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Forget the lilly-livered, carefully crafted, deliberately vague language of the Health Care for America Now campaign whose coverage on KELO set off Sibby's socialism alarm. Let's take a look at real socialized medicine and how well it works. NPR presents "Health Care for All," a series on national health care programs in Germany, France, the Netherlands, the United Kingdom, and Switzerland. Highlights from Wednesday's report on socialized medicine in France:
- The sicker you are, the more the government pays to help you. Kind of like triage: folks who need the care most go to the front of the line. Compare that to America, where the sicker you are, the harder it is to get any coverage, and the only ticket to the front of the line is money.
- The French pay 21% of their income into the national health care program. Employers pick up much of that. And they're still paying less than Americans pay for premiums, deductibles, co-pays, etc. (Don't believe me? Check out this NPR graphic that shows the U.S. spending a bigger chunk of its GDP—15.3%—on health care than six other industrialized countries and still achieving the lowest life expectancy of the group.)
- The French can still pick their own doctors.
- In a study of 19 industrialized nations, France's socialized medical system ranks first in the world in preventing avoidable deaths. America's private for-profit system ranks last.
- French moms get paid maternity leave, subsidized child care, even covered house calls from nurses and doctors. "In France, it just seems that it's so family oriented," says American mom Mary Lou Sarazin. "A pregnant woman is seen and regarded as a special moment."
Accept no substitutes: socialized medicine saves money and lives.
The only problem with the European model is the value-added tax (VAT) which supposedly helps to pay for health care.
ReplyDeleteWhen I lived in Hawaii, I paid this sort of tax. I had to pay a 4 percent "sales tax" on all of my royalty income, and that is 90 percent of my total income. This was on top of the federal income tax, the social security self-employment tax, and the state income tax. Moreover, it struck from the first penny.
If I bought one of my own books at the store, I would pay 4 percent on the retail price and then 4 percent of the royalty I would get from the publisher.
I could not ask the publisher to pay me 4 percent more to offest this. It was a 4 percent pay cut, plain and simple. And I was not then, nor am I now, nor do I ever expect to be, a rich dude.
There may be some other small businesses that cannot offset the VAT in this way, and they, too, take a double hit.
The thought of paying 15 to 20 percent off of both ends, in addition to the 30 or so percent I pay now (not to mention the looming state income tax) is enough to make me consider outsourcing myself should the USA adopt a tax such as that. I suspect that may have caused some emigration from Europe to the USA. If my memory is right, some Swedes actually found themselves paying more in taxes than they made, so they would be better off not working at all. (But I could be wrong; it was a long time ago.)
To say that "employers pay most of the cost" may appear to hold true for the average wage earner, but even that is an oversimplification. The VAT bleeds off revenue at multiple points in the stream, sort of like a garden hose with multiple leaks. The end result is that the little guy at the nozzle end gets a lot less, however you run the water to the tap.
There may be other funding schemes for national health care. But the VAT is a danger we must be wary of; it is regressive, hidden, easy to raise, and a great generator of government revenues -- and not only for health care. I do not suppose government could keep the VAT revenues confined to health care. So the end result would simply be bigger government. And I do not doubt for one instant that large corporations would find a way to tap this tax to line their pockets at the expense of the hungry, sick child in the ghetto.
Socialized medicine is a good idea on its face. But we have to be careful what we feed it, lest it grow all sorts of tumors that make the cure worse than the disease.
Even so, if I could stop worrying about financial ruin should I be diagnosed with cancer tomorrow ... maybe a few percent more in taxes (but not a VAT!) would not be so hard to swallow. A big piece of prime rib makes the medicine go down.
And this is the same government whose own Department of Education "misplaced" over $140-million???
ReplyDeleteNo thanks Cory... I'd rather take my chances with the free market. At least there THEY have to show some accountability, not Uncle Sam.
4% VAT? Well, that still would beat the 9% of my income I pay for family health insurance that still leaves me with an annual deductible of 25% of my income and the possibility that the insurer will yank my coverage at any time. You really like that gamble better, Jackrabbit?
ReplyDeleteWait a sec, Jackrabit1. How exactly do our current health insurance providers have to show accountability? Is it when they mess up and "forget" that something is covered and they have to pay for it and only "remember" when I have to spend time out of my schedule to fight with them on it? Is that the accountability you refer to?
ReplyDeleteOr do you mean accountable like Enron was accountable?
ReplyDeleteSorry, I couldn't resist.
Hey, companies screw up, they're held accountable... just look at Ken Lay and Bernie Ebbers.
ReplyDeleteGovernment screws up, someone usually gets promoted!
To play the devils advocate, I believe that our very high health care costs actually subsidize global costs by funding research here that benefits the global community. Socialized programs are not significant contributors of advances in the field of health care.
ReplyDeleteWe have to make a choice; if we want inexpensive health care, it's very possible for us to socialize it and the cost will drop just like other socialized systems of medicine. As a trade-off we must accept that break throughs in treatments and drugs will slow dramatically.
If we are not willing to accept this slow down, we should not expect any decrease in costs.
The fundamental problem with socialized medicine is there is absolutely no choice of one's provider, because it's the government 100% of the time. If a lazy bureaucrat that gets paid regardless of the customer service they provide decides to deny a claim, tell me I can't see a doctor or whatever, I'm just hosed. At least with private sector medicine, I have the option of getting a second opinion, moving my health insurance and voting with my wallet. I would much rather choose between hundreds of providers than just one, especially one that has a history of mismanaging, well, just about everything. Congress couldn't even properly run their own cafeteria, so they had to privatize it, what makes you think they could possibly effectively run the health care system?
ReplyDeleteMatt:
ReplyDeleteJust a comment from my life experience. On travel, I've had to deal with several different european socialized medical systems (note to self, need to become a better mountain bike rider). I came away from all of them with a very positive feeling. The care was timely, doctors were competent and seemed like they loved their work, and the facilities were in excellent care. I would honestly be very happy with that same level of care here in the USA.
I would argue that if administrators were elected much like mayors the needs of the community would be met even better.
Tony,
ReplyDeleteI would be interested to know how much the locals paid toward your healthcare. Socialized medicine is inherently more expensive because the profit incentive isn't there. There's no motivation for providers to try to cut their cost by providing more effective and affordable medicines. Cory would certainly argue since there is no profit to be had by the stockholders of medical companies, that it would be cheaper. Although I would much rather have stockholders trying to keep costs down rather than have the government just tax everyone more whenever costs go up.
Matt: Less free market fundamentalism, more reading of the actual article, please. The French get to choose their doctors. Their health care system covers more than ours does (remember the pregnant woman no American insurer would cover? she wasn't even sick, just pregnant). And it costs less.
ReplyDeleteThe US doesn't seem to do socialized programs well and the insurance industry won't like the idea. I worked for a non-profit BCBS (Colorado) that was antiquated but had a pretty good heart until they tried to transition to a for-profit insurer. We went under financially (Y2K, other issues) and were purchased by an existing for profit BCBS company (there are only a few now for all states) and boy did I see the focus shift to money and coverage suffer. However, the idea of socialized medicine scares me. Why not a voucher program or tax credit and let the consumer choose? And mandate hospitals and insurers be non profit. John Hess
ReplyDeleteThe reason we end up paying more here are multifold. One major contributor is...socialized medecine. If we didn't have the government involvement of Medicare/Medicaid US expenditures would be much lower. We need less soviet-care, not more.
ReplyDeleteps. NPR=fluff
Lets give health care to the Supreme Court, and it can mess things up...like it has our
ReplyDelete5th Amendment. And Congress can sit back. Socialism - Bad idea.