I watch the debate over health care with amazement. A million words are spoken on the topic with every passing minute, and as far as I can tell no one has ever addressed the real issue that’s upsetting everyone.

So, rather than wait in vain for someone else to finally speak the honest truth about the single-payer system, I’ll just have to do it myself.

Let’s Get Blunt

America should listen to Dr. Earl Sunderhaus. ASAP. Because he holds the key to the health-care debate.

Who? you might ask. Never heard of him.

    Dr. Earl Sunderhaus

I hadn’t heard of him either until I saw a brief article last month in the Raleigh News & Observer with the unsubtle headline “Blunt doctor gets in trouble.”

The article detailed the travails of an elderly North Carolina eye doctor named Earl Sunderhaus who opened a 21st-century Pandora’s Box when he poked a patient in the thigh and informed her that she was too fat. Insulted, the patient complained to the state medical board, and now the doctor might lose his license.

But Sunderhaus was not about to back down:

Sunderhaus notified The News & Observer that he was about to be “screwed” by the medical board. He admitted he told the patient that thick eyeglasses would not cause her to go blind “but her thick thighs and diabetes would.”

“I poked her thigh to emphasize that diabetes is the leading cause of blindness,” he said Thursday. “People have got to accept criticism without getting their bowels in an uproar.”

He then upped the ante by threatening to counter-sue the medical board.

A follow-up article in the Asheville Citizen-Times gave more details about the eccentric doctor, who has notions that range from the kooky (disband the DEA, compulsory vasectomies) to the enlightened. Turns out Dr. Sunderhaus wasn’t merely poking this one patient in particular, but rather poking an entire nation of patients just like her:

“They are chastising me for telling her she should lose some weight because it is raising the cost of health care and it is also bad for her children and she is going to end up with diabetes,” Sunderhaus said. “I had to take three days out of my practice and go down to Raleigh, losing income, just because somebody didn’t like that I told her that she was fat.”

The patient complained that Sunderhaus poked her thigh and told her she was fat, and scolded her as irresponsible for being unemployed and relying on taxpayers to pay for another pregnancy.

“I told her the thick glasses were not going to blind her, she would go blind because of her thick thighs because diabetes is the No. 1 cause of blindness in this country,” Sunderhaus said.

Sunderhaus said he feels it is his responsibility as a physician to tell his patients to live healthier lives and that obesity and diabetes are costing the country millions of dollars.

“Telling this lady that she is fat is the truth, and it’s for her own good health,” Sunderhaus said. “She should be taking better care of herself, and it will be cheaper for us as a society.”

And to drive home his point, he poked the North Carolina Medical Board too,

“I’m the type of guy who can tell them to stick it up their butt because I am 77 years old, and if they don’t let me practice, I’ll just quit.”

Eccentricities aside, Dr. Sunderhaus has spoken the unspeakable, and by so doing has changed the frame of the health-care debate.

Because millions of Americans are secretly thinking the exact same thing as Dr. Sunderhaus and I: Why should we be forced to pay for the costs of other people’s irresponsibility?

Proponents of the single-payer national health plan can’t understand why anyone would want to oppose the faultless idea of universal health care. It’s completely egalitarian, it’s altruistic, and it’s free, they say. What’s not to like?

“Free” is an illusion — but that’s not the point

Well, opponents of universal health care have focused on one particular objection to the idea, conclusively demonstrating that it’s not free at all. It’s “free” only in that the government inserts itself as a middleman into the payment system, so that you pay for your health care indirectly in the form of higher taxes to the government which then turns around and gives the money to doctors and hospitals — rather than individuals paying the doctors and hospitals directly. It just looks “free” on the surface. But someone has to pay for the medical care, and under the single-payer concept, that someone is Uncle Sam. But since Uncle Sam gets all his money from American taxpayers … you end up footing the bill anyway, and also footing the bill of a vast new government bureaucracy.

The argument then devolves into the minutiae of which system is more efficient and cost-effective: The current cumbersome HMO system, which still feels overpriced despite the theory that “market dynamics” should keep costs reasonable; or a new system dependent on government red tape, which long experience suggests will be even more cumbersome, less efficient, and ultimately more expensive overall than the flawed free-market system.

And that’s pretty much where the discussion over health care has stalled: If we have to have a middleman unnecessarily taking a cut of our doctor payments, should that middleman be a private company like an HMO — or should it be the government?

To my mind, that question is actually irrelevant. Because there’s a much deeper philosophical objection to “socialized medicine” that is so un-PC that it is rarely if ever voiced in public. And for that reason, the opponents of socialized medicine never even mention the real flaw in the concept that nags the unconscious of most Americans:

Not all ailments are equal.

Blame: the final taboo

A built-in false assumption with the health-care debate is that sickness is always no-fault sickness. It’s never socially acceptable to assign blame for people’s medical problems — especially blame on the patient.

But I’m not afraid to confess that I’m a judgmental person. And I’m pretty confident that most Americans who oppose socialized medicine share this same judgment: that some people are partly or entirely to blame for their unwellness.

I’m perfectly willing to provide subsidized health care to people who are suffering due to no fault of their own. But in those cases — which, unfortunately, constitute perhaps a majority of all cases — where the unwellness is a consequence of the patient’s own misdeeds, bad habits, or stupid choices, I feel a deep-seated resentment that the rest of us should pick up the tab to fix medical problems that never should have happened in the first place.

I’m speaking specifically of medical problems caused by:

• Obesity
• Cigarette smoking
• Alcohol abuse
• Reckless behavior
• Criminal activity
• Unprotected promiscuous sex
• Use of illicit drugs
• Cultural traditions
• Bad diets

Now, I really don’t care if you overeat, smoke like a chimney, hump like a bunny or forget to lock the safety mechanism on your pistol as you jam it in your waistband. Fine by me. And as a laissez-faire social-libertarian live-and-let-live kind of person, I would never under normal circumstances condemn anyone for any of the behaviors listed above. That is: Until the bill for your stupidity shows up in my mailbox. Then suddenly, I’m forced to care about what you do, because I’m being forced to pay for the consequences.

Reluctant busybodies

What I don’t like about the very concept of universal health care is that it compels me to become my brother’s keeper and insert myself into the moral decisions of his life. I’d rather grant each person maximum freedom. I’d prefer to let people make whatever choices they want, however stupid or dangerous I may deem those choices to be. Just so long as you take responsibility for your actions, and you reap the consequences and pay for them yourself — hey, be as foolish or hedonistic or selfish or thoughtless as you like. Not my business.

But if the bill for your foolishness shows up in the form of higher taxes on me, then I unwillingly start to care what you do. And, trust me on this, you don’t want me turning my heartless judgmental eye on your foolish lifestyle. Because I’d have no qualms criticizing half the stuff you do.

Do you want that? No. Do I want that? No. And that’s the point. Instituting a single-payer universal health-care system, or even a watered-down version as the government is now proposing, compels me to become a meddlesome busybody in your personal choices. And it will compel you to become a meddlesome busybody in everyone else’s personal choices. It forever douses the beautiful flame of individualism — freedom to act without interference, just so long as you are ready to accept the consequences, whatever they may be.

The sickening truth

My list of unhealthy activities above requires a bit of explanation. Let’s briefly look at each “health sin” in turn:

Obesity
Yes, I know that in some cases obesity can have a genetic component — that some people simply have a tendency to get fat. But the majority of obese people are overweight merely because they eat too much and exercise too little. Simple as that. And as a result, they are mostly or entirely to blame to for their own obesity. Now, there are all sorts of excuses offered up in defense of the overweight: They never learned proper nutritional guidelines; their eating is a symptom of underlying psychological problems; they were raised by parents who fed them unhealthy foods; and so on. To which I reply: I don’t care! Grow up already. Get over your immature problems and cut back on the potato chips. Is that so hard? It actually costs less to eat more healthily. And since being overweight is the #1 medical problem in this country, with countless ailments caused or exacerbated by obesity, making people become personally responsible for their physical conditions is the quickest route to solving the issue. If we made all medical treatment completely free, then people would continue to ruin their bodies with food and just let the free doctors deal with the resulting mess. Hey doc — fix me!

Cigarette smoking
Smoking kills you. Slowly. Expensively. Everybody knows that by now. Want to pay for your own medical bills as you lie in the hospital dying of emphysema or lung cancer? Fine. If you’re willing to pony up the cash, then smoke all you want. But if you want me to shell out millions of dollars to pay for the treatments and care you’ll require, then I’m going to come over there and yank that cig out of your mouth right now.

Alcohol abuse
Destroyed livers, car accidents, pancreatic failure, brain problems — the medical effects of alcohol abuse are well-known. The question is: Can we assign “blame” on the long-term alcoholic for his or her behavior? Contemporary psychology tends to give alcoholics and other addicts a free pass on responsibility, but I am less charitable. Every time you pick up that bottle, it is a conscious decision. And once again, under normal circumstances I just wouldn’t care, but if I’m compelled to pay for the expensive reconstructive surgery of a drunk who smashes his car into a tree, then yes, I care, and I blame the drunk.

Reckless behavior
Stupid people do risky things. Teens who imitate pro wrestling or the Jackass movies in backyard stunts. “Extreme sports” fanatics who jump off cliffs wearing flimsy parachutes. Leaning over the rail and taunting the tigers at the zoo. Eating mysterious mushrooms you found while out hiking. Playing “chicken” in drag races. Car surfing. Auto-erotic asphyxiation. Playing Russian Roulette. Using a hairdryer while in the bathtub. Dumb, dumb, dumb. Me? I don’t do stupid things. I spend my whole life trying to minimize risk. But those who consciously take risks often end up with injuries. Hospital emergency rooms are constantly filled with such people. Now, why should people like me who rarely if ever experience preventable “accidents” have to fund the foolishness of those who throw caution to the wind?

Criminal activity
Crime is dangerous. Not just for the victim, but for the criminal too. Gang members are constantly fighting with each other. Criminals often get injured during the commission of a crime, either while fleeing the scene or during apprehension by the police. Every minute of every day somewhere in this country, drug dealers are shooting at each other and stabbing each other in turf wars or deals gone bad. Doctors and hospitals in poor urban areas spend much of their resources treating gunshot wounds on victims who refuse to reveal how they got injured. And once again, the taxpayer is expected to pick up the tab. When was the last time you heard of a drug dealer diligently paying off the $100,000 hospital bill for the reconstructive surgery he received after being injured in a gun battle?

Unprotected promiscuous sex
AIDS. Chlamydia. Syphilis. Gonorrhea. Human papillomavirus. Herpes. Preventable. Preventable. Preventable. Preventable. Preventable. Preventable. Cover your peckers, people! The problem with discussing STDs is that the discussion always gets muddied with moral issues. But let’s try to set that aside for the moment. On a purely cost-analysis level, STDs are a significant unnecessary society-wide medical expense. Luckily, most STDs are now treatable or at least don’t require costly long-term care. With one noteworthy exception: AIDS. I realize full well that it’s totally un-PC to say this, but why should those of us who go to great lengths to ensure that we never get AIDS have to subsidize the astronomically expensive long-term care of those who through their own cavalier voluntary actions contracted AIDS? Once again, the responsible are expected to pay for the costs incurred by the irresponsible. If I stuck my hand in a blender, should I present my hospital bill to a guy with AIDS and expect him to pay it? And this gets to down to the core of why I oppose the notion of socialized medicine: If left to my own devices, I really don’t care about people’s private sexual practices, risky or not; but if compelled to pay for the treatment of people’s STDs, then suddenly I must become a nanny-state moralist, monitoring and criticizing any activities which might lead to an HIV infection. I don’t want to be in that role.

Use of illicit drugs
The social and medical costs of drug abuse are ruinous. Meth, heroin, crack and other drugs cause a plethora of serious medical problems, both short-term (overdoses, risky behavior) and long-term (rotting teeth, heart failure, malnutrition, immune system collapse, etc.). Drug-users fill our emergency rooms and treatment centers, incurring incalculable expenses. Because even under the current system some of these costs are already borne by the taxpayer, I already feel resentful of having to subsidize drug abusers. But under universal health care, my (and most other taxpayers’) resentment would go through the roof. Because I choose to not abuse my body and brain, I incur no costs for others to bear. But addicts give absolutely no thought to the social effects of their actions, and their thoughtlessness has become one of the main reasons to oppose socialized medicine.

Cultural traditions
All sorts of American subcultures have standard behaviors which increase the risk of medical complications. And I’m not talking about primitive tribespeople walking on hot coals. Instead, I’m talking about upper-class socialites who lie on tanning beds and give themselves skin cancer; street kids who engage in late-night “sideshows” of cars spinning and flipping in crowds of drunken teenagers; immigrants who fish in polluted harbors and feed their kids mercury-laden flounder; congregationalists who try to cure a disease by means of an exorcism; and all sorts of unwise activities specific to different cultural enclaves. Normally, including right now, I tend to think of such things as merely part of the rich tapestry of American society; but if compelled by the realities of socialized medicine to consider the long-term medical ramifications of such traditions, suddenly I become judgmental, condemning these practices and their practitioners solely because I have become partly responsible for paying the bill after the party’s over.

Bad diets
Who among us hasn’t looked on in horror at the grotesque dietary intake of the average American? Donuts, white bread, lard, Coca-Cola, pork rinds, preservatives, sugar, grease and artificial coloring. Little toddlers drinking sweet sodas instead of milk. Teenagers eating junk food instead of brain-building food. Nary a fresh vegetable in sight. Health nuts like me spend our lives trying to treat our bodies like temples, and provide good examples for everyone else; but it’s hard to compete with intense cultural pressure to eat the worst imaginable foods. As above, under normal circumstances I would sigh in mystification and let other people go their merry way, killing themselves with bad food. Yet once I start to ponder the overwhelming society-wide medical costs of keeping millions of unhealthy people alive for decades and decades, my anger grows. I want to ban advertisements for unhealthy foods on TV. I want to outlaw donuts. I want to tax McDonald’s to cover the full environmental cost of their products. I want to do all sorts of quasi-fascistic things that normally I would never advocate.

Because that’s what socialized medicine does: it turns each of us into a little fascist. A nagging nanny who tells other people what to do and how to live.

    Criminal activity often leads to injuries.

Do we want that kind of society? I don’t. If you look at other countries with socialized medicine, Great Britain being the most glaring example, these invasive and oppressive government dictates have already started to circumscribe people’s freedom, with every kind of potentially dangerous activity or unhealthy comestible being declared forbidden — for the good of society as a whole.

We call it “socialized medicine,” but in the end it pushes us toward fascism.

Freedom vs. empathy: the final dilemma

Which brings us back to Dr. Sunderhaus. On one hand, we’re headed toward a totalitarian nanny state whereby your freedoms are constrained for the good of others. But at the exact same time we’ve entered the Era of Hurt Feelings where it’s taboo to tell anyone they’re doing something wrong. The solution proferred by the universal health-care advocates is to expand the circle of responsibility to include all of us. So, rather than insult an individual by telling him or her to get healthy, we all have to pretend we’re all equally in need of self-improvement, and we all endure the restrictions and hardships and costs which by all rights should be reserved exclusively for those who earned them.

The attitude of people like Dr. Sunderhaus perhaps offers a way out of this dilemma. Drop the pretense of decorum. If someone has grown obese eating chocolate, the do-gooders would respond by banning chocolate entirely for all of us — to avoid offending the sensibilities of the individual who abused it. Dr. Sunderhaus would just tell the abuser, “Lady, put down that Hershey bar — you’re too fat!” Horrors, horrors!

But if we had a nation of Dr. Sunderhauses, we wouldn’t need socialized medicine. Because each person, at last, would assume complete individual responsibility. And I’d rather that the doctors do the bullying in private to the people who deserve bullying than me being forced to intervene in other people’s private business myself.

Since it’s nearly impossible to sort out who is personally responsible for which ailments, the only logical solution is to let each person pay for their own care, because that way there’s nothing left to argue about. But if we share costs, we share blame, and that’s the origin of resentment and anger that the average American feels about socialized medicine.

Instead of bankrupting the country to pay for foolish people’s foolish decisions, I want to take a giant Sunderhaus finger and poke each American in the thigh and shout: “Shape up!”

429 Responses to “Why America Hates Universal Health Care: The Real Reason”

  1. 1Walknot on Dec 15, 2009 at 3:11 pm:

    Excellent post! Nice to see ya back. Happy Holidays, Zombie

      

  2. 2stuiec on Dec 15, 2009 at 3:57 pm:

    Hmmm. Isn’t your doctor supposed to tell you frankly about how you can improve your present health and avoid future disease? I prefer having my doctor tell me to lose weight than to have my city ban trans-fats or tax soft drinks: I can take or leave my doctor’s advice based on my own judgment but the actions of my city (or state, or national) government reduce my freedom.

    One of the related problems our society has is the inability to accept any bad outcome, regardless of cause or fault. For example, I would be fine with a law that said that ambulance crews have the right to refuse treatment to motorcyclists who are injured while riding without a helmet – but apparently either I am in a tiny minority or my elected representatives think that I am, and so every motorcyclist has to relinquish the freedom to choose to go without a helmet.

    If you prohibit someone from doing something stupid that they really want to do, even though you do it for “their own good,” they aren’t going to thank you for saving them from something that might never happen – they’ll resent you for not letting them make their own damn mistakes.

      

  3. 3Hotdoug on Dec 15, 2009 at 4:17 pm:

    Zombie , you’ve got my vote! We’re do I sign?

    Thanks for this thoughtful and well organized essay.

      

  4. 4Redbear on Dec 15, 2009 at 4:43 pm:

    Zombie, I’ve missed you.

    This article is spot on, needed and necessary. The picture you paint is ugly and revolting, but I fear not quite as bleak as it will be under “socialized medicine”. Once you have been deemed “unhealthy”, for any of the reasons listed above – then no medical care for you – at all. I choose to smoke cigarettes. I know its stupid. I know its unhealthy. I know I’m slowly killing myself. I do not expect a lung transplant in my old age. But, if I break my leg – I’d like it set please. I can hear it now – sorry sir – you’re a bad investment in our society – no medical care for you – next. And before you non-smokers say Oh yeah – that’s OK – think about where this will lead, and read the entire list from Zombie again. What exactly are “THEY” saying is bad for you this week? eggs, coffee, sugar, artificial sweetener? Oh, and by the way sir, do you happen to exhale CO2?

      

  5. 5CattusMagnus on Dec 15, 2009 at 5:31 pm:

    I love the pictures you chose to illustrate your point.

      

  6. 6Perpetua on Dec 15, 2009 at 7:47 pm:

    This is a great post. I have been wondering about this a lot. Do you have access to the dollars associated with each activity? How much of total health care dollars go to treating diseases caused by: smoking, etc.?

    I am thinking I read somewhere that it is about $12,000 per year per HIV positive person for medications, not including the doctor visits, etc. There are at least 500,000 people in the USA with HIV/AIDS. So the annual cost would be more than $50 billion.

      

  7. 7MikalM on Dec 15, 2009 at 7:48 pm:

    Welcome back, Zombie!

    You’ve become as incisive and provocative an essayist as you have been a photographer. This one absolutely nails the central yet largely unspoken apprehension so many of us have about single-payer care: that it will socialize the costs of the stupid and self-destructive behaviors and lifestyles endemic in our fair Republic, and not only be ruinously expensive, but further erode the quaint concept of personal responsibility. Of course, as you pointed out, controlling the ensuing costs will spell the end of the Blame-Free Society — at least for matters of health — and turn us into a nation of finger-wagging control-freaks serving the Nanny State.

    (Appropriately enough, the biggest advocate of socialized health-care that I know is just this type of person: a cold-blooded, condescending control-freak who would be right at home trying to micromanage the lives of acquaintances and strangers alike in the name of “compassion.”)

    Again, good to have you back.

      

  8. 8DangerousNate on Dec 15, 2009 at 7:48 pm:

    Thank you!

    Thank you!

    You’ve basically summed up why I don’t like the government healthcare into this nice “little” essay!

      

  9. 9Keith on Dec 15, 2009 at 7:51 pm:

    Zombie the idea that Americans don’t want to pay for other peoples mess ups is propaganda, it’s not true. Americans paid billions upon billions to the failed banks. As Americans are paying billions to bail out corrupt banks you are telling Americans that they are money-savers who don’t bail people out. I don’t buy what your saying about the American people. I do agree with you that people should not endanger their health by doing stupid things but I do not place the blame on the individual. The idea of individual responsibility is a lie used to allow criminal elements in society to continue misleading the public because the misled are blamed rather than the misleaders. Television needs more censorship because people are stupid and they imitate what they see on tv, also I think their should be commercials that tell people to do basic things like eat vegetables… this can be funded by taxpayers. As far as whether or not tax-funded healthcare is a good thing I honestly don’t know. It’s a complex issue.

      

  10. 10The Red Skull on Dec 15, 2009 at 8:39 pm:

    9 Keith on Dec 15, 2009 at 7:51 pm:

    “Zombie the idea that Americans don’t want to pay for other peoples mess ups is propaganda, it’s not true. Americans paid billions upon billions to the failed banks.”

    No, Keith. Congress and a few special interests wanted the Porkulus, not the majority of the American people. Remember that, once ‘the catch’ became apparent and many banks wanted to repay the ‘bailout’, Obama said “no”. Note that a few banks managed to repay anyway.

    “The idea of individual responsibility is a lie …”

    No, self-evidently it is not.

    “… used to allow criminal elements in society to continue misleading the public because the misled are blamed rather than the misleaders. Television needs more censorship because people are stupid and they imitate what they see on tv, also I think their should be commercials that tell people to do basic things like eat vegetables… this can be funded by taxpayers.”

    Do I know you, Keith? Your linkage of ideas and choice of words seem familar, and in a way several others and I found amusing yet very strident and breathless.

    “As far as whether or not tax-funded healthcare is a good thing I honestly don’t know. It’s a complex issue.”

    No, it isn’t that complex. Zombie’s article covers most of the issues quite nicely.

    Further, the economics of single-payer health care have been discussed elsewhere; at a minimum, it seems clear that there is not and never will be enough money to fund such a system indefinitely.

      

  11. 11Alberta Oil Peon on Dec 15, 2009 at 9:25 pm:

    Great rant, Zombie!

    But don’t be so hard on the fatties. Don’t you realize they are volunteer carbon sinks? Every gram of fat translates to several grams of CO2 kept out of the atmosphere. And since those that believe in “free government healthcare” are also likely to believe in “anthropogenic global warming”, it becomes a win-win situation.

    Let the fatties pork out to their hearts’ content. And when they blow a coronary, or succumb to diabetes, instead of simply planting the stiff in the ground (where it slowly decomposes, and thereby pollutes the atmosphere with CO2), or simply cremating it, which adds the carbon burden of the crematorium fuel to that of the corpse itself, why not render the bodies down for their considerable fat content, and use it to make biodiesel? Why, a lard-bucket like Michael Moore would probably yield enough biodiesel to propel a Hummer loaded with nubile cheerleaders from Stanford to UCLA! And when all the fat has been rendered out, you can pyrolize the protein and sugars left behind to make fuel gas for the necessary process heat. The end result would be a few ounces of dry ash, just the same as in conventional cremation, but a large part of the contained energy in the dear departed would be recycled to do useful work. How could any environmentally-conscious person object to such a green policy?

    / (just in case)

      

  12. 12OmegaPaladin on Dec 15, 2009 at 10:29 pm:

    Interesting article.

    I do think you overestimate the role of free medical care in discouraging chronic health problems. Seriously, do you think the main reason people lose weight is to avoid medical costs? Of the reasons I want to lose weight, that is probably the least important to me, after improved ability to do physical activity, avoiding the suffering from diseases (as opposed to the cost), better appearance, better access to clothes, being able to fit in smaller spaces, etc. Most of the problems you mention are chronic diseases, where the illness will not occur for years. Additionally, most people don’t want to suffer from illness, regardless of how the care is financed. I don’t think “free” health care would make people want to be fat or light up a smoke who would not do so already.

    The matter of responsibility is a different question, and more relevant. It is part of the reason I don’t want health care to be run by the government.

      

  13. 13apotheosis on Dec 15, 2009 at 11:17 pm:

    I do think you overestimate the role of free medical care in discouraging chronic health problems.

    I don’t think his point was that free medical care (which, as he demonstrated, is anything but free) is meant to discourage those behaviors. It simply helps to ensure that the negative effects of your behavioral problems remain YOURS, and no one else’s.

    In short: if you make your problem my problem, you force me to act in such a way as to correct that problem.

    Is that what you want?

      

  14. 14Finally Free on Dec 15, 2009 at 11:39 pm:

    Great article, Zombie!

      

  15. 15Pvt Bin Jammin on Dec 16, 2009 at 12:26 am:

    Well stated, Zombie! Thanks for all of your hard work! Can’t wait to show this post to my hubby. He has said the same thing for a long time.

      

  16. 16arhooley on Dec 16, 2009 at 1:37 am:

    Heya, zombie. Man, I’m so prissy about this stuff I don’t even like pooling the risk in private insurance. When my ex-boyfriend revealed to me sadly that his son had been through (an expensive) drug/alcohol rehab TWICE, all I could think was “Did my premiums go up for that ass?” It contributed to the demise of our relationship! Every time I see those fatties in their Wall-e carts at Disneyland I feel like I’m paying for someone else’s sins.

      

  17. 17Starless on Dec 16, 2009 at 5:31 am:

    Impulse control. Every time I see a grossly obese person shovel a Big Mac into his or her gaping maw and then cry about how difficult it is to be grossly obese — the health problems, the social stigma, the impossible struggle with weight loss, Won’t Anyone Think of the Children! — my inner totalitarian screams, “Either put down the f*cking fork or stop whining!” And I wonder just how much of that sort of patently neurotic behavior is based on an adolescent need for attention. (BTW, image 2 gives your Up Your Alley images a run for their money in the, “I think I need to gouge my eyes out now,” category.)

    The only place I might quibble with your essay is on smoking. If anyone has been forced to pay, in real cash, for their poor lifestyle choices, it’s been smokers. The per pack tax may not offset later medical costs, but of the poor personal choices you list, it’s possibly the only one where the offenders are forced to pay some sort of up-front fee for their choice. Alcohol may be a close second.

      

  18. 18T. Yamamoto on Dec 16, 2009 at 5:42 am:

    I’m going to assume Keith was being sarcastic, if not oh boy.

      

  19. 19Sean Sorrentino on Dec 16, 2009 at 6:00 am:

    Instituting a single-payer universal health-care system, or even a watered-down version as the government is now proposing, compels me to become a meddlesome busybody in your personal choices. And it will compel you to become a meddlesome busybody in everyone else’s personal choices. It forever douses the beautiful flame of individualism — freedom to act without interference, just so long as you are ready to accept the consequences, whatever they may be.

    Zombie, for those pushing Facist Health Care, this is a feature, not a bug. Since you and I cannot personally tell people to stop their stupid behavior which causes us to pay lots of money, the government, in the person of politicians, will tell them for us. The pols get all the power to intrude into our lives because everyone in the country, including you and me, will tell them to. no more pesky freedom. any bets as to how long until politically incorrect sports like shooting get vastly higher insurance premiums? It’s for the Children!

      

  20. 20Joan of Argghh! on Dec 16, 2009 at 6:06 am:

    A most satisfying essay! Little to add, but it leads me to consider:

    Instead of bankrupting the country to pay for foolish people’s foolish decisions . . .

    Well, no, they want to bankrupt the country to pay for their own premium healthcare, vacation homes, perqs, payoffs and political favors, and for the control it will give them in future political battles to further infantilize the populace. You might care what I do or don’t do if you have to pay for it, but it seems fairly likely that Congress really won’t give a rat’s ass what their voting constituents do. We’ve already seen that with the welfare class. Not one legislator who gained office by promising more money to the shiftless has attached the moral adjunct of responsibility. And it’s already proven that the majority of obesity problems rest with the welfare class and now we’ll all be labeled some sort of racist/classist of some stripe. The race-class mongerers will not tolerate a loss of political power and this will give them even more wedges to drive us apart. . . and drive us mad.

    So we shall bicker amongst ourselves, point fingers and blame and clamor for more local czars, satraps and dog catchers to judge among us, more laws to encumber us, or we shall commence to bludgeon each other into submission.

      

  21. 21Joan of Argghh! on Dec 16, 2009 at 6:07 am:

    Drat! The italics button is sticky! Sorry!

      

  22. 22damaged justice on Dec 16, 2009 at 6:25 am:

    …the majority of obese people are overweight merely because they eat too much and exercise too little. Simple as that.

    Wrong. It’s because they eat too many damn carbs.

    Otherwise, I agree with every word.

    Everyone gets to go to hell in their own handbasket. But don’t expect me to pay for it, or join you for the ride.

      

  23. 23jables on Dec 16, 2009 at 7:00 am:

    Your amazing essay finally put into words the reason why universal healthcare feels so wrong!

    This essay briefly touches on another issue about “not hurting feelings” and that’s intelligence! You say you’ve spent most of your life minimizing risk, but you’re clearly smart enough to know to do that and many many many people just aren’t bright enough to know better. But our society looks down on people even more for calling unwise people fools than they do for calling fat people fat!

    I don’t think it’s so much a maturity issue as it is a baseline smarts issue. Some people just can’t cut it. Should we pay for them and subsidize their stupidity? Since there’s no real way to make the distinction, I have to agree with you that everyone should take responsibility for themselves.

      

  24. 24rumcrook® on Dec 16, 2009 at 8:18 am:

    good one zombie im going to excerpt it and link it at my blog.

      

  25. 25Finally Free on Dec 16, 2009 at 9:29 am:

    i blogged it at SSC (click on my handle for the link). My own argumentation in my own socialized medicine series (links there) basically centered on workability and sustainability of government healthcare.

    Zombie goes to the deeper issue that most people who’ve grown up in Euroland would never even think of (unless they are “neoliberals” which is what soft-libertarians are called there).

      

  26. 26Maria on Dec 16, 2009 at 9:45 am:

    Up in Canada I’ve been using the over the top example of sleeping or lack of it, to illustrate my point about the Nanny state and regulating behavior. Lack of sleep (eg. exhaustion) has proven to be the number one cause of accidents, car crashes and work related mistakes causing unfathomable economic losses. So of course the solution is to regulate sleep, monitor bedrooms and sedate those found to be not meeting their sleep quota. ;)

    Frankly, I don’t trust any system right now and am afraid of what’s going to come out of this. Both private and public or mixed healthcare are going to go down the road of punishing “risky” and irresponsible behavior, whatever they decided it is. We, as the public are already calling for it! And you can bet the farm that it’s going to be at least partly along moral grounds. So yes, that’s what I’m afraid of, more so than paying extra taxes.

    The question then becomes, what is risky behavior? The examples you show are easy to identify, but not all risk is categorized into simple stupid/not stupid groups. You chose to help at a student run art gallery to set up some temp walls. A dropped 2×4 falls about 8 feet and lands on your shoulder. This was 5 years ago and you still have occasional flares of pain. Where you engaged in risky behavior because you’re not a trained carpenter? You had a helmet on, gloves and even eye protection when sawing but like hell where you going to done football padding. There’s risk mitigation and then there is paranoia and utter impracticality. Sometimes shit just happens, especially if you choose to be involved in life.

    What’s my point? With the way things are going, the people who will be paying the lowest premiums will be the ones that do nothing, have never done anything and never plan on doing anything. Every activity has risk and we will most definitely be graded on what we do. Maybe at some point we will even be permitted to do things only if we can cover the premiums for that risk.

    So ya, I agree that personal responsibility is key, whatever system this nation and most other nations will gravitate towards will rely heavily on risk assessment. It’s unstoppable and is already here. I personally lean towards a free market system with some regulation, (ie, no hiking premiums due to preexisting conditions or genetic markers, highly accessible appeal boards, maybe even a la cart menus, etc)

    Who here really wants to spend most of their life weighing every action against a potential hike in their health premiums? If I agree to help at this kid’s camp will my insurance go up because I’ve exposed myself to the risk of west nile and lime disease? Do I cover this tense political protest, what if my health insurance sees me here and hikes my rate up because I exposed myself to a potentially violent situation and chemical irritants? Ya, these examples are sillybut someone please tell me that’s not likely to happen?

    The health care issue is no longer about who pays and how much it’s also about how will we allow ourselves to be monitored, classified and graded. It’s about how we will live our lives and you can bet every penny will be counted.

      

  27. 27fat jolly penguin on Dec 16, 2009 at 9:55 am:

    WOW. Fantastic, zombie!

      

  28. 28zombie on Dec 16, 2009 at 10:02 am:

    Joan of Argghh!: Drat! The italics button is sticky! Sorry!

    Don’t worry — I fixed it for you, and de-italicized your comment. Personal service!

    Now I’ll just bill the government for recompensation…

      

  29. 29Maria on Dec 16, 2009 at 10:04 am:

    As to the fat thing and that doctor. I pity that woman. I’ve had a doctor tell me that I needed to loose a few pounds. Ok, so she didn’t poke me in the thigh, but still, having someone say, “you need to loose wight or you will get sick.” wasn’t pleasant. But I didn’t get upset because she was fucking right. Almost all of my health issues could be traced directly to being fat. We sat down and went over a lot of info about many aspects of my diet (which wasn’t as bad as she thought, go figure) as well as issues I had with certain foods that caused pain and upset. If i had reacted like that idiot woman I’d still be in pain. She gave me the wake up call I needed to join a gym and try to loose some pounds. It’s been hard because I’ve always been fat, ever since I was a little child.

    While I htink Dr. Saunderhause might have maybe delivered the news a bit less harshly he’s probably sick and tired of seeing patient after patient after patient like her. pregnant, on welfare and unhealthy. Dude probably did the math and realized that he didn’t have much to loose at this point. God I hope Dr. Saunderhaus gives them hell because the topic needs to be raised.

      

  30. 30pacific_waters on Dec 16, 2009 at 10:08 am:

    Disbanding the DEA is far from a “kooky” idea. The War on Drugs has been a complete failure and has created an entire industry devoted to unconstitutional searches and seizures (forfeiture laws), unwarranted violent invasions of private homes and a militarization of police forces around the nation.

      

  31. 31zombie on Dec 16, 2009 at 10:10 am:

    #26 Maria

    Most excellent comment!

    I place it on the required reading list for everyone scanning this comments thread.

      

  32. 32Dianna on Dec 16, 2009 at 10:28 am:

    Thank you, zombie.

    And The Red Skull – you’re absolutely spot on.

    MikalM? Drop me a line sometime!

    The Red Skull: 9 Keith on Dec 15, 2009 at 7:51 pm:
    “Zombie the idea that Americans don’t want to pay for other peoples mess ups is propaganda, it’s not true. Americans paid billions upon billions to the failed banks.”No, Keith. Congress and a few special interests wanted the Porkulus, not the majority of the American people. Remember that, once ‘the catch’ became apparent and many banks wanted to repay the ‘bailout’, Obama said “no”. Note that a few banks managed to repay anyway.“The idea of individual responsibility is a lie …”No, self-evidently it is not.“… used to allow criminal elements in society to continue misleading the public because the misled are blamed rather than the misleaders. Television needs more censorship because people are stupid and they imitate what they see on tv, also I think their should be commercials that tell people to do basic things like eat vegetables… this can be funded by taxpayers.”Do I know you, Keith?Your linkage of ideas and choice of words seem familar, and in a way several others and I found amusing yet very strident and breathless.“As far as whether or not tax-funded healthcare is a good thing I honestly don’t know. It’s a complex issue.”No, it isn’t that complex. Zombie’s article covers most of the issues quite nicely.
    Further, the economics of single-payer health care have been discussed elsewhere; at a minimum, it seems clear that there is not and never will be enough money to fund such a system indefinitely.

      

  33. 33Dianna on Dec 16, 2009 at 10:30 am:

    #11 – And Soylent Green is people!

    Well-played sarcasm.

      

  34. 34Dianna on Dec 16, 2009 at 10:34 am:

    #12 –

    I don’t think “free” health care would make people want to be fat or light up a smoke who would not do so already.

    Zombie’s point, which you skated merrily past, is that your reasons for wanting to lose weight would become irrelevant: everyone would turn into your mother, least favorite ex and nagging, self-righteous jerk on her way to the gym.

    I’m with zombie – I have no desire to begin scrutinizing your behavior. Make me pay your bills, however, and I will.

      

  35. 35Scott Pigeon on Dec 16, 2009 at 10:46 am:

    I’ve always wished more people would be concerned with the liberty side as well. Threaten people with a tax hike, and “soda taxes” and “mammograms covered only for 50+” will be a reality. The Stupak amendment shows they’re already willing to ration. When others have a vested interest in your health, don’t be surprised when they want to see how well their money is being spent.

    Scott Pigeon for Congress

      

  36. 36Starless on Dec 16, 2009 at 12:01 pm:

    Maria: As to the fat thing and that doctor. I pity that woman. I’ve had a doctor tell me that I needed to loose a few pounds. Ok, so she didn’t poke me in the thigh, but still, having someone say, “you need to loose wight or you will get sick.” wasn’t pleasant.

    See, after reading that article, now I know that if a doctor hurts my feelings I can sue his ass. And here I’ve been assuming that doctors are going to be superior, high-handed, lecturing nags because it was just a natural part of their profession. Now I know better.

    Dianna: Zombie’s point, which you skated merrily past, is that your reasons for wanting to lose weight would become irrelevant: everyone would turn into your mother, least favorite ex and nagging, self-righteous jerk on her way to the gym.

    See: smoking. Do people really care whether others smoke because they have a genuine fear for their health and care about the cost of treatment of related illnesses, or because they’ve always been told it’s “a filthy habit” (i.e. “sinful”)?

      

  37. 37buzzsawmonkey on Dec 16, 2009 at 12:47 pm:

    For once, zombie, I disagree with you, albeit mildly—not as regards the problems of socialized medicine, which you lay out with cogency and clarity, but regarding your refusal to fund other people’s poor decisions.

    We all fund other people’s poor decisions already, and will continue to do so. We fund them when we join an insurance pool, even if the cost of our own contribution to that pool is somewhat adjusted based on our own good decisions. And we fund other people’s poor decisions, or their irresponsibility, when the poor, or the lazy, or the uninsured, or the criminals, or the illegal aliens, are treated for free or near-free and the cost of their care is made up to the caregiver (person, institution, or both) by the taxpayer.

    Neither of these forms of poor-decision subsidy will cease out of the land, even if the current healthcare assemblage reeling its way through Congress goes down in defeat. Nor would we want them to, much as we resent them both; the former allows us to obtain, if at high price, healthcare that would cost us far more dearly were we not insured. The second is the alternative to letting those who have made unfavored decisions die in the street like dogs, and few of us, despite our pleasure in expressing such base emotions, really want to see this.

      

  38. 38zombie on Dec 16, 2009 at 1:11 pm:

    re: #37 buzzsawmonkey

    Yes, I realize that we already have many forms and variations of “socialized medicine” in place at this moment, ranging from the pooled-risk concept of HMO health insurance, to Medicare and Medicaid and SSI and so forth. I’m not arguing against those concepts, even though there may be some overlap between my argument and an argument against any government-funded health care; What I was specifically addressing was compulsory universal single-payer health care, in which the “risk pool” is expanded to include everyone, and the funding is similarly expanded to include everyone.

    I say right at the beginning that “I’m perfectly willing to provide subsidized health care to people who are suffering due to no fault of their own.” That includes Medicare and Medicaid and SSI, since the elderly and most disabled people incur medical expenses which they can’t really help and which are beyond their control. Free medical care for the old — fine by me. They should be rewarded for even getting that old. Free medical care for the blind, the congenitally disabled, and so on: Fine by me. It’s not their fault. They need our help. I’ll pony up tax dollars for that.

    But if we don’t draw the line somewhere, we end up transitioning into a hive society, in which privacy and individuality and responsibility are negated, and everything everyone does is everyone else’s business.

    Your key point, that I am in favor of allowing “those who have made unfavored decisions die in the street like dogs” is off the mark– again, I never say that. Nowhere in the essay do I advocate that anyone should ever be denied treatment. No — far from it. I don’t want people to die in the street like dogs. Everyone, regardless of their circumstances, should be granted treatment unconditionally. All I’m saying is that once the hospital stay or doctor’s visit is over, the person who received the treatment should be the one getting the bill.

    This of course brings up all sorts of other problems, such as unwise people getting saddled with ridiculously high and essentially unpayable hospital bills. But the alternative being offered — a society bankrupted to pay off those bills — is no better.

    We admittedly are facing a serious crisis here, and there are no good solutions. But if forced to choose between the solutions on the table, I say that universal single-payer health care is among the worst. A much better idea is one that the conservatives are suggesting, which is to rein in costs (tort reform, etc.), rather than share the inflated costs among all taxpayers.

      

  39. 39buzzsawmonkey on Dec 16, 2009 at 3:10 pm:

    Did my reply post get eaten?

    And how do you do that nice “reply” header?

      

  40. 40Starless on Dec 16, 2009 at 3:25 pm:

    zombie: A much better idea is one that the conservatives are suggesting, which is to rein in costs (tort reform, etc.), rather than share the inflated costs among all taxpayers.

    Conservatives have suggestions about what to do about healthcare reform? The Democrats and mainstream media assure me that they don’t want to do anything about healthcare. Just as they have assured me that those who don’t adhere to the letter of the AGW law don’t want to do anything about that, either. In fact, my local news reminds nearly every evening that Republicans are responsible for the lack of progress in healthcare reform — because no Republican supports Harry Reid/Max “My Mistress is, like,totally qualified” Baucus/Whoever’s iteration of whatever crap Dems are throwing at the wall this week.

      

  41. 41zombie on Dec 16, 2009 at 3:36 pm:

    buzzsawmonkey: Did my reply post get eaten? And how do you do that nice “reply” header?

    Hmmm, strange. Thanks for pointing that out. I just checked in the “Akismet Spam” garbage bin, and your comment was indeed caught by the filter and pre-emptively rejected, before I (or anyone) even saw it. Not sure why. I rescued it and emailed it back to you, so try posting it again.

    As for the quote thingie: All you have to do it click the “double-quotation marks” graphic under the comment which you want to cite, and it will create the encoded quote in the comment box, ready for you to reply to. (And you can then delete excess verbiage from the comment, if you so choose). Give it a try!

      

  42. 42zombie on Dec 16, 2009 at 4:34 pm:

    Ooops, we got “Hot Aired“, leading to traffic overload temporarily.

    At least, that was the biggest site I could find linking to this post — there may have been others.

    And remember, whenever you try to visit here and instead you get a message saying “Error establishing Database Connection,” that’s just the computer’s way of saying “TOO MANY PEOPLE!!!” It doesn’t mean the site is broken. Wait a while, and it should come back to normal.

      

  43. 43buzzsawmonkey on Dec 16, 2009 at 5:04 pm:

    #38 zombie

    Again, zombie, I basically agree-I’m merely trying to point out the gray areas. For example, if you’re in favor of paying for care for the disabled (who could argue?), what about when the quadriplegic assumed that state because s/he was not wearing a helmet while riding the motorcycle recklessly on a switchback road on a foggy night?

    Etc.

    What you do etch in sharp relief, however—and for doing so, my applause will drown out the preceding cavilling—is that there has been absolutely no national consensus reached regarding the nature of the existing problems or what needs to be fixed. The Democrats’ refusal to utter anything that might be construed as “tort reform” is only one element; heck, “tort reform” itself is a can of worms, given that multimillion dollar verdicts are rarer than one might think and, if sometimes justified, sometimes also in response to largely frivolous suits based on junk science. There is the problem that the current “reformers” are half the time talking about health care and half the time talking about health insurance—and talking about them as if they were interchangeable, which they are not.

    The current efforts to “reform health care” have been primarily an articulation of grievances, not of problems-as with Obama’s campaign, in which “hope and change” was left to mean anything the hearer wanted it to mean, “healthcare costs too much” is an undefined grievance to which anyone can ascribe any meaning or cause they choose. There has been no clear or straightforward articulation of what the Administration thinks are the problems, because then a discussion over whether those problems were correctly identified would have begun. Instead, the Administration has relied on grievance—and since everyone wants to pay less, however little they are paying, the grievance, disguised as a statement of problem, gains wide currency.

    But the dickering over solutions that we see in the Congress is a dickering over solutions to problems that have not been straightforwardly named. If you don’t know where you’re going, any road will get you there-and if you don’t say what problem you are trying to solve, nobody can really argue with whatever solution you come up with.

      

  44. 44Ken on Dec 16, 2009 at 5:11 pm:

    I love the pictures you chose to illustrate your point.

    I don’t. That guy shooting up gave me the chills. I can’t stand needles.

      

  45. 45sue on Dec 16, 2009 at 5:12 pm:

    My reason , I have no interest in footing the bill for irrational hypochondriacs who are convinced healthy lifestyle will prevent aging, disease and even death. Human beings are susceptible to multiple elements beyond our control and no amount of free health care, expensive health care, or healthy living care will preserve our organic material in some state of holistic perfection.

    Imagine, a Universal Health Care culture hooked on Dr Oz incessantly paranoid that every aspect of their life may potentially lead to aging, disease and death.

    Certainly bad behavior is not helpful particularly those bad behaviors which involve literally thinking one’s self into a state of sickness; I do not want to be drag into the lives of others obsessive neurotic compulsions.

      

  46. 46Whitehall on Dec 16, 2009 at 5:21 pm:

    Motorcycles.

    There are two approaches to dealing with this high risk activity, California and other states require helmets. This does reduce injury costs. Florida just makes having health insurance a condition on holding a motorcycle license.

    I prefer Florida’s approach.

    Donuts in moderation are no vice!

      

  47. 47Stuart on Dec 16, 2009 at 5:24 pm:

    For its proponents, the fascism inherent is socialized medicine is not a bug, it’s a feature. And HIllary Clinton and her ilk will be the “nagging nanny who tells us how to live.”

      

  48. 48Admirer on Dec 16, 2009 at 5:31 pm:

    A great post applying practical “small-L libertarian” principles. Lockean!

    OT: Zombie, do you find yourself cooperating less with Charles Johnson?, as he (IMO) reverses himself on numerous conservative/ libertarian positions he once held? He’s enchanted with ObamaCare, has become a zealous convert to the Church of AGW, etc., etc., whereas YOUR views, right or wrong, have remained steady.

      

  49. 49CattusMagnus on Dec 16, 2009 at 5:41 pm:

    Zombie,
    The first comment on Hot Air says that this post is full of hate speech. You big meanie.

      

  50. 50zombie on Dec 16, 2009 at 5:46 pm:

    buzzsawmonkey: 43 buzzsawmonkey
    #38 zombie

    Again, zombie, I basically agree-I’m merely trying to point out the gray areas. For example, if you’re in favor of paying for care for the disabled (who could argue?), what about when the quadriplegic assumed that state because s/he was not wearing a helmet while riding the motorcycle recklessly on a switchback road on a foggy night?

    Etc.

    Yes, examples such as the one you give are the irresolvable core of the dilemma. The average American is irked at the idea of paying for the medical bills of a patient who is “at fault” in some way — yet who but God or some omniscient observer can determine who is to blame for every little thing that happens? Are we to have a trial for each and every medical procedure to determine the party liable for the expense? Impossible. As a result, every blame-worthy patient can always come up with some kind of semi-believable excuse as to why he or she did whatever it was to end up in the hospital: “I didn’t put on the helmet because the strap was broken — sue the manufacturer.” “I was shot in the gang rumble because I was only there to try to break up the fight; I’m a peacemaker, not a thug!” “I eat and eat and eat to mask the pain of being molested as a little girl; I’m the victim here.” “I’m a sex addict — I just can’t help it.” And so on and so on. I doubt anybody would ever voluntarily assume blame for anything.

    And so there’s no reasonable way to segregate the blameworthy medical expenses from the blameless medical expenses.

    Consequently, we need to either:

    Subsidize them all equally;
    or
    Let each person pay their own way.

    Hard to reason our way out of this all-or-nothing dilemma.

    But as to your specific example, of chronically disabled people who got that way due to questionable circumstances — well, the only way to deal with this prickly issue is to engage in the exact sort of nanny-statism that many find so distastful. Strictly enfore helmet laws, seatbelt laws, and other safety laws, and just hope that they cut down on the number of paraplegics who got that way due to recklessness.If they are few in number, I think the society as a whole can be generous in spirit and just pay for their lifetime care.

    Motorcyclists with broken necks are one in a million. They aren’t what’s bankrupting us. The real problems are obesity and bad diets (often the same thing, really), drug abuse (both licit and illicit), and long-term care for AIDS patients (though this is becoming less of a crisis as time passes). Yet even in those cases, it’s very difficult to sort out the layers of blame and responsibility.

    Do I have the magic answer? No. Nobody does. I’m merely pointing out what I believe is the underlying philosophical objection to single-payer health care which nags at most Americans without ever being vocalized.

      

  51. 51Rick on Dec 16, 2009 at 6:00 pm:

    While you do understand the facist intent of universal health care, you miss the problem that on the whole no one really knows exactly how to live a healthy life. My father in-law lived past 85 smoking like an industrial plant and being incredibly overweight to boot. Sorry guys, as much as I love personal responsibility, it is actually hard to tell what leads to a healthy life.

    A second problem is that most of the cost comes from drastic interventions. These all happen at the end of life. Life comes to an end whether you have lived a healthy life or not. So once again the personal responsibility thing is nonsense. Rather, universal health care has the government intervening in life and death decisions. The problem here is that a general rule which is 99% correct will put to death 1 in a hundred people. Not very enticing is it?

      

  52. 52Buzzbomb on Dec 16, 2009 at 6:23 pm:

    GREAT article, sir… but my opposition to Universal Health Care is more basic: It will lead to the largest Entitlement program that the US has ever seen and it will never be repealed. The size of our government will grow far too large for me (actually, its already there). :(

      

  53. 53rawmuse on Dec 16, 2009 at 7:00 pm:

    Zombie, that was just super. Super!

      

  54. 54Heather on Dec 16, 2009 at 7:08 pm:

    As a physician, I’ve got to say this is an awesome article. I strongly oppose the current healthcare proposals. The patients with the worst health habits are those on entitlement programs like Medicaid. Try to get a Medicaid patient to pay $5 for their medications-no, they need it for cigarettes. They have no financial consequence for their bad behaviours.

    If you eliminate personal financial responsibility for health care costs, total costs will skyrocket.

    Nothing in the current legislation addresses any of the current problems with healthcare. It will increase costs. It will bankrupt our country. If we spend this much money now, there will be no money left in 20 years for even basic healthcare.

    Motorcycle riders that don’t wear helmets should be repsonsible for their own health care costs. The Florida approach works for me.

    The only real thing we need in health care reform at a government level is elimination of copays once the individual has hit $5000 per year.

      

  55. 55Ric on Dec 16, 2009 at 7:44 pm:

    And paying for someone else’s lifestyle choices is only the beginning of where we start to pay. But then, because we can’t afford to pay the health care costs of unrestrained bad behavior, the government MUST start to ration health care. And then I, who live a healthy lifestyle, will be denied my share of the resource because it has already been given out to someone else.

      

  56. 56Joe on Dec 16, 2009 at 7:57 pm:

    The obese patient should’ve poked Sunderhaus back and said “you’re old!”

      

  57. 57eidylon on Dec 16, 2009 at 9:39 pm:

    Excellent, Excellent, EXCELLENT article!!!!! I could not express the sentiments more plainly or perfectly!

      

  58. 58Silk on Dec 16, 2009 at 10:55 pm:

    I quit smoking two years ago and now I’m fat…hell, can’t win! LOL.

    Great rant and very to the point, just reading some of these comments show how much people turn into little fascist at the thought of other people doing what they perceive is wrong. I am no exception, you can be healthy as a horse, but should I have to pay for your sports injuries? Where will it stop, when will it stop? It is here already, but it will become ugly under a single payer system.

    I have a real big beef with alcohol drinkers, alcohol contributes to so much illness, injury and voilence in our society, it’s sickening. How many here posting about the fatties and the smokers and the whateveryoudon’tdoyourself categories are actually a clean slate yourselves? No one is and who is going to be on the panel that draws the line in the sand and says this activity wont be covered..because if it is me, alcohol is going to be first on the list.

    I agree, Single Payer, we all become fascists and nanny state government becomes a way of life..great article.

      

  59. 59Guy Average on Dec 17, 2009 at 12:06 am:

    Glad to see you back, Zombie. I was worried a little. I’ll digest this report and comment later on it. After skimming, I’d say that the bikini top on the girl in the tanning bed looks like it was photoshopped on.

      

  60. 60N.C. on Dec 17, 2009 at 12:53 am:

    This nation’s highways are full of irresponsible drivers. Therefore, we should abolish “public” roads, which are clearly a nanny state project for tiny fascists who want to tell us “how fast” we can go and what color our headlights should be, and only let people drive on the pavement that they’ve personally contracted out to build.

      

  61. 61Finally Free on Dec 17, 2009 at 3:03 am:

  62. 62Squid on Dec 17, 2009 at 10:28 am:

    Reluctant Busybodies

    That is precisely the term I’ve been looking for. People who think that their lives are none of my business are going out of their way to make their lives my business. And the truth is, none of us want to be in that position.

    None are so blind as they who will not see.

      

  63. 63Mike T on Dec 17, 2009 at 10:31 am:

    What I don’t like about the very concept of universal health care is that it compels me to become my brother’s keeper and insert myself into the moral decisions of his life. I’d rather grant each person maximum freedom. I’d prefer to let people make whatever choices they want, however stupid or dangerous I may deem those choices to be. Just so long as you take responsibility for your actions, and you reap the consequences and pay for them yourself — hey, be as foolish or hedonistic or selfish or thoughtless as you like. Not my business.

    Being your brother’s keeper doesn’t necessarily entail you being a busybody. If your friend was in an abusive relationship, and was justifying his attachment to a psychotic woman, wouldn’t you actively intervene to convince him of what everyone else was seeing? Or would you just let your friend get worse and worse so as to not interfere with his life(style)?

    You basically say here that not all lifestyles are created equal. There is nothing wrong with telling people that they shouldn’t be doing something. In fact, the very attitude that most social libertarians have on sex, for example is, “if I concede that I shouldn’t be fornicating, that it is immoral, then maybe I should prohibit it.” Yet, why couldn’t you easily say that fornicating is immoral, but choose to let people behave immorally? Does morality automatically demand enforcement? I don’t think so. Ironically, the Bible doesn’t make that argument either.

    That said, I agree with you about the busybody ramifications here. I personally applaud the British NHS for having the integrity to start telling the public that if the chavs want their healthcare paid for by the tax payers, the NHS will be moral-bound to start regulating their pleasures so that it can control costs. Once you make others foot your bills, you lose your right of self-determination.

      

  64. 64PacRim Jim on Dec 17, 2009 at 10:55 am:

    America is heading for a medical care system–and government–concerned only with those belonging to the party in power, i.e., Venezuela writ large.

      

  65. 65illini Fat Person on Dec 17, 2009 at 10:57 am:

    The element that is missing from this discussion is charity. We have all been sucked into the progressive scam that says that the only obligation we have to our neighbors is to support a compassionate government that takes care of the vulnerable among us. This benefits the rich because they no longer need to meet the poor face to face and get their lives all messy. It benefits the selfish and arrogant because they can coddle worldviews about how the mean, evil, lazy, and corrupt Other is the cause for all of the worlds problems and they are not to blame. It benefits the victims of society because they can blame all of their problems on the rich and never need to come to terms with the fact that life is fundamentally unfair to all of us and that the only way to rise above their problems is to take responsibility for their predicament.

    In the case of the good Dr. Sunderhaus, this would mean that he would take it upon himself to invite the woman over for dinner, listen to her predicament, and give her the confidence to solve her problems. Will this work? Probably not. However the woman will see a living example of someone who has tackled life’s problems. The good doctor will gain an understanding that weight control is rarely ‘simple’. And slowly society as a whole starts to heal as the class interact with each other and become more as one….well I can dream can’t I :)

    Notice that this solution does not involve any government intervention at all which should make it attractive to libertarians.

      

  66. 66Mike T on Dec 17, 2009 at 11:19 am:

    t benefits the selfish and arrogant because they can coddle worldviews about how the mean, evil, lazy, and corrupt Other is the cause for all of the worlds problems and they are not to blame.

    Not all of them, but the evil, lazy and corrupt do account for a statistically significant percentage of those problems. Mainly the evil and corrupt.

      

  67. 67zombie on Dec 17, 2009 at 11:20 am:

    Ooohh, I see we just got an Instanlanche — a link from Instapundit. Luckily, it happened at 7am East Coast time, thus 4am West Coast time, so most people (including me) missed the period during which we were knocked offline by the traffic.

    Hopefully, some intern for a bigtime pundit will see the link there, and submit this essay to the pundit as part of the daily research briefing, and then he’ll steal the idea and use it on all the talk shows, and it will thereby get even wider dissemination as a concept.

      

  68. 68Starless on Dec 17, 2009 at 11:28 am:

    Silk: No one is and who is going to be on the panel that draws the line in the sand and says this activity wont be covered..

    People with the best of intentions. Or, at least, people who tell themselves that they have the best of intentions.

    I keep thinking of this (admittedly not perfect) analogy: people who live in a large city which is situated primarily in a giant bowl between a large lake and a large river, near a large gulf named after a country where masked professional wrestling is quite popular, and which sees catastrophically destructive weather on a regular basis. This destructive weather can be ruinous both in its cost to property and life. A cost which is borne not only by those people, but by me too. How is it that I have no say, through the gov’t as a proxy, whether they should be allowed to move back to the same place which is guaranteed to see ruinously destructive weather again (i.e. continue to engage in their self-destructive lifestyle)? I know better — it’s clearly evident to me that their behaviour is bad for them and costly to the rest of us and they should be forced to do what I think is good for them.

    Next up will be people who insist on continuing to live in a state which is known to be prone to catastrophic earthquakes on a regular basis.

    zombie: Hopefully, some intern for a bigtime pundit will see the link there, and submit this essay to the pundit as part of the daily research briefing, and then he’ll steal the idea and use it on all the talk shows, and it will thereby get even wider dissemination as a concept.

    Like maybe a one man blog of stewing cerebral juices?

      

  69. 69Dianna on Dec 17, 2009 at 12:03 pm:

    Joe: The obese patient should’ve poked Sunderhaus back and said “you’re old!”

    More fun than suing, that’s for sure, if a bit less potentially profitable. I like it!

      

  70. 70atwood on Dec 17, 2009 at 1:35 pm:

    Excellent article Zombie. I’m glad you are examine the assumptions of the morality of socialized health care. Its an argument more on the right should be making but unfortunately only look at it in terms of economics. How much is it going to cost ? Can we affort it ? etc…

    I read something similar a few years back by a Canadian Libertarian, Karen Selick who wrote about the moral myths of socialized medicine by in 2005.

    You can read it here : http://www.karenselick.com/Moral_Myths_of_Medicare.html

      

  71. 71RJ on Dec 17, 2009 at 1:44 pm:

    While I agree 100% about Dr. Sunderhaus and the creeping fascism that accompanies government healthcare, there is a major flaw in your argument. It’s quite likely that healthy people actually incur HIGHER health care costs over a lifetime than unhealthy people do. Health Care Costs Higher For Healthy Individuals Over Lifetime, Study Finds Not only that, but the bulk of their healthcare costs are likely to happen after they are retired and the government is paying for them via Medicare. It reverses your question: Why should we be forced to pay for the costs of other people’s responsibility? Not to worry, though, the socialists have a plan for that, too. They’re called “death panels”… oops, I mean “end of life advisory panels.”

      

  72. 72zombie on Dec 17, 2009 at 2:02 pm:

    RJ: While I agree 100% about Dr. Sunderhaus and the creeping fascism that accompanies government healthcare, there is a major flaw in your argument.It’s quite likely that healthy people actually incur HIGHER health care costs over a lifetime than unhealthy people do.Health Care Costs Higher For Healthy Individuals Over Lifetime, Study FindsNot only that, but the bulk of their healthcare costs are likely to happen after they are retired and the government is paying for them via Medicare.It reverses your question: Why should we be forced to pay for the costs of other people’s responsibility?

    I’m not sure sure that’s a valid rebuttal. From the linked article:

    Obese individuals had the highest health care costs from age 20 to 56, and obese individuals and smokers had a higher rate of heart disease than healthy individuals, the study found. However, the study found that obese individuals and smokers had lower lifetime health care costs than healthy individuals because they died earlier.

    Let’s say you buy a car and I buy a car at the same time. Your car is extremely well-made and requires almost no repairs. Mine is a piece of crap and starts disintegrating after a year.

    You spend $400/year for 20 years maintaining your car with oil changes and occasional checkups and minor fixes — for a total of $8,000 in repair expenses over the lifetime of the car. My car, however, requires $7,000 in emergency repairs in the first two years, before I just give up and junk it.

    According to the logic of that study, your car was “more expensive to maintain” than my car, because you spent $8,000 on it over the 20-year lifetime of the car, whereas I only spent $7,000 over the 2-year lifetime of my car.

    You see how nonsensical that study is now? A much better way of calculating the costs is the amount of medical expenses per year of someone’s life. Saying that unhealthy people are cheaper for the system because they die sooner is an absurd argument.

      

  73. 73zombie on Dec 17, 2009 at 2:06 pm:

    #70 atwood
    I read something similar a few years back by a Canadian Libertarian, Karen Selick who wrote about the moral myths of socialized medicine by in 2005.You can read it here : http://www.karenselick.com/Moral_Myths_of_Medicare.html

    Good find!

    She does indeed address briefly some of the exact same points I do, although she buries her argument near the end of a long technical essay about Canadian health care. Here’s the crucial passage:

    I think what underlies this moral myth is the notion that ill health is something that strikes at random, that it’s sheer bad luck rather than bad management, that there’s nothing a person can do about his or her health. So there’s this feeling that because it could happen to any of us, just like we could be struck by lightning, we should not be allowed to draw distinctions between who gets treated and who doesn’t.

    There are three different ways that I want to tackle this moral myth.

    First, I want to deal with the notion that needing health care is just bad luck, and it’s something that could happen to any of us. There are a few instances in which this is true. Almost any of us could be struck by lightning or hit by a car, through no fault of our own. And there are some illnesses such as Multiple Sclerosis or ALS that appear to come out of the blue and strike some people who have done nothing risky or inappropriate.

    But this, I would argue, represents only a small percentage of the health care costs we are actually incurring these days. You can think of myriad examples of ways in which people voluntarily cause themselves to need more health care than other people. There are people who engage in risky sports, for instance. Why should someone who goes mountain climbing, or race car driving be entitled to the same “free” health care as someone who doesn’t assume these risks? Where’s the moral imperative in that?

    Then there are the people who increase their medical needs because of their lifestyles. The more knowledge we get about how the body works, the more possible it is to control or at least affect your health through your conduct. Consider two people at the extreme ends of the spectrum. One person smokes three packs a day, drinks to excess, overeats, never exercises, parties all night and doesn’t get enough sleep, doesn’t wash his hands after going to the bathroom or before meals and so on. The other person doesn’t smoke, eats moderately, doesn’t drink, takes vitamins, gets enough sleep, washes his hands before eating, and exercises regularly. Statistically speaking, it’s pretty easy to predict that the second person is likely to need less health care than the first. I cannot imagine why anyone would think it’s immoral for them to get different amounts of free health care.

    Spot on!

    Thanks for pointing that out.

      

  74. 74RJ on Dec 17, 2009 at 2:42 pm:

    According to the logic of that study, your car was “more expensive to maintain” than my car, because you spent $8,000 on it over the 20-year lifetime of the car, whereas I only spent $7,000 over the 2-year lifetime of my car.

    You see how nonsensical that study is now? A much better way of calculating the costs is the amount of medical expenses per year of someone’s life. Saying that unhealthy people are cheaper for the system because they die sooner is an absurd argument.

    I don’t think it’s an absurd argument at all, and has little in relation to how we buy and maintain cars. It doesn’t matter, though. If you look at the linked article again, you will see that average annual costs were also substantially lower for unhealthy people than for healthy people. ($4964 – Healthy, $4638 – Obese, $4233 – Smokers.) I know this is counterintuitive, but it’s not surprising when you think about it. Most health care costs are incurred late in life. Those extra 4-7 years enjoyed by people who live a healthier lifestyle are very expensive. They also occur when the individual’s health care costs are covered primarily by the government.

      

  75. 75Flubber on Dec 17, 2009 at 3:25 pm:

    Wonderful post. “True wit is nature to advantage dress’t, what oft was thought but ne’er so well expressed.”
    My own stirring of the pot in re motorcycle helmets: Since far more people receive head injuries each year while driving cars, they should be made to wear helmets as well. And of course there are those who cannot understand the operation of a seat belt….

      

  76. 76Starless on Dec 17, 2009 at 3:38 pm:

    RJ:

    There’s the similar argument about preventative care, which is that it increases overall healthcare costs because it requires more visits to see a doctor.

      

  77. 77zombie on Dec 17, 2009 at 4:18 pm:

    RJ + Starless:

    Expenses incurred at the very end of a long life, as I mentioned in my original essay, are not philosophically irksome to the average American, because in most cases they are beyond the control of the patient, and not his or her “fault.” I have no problem with subsidized health care for the elderly, because all elderly people are going to need it eventually, as a corollary to growing old. So the expenses of the “healthy” people in that Dutch study are mostly unavoidable blame-free senior-citizen expenses, whereas the expenses of the obese and smokers are blame-worthy expenses incurred when they were younger and should have been healthy.

      

  78. 78Curmuegeon on Dec 17, 2009 at 4:36 pm:

    Cigarette smoking will bring down medical care. My father died of lung cancer at age 67, most likely the result of fourty years of cigarette smoking, which he quit at age 58 when his MD informed him that emphysema had taken away use of a lung. Had he lived 15-20 years more , he would have incurred much more medical costs.

      

  79. 79zombie on Dec 17, 2009 at 4:51 pm:

    #78 Curmuegeon:

    #74 RJ:

    So, we have arrived at an interesting conclusion: Socialized medicine benefits as a system when people have shorter lives. Since bad behavior = shorter lives, that means obese smokers are good for the system overall!

    Nice!

    Everybody: Die as quickly as possible, to make universal health care a viable program. Do your part for society!

    And for those who disobey and bankrupt us with their long lives, well…maybe Sarah Palin wasn’t so out of line with that “Death Panels” comment after all.

    They should remake and update “Logan’s Run” to be more realistic, and have 70-year-olds fleeing from their government-mandated death sentences. Maybe re-title it “Palin’s Run.”

      

  80. 80stuiec on Dec 17, 2009 at 5:00 pm:

    zombie: Everybody: Die as quickly as possible, to make universal health care a viable program. Do your part for society!

    So really, Obama should want America to turn into Pinocchio’s Pleasure Island, where the citizens’ lives are filled with fun and excitement and sensual gratification — right until they drop dead. Live fast, die young and leave no unpaid medical bills.

      

  81. 81stuiec on Dec 17, 2009 at 5:06 pm:

    They should remake and update “Logan’s Run” to be more realistic, and have 70-year-olds fleeing from their government-mandated death sentences. Maybe re-title it “Palin’s Run.”

    Here’s a sad irony: the Left constantly brings up average life expectancy as a critique of the American system of health care. The Swedes and the Japanese outlive us, on average, they say, proving that the Swedish and Japanese systems of health care are superior.

    But for average life expectancy to rise, you have to have a lot of people who live to a very ripe old age. It’s not enough to eliminate infant and childhood mortality and reduce mortality from adult diseases, ensuring that people live to retirement age in good health: if you don’t help some of those retired people hit 85, 95, 105, then your upper limit will be curtailed. So life expectancy statistics very much depend on the resources society invests in prolonging the lives of the elderly.

    It’d really be ironic if nationalized health care created financial incentives for people to make “robust end-of-life choices” and thus caused America to fall lower and lower on the life expectancy league tables.

      

  82. 82Barb on Dec 17, 2009 at 7:19 pm:

    Back in the 70s, one of Stephen King’s books, “Salem’s Lot,” was done as a TV-movie. One of the most fantastic parts of it, if watched today, is watching the main character stop at the window on his way out of the hospital after a beating and pay his bill (whether by cash or an insurance card, we are not shown).

    Odd how we didn’t even notice back then how incredible that scene was. In fact, it was required. They had to put that scene in; otherwise, the audience would have seen this character, who was the good guy, as a bum, having gotten something for nothing.

    There was still a fairly widespread notion of responsibility back then, and it was okay to be judgmental, too. The concept of freedom back then was well understood, and it was about something bigger and more intangible than not having to bother about other people’s behavior.

    I like your blog post a lot–as far as it goes. However, by supporting the “anything goes” interpretation of freedom, I think you’ve sipped the Koolaid, too. There has to be a sense of what is right. For everything we do, there has to be an “accounts payable” window up there just before the exit, and we all have to feel morally compelled to stop there and pay the bill.

    The problem with socialized medicine, as you point out more effectively than anybody else that I’ve read so far, is that it turns everybody fascist. To many people, though, that’s not a bug, t’s a feature — lots of people, including Americans, like to be fascist, as long as they aren’t made to feel like Nazis for embracing it. Just live in a place like New York state or California for a while and, say, put your plastic bottles in the trash or something; you’ll see what I mean. (Such people may be found anywhere in America, of course–that’s just one example.)

    My problem with socialized medicine is that it is government compulsion to stop at the “accounts payable” window (i.e., the tax bill) and will bankrupt us all eventually. There is only one effective alternative to that: the moral road. An lot of Americans, whether they realize it or not, have not yet abandoned that, and that, ultimately, is why America hates universal health care, and a lot of other stuff, too. It just doesn’t realize that yet.

    We’re just now watching the water in the bay recede and trying to explain it–the full tsunami of culture readjustment coming in has not yet become fully apparent to us yet. It will.

      

  83. 83Barb on Dec 17, 2009 at 7:23 pm:

    PS: Sorry for all the typos and grammar goofs. Just got up and obviously am in need of another cup of coffee.

      

  84. 84Guy Average on Dec 17, 2009 at 10:46 pm:

    I finally had a few minutes to read and digest this post tonight. It is very insightful which is not a surprise coming from you, Zombie.

    The opinions here do not just apply to Universal Healthcare, but to every part of Socialist Principles, which are the Polar Opposite of Personal Liberty within the context of Self-Government.

    If the Talking Heads (not the band) in this country would frame the debate this way, then their credibility would go way up.

    Zombie, I’m going to link to this and I thank you. Anyone should be able to respect someone who stands firm in their opinion and backs it up with sound reason, as you have here.

      

  85. 85Guy Average on Dec 17, 2009 at 10:49 pm:

    Barb: Back in the 70s, one of Stephen King’s books, “Salem’s Lot,” was done as a TV-movie. One of the most fantastic parts of it, if watched today, is watching the main character stop at the window on his way out of the hospital after a beating and pay his bill (whether by cash or an insurance card, we are not shown).Odd how we didn’t even notice back then how incredible that scene was. In fact, it was required. They had to put that scene in; otherwise, the audience would have seen this character, who was the good guy, as a bum, having gotten something for nothing. There was still a fairly widespread notion of responsibility back then, and it was okay to be judgmental, too. The concept of freedom back then was well understood, and it was about something bigger and more intangible than not having to bother about other people’s behavior.I like your blog post a lot–as far as it goes. However, by supporting the “anything goes” interpretation of freedom, I think you’ve sipped the Koolaid, too. There has to be a sense of what is right. For everything we do, there has to be an “accounts payable” window up there just before the exit, and we all have to feel morally compelled to stop there and pay the bill. The problem with socialized medicine, as you point out more effectively than anybody else that I’ve read so far, is that it turns everybody fascist. To many people, though, that’s not a bug, t’s a feature — lots of people, including Americans, like to be fascist, as long as they aren’t made to feel like Nazis for embracing it. Just live in a place like New York state or California for a while and, say, put your plastic bottles in the trash or something; you’ll see what I mean. (Such people may be found anywhere in America, of course–that’s just one example.)My problem with socialized medicine is that it is government compulsion to stop at the “accounts payable” window (i.e., the tax bill) and will bankrupt us all eventually. There is only one effective alternative to that: the moral road. An lot of Americans, whether they realize it or not, have not yet abandoned that, and that, ultimately, is why America hates universal health care, and a lot of other stuff, too. It just doesn’t realize that yet. We’re just now watching the water in the bay recede and trying to explain it–the full tsunami of culture readjustment coming in has not yet become fully apparent to us yet. It will.

    Tres interessant. Well said.

      

  86. 86Johnny Utah on Dec 18, 2009 at 4:42 am:

    another real reason Americans hate the idea of UHC is: they don’t want the government sticking its big ugly snout into their private affairs any more than it does already. I want my healthcare decisions to be made by me and my doctor, in his office, free from govt intrusion.

      

  87. 87Starless on Dec 18, 2009 at 5:27 am:

    zombie: So, we have arrived at an interesting conclusion: Socialized medicine benefits as a system when people have shorter lives. Since bad behavior = shorter lives, that means obese smokers are good for the system overall!Nice!Everybody: Die as quickly as possible, to make universal health care a viable program.

    I wasn’t presenting as valid the position that preventative care makes healthcare more expensive, but it has been put forth with a straight face by some in defense of Obama/Reid/WhateverCare and is a point of view which has already led to things like the federal gov’t recommending that women (under age 50, was it?) shouldn’t get mammograms. A brilliant move, BTW, particularly after women have been told for decades that if they don’t get mammograms ASAP their boobs will kill them. As it is, the killer boobs women need to worry about right now aren’t the ones on their chests. [Sorry -- I couldn't resist.]

      

  88. 88C. Hagen Radick on Dec 18, 2009 at 6:57 am:

    There are very few essays on the Internet I wish I’d written. This, however, is one of them. Well said.

      

  89. 89An Independent on Dec 18, 2009 at 8:58 am:

    I don’t see any disagreements to your article posted, but I’ll try anyway.

    While I agree with many of your points, there is still an issue with your arguments that bothers me. Simply put, most of the detractors of a so-called “universal health-care system” are part of the same group that vehemently oppose many scientifically-proven and common-sense approaches to improving the health and welfare of many Americans. Sex education (beyond abstinence only), clean needle exchange, condom distribution and many other no-brainer remedies are partial solutions to the issues that have become a huge part of the socialized costs that this article argues against. The opposition is 100% premised on so-called moral grounds, although it seems more ignorant than immoral to me. Study after study has shown that condoms and clean needles stop the spread of disease and do not lead to greater promiscuity and addiction, but in fact reduce sexual activity and drug use. Yet the conservative movement disavows this science on moral grounds.

    Compounding the reluctance to help stop the spread of disease with simple, low-cost solutions is that people who lack access to health care also lack access to the health and lifestyle eduction that is so very well provided by HMOs and the like. The medical community can and should counsel and educate society that smoking, diet, and exercise choices will ultimately affect their health.

    Universal health care, if implemented properly, will provide checks and balances to some of the problems with private insurance and help to reduce the total national cost of health care. It’s time has come — let’s do this!

      

  90. 90Finally Free on Dec 18, 2009 at 9:16 am:

    @an independent: unlike most people here, I have lived under various socialized medicine systems for over half my adult life. I’ve reviewed some in detail in a series on my own blog:

    * Part 1: Germany (the granddaddy of them all)
    * Part 2: Israel (comes close to working thanks to unusual circumstances, particularly unusually young average population age)
    * Part 3: Belgium (sustainability through euthanasia? No thanks!!!)
    * Part 4: Summary and Outlook

    Basically, you’d end up trading one set of problems for another at best.

      

  91. 91zombie on Dec 18, 2009 at 10:19 am:

    An Independent: “I don’t see any disagreements to your article posted, but I’ll try anyway.While I agree with many of your points, there is still an issue with your arguments that bothers me.”

    The problem with your rebuttal is that it rebuts a nonexistent stereotype of the opinions that you imagine the typical “conservative” holds. I, however, am not a “conservative,” nor do I hold the opinions you decry, so your attempt to to turn the tables is completely without substance. Nowhere in your comment do you address any of the arguments I made; instead, you attack other arguments that other people have made, and try to connect them to me by saying “People like you also make these weaker arguments.” FAIL. How about addressing what I actually said, rather than put words in my mouth?

    This is a standard tactic of people who feel they’re about to lose an argument: misdirection. Change the subject and argue on friendlier ground, rather than continue the actual argument being conducted. Yes, there may be people out there who count themselves as “conservative” and have what they and you believe is a consistent cohesive worldview based on moralistic principles which make sense to them and no sense to you. However, I’m not one of those people. (There is no word to describe my worldview — yet. I’m working on it).

    So if Americans want to engage in the purportedly preventive measures that you suggest — go for it! Fine. But the key point is: Nothing about your suggestions has as an essential prerequisite the implementation of compulsory universal single-payer health care. In fact, many municipalities already hand out needles and condoms, and have sex education and nutrition education, and none of those municipalities have universal health care, nor are they required to in order to implement those programs. So your argument fall flat once again.

    Lastly, you say, “Study after study has shown that condoms and clean needles stop the spread of disease and do not lead to greater promiscuity and addiction, but in fact reduce sexual activity and drug use.” Really? I’ve never heard of such studies. Link, please. In fact, the only stories I’ve heard in relation to this went the opposite way.

    Zurich, Switzerland, for example, decided a few years ago to hand out free needles and stop prosecuting heroin addicts for breaking the law. The theory was that if you stop criminalizing heroin addiction, then it will stop being a social problem. The end result? Zurich was overrun by thousands of heroin addicts, who for a while turned the whole place into “Needle Park.” In order to solve that problem, the city then “medicalized” heroin use, providing not just free needles but free heroin to anybody who wanted it, just so long as they injected it in a government-financed free heroin clinics. In other words, eventually free heroin came to be included as part of universal health care. While later defenders of the program have pointed out that over time the number of new users has since fallen, as hoped, buried in the statisitics is the depressing fact that “the average length of time each user spends on the drug has increased” under the program. In other words, it just keeps addicts addicted and alive longer, but doesn’t succeed in getting them off the drug.

    As for the condom-handing out — I can’t quite visualize how handing out condoms to teenagers somehow magically “reduces sexual activity” as you claim. In fact, overall society-wide, there is a great deal of condom-handing-out going on over the last 15-20 years, and coincident with that is a lot more sexual activity among teenagers. Which came first, or free condoms or the sex? Who knows. But I have yet to see a study which says that sexual activity has decreased in any way, whether due to condom distrubution programs or any other reason.

    As for sex education programs: That has nothing to do with health care reform. Most schools already have sex education classes, right now, even though there is no universal health care. It’s an education issue.

    Same applies to nutrition education. You think the government hasn’t tried to amp up nutrition eudcation? It does everything it can. And I support those programs.

    But in the end, not a single point raised in my essay was addressed by your objection. Thanks for playing, but…next!

      

  92. 92tantheman on Dec 18, 2009 at 10:21 am:

    not a major point but it’s actually cheaper to eat more unhealthily, one of many reasons fat people eat terrible.
    http://www.michaelpollan.com/article.php?id=88

      

  93. 93zombie on Dec 18, 2009 at 10:46 am:

    tantheman: not a major point but it’s actually cheaper to eat more unhealthily, one of many reasons fat people eat terrible.
    http://www.michaelpollan.com/article.php?id=88

    Michael Pollan has some good points, but on this issue he is completely full of shit. He constantly tries to argue that it is monetarily cheaper to eat junk food than it is to eat healthy food — a situation caused by bad government policies, he claims.

    Really? I’ve actually met Michael Pollan in person, and he’s nice enough, buit I still don’t know what planet he’s living on.

    Buying basic food staples and fresh vegetables is much less expensive per calorie and per meal and per-anything than buying junk food. If you cook at home, you can eat for very little, and the food you make will be good for you. All over this country, you can buy a pound of dry beans for under a dollar; a pound of uncooked rice in bulk for under a dollar; some inexpensive chicken or ham hocks or ground beef, or if you’re vegetarian, even less expensive tofu or whatever. Add in a couple bucks worth of vegetables, and you can make about six meals’ worth of very healthy and tasty food, for probably under six dollars. With that same six dollars, you can buy maybe two junk food meals at most.

    I’m no fool, and I’ve lived in American society all my life, and I’ve eaten in all sorts of places and circumstances. And after a lifetime’s experience, I’ve come to the inescapable conclusion that it is cheaper to eat healthily than it is to eat unhealthily. Sure, if you buy the kind of upscale organic shade-grown fair-trade, hand-massaged pesticide-free locally-grown boutique vegetables and meats so favored by Michael Pollan, you can spend a pretty penny. But if you just buy regular ol’ food, it’s not expensive at all.

    He’s very politically motivated, so he keeps trying to make this point, in order to influence public policy in some way, but he has never convincingly shown that his claim is true. Give me a twenty dollar bill and I can buy and construct any number of delicious meals that are vastly less expensive than either the junk food in the store or the fast food in the restaurant.

      

  94. 94Starless on Dec 18, 2009 at 11:35 am:

    zombie: Zurich was overrun by thousands of heroin addicts, who for a while turned the whole place into “Needle Park.”

    As I understand it, medicalizing pot in California has created a similar atmosphere. Doug Benson, IMO, is a hilarious comedian, but his movie “Super High Me” made the exact opposite point from what he intended. That is that medicalizing pot has succeeded in bringing out people willing to lie and fake medical conditions in order to get pot for recreational use. He spends basically the whole movie metaphorically winking (and giggling) to the camera, sure that everyone knows that it’s all a big lie. But that’s cool because everybody knows that the only reason pot is illegal in the US is because of the religious right wing moral Puritans.

    zombie: Buying basic food staples and fresh vegetables is much less expensive per calorie and per meal and per-anything than buying junk food.

    There’s the simple, obvious point that junk food is processed. Processed means more work, more work means more expense. Unless, as you point out, the vegetables are “organic” (a food science prof once pointed out, a long, long time ago, that “organic food” is a bullshit redundant marketing term — anything you can eat and process is organic…but anyway) and have been individually hand-reared by an astute farmer who knows that guilt-ridden middle class white people will pay almost any price to assuage some of that guilt.

      

  95. 95Capitalist with a conscience on Dec 18, 2009 at 3:37 pm:

    If only those who are outraged about the concept of a single payer system were HALF as outrages about how screwed up the current system is!
    Let me tell you a real and personal story, served up hot and fresh. This happened, just before Thanksgiving, 2009.
    My wife was advised by her doctor to get 2 CT Scans and referred to the imaging facility just up the street from the doctor’s office. She IS responsible so has VERY HIGH ($10,000) deductible on her insurance to keep her premiums affordable. She inquired of her doctor about the likely cost of the 2 prescribed CT Scans. “About $5,000″ was the answer.

    Since effectively all of that charge would have been out of pocket for her, she decided to get on the phone and shop around a bit. Yes, the ‘recommended’/referred imaging center’s cost was ~$4,800. Other places were under $4,000, but she found another imaging center (less than a mile away from the recommended center) that did the two CT scans for $300 each. $600 total. PROVIDED that there wouldn’t be any insurance involved! (The lowest priced imaging center advised they would have charged approx 3X as much if insurance was to be billed. And of course, all of what the insurance company would have been billed would have been out of pocket on her deductible.)

    The doctor also wanted some blood work done and gave my wife the list of 7 tests that needed to be run. She also gave her the name of a medical laboratory just up the street. My wife called for pricing again and the recommended lab was just under $1,000 for the 7 tests. Good shopper that she is, she checked out 2 other labs here in town and found one that would run all 7 tests for approx $300, again with the proviso that there would be no insurance involved!

    My father needed some prescription medicine after his hip replacement surgery about 4 years ago. My mother shopped for the prescription and found the very same prescription at one pharmacy (I forget which one) was $7.00. Yep: Seven dollars. Walgreens sells it as a covered prescription at a cost of $300. That’s THREE HUNDRED dollars for the very same prescription. Not generics; The exact SAME prescription. Well, Dad’s deductible (co-pay) on the insurance was about $20, so the $7 charge outside of insurance was the better deal.

    We have been calling this a health care debate. Health care is only a part of the problem. I’m convinced that Health INSURANCE is the bigger problem. The fact is that pretty much NOBODY shops for health care, because, well, it’s covered by insurance! So we take our doctor’s judgment as gospel truth and blindly go where the doctor sends us for the prescribed tests and treatments. Insurance companies have caused us to pay more for pretty much everything, while taking our insurance dollars and paying their executives HUGE sums of money.
    FACTS:
    Executive compensation of 3 people in the health insurance business (I haven’t gotten 2009 figures yet):
    Ronald A. Williams, Chief Executive Officer, Aetna Inc.: In 2008, collected $18,608,778 in total compensation.
    H. Edward Hanway, Chief Executive Officer, CIGNA Corporation: In 2008, collected $12,236,740 in total compensation. (poor guy. In the previous year he made $24,335,038. Total CEO compensation has decreased by 50%.)
    Thomas R. Watjen, Chief Executive Officer, Unum Group. In 2008, collected $12,262,978 in total compensation. (In the previous year the CEO of this company made $13,769,784. Total CEO compensation has decreased by 11%.)
    In case you’re wondering: These guys did not raise a scalpel nor invent the cure for cancer.
    Here’s what they do: http://www.pbs.org/moyers/journal/07312009/watch.html

    If you’ve got time to be fully informed about 2 key issues are in the current reform debate, check out
    Rationing health care: http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html
    and
    Our current economic circumstance has been a long time coming. WE have all been warning each other that America has been bankrupting its future. Watch this (http://video.pbs.org/video/1099844054/) for a real understanding of how deep is the hole we’re in, how we got here and and what some of the options are for America now that the future has started to arrive. This IS about health care, too. Watch it all the way to the end.

    If you do watch all the way to the end, you’ll be more likely to agree that some change is desperately needed in health care and especially how health care is paid for and going to be paid for in the future. It should be apparent that free enterprise (supply and demand) that the conservatives support is NOT working in our current system. Well, it hasn’t so far, anyway! I’m a huge champion of free enterprise when it works. Americans shop for everything from shampoo to cars, but health care isn’t something that is practical to shop for. If I’m bleeding internally, I don’t want to be calling for the lowest priced surgeon!

    So let’s agree that the status quo isn’t so hunky dory. All right.. Let’s get completely pissed off about it and decide that ALL ALTERNATIVES merit some consideration because the current system is TOTALLY SCREWED UP.

    We probably won’t agree on what the reformed health care system / health insurance system should be, but we should be ENCOURAGING our elected representatives to do something BOLD to change or fix a badly broken system. We should work to make sure they take on this task without the influence of lobbyists (and other corrupting influences) and remember that the lawmakers are mostly lawyers (and the legal profession has its own lobby) and Tort Reform is something they may not be completely independent about.

    Lastly: There are people who are simply opposed to any system run by the government. I grant that not all government programs are overwhelming successes, but there are some things that government can do better than private enterprise: If you’ve ever driven on an interstate highway, flown on an airplane with the Federal Aviation Administration keeping track of your flight (and the thousands of other airplanes in the air simultaneously); if you’ve ever been to a national park or used your public library, or slept better knowing that our military is awake, I think you’ll agree there are some effective government functions. Even the U.S. post office had many proud decades, although its prime has obviously passed.

    Doing nothing but arguing in favor of the status quo is a symptom of Ostrich’s disease for which the cure is obvious to everyone but the afflicted.

      

  96. 96ChrisFS on Dec 18, 2009 at 5:53 pm:

    If you don’t want to be your brother’s keeper, you should move to an island by yourself, otherwise, you’re part of a society, people pay taxes to support the police and road crews and fire departments that benefit you and not them and you do the same. Pure libertarianism leaves everyone in the caveman era.

      

  97. 97stuiec on Dec 18, 2009 at 6:05 pm:

    ChrisFS: If you don’t want to be your brother’s keeper, you should move to an island by yourself, otherwise, you’re part of a society, people pay taxes to support the police and road crews and fire departments that benefit you and not them and you do the same. Pure libertarianism leaves everyone in the caveman era.

    Chris, I am sure you have a spare bedroom for my family to move into. We are tired of keeping ourselves, and we want you to keep us for a while. Okay, brother?

    Oh, and if you don’t have a spare room, that’s okay. You can sleep in your car. Or your bathtub.

      

  98. 98Noam Sayin' on Dec 18, 2009 at 6:17 pm:

    Nice work, Zombie.

      

  99. 99Starless on Dec 18, 2009 at 8:49 pm:

    stuiec: Chris, I am sure you have a spare bedroom for my family to move into. We are tired of keeping ourselves, and we want you to keep us for a while. Okay, brother?

    Amen to that. I’m really tired of this “work” stuff and I think Chris should do some of that for me for a while.

      

  100. 100pat on Dec 18, 2009 at 11:46 pm:

    Let the pig die.

      

  101. 101Finally Free on Dec 19, 2009 at 12:47 am:

    @An independent: I have lived under several different socialized medicine systems for much of my adult life. I’ve picked them apart in a series on my blog (click on my handle, then go to “Socialized medicine series” in the sidebar — the spamfilter here won’t let me post all the links).

    * Part 1: Germany (the granddaddy of them all)
    * Part 2: Israel (comes close to working thanks to unusual circumstances, particularly unusually young average population age)
    * Part 3: Belgium (sustainability through euthanasia? No thanks!!!)
    * Part 4: Summary and Outlook

    Basically, you’d end up trading one set of problems for another — in the best-case scenario. If every American family decided to have 4 children on average, brutal tort reform was enacted, … just maybe things could be made sustainable. Or if “doctors” who have forgotten the meaning of the Hippocratic Oath start euthanizing sick elderly people the way the Belgians and Dutch are increasingly doing…

    Even if the philosophical objections Zombie outlined so brilliantly in his/her article could somehow be overcome, pragmatic considerations would do things in.

    If anybody were serious about making healthcare more affordable they’d start working at tort reform first. But fat chance of that happening with a party financed by ambulance chasers (as well as entertainment moguls and megafinancers) in power.

      

  102. 102Vince on Dec 19, 2009 at 12:32 pm:

    Great essay. Hits all the salient points. And I don’t know where you culled up all those photos to
    accompany the post, buy, my God! Sometimes the right image in the right place can really
    make the point like nothing else, and those really do the trick.

      

  103. 103stuiec on Dec 19, 2009 at 1:13 pm:

    OT:

    Has no one noted the fundamental shift reflected in changing the target from CO2 ppm to degrees? Why, it’s as if the Copenhagen delegates understood that the world’s climate was entering a cooling phase, and decided to shift the target to temperature in the secure knowledge that the naturally-cooling planet would do the work for them to let them claim a phenomenal victory in a few years’ time.

      

  104. 104Starless on Dec 19, 2009 at 1:46 pm:

    stuiec: OT:Has no one noted the fundamental shift reflected in changing the target from CO2 ppm to degrees?Why, it’s as if the Copenhagen delegates understood that the world’s climate was entering a cooling phase, and decided to shift the target to temperature in the secure knowledge that the naturally-cooling planet would do the work for them to let them claim a phenomenal victory in a few years’ time.

    Oh, yeah, I just saw that. Maybe they’re just tacitly acknowledging that Kyoto has FAIL written all over it and are throwing stuff against the wall to see if they can luck across a better looking outcome.

      

  105. 105Shug on Dec 19, 2009 at 9:05 pm:

    Zombie,
    Great article. I’m a physician. I’ve told a few Mothers who smoked cigarettes and demanded a prescription for WIC for “free formula” to give up smoking and spend their cigarette money feeding their kid.
    The looks I’ve received from them is priceless. Nobody talks to them like that.
    Everybody wants something for nothing, except for those of us who work to pay for these freeloaders.

    This doctor is a dying breed, and with Obamacare looking like it will be a reality in some form, and with the growth of the welfare class, I’m afraid that Good old American doctors will become more and more scarce and will be replaced with FMG’s ( Or IMG’s as the PC police now call them ( International medical graduates)

    PS: glad to see you back blogging from wherever you were. You were missed by so many people

      

  106. 106Denise on Dec 19, 2009 at 9:23 pm:

    Wow, I’m glad there are so many people out here that are perfect, never make a bad decision and have no vices. Do you have a life or do you simply hide inside the walls of the Internet world and hope no one sees the real you? I am by no means perfect and I like the person I am just the way I am, and I pay my own way in this world without ever asking or taking from the government or anyone else for that matter. Everyone says this is complicated, but the reality is the answer is so simple…Do away with insurance all together. If we have a sliding scale system of payment for all, we can control costs and allow patients to control their own destiny. Insurance is a way to inflate costs to charge to the uninsured and minimize the return to physicians in the process. How many people get residual payments monthly out of the premiums we pay? Why? Does your insurance agent help you when your claim is denied? No. And, the drug manufacturers market aggressively to physicians and work out a compensation system that most individuals know nothing about: prescribe this medicine doc and we will provide you with a sizeable kickback for the favor of prescribing our medicine over our competitors medicine. Allow each individual to work directly with their personal physician and we will see true health care reform. Institute more insurance policy provisions or government run “insurance” and we will continue down the same money hungry path designed by the insurance companies to keep us dependent on the system. This isn’t difficult people and it is not a result of personal vices leading to obesity, cigarette and alcohol addiction, sexual dysfunction, etc. It is money…they want it and we continue to give it to them.

      

  107. 107zombie on Dec 19, 2009 at 11:25 pm:

    #105 Denise

    There is some merit to your idea, and in a perfect world I would agree with you. I personally loathe HMOs and the whole concept of health insurance, because they exist simply to skim off money in the transaction between the patient and the doctor. And furthermore, they create a ridiculous amount of paperwork and red tape and bureaucracy that must be waded through in order to do the simplest thing medically.

    HOWEVER, the health insurance industry arose because normal people became increasingly incapable of handling “catastrophic care” costs. For example, if a guy spends his whole life trying to be healthy, and saves a tidy sum for his retirement, and then one day slips on some ice while out walking his dog, and injures his spine, he would end up spending his entire retirement nest egg to pay for the expensive spinal surgery just to get back on his feet. And so he worked his whole life to live in ease in his old age, and instead he’s stone broke without a cent to his name at the age of 65.

    This happened so often in the 1960s and ’70s to so many people that they idea of buying insurance to cover potential catastrophic costs suddenly became a very attractive deal, and many people jumped at the chance. Sweenteners and enticements were added to the insurance packages to include checkups, etc., as a way to lure in customers — and before long, the idea of health insurance became viewed as an “essential.” And soon after that, it became (according to the Obama-ites) a “human right” that everyone must be granted.

    Strange how something that hardly even existed a few decades ago is now a fundamental human right. What the hell happened?

    An alternate solution to yours is not to entirely do away with health insurance — because if we did that we’d revert to the old problem of brief hospital stays bankrupting whole families — but rather limit them to cover catastrophic costs only. Policies would be much cheaper that way, too. So, we could all agree on some set deductible applicable across the board. Say, pulling a number at random out of a hat, $10,000. Each person could then shop around and find the best catastrophic health insurance, and then pay a very reasonable monthly fee: the first $10,000 he (and/or his family) incurs during a calendar year is his responsibility to pay. And anything beyond that is covered by the insurance.

    This way, people do have a strong financial motivation to stay healthy, because they’d have to pay out $10,000 of their own money if they got sick; but no one would be compelled to go broke and lose the retirement fund to pay the exorbitant costs of surgery or hospitalization. Healthy people benefit by not having to pay anything except for a modest monthly fee, and “irresponsible” or unlucky people at least won’t go bankrupt.

    (Needless to say, adjust the deductible up or down according to your preferences in this scenario. Is $10,000 reasonable? You tell me.)

    The government really doesn’t need to be involved, except to tell the insurance companies that everybody must have the ability get the coverage if they want — no turning people away. We wouldn’t need a “public option,” since the insurance companies will still be competing against each other to lure in customers. And since it is the patients’ responsibility to pay the first $10,000, in most years, there will be basically no burdensome paperwork or red tape. Just perhaps a running total on your monthly bill telling you how much of your deductible you’ve paid out so far that year. No need to wrangle over every visit to the doctor.

    Anyway, that solution is just off the top of my head — there are certainly others as well. What is going to be coming out of the Senate and signed by Obama is a monstrosity — insanely complicated, numbingly expensive, messy, unnecessary, and repressive. What’s not to hate?

      

  108. 108Starless on Dec 20, 2009 at 6:39 am:

    zombie: For example, if a guy spends his whole life trying to be healthy, and saves a tidy sum for his retirement, and then one day slips on some ice while out walking his dog, and injures his spine, he would end up spending his entire retirement nest egg to pay for the expensive spinal surgery just to get back on his feet. And so he worked his whole life to live in ease in his old age, and instead he’s stone broke without a cent to his name at the age of 65.

    Funny you should use this as an example. I had a member of my family, a health fanatic marathon runner on the verge of retirement, who fell and suffered a traumatic brain injury along with some broken bones. His hospital stay consisted of three visits to the OR to stop brain bleed, two weeks in a coma in SICU, about a week or two in a standard hospital room, three months of in-patient therapy (cognitive and physical), and years of follow-up therapy. I forget what the final bill for the hospital stay was, but I do know that if he had been handed the bill and told to pay up then and there, the entire family would have been bankrupt and paying the bill off for a very long time. And he had really, really good insurance. Even under the existing HMO system, if his coverage hadn’t been so good, his accident still could have bankrupted the family.

    I think the lesson of health insurance is: shit happens. We can argue about the extent to which people are responsible for that shit (IMO, when people are involved, the extent to which something is “accidental” is a question of how far back you want to follow the causal chain) but somewhere someone is going to pay. If we want to receive excellent health care, we need to pay as a group, otherwise no individual could ever possibly afford that excellent care. The question right now is: do we want a new devil or do we try to fix the old devil we know?

      

  109. 109zombie on Dec 20, 2009 at 11:02 am:

    Capitalist with a conscience: Doing nothing but arguing in favor of the status quo is a symptom of Ostrich’s disease for which the cure is obvious to everyone but the afflicted.

    I’m not advocating doing nothing. Nor am I one of those people who don’t want the government in any role in our lives. Obviously the federal government can and does serve some good functions — not just the examples you gave, but also the FDA, which keeps dangerous drugs off the shelves and enforces labeling laws; the TSA, which tries to prevent hijackings; etc. etc. I’m not some anti-government militia member. But just because the government has a valid role in some areas doesn’t mean it then also has a valid role in all areas. I want the federal government out of media control; I want it out of education; and so on. And one area in which its role should be severely limited is health care.

    Yes, as we all concur, the current system is broken. (Well, it’s not even really a “system,” just a mishmosh of accidental programs all mushed together.) And yes, the scenario you described of “in-network” referrals being often vastly more expensive than out-of-network referrals has happened to me and plenty of other people too.

    A solution to this, which is a clarification/amendment to my solution outlined in comment #106, is that the insurance company should have no right nor ability to dictate which doctor or specialist you use, especially when you’re still beneath your $10,000 deductible. People should be free agents: You can see whatever doctor you want, and whatever tester/specialist you want, as long as you’re still responsible for paying that first $10,000. After that you still should be free just so long as you’re not being flippant — jetting off to Switzerland to get an unnecessary nose job, or whatever.

    Under this scenario, ALL the blood-testing places described in your scenario should be approximately the same price, since there won’t be an insurance company intermediary driving up the prices at certain places to pay for all the bureaucrats and middlemen.

    It’s one thing to say “We nee to fix it!” and quite another to assume that the current Senate bill is that fix we’re looking for. It is possible to make things worse. And from what I’ve seen of this bill — it will definitely make things worse. More complicated = more paperwork = more bureaucrats = more expensive overall. What makes health care expensive is paying for man-hours. The actual procedures and/or materials involved often aren’t that costly; what costs are the hourly rates of the people involved. (And of course massive price-gouging.) The solution is to minimize man-hours and somehow put a stop to price-gouging. One way to achieve that is to allow everyone to do the exact kind of “shopping around” your wife did, to find the best price. Then market forces do come in to play, and will keep prices reasonable.

      

  110. 110zombie on Dec 20, 2009 at 11:34 am:

    Holy cow, am I prescient or what?!?!

    Someone actually read the Senate health care bill and discovered that my predictions are already starting to come true!

    Above, I say, “All sorts of American subcultures have standard behaviors which increase the risk of medical complications. …I’m talking about upper-class socialites who lie on tanning beds and give themselves skin cancer…”. Lo and behold, in the Senate bill about to be passed, they start the process toward nanny-statism by imposing a special punitive tax — on tanning beds! :

    The Volokh Conspiracy: The Tanning Salon Excise Tax
    SondraK: Not About Control, Ya Say?

    (b) EXCISE TAX ON INDOOR TANNING SERVICES.—
    Subtitle D of the Internal Revenue Code of 1986, as
    amended by this Act, is amended by adding at the end
    the following new chapter:
    CHAPTER 49—COSMETIC SERVICES
    ‘‘Sec. 5000B. Imposition of tax on indoor tanning services.

    ‘‘SEC. 5000B. IMPOSITION OF TAX ON INDOOR TANNING

    SERVICES.“

    (a) IN GENERAL.—There is hereby imposed on any
    indoor tanning service a tax equal to 10 percent of the
    amount paid for such service (determined without regard
    to this section), whether paid by insurance or otherwise.

    And so it begins. Expect the government to start interfering in unhealthy lifestyle choices — exactly as suggested in this essay.

    Baby steps on the road to totalitarianism.

      

  111. 111Guy Average on Dec 20, 2009 at 12:03 pm:

    Zombie, I have been processing what you say in this post and I’m able to take the time to jot a few thoughts today. Before I go on, thanks again for your work.

    This scenario would promote public support for fascist laws as well. An individual may speak out against something that they do not participate in that has negative health risks and also not particpiate in that thing, such as tanning beds for example, but the tendency for the general public would be to support laws that on the bottom line protect their checkbook by controlling the behavior of everyone if indeed they are paying the bill for negative health consequences for everyone. Thus, the government would be able to portray itself as being helpful while passing laws that choke liberty at every point, and as new generations are indoctrinated in this way of thinking, the totalitarian state is established and even supported by its citizens. It would become the “comfort zone” of the masses, if you will.

    For those of us who know what personal liberty is like this would not be acceptable. For a generation who sees the government as a source for their security it would be desired. This may take more than one generation to be solidified, but it has already been in-process for more than one generation. We are in a period of “creeping fascism” which is apparently coming to its fruition. The things that this current government is doing may not have been supported and/or technically possible in the past. With the acceptance of gradual levels of fascism, the gross deceit that our current government is using to impose control behind the smoke-screen of feigned Constitutional prudence, and the existence of the technology to control lives on a personal level (and the voluntary integration of much of that technology into our lives), the stage is set for a level of total government control. The last major dominoes left are Private Property Rights and the Right to Keep and Bear Arms.

    The Founding Fathers had a Source for their security that they believed was above the level of mankind. That is why they were able to risk all they have against what seemed insurmountable. Those who put their faith, trust, and belief in a government made of humans will never have a reason to risk all in order to achieve Liberty.

      

  112. 112Zombiefan on Dec 20, 2009 at 12:59 pm:

    Mr. Zomblog, I completely agree with what you posted! I’m not in perfect shape. I eat too much junk food. But I work to cut down, I exercise, I don’t smoke or drink or use drugs. I hate the idea that I should pay millions of $ for all the medical help needed by someone who weighs 400 lbs, or for Nadya Suleman to have have 14 (likely mentally ill and developmentally impaired) offspring. I’m responsible for take care of my health and I don’t want to pay for the foolishness and bad decisions of others. I don’t tan, and I wear sunblock, and yet people who are irresponsible want me to pay for their skin cancer treatments? Fat people want me to pay for their diabetes? Smokers want me to pay for their lung cancer? Nadya Suleman wants me to pay for her 14 children?

      

  113. 113Denise on Dec 20, 2009 at 2:10 pm:

    Zombie, in your response to my post, I think you made the most compelling argument for a reasonable health care reform and far less offensive than criticizing people for their lifestyle choices. Catastrophic care only protects everyone and makes individuals responsible for their own lifestyle decisions.

    Let’s keep the focus where it needs to be…health care between the patient and physician, where costs and ability to pay have no impact on medical decision making and everyone has a fair and equal opportunity to have quality, affordable health care. There are several people that have diabetes who are not overweight and are otherwise healthy. There are people with lung cancer who have never smoked a cigarette in their life. There are people who are naturally clumbsy who do not take foolish risks but end up with severe injuries from accidents. Pointing out that if people would just eat right, exercise and play it safe would allow us not to have to pay for the poor choices of others is counterproductive. The focus should be on why insurance companies and government agencies have been empowered with the right to dictated what medical procedures patients should have, regardless of what their treating physician indicates is in the patient’s best interest.

    In the end, I could not agree more with your statement, “What is going to be coming out of the Senate and signed by Obama is a monstrosity — insanely complicated, numbingly expensive, messy, unnecessary, and repressive. What’s not to hate?”

      

  114. 114zombie on Dec 20, 2009 at 2:27 pm:

    Denise: Zombie, in your response to my post, I think you made the most compelling argument for a reasonable health care reform and far less offensive than criticizing people for their lifestyle choices.

    Ah, but the thesis of my essay is NOT that we should be criticizing people for bad lifestyle choices. In fact — quite the opposite! The reason I oppose single-payer health care is that it will compel us to criticize other people’s lifestyle choiceswhich I don’t want to do. I purposely made the post as “offensive” and blunt as possible, to get everyone’s attention (which seems to have worked!), but my essay is actually a plea to let me butt out of your business. I don’t want to criticize anybody. But the nanny-statism implicit in ObamaCare will twist my arm and turn me (and every American) into the kind of person I hate — a busybody critic.

      

  115. 115stuiec on Dec 20, 2009 at 3:57 pm:

    Insurance doesn’t merely skim off a service charge between the patient and the physician. Insurance is supposed to pool risk and let a group of insured persons enter into a voluntary agreement that they will help each other pay for medical expenses. All will draw on the pool for routine expenses and preventive care, but only some will draw on the pool for help with catastrophic illnesses and injuries. Thus an individual could put a smaller amount aside in premiums than would be required in savings to protect against the worst-case scenario.

    At least, that’s how it’s supposed to work and how it used to work. However, when the misconception arose that the insurer is the payor — in the sense of a bottomless source of health care funding — the link between shared risk and payment for care became broken. Bureaucrats decided to force hospitals and insurers to pay for services that were not reflected in their fee and premium structure.

    The current “health care bill” exacerbates that situation beyond all repair. It actually replaces the insurance company’s actuaries with legislative mandates on how much of the premiums coming in must be paid out. It’s insane.

      

  116. 116Starless on Dec 20, 2009 at 4:41 pm:

    stuiec: The current “health care bill” exacerbates that situation beyond all repair. It actually replaces the insurance company’s actuaries with legislative mandates on how much of the premiums coming in must be paid out. It’s insane.

    It also creates a situation where, like with the tanning bed tax, legislators have more say in what specific treatments should be covered and what shouldn’t. These are people who live their professional lives through polls and lobbyists. You think the NYT and pharmaceutical and medical device manufacturers have a lot of sway now, just wait until this thing gets rolling.

      

  117. 117Marilyn on Dec 20, 2009 at 10:37 pm:

    Awesome post. Wish they could hear you up in Washington DC.

    Glad you allowed for those of us who are heavy because of uncontrollable problems. I live on grass, twigs, and air but still am heavy. I have a reverse T3 problem along with autoimmune thyroid. At least I can maintain between 160-170 (a 5’6″ female) on 1000 calories a day. Not fun, but doable.

      

  118. 118Sean on Dec 21, 2009 at 3:24 pm:

    What an absolutely wonderful article. You’ve communicated the concerns many have had in a very readable way. Now it’s time to mass produce these very real concerns. It’s time to promote a style of government that induces individual responsibility.

      

  119. 119Starless on Dec 22, 2009 at 5:52 am:

    Sean: It’s time to promote a style of government that induces individual responsibility.

    “Induce” as in “promote” or “force”? Because “induce” suggests the latter and if that’s the case, what you want out of gov’t is merely the flip side of the same nanny state coin.

      

  120. 120FeFe on Dec 22, 2009 at 6:28 pm:

    I have often thought the drunken yobs in the UK are a direct result of their NHS. How invincible you feel when young, and even more so when you need never worry about a medical bill. Is it any wonder their streets are filled with Jackasses?

    Thank you for saying what needs to be said. Merry Christmas.

      

  121. 121Rob on Dec 22, 2009 at 9:52 pm:

    Zombie, I gotta hand it to you man, you have a great way with words. Your research in other blog posts and web pages, your photos and explanations of them all… it’s all friggin’ exemplary bro. This is the first time I have commented on one of your blogs, but I started following after seeing the post exposing Jennings: http://www.zombietime.com/zomblog/?p=927 It hasn’t been that long ago, really, but that sealed the deal for me after checking out the whole site. You are a great American! Thank you.

    @Starless
    Induce can be taken in different ways, but would you rather the government force you to be an individual, or would you rather them push your hand towards statism? I think that is the main point of… lemme look at the name… Sean.

      

  122. 122Ryan on Dec 22, 2009 at 11:27 pm:

    Although I agree with many of your points, your argument is still fundamentally flawed. The biggest problem with a capitalistic free will enforcing health care is the motivation of the doctors. Why would a Doctor want to actually cure his patients rather than just treat them. This is the problem with the American health care system as it stands. Doctors make money for the treatment not the cure. This is why there are thousands of drugs that are designed to treat the symptom and not attack the cause. This is why people are overly medicated. If the pay system for Doctors was somehow related to the health of their patients we would see a more efficient medical system. This efficient medical system would spend more money educating people about their choices then waiting for them to screw up so they can make the big bucks.

      

  123. 123RoboMonkey on Dec 23, 2009 at 4:49 am:

    zombie: I don’t want to criticize anybody. But the nanny-statism implicit in ObamaCare will twist my arm and turn me (and every American) into the kind of person I hate — a busybody critic.

    It will also put you on the receiving end of every busybody critic whose opinion of what’s “right” and “healthy” differs from your own. You won’t just be forced to make more criticisms, you’ll also find yourself on the receiving end from all the people who think you shouldn’t eat meat, should get rid of your car and jog fifty miles to work, etc. I, like Zombie, don’t give much of a goddamn what consenting adults do to themselves, and I don’t want anybody else getting in my face about what I do to myself. Eat what you want, worship what you want, etc.; your fight to swing your fist ends where my nose begins.

      

  124. 124Starless on Dec 23, 2009 at 5:47 am:

    Rob: @Starless
    Induce can be taken in different ways, but would you rather the government force you to be an individual, or would you rather them push your hand towards statism? I think that is the main point of… lemme look at the name… Sean.

    I’d say “neither” and let me clarify. I already have a mommy and a daddy, I don’t need the feds to try to fulfill either role for me. Any law intended to induce (and “induce” does have a specific meaning) particular behavior in me is an attempt to try to get me to do what they have decided is good for me. Whether the means of achieving that is through coddling me with maternal arms or hanging the paternal threat of the wood shed over me, it’s all the same.

      

  125. 125Common_sense on Dec 23, 2009 at 6:10 pm:

    Excellent post Zombie. I’d say award-winning but what’s an award worth anyway (especially of the “Nobel” variant)?

    I feel I owe you something for such an eloquent piece. SO very well stated and illustrated.

    I can give this laurel, and hearty greeting and offer my thanks/assistance should you ever need it.

      

  126. 126Honcho on Dec 23, 2009 at 7:52 pm:

    Zombie, you’re the best. The worthy successor to LGF! Keep it going!

      

  127. 127Keith on Dec 24, 2009 at 1:34 am:

    Come on you guys. Zombie is just buttering you all up with false ideas about what it means to be American so you will support his healthcare position. I don’t know what the best healthcare position is but at least be a bit more critical in your thinking.

      

  128. 128buzzsawmonkey on Dec 24, 2009 at 2:31 pm:

    Ryan: Although I agree with many of your points, your argument is still fundamentally flawed. The biggest problem with a capitalistic free will enforcing health care is the motivation of the doctors. Why would a Doctor want to actually cure his patients rather than just treat them. This is the problem with the American health care system as it stands. Doctors make money for the treatment not the cure. This is why there are thousands of drugs that are designed to treat the symptom and not attack the cause. This is why people are overly medicated. If the pay system for Doctors was somehow related to the health of their patients we would see a more efficient medical system. This efficient medical system would spend more money educating people about their choices then waiting for them to screw up so they can make the big bucks.

    I don’t think I have ever in my life met a doctor who was looking to farm his or her patients to keep getting money from them.

    Such creatures no doubt exist—there are dogs in every profession—but to believe that doctors as a class are overly medicating patients as a means to avoid curing their patients is quite simply nuts.

      

  129. 129JesusLovesInfeidels on Dec 24, 2009 at 3:52 pm:

    Merry Christmas Zombie.

      

  130. 130Starless on Dec 25, 2009 at 3:37 am:

    buzzsawmonkey: Such creatures no doubt exist—there are dogs in every profession—but to believe that doctors as a class are overly medicating patients as a means to avoid curing their patients is quite simply nuts.

    Yeah, I don’t think too many doctors are concerned about running out of customers any time soon. Last time I checked I don’t think there’s even a cure for the common cold yet. OTOH, maybe there really is and they’re holding out on us.

      

  131. 131Ringo the Gringo on Dec 25, 2009 at 8:50 am:

    Merry Christmas, zombie!

      

  132. 132tannin on Dec 26, 2009 at 2:41 am:

    You are wrong zombie, wrong, not in any one instance that you mention, but in your conclusion.
    However, as a Canadian, i’m fine with that; we, in Canada, have many tens of thousands of ‘American’ jobs because we have an efficient single payer, state run, system.
    I’ll explain; if Ford has been operating for many many years, then it will have many older employees and many retirees, all of whom it pays health benefits for. If Toyota, or ChineseAuto, set up a new plant, they will pay no health insurance for retirees, because they won’t have any, and will have hired young workers for its new plant, and their insurance costs will be much lower than for older employees. That’s the way it operates in the U.S.A.
    In Canada, Ford is not responsible for the basic health insurance of its employees or its retirees, so it is not at a disadvantage when ChineseAuto sets up down the road.
    ie, Your health policies have been responsible for killing off many of your large successful manufacturers, or sending them abroad to manufacture. I’m not suggesting that there aren’t other factors hurting U.S. manufacturers, but that has been a major one.
    Both my parents have died over the last three years, both over 90. The medical care from the state ( province ) medical system was exemplary in both cases, and virtually free, including medicines. They did not need to worry about how to pay and neither did we, their family.
    Our single payer payer medical system covers 100 % or our population for 40 % less than you pay to cover 80 %; ie, it is way less expensive, and covers everyone.
    Your argument against health care is based on you not wanting to pay for some other persons bad habits or poor choices.
    I put it to you that we all make decisions that are less than optimal for our health; riding motorcycles ( often bad back problems later and higher risk driving anyway ), riding bicycles ( high accident risk ), living in the city ( pollution ), living in the country ( much higher ‘legal’ drug abuse ), being a dentist ( back problems and higher suicide attempt rate )…..many occupations have particular risks that are higher……etc
    You worry that the state will interfere more in peoples lives if the state is responsible for health care; i think you’re right, and sometimes i’m not happy about that; othertimes, when for example is see the state allowing transfats to be used ( which act like plastic adhering to the sides of your veins that cannot be flushed out by the blood——similar to normal fats, but much much much worse ) i wish the heck governments would take at least the most basic actions to protect its citizenry from corporate abuse.
    Finally, EVERY western European country, Canada, Australia, New Zealand, Japan, Korea, Taiwan, Saudi Arabia and others, have the equivalent of single payer state run systems, all different from each other but all, ALL, giving 100 % of the citizens of their country worry free health care, on demand.
    Is every one else wrong, and America right, or……….
    You are wrong Zombie.
    And this new Obama health care system is wrong; an attempt, but a weak one, to improve a catastrophically bad system.
    America took the wrong direction when it turned down Truman’s attempt to get a state run single payer system going, and just keeps going further down the wrong road.

      

  133. 133Finally Free on Dec 26, 2009 at 8:32 am:

    @tannin: Pray explain how come that there is medical tourism from Canada to the USA by people who otherwise would have to wait 6 mo. to 2 years for procedures.

    All: click on my handle for a summary of an article on State health insurance schemes in the USA, all of them miserable failures.

      

  134. 134Guy Average on Dec 26, 2009 at 3:04 pm:

    tannin: Both my parents have died over the last three years, both over 90. The medical care from the state ( province ) medical system was exemplary in both cases, and virtually free, including medicines. They did not need to worry about how to pay and neither did we, their family.

    You did pay for it. You didn’t have a choice in the matter.

      

  135. 135Keith on Dec 26, 2009 at 5:54 pm:

    Wow you guys are sure some shrewd no-nonsense pragmatists…. who have just been swindled by wall street for billions of dollars!?!? Come on, stop trying to pretend you are something you are not. Americans just got swindled. I don’t know if healthcare should be public or private but I do know that the streets should be flooded with people who are outraged by the banker bail-outs… people should be demanding that their money not be taken from them in order to enrich the corrupt bankers. But I guess you guys can keep acting like you are something you are not and live in dreamworld. Ok.

      

  136. 136buzzsawmonkey on Dec 26, 2009 at 8:11 pm:

    Keith: Americans just got swindled.

    Assuming for the sake of argument that you are correct regarding the “swindle” of banker bailouts, how is that in any way germane to the Obama healthcare fraud?

    Again: Obama and his gang have not identified any actual problems, nor—since they have identified no problems—offered any solution to any particular problem. They just created a massive wad of entitlements and rammed it through the legislature, with a big bow of rhetoric that claimed it was “fixing healthcare.”

    But a big ribbon bow does not alter the turd beneath.

      

  137. 137Formercorpsman on Dec 26, 2009 at 8:51 pm:

    Keith G.

    I have read through this quickly, and quite frankly, your tying this topic to bankers is absurd.

    Did you even read this?

      

  138. 138zombie on Dec 26, 2009 at 10:42 pm:

    tannin: Both my parents have died over the last three years, both over 90. The medical care from the state ( province ) medical system was exemplary in both cases, and virtually free, including medicines. They did not need to worry about how to pay and neither did we, their family.

    Guy Average: You did pay for it. You didn’t have a choice in the matter.

    Yes indeed. Guy Average is right, tannin — you did pay for it, whether you realize it or not. The costs are not direct – -they are hidden in the Canadian taxation system. Money doesn’t come out of thin air. Places like Saudi Arabia can have universal health care because they are sitting on a gigantic natural resource (oil) that essentially funds all public projects. But few countries are that lucky. In just about all the other countries you list, the “free” national health care is funded by taxes from the citizens. Also, as many analysts have pointed out, the US is a much larger country with a much greater population than just about all the others, which makes managing and implementing a nationwide system much much more complicated. The only way to do so is to grant the government a great deal of centralized power. The United States has approximately ten times the population of Canada. It also has a tens of millions more illegal immigrants than Canada does — in fact, there are probably more illegal immigrants in the US than there are total people in all of Canada. That issue alone makes the problem extremely difficult. It all sounds very peachy keen when a small country or a country with a comparatively small population offers universal health care — but pulling off the same thing on the scale of the US is a different kettle of fish, and also in most other examples, there is the accompanying higher tax rates, and more nanny-statish government which we are hoping to avoid here in the US.

      

  139. 139zombie on Dec 26, 2009 at 10:50 pm:

    Keith: Wow you guys are sure some shrewd no-nonsense pragmatists…. who have just been swindled by wall street for billions of dollars!?!? Come on, stop trying to pretend you are something you are not. Americans just got swindled. I don’t know if healthcare should be public or private but I do know that the streets should be flooded with people who are outraged by the banker bail-outs… people should be demanding that their money not be taken from them in order to enrich the corrupt bankers. But I guess you guys can keep acting like you are something you are not and live in dreamworld. Ok.

    Uh — how exactly is this relevant to the discussion of health care?

    And why do you assume that everyone here agrees with the bank bailout? In fact, the very same people who tend to oppose universal health care are the ones who also opposed the bank bailouts. Both actions increased crentralized government control of major industries. And no one, including I assume most of my readers, isn’t outraged by tales of bankers living high on the hog off our bailout money.

    There are some arguments to be made for bailing out banks (i.e. failing to do so might cause a panic and hurt the econony even worse), but there’s plenty of outrage to go around. You’re delivering your disgust in the wrong direction.

      

  140. 140Keith on Dec 26, 2009 at 11:26 pm:

    I just wish Americans would take an honest look in the mirror and not pretend to be something they are not. I get so annoyed at people when they complain about a homeless guy asking for spare change while those same people are giving much of their money away to via their taxes to corrupt bankers and bloated inefficient government bureaucrazies. People acting like they are some no-nonsense money saver while the government swindles them. It’s like their is some big predator robbing them and then they focus their aggression on some small vulnerable creature askng for a handhout. Hypocracy. It’s relavant because maybe people should feel shame about how dumb they are instead of strutting around with their nose in the air acting like they know something when they don’t know a thing and haven’t defended a shred of their territory.

      

  141. 141tannin on Dec 27, 2009 at 2:34 am:

    To finally free, guy average and zombie;
    Appreciate your responses, but…….
    first, of course i understand that the health care i/we receive in Canada isn’t free; yes, it’s paid for through the tax system; every Canadian knows that, we do not delude ourselves at all.
    For myself, i’m getting old, have owned and run several companies and have two degrees in economics; i tell you this so that you understand that i don’t come from naivete, youth, stupidity, envy or left wing thinking. However, once in a while, those on the left do have the occasional good idea ( not often, but sometimes ).
    No political party in Canada, not even the present centre right party in power, would consider destroying our single payer govt system; i would guess that 90 % or more of Canadians consider our health system as inviolable.
    As to Canadians crossing into the U.S. to get health care; sure it happens. The wealthy always have the additional choices that money can offer, and those who don’t think that they are getting the right treatment or quick enough treatment and who have the cash cash cash, go stateside. We might be talking about 1/10 of 1% of those treated, or less; ie a very tiny percentage. However, it is true, and sometimes it certainly reflects faults in our system.
    No system is perfect, certainly not Canada’s, but very few Canadians would swap our system for yours, which is why even the center right political party supports our single payer system.
    As to the size of America vs Canada; in Canada the system is mandated by the central, or federal government, but run by the provincial or state governments, with funds transfered from the federal govt to the ‘state’ govts to cover a substantial percentage of the costs. The actual operation is in the hands of the ‘state’ govt, and each ‘state’ has slightly different rules as to what drugs are covered, what procedures are etc etc,; this could apply equally to the U.S. should they choose to use such a system.
    Someone also mentioned the huge illegal immigrant population that you have. Surely that is a problem whatever system you use ? Are you really going to let those who are sick die on the streets ? I’m not even sure what we do with our illegals, and we have many as well. My point here is that we should be choosing the best system for our citizenry, and will have to make whatever accomodation we deem appropriate for illegals.
    Putting aside that absurd parody of a country named after its founding family, Saudi Arabia…..
    every country in western Europe, and add Japan, Canada, Australia etc, has universal health care that is way less expensive than the American system – less expensive means that there is more money left, after health care, to handle other societal requirements – have health statistics that are better than the U.S., and have populations that support their health systems and thus there is no political party that would challenge. While none of these systems are perfect, all of these systems are considerably closer to perfection than the failure of a system that is working so poorly in the U.S.
    Honestly, it is sad to see America in such a mess.
    I would also mention that you, in America, have been under a sustained misinformation campaign supported by those who benefit financially from your health system.

      

  142. 142zombie on Dec 27, 2009 at 3:42 am:

    tannin: I would also mention that you, in America, have been under a sustained misinformation campaign supported by those who benefit financially from your health system.

    What misinformation campaign? From my vantage point, 95+% of the media coverage is pro-Obama and his policies. Frankly, I’ve hardly seen any information “campaign” about the health care bills, mis- or otherwise. Just a lot of people screaming at each other. And I can assure you that my essay was my own idea, conceived and written independently, with no recompense, supported by no one.

    If you re-read the essay, you’ll see I’m not advocating any personal plan or agenda: I’m merely spelling out what I believe is the underlying philosophical objections most Americans have to the very concept of universal government-mandated health care. Arguing with me all day long won’t do any good, because I’m not the sponsor of the “zombie plan” or anything like that; even if I personally caved in, the average American would almost certainly still maintain the same objections I described.

    America has a personality unlike any other nation in the world. We crave individualism and independence the way other populations crave food and water. It’s the only country in the world that has as a fundamental right the ability to own and use firearms, specifically for the purpose of overthrowing the government should tyranny arise. Because of these “counter-intuitive” principles, all sorts of common-sense solutions adopted by other countries are totally off-limits. For example, in most developed countries firearms are strictly controlled, which cuts wayyyy down on gun violence in those countries; The US, on the other hand, is still basically like the Wild West, with a ridiculous amount of gun violence and gun-related deaths every year. Other countries look at us and say, “Are you people nuts? You’re killing youself with guns! The solution is obvious: Just ban guns.” And that may be true, in theory, but the very notion of banning guns is anathema to most Americans, even if it wasn’t enshrined in the Bill of Rights. Because to ban guns would take away a bit of freedom. And we’d rather live in the middle of a bullet-whizzing free-for-all than have even one freedom taken away.

    Different priorities.

    We’d rather have the Internet filled with all sorts of pornography, viruses, scams, spam, lies and craziness than have one rule restricting freedom of speech. And once again, stubborn insistence on maximum freedom causes all sorts of ancillary problems. But to us, the highest priority is freedom and independence, even if that leads to a whole welter of otherwise preventable social ills.

    And so we come to health care. Yes, in a utopian scenario as you describe, it could and would be a sensible system to have some form of government-mandated health care. But deep in the guts of the average American, that Freedom-Erosion Radar starts beeping wildly every time the issue is raised. Problem is, in this particular case, no one ever voiced exactly what felt so wrong about universal health care, because (contrary to your statement) the propaganda is almost all going the other way, and formulating theses such as the one in this essay is simply beyond the pale — cruel, lacking empathy, heartless. And so the average American was left with a silent, wordless grumpiness about the whole topic. Until I came along and put that grumpiness into words.

    Does the rest of the world, including Canada, look at our reticence and think we’re out of our minds? Probably. But just as in all the other examples proffered above, we’d rather have a Wild West-style totally dysfunctional dog-eat-dog skin-of-your-teeth health care system than voluntarily climb into the protective but stifling cocoon of government control over private decisions. Because in our view, one drop of freedom is of greater value than an ocean of comfort.

    Other societies place a different valuation on freedom and comfort. Hive societies like China place almost no value on freedom at all. Ethnically homogenous countries like Sweden or Canada or Japan have a sort of sense of universal kinship amongst all citizens, and people feel just as OK paying for each other’s health care as would a family paying for the health care of its family members — because, in an extended sense, everyone in the nation practically is one big family. But America is a nation of immigrants and aliens, and everyone is a stranger. The is no cultural, or ethnic or genetic glue to hold us to together. The only things that brings us together as a nation is a mutually agreed-on consensus to honor and facilitate each person’s independence and individuality.

    Are our freedoms being taken away here and there, against our will, or stealthily? Certainly. And it pisses off a lot of people. We fight freedom-diminuation whenever we can, not always successfully. But we try.

    Will our bizarre national quirks eventually spell the doom of the American experiment? Possibly. We may drown in debt and perish in a hail of self-inflicted gunfire. But at least we did it our way.

      

  143. 143Formercorpsman on Dec 27, 2009 at 5:58 am:

    I just wish Americans would take an honest look in the mirror and not pretend to be something they are not. I get so annoyed at people when they complain about a homeless guy asking for spare change while those same people are giving much of their money away to via their taxes to corrupt bankers and bloated inefficient government bureaucrazies. People acting like they are some no-nonsense money saver while the government swindles them. It’s like their is some big predator robbing them and then they focus their aggression on some small vulnerable creature askng for a handhout. Hypocracy. It’s relavant because maybe people should feel shame about how dumb they are instead of strutting around with their nose in the air acting like they know something when they don’t know a thing and haven’t defended a shred of their territ

    ory.

    Keith G. the only hypocrisy is that you are trying to move the goal post as it relates to the bones of this argument.

    This thread topic is about the largest government takeover of a mostly private American industry, and 1/6 of our economy.

    Who said anything about a homeless person? Moreover, how is it relevant to this discussion, other than your musing about folks who see this as a disaster for a multitude of reasons, let alone the unprecedented encroachment by the federal government into the average American existence.

    Those same people are giving too much of their money away. Those same people do not want the banks bailed out either. If you actually read this article over a couple more times, you will see it is well researched, and with legitimate examples cited.

    You are trying to counter facts, and rationale with hyperbole.

      

  144. 144Starless on Dec 27, 2009 at 7:14 am:

    Keith: Hypocracy [sic].

    Breaking: Americans are hypocrites, News at 11.

    As though everyone else in the world is entirely consistent in everything they do and believe. It’s all very easy to sit and call America hypocritical, interventionist, fat, greedy and lazy until some massive natural disaster occurs or some injustice needs to be rectified. Oh, well then! America is indispensable and, in fact, morally obligated to be everything so many in the rest of the world are quick to criticize. So go ahead and trash us all you like and then see what we do the next time your ass is hanging in the wind and you’re demanding our help.

    Talk about hypocrisy.

    You think the US handles its social problems wrong? Well, I think most of the rest of the world has its head firmly crammed up its own backside, refusing to acknowledge that economic and social issues are not ruled by some insubstantial set of magical factors. So there!

      

  145. 145Keith on Dec 27, 2009 at 12:13 pm:

    Zombie, to respond to what you said about Americans craving individualism and independence, I am an American and don’t crave independence and individualism. I’m not sure how many Americans crave that. But what I value is being part of a community and being close to my friends and family.

      

  146. 146Keith on Dec 27, 2009 at 12:19 pm:

    But just to repeat what I said earlier, I am not sure what is best with regards to health care in terms of whether it should be public or private. I do think though that maybe the government should be given money to buy commercial time to use to educate people to eat healthier and get some exercise. Sometimes people need to be reminded of obvious things. Some people in America barely eat any vegetables.

      

  147. 147CattusMagnus on Dec 27, 2009 at 10:46 pm:

    Comment #141 was superb Zombie. I am an American and I crave individualism and independence.
    Speaking of individualism and independence, are you a fan of Ayn Rand?

      

  148. 148tannin on Dec 28, 2009 at 1:40 am:

    Well said Zombie, re 141.
    A stout defense, and an honest one.
    One small caveat; Canada, like the U.S. is very much an immigrant nation, and not in any way homogenous.
    I would suggest that you already have many government run social schemes that are now part of the warp and weave of American life, but when first suggested produced the sort of response that you, and many others have, for a single payer government health scheme.
    You have an unemployment insurance scheme, i think you have some sort of medical system for the elderly…to name two. I’m sure you can name a few more. Do you have an old age payment scheme, as we do ?
    As to ‘propaganda’ from those benefitting from the present health set up, what i’m suggesting is that the huge benefits to the individual and to the society that any of the different health systems in Europe/Canada etc could offer to America is never focussed on; on the contrary, you are told about Canadians crossing the border to pay for treatment in the U.S.. Gotta tell you, in southern Ontario, every year, we absorb many million dollars of medical expenses from U.S. citizens who ‘happen’ to be in our area when their babies are due, or similar ‘must be handled’ emergencies. They are sent a bill…………..and you know how many pay…..
    Anyway, to tell you that the American system is better because joe or mary from Canada chose to use it, is just bs, and deliberately misleading. Far more informative for Americans would be to know what percentage of Americans would swap our system for yours; i doubt 10 % would, probably less.
    But i do hear you; America is a ‘ different’ place, where the pain will be accepted, to realize the gain.
    You are right, that every time the government ‘takes over’, some freedom is lost, and like yourself, i value individual freedom.
    I would put it to you though, that the cost being paid in the health issue, the pain, is being born by the poor, lower middle class and those who lose their jobs, not equally in the society, and i think it is damned unfair for you to expect those people to accept the pain; when you really look at things, you’ll find the same groups bears most of the pain required, think gun deaths, think abusive mortgage practices, think abusive interest rates for credit cards…etc.
    ( yea, i know the interest rate rational; more risk requires higher interest rates to cover; i’d reverse that and say, higher interest rates to poorer people guarantees higher default rates, upsidedown economics, but as true as the first bit. )
    If the unique American way, the one you talk of, is to continue to succeed, and i for one want a strong and successful America, better decisions have got to be made in any number of areas; i say health care is one of them. I also say that, if Americans really understood how badly they are being served by their present system, the current changes being considered would have been far more radical, and would have included a single payer govt option.

      

  149. 149Starless on Dec 28, 2009 at 4:53 am:

    tannin: I would put it to you though, that the cost being paid in the health issue, the pain, is being born by the poor, lower middle class and those who lose their jobs, not equally in the society, and i think it is damned unfair for you to expect those people to accept the pain;

    You’re demonstrating a fundamental error people, generally non-Americans and American Progressives, make when they come to conclusions about what’s wrong with the US. Liberty is a foundational element to the idea of the US, not equality. If you look at the French and Russian revolutions compared to the American revolution, you see that the primary difference between the former and the latter is that the French and Russians looked first to equality while the Americans looked to liberty. For the French and Russians, their motivations were understandable — they had a corrupt internal enemy in the upper classes — but their logic was flawed and that played out in their revolutions. There wasn’t enough wealth in the wealthy to deal with all of the poor — that is, eventually they ran out of truly rich people and they had to go after the not-so-rich. As the saying goes: eventually you run out of other people’s money.

    Poverty is part of the human condition and there’s only so much you can do to combat it directly. If you try to force equality through revolution or legislation, you can’t help but tear other people down in the process. This is the danger of the mob. OTOH, by getting gov’t out of the way and creating an environment where liberty is paramount, at least everyone can have a chance to succeed. Liberty encourages individual prosperity while gov’t-sanctioned equality discourages it.

    Unbridled and unregulated capitalism is very cruel and gives the truly unscrupulous bullies too much freedom to prey on the weak and defenseless. But as you yourself pointed out, we don’t have unbridled and unregulated capitalism — we never have and we likely never will. What we do have is a system based on the idea that everyone deserves a fair chance and regulatory bodies’ jobs is to make sure that everyone gets that fair chance. That’s very different from saying that everyone should be equal.

    The funny (or, really, not-so-funny) part of Obama’s socialist approach to the economy is that it entirely misses the mark. He claims that he wants to go after the “fat cats” but that’s not who he’s really punishing every time he sticks his incompetent finger in the market — whether it’s car companies or banks or HMOs. The people he’s really hurting is the whole mass of people, the little people as I imagine he thinks of them, who are stockholders in the companies he’s tinkering with. IOW, basically everyone except the rich fat cats.

      

  150. 150RoboMonkey on Dec 28, 2009 at 6:58 am:

    Keith: I do think though that maybe the government should be given money to buy commercial time to use to educate people to eat healthier and get some exercise. Sometimes people need to be reminded of obvious things. Some people in America barely eat any vegetables.

    Like the danger of cigarettes, I don’t think that any rational person who doesn’t like a cave is unaware of the important of a proper diet and exercise. We already get that message from multiple sources. Some people merely choose live an “alternate lifestyle”. Wasting government money on re-education efforts will have little result; that’s why a government takeover stripping us of our individual liberties and forcing us to comply with the nanny state is the liberals’ answer.Why can’t they at least start with their own if they want to demonstrate to the rest of us the efficacy of their plans?

      

  151. 151RoboMonkey on Dec 28, 2009 at 6:59 am:

    RoboMonkey: doesn’t like a cave

    (That should be “live in a cave”)

      

  152. 152Keith on Dec 28, 2009 at 11:58 am:

    The government spending money on commercials to encourage people to eat healthy and get exercise is not a nanny state policy.
    Some people on the comments said they like individualism and independence. What do those words mean to you? The only independent person is a person who live alone in the woods growing his or her own food. We all depend on eachother to perform certain functions in order for us to get whatever stuff we need. Society is based on inter-dependence. Individualism just is a nonsense word. It makes no sense. Rational people accept the wisdom of people in the past and they build upon that wisdom. Rational people also find groups of people with similar interests and associate with those people.

      

  153. 153RoboMonkey on Dec 28, 2009 at 1:29 pm:

    Keith: The government spending money on commercials to encourage people to eat healthy and get exercise is not a nanny state policy.

    (1) There are already plenty of commercials and other routes already getting the message out.
    (2) And if the government does start running its commercials, and nothing happens… what next? Coercion.

      

  154. 154Dane on Dec 28, 2009 at 2:08 pm:

    CattusMagnus: Comment #141 was superb Zombie.I am an American and I crave individualism and independence.
    Speaking of individualism and independence, are you a fan of Ayn Rand?

    I agree with, or at least can understand and sympathize with the reasoning behind, most of the themes that Rand uses in her stories – but let’s be honest, her writing was terrible.

    As an alternative I would strongly recommend Heinlein’s The Moon Is A Harsh Mistress, which hits on many of the same thoughts but in a much more acessible and interesting way.

      

  155. 155Starless on Dec 28, 2009 at 2:25 pm:

    Keith: The government spending money on commercials to encourage people to eat healthy and get exercise is not a nanny state policy.

    LOL. I don’t think you can get more nanny state than telling people, “Eat your vegetables”. Besides which, at least in my state, Blue Cross/Blue Shield is already running exact those sorts of commercials.

    Dane:
    I agree with, or at least can understand and sympathize with the reasoning behind, most of the themes that Rand uses in her stories – but let’s be honest, her writing was terrible.As an alternative I would strongly recommend Heinlein’s The Moon Is A Harsh Mistress, which hits on many of the same thoughts but in a much more acessible and interesting way.

    Ayn Rand — an absolutely horrible writer and an unfortunate choice by Tea Partiers as an intellectual hero. Heinlein would be better in many ways but most people just don’t get him. He’s either the pervert or the war-monger.

    I wouldn’t mind seeing Prof. Bernardo up to a little mischief, though.

      

  156. 156RoboMonkey on Dec 28, 2009 at 3:21 pm:

    Starless: Heinlein would be better in many ways but most people just don’t get him. He’s either the pervert or the war-monger.

    There’s certainly some basis for both of those characterizations, especially the former – the latter probably comes mainly from people who didn’t understand what points he was trying to make in his books (or just watched the movie adaptation of Starship Troopers by a director who clearly didn’t understand the source material himself). The Moon is a Harsh Mistress is an excellent choice and one of my favorites by RAH (Heck, one of my favorite novels period). Another good choice, which I just finished re-reading, is The Puppet Masters.

      

  157. 157stuiec on Dec 28, 2009 at 3:31 pm:

    Keith: Zombie, to respond to what you said about Americans craving individualism and independence, I am an American and don’t crave independence and individualism. I’m not sure how many Americans crave that. But what I value is being part of a community and being close to my friends and family.

    You belong to a grand interdependent society: why are you wasting your time with people you want to be near, instead of putting yourself near people you don’t even know? What gives you the right to choose to be close to your friends and family? How dare you put them ahead of the tens of millions of other citizens who need your support more than they do?

    You hypocrite.

      

  158. 158Starless on Dec 28, 2009 at 3:57 pm:

    RoboMonkey:
    There’s certainly some basis for both of those characterizations, especially the former – the latter probably comes mainly from people who didn’t understand what points he was trying to make in his books (or just watched the movie adaptation of Starship Troopers by a director who clearly didn’t understand the source material himself). The Moon is a Harsh Mistress is an excellent choice and one of my favorites by RAH (Heck, one of my favorite novels period). Another good choice, which I just finished re-reading, is The Puppet Masters.

    When I think of Heinlein’s later work, I don’t think pervert, I think dirty old man. But even that’s not fair. He was a boundary and button pusher. The Puppet Masters wasn’t about alien invasion, it was about American squeamishness regarding nudity, something which the film version utterly and completely missed as well as being a just plain horrible movie. Starship Troopers wasn’t about militarism, it was about citizenship and the personal experience of the soldier. (The real tragedy of the movie version was that Ginny Heinlein said it was just great. Though I have a feeling she thought the check was just great.)Mistress is about a lot of things but after a million re-readings, I’ve concluded that a significant portion of it is about bigotry and racism — the scene where Manny is thrown in jail after a photo of him and his family is published in the US is pivotal to that.

    Most notably, in the context of Rand v. Heinlein, his non-fiction polemic about politics and government, Take Back Your Government is really boring. He was better off couching his rants in fiction.

      

  159. 159Keith on Dec 28, 2009 at 4:23 pm:

    @ stuiec

    I’m not sure what you are talking about, can you explain a little bit where your coming from. Society si of course inter-dependent. It is a fact. Did you make your pants? A society being inter-dependent does not mean that a person shouldnt value their family and friends. I dont know how those two things would even be remotely connected with one another.

      

  160. 160CattusMagnus on Dec 28, 2009 at 4:39 pm:

    Dane: I agree with, or at least can understand and sympathize with the reasoning behind, most of the themes that Rand uses in her stories – but let’s be honest, her writing was terrible.As an alternative I would strongly recommend Heinlein’s The Moon Is A Harsh Mistress, which hits on many of the same thoughts but in a much more acessible and interesting way.

    I have read The Moon Is A Harsh Mistress and thought it was pretty good. I underlined several poignant passages. I plan on reading Starship Troopers and Stranger In A Strange Land in the future. But I love me some Ayn Rand. Do I think she’s a terrible writer? No. I think Ernest Hemingway is a terrible writer. But I can understand why people have problems with her style. For instance: did Galt’s radio speech really have to be 5 million pages of redundancy? I can see why it would drive people crazy.

    Starless – why do you think Rand is and unfortunate choice as an intellectual hero for the Tea Party movement? Do you think Tea Partiers don’t understand objectivism? Do you think Rand wouldn’t like them because many are Christian conservatives?

      

  161. 161Beckaholic on Dec 28, 2009 at 5:47 pm:

    I think the Tea Partiers understand Rand intuitively, even if they’ve never read her. It’s the Tea Party critics that you can tell haven’t really read Atlas Shrugged, as they always confuse “selfish” with “self-interest”, thus missing the entire point, and dismissing her as this horrible monster. She’s the anti-Stalin.

      

  162. 162zombie on Dec 28, 2009 at 6:08 pm:

    CattusMagnus: Speaking of individualism and independence, are you a fan of Ayn Rand?

    Dane:
    I agree with, or at least can understand and sympathize with the reasoning behind, most of the themes that Rand uses in her stories – but let’s be honest, her writing was terrible.As an alternative I would strongly recommend Heinlein’s The Moon Is A Harsh Mistress, which hits on many of the same thoughts but in a much more acessible and interesting way.

    Starless: Ayn Rand — an absolutely horrible writer and an unfortunate choice by Tea Partiers as an intellectual hero. Heinlein would be better in many ways but most people just don’t get him.

    CattusMagnus: But I love me some Ayn Rand. Do I think she’s a terrible writer? No. I think Ernest Hemingway is a terrible writer. But I can understand why people have problems with her style. For instance: did Galt’s radio speech really have to be 5 million pages of redundancy? I can see why it would drive people crazy.

    Starless – why do you think Rand is and unfortunate choice as an intellectual hero for the Tea Party movement? Do you think Tea Partiers don’t understand objectivism? Do you think Rand wouldn’t like them because many are Christian conservatives?

    Beckaholic: I think the Tea Partiers understand Rand intuitively, even if they’ve never read her. It’s the Tea Party critics that you can tell haven’t really read Atlas Shrugged, as they always confuse “selfish” with “self-interest”, thus missing the entire point, and dismissing her as this horrible monster.She’s the anti-Stalin.

    To be completely frank, I’m not really familiar with Objectivism, and haven’t realy bothered to look into it much. Never read Heinlein — sorry. Not one word.

    However, having said all that, I have read exactly one Rand book, long long ago: Anthem. And I though it was excellent! (Then again, this was in Junior High School, so any adult-level novel might have seemed excellent to a mind still insulted with books aimed at children.) I thought it really skewered communism and collectivism so devastatingly that they would never recover as philosophies. Only much later did I learn that Anthem was basically a sort of Objectivist novel.

    Skimming over a layman’s summary of Objectivism, I’d say I agree with about 60% of it, though there seems to be too much focus on unapologetic egotism and a vilification of altruism. I personally admire altruism — when it is freely given of one’s own free will. When altruism is enforced by law — such as with Universal Health care — then it becomes intellectually objectionable. And there’s a big difference between individualism and egotism. Individualism is an honoring of the uniqueness of one’s own self; whereas egotism is admiring one’s own self to the exclusion or detriment of others, that last phrase being the part that bothers me.

    So, I can’t say that I’m an Objectivist, but compared to other noxious philosophies, such as Deconstructionism or Postmodernism or lower-case-c communism, it seems like Objectivism would be obviously preferable.

    So far, I haven’t encountered a pre-existing philosophy that encompasses even approximately my unexpressed philosophy; I suppose, like Rand or Marx, I’ll just have to come up with my own.

      

  163. 163Beckaholic on Dec 28, 2009 at 7:20 pm:

    Everyone should read Atlas Shrugged and Stranger in a Strange Land, the earlier in life, the better! :-)

    Rand is defending the entrepeneur- the engine that drives the economy in a capitalist society. The individual who wishes to be their own boss, do things their own way, start their own business, and risks everything to do so, puts up their own stake to do it, and who is grossly underappreciated by certain segments of society that assume that business is easy, that it justs springs magically out of the ether and that they are owed a part of it. That they are owed a portion of the efforts of others. Kinda like the health care debate- that health care is a human right- Is anybody owed the efforts of another individual? No, not unless that individual (the doctor) is employed by the government and thus supported by taxes and then it can be argued that you own a portion of that output since you are paying for it, which , I think, is the direction they want to take this thing.

    Rand wants everyone to stand on their own hind legs and be a responsible member of society if and whenever possible. Not become dependent on charity- to have one’s reward be proportional to one’s efforts. Having been from Russia, she saw acutely the miracle of capitalism and the value of the individual and also the forces that exist to take it for granted.

      

  164. 164Keith on Dec 28, 2009 at 7:49 pm:

    Zombie you say individualism is honoring the uniqueness of ones self. I don’t understand how the uniqueness of ones self can’t be honored, it seems that the uniqueness of ones self is a matter of fact regardless of whether one follows the same religion as others or not and regardless of whether one dresses like others or not and regardless of just about anything. A persons uniqueness generally finds expresion is subtle ways even if one looks like a conformist.

      

  165. 165CattusMagnus on Dec 28, 2009 at 7:55 pm:

    So far, I haven’t encountered a pre-existing philosophy that encompasses even approximately my unexpressed philosophy; I suppose, like Rand or Marx, I’ll just have to come up with my own.

    Zombieism!! I’d love to hear all about it. And, yes, Anthem kicks ass.

      

  166. 166Starless on Dec 28, 2009 at 7:59 pm:

    CattusMagnus: I plan on reading Starship Troopers and Stranger In A Strange Land in the future.

    I’ve read pretty much everything Heinlein wrote, including For Us The Living — a not very good novel he stuck in a back drawer and didn’t publish in his life time for a reason. The Past Through Tomorrow is an excellent collection of his early Future History short fiction. I don’t know if it’s in print anymore, though, but it covers pretty much all of his philosophy.

    CattusMagnus: But I can understand why people have problems with her style.

    I can’t get past her turgid style. Okay, okay, you’re an angry woman and you’re going to lecture me about it until I want to blow my own brains out, I get it already…

    CattusMagnus: Starless – why do you think Rand is and unfortunate choice as an intellectual hero for the Tea Party movement? Do you think Tea Partiers don’t understand objectivism? Do you think Rand wouldn’t like them because many are Christian conservatives?

    I’d have to go with what Zombie said about egotism and altruism. If the world were purely intellectual, I could see an argument for unfettered capitalism and against altruism, but the world isn’t purely intellectual. My own take on altruism is that it doesn’t actually exist — no one does anything where they give entirely and gain nothing, but that doesn’t mean that people can’t still be nice to each other, and a completely unfettered and unapologetic capitalist has no conscience. Rand’s philosophy, IMO, is entirely unrealistic and weaves too closely toward Social Darwinism. OTOH, symbols are never realistic and I can see the appeal of Rand to Tea Partiers.

    Mostly, though, I doubt they really do understand Rand. Akin to that is the minor Simon Jester fad. I saw that and I just shook my head because I could see that they really, really don’t get Simon Jester.

    You know, now that I think about it, and considering Heinlein, it would have been really cool if Tea Partiers had chosen E.E. “Doc” Smith as their intellectual hero. What he wrote was huge and broad and brimming with American Exceptionalism.

      

  167. 167CattusMagnus on Dec 28, 2009 at 9:03 pm:

    Starless,
    Well, at least we know that Tea Partiers have been reading when they’re throwing around names like John Galt and Simon Jester. I’ve heard of E.E. “Doc” Smith but I have not idea what he wrote. I’ll have to investigate it . . . .

      

  168. 168tannin on Dec 29, 2009 at 2:00 am:

    Read Atlas Shrugged; appreciate the points Rand made; didn’t think much of the writing.
    An individual is usually the spark, the genius, the innovator, the ‘driver’, not a committee; on the other hand, very little is actually achieved without a group or team effort.
    Rand is so anxious to make her points, re the individual, that she writes a polemic; badly written and no balance as to the individual and the team. However, she made a point that needed to be made, especially at the time she wrote it.

    Starless, i hear you on ‘equality’; my point is that ensuring that all citizens have some reasonable level of health care, is not ‘equality’.
    Equality would mean that we all have an equal share of resources, regardless of how much we have, or haven’t, worked, or how much we might ‘ deserve’. I’m not suggesting that at all.
    I say you provide good basic healthcare to every citizen, and you ensure that, regardless of their contribution or lack of contribution to society, no one starves and everyone has some sort of roof over their head. That, and one vote per person is what each citizen gets; in return, that citizen is responsible to defend his/her country when called upon and is expected to respect its laws and customs.
    The alternative, the present setup in the U.S., is that you will not be allowed to starve, and a roof will be found for you, sortof, but no health care will be provided for you ( save and except for very marginal resources made available ).

      

  169. 169Starless on Dec 29, 2009 at 5:40 am:

    CattusMagnus: Well, at least we know that Tea Partiers have been reading when they’re throwing around names like John Galt and Simon Jester. I’ve heard of E.E. “Doc” Smith but I have not idea what he wrote. I’ll have to investigate it . . . .

    Yeah, that was a bit of a tangent on my part. The tangent was based on the fact Heinlein and Smith were friends and if you read both of them you can see how much of an influence Smith was on Heinlein. The trouble with Doc Smith was that he was a bit too much in favor of eugenics and a ruling elite. But, as I said, he was a very big proponent of American Exceptionalism (to the extent that he believed Americans would lead humanity and humanity would eventually result in a new species which would lead the universe). As a chemist, he was also instrumental in advances in powdered sugar donut technology. Too few people appreciate the importance of the powdered sugar donut.

    To clarify what I meant by saying Tea Partiers likely don’t “get” Rand, what I mean is that if they were faced with actual Objectivism, I don’t think they would like it as much as they think they would, and regarding Simon Jester, I think he would tell his current admirers to come up with their own ideas.

    tannin: I say you provide good basic healthcare to every citizen, and you ensure that, regardless of their contribution or lack of contribution to society, no one starves and everyone has some sort of roof over their head. That, and one vote per person is what each citizen gets; in return, that citizen is responsible to defend his/her country when called upon and is expected to respect its laws and customs.

    See, when you make these sorts of sweeping generalizations (“provide good basic healthcare to every citizen”) you are advocating a dubious sort of equality which can’t exist as long as humans are human. If you were to say, “We have a moral obligation to make sure that the poorest — the people who for one reason or another are incapable of taking care of themselves, let’s say the bottom ten percent — have healthcare”. I might agree with you. The trouble with talking about “every citizen” is that you end up taking liberty away from many to provide for some and you also end up with schemes like the current one where freedom of choice (opting out) is punished.

      

  170. 170GUY YOU LOVE TO HATE on Dec 29, 2009 at 7:50 am:

    laugh, laugh you little bitches. What ever happened to taking care of your fellow man and going to church on Sunday… It’s all bullshit. Well guess what…I’m one of those people you guy’s love to hate unemployed,living off the government, free healthcare,YUMMY!

    Well, I’m off to have a doughnut, a cigarette, and chug a can of coke. The American Dream…So anti up my BITCHES cause it ain’t gonna be cheap

      

  171. 171Starless on Dec 29, 2009 at 8:52 am:

    GUY YOU LOVE TO HATE

    I think you mean “ante” not “anti”.

      

  172. 172zombie on Dec 29, 2009 at 10:04 am:

    GUY YOU LOVE TO HATE: Well, I’m off to have a doughnut, a cigarette, and chug a can of coke. The American Dream…So anti up my BITCHES cause it ain’t gonna be cheap

    You’re laughing now, but under ObamaCare the government is going to take away your cigarettes and transfat donuts and high-fructose-corn-syrup Coke, and you’ll be forced to watch indoctrination films about Brussels sprouts and sustainable farming techniques.

    You’ve completely misapprehended this entire essay. I’m the one in favor of allowing you to kill yourself on your own terms, as you are currently doing. Under the upcoming Universal Health Care system, the nanny-state meddlers will start messin’ with your lifestyle.

    You asked for it. Reap what you sow.

      

  173. 173Freebrain on Dec 29, 2009 at 10:11 am:

    This is crap, and hateful crap.

    I hope you get sick and a doctor decides that you will never have enough money to pay for your cancer treatment.

    WE ARE ALL ENTITLED TO FREE, CAREFREE HEALTHCARE.

    This security must not only be the province of the rich.

    MOST WRH peeps are smarter than this, but that website is weak on immigration, healthcare and is occasionally hateful towards gays and minorities.

    Get your head out of your ass. Better yet, pay a doctor to do it!

      

  174. 174Dane on Dec 29, 2009 at 10:36 am:

    Starless:
    The trouble with Doc Smith was that he was a bit too much in favor of eugenics and a ruling elite.

    Agreed. I enjoyed E. E. Smith’s work for what it was, but I don’t think it has aged terribly well and there are a lot of things that would raise eyebrows (at least!) for modern readers. I can’t even begin to imagine the field day shows like 60 Minutes would have with some passages from his writing if Tea Partiers were waving around Lensman books instead of Atlas Shrugged.

    Freebrain:
    WE ARE ALL ENTITLED TO FREE, CAREFREE HEALTHCARE.

    There ain’t no such thing as a free checkup.

      

  175. 175zombie on Dec 29, 2009 at 10:51 am:

    Freebrain: I hope you get sick and a doctor decides that you will never have enough money to pay for your cancer treatment.

    And I hope you live a long and completely healthy life.

    This is crap, and hateful crap.

    Are you talking about my essay or your comment?

    WE ARE ALL ENTITLED TO FREE, CAREFREE HEALTHCARE.

    You lost me at “entitled.”

      

  176. 176zombie on Dec 29, 2009 at 11:05 am:

    Freebrain: WE ARE ALL ENTITLED TO FREE, CAREFREE HEALTHCARE

    Hey everybody, let’s play the Entitled Game with Freebrain. It’s sort of like MadLibs, but it has the added benefit of overburdening the system according to Alinskyite principles, leading to the collapse of the capitalist structure. Whoopee!

    Just fill in the blanks with the universal entitlements of your choice:

    ————————————————————————–

    We are all entitled to free, carefree healthcare.

    We are all entitled to a decent living wage.

    We are all entitled to a job guaranteed for life.

    We are all entitled to a mortgage loan regardless of credit history.

    We are all entitled to a free lunch.

    We are all entitled to praise, respect and self-esteem.

    We are all entitled to own the means of production.

    We are all entitled to free stuff!

    (Now it’s your turn:)

    We are all entitled to ____________________

    We are all entitled to ____________________

    We are all entitled to ____________________

    We are all entitled to ____________________

    We are all entitled to ____________________

    We are all entitled to ____________________

    (If you can’t think of any, just drop by your local ACORN office and they’ll help you demand satisfaction on your own long list of entitlements.)

      

  177. 177CattusMagnus on Dec 29, 2009 at 11:28 am:

    Hey everybody, let’s play the Entitled Game with Freebrain.

    I’m entitled to a pony. I’ve been asking for one since I was four. And my mean daddy never gave me one.

      

  178. 178Steve on Dec 29, 2009 at 11:54 am:

    Being born in the UK in 1960 and having lived here my whole life, I have known nothing but Universal Health Care and you know what? It’s fantastic. Not once in the whole time I have used it have I had to deal with a bureaucrat who determines what treatment I am to receive or not. Not once has some Government official determined what was good or not for me.

    Last year, I suffered a stroke – it’s a genetic thing for me not lifestyle – and in all the time I spent in hospital the only staff I saw were Doctors, Nurses, Nursing Auxillaries, Cleaners and Porters. Not one single bureaucrat did I see and not one single bit of paper did I have to sign.

    Last week my autistic son dislocated his shoulder during an epiletic fit. Straight down to the hospital where it was reset, the Doctors explained everything as they went along, showing me the x-rays etc, treating my son with great dignity in a difficult time for him.

    It’s not perfect is our Universal Health Care, but it’s cheaper than the US, and most people over here wouldn’t dream of getting rid of it.

      

  179. 179RoboMonkey on Dec 29, 2009 at 11:56 am:

    Freebrain: WE ARE ALL ENTITLED TO FREE, CAREFREE HEALTHCARE.

    You aren’t entitled to anything that you have to steal from others to acquire.

      

  180. 180CattusMagnus on Dec 29, 2009 at 12:09 pm:

    Starless – I hope GUY YOU LOVE TO HATE pauses from playing D&D for a moment to thank Doc Smith for the powdered doughnuts he’s shoveling down his gullet.

    There ain’t no such thing as a free checkup.

    Don’t you mean: TANSTAAFC?

      

  181. 181Starless on Dec 29, 2009 at 12:33 pm:

    Dane:
    Agreed. I enjoyed E. E. Smith’s work for what it was, but I don’t think it has aged terribly well and there are a lot of things that would raise eyebrows (at least!) for modern readers. I can’t even begin to imagine the field day shows like 60 Minutes would have with some passages from his writing if Tea Partiers were waving around Lensman books instead of Atlas Shrugged.
    There ain’t no such thing as a free checkup.

    Have the Lensmen not aged well, or have we not aged well?

    Pundits would be waving whatever document Tea Partiers chose as proof that they’re a bunch of crazies.

    zombie:

    We are all entitled to a federally subsidized vehicle. (What was it? 22 grand each cash for clunkers deal cost us?)

    CattusMagnus: Starless -I hope GUY YOU LOVE TO HATE pauses from playing D&D for a moment to thank Doc Smith for the powdered doughnuts he’s shoveling down his gullet.Don’t you mean: TANSTAAFC?

    Mmmmmm….donuts.

    More mmmmmmm…donuts shovelled into a greasy maw.

    Steve: Not once has some Government official determined what was good or not for me.

    You sure about that?

      

  182. 182zombie on Dec 29, 2009 at 2:01 pm:

    Steve:

    Yes, for those such as yourself who are on the receiving end of the largesse, it seems like quite a brilliant system indeed. But for every person in your situation who receives more value of medical benefits than you pay in taxes funding those medical benefits, there must necessarily be someone else who is paying out much more in taxes than they’re getting back in benefits. Otherwise, the system would very rapidly go broke. And for those on the paying end, the situation is not so rosy.

    But yes — no one is denying that universal single-payer health care is possible; and that it can be funded successfully. But what happens is that the British government confiscates 39% of all income in the UK annually, in order to fund the NHS and other welfare schemes. 39%. Think about it. In the Unites States, by contrast, the government only confiscates 28% of all income. That’s an 11% difference, which may seem insignificant on the surface but which is extremely significant when it comes to economic structure. Yes, if Americans were willing to give another 11% of our gross domestic product to the government in the form of much higher taxes, then we’d have plenty of money to fund universal health care. But a large majority of Americans don’t want to hand over another 11% to the government above and beyond what we’re already giving.

    And if you look at that second chart again, then click on the second column to rank it by percentage, you can see that all those nations which are constantly touted as having universal health care are also the nations which have far and away the highest tax rates: Denmark, Sweden, Belgium, France, Cuba, Norway, Finland, etc. Which goes to show: Yes, it is a viable model: Very high taxes can pay for increased government benefits and government welfare. But the question then becomes: Which structure does a nation prefer? High taxes and universal welfare and dependency? Or comparatively lower taxes with fewer government benefits? Both sides have their ups and downs. But as I was saying in comment #141 above, America has a unique personality whereby we place greater value on individual autonomy than we do on collectivism.

    And speaking of your experience in the UK, it only further demonstrates my point that increased government responsibility leads to diminished individual freedom and more invasive regulations. The UK has all sorts of privacy-violations and individual-freedom violations — such as CCTV surveillance cameras on every single street corner in the country, and invasive laws about what you’re allowed to photograph, etc. etc. — that would be completely unacceptable in the US, both morally and constitutionally. And yes, Steve, there is a definite link between the British Welfare State and the British Big Brother State. Since you’ve lived there your whole life, you may have gotten used to the creeping totalitarianism, and you may not even notice it by now. But we’d notice if the same thing happened here. And we would find it intolerable.

      

  183. 183buzzsawmonkey on Dec 29, 2009 at 4:39 pm:

    CattusMagnus: I’m entitled to a pony.

    In English slang, a “pony” is 25 pounds sterling.

      

  184. 184zombie on Dec 29, 2009 at 5:05 pm:

    buzzsawmonkey:
    In English slang, a “pony” is 25 pounds sterling.

    I wonder if that’s the source of the phrase “pony up,” i.e. to pay your share of money.

      

  185. 185Common_sense on Dec 29, 2009 at 9:21 pm:

    well, if people have a “right” to healthcare, don’t they have rights to more basic needs

    like food
    like water
    like shelter
    like clothing

    without the above – you’d certainly die, doctor or not
    like transportation (how you gonna get to the doctor without a free car?)
    free fuel for said car

    so now that we met the more basic needs than medical care
    everyone gets free food, clothing, shelter
    would we not be “the” most healthy country in the world ?

    think of how groovy that would be
    with the basics provided for free
    why, we wouldn’t even have to work because honestly
    beyond, food, clothing, shelter – what else does anyone need ?
    surely not a “job”

      

  186. 186tannin on Dec 30, 2009 at 2:00 am:

    Zombie spells it out;
    To keep the tax rates down for the wealthy and upper middle class, the lower middle class and the poor go without decent health care, or with none at all.
    Given the increased pauperization of the U.S., there will be a larger number of people in the less wealthy economic groupings. If there were a more responsive sort of democracy in the U.S. that the present gerrymandered system, you could expect that shift to result in some sort of single payer system covering everyone.
    What actually is taking place is that, to keep ‘on side’ enough of the population to maintain the present absurd abortion of a health system, various groups, like the elderly, are given special health priviledges, ones that look very much like, guess what, a state run health system. Did i read somewhere that the very young were to given some similar treatment ?
    Taxes; the U.S. is radically undertaxing the very wealthy, who are basically getting a free ride by the standards of all the other first world countries. The upper middle class are similarly being under taxed, though they are getting nothing like the free ride of the wealthy; i don’t think there is another country in the first world where you can deduct your homes’ mortgage interest from taxes, for example.
    The lower middle class, the poor, and the budget deficits are paying for the indulgence to the well- to- do.
    One of the results, apart from the health issue, is an income disparity within U.S. society that is the highest amongst first world countries, another is, imho, the lawlessness and disorder that America fights with huge police budgets and the highest incarceration rate on the planet.
    One last thought; there are people who are poor, and rich, in the U.K., France, Germany, Japan and Canada, yet all those countries have single payer govt run health systems, of various sorts. People who can, work, in those societies, very few decide that, because health care is guaranteed and a rock bottom few dollars for food and shelter is available to those who need it, that they don’t want to work. That is to say, the addition of guaranteed health care hasn’t diminished the work ethic at all.

      

  187. 187tannin on Dec 30, 2009 at 2:23 am:

    Still not finished.
    Zombie, you wrote that if Steve, in the U.K., ‘ received more value in medical benefits than you paid..for, there must necessarily be someone else who is paying out much more than they’re getting back in benefits ‘.
    Huh; isn’t that exactly the same thing that happens within the private system of health insurance that you want. The amount that you pay may be varied according to your age and sex, but the whole system is still based on the fact that some will cost the insurer vastly more than they paid in, and on others the insurer will make money. Same game.
    Of course, if you really want to pay for hundreds of different marketing campaigns, thousands of well paid directors, many hundreds of hugely overpaid chief executives and for steadily rising profits for investors, oh, and for some grandiose head offices, then just stay with your present system, at least you know what some of your money has gone to pay for.

      

  188. 188Starless on Dec 30, 2009 at 7:05 am:

    tannin

    Here we go again — with the mythical rich and faceless insurance companies as the bad guys. Who are the rich? According to Obama, the “rich” are any household with a combined income of $250k. Don’t get me wrong, that’s far from poor, but if you have any idea of what it takes to live in the US, $250k isn’t rich. It may be upper middle class, but only just barely on the borderline. And those insurance companies aren’t owned by 19th century style fatcats who light their cigars with $100 bills, they’re owned by stockholders.

    That being said, I don’t think there are many people, beyond insurance company lobbyists, who are ecstatic over the current set-up. Maybe I missed something, but I certainly haven’t seen anyone in this thread shouting, “Hurray for the status quo!” Setting up a false dilemma where you say that all we offer is evil, corrupt pro-insurance/pro-rich inaction and the only alternative is single-payer universal healthcare is simplistic and dishonest.

      

  189. 189Common_sense on Dec 30, 2009 at 10:38 am:

    tannin: We in America do not style ourselves like the rest of the world, hence no need to tax like them. No need to surrender to Naziism, Japanese Imperialism, or lately, Islamo-imperialism or liberal-imperialism. Get over it, we are not like any other nation on earth. I am not saying we are better, but we stand alone, geographically, spiritually, intellectually, etc. Now, why should we tax “the rich” more ? Maybe we should instead “work” the poor more. You know, workfare or like in Cambodia, re-education camps – so they can learn what it takes to be “rich”. But, do tell, how the fock do the poor pay more than their fair share when they don’t pay tax ? I’d like to hear that one. What we really need is health insurance rates based on probability. Fat people pay more. Drug users (and yes, I’d test for drug use, alcohol and tobacco too) pay way more. Gay men, yup – they get it too, so to speak. Occupations can also be “rated”. For example, if you list; gambler, outlaw biker,meth maker, drug runner or lookout, midnight money-lender, etc. as your means of support – you pay more. Lastly, if you have voted for or given money or tanglible support to a democrat-party or left-of-center candidate any time in the last 10 years, no make that seven, like bankruptcy law, you pay more.

    But you did not seem to mention my posit that there are more basic needs than “health care”. Food and shelter are more urgently needed by humans, how you gonna just skip over those needs ?

      

  190. 190CattusMagnus on Dec 30, 2009 at 11:28 am:

    buzzsawmonkey: In English slang, a “pony” is 25 pounds sterling.

    I’m entitled to that too. That adds up to $50 or something!

      

  191. 191zombie on Dec 30, 2009 at 11:34 am:

    tannin: To keep the tax rates down for the wealthy and upper middle class, the lower middle class and the poor go without decent health care, or with none at all.

    Wrong. The “poor” already have basically free universal health care, through Medicaid, Medicare, SSI, etc. The people at the lower end of the income scale are already covered. If you’ve ever lived and hung out in a ghetto community, as I have, you’d know that medical costs are not even an issue for most people. It’s just assumed that all medical coverage is free — and it is. And people most definitely take advantage of the situation, and even abuse it; hospitals are full of people getting minor ailments attended to; people get prescriptions they don’t really need for free and then sell them on the street to recreational drug users; people call 911 to get free ambulance rides sometimes just as a taxi service to go across town; and so on. Medicare and SSI picks up the bill. And if for whatever reason some treatement isn’t covered, well the hospitals are not allowed to turn away patients in need, so they are always treated anyway, and when the bill arrives afterward, people just laugh and throw it away, because they are indigent and have no real monetary assets, and since there is no debtor’s prison in the US, there’s no way to get these people to pay the medical bills they supposedly owe the hospital or the government. When you are in a permanent state of bankruptcy, as most people on welfare are, it’s impossible to squeeze any money out of you.

    At the other end of the scale, wealthy people and upper middle class people can afford to pay for their own health insurance. No problem.

    And in the middle, employed middle class people generally get their insurance coverage through their work.

    The people who are suffering are lower-middle class, or unemployed, or self-employed people. Those who have the kind of job which does not provide coverage, but who aren’t poor enough to qualify for Medicaid. But here’s the hidden secret: A lot of the people in this category are fairly young, just starting out as adults, and those are the people who generally don’t need or even want to buy health insurance anyway. So the actual target groups of sufferers are middle-aged lower-middle class, or unemployed, or self-employed people. What percentage of the country is that? I couldn’t tell you. But it’s not a huge percentage, nor are they a cohesive voting block, since a lot of people who fit that description are struggling entrepreneurs or small-business owners who often vote Republican.

    tannin: Taxes; the U.S. is radically undertaxing the very wealthy, who are basically getting a free ride by the standards of all the other first world countries. The upper middle class are similarly being under taxed

    A ha! So, that’s what this whole debate about health care is about: taxes. Leftists want to tax the rich more, as a matter of principle. But under our current system over the last several decades, there was no real need to tax the rich beyond the current tax rates, as the country continued to hum along. And so the Left needed to concoct a desperate immediate CRISIS that needed to be fixed NOW and the only way to to fix it was with A LOT MORE GOVERNMENT MONEY and the only way to get it was to TAX THE RICH. Voila! Goal achieved.

    But I’m not going to go back to Economics 101 and explain how taxing the rich and upper middle class ends up hurting the economy overall. Because you probably already know that, and choose to ignore it. Rich people don’t just sit on a big pile of gold coins counting them greedily every night. Their money is invested, or put to use creating businesses and jobs. Very little money is “inert” anymore. Even if the rich guy puts the money in a bank, the bank would then turn around and use it to invest in things. This is how the economy works, and how jobs are created. Take away money from the upper middle class, and you take away the salaries of employees they would have been able to hire with that money. And more jobs disappear. Etc. etc. etc. — basic economics. The Chinese already tried your experiment and took it to its logical conclusion in 1949, as did the Russians in 1923, removing all wealth from the wealthy, and what happened was pretty disastrous in both cases. After decades of failed communist experiments, both countries in the ’90s had to reluctantly return to a mostly capitalist economic structure to get back on their feet (although, in both cases, retaining a totalitarian political structure). Do we want to repeat that same failed experiment?

    tannin: The lower middle class, the poor, and the budget deficits are paying for the indulgence to the well- to- do.

    What? The poor and lower middle class pay almost NO taxes in the US. Look it up. The wealthy and top half of the middle class (i.e. upper middle class) pay 97% of the taxes. The wealthy all by themselves (i.e. the top 20% of the country) pay 82.5% of the taxes.

    No, it’s not like the poor are bearing most of the burden. (In fact, as you see on the linked chart, the poor pay -2.3% of the taxes — that’s minus 2.3%, meaning they actually get more money back from the government than they pay in.) The top earners already foot basically the entire bill.

    So the only way you can justify taking even more money from the top half of earners is by concocting a new social ENTITLEMENT that is a FUNDAMENTAL RIGHT which never existed before, which requires TRILLIONS of dollars to fund. Which is exactly what the Left has just done.

    tannin: One last thought; there are people who are poor, and rich, in the U.K., France, Germany, Japan and Canada, yet all those countries have single payer govt run health systems, of various sorts. People who can, work, in those societies, very few decide that, because health care is guaranteed and a rock bottom few dollars for food and shelter is available to those who need it, that they don’t want to work. That is to say, the addition of guaranteed health care hasn’t diminished the work ethic at all.

    Say what? Have you looked at England recently? The exact opposite of what you say is true there. Vast segments of the population are simply coasting along on the dole. Analysts are all decrying the end of the British work ethic, as the universal welfare state there has removed the incentive to work at low-level or menial jobs, since you could live just as comfortably doing nothing. Goofing off is the new national pastime.

    As for Germany and Japan, they are genetically encoded to be little worker bees, so they’re kind of outside the norm; you couldn’t stop them from working even if you tried.

    tannin: Of course, if you really want to pay for hundreds of different marketing campaigns, thousands of well paid directors, many hundreds of hugely overpaid chief executives and for steadily rising profits for investors, oh, and for some grandiose head offices, then just stay with your present system, at least you know what some of your money has gone to pay for.

    As Starless pointed out already, no one here is applauding the current system as wonderful and perfect. Yes, HMOs are inefficient and have too much bureaucracy and skim too much off the top. But as Starless pointed out, it’s a false dichotomy to say that one must either adopt universal single payer OR stay with the current system. There are other solutions, which are exactly the solutions that conservatives are proposing: Diminish costs, simplify the system, etc. It’s not an all-or-nothing proposition.

      

  192. 192zombie on Dec 30, 2009 at 11:57 am:

    zombie: people call 911 to get free ambulance rides sometimes just as a taxi service to go across town

    As if on cue, this story just appeared on the wires:

    Fla. man wanting ride to bar calls 911, arrested

    OLDSMAR, Fla. (AP) — Authorities say a Florida man who called 911 claiming he’d been beaten and shot at was hoping the tale would get him a ride to a bar. Instead, 37-year-old Gregory J. Oras is facing charges of misusing the 911 system and battery of a law enforcement officer.

    An arrest report says Oras called 911 three times before his arrest early Tuesday in Oldsmar, northwest of Tampa. He told the dispatcher he had a broken nose and bleeding ears, and claimed people were shooting at him.

    Authorities say he was actually looking for a ride to another bar.

    The report also says Oras kicked a Pinellas County sheriff’s deputy in the knees and a Taser was used to subdue him.

    Stuff like this happens on a daily basis, but is rarely reported.

      

  193. 193Starless on Dec 30, 2009 at 12:05 pm:

    zombie: Leftists want to tax the rich more, as a matter of principle.

    And that’s what this is about. Who’s got the bigger political wang. The thing is that the rich will always be rich, the poor can’t pay for anything, so it’s a matter of who gets to pound on the middle class and how much do they get to pound on them. Approaching this problem from a moral position is a big fat lie.

      

  194. 194FredGarvin on Dec 30, 2009 at 5:39 pm:

    184 Common_sense on Dec 29, 2009 at 9:21 pm:
    “well, if people have a “right” to healthcare, don’t they have rights to more basic needs

    …like transportation (how you gonna get to the doctor without a free car?)
    free fuel for said car”

    aka. Peggy Joseph Syndnrome

    http://www.youtube.com/watch?v=P36x8rTb3jI

      

  195. 195Keith on Dec 30, 2009 at 8:18 pm:

    Ya’ll a bunch of ideological fundamentalists. No wonder people are losing their jobs and the country is going downhill economically. People just cant think properly and people just dont have a sense of priorities.

      

  196. 196zombie on Dec 30, 2009 at 9:23 pm:

    Keith: Ya’ll a bunch of ideological fundamentalists.

    Exactly what type of “fundamentalism” is the basis for our ideology? Seriously, I’m curious to know. As far as I can tell, there is no named ideology which describes this essay.

    More likely, is the word “fundamentalist” just an all-purpose insult in your lexicon?

    No wonder people are losing their jobs and the country is going downhill economically. People just cant think properly and people just dont have a sense of priorities.

    You’ve got me scratching my head with that one. Are you saying that if the U.S. adopted socialized medicine, it would somehow magically solve the unemployment problem? Pray tell, how will that work? Will the government form an entirely new branch as big as the military to manage the health-care system, and hire ten million people to run the bureaucracy? Why, that sounds like a plan! In fact, that sounds like…socialism. Hmmmmmm.

    Explain more clearly how the collapsed economy is caused by medical costs, and how me changing my mind about universal health care will end the depression we’re in. I’m all ears.

      

  197. 197Keith on Dec 31, 2009 at 12:35 am:

    I don’t know what is best with regards to the financing of healthcare. When I say ideological fundamentalist I mean that when people look at any problem they approach it with the same formula the same ideology. And so I see a lot of people on here deciding on answers to political problems not based on practical solutions but rather they try to figure out what solution conforms to the ideology of individualism. I’m not anti or pro individualism but it solutions should be based on whats practical as opposed to whether or not the solution is individualistic or collectivistic.

    This country is going downhill because people apply formulas in order to address problems rather than looking at each individual problem on a case by case basis. And so what I am saying is that economic situations should not be dealt with ideologically. Another thing is is that people don’t know what they are trying to do. They don’t have a set of concrete goals, a clear idea of what they are looking for in society. It’s impossible to solve problems if you don’t know what the solution looks like. Basically peoples thinking has become so abstract and theoretical that the human mind has separated from reality and is unable to effectively deal with situations because situations are real and require practical solutions and it is impossible to have a practical solution if one is unable to be flexible with ones thinking.

      

  198. 198tannin on Dec 31, 2009 at 2:02 am:

    Starless, i understand the health insurance companies are usually owned by stockholders, not some ultra greedy scrooge mcduck. The usual argument for using private enterprise is that the job will be done better and cheaper than the state could do it. In health care, if you check out the stats, the job done by private health care in the U.S. is way more expensive than elsewhere; i’m suggesting that part of that extra expense is the cost of duplication, hundreds of advertising campaigns, many thousands of highly paid executives etc, not a scrooge mcduck.
    Zombie, you write of the low, or negative, income tax of the poor, and i appreciate you giving figures, which can save us, me included, from wild statements. I would say in response that, i cannot honestly claim to know enough in that arena, especially re the U.S., but i would suggest that income taxes are only one of the many taxes that affect most people. Up here we have a sales tax, well two sales taxes really, which add 13 % onto the price of an article or service; i’m sure there are some, hopefully not as high, similar taxes stateside; those who own homes stateside can deduct mortgage interest from income, does a poor person who rents have a similar benefit ? Possibly, if the landlord owes a big mortgage, or maybe that benefit doesn’t trickle down. Of course, you’d say that the poor get free health care, others pay, and that should count as a negative tax…………wish i knew more of your stats, but i think i must be wrong in my ‘poor pay to much tax’ comment; sorry.
    Not sure that it is adequate, though tongue in cheek, to suggest that the Japanese and Germans work hard despite universal health care because they are genetically encoded; the Brits actually work more hours per year that most ‘continentals’.
    I understand many of the points made by those who want the private system to continue, and certainly agree with them that, if it is to continue, things must be organized and run more effectively, and less expensively.
    The englishman writing here, can’t remember his name, wrote that very few people in England would consider giving up the single payer govt run system ( i should add the Brits have the choice to pay for private care, and many upper middle and upper class do; doctors ofter serve in both systems, sort of morning working for the state and afternoons for the private sector ), and certainly in Canada any political party suggesting that we give up our state health system wouldn’t elect a member anywhere in the country ( again, should add that Canadians can take advantage of private health care stateside if they wish; some do, making our system, in total, a bit reflective of the Brit dual system. 95% of us don’t go stateside, or maybe 99 %…..just guesstimating of course ).
    What i’m saying is that those who have single payer govt systems like ‘em, a lot; and wouldn’t change.
    I’m also saying that some elements of free enterprise health care, keeps the system honest, can handle problems, etc.
    Would also suggest that single payer govt system, universal,,catches health problems earlier for many and possibly saves money for the society because of that.

    Anyway guys and gals; i’m off to Barbados Jan 1st, so this might be my last contribution for awhile. I read every comment and have learned a lot. Many thanks zombie for your thoughful responses, which set the tone for an interesting and informative discussion.
    All the best for a healthy, happy and prosperous new year to all on this blog.

      

  199. 199Starless on Dec 31, 2009 at 6:01 am:

    Keith: When I say ideological fundamentalist I mean that when people look at any problem they approach it with the same formula the same ideology.

    That’s a pretty self-evidently human way of approaching the world. Our experiences and prior knowledge inform how we view ideas — how could it be any other way? I seriously doubt you could point to some time in US political history where people didn’t “apply formulas in order to address problems rather than looking at each individual problem on a case by case basis”. That’s what politics is. The current healthcare debate isn’t about healthcare or fairness, it’s about politics. It’s about who controls the big pile of (real or made up) cash and the power that comes with it. And, to answer some of what tannin is saying, I personally am not willing to just lay down and accept that somehow the federal gov’t, after oh-so-many failed social engineering programs, is suddenly competent enough to handle this particular problem.

    So, yeah, I come to this thinking, “The federal government will screw up managing healthcare and the Left is at a place right now where all they’re interested in is exercising their power by taking something important (liberty) away from me”.

    tannin: the job done by private health care in the U.S. is way more expensive than elsewhere

    In aggregate, I’d buy that, OTOH, the US also has the most advanced, and therefore expensive, healthcare technology. What I’m not buying is that cost is hugely inflated by mailers and TV advertising or that somehow notoriously inefficient federal bureaucracy is going to save more money than private, for-profit, bureaucracy. On the subject of wasting healthcare money on ads: the state of Minnesota received one of the largest (possibly the largest) settlements against a tobacco company and, as a result, put that tobacco company out of business.

    The state received $5 billion which was to only be used for tobacco use cessation programs. IOW, to help smokers quit and to keep kids from starting in the first place. Years after the settlement, a bit of a scandal occurred — nobody quite knew what was going on with the money. It turned out that the sum total of the tobacco use cessation program comprised of some mailers and a web site (TV too, I think). That was it. To top it all off, state legislators kept trying to go to the tobacco settlement fund well and transfer it to the state general fund so they could use it for whatever the hell they wanted.

    Now you tell me that a universal healthcare program in the US isn’t going to be subject to the same sort of bureaucratic incompetence and political graft. These are, after all, the same geniuses who decided it would be a really good idea to buy the majority of an automobile manufacturer (GM) which is clearly coughing up blood and beyond hope.

    Hey, everybody, go out and buy a cheap Pontiac or Saturn. Uncle Sam’s footing the bill!

      

  200. 200zombie on Dec 31, 2009 at 11:20 am:

    tannin: i cannot honestly claim to know enough in that arena, especially re the U.S., but i would suggest that income taxes are only one of the many taxes that affect most people. Up here we have a sales tax, well two sales taxes really, which add 13 % onto the price of an article or service; i’m sure there are some, hopefully not as high, similar taxes stateside; those who own homes stateside can deduct mortgage interest from income, does a poor person who rents have a similar benefit ? Possibly, if the landlord owes a big mortgage, or maybe that benefit doesn’t trickle down. Of course, you’d say that the poor get free health care, others pay, and that should count as a negative tax…………wish i knew more of your stats, but i think i must be wrong in my ‘poor pay to much tax’ comment; sorry.

    To answer your questions:

    No, the United States does NOT have a nation-wide federal sales tax, the way that Canada does. So, once again, there is no “regressive” tax penalizing the poor. (Yes, most states have a sales tax, in all cases much less than the Canadian tax, but those funds go into state coffers, and are not part of the federal government in any way; the Feds receive NO money from sales taxes.)

    And YES, a poor renter does receive similar tax benefits to the deductible mortgage interest; there’s something called “Earned Income Credit” that’s basically for working families that don’t make much money nor own property or other investments; and also most states have a “renters’ credit” section of the tax code. But you’re misunderstanding the nature of the deductible mortgage interest: the law does NOT apply to landlords who own income property. It applies to families who own one home and live in it. The law is supposed to encourage home-ownership among the not-so-well-off, as opposed to giving a free handout to big landlords and those who own income property. If you are a big landlord, there are other ways you deal with mortgage payments — i.e. they can be construed as a “business expense” if you’re a real estate wheeler-dealer — but that’s an entirely separate issue.) So in no case is there some “benefit” that landlords get that doesn’t “trickle down” to the tenants, as you suggest.

    Non-Americans apparently have this mis-apprehension about the US tax code, that rich people get a free ride whereas poor people have to carry all the weight, paying way more than their fair share. In fact, quite the opposite is true, and poor people get all sorts of extra tax benefits, and the tax code is extremely “progressive” (i.e. in the old fashioned sense of the term — the less you make, the lower percentage you have to pay; and the more you make, the higher percentage you have to pay.) And because of the Earned Income Credit, the poorest of the poor actually get more money out of the IRS than they pay (i.e. they generally pay zero, and still get a check in the mail for the EIC).

    I know it goes against the stereotype of the cruel capitalistic US, but the IRS tax codes are themselves a giant social engineering system designed to benefit the poor. As the stats show, the wealthy and upper-middle class pay 97% of the tax in this country, which means they fund 97% of all social programs, 97% of defense, 97% of everything — and 97% of health care costs, if Obama gets his way.

    Thank you for being the rare person to admit that your impression about “poor people pay too much tax” being wrong.

      

  201. 201Starless on Jan 1, 2010 at 4:30 am:

    zombie:

    The flip side of the mortgage refund is real property taxes. State politicians will tinker with property values depending upon who they’re pandering to at any particular point in time. My state has been undervaluing property for quite some time but that law expired in 2009. So in some of the worst economic conditions, they’re going to stick it to property owners. In particular, stick it to property owners who in the main were responsible and didn’t get foreclosed upon.

    So, yeah, property owners will get a mortgage interest refund from the feds and the state, but the state will tax them in perpetuity on property they already paid sales taxes on at the time of purchase. A tax which legislators can raise on a whim. So as a property owner you can see the light at the end of the mortgage tunnel, but you will never, ever see the end of taxes on your property and there is virtually no way, short of moving to another state, you can have a significant impact on what your tax rate is.

    As a sort-of economist friend of mine told me, real estate, due to taxation, is a pretty crappy investment.

      

  202. 202Starless on Jan 2, 2010 at 6:28 am:

    This has me wondering: at what point will ObamaCare start to impose healthcare quotas based on identity group due to pressure from PACs? Cuz, you know it would happen.

    More to the point of the article, haven’t we been told for decades how stupid American students are, particularly in math and science, and how something must be done about it? How is this move by Berkeley High School helpful in combating American student stupidity and how does it not prove that identity politics trumps actual education?

      

  203. 203Wm T Sherman on Jan 2, 2010 at 5:09 pm:

    OT- Zombie, I have seen claims that the Mohammed cartoons were re-printed in a major Egyptian newspaper months before the big worldwide outrage, and did not draw any reaction. Have you ever examined that angle of the story?

      

  204. 204zombie on Jan 2, 2010 at 8:47 pm:

    Wm T Sherman: OT- Zombie, I have seen claims that the Mohammed cartoons were re-printed in a major Egyptian newspaper months before the big worldwide outrage, and did not draw any reaction. Have you ever examined that angle of the story?

    Yes, I am aware of that fact — in fact, I mention it already on my page about the Jyllands-Posten Mo cartoons:

    While people across the Middle East are rioting over the publication of the 12 cartoons in European papers, no one seems to have minded that the cartoons were printed last fall in an Egyptian paper as well.

      

  205. 205Wm T Sherman on Jan 3, 2010 at 1:27 pm:

    How I missed that, I don’t know. FYI: The Sandmonkey cartoons link jumps to the Sandmonkey main page after about 10 seconds. You might consider using this link as well: http://freedomforegyptians.blogspot.com/2006/02/egyptian-newspaper-pictures-that.html

      

  206. 206Gonzalo on Jan 6, 2010 at 6:50 pm:

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  207. 207shortshirft on Jan 7, 2010 at 12:13 am:

    Excellent post. I quarrel with :

    “I’m perfectly willing to provide subsidized health care to people who are suffering due to no fault of their own.”

    Why? Should a friend or relative suffer, then offering a helping hand is understandable. A suffering stranger – even though a fellow national or resident within the borders – is a different matter. Providing funds to the government to prevent the suffering of those to whom it comes due to no fault of their own, is fraught with moral hazard. The argument that ours is not the sort of society that could tolerated seeing dead bodies on the street is utter tosh. The old die, the homeless die, accident victims die, the incurable die. It is precisely for unforeseen future illness and accidents that medical insurance exists. If allowed to work without government interference skewing the actuarial risk calculations, insurance is what will keep the corpses off the streets. In a world where insurance companies are competitive, the variety of insurance products and costs would make coverage for the catastrophic illness or rare illness affordable. If a rich person without medical insurance gets ill, he can pay for treatment. If a less rich person without medical insurance gets ill, he might have to sell his house or go into bankruptcy so that he can pay for treatment. If a poor person without medical insurance gets a fatal disease and cannot afford treatment, has no friends or family to help, and is turned away by charitable institutions, he will die. In short, the decision not to buy insurance is the same kind of decision as smoking, eating whoppers, taking drugs etc. What about those who cannot take such a decision? Parents will bear the cost of their ill children, if they make the choice not to insure them – or, once again they must adjust their spending, find assistance, or in the worst case, see their children die. Why should society care more for those children than the parents, who in any case will be making “lifestyle” choices for them ? Pre-existing conditions? Same logic applies . If the person was not insured before the condition, not taking insurance was a bad lifestyle decision, and the consequences are as they may be. Uninsured severe congenital conditions? Parents readjust their budgets. Old age does not “deserve” free care any more than the new-born. Either the old person has provided adequately for his old age, or he hasn’t. If he has lived wisely, old age itself is his reward. If he has been lucky, he has spent the cost of the insurance on living and is not entitled to free care. This is not to say that any individual should be prevented from assisting the destitute or paying into a charity – or even taking responsibility for the sick person on the sidewalk that they would otherwise trip over – but that government is no substitute for that individual. The government should not be the conduit for Pious Peter to rob Prudent Paul to pay Doctor Derek for the care of Foolish Fred, Smoking Sally, or, worst of all, Hypothetical Harry, a-lying on the street.

      

  208. 208Beckaholic on Jan 7, 2010 at 9:26 am:

    Shortshrift- It’s called compassion. There but for the grace of the diety of your choice, go I. Bad things can happen to people who HAVE done all they can to prepare for old age, infirmity, etc. And in our society, since the fraction of individuals in dire straits is relatively small, we can absorb them with little expense. If we were India, and not the US, we couldn’t carry the burden of the destitute, so they literally do die in the street, but here at this point in time, we can do it. I don’t mind it- it’s the people who can do better and just don’t bother, that I resent carrying.

      

  209. 209shortshirft on Jan 7, 2010 at 10:12 am:

    Beckaholic,

    Nothing to prevent you from being compassionate. But do not indulge in moral preening at the expense of others. There is no way to distinguish between the deserving and undeserving, without massive government intrusion into private lives. Zombie’s post made that abundantly clear. “Society” should be just, not compassionate. I find it appalling that individuals should take pride in having a “compassionate” government, as if that horribly unjust, coercive redistributive impulse raised the moral standing of the nation. India has many reasons to be ashamed of itself, but the dead on the streets is evidence of greater national outrages than lack of compassion.
    I have never understood why compassion is held to be the highest public moral virtue. It is a private decency.

      

  210. 210shortshirft on Jan 7, 2010 at 10:21 am:

    Beckaholic:

    And furthermore, the test of true compassion would be to help the undeserving.

      

  211. 211Beckaholic on Jan 7, 2010 at 12:51 pm:

    Shortshrift:

    I know what you are trying to argue here-

    What is the moral code of altruism? The basic principle of altruism is that man has no right to exist for his own sake, that service to others is the only justification of his existence, and that self-sacrifice is his highest moral duty, virtue and value.

    Do not confuse altruism with kindness, good will or respect for the rights of others. These are not primaries, but consequences, which, in fact, altruism makes impossible. The irreducible primary of altruism, the basic absolute, is self-sacrifice—which means: self-immolation, self-abnegation, self-denial, self-destruction—which means: the self as a standard of evil, the selfless as a standard of the good.

    Do not hide behind such superficialities as whether you should or should not give a dime to a beggar. That is not the issue. The issue is whether you do or do not have the right to exist without giving him that dime. The issue is whether you must keep buying your life, dime by dime, from any beggar who might choose to approach you. The issue is whether the need of others is the first mortgage on your life and the moral purpose of your existence. The issue is whether man is to be regarded as a sacrificial animal. Any man of self-esteem will answer: “No.” Altruism says: “Yes.” Ayn Rand.

    Altruism (or “true” compassion) to you doesn’t differentiate between the deserving and the undeserving- I could not disagree more that it’s not possible to distinguish between the two. And I don’t know why you would say you don’t get why compassion is a virtue, but if you want to “really” be virtuous you would give to the undeserving. Not logical.

    It doesn’t require sacrifice on my part (maybe yours, though) to help the truly helpless. It’s not against my own self-interest to do so, and I can argue that it’s in my interest for the sake of psychic peace to not step over bodies on the sidewalk and to realize it could be me one day. And I realize that if I lived in India I probably couldn’t say the same thing as the burden would simply become onerous. I’m also not required to have compassion for your interests- I don’t care if you think the burden on you to help a sick destitute 90 year-old grandma is too great, because unless you are helpless yourself (you don’t sound like you are) it’s not really at this point in time. That may change at some point in the future (Obamacare and demographics) and need to be re-evaluated, though.

      

  212. 212shortshirft on Jan 7, 2010 at 1:58 pm:

    Beckaholic:

    Thank you for the Rand. I prefer the Hayekian disparagement of “altruism” as an economic detriment – and moral absurdity – outside a face-to-face community. You say:
    “I’m also not required to have compassion for your interests- I don’t care if you think the burden on you to help a sick destitute 90 year-old grandma is too great, because unless you are helpless yourself (you don’t sound like you are) it’s not really at this point in time.”
    Not too sure what you mean here. An inadvertent omission? But it sounds a little like , “If you are not at rock bottom, you must contribute to those you might be, even if you do not, as I do, get a moral frisson from it, because one day I might be at rock bottom too.”

      

  213. 213Beckaholic on Jan 7, 2010 at 9:43 pm:

    Shortshrift:

    How do you feel about dog shelters?

      

  214. 214shortshirft on Jan 7, 2010 at 10:21 pm:

    Beckaholic:

    I’m sure the destitute 90 year old granny would be grateful to be placed in one.

      

  215. 215ptbo on Jan 9, 2010 at 10:38 am:

    zombie’s eassy make no sense…

    The concept that personal choices that adversely affect people’s health are paid for by everybody is true in a private insurance scheme as well as a government option. More people get cancer because of more smoking then premiums go up.

    America’s current system is far too expensive, obscenely immoral and in need of complete government takeover from private insurance companies that make profit by playing God with people’s lives.

      

  216. 216FlyingDutchman on Jan 10, 2010 at 7:14 am:

    What an idiot. Honoustly, is this article for real? You won’t need to pay for other people their treatments. Whether their health got threatened by their own stupid mistakes or by unlucky chance, you won’t be paying for that. You’re paying for YOUR OWN insurance in the form of extra tax. See? You’re paying money to safeguard your own health. Do you honoustly think you’ll get a letter in your mailbox saying: “You neighbour has been diagnosed with lungcancer due to his smoking habits, pay for his treatment or be fined.”?! The money you pay in the form of tax will be a FIXED price, probably way less than the amount of money that you’re probably saving right now should you ever get diagnosed with a severe illness or get involved in an accident. The tax will go the people who are in need of medical treatments, including you if you’d ever happen to need it. Unlike private insurance companies, the government won’t tell you stuff like: “sorry, you’re a heavy smoker, so we don’t feel the need to fix that leg of yours”, no, they will have to treat EVERYONE. And with the money that will come in through tax, they WILL be able to do that.

    Telling people lies about them being forced to pay for other’s treatments…fool…stop being so goddamn paranoid and try to appreciate the fact that your government is finally doing something about the ridiculous state of healthcare in your country.

      

  217. 217Higuma on Jan 11, 2010 at 4:14 am:

    Flying Dutchman, and where do you think that money goes on the long run? You’re not only paying for yourself. The yearly report I received from my health insurance (when I was still on the local nationalized one) stated clearly that, while I pay for my own insurance, everything I don’t need in money goes into the whole pot, thus financing people who refuse to work (for example.)

    I live in a country that has a similar system. And guess what… every single health insurance that is controlled by either the state or the provinces, aka the different levels of government, is broken. Some of them are bankrupt. Plus, you get waiting lists on some of the most basic treatments.

    Here people who can afford it flock to private insurances because, in the end, you get what you pay for.

    No Flying Dutchman, the government won’t tell you “sorry, you’re a heavy smoker, so we don’t feel the need to fix that leg of yours.” Nope. But they will tell you “Sorry, you have skin cancer, but the waiting list for surgery is three months” (like in the UK). They will tell you “Sorry, but the waiting list for your varices surgery is at least year” (like in Austria). They will tell you “Sorry, but we don’t have a pediatrician in this hospital.” or “Sorry, we can’t accept this patient, even though it’s an emergency, but we’re lacking the staff and equipment” (like in Japan).

    And then people are left with only one thing: private insurances. Because you get what you pay for.

    As an example:

    Here, if you only have nationalized health insurance and if you end up in hospital, you will end up sharing a room with up to 5 other people (at times even 7 others, depending on the hospital, because some hospitals still have infrastructure from 100 years ago.) Normal rooms in the wards. You will get standard treatment. Standard. The least common denominator, to pull math in. Dentist or eye doctor and all that will be provided, but at the cheapest possible solution.

    If you’re unlucky, you might even be housed in the corridor, in a so called “corridor bed”. Yep, that’s a normal bed on a normal ward, but since the ward is out of room, and they’re still accepting patients, some patients end up living in the corridor (politicians say these beds don’t exist anymore, but that’s a lie.)

    If you want more than that. If you want your own room. If you want different diets. If you want privacy. If you don’t want to be treated like a number, then you have to pay extra. That’s how it is.

    Our nationalized health care has been in place for over 40 years. And it has been crumbling for at least 20 years (shortage of nurses, shortage of room, shortage of money, because such a system also gets abused heavily.) By now it’s close to collapsing.

    You should visit a local doctor in the city I live in. I only go there if I’m sick and really need help, but whenever I got there, the very first thing I see is: dozens of old women. Old women who go there to chat. The doctor then measures their blood pressure and what not and, of course, bills that. Those are millions thrown out the window every day.

    And no, this is not a third world country. This is a western European country with one of the top economies in Europe.

      

  218. 218FlyingDutchman on Jan 11, 2010 at 6:35 am:

    Weird, how I did seem to get treated on the very same day for a leg I broke while snowboarding. I went to the doctor, who confirmed it was broken, he send me to the hospital, where I waited for 7 minutes to get an X-ray taken, and afterwards I waited another 5 minutes for some guy to straighten out my leg and spalk it. I spend half a day in a hospital room resting my leg, while I talked to my roommates about their accidents. All the costs were dealt with by our “socialist health care system”. If there’s an emergency, you WILL get treated, no matter what. And we’re talking about hospitals, not hotels. Ofcourse you’ll share a room with 2 or 3 people, and I don’t see the problem with that.

    And the arrival of universal health care in America does NOT mean that you’re obliged to stay in a hospital with 3 others in your room. You’re not obliged to eat whatever they give you. Nobody is holding a gun to your head saying you have to stay. If you want to leave with a bullet in your leg, go ahead. If you want to eat something different, go ahead, ask your friends to bring you something else e.g. During your entire stay in a hospital, you will be given ADVICE. If you decide to ignore that advice, that’s your problem, and you’ll have to live with the medical conscequences, but you’re acting like the government will get full control over what you can or can not do, which is utter bullshit.

    In my country, everything works perfectly fine. Who’s to blame for the collapsing system in your country? The government, or the people abusing the system for their own benefit? I think you know the answer to that one. Don’t blame the system for things that the people around you do wrong. It’s called moral responsibility, and if that’s not present in your country, not only the health care system will collapse, but your entire country in general.

      

  219. 219kevin on Jan 17, 2010 at 12:10 am:

    will never understand america..don’t mind spending billions killing children overseas but don’t want to spend anything to help fellow americans

      

  220. 220tannin on Jan 17, 2010 at 11:51 pm:

    Higuma, ” old women who go there to chat “, your comment on seeing so many elderly women waiting to see a doctor, is the assumption of a younger, and arrogant, male.
    Believe it or not, elderly women have as much to fill their lives with as, well, as you do. Let’s hope they stay healthy because they are often the main caregiver for elderly men, typically their husbands.
    Btw, in all the nations with a single payer medical system, many of which have a govt single payer system, i read of no ‘ push’ to change into an American style free enterprise health system; i suggest that no government could get elected in any of those countries that suggested moving over to the American system.
    What is taking place, in all those systems, is continual finessing to save money and improve the system.
    On average, these single payer systems are covering their entire populations for 30- 40 % less, as a percentage of gdp, than America is spending to cover 80 % of its population, giving those countries using a single payer system a significant economic advantage over America.
    In addition to the economic advantage, those countries using a single payer system have longevity figures as good or better than the U.S., and the same can be said for most other measures of health.

      

  221. 221PR1Samantha on Jan 20, 2010 at 7:54 pm:

    You may have just changed my mind. I wondered why greedy americans won’t help the poor with socialized health care. Now I don’t want to become ticked off having to pay taxes for all the preventable stupidity ultimately having everyone getting “socialized” by getting into everyone else’s personal business. America is different from the countries who socialized medicine works for…they’ve historically not wanted anyone in their business. I get it now. I don’t either.

      

  222. 222PR1Samantha on Jan 20, 2010 at 8:04 pm:

    Oh, and America is the most immature country and eventually we’ll all grow up and become all for socialized medicine but for now the US is a whiney teenager “I donwanna pay for her, she’s fat…it’s not my fault…mind your own business…but it’s not faaaiiiir, whaa”.

      

  223. 223Tim B on Jan 21, 2010 at 2:19 am:

    If you look at other countries with socialized medicine, Great Britain being the most glaring example, these invasive and oppressive government dictates have already started to circumscribe people’s freedom, with every kind of potentially dangerous activity or unhealthy comestible being declared forbidden — for the good of society as a whole.

    I’d really love to hear examples of these activities and food we’re forbidden from partaking in over here. Maybe you’re thinking of the ban on smoking in enclosed public places, but that’s more about protecting people from other’s smoke than from themselves, and anyway from what I understand it was parts of the USA which led the way in smoking bans.

      

  224. 224darren on Jan 21, 2010 at 6:18 am:

    I am filled with a mixture of admiration and repulsion at this article. I think universal healthcare is a good thing and I would rather live in a society that has it than a selfish society that cares only about what’s in it for me. Here in Ireland we pay a thing called PRSI(pay related social insurance) which is supposed to cover health care; and yet I also have to pay private monthly insurance. PRSI is just a government tax scam, but I would rather pay it than have some genuine less-well-off mother with a sick child being told by some commercial hospital that they can’t treat her sick child. This to me stinks of a lot that is wrong with the USA. As for one of your bloggers refuting the suggestion that the American people are not caring by pointing out that they gave lots of money to bail out the banking sector – I can only hope that this was irony.

      

  225. 225Crawdad on Jan 22, 2010 at 12:32 pm:

    darren from ireland,

    I’ll just leave you with a little nugget of wisdom from Federic Bastiat:

    “Socialism, like the ancient ideas from which it springs, confuses the distinction between government and society. As a result of this, every time we object to a thing being done by government, the socialists conclude that we object to its being done at all.

    We disapprove of state education. Then the socialists say that we are opposed to any education. We object to a state religion. Then the socialists say that we want no religion at all. We object to a state-enforced equality. Then they say that we are against equality. And so on, and so on. It is as if the socialists were to accuse us of not wanting persons to eat because we do not want the state to raise grain.” -from “The Law”

      

  226. 226Crawdad on Jan 22, 2010 at 12:40 pm:

    Also,

    Here’s a nice supplement to Zombie’s essay:

    http://www.csmonitor.com/Commentary/Opinion/2009/0107/p09s01-coop.html

      

  227. 227Jim on Jan 25, 2010 at 11:44 am:

    Preventative medicine is what is needed not more health care reform. If you want that fix Medicare and medicade!
    It sounds like what the good doctor was doing was just that. Telling the woman to do something about the way she was before things got worse.
    Of course preventive medicine – or so I have heard – isn’t covered by insurance or doctors get paid more for things that could have been prevented.
    This is an old fashioned doctor and we need a lot more of him.

      

  228. 228ELS on Jan 25, 2010 at 9:02 pm:

    every where I turn I hear people say “I dont want universal health care because I dont want to pay for other peoples foolish behavior” and in the same breath say “what we need is more doctors who will bluntly tell us how to prevent preventable diseases” Lets take a look at a bigger picture here. yes, we will be footing our own and somebody elses medical bills through taxes and EVERYONE has to pay taxes. So, you pay for thier foolishness and they will pay for yours. There is not one person on this earth or especially in this nation that can aviod every “preventable” disease. Many on which (despite popular belief) still contracted by accident. what if you are a basic first aid responder and your glove breaks as you touched a bloody victim and you contract HIV, is that your fault? No. what if you cant pay the medical bills for treatment, would you not want someone to help you? What if your son is hit by a drunk driver and is severly injured is that your fault? No. would you not want some help paying medical bills? What if you are raped and contract an STD? What then? thats not your fault either. All of these things are something that people automatically blame the condition of the person on them before even asking questions of how they contracted the disease. These things can get very expensive and fast. What if everyone, before even asking how the disease was contracted said, its your fault you foot the bill? what if they really didnt care? With a Universal Health Care system, everyone despite thier circumstances can recieve help. Less than half of all medical emergencies are the fault of the victim. If the United States adopts a universal healthcare plan more doctors would tell us how to prevent diseases and actually cure our ailments instead of prescribing SYMPTOM COVER UPS because they would actually be paid more to cure the our diseases rather than (as in our current circumstance) get paid more NOT to cure our condition. Under our current healthcare plan, Americans are told “here, take this pill and if your SYMPTOMS do not improve within (insert time period) come back and see me in a week. In Canada (which has a Universal Health Care plan) patients actually come out of the doctor’s office healthier than when they went in and completely understand what exactly was or if its incurable is wrong with them. With a universal health care in the United States, we can have that. We can feel confident that our doctors are actually trying to help us over come our conditions and are not just telling us what we want to hear or making us take unnecessary tests or do unnecessary surgerys or even presribe pills we dont need just because they get paid more if they do. Under a Universal Health Care plan we can be confident that we are getting the care we need for the condition that we have and the doctors care more about curing us than coming up with a way to screw us up to get more money. Did you know Iraq has universal health care? do you know why? Because we the United States taxpayers are giving it to them. We are paying for Iraqis to have health care, why deny ourselves the same basic rights? We the United States taxpayers already provide health care for criminals, drug addicts, alcoholic, etc. why should we deny it for ourselves? Why should we foot our bills and thiers when they do not help foot ours? Under a universal health care plan they will be forced to help foot our bills because they just like everyone else must pay taxes. Everyone gets sick, whether by accident or not is not the question, the question is do they help foot our bills when we already help foot thiers?

      

  229. 229John on Jan 26, 2010 at 1:25 pm:

    A lot of supportive comments — I guess it is only natural that people who read a blog, are more likely to be the ones who support its writer’s views.

    Regarding UHC and your point that “everybody should pay for himself”, there are a couple of points.

    1. UHC is essentially mandatory medical insurance.

    Let’s face it, if, for whatever reason, you develop a medical condition or get injured, and it prevents you from working for a significant time, you will be (a) spending a lot of your earned money (if not all, unless you are very well off) and (b) will have no way of earning extra money meanwhile.

    For these reasons it makes perfect sense to take out insurance, which spreads the costs of your potential treatment among every participant. In the case of UHC, the number of participants is going to be the largest possible, therefore reducing your expenses the most.

    That is not a bad idea and there are a number of European countries in which this works well [see Scandinavian ones, for example].

    2. The people who are ill by their own fault.
    As you said yourself it is hard to draw a line. With regards to medical reasons it is not even possible. You have AIDS? What if you got it from your mother?

    Okay. Obesity, smoking and in general unhealthy lifestyle is a problem. However, UHC is not going to swing it one way or the other, and limiting your own access to potential treatment you might happen to need just tomorrow — through no fault of your own — just because meanwhile you may be footing 1/100th of a bill for a fat smoker, does not sound like a survival plan.

    If I was that worried about fat people getting treatment “for nothing”, I would consider what are the actual differences between the US, and, let’s say European countries, which do not (with perhaps the exception of Britain) show massive abuse of the health care system – universal or not, nor they show by far that number of obese people either.

      

  230. 230Rachel on Feb 16, 2010 at 1:39 pm:

    Interesting points, though the proof is always in the pudding. Countries with “socialized” medicine are factually healthier and happier nations. Healthcare in the United States simply does not work for most Americans. The American people make up a large majority of the fattest and unhealthiest people in the world. If the average American would stop looking at healthcare with a “me me me” attitude, and actually learn how to be kind to one another; to learn how to care for their fellow man rather than be incessantly concerned with their own well-beings, then many of your problems would be solved.

      

  231. 231LS on Mar 22, 2010 at 8:33 am:

    Do Americans ever look out into the world and see what is clearly working for the happier, healthier countries on the planet? Assuming this explanation is the true reason so many Americans are opposed to social health care, I think it proves the US is not on the same page as the rest of the civilized world. The utter fear and disgust the Americans demonstrate toward social health care is a reflection of the selfish, ignorant and malicious morals of the country. I feel sorry for Americans. As a country you are forced inside a bubble where the truth about the world and where you stand in it is clouded by greed and the out-dated (and clearly fictitious) “American Dream”. Wake up! Perhaps the definition of a great country is not how wealthy the very few member’s of its society can become and more about how compassionately you can treat your less fortunate. Maybe if everyone shares the burdens of “stupid decisions” that lead to illness, people will look around and seek better ways to try and prevent the stupid decisions from happening. Preventative medicine, compassion, equality, social responsibility….are these terms even understood in the vernacular of the American people?

      

  232. 232Sal on Jul 4, 2010 at 6:42 am:

    Keith wrote:
    Zombie the idea that Americans don’t want to pay for other peoples mess ups is propaganda, it’s not true. Americans paid billions upon billions to the failed banks. As Americans are paying billions to bail out corrupt banks you are telling Americans that they are money-savers who don’t bail people out. I don’t buy what your saying about the American people.
    _______________________________________________________
    Sorry Keith, but 64% of Americans were against the Health Care Reform the way it was presented, argued and then rammed down our throats. The majority of Americans were and are not in favor of bailouts of any kind by a 55% majority. The majority of Americans are freedom lovers! We cherish yet we take our freedoms for granted and yes, even abuse them. When Americans are forced to pay for their OWN choices is when people will wise up, and not until. Centralizing government “with all the answers” is the worst answer possible. Let ‘em fail is the best answer, regardless of the problem.

      

  233. 233شات كتابي on Sep 27, 2010 at 11:21 am:

    Oh, and America is the most immature country and eventually we’ll all grow up and become all for socialized medicine but for now the US is a whiney teenager “I donwanna pay for her, she’s fat…it’s not my fault…mind your own business…but it’s not faaaiiiir, whaa”.

      

  234. 234plainwhitetee on Sep 29, 2010 at 3:45 pm:

    The idea that ‘picking up the tab’ for others’ ‘stupidity’ is unique to socialized healthcare is completely wrong – your medical insurance premiums will reflect the amount of claims being paid out by insurance firms. Presumably these stupid people don’t just appear out of the blue with a socialized healthcare system – they’re claiming for their ‘stupidity’ right now and increasing how much you pay to your insurance company. You’re picking up the tab anyway.

    Just like with your car insurance, you’re paying more because of ‘stupid’ drivers. If they weren’t having all of those accidents and causing claim payouts, the insurance companies would not be trying to hoover up more profit by charging higher premiums to customers as a whole.

    To me, the question is simple – do I want a healthcare system that helps those less fortunate than me, or not? There are faults with both, but that really is the bottom line.

      

  235. 235Ozzie on Nov 4, 2010 at 11:52 pm:

    I live in Australia – a country which has “socialised medicine” and wouldn’t you know it: noone has refused me free healthcare because of anything I might have done to incur the need for that healthcare. Furthermore, I don’t need to take out a loan, declare bankruptcy etc just to recieve adequate healthcare. And don’t worry, there are plenty of fatties here too – and they don’t get stopped in the street by other taxpayers and abused for costing the country too much money in healthcare because of their fatness. The Government, NGO’s and citizens try to give incentives to improve people’s health and burden on the system by actually recognising that juknfood ads can harm children and banning them during prime time kids TV. They impose taxes and restrictions on cigarettes – these are working and you don’t hear people wailing about their freedoms being eroded – how is it freedom when people are being deceived by cigarette corporation marketing that smoking is cool etc, when in fact people are simply just sources of profits for these shitty companies and their even shittier products? I don’t mind being protected at all…if I didn’t have socialised medicine, (or free education) my life would be the pits.

      

  236. 236Ozzie on Nov 5, 2010 at 12:05 am:

    And I agree with LS – when will this ridiculous rhetoric of the “American Dream” be abandoned? It literally makes me feel naseous the way it’s used in the US: ‘if you just try hard enough you can make your dreams come true, and if you fail – YOU’RE NOT TRYING HARD ENOUGH.’ This just further victimises those who are already at the receiving end of injustice. If you had decent healthcare and free education, you wouldn’t have to resort to dreaming to fulfill your potential in life and treat your fellow human as an obstacle to these “dreams” instead of part of your community.

      

  237. 237Robin WIlt on Nov 7, 2010 at 11:42 am:

    This is a bogus argument. Just because people are uninsured does not mean that we do not pay for their healthcare. We pay through increased premiums overall. The system is fragmented, but it is not closed. People access it even if they are uninsured. It just means that they may be accessing it in the most expensive way possible, and driving up everyone’s rates. We would do well to make sure that everyone is getting the preventative care they need, and then our overall costs would go down. Those actuarial tables used to determine our premiums include all of the behaviors and circumstances that you listed. If we improved access to preventative care, we wouldn’t see such poor health among people in this country as a group.

      

  238. 238danr. on Dec 13, 2010 at 4:43 pm:

    toast

      

  239. 239Chris Nunn on Dec 29, 2010 at 8:47 am:

    Wow, I don’t even know where to begin disecting this argument. First of all, whether we like it or not we do end up paying for people’s stupidity. We pay in the form of higher taxes and insurance premiums. Both of which stem from the fact that the uninsured still can seek help in the nation’s Emergency Rooms. The hospital still has to treat them and they then have to make up for the expenses incurred by that person, and merely shift it to the insurance companies of the insured, as well as the county and state governments that help fund their hospitals. Secondly, universal coverage is not necessarily socialized medicine. Socialized medicine is when all hospitals and clinics are run by the government and all hospital employees are all, in turn, government employees. Many nations around the world that offer universal healthcare (the US is one of only teo industrialized nations that don’t by the way) actually do not own or operate local hospitals. The hospitals are run by a board of directors, much like the hospitals in the US. Universal healthcare is insurance for everyone, comparable to Medicare for the old and the VA for veterans in the United States. Those are perfect examples of Universal Healthcare. Are you suggesting that we get rid of those institutions in favor of for pay systems? More and more studies have shown that it is actually more beneficial and actually quite a bit less expensive to provide universal healthcare to a population. Take for example the Canadian system. In 2009, Canada spent only 10% of it’s GDP to provide 100% of it’s population with health insurance, while the US spent 17% of it’s GDP on healthcare, yet 15% of the population is uninsured at any given time. Canadians live longer than us on average and have a lower infant mortality rate. They also have a better chance of surviving many cancers as well as other illnesses than we do. And that’s by the US numbers. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html
    And as far as the tax arguement goes, the average Canadian tax bill is only 10-15% higher than the average American tax bill. Maybe I’m part of the minority but I’d gladly pay 10-15% more in taxes if it meant that 100% of the US population had health insurance. In closing, I’d like to point out that many scholars who’ve been questioned about the issue maintain that just the savings that we’d experience from having less overhead with a universal healthcare system would fund the majority of the inititive if not all of it. So I end, by asking, Universal Healthcare, where do I sign?

      

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  242. 242Landothedead on May 9, 2011 at 4:51 pm:

    Don’t you get the bill for people’s stupidity in you insurance bill. I’m no expert but I think companies factor in things like this when they calculate their rates. I guess you could argue that they increase rates for risky behaviors, but is that not the same as taxing soda, which contains a lot of sugar, leading to obesity?

      

  243. 243The Teradactyl on Jun 3, 2011 at 6:37 pm:

    You’re assuming everyone is born into the genetic and social class lottery. There are countless stories of people digging themselves out of the “ghetto” from sheer will and determination. So in some cases we can overcome, we are equals and have a fighting chance to improve our lot through hard work and perserverance. Yet what of the baby born with fetal alcohol syndrome. He is BORN. He suffers from brain deficiencies that were no fault of his own. He may one day get far enough through school to get a very menial job – but this job never quite gives him the extra income to pay for premium health insurance. His life outcomes were not equal from the beginning. He could have studied till the wee hours since kindergarden and never gotten his lessons. But he serves a function in your daily life, he drives the garbage truck, is the janitor at your local gym or your kids school. He might even have gotten a family of his own. He’s doing the best he can with what he was given, and while he serves your interests every day. He IS a necessary part of what makes your enjoyment of your middle-class life possible. Let’s even kick in that he doesn’t smoke. Him nor his wife are obese (but statistically, those in lower income thresholds tend towards obesity or poor diet because the cheapest available foods are the least nutritious) and she gets cancer, or he takes a tumble off his garbage truck and can’t work. Whatever. He can’t afford the healthcare costs for any of these mishaps, pretty soon what was a hardworking albeit simple guy and his family can’t pay the mortgage/rent because he’s off sick or medical bills are piling up. WHO’S FAULT IS THAT? I don’t mind paying an extra tax, because I know human outcomes are diverse, and they are NOT equal. I’m a responsible 29 year old, university educated married woman. Technically I should turn my back and scoff – not on MY dime you will this man get help. NOT on my watch. Could I really think that way? Try as I might. I can’t. I’ve had one family member who lived in the United States who was forced to return to Canada after a stay in a California hospital following a heart attack overrode his insurance and cost him everything. He’s already a senior citizen and is still working to pay his bills. I live in Australia, where like Canada they also have universal health care. People are not busy nitpicking about who’s abusing the system, but WE ARE greatful that should bad times befall us or our families, or our friends – we will only have to worry about supporting each other, and maybe some lost wages. Not additional healtcare bills. I am, what you, Zombie, might consider a fine upstanding and educated citizen, who should be outraged that I’m paying for other people’s stupidity.
    Your argument goes that I should have the right to only look out for me, look after my own because I’m responsible for my own behaviour – right? I consider the peace of mind, and ease of life without fear of having no health coverage – and my support of universal health policies in government – to be my way of looking out for my own interests. I’m footing my own bill when I do my taxes every year – and do you know what? I live (by my own standards anyhow) an amazing life full of abundance, to pay for this healthcare system doesn’t seem to make my life any worse. So why would I EVER consider changing to a capitalist based system, having to sweat and choose between insurance providers, and pray my case doesn’t get rejected because I fell through a loophole in their policy since my mother had cancer and now I’m considered pre-disposed or pre-existing condition? I’ve watched Sicko, I’ve known good, honest, hardworking educated people just like you, Zombie, to whom these things have happened to. I want to be able to choose my workplace based on my career aspirations, not their health-care plan. I don’t want to think about one more bill every month. I think I’ve gone off and written too much here, but I can think of another 1000 words to support my point. I want the best for every man woman and child, not just because I was lucky enough to be born to a middle-class family, without any medical abnormalities, who had the money to put me through university. Lucky me – not everyone gets that kind of jump-start in life. If paying my taxes helps one person who started out with the short end of the stick have one less worry in life (and your health IS a huge worry) then so be it. The free-riders will take their ride, but in the meantime there are still multitudes who will get the healthcare they deserve as human beings, who through no fault of their own needed medical care. Whew. I’m done now. :)

      

  244. 244Manuel Sata on Jul 18, 2011 at 7:07 am:

    A final de 2009, trabajaban para la sanidad privada unas 340.000 personas, sin que se hubieran registrado pérdidas de trabajo. Los médicos siguen siendo el grupo más representativo, pues 96.000 http://www.sanidadprivada.es ejercen en la sanidad privada. Y las enfermeras, el segundo colectivo en número, ssanion las que manifiestan un mayor descontento con sus condiciones salariales y laborales con respecto a la sanidad pública.

      

  245. 245Michea on Jul 19, 2011 at 10:21 am:

    …..*clap*
    I never really understood why Americans hate Universal healthcare and all, being from Canada. But now that you have explained it ,I could see myself doing the exact same thing. Thank you for this awsome post.

      

  246. 246Pro Libertate on Jul 22, 2011 at 3:02 pm:

    Brilliant article!

    Now to those who criticized it with completely bogus arguments, who claim that universal health care would be “cheaper” or that we pay anyway.

    Let me start by pointing out that I’m Swiss, not American, but that I know the US and Canada extremely well, as I lived and worked in both countries, as well as in Russia, Ukraine and all over Europe. So I have first-hand knowledge of the various health care systems and I’ve seen the left-overs of communism as well as the working (or non-working) of socialist systems in the UK, France, Germany and Italy.

    I can guarantee everyone here that if they had to deal with a system such as in France or the UK, they’d run away screaming. Far from being “the best in the world”, as the WHO claimed about France, it is one of the worst in the developed world. It is only “best” based on the communist principles behind the WHO analysis, which attributes 2/3 of the points for things that are completely unrelated to health care, that only are concerned with fictional “access”.

    In other words, a government gets points when it declares that “everyone has the right to free health care”, whether such access is real and useful or not.

    In France, you get “access”, but only if you are very, very patient and are able to waste your entire day in the waiting room of a doctor. The doctor then gets 20 Euros paid back and anything beyond that, you have to pay out of your own pocket. Given that a lot of people can’t pay more, the doctor often doesn’t even bill the patient. That’s one way of keeping costs low: just don’t pay the doctors.

    A consequence of this is that doctors are unwilling to provide extensive treatment to people who don’t have private health care or they just send them on to a hospital, where government will have to pick up the tab.

    In the UK, public health care is very similar to what I saw in ex-communist countries: abysmal, except for the patients with private insurance, which, as a friend in hospital put it, cost him only a few beers every month (about 60 pounds). And he was happy about his decision to pay for private insurance every day of his remaining 2 years after he was diagnosed with cancer. If he had been treated under the public system, he’d have had a 6 month waiting period just to get a proper diagnosis, by which time he would already have been dead. As it was, he was treated in a much more decent part of the hospital than the public patients, in a private room. He received every possible treatment to extend his life and make it more bearable.

    Now on to Switzerland, which still has the 2nd best health care system on the planet, right after the US. And I’m talking BEST in terms of actual treatment!

    A health care system is not defined by statistics about life expectancy, which are based entirely on genetic factors, life style choices and so on. The US has a gigantic population of legal and illegal immigrants who arrived from poor countries with poor health. It also has a large number of people who – as this article here points out correctly – make very bad choices that ruin their health.

    You want a very long life expectancy? Look at Japan, where people have a very different diet and genetic makeup, with almost no immigrants. Or the Caucasus region, where they have virtually no health care system at all, but one of the highest life expectancy world wide.

    No, the quality of a health care system is defined by its performance when actually used to cure people, e.g. for cancer. The US have the highest post-cancer treatment survival rate on the planet, i.e. if you are operated for cancer, you will live about 10 years longer in the US than in any other country in the world.

    The US also are able to provide treatment for more and more complex illnesses than any other country. Difficult cases sent from Europe all the time.

    Switzerland is the only other country that can measure up, by being world leader in some specialty areas such as leukemia treatment and reconstructive plastic surgery. Keanu Reeves sister was treated here in Lausanne for years. A Russian who had his face chewed away by a bear was given a new face also in Lausanne. Dignitaries from around the world – including France, Germany, the UK and Russia – come to Switzerland or the US for treatment.

    Switzerland and the US are also the biggest pharmaceutical research and development countries.

    Naturally, such high-tech health care is very expensive. Merely based on what you get, the US and Switzerland are not comparable with all the other countries. I myself was very impressed with the quality of treatment in the US, when I attempted to have laser eye surgery, which the head of the clinic ultimately advised against – and refunded the money I had already paid, for a tiny risk 15 years down the road.

    Now on to the really interesting point: Switzerland has mandatory health insurance since 1994. I heavily opposed it back then and warned about what this would imply. Everything I expected occurred and almost exactly in the sequence I predicted.

    - Costs EXPLODED. We now pay about 1100% MORE than before 1994. In 1993, full voluntary coverage cost me 60 CHF (back then about $45) per month, with no additional costs. Now I spend 650 CHF (about $800 now) for 2 adults and a small child, but I have to pay $2000 per person per year before the insurance kicks in.

    - the extent of coverage was reduced; government fixes a catalog of what’s to be covered

    - government interferes much more in the entire health care system

    - in the past, private, voluntary extensive coverage bought by high-income people paid about 60% of the entire medical expenses; most people stopped buying such extra insurance when the mandatory insurance costs started rising

    - the cost of all treatments exploded, because people cannot get out of the system anymore; the clients are now CAPTIVE and hence can be milked as much as the health professionals want; doctors exploit the official code to the hilt

    - the more socialist a canton (= state) is, the higher the cost of the health insurance; the cheapest cantons that are the most conservative ones with the lowest taxes also have health insurance premiums that are up to 50% lower than the high tax cantons. That’s not the least bit surprising, because the more socialist cantons subsidize more health insurance premiums for low-income people. And statistics show that the biggest consumers of health care are those who do not pay for their own premiums.

    - those who pay no premiums are the biggest users of emergency services, which causes an explosion of the costs; 90% of the time, they could just as well have gone to see a doctor during normal business hours, but they don’t bother to make an appointment; most of the people behaving that way are immigrants and asylum seekers, even after years of living in Switzerland; their consumption stay at a fixed average of around $4000 per year (& insurance of around $4’500 per person) year after year

    In other words:

    - mandatory health care does NOT lower any costs
    - it creates a catastrophic incentive for over-consumption
    - it creates incentives for the providers to continuously increase the costs and the offer of services
    - health care insurances raise costs just to maintain their reserves

    Of course a single payer insurance would be even far, far worse. At least the current system still allows for competition among health insurances, which can offer the same basic insurance with price differences of up to 50%. If the system became single-payer, the cost is guaranteed to rise to the highest current costs + an additional 20 – 30%. With further exponential growth.

    Interesting Trivia:

    The systems in France, Germany and the UK are in debt by about 40 – 80 billion Euros, i.e. completely bankrupt!
    In Germany, the health care system employs more people in the administration than nurses and doctors.

      

  247. 247Sweaty Ted on Sep 2, 2011 at 6:15 pm:

    Facts:

    1. Every single nation with universal health care has over 50% income taxes, no freedom of religion, speech, assembly, right to bear arms, universally low wages, death squads and dictators.

    2. The citizens of all the countries with socialized medicine want to abolish their systems and replace it with ours, the only problem is that they are not allowed to protest because in countries like France you get shot to death if you speak out against the government.

    3. Over 200,000,000 foreigners from every single nation came to America last year for health-care that they couldn’t get in the inferior systems of nations like Israel, Germany, Japan, Australia and Switzerland where life expectancy is short and waiting lists are all very long for life-saving procedures.

    4. Over 80% of Canadians surveyed have come to the United States for healthcare that they couldn’t get in their own country.

    5. 98% of new vaccines and medical procedures originate in the United States. Countries with UHC such as Germany, Japan, Australia, Switzerland and Britain have virtually no innovations in medicine and have contributed virtually nothing to research and development.

    6. The only reasons countries like Hungary, Poland, Lithuania, Latvia, Estonia, Czech Republic, Slovakia, Romania, Bulgaria and others were able to afford universal health care is because we provided their defense for them and prevented them from falling under Soviet communism.

    7. Also, the only reason Canada can afford universal health care is because we provide all their defense against the Soviet Union currently!

    8. If you want insurance, all you have to do is get a job. Everyone who works gets great health insurance! The only people without insurance are illegal aliens, lazy parasites and people who spend all their money on rims for their Escalades. No full-time job is without great benefits!

    9. No American has ever gone overseas for medical treatment. Ever!

    10. Glenn Beck, Bill O’Reilly, Ann Coulter, Michele Bachman, Sarah Palin, Rush Limbaugh and Sean Hannity are the most smartest Americans ever!

    Thank you, Fox News for keeping us infromed!
    Keep your government hands off my Medicare!

      

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  249. 249yankeedoodle on Oct 12, 2011 at 9:40 pm:

    to the tard yankee who wrote this article… wtf is wrong with you ? usa is the only developed nation that doesn’t have universal health care. All you yanks have been brainwashed by your pilgrim squatting idiot grandpas. Fools don’t know what you have been missing.
    And what’s up with your retarded 2nd amendment… what, you think you will be taking your guns when you go out for a jog and shoot evil bad guys that want to “harm you and your own?” When you are in a crowd of people and someone is shooting someone, is he shooting the bad guy, or is he the bad guy? When you pull your gun, does everyone know you are trying to help, or are you bad guy accomplice?
    you all live in fear , and it is really quite pathetic…

      

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  264. 264Gandolf the grey on Jan 8, 2012 at 3:33 pm:

    To be honest I am from England and I cant believe the biggest and best county in the world does not have public healthcare. It seems crazy for me that you dont have it and I consider our public healthcare to be one of our greatest assests. the ability no matter if your broke to go out and get medical care and not have to worry about crippling debts is unbelievable. I look at it this way a husband and wife are driving home when they get hit by a truck, the husband is seriously hurt and goes into a coma, and the wife is hurt and cant work. That couple will still have to pay for treatment. I understand the thought that you dont want your taxes being spent on people that are reckless and bring it upon themselves, however there is a kind of understanding there that everyone is entitled. Alsofollowing up on the essay’s point on our harsh government rulings, this is not generally the case, things such as plastic surgery and non medical or needed procedures are not allowed on the health service, but even if you are unhealthy you will be given treatment that is what is meant by healthcare for all. Again going back to that point when it is claimed that not everyone can afford healthcare it seems to me like its back in the olden times when only the rich could be treated and the rest died from curable things.

    However my personal opinion to why the United states public is not in favour of universal healthcare is the conservative nature of your opinons, from an outside persepctive it seems as though the country as a whole is backwards very reluctant about gays, healthcare and still going on about communism but big on invading other countries (dont get me wrong I believe you are probably the most needed country for global freedom there is, you alone can do it, however if you spent a little more on health as you do on arms universal healthcare could be easily achieved) Also the fact that americans pay very very little tax in relation to other countries again this from an outside perseptive is becuase 1 you dont like government involved in pubic things as you are still very concerned with not looking communist in anyway and 2 becuase you want to keep taxes low for yourselves.

    Please dont get me wrong I love your country and rate it as probably the best in the world in many areas however as I said before the whole healthcare issue is a very backwards on in my opinion and that of our country and the majority of wester european countries

      

  265. 265Gandolf the grey on Jan 8, 2012 at 4:01 pm:

    just seen sweaty ted’s post. What the hell are you talking about! Let me reply to each one of your facts however I would love to see where you got them from or as it seems from reading your post you just made them up off the top of your head.
    1 i live in england where the hell are my death squads, and what about this dictator that was democratically vote for every 5 years
    2 I dont want to scrap my healthcare system and replace it with yours not a chance, and looking at U.S news i think UK news is a bit more globally involved and I have not once seen french people being killed for protesting (and believe me they do alot of that)
    3 Those countries you cliam have short life expectancies have about the same rate as yours so that is complete rubbish
    4cant comment on this one as im not sure about it
    5 that 98% your on about is rubbish again as britan is at the forefront of many leading trails in medication, and also would like to know how much of the 98% of medication the average american could afford to use
    6 ok so your brining up your army again this is the problem too much money being spent on your army. well in any case communism was stopped in eastern europe about 20 odd years ago so thats a little time they’ve had now without it, so cant really use that argument. And if you want to get deep into history we can, those countries were actually occupied by the soviets and their communism and so your defence was therefore little to nothing. So that argument was a little foolish
    7 again this makes no sense, Russia is not the world dominating power america once thought it had to defend against it is not contantly looking for world domination, Anyway you own alaska so of course you will put your defences there, its not you defending them its you defending your own. And even so what would russia want with canada, seriously
    8 i cant again comment on this as i dont know your benefit systems (unlike you I dont talk about thing i dont really know about)
    9 this one again is not true i know of many american that come either to england, canada or france to recieve healthcare as it is alot cheaper here (free) here, such as cancer treatment
    10 cant really comment on many of those people apart from palin who is treated over in western europe as a fool, she has constitantly embarassed herslef in interviews and here limited knowledge of her own preposed policies was alarming. Also it doesnt bode well if your grammer isnt correct when you describe the smartest american you know

    I would however like to see where you did get your facts from as they dont seem that real. But i hope you feel a little stupid as some of your comments were a tad unrealistic

      

  266. 266JoeCanadian on Jan 11, 2012 at 12:55 pm:

    If private healthcare emphasized “personal responsibility” then America wouldn’t be the fattest country on earth! It just is not true.

    Countries with public healthcare have healthier populations. It’s not rocket science!

      

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  268. 268Andrew on Jan 30, 2012 at 6:37 am:

    This site and the comments on it is absolutely appalling
    I am a doctor and have worked in the states (where I have to say the standard of medicine was very average) the uk Australia and new Zealand. The comments are all about me me me …no sense of solidarity or compassion for those less fortunate even if their ailments are selFinflicted and believe me after doing 25years of mediCine I’ve seen it all.
    In Australia we have a very good public sector (just as good in terms of quality off care and outcomes than I the states if not better, we have longer life expectancies lower infant mortality and in the area I work which is critical care and lung tRansplantation far better outcomes and survival rates than anywheRe in the states -standards oF critical care and transplantation even in the best us centre are poorer than they are here-it’s well documented.
    There is also a pRivate sector that does very well. I have never heard of people going bankrupt because of health bills and it’s not because our standard of care is less -quite the contrary-oh Yeah I get paid better than us docs do

    Your me me me attitude Sickens me – you never now-you may end up with diabetes or hypercholesteraemia and have an mi. It’s attitudes like these that make the us such an awful place – its all about me I think that sums up ameRica in a nutshell

    Are

      

  269. 269Andrew on Jan 30, 2012 at 6:42 am:

    Oh and this business of socialized medicine leading to increased ‘bad lifestyles etc’ doesn’t hold much water. We have socialized medicine and you dont but your obesity rates smoking rates alcohol related illness and use of illicit drugs is still much higher here – so go figure.

      

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  272. 272Shannon on Feb 15, 2012 at 3:34 pm:

    I know this response is way down the line from the original post, but I just wanted to make the point that you already pay for the people who have made questionable or irresponsible life decisions. Those are the people for whom the government and charity funded organizations already exist. The government currently assists with mental health treatment, drug recovery, indigent care and assistance for the unemployed. This is already being paid for by your taxes. The people currently receiving no care are the working poor who have good habits and whose income is too high for free or reduced cost care, but too low to afford health insurance. People who also pay taxes, and have made good life choices, but get caught in bad situations. The millions of people who were laid off in 2008, for example, who accepted much lower paying jobs instead of taking unemployment pay.

      

  273. 273Mike on Feb 24, 2012 at 8:23 pm:

    I don’t quite understand why a person would be bothered about somebody else’s lifestyle choices, isn’t this the case with private cover as well? And no matter how much you hate other people and the way they carry on with their lives, you can’t legislate human behavior.

    Again,

    YOU CAN’T LEGISLATE HUMAN BEHAVIOR.

    BTW Dr. Sudenhaus SHOULD have his license revoked. He’s an OPTOMETRIST, not a primary care physician. It’s not an optometrist’s job to give dietary advise to fat people, no matter how much he thinks he’s helping (which I doubt).

      

  274. 274English on Feb 28, 2012 at 8:41 pm:

    You Americans are such a joke to the rest of the world!
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    Here in the U.K. we pay nothing for our health service and practically nothing for our prescription drugs. It’s all taken as a minuscule amount from our taxes; nothing that effects our lives in the slightest. Doctors are payed better for working harder and making more people better, and it’s within their best interest to have you as healthy as possible. Having a doctor who’s best interest is with making money is just wrong… so completely wrong and your such a blind country to your own propaganda that you don’t even see it! They paint things up so well as being the right choice for you that you follow blindly believing that your getting the best, but please… from a country that follows America through so many of their poor, corrupt, money making ideas.. learn to recognize what is best for yourselves and not what is best for the people making profits from you!! Even England wouldn’t follow you to through with that idea.

      

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  283. 283jba462 on May 28, 2012 at 2:04 pm:

    “Since it’s nearly impossible to sort out who is personally responsible for which ailments, the only logical solution is to let each person pay for their own care”

    Really? Because you have just basically described the system we currently have and I must say it is awful.

    If you get sick, injured, etc. and you try to bill your insurance company for a doctor’s visit/surgery, unless you are one of the fortunate few with premium coverage, they will go to great lengths to prevent you from receiving the benefits to which you are entitled, citing reasons and ways that you have technically “infringed” on your agreement (oh, well THAT kind of thing is actually not covered by your plan). Furthermore, every doctor’s bill is carefully examined and “adjusted” to ensure that the insurance company pays as little as possible when they ARE required to contribute.

    Fast forward into the future you described: we now have a single payer system, but legislators decide which kinds of ailments are “your own fault.” The problem is precisely the same: that ANYTHING can be construed as being the victim’s fault when others are unwilling to assume financial responsibility. “Of course you got sick; you don’t put your trash can under the sink like I do. You just leave that germ factory out in the open like an animal! Never mind the fact that you live in a badly insulated inner city apartment in close proximity to to other people who are too poor to pay out-of-pocket for antibiotics; I’m not helping you out because I’ve convinced myself that this is YOUR FAULT!”

    The unspoken problem in both of these scenarios is that aside from both systems being laughably ineffective, all of that wishy-washy decision making is EXTREMELY EXPENSIVE and creates an unnecessary degree of bureaucracy.

    “being overweight is the #1 medical problem in this country”

    But

    “making people become personally responsible for their physical conditions is the quickest route to solving the issue?”

    What are you talking about? Independent American adults ARE personally (financially) responsible for their physical conditions TODAY and obesity rates are still increasing. You solution to the problem was in the process of failing while you wrote this page.

    By the way, craving sugary, salty, fatty food is not immature; it’s a survival mechanism that kept our species alive for eons, and has only recently become problematic. Statistically, I’m not overweight. Granted, I’d like to be leaner and more muscular but I also like red meat, ice-cream and sweet tea on occasion, so my two desires have arrived at a compromising point. However, I don’t want to be punished for eating food that tastes good and I DO want overweight people to realize that trying to lose weight is important, though you don’t have to be a neo-puritanical vegan health nut to do so. The reason that critical nutritional information is limited is that when people see a morbidly obese person on TV who should seek good nutritional advice from a doctor they say, “Hey Fatty, go pay a professional lots of you own money so they can rewire your digestive tract before you eat yourself to death.” Americans don’t have a problem with universal healthcare so much as we have an unhealthy obsession with blame. I think we could benefit from SOLVING problems in our country together, not because they are my fault, but because they affect my cost of living indirectly.

    I don’t believe that STARTING an egalitarian, universal healthcare system based on a progressive income tax would be “cheap” for anyone involved, but there is a very big and fundamental difference between private and public healthcare that no one seems to care about. Public healthcare systems that WORK focus on treating ALL citizens and ALL conditions and PREVENTING disease; they do not have to be driven by profit. Private healthcare companies are NOT focused on treating disease or making themselves beneficial to the well-being of a society. They want to generate profit by creating profitable “risk pools.” This means they do business with only the the healthiest members of society who are still willing to pay for insurance and charge premiums that, in almost all individual cases, far exceed the medical cost of their clients. Ergo, PRIVATE INSURANCE COSTS MUCH MORE THAN THE ACTUAL HEALTHCARE!!!!

    If the goal of a nation’s healthcare system is to treat ALL of its citizens, it will have an incentive to implement cost-effective preventative care and encourage people to live healthier, less medically expensive lives. Thus, the overall risk pool will become lower and HEALTHCARE WILL BECOME CHEAPER OVER TIME. It’s simply a function of math and human behavior. On the contrary, if the system’s goal is to maximize profit without being shut down, well, why doesn’t everyone take a look at our current situation? Are you truly happy with the way things are? Is this the most “logical” solution we can come up with?

    If so, then please stop complaining when insurance agents try to squeeze every nickel and dime out of you, contest your eligibility for benefits, and make the reception of benefits a cumbersome and time-consuming ordeal. That’s what they get paid to do ;)

      

  284. 284craig thain on Jun 11, 2012 at 6:38 am:

    ive nwver read so much utter rubbish. how can looking after poeples health turn them into nazis, more like not careing for certain parts of society is a nazi trait not a socialist one.

      

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  286. 286Matt on Jun 28, 2012 at 8:47 am:

    I dont agree with you.

    If everyone was brought up in the same environment, with the same family values, with a similar level of education, opportunities and financial support, then you might have a point. BUT WE ARENT. There are literally millions of people who are vulnerable to premature death that could be saved by having a socialized healthcare reform but you want to concentrate on the frankly small minority who might benefit from it who fall into your group. You are 5 times more likely to die driving your car then you are taking public transport…so am I going to argue that people who take their car to work should’nt be treated in the same way because I take the bus? You give examples of alcohol, have you actually read how many much money is spent on care to treat alcolism? Its a tiny amount.

    Malnutrition is one of the biggest costs to the NHS is England, this is from the elderley and children who generally at risk through social depravity. These are groups who are being looked after because they are vulnerable. But your argument ignores these people. One day you might be elderley, who lived a perfect life without touching alcohol, cigarettes and lived with one women but who finds himself struggling financially. I wonder if your argument would mean so much then?

    But its okay for me, I live in England where we have a national health service and we look after each other like a community

    ….but as you put it ‘You do what you want, it doesnt effect me so i dont care what happens to you’

      

  287. 287TheBoxingannabyte on Jun 28, 2012 at 12:56 pm:

    “A built-in false assumption with the health-care debate is that sickness is always no-fault sickness. It’s never socially acceptable to assign blame for people’s medical problems — especially blame on the patient.”

    Way to pigeonhole the arguments as much as possible! Zombie? Lol, kinda ironic, considering what I’ve just read.

    One thing I hear all the time as a former libertarian (when I was an active libertarian) is these giant tirades about personal responsibility. As if people are so mentally strong that we are in complete control of everything we do. This prideful, borderline “flip a switch” mentality shows litte-to-no understanding of neurological science and pschology.

    This idea that addicts should just be fucked, just be completely screwed over because they went through whatever they went through and deserve a horrific and slow end (unless they have the holiest of holies, money) is insane. The idea that Universal Health Care is unsustainable is simply unproven and a biased view, it does work, it has worked, and it could work here. The idea that we’d go bankrupt taking care of so many sick people should make us take a closer look at the extremely high profit margins that drug companies make. Mandates to make sure that the poor don’t have to go from one day being 26 and under their parents insurance, to the next having to pay literally 5-10x as much for a medication that they quite literally need to live.

    When we have medicine, a good supply of it, I may add. Enough to take care of everyone for most ailments-And we deny them that medicine, we are denying them the right to live. Now that part is one of the few parts that is that simple to work through morally. So either you think it’s more important to have these libertarian ideals on “Freedom” and “personal responsibility” (never mind the fact that no two people have the exact definition of what those words mean), or you like the freedom and ability to move through life, the ensurance that you aren’t one medical catastrophe away from complete financial ruin-Orrr we can continue down the no-plans that the republican party and the right-leaning libertarians have.

    I’ll put it this way, I’ve never met anyone like me, an injured athlete (boxer, martial artist, decent amateur on both, as well as writing. Fairly educated but never given a good chance to take advantage of anything due to a sharp health decline, a few sob-stories and tragedies, yadda yadda :P), who just lost his insurance, has been denied disability 3 times, is trying to decide between taking (exclusively) shitty, low-paying jobs that I’m frankly not cut out for, or to try to re-apply for disability, can’t do both at once. If I get a job even for 2 days I have to wait to a year to re-apply.

    To get in I need lots of evidence, which I have quite a bit. But they always need more, when you can’t afford the doctors appointments to get the treatment you need to get better you need to go there to get evidence, of which you need money for to get the treatment you need, without either you don’t get the money to live off of and get better. So instead I get put on a maintence programl.

    17 years old was when I first started getting prescribed oxycontin here in Utah, I’d had over 60 amateur bouts and only 12 losses, in my officiated stuff I was 20-0 (17 TKO)-3 (draws, 1 no contest to my shame). I was doing good, and I Was popping lots of pills, the doc gave me as much as I wanted. Shitloads of the stuff, I was taking up to 5 80s a day, which is like 300 bucks worth of pills a day (street prices). Anyway, I continued to win until one morning I couldn’t get up out of bed.

    from then I got put on the more effective, far more addictive, and more-prone-to-over dosage of methadone and now 5 years later I’m still on it for maintenence because I cnanot afford physical therapy.

    Basically when I talk to people who are libertarian or republican and ask them what I should do it turns into this bumbling, convulted mess of how we need to completely change the paradigm or how it’s all Obama and the liberals fault and how women need to stop being whores and stop getting abortions.

    As far as the libertarian-left/right overlap we all have a bit at stake here. The libertarian party-if it weren’t so batshit selfsish along with most clued-in republicans (The big divider I think is most libertarians have some sense of political awarenes and, as someone who lives in Utah, every single 20-something republican friend I have, literally not ONE could tell me who Nancy Pelosi is, or who Mitch Mcconnel is or who John Boener is. That’s their level of knowledge. Most liberals I tend to hang with are barely affiliates with any aprty, liberal/libertarian/anarchist, socialist/liberal/libertarian (which is what I’m closest to, I like policies and ideologies from all three while rejecting most of libertarianism and parts of socialism which I think is a very clean, rational word and ideaology, when it’s mixed together. I’m an anti-capitalist in many senses of the word though I do believe in a regulated market.)

    In the end I fear corporations far more than the government. tHe government is and can be-Us, and by us, for us-Corporations have an agenda. That’s why everything has gotten worse since lobbying has become a religion and Reagan jump-started the prison industrial complex to go along with the Grand Emporer Dick Nixon’s great (failed) Drug War. Like peas’n’a’pod they are! :P

      

  288. 288WrathChylde on Jun 29, 2012 at 5:30 pm:

    I think you’re awesome. Well said! However, you neglected to address another aspect, and really the more important one. Pharmaceutical companies in America are among the richest people on the planet from over pricing drugs that ought to be available “at cost” to patients. Medicines that cost me over 400 dollars US per refill cost pennies in other places. I can order my meds from over seas, and get them at less than 5% of the cost in America.

    If you want to be the uber realist and fascist nanny, then go after everyone not just the idiots.

      

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  291. 291ProudBrit on Jul 30, 2012 at 8:06 am:

    “..Do we want that kind of society? I don’t. If you look at other countries with socialized medicine, Great Britain being the most glaring example, these invasive and oppressive government dictates have already started to circumscribe people’s freedom, with every kind of potentially dangerous activity or unhealthy comestible being declared forbidden — for the good of society as a whole…”

    What absolute utter rubbish. You should be scorned for such blatant disregard for reality. Here in the UK we are proud of the established National Health Service which is a shining example of care. If we are ill or have a sudden accident we don’t have to worry about whether or not we can afford care, or whether we will be accepted in the closest hospital as we have standardised and welcoming staff across the board.

    Of course our government publicises healthy living and lifestyle but that is not unique to here, we are not alone in implementing a smoking ban for instance. There is nothing wrong with being reminded that some things in life are bad for you, however we are free to make our choices and still have the benefit of social healthcare.

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