing. By operating on a cash basis he lowers his overhead considerably, thereby making it possible to charge much lower prices than other doctors. He often charges just $35 dollars for routine maladies-only slightly more than the insurance co-pay that other offices charge. His affordable prices enable low-income patients to see him before minor problems become serious, and unlike most doctors, Dr. Berry see patients the same day on a walk-in basis.

Those who favor national health care schemes should take a good, hard look at our veterans' hospitals. There is your national health care.

Lea--We really should walk the halls of our VA medical centers and actually interview patients, staff and doctors.

Wasn't it the VA hospital in Pittsburgh PA, that eliminated 80% of its MRSA infections, and led the way for the rest of the private plan hospitals, which couldn't even post improvement results? They were still comfortable with MRSA as an unavoidable side effect of a hospital stay. It was in the culture, and accepted.
Our culture will also have to change, to bring about a real working model for health care, but it starts with the VA, and yes, you may have to sit next to a smelly, bearded homeless person (who is not there for care, but is also not turned away at the inn... er, door.)You need not worry about mixing with the lower class, as there are working examples of premium plans in UHC covered countries.
The VA took wonderful care of me when I needed surgery for hernia (4 day wait, total cost for surgery was $250) and for years after with primary care, yearly physical checkups, etc. All for a very affordable price. Sometimes I showed up late for an appointment, but still was seen in less than 30 minutes.
What you see in the news is often the worst-case scenario, distorted way out of reality... Not every VA hospital is as bad as the disgraceful lack of care for our Iraq war vets unlucky to be sent to overcrowded centers, ignored and told to "suck it in" only until a crisis hit the press, and then of course, it all becomes political CYA.
No one wants to appear as if they don't care for our vets when they rotate back home with a career ending injury, and no longer useful to the war effort. For those who paid the ultimate price, it's easier (especially for our politicians) to be patriotic at a funeral, or on memorial day, since they only need to genuflect, and then on to their own lives, and not have to deal with those troublesome, costly survivors.

Not to mention the thousands of soldiers whose medical history were checked via the "Patriot" Act before they shipped out to the war zone, and then denied medical treatment, especially psychiatric treatment, due to pre-existing conditions, often based on the thinnest of reasons. Sounds like our govt getting into the business of denied claims, taking a page from private plans. Our govt using terrorist tracking tools against our own soldiers fighting those very terrorists. Typical. Add that to the Catch 22 list.

Increased PTSD was of course obvious from the start of OEF and the invasion of Iraq; soldiers are given anti depressant drugs like candy in combat zones to this day, greatly increasing the need for treatment back home. Little planning and scant few doctors hired, there seems little concern from those in "command" to spend the hard fought increased budget dollars for those most in need.
The problem is political: the money exists, just not leadership. On the ground, in reality, many good doctors are donating their services, showing the kind of leadership so sorely lacking with the current CIC.

Our local VA hospital has been regularly filled with overflow from the other non-VA "competitive" hospitals, since the population is rising and good, old fashioned hospitals have been razed or turned into outpatient clinics. Without the VA, where would those private plan patients stay?
The solution to our healthcare problem is all around us, and starts with the VA model. It will take a change of attitude, a cultural change, construction of new hospitals in every city (new jobs, good paying jobs) and a redirection of the thousand billions spent on bombs toward more constructive methods.
And there should also be room for doctors who want to opt out, no doubt they will be more effective on the local out-patient level.

So God didn't give you medical care when you came out of the womb you sick cry baby? How about going out and getting some yourself! That is my point. I have had no health care before and it is not a good thing when you do have a problem like when I rolled my car. I thank God for health insurance now. I got myself a job with health care.

Ever hear the term "preexisting conditions"? Ever heard of coverage being denied to, say, asthmatics? Ever heard of companies cutting benefits, or co-pays and premiums rising beyond what people can afford? Ever heard the term "market failure"?

We're trying to deal with the real world here, not your jerkoff vulgar-libertarian candyland.

As for God, "As you do unto the least of these, so you do unto me."

All well and good if you want to wait forever for your operation to happen like up in Canada where you have to wait for 3 to 6 months for an operation that you get on a list that takes 7 to 10 days here in the United States.

I've lived in Canada, pal. That's not quite what happens there. Or here, for that matter.

Those who support or argue for the status quo or minimal changes (US health care) often fall back on "life-style" issues.

The issues were fabricated in the first place to make ppl feel guilty, have blame to toss about, or on the positive side, responsible for their own health, as *individuals*, but not as part of a community that is willing to share risk and adversity. The behaviors blamed change over time, due to lobbies affecting the US gvmt, drinking, eating fats, or sugar, smoking, etc., actions that the individual undertakes - but not issues that are societal, such as the crippled by guns, cars; contraception, etc. Of course, that isn t "health" one might argue.

Anyway, the life-style issues as narrowly framed dont stand up to scrutiny. Australians are as fat or fatter than Americans, and in many developed countries, ppl drink and smoke far more than in the US. They also dont exercise deliberately or avoid sugar and fat, and are often allowed to use drugs. (In comparison.)

Now, that doesnt mean the *lifestyle* argument holds no merit - but only that the measures, the criteria, are not the right ones.

The knee jerk reaction to *socialism*- is bewildering to behold if comprehensible to me. With Medicare and Medicaid, plus programs for the poor, some emergency care, etc. the US is in the eyes of some practically a communist state! And to branch out a bit - what about Agri subsidies in the US? And the recent (illegal?) bail outs of financial institutions? Forbidding shorting of certain bank stocks? Oh, the horrors!

And as for massive bureaucracies... totting up how many ppl work for the Nation or para-state organisms in the US (paid for by the tax payer) is tough. Mostly now in "security" (as an addition) to compensate for the loss of industrial employment. I ll leave it there.

The point is that catch words, slogans, mantras, referring to political cum ideological strands should just be given up in favor of cold analysis of health outcomes and the movement of money (as well as consideration of what is happening in Gvmt.) The US used to be good at that kind of analysis - in fact they were pioneers and a model for others. No more.

-- don't have the single quote it is replace thruout by space, nothing, dash, double quote, star, etc.

I don't think obesity is a reason for poor health, it is itself the resultant poor health experienced when there is something amiss in the culture. For example, our high levels of stress; lack of time for cooking, exercise, vacation, etc.; processed foods and fast foods and terrible food served in schools, and so on make it enormously difficult for working middle class people to rise above all the hurdles. But in the end, I bet it turns out to be stress that is the biggest factor.

There was recently an article about how the New York City elites were starting to pack on the pounds as a result of what's happening on Wall Street.

I love how bigdude wants to hammer at this mantra; "Universal health care is compulsory." Along with; "healthcare sucks under UHC."

And yet France apparently has the very best rated health care in the world and we are way down the line. Here, I have to go to the ER for antything (or did until rather recently). In France, whether I have other insurance or not, whether I can pay out of pocket or not, I could get care like anyone else. If you are French and living in France, you really don't have to worry about it.

So why do I bring up France, other than the fact that they offer a form of UHC? Because most French people also have other health insurance or pay out of pocket for a better level of care. All that state funded health care in France has done, is to make sure that everyone can get care. And by the way, it costs less per capita there than it does here.

Hi DuWayne, where have you been other than at Drug Monkey?
Really do need you here to support my occasional rant on cannabis.

You support my case, through Ron Paul: "inexpensive catastrophic insurance for serious injuries or illnesses". Crud, this was the case 40 years ago.
As a child I can remember that we were poor, probably dirt poor, however, as a very sick child there was never a time that I could not go to the doctor for medical care.

Again, Ludwig von Mises once said: government interventions create unintended consequences that lead to calls for further intervention, and so on into a destructive spiral of more and more government control.

Get government out of our lives, we really can "function" without them.

Ludwig von Mises once said: government interventions create unintended consequences that lead to calls for further intervention, and so on into a destructive spiral of more and more government control.

...and yet it WORKS, in country after country, and has for decades. So he's wrong. How can you ignore this gaping flaw in your (and his) arugment? You can't say "it won't work" when it DOES!

"The world can't possibly be round, because we'd all fall off".

"But look! It's round! LOOK!"

"Nope, couldn't possibly be round. Doesn't make sense. Sorry".

Those who favor national health care schemes should take a good, hard look at our veterans' hospitals. There is your national health care.

No, they should look at the countries with national health care schemes to see national health care.

Thanks for wonderfully illustrating what I was talking about, by the way. This utterly blinkered view - don't look outside the US! Them foreign devils can't possibly know how to do anything. Let's look at a half-assed version inside America, because there couldn't possibly be a better example anywhere else.


You're funny Magpie, I've read your stuff before.
And no where did I say it wasn't right to look outside of the US, you're just reading too much into my comments.

"It" ain't working blinky. Mortgage meltdown, falling dollar, thousands losing their jobs, a growing senior community that will certainly be forgotten because of mismanagement within the government, a war that is bankrupting us, rising fuel costs, rising food costs . . . .

Sigh -------

I pay 350.00 a month for health care....If national health care comes along and takes 40% to 1/2 of my pay as it does in many countries with "free" health care, how does that help me? I would need the government to help me pay my mortgage.

Lets see 6000.00 a month minus 40%...or 6000.00 a month minus 350.00....easy math and I can still pay for my mortgage, my car, my food, clothes, internet, cell phone....without other tax payers subsidizing my life.

Even if I paid 2000.00 a month for health care it is still less than a health care tax would be....I think basically it comes down to the belief that some people think health care is a right and others should fund their right.

So if some guy smokes or is obese do I get a say about how much we should spend on an operation? Do I get a say in how much and what kind of food they will be allowed to eat?

The thing that scares me is that eventually the costs will force us into being a country that polices it citizens behavior "for the greater good" to the point we wont be allowed to have fast food, drive cars, lay out in the sun, ride motorcycles, ride ATV's, own guns, or anything else society deems risky.

I prefer liberty over big brother.

Even if I paid 2000.00 a month for health care it is still less than a health care tax would be

Do you even think about these things? This is ludicrous on the face of it; the only way anyone could believe it is to mindlessly swallow propaganda. The top Canadian tax rate is 29%. If every penny of your taxes went to health care (they don't, duh) you'd have to be earning $90,000 for this to be true. Since in reality health care takes less than 25% of taxes, you'd need to be earning some $400,000 for this to be true. That's not an average salary in Canada or the US. It takes about a second and a half to think about this and run the math.

Another way this is instantly and obviously a stupid thing to say is the per-capita cost of health care. It's about $3000 per person per year in Canada -- a fact that can be turned up in seconds with a google search (for example, New England Journal of Medicine, Apr 20 2006). (US costs are about twice as high per capita.) You don't get $3000 per year out of $2000 per month.

Once again, there are pros and cons to the Canadian health care system. But when you make comments that are not just wrong, but are obviously wrong with a half-second's thought, it's clear that you haven't put that half second into considering the issues.

"Do you even think about these things? This is ludicrous on the face of it; the only way anyone could believe it is to mindlessly swallow propaganda. The top Canadian tax rate is 29%."

Hey take it need to call me stupid....I was just throwing a random number out there. I used to live in Canada I understand their system of taxation.

All, I was trying to explain is that I pay 350.00 for health insurance every month, this is just over 4000.00 a year.

In Canada, taxes are spread out. There is the GST/PST of about 15%. There is sin tax on alcohol and cigarettes, fuel tax...37 cents a gallon, I think it was. property tax, health and social ins. levies, import duties, excise tax...

When the numbers are all added up Canadians pay nearly 50% of their income in taxes.

If I paid that effective rate of taxation, I would pay nearly 3000.00 a month in taxes. Free health care and social services are not worth 3000.00 a month to me.

Costs for health care are a result of many factors. One Dr.'s in America get paid much more than Canadian doctors. This explains why many of their best Dr.'s practice in the US. Medical school is much cheaper in Canada. Malpractice ins. in the US is very expensive due to a highly litigious society.

You also have to consider per capita costs of Canadians that don't pay taxes. This increases the cost to each Canadian tax payer. I believe, Canadians don't pay taxes if they earn less than 20,000.

Also, a little talked about practice in Canada is paying cash for care. I did it myself.

Also, you have to consider what Canadians consider to be taxes. Premiums for Pension Plan and Employment ins. are not considered taxes, therefore not counted in the tax rate. They have a dedicated health fund like we have a dedicated social security fund, not.

So, please take it easy, I was just trying to speak from experience, not trying to knock Canada or health care.

I am just not interested in paying the gov't to take care of my health ins. because the cost I pay now is so low...

hey Ian thought you might enjoy

As it happens, NPR has been doing a month-long series on Health Care in Europe. They've looked at Britain, France, Germany, The Netherlands and Switzerland, that I know of, and maybe more. In almost all aspects (even the admittedly poor British system), they get better care for less money. Take a look here:
The interviews are with both doctors and patients. FWIW, I sort of like the idea that if I'm REALLY sick, the first response is to send a physician to me, rather than dispatching an ambulance to haul me to the hospital. (Dutch model)

Lea-- So you dont want to look at the facts on the ground, but rather propose utopian libertarian ideals. Dont get me wrong, I would vote for Ron Paul just for his courageous stance vs foreign wars and the abolishment of income taxes for us middle and lower classes.

Health care used to be affordable and was made affordable to those without the means. My sister spent at least three weeks in ICU and then hospital bed due to appendicitis with gangrene infection. How my parents afforded that and the rest of their 12 children, I have no idea but that health care costs were affordable and adjustable.
But then came HMO's and insurance plans, and ruined everything. Not to mention workers comp: Once the hospital sees that you were on the job, the price goes up 10 to 100 fold. And then the company insurance plan goes up, now to the point where our biggest of big business (ie: GM) is crying uncle, and would welcome UHC with open arms, and then become more competitive vs imports.
Multiply this effect across the entire country, big and small business, relieved of the health care burden, will be able to hire and grow, and of course, with less deferred sicknesses that bloom into serious illness, a more stable work place as well. Us americans would even be able to take more time off, engage in true Family Medical Leave, longer vacations; longer life spans, anyone?
What price wellness? Or should we continue to dump grandma and all the rest of the penniless onto skid row after they wear out their welcome at Kaiser? I don't think the government is to blame for those nurses and doctors who participated in the killing off of serious long term illness patients. When dollar signs get in the way of good medicine, these are the natural results. Take away the dollar concerns and health care gets better.
Since our soldiers were promised health care, they get the VA, which everyone here seems to think is just a notch above execrable, but actually does a better job than if they were waiting (and dying in line) at ER's after filling out the forms stating they cannot pay for services...
None of this matters if you live in a bubble within your McMansion in your exclusive neighborhood behind security gates. Your $350 to $400 a month health care premium is a drop in the bucket, and you don't care that it might even balloon up to $1000. Just don't let your gardener, your roofer, painter, carpenter, electrician, plumber etc. get injured on your property, or your insurance will be overpaying their medical costs.

Tweleve children! Goodness, are you the oldest, youngest, or middle? You certainly must have a high level of tolerance having been exposed to that. I'm the baby out of four.

"rather propose utopian libertarian ideals" Take out the word utopian and it might be a yes Douglas, and I say might be because I will not align myself with one side of the spectrum or the other. There's just too much crap floating around these days, we're on information overload you see.

Ron Paul represents a radical change, for lack of a better description, and gosh darnit, radical or not I'm willing to take the chance.

Go read some of this: Ron Paul's Campaign for Liberty

Number 9, many memories helping Mom with the youngest kids, and older sisters helping me when sick. Learned how to get by without making much noise or being seen snacking out of the Empress Jam jar. Honestly don't know how my folks paid for my hospital stay for first hernia operation, and my sister's brush with death, but it was before HMO's and insurance controls.
Now I want a RP edition Jones Cola...
Just how close is the dollar and world's finances to collapse?
This all important subject barely makes the news. I guess then Ron Paul would win as a write in candidate. Is that allowed anymore?

Your first question: Close in my opinion, we're walking the razors edge and plenty of people have already fallen off.


Maybe I don't have eveything right (after reading some of the other posts) about the Canadian health care system, but somebody up there ^ did post that you do have some long waits still for some procedures. Maybe the U.S. health care system is not the best, but it is fine by me and I like the doctors here. The rest of the world may have some fine systems and they may have fine doctors, but I don't like socialist medicine, so they can have thier sysytems if they like them.


I have heard of pre-existing conditions. I have a couple. I have a couple of chronic conditions and a terminal condition. As far as upping the co-pays or premiums. I am smart enough not to sign-up for a health insurance plan that does that to you. As far as "market failure". I've heard of that. I am sorry if that happened to you. Since you used the term "jerkoff", all I can say is it takes one to know one buddy. Use that vasoline or something and you might have a better disposition.

Also Phila, you know nothing about what I do for people. So don't judge. You don't know me as a person, nor do I know you as a person. I do good for the people in my life and for the people around me. I give to numerous charities. I volunteer my time. I make my money available to those in need.


You asked "I might be wrong, but I don't think that's what revere asked. You claim that the American Human Development Report is a Socialist organization. It is in fact funded by at least the three organizations revere mentioned above. It looks to me like revere is suggesting that implicit in your claim is an accusation that at least one of these three organizations is a Socialist organization as well. Is this true and why?"

Well, I did get it wrong when you state it that way, so I apologize to Revere, you and everyone else. I do think the writers of the report come from a very socialist organization. the Social Science Research Council. Also the Rockefeller Foundation is bedrock socialism at it's best, seeking globalization and a One World Government.


Honor and dignity have always remained in America. That is why we asked the Brits to send their criminals to Austrailia so we could keep our Honor and Dignity.

You can have your socialist ideals lady. I'll cling to my God and my guns.

You have a sick mind and a sick way of looking at health insurance. "Expecting a better outcome by letting others die"; it is you who are contemptable.


Since when does a Socialist care about taxes? I thought you would be glad to pay more taxes, then wealth would be redistributed. You are not making sense as a true socialist here. Perhaps you are turning into a Republican who does not like taxes? Also, all is fair in business. Besides, we have no competition right now, so my health insurance is going to stay until I retire.

I will retire in several (maybe 5-6 months) and may lose my health care. So it was a good ride while I was on it. I may only have a couple of years to live anyways, so that is fine. I try not to let the little stuff bother me and I hate to see everyone get so petty. I like to have a little fun here and laugh. Sorry for the jabs, you usually deserve them

You are a good group, even though we have differences of opinion and different political interests. Health care and disease are matters that we should take very serious as the world population increases and our water and food resources become more poluted and scarce. We are reaching a breaking point and diseases are reaching a point where they may mutate into things that are completly resitant to all anti-biotics or vaccines. Both animal and plant diseases may someday wipe out life as we know it in a matter of weeks. The next war may not be one of bombs, but one of bugs. So how do you fight and win that?

By bigdudeisme (not verified) on 22 Jul 2008 #permalink

You don't bother me bigdudeisme so continue please.
Not everyone is going to see eye to eye.

Don't take anything personally, when you do, call 'em on it and then let it slid off your back. Kinda like water off a ducks back scenario.
When I first came to EM there was a great deal that bothered me about commenter's responses. I can't say the responses still don't bother me but then again I can say I don't let it ruin my day.
We're all the Judge and Jury in our own lives.

Perhaps with enough anecdotal examples from real life, it can be seen that our health care system needs to change to coverage for all, a real, Universal UHC. None of the candidates even approach the real thing, so breathe easy, you Socialiphobes.
You get all worked up over "socialized" health care, but seem to accept our fire, police, public works, sanitation, Homeland Security (the govt couldn't possibly screw up our very security, could it?), Army, Navy, Air Force and Marines, the National Guard, the entire Pentagon procurement process (Karl Marx couldn't have dreamed up a better system), ad infinitum.
The bugs, by their very nature are one up on us all the time. We sometimes strengthen them with our antimicrobial efforts, even though for the most part we have beaten down the more common dangerous disease makers. Less common are the kind of bugs that still do real damage.
Only today, a clerk at a store told me that he had stepped in raw sewage at home with his sandals on. Earlier that day he had a root canal, so his immune defense was distracted. Not long after, his skin started dropping off his feet, until there was only bone on his heels and toes. Treatment lasted for over a year, so he was out of work and lost all savings.
His health insurance did NOT cover the doctor or pharmacy bills.
It wiped him out, financially, even as his toenails grew back in. Still can't walk barefoot, no callouses will form.
That's when I told him how great the VA is for me, as it would definitely have covered treatment and medicine.

So some would rather play dice with big Insurance vs permanent hardship and financial ruin, then have that multiplied over 250 million people across the country. What an opportunity cost with an exponential multiplier effect.


Thanks for your comments and support, I appreciate that.


I am so glad you enjoy the free medical or reduced medical at the VA. Good for you. Myself, I had very bad experiences with them twice when I turned to them for care and they let me down. I thought they were just a nightmare. So different people, different experiences, same VA. It works for you and not for me.

As far as socialized universal health care in the United States, that is a tough sell. I want to know who is going to pay for it? Are you going to continue to tax the rich? They already pay pay most of the taxes in this country. The top ten percent of wage earners in this country, i.e. the rich, pay 71% of all of the taxes in this country. The top 50% of wage earners pay 97% of all taxes. That means that the bottom 50% only pay 3% and yet they get over 90% of the benifits. So if you want to hand out even more benifits, then you have the top 50%, the ones actually making the money and paying the taxes, looking at your proposal and thinking that this is taking more of thier money away from them and giving it away. So show me the money for UHC and maybe I will change my mind. Also, doctors get paid less under these UHC systems. The U.S. attracts some of the best doctors in the world. That will all change under UHC.

In a capalist society, it is not an easy sell to change to a socialist society unless the state owns everything and povides everything for everybody. Here in the United States, we the people still are allowed to own property, buy and sell goods, make our own decisions, and travel freely. Are you going to take all of that away and have the state provide and tell us what to do? That is what the Soviets did. Bread lines, vodka and UHC, I can see your utopia now.

Your niravana of universal health care may work in other countries that have the state providing nearly everything behind the scenes for society, but here, the state still does not control everything. However, forces are at work to change this, and they are not socialist forces. You should read the legislation and plans for emergencies and the powers the government has. You'll get your substandard UHC in some work camp if some in power have their way.

Somehow you equate government employees and services as a form of socialism. Every form of government, worldwide has government employees, whether it is a totalitarian regime, a marxist government, a socialist government, a democracy, a republic, a royal kingdom, etc..

The fact that a government provides services does not make the work force of those services a socialist work force, they are merely employees of a service sector.

I do not denegrate government employees. I have found that they work often in tedious or harsh conditions, often for low pay, and recieve little acclaim for the job they perform, yet they show up for work day after day, month after month, year after year. They raise their families and put their kids through lesser colleges than people of means, yet they manage. More than often, they live in lower middle class neighborhoods, in a paycheck to paycheck situation thier whole lives. These unappreciated people are the backbone of our government, keeping the wheels turning. My hat is off to them and I never disrespect them or talk down to them.

I have been screwed with by insurance companies and I have won battles with insurance companies also. I have a good insurance company right now for my medical insurance and everything seems fine now. They pay most everything. It is not a perfect world and you can't have everything. Unless you were born rich or win the lottery, you are going to have some big bills at some point and some disapointments also. Insurance is one way to soften the big bill blow. Sure, UHC would be one way to take the health care burden away from everybody, but there are more like 300 million of us with a million or two added every year when you count the illegal aliens pouring into the country and who is going to pay for all of the expense of the UHC? It would probably be close to a half a trillion dollars a year. If you shut down welfare and food stamps, maybe you could pay for it.

By bigdudeisme (not verified) on 23 Jul 2008 #permalink

I'm kinda pissed reading this thread.

I have personally worked and lived in many countries - with and without UHC. I'm lucky that I've been able to afford to pay for healthcare when necessary. I've come to the staggering conclusion that no system is perfect.

However - when I review what the societal and personal goals of a healthcare system should be, I have to come down on the side of UHC - warts and all.

'corporate' healthcare: almost all of the ills can be attributed to the dominance of the profit motive. This leads to claim denial (else reducing margins), no coverage for pre-existing conditions (got to protect shareholder interests), and high-cost procedure bloat (why does every damn medical office need an MRI with single-digits utilization?)

UHC: lowest common denominator care, poorly paid practitioners, lack of 'incentive' for practitioners, long wait times, lowest cost operations.

Yet despite the seemingly damning challenges faced by UHC, dollar for dollar it provides better care for more people than any other variant.

Here in the US, we pay federal taxes - that pay for medicare/medicaid/welfare. we pay health premia that are heavily subsidized by our employers (a typical $300 employee premium can cost the company twice as much). We contribute to charities (who then provide funds for charitable medical programs).

In the UK - a proportion of my taxes went to pay for UHC. But I got medical care when I needed it. I got prescription drugs that I needed (at a reasonable cost). I got access to surgery if needed.

In Switzerland - I paid a premium fixed by the canton (state) for basic healthcare - and every insurance company offered the same services. Health companies competed to provide me better care for that cost than their competition (maybe easy access to a hospital with specific facilities in my town) - but I could use any facility and any primary physician. I could also 'buy up' additional premia for other services (such as private rooms during a hospital stay)

In France - I also purchased additional insurance, to buy access to specialists with a reduced wait-list.

In Canada - I paid for additional insurance to buy 'direct' access to specialist care for my daughter. But we still used our primary physician (via UHC) for almost everything else - making the advanced care we bought a lot more affordable overall.

In all of these countries - UHC was the guiding principle. Everyone was covered. In some cases that coverage 'required' a premium (Switzerland) - but that was essentially means tested. In others, the UHC was paid for by direct federal taxes (UK, Canada, France) - so if you earned less, you essentially paid less - earn more, pay more.

Regardless of funding source, UHC did not mean less care. It did not mean less competition. It did not mean less qualified staff. It did not mean more overcrowding.

I would much prefer a healthcare system modeled on France, or Canada, or the UK, or Switzerland - rather than the completely broken mess that is the healthcare industry in the US.


to bigdudeisme:

You need to get out more. Your image of a socialist society is straight out of 1950 (McCarthy, anyone?). Socialism does not equal communism, dude.

Have you ever actually lived in a modern socialist country. For your information, most of the rest of the developed world are considered 'socialist' (or socialist progressive, socialist democratic, or similar).

If you get your head out of your regressive 1950's ass, then maybe you can start to make some sense. All I've heard to date is blowhard bullshit.

My 2c. (now less than 0.5c thanks to the pure refined capitalism of the republicans)


I think McCarthy had it right by the way. There were a lot of communists running around in Hollywood and they did desrve to have their collective reputations ruined.

To me a socialist is a socialist, you put whatever label on it you want. I don't care to get out to their countries at all. I have been to several of them and I thought they were pretty screwed up. I saw many problems with their so called progressive societies. Those same problems are here now because of the social progressives among us. I don't care to live in a socialist society, you go right ahead though, just leave me all of your property.

I happen to like capitalism, if you don't please leave my country, because that is our system in case you haven't paid attention.

You hear what you want to hear. It offends your sensibilities that someone would challenge socialism and defend capaltilism. Well, excuse meeeee! I am not hear to apologize to you for how I speak or feel. Maybe it is you that has your head up your ass for living in the wrong country, when you should be living in a socialist country you jerk.

If your two cents are not worth so much, go get some euros and move to europe, where your point of view will be well recieved. I'll help you pack. :)

Oh, yes. If you don't like my rants, do we really have to be bored by yours also? UHC this, UHC here, UHC there, UHC that, me UHC, you UHC, be UHC, go UHC, score UHC. Give me a break.

By bigdudeisme (not verified) on 23 Jul 2008 #permalink


In general, I read this blog never have the impression of ranting. I read yours and appreciated your authentic disclosure. People approaching retirement in fact is the elite group of the possible national treasure. Gore and Carter have shown vibrant ones. Yours may prove one in the future. I don't think that your need Nobel to soothe your confidence:-)

Having said your positive parts let me remind you a chapter of gentleman character-American version. Never criticize people's ancestors, because it is irrelevant to the debate. Why people has to bear their ancestors' responsibility; good or bad. Moreover, to be grateful for our past and move on is an important stance of a person's well-being.

I cherish this blog's style to let people have safety to express authentically. We should keep it in the border. Do you agree?

Big D: What kind of socialism do socialiphobes like you eschew? National Socialism, creators of the "People's Car," supported by the likes of IBM and Prescott Bush of Buckeye Steel Castings of Columbus Ohio or Soviet Socialism, their Arch enemy?
Dont worry, they both are history.
So, among these states providing affordable health care to all citizens, and sometimes permanent residents, Belgium, Bosnia, Bulgaria, Croatia, Czech Republic, Denmark, Finland, Estonia, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Malta, the Netherlands, Norway, Latvia, Liechtenstein, Luxembourg, Poland, Portugal,Romania, Russia, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland and the United Kingdom, Australia and Canada, which of these are the dreaded socialist states that you so decry?

Their citizens will tell you they are most democratic. And if the majority of their citizenry opposes sending troops to Iraq, their governments are bound to that. Sounds like democracy to me. Why don't we practice a little democracy here, in our government of, by and for? For example: If 51% of the citizenry oppose invading Iran, then does our government listen?
McCarthy was a true believer; his religion: political power. He was high priest for a little while, and it didn't matter whether he had facts or empty accusations. He enjoyed practicing fear mongering and hatred stirring, all the while blinded to the truth, as is any properly indoctrinated religious fanatic.
Looking back at McCarthy it starts making sense at how the religious right has come bowing to the throne of political power, worshipping their own political might, exalting their financial rewards, etc. Basically idol worship, themselves and their own ideas as God, ignoring the 1st Commandment and those scriptures which make them uncomfortable. I'm sorry, but when you mention McCarthy, it gets into politics as religion.

You prefer to stay the course and stick with private insurers, which guarantees that millions of citizens will go without basic health care. And drive up the cost of well-being for everybody, including the millions of employers who will raise their prices, and now we have the makings of stagflation, a gift from Nixon and now Bush II, not to mention the insurers rising profits, feeding off the carrion of the market.
I can hear them now: "stop whining and jump in your grave!"

You probably are not aware that the VA has doctors who practice at private insured hospitals and the like. Many a good doctor at Stanford Medical also serve at the Palo Alto VA, and the list gets longer as you look across the country.
And when the skin falls off your feet and your plan wont cover this "unusual" disease, your premium goes up from your claim denied, just remember you can get care at the VA. They won't turn you away. They're good people. Not socialists, just good soldiers.