On Sun, 02 Aug 2009 15:19:44 -0500, Neeum Zawan wrote:

> On 08/02/09 13:29, Jim Henderson wrote:
>> Arguably, many of these same people are the ones who proudly proclaim
>> that America has the "best health care system in the world", despite
>> the cost of health care here being the *highest* in the world, the
>> system itself being ranked something like 50th in the world, and the
>> average life span being something like 37th in the world.
> 
> 1. Cost of health care being high doesn't negate it being the best.

True, but studies have shown that it's not the best in the world.  And 
yes, it does depend on whose ranking you look at and what the criteria 
are.  If the criteria is "makes the most money for shareholders", damned 
straight, we've got the best system in the world. ;)

> 2. To be fair, it all depends on what ranking you look at. Not all place
> the US that low. The usual ranking people invoke is the WHO, which puts
> it just a bit below 30th - nowhere near 50th.

I think I mixed the numbers up, I was afraid I might do that.  The WHO is 
who was cited in the numbers I heard.

> 3. Most of the people I hear from who are against universal health care
> don't claim the US is near the "best". They claim that people who "work
> hard and earn a lot" should get some sort of priority over deadbeats who
> don't. (Not my view, but thought I'd point out that it's not about being
> the best). Effectively, the argument is that access to health care is
> not a human right (although they'll never put it in those terms).

Yes, agreed - and I appreciate that you don't agree with that view.  I 
agree that heath care is and should be a human right.  The needs of 
society for a healthy population outweigh the needs for profits or other 
motivating factors.

> 4. To be fair, among industrialized countries, the US _does_ rank near
> the top for the treatment of certain conditions (e.g. certain cancers,
> etc). I don't know if they include people who just don't get care
> because they can't afford it. To be even fairer, the same study shows
> that the US is worse and in some cases really bad for a number of other
> common serious ailments.

Sure, one can cherry pick parts of the system and say "that's good" and 
"that's not good", but the point is to evaluate the *system* not 
individual components of the system.

> 	I haven't deeply looked at Obama's plan. I don't know if it's
> particularly good. It's not what most advocates of universal health care
> want. I don't know of any country that actually uses his plan as a
> model. The countries that do come close (Switzerland?) and have a system
> of private insurance actually enforce limits on the amount of profit
> insurance companies make. That doesn't seem to be in his plan.

I haven't looked at the plan in great detail, but the vibe I get from 
what I hear about it is that it's not a replacement for the current 
system, but an addition to it.  Those who oppose it say it's a bad idea 
because "government run programs don't work efficiently" - like the 
military or the post office don't work well at all.  (But wait, they 
do. ;-))

But those same people then say that it would supplant the current system 
because of competition.  But wait, if the current system is good and 
competition is good, then adding an option run by a supposed inefficient 
government agency shouldn't be a threat to the existing system, should 
it?  The opponents need to decide, either the government can run it 
effectively and competitively (thus undermining shareholder value in the 
current scheme), or the government is incompetent and can't run an 
effective program that's any better that what we currently have - in 
which case, it's not a threat.  It can't be a threat and not a threat at 
the same time.

> 	I think what a lot of UHC advocates have to understand is that 
just
> because it's government run doesn't mean it will work at all well. There
> are a lot of issues and concerns that simply are not being addressed.
> It's a long article, but you should read:

True, and while I support the plan based on what I've heard about it, I 
don't believe it's a magic bullet that'll solve all of our problems.  But 
it's a step in the right direction.

Part of the reason it won't be a magic bullet to solve all of our 
problems is that the legislative process requires compromises be made.  
Some compromises will be good for the plan overall, and some will be bad 
for the plan overall.

> http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?
currentPage=all
> 
> 	It's purely discussing government run care, and how in some cases 
it
> can be really abused, without the guilty party even consciously _trying_
> to abuse it. If they don't address this kind of stuff, UHC won't work
> that well.

Sure, but the current insurance-based system also doesn't work that well, 
can be abused, etc, etc, etc.  The same arguments that are used against a 
single-payer system apply to the system we have now.

Jim

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