Tag Archive 'Health Care'

New Zealand’s Sign on the Door

No Fatties.

Health Care Costs

Megan McArdle looks at why health care costs so much. Plus an anecdote on why they will continue to grow.

(we keep costs low here at ASHC by outsourcing our health care blogging to Megan)

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Revolt of the Cherubs

A dissuasive argument against government healthcare actually.

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The Gulag

Too often, I have heard people I know laud Cuba’s health care or some other aspect of their nation.

If you are someone who admires Castro’s Cuba – please read this

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With This Ring

Bride What attracted you to your spouse?  Was it his devilish sense of humor?  Her warmth and abilities to be a fine mother?  His strength and intelligence?  Her beauty and sexiness?

Today, we find couples tying the knot for another reason:  excellent health insurance.

Bo and Dena McLain of Milford, Ohio, eloped in March so he could add her to his group policy because her nursing school required proof of insurance. Corey Marshall and Kim Wetzel, who had dated in San Francisco for four years, moved up their wedding plans by a year so she could switch to his policy after her employer raised premiums.

We can argue what exactly we should do to change it all.  But, are there very many out there who disagree with the proposition that our entire system of health care and insurance is in dire need of complete overhaul?

Who wants to hear their adult child phone home and breathlessly announce:  “Mom and Dad; I found my future spouse!  He has Blue Cross/Blue Shield with no deductible!”


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A Conservative Blueprint for Health Care?

Ryan Ellis, the Tax Policy Director at Americans for Tax Reform, presents 3 principles of conservative health care.

Principle 1: Conservative health care reform should neither raise taxes nor increase the size of government. You’d think this would be a no-brainer, but trust me that it isn’t.
Principle 2: Health insurance should have nothing to do with your job unless you want it to. In any event, health insurance should be 100% portable.
Principle 3: Shopping for health care should look more like currently shopping for prescription drugs, dental, vision, and cosmetic surgery, and less like going to the hospital or getting a checkup. The former is price transparent and market-responsive. The latter is bureaucratic and doesn’t work

He offers the the Health Care Freedom Coalition as a possible package and then asks for reader suggestions in the comments. Sadly the comments then fill up with sidetracking discussions about illegal immigration. If you have any ideas, feel free to chime in at the Next Right.

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Boundary Issues

Peg pointed me this way, and I really enjoyed nodding in agreement. Of course, I have long nodded in agreement with Megan. Especially on these:

2) Gay marriage. I’m basically pro, but I take the Burkean arguments seriously.

3) Immigration. Again, I’m pro–but while I think the anti-immigration side makes often ridiculously ahistorical arguments about how current immigration differs from past waves, I think that more-open-borders folks like me don’t give enough respect to the real cultural frictions that immigration causes.


5) Taxes. I don’t have any very well thought out position on the optimal level of taxation in society. I take seriously both the justice arguments of the libertarian absolutists, and the notion that anyone living in a wealthy society owes their prosperity at least as much to the wealthy society as they do to their own skill and hard work–and if you doubt this is true, I suggest you go try to deploy your rugged individualist talents in Zimbabwe. I think society has a duty to care for those who genuinely can’t care for themselves, but I am against an ever-expanding notion of what constitutes “can’t”.

6) Intergenerational equity. I don’t mean social security, which I think is largely a stupid program. I mean questions about how we should privilege the interests of people who exist now over those who will exist in the future. The environment is the most obvious, but not the only, area where these questions come up. To me, health care is another one; the core issue is that we can probably help some people by moving to a single payer system today, but only by destroying the innovation machine that will help many many more people down the road.

7) Humanitarian intervention. I am often tempted by the isolationist stance, the cool purity of its single-rule decision making. Then another Darfur rends my heart. I don’t mean to address the prudential, utilitarian calculus, but rather the question: if there’s a good chance that we could make things better, should we? And under what circumstances?

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And On This Topic -

John McCain gets my vote.

What exactly is the problem with the American health-care system?

The problem is not that Americans don’t have fine doctors, medical technology, and treatments. American medicine is the envy of the world. The problem is not that most Americans lack adequate health insurance. The vast majority of Americans have private insurance, and our government spends many billions each year to provide even more.

The biggest problem with the American health-care system is one of cost and access, and as a result tens of millions of individuals have no insurance. For example, we currently spend for about 2.4 trillion dollars a year on health care. A decade from now that number, under current projections, will double to over four trillion dollars.

The Obama and Clinton response to these problems is to promise universal coverage, whatever its cost, and the massive tax increases, mandates, and government regulation that it imposes. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We’ll have all the problems, and more, of private health care — rigid rules, long waits, and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

I have a different approach. I believe the key to real reform is to restore control over our health-care system to the patients themselves. To that end, my reforms are built on the pursuit of three goals: paying only for quality medical care, having insurance choices that are diverse and responsive to individual needs, and restoring our sense of personal responsibility.

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Why White People Like Free Health Care

Yet another reason to read Steve Newton, you discover blogs with stuff like this on it:

But the secret reason why all white people love socialized medicine is that they all love the idea of receiving health care without having a full-time job. This would allow them to work as a freelance designer/consultant/copywriter/photographer/blogger, open their own bookstore, stay at home with their kids, or be a part of an Internet start-up without having to worry about a benefits package. Though many of them would never follow this path, they appreciate having the option.

If you need to impress a white person, merely mention how you got hurt on a recent trip Canada/England/Sweden and though you were a foreigner you received excellent and free health care. They will be very impressed and likely tell you about how powerful drug and health care lobbies are destroying everything.

Though their passion for national health care runs deep, it is important to remember that white people are most in favor of it when they are healthy. They love the idea of everyone have equal access to the resources that will keep them alive, that is until they have to wait in line for an MRI.

This is very similar to the way that white people express their support for public schools when they don’t have children.

Actually, the first paragraph for the first time made me wish we did have free health care!

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Surgery on the Middle Man

We all expect to eat – but we don’t get insurance to guarantee food.  We all need various sorts of transportation.  But, other than some insurance to cover the value of a valuable vehicle, we don’t need insurance to make sure that we can get around.

Why then, do we need health insurance for routine exams, medications, doctor visits and the like?

Jonathan Kellerman, professor of pediatrics and psychology at USC’s Keck School of Medicine asks some insightful questions and provides some well grounded and thoughtful answers.

Insurance is all about betting against negative consequences and the insurance business model is unique in that profits depend upon goods and services not being provided. Using actuarial tables, insurers place their bets. Sometimes even the canniest MIT grads can’t help: Property and casualty insurers have collapsed in the wake of natural disasters.

Health insurers have taken steps to avoid that level of surprise: Once they affix themselves to the host – in this case dual hosts, both doctor and patient – they systematically suck the lifeblood out of the supply chain with obstructive strategies. For that reason, the consequences of any insurance-based health-care model, be it privately run, or a government entitlement, are painfully easy to predict. There will be progressively draconian rationing using denial of authorization and steadily rising co-payments on the patient end; massive paperwork and other bureaucratic hurdles, and steadily diminishing fee-recovery on the doctor end.

Some of us are old enough to remember visiting the doctor and paying him/her directly by check or cash. You had a pretty good idea going in what the service was going to cost. And because the doctor had to look you in the eye – and didn’t need to share a rising chunk of his profits with an insurer – the cost was likely to be reasonable. The same went for hospitals: no $20 aspirins due to insurance-company delay tactics and other shenanigans. Few physicians became millionaires, but they lived comfortably, took responsibility for their own business model, and enjoyed their work more.

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The Sickening

Cuban medical facility
A Cuban medical office with a sign reading “No prescriptions available.” Photo by: Dr. Darsi Ferrer [via The Real Cuba].

News of Fidel Castro’s retirement has elicited some interesting responses. Chris Bertram’s has to be one of the most arrogant and least informed:

So let’s hear it for universal literacy and decent standards of health care. Let’s hear it for the Cubans who help defeat the South Africans and their allies in Angola and thereby prepared the end of apartheid. Let’s hear it for the middle-aged Cuban construction workers who held off the US forces for a while on Grenada. Let’s hear it for Elian Gonzalez. Let’s hear it for 49 years of defiance in the face of the US blockade. Hasta la victoria siempre!

Bertram is being purposefully provocative with his post, which is what makes it so arrogant, but he’s doing so based on leftist myths, which is why it so misinformed.

The wonderful Cuban health careCuban hospital and education systems are shibboleths of Castro apologists everywhere. For example, film provocateur Michael Moore used the health care myth to agitate for socialized medicine in his propaganda piece entitled Sicko. However, as is the case with propaganda, reality begs to differ:

One of the greatest fallacies about the so called ‘Cuban Revolution’ has to do with healthcare.

Foreigners who visit Cuba, are fed the official line from Castro’s propaganda machine: “All Cubans are now able to receive excellent healthcare, which is also free.” But the truth is very different. Castro has built excellent health facilities for the use of foreigners, who pay with hard currency for those services.

Argentinean soccer star Maradona, for example, has traveled several times to Cuba to receive treatment to combat his drug addiction. But Cubans are not even allowed to visit those facilities. Cubans who require medical attention must go to other hospitals, that lack the most minimum requirements needed to take care of their patients.

In addition, most of these facilities are filthy and patients have to bring their own towels, bed sheets, pillows, or they would have to lay down on dirty bare mattresses stained with blood and other body fluids.

The facilities available to most Cubans are nothing like the ones featured in Sicko, and the “free health care” is not really worth much. [See what real Cuban health care looks like after the jump] (more…)

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Errors in Modern Gender

Alan Finch

Meet Alan Finch (). Alan became Helen Finch at 21, through sexual reassignment surgery…and then became Alan again when he was thirty. As you can see above, the results of his original surgery were extraordinarily effective. But Alan has decided he was misdiagnosed as suffering from gender identity disorder, and is now suing the clinic that treated him for “surgically mutilating” him. Alan claims what he needed instead was simple psychotherapy. While a tragic predicament, it’s abhorrent that someone should seek to punish physicians for what was clearly an unforced free choice in a free society. Plus…I do get the nagging feeling in looking at Alan’s photographs, that we may be hearing from him again in ten years, suing his psychotherapist.

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Private health care comes to Sweden

Why? Because people are fed up with waiting for care and a health care bureaucracy with no incentive to improve:

Waiting times for medical care in Sweden are the longest in Europe, according to the Health Consumer Powerhouse, which analyzes health-care systems in the region. About 33,000 people had been waiting more than three months for surgery or other major treatments at the end of August, an increase of 43 percent from May, a report by the Swedish Association of Local Authorities and Regions showed.

Critics of Sweden’s welfare model say there are no incentives for hospitals to improve efficiency. Oscar Hjertqvist, director of the Health Consumer Powerhouse, likens the current system to a bad restaurant getting government funding.

“In Sweden, you would get paid just to have a restaurant, but there would be no requirements that people should get any food,” said Hjertqvist, whose group has offices in Brussels and Stockholm.

The reaction of the Swedish left to people using private care?

“The new hospital for the children of the upper classes is a mockery of the most fundamental values of the Swedish system,” said Lars Ohly, leader of the Swedish Left Party. “Care should be given based on needs, not wallets.”

Of course, he doesn’t want to merely express this opinion, but deny people the right to seek alternatives to the state run system. McQ has more.

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Hanging Out in the TMC


Yeah, that’s me after a few too many cocktails in the hotel lounge. As Lance related, I’m in Houston in the Texas Medical Center (TMC) visiting my father who recently had an internal defibrillator put on his heart. The surgery went remarkably well and he seems more lively than when he went under the knife on Thursday, but he’s trapped in the bureaucratic waiting-for-approval world of hospitalization that feels like standing in line at the DMV…only with your ass hanging out of a gown. Thus my mother and I keep him company during the day and sit starring at the hotel walls at night. I decided to start obliterating the time with vodka this evening, thanks to the encouragement of the medical-student bar staff who have seen this all before.

As always when I’m here, I’m struck by the bizarre experience of this health care city (and I’ve unfortunately been here a lot with Dad’s ongoing heart problems). The TMC is the largest medical district in the world, with one of the highest concentrations of hospitals, clinics, research centers and doctors anywhere (photo of the TMC’s rows and rows of hospitals). Just looking out my hotel window I can see the Texas Children’s Hospital, St. Luke’s Hospital, the Methodist Hospital, the MD Anderson Cancer Center, Baylor’s College of Medicine, Ben Taub Hospital, office tower after office tower of medical offices, research facilities…and seemingly perpetual construction for even more. There’s a boutique across the street for designer scrubs (the official uniform of this city-state) and almost every store/cafe/bar has a somewhat medical theme or is named after a famous surgeon, doctor or whathaveyou.

It’s a highly Ballardian place, full of sanitized winding corridors to nowhere, sterilized corporate conformity, multi-million dollar ugly sculpture, startlingly advanced high technology, foreign doctors nabbed from the world over, meticulously manicured lawns, smiling receptionists in vivid eyeshadow…and just beneath the surface –infecting the place with its sole purpose– life and death. Think Super-Cannes for physicians.


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A New Nigerian Shakedown

cigarettes and ash tray
(photo: Jonathan Boeke)

The latest 419 scams aren’t the only nuisances for American businesses emerging out of Nigeria this year. Using the vast archive of documents made public during the 1990s epidemic of class action lawsuits against tobacco companies, Nigeria has decided to get in on the gravy train. The BBC is reporting today that Nigerian prosecutors are seeking an astronomical $44 billion in damages against American and European cigarette makers, for the costs supposedly sustained by their health care system. To put this allegation in some perspective, that’s approximately 43 times the entire 2007 Nigerian national health budget.

The government seems confident enough though, describing the tobacco companies as “dead on arrival” in court. I don’t envy the firms after hearing such definitive assessments from the state. In May of last year when prosecutors were beginning work, 23 Nigerian judges were removed from the bench on charges of bribery and corruption.

For Nigeria it would be an interesting approach to federal revenue diversification. Presently the country derives 80% of its fiscal budget from oil exports. At 2007 levels of expenditure victory in this suit could finance the entire Nigerian state for three years.

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