Author: belledame has written 7 posts for this blog.

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75 Responses

  1. 1
    little cabbage 7.9.2007 at 6:12 am |

    Oh my God, this may not actually be the greatest place in the world to live after all.

    This. EXACTLY this.

    I grew up in America and left in my mid-teens when my dad changed jobs. I remember well the shock of realizing that we actually learned about other countries in school apart from their ancient history, that I suddenly saw my dad a lot more, and that even my poorest classmates got to see a doctor if they needed one rather than having to go without or save up.

    For a while I was actually pretty surprised at myself for having been so duped. Now I’m just sad.

  2. 2
    Mireille 7.9.2007 at 6:52 am |

    Maybe you’re thinking of cognitive dissonance?

  3. 3
    Azundris 7.9.2007 at 6:58 am |

    It sounds a bit like you may be referring to this experiment re cognitive dissonance?

  4. 4
    dingbat 7.9.2007 at 8:11 am |

    I think this has become my life’s work with the fam back home, to remind them that the way things are isn’t the way they have to be, for any number of reasons–one of which being that they consistently vote Republican even when they disagree with everything they’ve done in office. I’m at my wit’s end.

  5. 5
    Summer 7.9.2007 at 8:16 am |

    “For us or against us” really did win the day, didn’t it? We’ve entered an age of the stupid, that’s for sure. I always thought that it was the preoccupation of small, struggling, new nations – the whole debate about who we are and are we being nice enough to ourselves? Are we shaming ourselves in the eyes of others? Do we laud our heroes enough, do we love cricket and the Holy Prophet (Pakistani for: mom and apple pie), do we follow in the footsteps of our founding father(s)? But I guess not. Was the US always this obsessed about “hate America” or is this a new thing now, in these last ten years? If the history of nations is any guide, it shows a sort of desperation on the part of the collective (whatever the hell that means – sorry about the generalization). Once you’re worried about whether or not you are a force for good in the world, you have to realize that someone or something has just shaken your foundations. I don’t understand why anyone cares about whether America is good or bad. It’s a country. Its government does things and its people do things, and some are good and some are not so good. Not everything needs a ticker-tape parade or a public display of self-flagellation. But I guess you said that already. But if people are that worried about it – something is rotten in Denmark. (Wait, Denmark?)

    Thanks for the mention and commentary. Much appreciated.

  6. 6
    Henry 7.9.2007 at 10:05 am |

    You know, worries about American decline and loss of standing aren’t exactly new, that’s been going on since at least the seventies.

    As far as universal healthcare goes, it sounds like a lovely idea in theory, but you’ll never get the American people to stand for the massive tax increases it would take to fund a system.

  7. 7
    Bitter Scribe 7.9.2007 at 10:48 am |

    When I was a kid in school, back when the Earth was cooling, we were taught that America was the greatest country in history, and the reason we had so many immigrants was that who would ever want to live anywhere else if they could come here?

    Now, of course, I know that most immigrants come here to escape political and/or economic repression in their homelands. (Which is why no major U.S. city has a Little France.) I still am very fond of my country, but that doesn’t entail blindness to its flaws.

    As for the taxation issue that Henry raises, I recall a discussion with a French entrepreneur on this subject. He brought up the higher taxes the French pay, and he seemed very surprised when I told him that when you take the amount I pay for health care and my 401(k) and add that to my taxes, it would probably equal if not exceed French taxes.

  8. 8
    zuzu 7.9.2007 at 11:14 am |

    As far as universal healthcare goes, it sounds like a lovely idea in theory, but you’ll never get the American people to stand for the massive tax increases it would take to fund a system.

    The tax burden only seems massive if you don’t consider how much money is already spent on health care, and the very poor ROI.

    As for the American exceptionalism: yeah. People do get very angry about acknowledging that maybe America may not be the very best at everything, and that there may be more attractive places to live. Try announcing sometime that you’re considering moving elsewhere. Very angry people come out of the woodwork to lecture you about abandoning the country, or you’re a coward for leaving, or how dare you leave when others can’t, what have you. And yet these same people don’t apply the same logic to their friends from other countries who came here. Because *of course* they want to live in the US! It’s somewhere people immigrate *to,* not somewhere they emigrate *from*!

    It’s like Hotel California, for Pete’s sake.

  9. 9
    Dianne 7.9.2007 at 11:22 am |

    It’s somewhere people immigrate *to,* not somewhere they emigrate *from*!

    Speaking of which, does anyone know of any reliable statistics on the rate of emigration from the US? It’s one of the few stats that most countries keep but the US doesn’t and I’ve never been able to find the data. I calculated it once, roughly, using population, birth, death and immigration figures from the census and got an emigration rate of about 1/3 of the immigration rate (in the 1990s), but I’m not sure how accurate the numbers really were or how the long term trend looks.

  10. 10
    SarahMC 7.9.2007 at 11:37 am |

    you’ll never get the American people to stand for the massive tax increases it would take to fund a system.

    Well, we have to educate the American public. The extra money we’d pay in taxes would no longer be spent on insurance and co-pays!

    Why is that so difficult for the American public to grasp?

  11. 11
    SarahMC 7.9.2007 at 11:38 am |

    Oops forgot to close the italics tag.

  12. 12
    Sarah in Chicago 7.9.2007 at 11:42 am |

    Try announcing sometime that you’re considering moving elsewhere. Very angry people come out of the woodwork to lecture you about abandoning the country, or you’re a coward for leaving, or how dare you leave when others can’t, what have you.

    Try being here on a temp visa (student in my case) and saying you’re not intending to stay here when you’ve finished whatever the visa is for. People seem at least surprised that you are intending to leave, and very quickly ask why … and then when I point out things like health-care, protection from harrassment, ability to marry, retirement, etc you do get some really negative reactions. I’ve honestly been told to leave now since I apparently want to so badly, or that since I am here on a visa, I don’t get to have an opinion about how things are done here in the US.

    Even amongst liberals there is the basic assumption that I am intending to leave. And then when I say no, they assume I am then going home … which I guess is a reasonable assumption, but then when I say no, I am not doing that, consternation goes across their face as though chosing any other country other than the US over your home is just strange.

    Though, I will say, with liberals now this is changing I have noticed since I arrived in 2001, where they say they would like me to stay and help fight for their country, but understand why I would want to leave.

  13. 13
    Sarah in Chicago 7.9.2007 at 11:44 am |

    Oops, the above should read:

    Even amongst liberals there is the basic assumption that I am intending to STAY.

  14. 14
    Henry 7.9.2007 at 11:59 am |

    Well, we have to educate the American public. The extra money we’d pay in taxes would no longer be spent on insurance and co-pays!

    Why is that so difficult for the American public to grasp?

    The difference is that when you spend money on insurance and co-pays and the like, you know exactly where the money is going. You’re spending your own money on something that is necessary to you. When you spend that extra money on taxes, you have no idea where that money is going. The pill goes down easier when it’s for your own tangible benefit.

    I think on this issue there’s just a fundamental difference of opinion regarding the purpose and responsibility of government that will be difficult to overcome.

  15. 15
    Lindsay 7.9.2007 at 12:01 pm |

    It took my German boyfriend to make me realize that yeah, America is not so much number one. I am now sick of this whole patriotism shit going on and if you’re not all AMERICA #1 then you can geeet ooout! I say right now, if I can move to France and have health care plus more time to see my children and time to spend my life with them on vacation, send me a passport and a plane ticket, please! I mean seriously, I feel like all throughout my public schooling I only heard about the brave and noble men of America were always the good guys that saved the poor other countries that just weren’t America so we had to jump in and make everyone like us! And how all the other countries in the world envy us and want to take us down because of their jealousy of us. It’s sickening.

    It really makes me mad that so many Americans don’t want everyone in our country to have health care! So what if your taxes go up, it’s still saving you money every month! Not to mention it’s the ones that already have health care and can afford it that don’t want others to have it. I think a lot of it has to do with people thinking only the privileged should be taken care of and everyone else that can’t is beneath them. You can’t tell me that a country that spends millions on abstinence “education” can’t stop with that money and put it towards giving people, at least children who have no choice or voice in the matter, some decent fucking care!

  16. 16
    zuzu 7.9.2007 at 12:05 pm |

    The difference is that when you spend money on insurance and co-pays and the like, you know exactly where the money is going.

    Really? Because when I had insurance (I’m currently going without), I often wondered just what my $500 a month was paying for. I never did figure out the algorithm on my prescription coverage, since sometimes I paid vastly differing amounts for the exact same medication.

    And it’s easy to wonder where your money’s going when they start denying your claims or questioning them. Like when I got bitten by a dog and the insurance company kept trying to deny the claim on the ground that someone else must have been responsible for the injury. Yeah. A dog. Who can’t be sued.

    Also, Henry, IIRC, you’re in the military. Which is a whole different world in terms of health care. A world sort of like the one we’d like for everyone else in the country.

  17. 17
    SarahMC 7.9.2007 at 12:05 pm |

    When you spend that extra money on taxes, you have no idea where that money is going. The pill goes down easier when it’s for your own tangible benefit.

    The same can be said for every other public good that’s funded through tax dollars. When I spend money on taxes for the fire department, I have no idea where that money is going. The pill would go down easier if I were responsible for putting out my own fires with no help from professionals. At least then I know I’m the only one benefitting from my money.

  18. 20
    zuzu 7.9.2007 at 12:10 pm |

    and yeah, Land of Opportunity: a helluva lot of Irish folk (for instance) are going -back-. I’m just surprised we’re not all trying to follow.

    I’m one generation too far removed to get an Irish passport, which sucks.

  19. 23
    SarahMC 7.9.2007 at 12:14 pm |

    Not to mention, belldame, that we DO know where tax money goes. Sure, some people are too lazy to research it, but it’s not a mystery.

  20. 25
    orlando 7.9.2007 at 12:28 pm |

    I’ve heard the tag “America is the greatest country in the world” (incidentally, do Canadians and Central and South Americans feel this includes them, or do they get cross at the implication that they don’t exist? Because it usually seems to be phrased “America” not “the U.S.A.”), and sure it made me feel queasy, but more significantly I have wondered: What on earth does that actually MEAN?

    I mean, what are they measuring? No one, surely, thinks that the U.S. has the best education system? Literacy rates? Health care? Judicial system (only five countries left in the world that execute people for crimes commited as a minor, more people incarcerated per capita than just about any other country)? Artists? Writers (sure it has some of the best writers, but no more than, say India or Ireland)? Social harmony? Gross National Happiness?

    I suppose it has the most military power (or is that China?), but the only thing I can think of that seems certain is that it’s the world leader in branding and marketing. Definitely, no one can touch the U.S. for that. Not an area I would consider the best measure of “greatest”, but maybe when people use the expression they are referring to aspects I haven’t thought of?

  21. 28
    Henry 7.9.2007 at 12:37 pm |

    Also, Henry, IIRC, you’re in the military. Which is a whole different world in terms of health care. A world sort of like the one we’d like for everyone else in the country.

    We’ve had this discussion before. Please remember, in exchange for that sweet, sweet free health care I’ve become government property who must follow orders on pain of imprisonment or death. So I don’t know if that’s a good example for everyone else. Fitting though, as the more you force government to do for you the more they get to tell you what to do. Nothing in life is free, ever.

    The same can be said for every other public good that’s funded through tax dollars. When I spend money on taxes for the fire department, I have no idea where that money is going. The pill would go down easier if I were responsible for putting out my own fires with no help from professionals. At least then I know I’m the only one benefitting from my money.

    First off, fire departments are funded at the local level in most cases. Secondly, we again run into the perception of the proper role of government. Public safety is generally considered a proper responsibility of government, providing for individual welfare as opposed to common welfare is not by a great deal of people in this country (myself included). It’s not that I’m opposed to individual well being of course, just that I think government is a poor tool for the job in most cases. This isn’t a compassion vs. heartlessness issue. It’s a philosophical question about the nature of our system.

  22. 29
    SarahMC 7.9.2007 at 12:43 pm |

    Well you made no mention of the different levels of government, Henry.
    How is healthcare not a public safety issue?
    Maybe people should just be more careful when smoking in bed. Maybe people should take personal responsibility for their housing’s wiring. Why should I have to pay for YOU to put your housefire out?

  23. 30
    orlando 7.9.2007 at 12:43 pm |

    “the more you force government to do for you the more they get to tell you what to do.”

    Oh Henry, this is such a myth. Tell it to someone in the Netherlands and they’d laugh in your face.

  24. 32
    Henry 7.9.2007 at 1:03 pm |

    How is healthcare not a public safety issue?

    If you get cancer, or need surgery, and can’t get them, you die. The rest of your block doesn’t die, just you. The government has an agency to death with public health outbreaks. If your house catches on fire, and no one puts it out, half the city could burn down, resulting in widespread panic, death and rioting. It’s a difference of scale.

    Oh Henry, this is such a myth

    Really? Well then I stand corrected. Obviously if things are working out for the Netherlands then history must not record any examples of encroaching authoritarianism introduced by measures for the public good. How free is Britain these days?

  25. 33
    Bitter Scribe 7.9.2007 at 1:35 pm |

    The bottom line is, when you put private, for-profit businesses in charge of rationing health care, you’re putting your heath care in the hands of people who are motivated to let you have as few services as possible. I don’t care how inefficient, corrupt, etc. you think governments are, at least they won’t get rewarded for turning you down.

  26. 36
    zuzu 7.9.2007 at 2:50 pm |

    We’ve had this discussion before. Please remember, in exchange for that sweet, sweet free health care I’ve become government property who must follow orders on pain of imprisonment or death. So I don’t know if that’s a good example for everyone else. Fitting though, as the more you force government to do for you the more they get to tell you what to do. Nothing in life is free, ever.

    The government doesn’t own your dependents, yet provides health care for them.

    And you don’t have to worry about being bankrupted just to get care for one of your chronically ill kids. Which is kind of the point of universal health care — spreading the risk. Some people will use a lot of services, some will use few.

    But if people don’t have to declare bankruptcy because of health care costs (and more than HALF of all bankruptcies are filed due to a medical crisis, and a huge percentage of those people have health insurance), or burn through all their assets just to be able to get medical care from the government, then we’re going to have a more stable and secure economy.

    If people can get health care when they need it rather than having to wait until things get so bad they can no longer be ignored, it’s going to have a positive effect on public health and probably the economy, especially where preventable diseases are prevented.

    And not only that, businesses can be a hell of a lot more competitive in the US (and the US will be a more attractive place for businesses) when they don’t have to shoulder employee health care costs. Or don’t you remember hearing about some auto plants that were put in Canada rather than the US due to spiraling health care costs?

  27. 39
    SarahMC 7.9.2007 at 2:57 pm |

    encroaching authoritarianism introduced by measures for the public good

    Yeah. I mean, I know I get calls from FHWA all the time, reminding me to drive only between certain hours, for X number of hours and only to and from locations Y and Z. That’s what we get for asking government to build and Interstate Highway system.

  28. 40
    SarahMC 7.9.2007 at 2:58 pm |

    Yeah. I mean, I know I get calls from FHWA all the time, reminding me to drive only between certain hours, for X number of hours and only to and from locations Y and Z. That’s what we get for asking government to build an Interstate Highway system.

    Oops. Fixed.

  29. 42
    SarahMC 7.9.2007 at 3:00 pm |

    My “oops fixed” comment will make sense once the original comes out of moderation.

  30. 44
    Mnemosyne 7.9.2007 at 3:01 pm |

    The difference is that when you spend money on insurance and co-pays and the like, you know exactly where the money is going.

    We do?

    Of course, we do — it’s going into the pockets of the CEOs of the companies. Apparently, Henry thinks keeping healthcare CEOs’ income as high as possible is more important than actually providing healthcare for the customers who pay for it, or he wouldn’t defend those salaries so strongly.

    Oh, sorry, Henry, were you under the illusion that the money people pay for health insurance goes anywhere other than the CEO’s pocket? If so, you clearly haven’t had to deal with a private health insurance company lately.

  31. 46
    Kristen 7.9.2007 at 3:09 pm |

    The difference is that when you spend money on insurance and co-pays and the like, you know exactly where the money is going. You’re spending your own money on something that is necessary to you. When you spend that extra money on taxes, you have no idea where that money is going. The pill goes down easier when it’s for your own tangible benefit.

    Actually, I’ll know exactly where it’s going. It’s going for my own health and well-being. It’s going for the health and well-being of my co-workers (who hopefully won’t make me sick every winter because they can’t afford to go to the doctor). It’s going for the homeless client I had yesterday who can’t keep a job because he can’t afford his psychiatric medication. It’s going for one of my best friends and her family who had to cancel their insurance because their monthly premiums sored to $1500 a month when one member of their plan died of cancer.

    In short. It’s going to help people. Period. And if that takes 50% of my paycheck, so be it.

  32. 48
    SarahMC 7.9.2007 at 3:18 pm |

    I’m 25 years old. I have a steady, decent-paying job. I got a very good education and I’m in the process of preparing to go back to school for a Master’s. I have two supportive parents.
    But my god, I can’t even imagine how I’d survive if I didn’t have health insurance. I take three medications on a daily basis. One for depression and two for chronic pain. I take 3 capsules of one of the chronic pain meds 3 times a day. My bedroom looks like a pharmacy. If I had to pay out-of-pocket, I seriously don’t know what I’d do. I don’t even like to think about it. If I had to go without my medicine, I’d be in constant, agonizing nerve pain. It sucks. And I’ll have to take a number of different medications for the rest of my life (probably), just to feel kind of normal. And I have it a lot better than some people.

  33. 49
    SarahMC 7.9.2007 at 3:29 pm |

    I don’t really know what I intended the point of that story to be, but I guess the point is that it’s simply WRONG to say “Well, if you’re too lazy to get a good job, you don’t deserve healthcare.” Or, “Just don’t get sick!” Or, “Shouldn’t it be your family’s responsibility to care for you when you’re sick?”

    Plenty of people HAVE jobs they work hard at, and still can’t make it. It pisses me off that people must be dependent on their employer for healthcare in the first place.

    Second, and this SHOULD be obvious, but sickness can happen to anyone. Anyone. I didn’t choose to get an inoperable spinal cord tumor. I’ve had it since I was a baby. What do you say to CHILDREN who suffer because their parents can’t afford their healthcare bills? Should they just pull themselves up by their little bitty bootstraps?

    And not everyone has a supportive network of family and friends. I always think about people who “age out” of the foster care system when they turn 18. Not only are they at a very high risk for homelessness; they have NOBODY to show them how to navigate through the world. I can’t even imagine.

  34. 50
    Henry 7.9.2007 at 3:44 pm |

    Yeah. I mean, I know I get calls from FHWA all the time, reminding me to drive only between certain hours, for X number of hours and only to and from locations Y and Z. That’s what we get for asking government to build an Interstate Highway system.

    Interesting. I wonder how many times state legislation has been altered by threats from the federal government to withhold funds for maintenance of said highways (and other systems the government gives money for). I guarantee that number is not zero. Not to say I’m not a fan of Interstate highways.

    In short. It’s going to help people. Period. And if that takes 50% of my paycheck, so be it.

    I’m glad you’re so optimistic on the efficiency and good will of government agencies. I am not. Sorry. If you have a burning desire to hand over 50% of your paycheck to do good works, there are many, many agencies that will gladly accommodate you.

    At no point did I wish to give the impression that I think health insurance companies are just super. I know they’re run by greedy scumbags, I get it. But what you’re proposing is nationalization of a massive private industry, as if government can just swoop in like salvation from on high and make everyone’s life awesome, and I’m not buying it. Politicians and civil servants are every bit as venal and corrupt as CEO’s, because they’re human.

  35. 53
    MJ 7.9.2007 at 4:03 pm |

    This is not to say that ‘I hate America, or Americans’, or any such nonsense. Americans are as good as the people anywhere else. I’m sure the USA is a good country to live in. But the health care system, ah, needs some work. Politely said, in my humble opinion, a major overhaul would not be out of line.

    As a Canadian, I have to say, I like my universal health care.
    Though coverage does differ from province to province (theres that local control of funding you want, Henry), I’m pretty satisfied. Yes, there is room for improvement. There is for any system. It isn’t a broken system, by any means. I had a 6 week wait for minor, non critical surgery once. I was in no pain, and the wait did not affect any day to day activities. It did not put my life in danger. I know, because I got biopsy results within a week. That wait became a 3 week wait when someone canceled. I suppose if I’d been in a private system I might have been seen sooner. Or I might have not gotten surgery at all. Or, my surgeon could have seen me sooner and not someone that needed surgery urgently. I know where my money goes. It pays the doctors and nurses and technicians. It pays for the hospitals and equipment. It doesn’t line the pocket of a CEO or a shareholder. The money that goes in, goes to take care of people. I’m not a communist. I just think my fellow citizens should not have to die or not get treatment so that someone’s stock can rise. Pay the doctors and nurses well, because they do an important job. There are things that should not be used to make an enormous profit, and someone’s illness is one of them.

    For what its worth, I would not visit the US without travel insurance. After seeing Sicko, I don’t think I would chose to live in the US, (even at a higher rate of pay and with lower taxes) because of the health care issue. I was hesitant to think about it before. All it takes is an insurance company stamping ‘denied’ on a form and you are up a creek, financially. Or, that denied stamp could kill you. Or a child. Or someone else’s child.
    I’m not saying that private insurance is a bad thing. I have critical care insurance to pay bills if I get sick and can’t work. I have insurance that covers prescription drugs, vision care, and all sorts of things the provincal system does not cover. And honestly, I think the province should do a better job of covering the prescription drugs for low income people. Or everyone. Because there are people who need help. And they would be going to school or work, or living longer, healthier lives if they had their meds covered.

  36. 54
    SarahMC 7.9.2007 at 4:07 pm |

    I know, right? I know too many people my age who are in shitty, low-paying, dead-end jobs because they “need the health insurance.” It’s like a conspiracy to turn young people into soulless, uncreative drones for the ruling class. I know other people who’ve quit exciting jobs to move home with mom & dad because they weren’t getting health insurance. It makes no sense. Why is health insurance a benefit? Why doesn’t my employer just pay for my auto insurance as well? Or my renter’s insurance?

  37. 56
    Mnemosyne 7.9.2007 at 4:22 pm |

    At no point did I wish to give the impression that I think health insurance companies are just super. I know they’re run by greedy scumbags, I get it. But what you’re proposing is nationalization of a massive private industry, as if government can just swoop in like salvation from on high and make everyone’s life awesome, and I’m not buying it.

    Here’s what you don’t seem to understand, Henry: our current health insurance system is set up so that health insurance companies have incentives — not just the ability, but actual incentives — to deny care to the people they insure.

    Example: Say you have diabetes. Your doctor recommends that you take insulin to keep your diabetes under control. Your health insurance company refuses to cover it and says that if you want it, you have to pay for it out of your own pocket while continuing to pay them the same amount for coverage. If you have complications down the road from uncontrolled diabetes, then they might pay to treat those problems … assuming, of course, you’re still with that insurance company. Because that’s what they’re counting on — in our current system, companies change their health insurance coverage almost every year depending on prices, and employees have to change as well.

    So if your insurance company was Wellpoint last year, but your company is switching to Blue Cross next year, what incentive does Wellpoint have to treat you for a chronic illness? It’s money out of their pocket that they won’t see any kind of return on, because your company isn’t going to be using them anymore. So they deny and deny and deny the claim and gamble that by the time your chronic illness requires, say, an amputation, they won’t have to pay for it because you’ll be insured by someone else.

    At this point, the government doesn’t even have to “swoop in like salvation …. and make everyone’s life awesome.” If they can just not kill people or drive them into bankruptcy by denying them care, that would be a major improvement over what we have right now.

  38. 57
    SarahMC 7.9.2007 at 4:33 pm |

    I’m glad you’re so optimistic on the efficiency and good will of government agencies. I am not.

    Wow. The neocons and Christo-fascists have done a damn good job of convincing people the government is a worthless, ineffective albatross hanging around America’s neck.

    Here’s the thing:

    Government COULD be efficient if the people in charge (i.e. the people WE elect) gave a damn about serving the country. When you put people like Bush in charge, you’re going to get an inefficient, incompetent government. He doesn’t CARE. He and his friends didn’t enter public service in order to serve the public. They’re in it to serve their buddies. While failing to do their jobs, they’re telling Americans that government can’t be a force for good, only evil. It’s a self-fulfilling prophesy!

    There is no reason government couldn’t be efficient. Government is not a foreign, alien entity. It’s made up of PEOPLE. If caring, intelligent, fair-minded people were in charge, government might actually DO something for us for a change.

  39. 58
    still censored... 7.9.2007 at 4:57 pm |

    With Henry’s contributions I almost have Libertarian troll BINGO! (see Pandagon). How timely! All that’s missing is the obligatory “bootstrapping” comment. But seriously, Henry, on top of all the other counterarguments already offered, you can’t on the one hand decry how high the taxes would be to fund universal healthcare and on the other hand make statements like

    Fitting though, as the more you force government to do for you the more they get to tell you what to do. Nothing in life is free, ever.

    So which is it Henry, because you can’t have it both ways in denouncing the idea. Either universal health care is a) “FREE but not REALLY free” because, while LESS EXPENSIVE, it comes at the price of our precious autonomy and right to self-determination *cue ominous music*, or it’s b) HIDEOUSLY EXPENSIVE, much more so than the current system. The current system, by the way, in which we are completely at the mercy of private corporations in terms of what services and procedures are available to us, and the mercy of our employers in terms of what health plan we are allowed (if any). Which does not, y’know, sound particularly like freedom.

    Your comments betray a painful ignorance of how the rest of the world functions…myopia indeed. And conceptualizing illness, whether a common cold or a chronic medical condition, as an individual problem rather than a public health / safety problem, is just pathetically illogical. There is contagion to consider, there is intergenerational transmission, there is worker productivity (that should be a magic word for someone of your worldview), there is impact on family and community, there is chronicity and degeneration, which take a toll on the individual and their ecology that prevention and early intervention could avoid.

    The fire department analogies other commentors have drawn are right on. What would happen if the concept of a “pre-existing condition” entered into the fire department’s considerations of what fires to put out and thus, which lives to save? What if, while your house was turning to ash, they took you through a comprehensive screening process to determine whether the fire was caused by “lifestyle / behavioral factors” or a more structural problem, then made their decision about you and your family’s worthiness not to die or become homeless? What if they decided it would be unethical to not put out the fire, and did so, but then sent you a bill for $450,000 because they thought it wasn’t technically NECESSARY because you could have just abandoned it and moved to a different house?

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    KH 7.9.2007 at 5:24 pm |

    I’m glad you’re so optimistic on the efficiency and good will of government agencies. I am not.

    It’s an empirical question, & we don’t have to rely on airy generalizations about the efficiency of large bureaucraciies, public or private. Just compare the existing private system with, say, the VHA, or HCFA, or any of a number of other countries. As it turns out, arguments from efficiency are a major reason for universal health care.

    Likewise with generalizations about the comparative good will of large public & private bureaucracies. For-profit systems are by design legally required to subject the good will of individual health care providers to the financial interest of stockholders. They can be just as indifferent as public systems, which are at least under democratic control. Best to consult data on satisfaction levels of enrollees in private & public systems, which again generally favor the latter. If you measure good will by the number of sick people denied decent care, or bankrupted by illness, the existing system isn’t obviously superior.

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    octogalore 7.9.2007 at 6:46 pm |

    Belle, I love the post and I’m glad your mom is doing better. You’re right, we all know some lucky ones (my mom — lung cancer, luckily isolated and removed, had coverage) and some unlucky ones.

    I have not seen the movie and am curious about whether Moore discusses why universal healthcare has proven so difficult even for well-meaning politicians, like say, HRC. It doesn’t seem more inefficient or necessarily more expensive than our existing system. What are some of the obstacles? Is it getting it passed through our current system, or are there other roadblocks that aren’t as clear? I would think a next step to Moore’s movie (unless this was covered in it) would be figuring out exactly where the obstacles to such proposals have been in the past, and applying pressure there.

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    Henry 7.9.2007 at 6:53 pm |

    So which is it Henry, because you can’t have it both ways in denouncing the idea. Either universal health care is a) “FREE but not REALLY free” because, while LESS EXPENSIVE, it comes at the price of our precious autonomy and right to self-determination *cue ominous music*, or it’s b) HIDEOUSLY EXPENSIVE, much more so than the current system.

    Sure I can. It will be hideously expensive. That doesn’t speak to whether or not it would be worth the money, but it will be expensive. And as government assumes more and more responsibility for individual health, it will be more and more obligated to legislate personal behavior in the long term. Our congress certainly has never been shy about attempting to expand it’s domain.

    Your comments betray a painful ignorance of how the rest of the world functions…myopia indeed

    Well you do have me there, I’m afraid. I am rather ignorant. Perhaps our difference from other nations stems from our inherent ignorance and mean-spiritedness. Or perhaps it comes from a different conception of government responsibility. Probably the first one.

    There is contagion to consider, there is intergenerational transmission, there is worker productivity (that should be a magic word for someone of your worldview), there is impact on family and community, there is chronicity and degeneration, which take a toll on the individual and their ecology that prevention and early intervention could avoid.

    I thought I had mentioned that the government has an agency that deals with issues of that nature. Perhaps I’m misinformed, but isn’t that what the CDC does, study and react to contain contagious illnesses that threaten public health?

    What I’m curious about, is if the main beef here seems to be insurance companies denying necessary care in an unethical manner, why is the focus not on legislating insurance company practices? If you’re going to call down the congressional hammer, why not there? This would seem like a classic case for government intervention to regulate a business practice.

    Let’s say for the sake of argument that I’m a heartless ass and you all are completely correct. Fair enough. Does anyone have any suggestions or insight into how to deal with the problems inherent in a nationalized system? Or is it enough to plunge headlong and deal with the issues later?

    And for the record, I don’t think I qualify as a troll. To my knowledge, I’ve never made any outrageous or intentionally inflammatory statements, and I’ve done my best to be respectful. For what that’s worth.

  43. 62
    Kristen 7.9.2007 at 7:30 pm |

    Does anyone have any suggestions or insight into how to deal with the problems inherent in a nationalized system? Or is it enough to plunge headlong and deal with the issues later?

    Sure. What about Dr. Emmanuel’s [sp?] voucher idea? I’m sure their are some draw backs, but it sounds like a good place to start.

  44. 63
    Kristen 7.9.2007 at 7:32 pm |

    Does anyone have any suggestions or insight into how to deal with the problems inherent in a nationalized system? Or is it enough to plunge headlong and deal with the issues later?

    Sure. What about Dr. Emmanuel’s [sp?] voucher idea? I’m sure their are some draw backs, but it sounds like a good place to start.

  45. 64
    Kristen 7.9.2007 at 7:36 pm |

    Ooops…my bad. Sorry for the double post.

  46. 65
    KH 7.9.2007 at 7:48 pm |

    …if the main beef here seems to be insurance companies denying necessary care in an unethical manner, why is the focus not on legislating insurance company practices?

    Arguably, the desired changes can’t be imposed within the framework of the private for-profit system, the morally unsatisfying aspects of which are largely attributable to its peculiar incentives & inefficiencies, e.g., the way profit maximizers respond to adverse selection. But there may be more than one way to skin a cat, & the existing proposals for universal coverage differ in important respects. If you have a proposal that specialists in the field have overlooked, spill it. (I assume that whatever you have in mind would seek to avoid the sort of transfer of wealth to private industry that Republicans enacted in Medicare Part D under the aegis of preserving the free enterprise system.)

    Does anyone have any suggestions or insight into how to deal with the problems inherent in a nationalized system? Or is it enough to plunge headlong and deal with the issues later?

    It’s hard to answer the question without knowing which specific proposal & which specific problems you’re talking about. The literature on health care policy encompasses a wide range of proposals, & seeks to address a wide range of possible problems. But as a general proposition, no, it’s not a good idea not to try to anticipate the problems inherent in any proposed legislation.

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    still censored... 7.9.2007 at 9:49 pm |

    Henry, the “Libertarian troll bingo” is a label taken verbatim from another site. I couldn’t very well leave “troll” out of it; that would have been misrepresentation. :)

    And you don’t really mean to suggest that the CDC addresses ALL the illnesses, and the effects of illness, that I and others have mentioned, do you? Because we both know that’s inaccurate, and frankly absurd. You seem to have stopped reading at “contagion,” as if that were the only aspect of illness that has any impact on other people, or society at large–without addressing: intergenerational transmission, worker productivity, classroom environment, economic and emotional impact on family and community, etc. The CDC is not going to intervene if my kid has asthma, say, but (let’s imagine, for maximum impact, I’m a single parent living in an urban area, where it’s well-known that childhood asthma is extremely prevalent) I will still miss work when he is sick, and because we can’t afford the expensive medication or more expensive apparatus (regularly, if at all), I have to supplement the medication with over the counter non-asthma-intended medications, which aren’t as effective and mean more severe attacks, which means we go straight to the emergency room (when regular asthma maintenance would have been much more effective), and because we can’t afford regular doctor visits we don’t get the medication adjusted at regular intervals based on height and weight changes, and don’t know to do so, which ALSO means more trips to the emergency room and more sick days, and perhaps I lose my job because of missing so much work, and my child will certainly miss school, and perhaps miss out on recess and playing outside because exercise is a trigger and allergens / environmental toxins are a trigger, and maybe on the asthma medication plus lack of exercise plus eating cheap food because we’re poor he will become overweight and perhaps develop diabetes. And I’m stressed out and he’s socially anxious and sad. And in his classroom, there are 14 other poor kids with asthma, and there are so many absences that the material has to be repeated a lot, and the entire classroom falls a bit behind. Etcetera, etcetera. And the CDC is still not going to intervene and take care of our medical or mental health needs and all their sequelae. Is this really something that needs to be said? (And before you hazard a guess, the above is not my life situation; it’s just that I can *imagine it because I allow myself to truly listen to the situations of others, a myriad of others, who are not myself, and also have this thing called empathy*. Incredible, I know.)

    And I sincerely hope you weren’t insinuating it was *mean-spirited* to call you ignorant, when it’s purely factual. Wait, let me guess, is it *partisan* too? Us wacky libruls!!

  48. 67
    Deanna 7.9.2007 at 10:18 pm |

    Henry:

    The United States spent $5,711 per capita on health care in 2003. That’s not per person receiving health care, that’s per person in the country.

    Canada spent $2,998 per capita.
    France: $3048
    UK: $2,317

    Seems to me if you kicked your HMOs and insurance agencies and went into universal healthcare with single payer insurance, you’d save $2,000 each.

    http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

  49. 68
    Mnemosyne 7.9.2007 at 10:57 pm |

    And as government assumes more and more responsibility for individual health, it will be more and more obligated to legislate personal behavior in the long term. Our congress certainly has never been shy about attempting to expand it’s domain.

    And yet that hasn’t happened in either Canada or the European countries that have universal healthcare. I think your fear says less about universal healthcare and more about the American tendency to want to meddle in other people’s business (cf. forced-birthers, outdoor smoking bans, etc.). If people could actually say things like, “I’d never have an abortion, but it’s not really my business if you have one,” it wouldn’t be a problem.

    But, sadly, we have a country where our right-wing government thinks that legislators make better medical decisions than doctors, so you’re right that, under this administration, universal healthcare would be a disaster. If we could actually get some people back in office who knew how to run a government, then we might be able to get something going.

  50. 69
    Mnemosyne 7.9.2007 at 11:00 pm |

    Oh, and if you don’t know, “single payer” and “single provider” are two completely different systems. France and Germany have single payer systems; England has a single provider system. Single provider probably wouldn’t work in the US since we’re too big geographically, so each state would administer its own healthcare system. And, like so many things, we’d probably have blue states with great healthcare and red states with lousy healthcare, and yet the red states would never shut up about how they’re morally superior, anyway.

  51. 70
    zuzu 7.10.2007 at 12:43 am |

    But even then, we could have federally-mandated minimums, so that nobody could go bankrupt due to health care costs. And even prenatal care is paid for.

  52. 71
    lauram 7.10.2007 at 1:16 am |

    A recent survey by the management consulting company McKinsey estimated the excess bureaucratic costs of managing private insurance policies – scouting for business, processing claims, and hiring “denial management specialists” to tell people why their ailment is not covered by their policy – at about $98bn a year. That, on its own, is significantly more than the $77bn McKinsey calculates it would cost to cover every uninsured American. If the government negotiated bulk purchasing rates for drugs, rather than allowing the pharmaceutical companies to set their own extortionate rates, that would save another $66bn.

    Post w/attributions

  53. 72
    libber 7.10.2007 at 2:14 am |

    As far as universal healthcare goes, it sounds like a lovely idea in theory, but you’ll never get the American people to stand for the massive tax increases it would take to fund a system.

    that’s got to be a joke. most people in america have very little left to spend after their employers take out health care etc etc from their already ridiculously small wages.

  54. 73
    Kristen 7.10.2007 at 11:54 am |

    And, like so many things, we’d probably have blue states with great healthcare and red states with lousy healthcare, and yet the red states would never shut up about how they’re morally superior, anyway.

    Yeah…that’s one of the reasons I thought the voucher system might at least be a good place to start. I do not want health care in the hands of the states. Federalism is a super idea except when it comes to human rights…then the disenfranchised tend to get screwed…

  55. 74
    Autumn Harvest 7.11.2007 at 3:47 am |

    I’ve heard the tag “America is the greatest country in the world” (incidentally, do Canadians and Central and South Americans feel this includes them, or do they get cross at the implication that they don’t exist? Because it usually seems to be phrased “America” not “the U.S.A.”), and sure it made me feel queasy, but more significantly I have wondered: What on earth does that actually MEAN?

    I mean, what are they measuring? No one, surely, thinks that the U.S. has the best education system? Literacy rates? etc. . .

    As a member of the greatest country in the world, I’ve thought about this a lot, and honestly, I think the answer is that American is ordained by God to do God’s will. Seriously. No joke. I doubt many conservatives would say it like that, but that’s realy what it boils down to. American occupies a special place in world history, a “city on the hill,” if you will, that will save the world from the demons and devils that will plague it in its later days. The most obvious sign of this being our overwhelmingy military superiority (see how easily the Iraq war went?)

    I just watched Glen Beck today, as part of my daily exercise routine (15 minutes of conservative news, 15 minues realaxing, with intense self-flaggelation), and got this cute bit : “Does anyone really believe that we can lose the war in Iraq if we don’t want to? Does anyone really believe that American can lose a war that it really want to win? If you said ‘yes’ to either question, we’re in a really deep problem,” Some knucklehead might think that in a war, usually both sides desparately want to win. But Mr. Knucklehead, may I point out that only one side has been ordained by God to do God’s will on Earth.

    P.S. Obviously Canada and Central and South American are not included in “America, the greatest country in the world.” Don’t be a dolt.

    P.P.S. Does anyone have a better explanation of why American is the greatest country on Earth? Seriously, I’d like to know?

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