Professor Blanchard addresses my calls for single-payer, not-for-profit health care, also known as real universal health care, the Kucinich plan, socialized medicine, and the way darn near everyone else in the industrialized world does it. I happily address back (redress? retrodress? undress? hmmm...):
Master of the red herring, Blanchard notes that the purveyors of European-style socialized health insurance are the same folks "who told us that Castro's Cuba was a model for Latin America." In the same vein, Germany brought us Nietzsche and Hitler*, but that doesn't change the fact that the Mercedes is a fine vehicle.
Proceeding to tenuous assertions, Blanchard decries socialism in general by citing these comments from Jurgen Reinhoudt on "France's Broken Social Model":
To say that France's social model is far from perfect is an understatement: in spite of the state absorbing more than 50% of GDP, France has suffered, since the 1980s, from rising child poverty rates, persistently high unemployment, a chronic sense of economic malaise, and the continual enrichment of the system's "insiders" at the expense of the system's "outsiders." More importantly, France's social model fails to deliver precisely what it proclaims to: economic justice, inter-generational fairness, economic opportunity and social protection, particularly to young workers entering the labor market, minorities, immigrants, middle-aged women and other vulnerable groups. [Jurgen Reinhoudt, "France's Broken Social Model," Real Clear Politics, 2008.07.13]
Enrichment of insiders, failure to provide economic justice, barriers to vulnerable groups entering the labor market... gee, sounds like capitalist America.
Blanchard fails to give sufficient attention to Reinhoudt's summary of Timothy Smith's argument that the problem with France isn't that it's socialist, but that it's not socialist enough. Regressive tax structure, ineffective income redistribution policies— that's a critique of cronyism and special interest politics, not socialism.
More importantly for our discussion of health care, Reinhoudt doesn't give any indication that France's health coverage model doesn't work. Blanchard thus fails to offer any direct refutation of the evidence of the superiority of French (and British, German, Dutch, and Swiss) universal health care presented in the NPR series I highlighted last week.
Blanchard mentions that socialism is all about protecting people from things like market forces. Blanchard does us the favor of not going full-bore market fundamentalist on us, but we can all stand a reminder that protecting people from market forces is actually a good thing. France protects moms and babies from market forces by ensuring they have access to health coverage, unlike America, where market forces dictate that private insurers describe a pregnant woman as "a house on fire" and refuse to offer her coverage.
We already engage in socialism to provide health coverage for senior citizens, veterans, and the poor. You could argue that health insurance in general is socialistic: we realize almost no individual can cover his or her own medical expenses, so we "unionize," paying "dues" (premiums) into pools in an attempt to protect each other from getting flattened by the free market forces that drive health care costs up (and still contribute to over half of all bankruptcies in the U.S.). It's the free-market insurers who pervert that reasonable system of cooperative protection into a system that generates its profits by denying its clients the services they've paid for.
Does the French social system have problems? You bet. Everyone's does. But, with varying degrees of socialism in health coverage, the French, Germans, British, Dutch, Swiss, Japanese, Canadians, Finns, and others spend less on health care and get better results than our bloated profit-based system.
*Yes, I know: Hitler was born in Austria. Don't be a wise guy.
CAH:
ReplyDeleteA few quick questions. How is cost minimized in a social health care program?
From my use of said systems, I didn't see any particular mechanism. In our system, insurance companies make it adversarial which minimizes cost.
I assume that social health care systems are not adversarial. What limits overuse, and there in, spiraling system costs? How does such a system develope new treatments at a lower cost than an adversarial systems?
Does a well functioning social system require that the administrators are altruistic? How do social systems prevent corruption without some form of motivation? (this last one is my biggest concern)
Let me shoot from the hip on this one:
ReplyDeleteAdversarial? My experience is that I'm paying a private insurer who turns around to be adversarial toward me, looking for any excuse to deny coverage.
What limits overuse? The really expensive stuff—e.g., emergency care, long stays—aren't on most folks' list of things they want to go get a lot of anyway. Folks might like going for a checkup and go for more perventative care, but that increased use pays off in the end.
How are costs minimized? Among other things, by getting rid of the 20-30% administrative overhead that pays for executive salaries, lawyers working to deny me coverage, and the byzantine private bureaucracies of hundreds of private insurance companies creating lots of extra work for hospitals and individuals.
Preventing corruption: We have about the same leverage as we do against private insurers... maybe more, since even poor people can show up and vote, even if they can't afford to exert market pressure.
Cory, Let's say that France has an amazing health care program. How do we know it'll work in the United States?
ReplyDeleteNo guarantees, Matt, but I like the looks of a system that works (France) against a system that doesn't (U.S.: millions with no coverage; bankruptcies from medical costs; 20-30% admin overhead...).
ReplyDeleteOnly someone with an extreme case of American exceptionalism would suggest that systems that work in 95% of the industrialized world can't work here. But I welcome your analysis....
The irony of using Reinhoudt's article to criticize socialism is incredibly funny. That was about the only snippet Blanchard could have used from the entire thing and try to make that case. I found Rhinhoudt's reasoning to nonsense since the problems he points to are the natural consequences of socialism in the first place. Protecting people from market forces is how to guarantee to have the worst product that costs the most. The problem is that everyone wants to compare our health care system without paying any attention to our demographics. We are the fattest, most inactive country in the world. We have triple the level of obesity in this country than France. The cost of that alone should outweigh the supposed lower amount spent in France and other socialized countries. That 20-30% overhead CAH always mentions is an illusion. We can have inexpensive health care in America. All we need to do is bike around as much as CAH :)
ReplyDeleteThe problem with socialized medicine is that the government starts making requirements from you. And only the healthy are going to the doctor for routine check-ups. Then, when you're not healthy you don't get medical care. Kinda' like the insurance companies.
ReplyDeleteThe only difference is that you gave up your freedom for free stuff that actually cost an awful lot!
Let's just be responsible and pay for the care we need. Help those who really need it and keep our Freedom. It's what the founding fathers would do.
Guy: what requirements are the French, British, German, etc. govts making?
ReplyDeleteHere's a Web page that goes into some detail as to how the Kucinich plan would be paid for:
ReplyDeleteFinancing H.R. 676
Who has unlimited money to pay for the unlimited care?
ReplyDelete'Shooting from the hip' is what Nationalized Health care will be. A lot of unnecessary death.
'Specialists' would have to see anyone who wants to get seen. Right? So, what about those who NEED it?
What requirements are the French, German, British governments making? Everyone NEEDS to be seen.
Your heart is in the right place. Things just aren't as simple as giving away Healthcare, unless you're a Politician!
Stan,
ReplyDeleteI like his 'what if' explainations to the right. He's assuming a lot of information for a plan costing over $2 Trillion dollars.
Good thing he's getting it from those Tax Payers, eh?
And what about the fact most hospitals are in the red paying for healhcare for the uninsured, now? He could use that as a selling point. 'Take the burden off the hospitals and place it on your own shoulders!'
That burden on your shoulders? It's already there! You, me, all of us are already paying for the uninsured. You think hospitals don't pass those costs on to us?
ReplyDeleteKucinich and I want to take some of that burden off your shoulders. Instead of hundreds of private insurers dividing the market, creating bureaucracy, and still leaving 40+ million Americans without coverage, we put 300 million Americans in one pool with massive buyer power.
But Guy, if you like paying more and getting less, well, go right ahead....
I'm getting what I pay for. If you have insurance from any source they are combining premiums to help pay for those who can't pay all of their medical costs.
ReplyDeleteWhat you want to MAKE me do is pay for someone who WON'T pay and then take a back seat to them.
I'm sure you've never HAD to go to the doctor for something serious or actually NEED a specialist, because this would make perfect sense.
Never anything serious... just a newborn with pneumonia in the NICU.
ReplyDeleteBetter hope my wife doesn't hear you making those assumptions, Guy. And you better come prepared to discuss the issues with real neighbors, not argue with the straw men you prefer to imagine.
Sounds like you got taken care of. What would you've done if they said you needed to wait because the doctor that needed to see your child was at the Free-clinic? That all you could do is wait it out and take some tylenol until he gets here?!?!
ReplyDeleteSo what would your wife have to say about your promotion of a medical system that puts your childrens healthcare behind people who don't want to take care of their own children?
Guy, I'd say that my Canadian friends (and yes I know several since we lived in Canada for eight months) are appalled at the health care system in America and none of them had their children's lives put at risk because of the their provincial insurance programs. Quite the opposite, in fact. Your assessment is way off-base from the experiences I heard about while in Canada.
ReplyDeleteCory's promoting a system where ALL children get the health care they deserve. And frankly, I don't care what some children's parents have done or not done. It has absolutely no bearing on whether their children "deserve" adequate health care or not. They ALL do.
So why do you like Nationalized Healthcare?
ReplyDeleteOr Socialized Medicine?
If the original post didn't make that clear, let me summarize: single-payer, not-for-profit health coverage is the most efficient and moral way to cover the health care costs of all of our fellow Americans.
ReplyDeleteIt also...
---helps small business
---protects women and babies
---cuts overhead as much as 30%
---secures a basic human right
---is supported by a majority of doctors
---provides better care
---would save 101,000 American lives a year
---helps farmers
---helps people live longer
---and oh yeah, saves tons of money!
Keep reading, Guy -- you might learn something!
Whoops! missed that link on saving 101,000 lives a year, the equivalent of stopping 33 al-Qaida 9/11 attacks. We've gone to war for much less.
ReplyDeleteIn a nutshell, I favor socialized health insurance (which is different from nationalized healthcare/socialized medicine) because it's the most efficient use of money: it allows for the most healthcare coverage for the greatest number of people, which is good for the country as a whole. It's good for the poor, the middle class, AND the rich. It's good for individuals and it's good for business, both small businesses and large corporations. It also allows me to choose my physicians.
ReplyDeleteI also don't think healthcare (or the insurance that pays for it) should be for-profit. I don't think one red cent of our premiums should be spent on anything other than actual healthcare or its administration. I think my premiums (and taxes in a socialized insurance system) should be spent on healthcare, not on multi-million dollar CEO salaries.
---helps small business
ReplyDeleteIt seems by the article, the state run insurance program was modeling itself off of private companies working in the Free Market. This illustrates how little government knows about healthcare.
Government Social Programs just don't work. Social security, Welfare, Medicare, name one. The government gives enough to get people to vote and ends up taking the rest. When has government NOT spent the money the were supposed to get?
I don't have room to list rebuttals for each one in a single post so I'll do one or two at a time.
Healthcare is too, imporant to put it into the hands of the government.
OK, everyoneof your links are to your own writtings. Yes, you do have links within the links. But you can write the book 'War and Peace' with enough quotes from other pieces of literature.
ReplyDeleteAlso the reason, you didn't link the '101,000 lives saved' reason, is you already used the link.
Response:
The Free Market System adjusts faster and closer to the publics desires than government. Due to the process of writing laws.
You can trust the CEO's more than politicians. CEO's have their names associated with an organization and are subject to more regulations. Politicians write the regulations and rarely regulate themselves.
The answer is let the Free Market work. Take care of yourselves. Keep government from making decisions for yourselves. And give to those you think need help.
Multi-million dollar Salaries usually come from Multi-million transaction business'. If you want to target large amounts of money going to worthless causes, look at Bill Clintons speach tour. I mean, if you want to delegate where money should go.
Exactly, Guy: the links are to earlier blog posts that give links to the evidence you need to read. I used to be like you, Guy. I argued from the ideology I wanted to cling to. I used to love saying, "Let the free market work!" I still do... but I have realized that sometimes, as with America's Rube Goldberg private health insurance system, the free market doesn't work.
ReplyDeleteBut read the links, see for yourself. You say "Government social programs just don't work," but the evidence is against you. The French, the British, the Germans, the Japanese, etc. all get better medical care for less cost, thanks to national health insurance systems. More efficient, more effective, more moral.
I'm not interested in debating your ideology. I'm interested in debating reality.
Reality is people need to care for themselves or they lose their humanity. Ya know 'teach a man to fish...'
ReplyDeleteBut socialism isn't about caring for the less fortunate. It is a form of control.
Robin Hood didn't take from the RICH and give to the poor. He took from an OVER-TAXING government, trying to live off the people. Did ya get the part of the plan where the rich(like a politician) can still get whatever healthcare they want?
Socialized Medicine, National Healthcare, Expanding Medicade, whatever they want to call it, doesn't make people healthy! It doesn't care for people any better than our current doctors and nurses(they provide the care or don't provide the care.) It doesn't make people see the doctor!
The Reality is no one will get any more care than they already do. Americans are the most charitable country in the world!
Healthcare will be more expensive, if only because the government will take away more choices.
And you will be getting Less, because you will have more illegitimate persons in the system (like illegals and the non-sick.)
This is a system for socialists to rally behind. Because helping people out makes the "stabbing the self-sufficiant people in the back" pain go away.
Yeah, Medicare and the drug prescription programs are so cost efficient! And even though I think the care offered at the SIoux Falls VA is great, there are many complaints about the care offered at other gov't run facilities. Universal health coverage run by the feds would be a huge, wasteful, bureacracy with heaps upon heaps of red tape, paperwork, and inefficiency.
ReplyDeleteNothing is free. Someone has to pay for this "free" health insurance. And those someones will be the usual responsible persons paying for the illegals, the irresponsibles, etc. Socialism is not the answer.
Sorry to pop your bubble, Anon 12:39, but Medicare is more cost efficient. Read what I found in the National Health Insurer Report Card last month. Medicare outperforms private insurers in paying bills and fulfilling private contract. Medicare also has lower overhead, in large part because they, unlike private insurers, aren't blowing our money on million-dollar CEO salaries, marketing, or lawyers create loopholes to deny us coverage.
ReplyDeleteMaybe we just notice foul-ups in government health care more because we are able to hold government to more public scrutiny and accountability.
Why government run healthcare is a path to disaster:
ReplyDeleteInsolvency - The Medicare Hospital Insurance Trust Fund is projected to become insolvent by 2019 while the share of federal spending will go from 13% to 23% in the next 20 years. This is while Social Security starts to devour the Federal Budget after it starts to cash in their T-Bills. Since there is not a 20% savings in overhead cost, expanding the role of government to everyone's health care will only result in the inability for the Federal Government to pay for anything else.
Erin: As nice as it would be to give sunshine and lollipops to everyone, if it isn't sustainable than it isn't good policy, nor is it ethical to pretend it is if it is not. Personal experience is not a reliable replacement for objective data: Singe payer does not work in CANADA