Thanks for pointing out we aren’t getting the NHS system (which is true has its own problems). The right wingers always point to the NHS because it is probably the least good universal healthcare system. That of France and Switzerland are much better, but they never tell you that.

NHS in the UK might not be the best, but an NHS level of health care would be a big step up for most people in the US. Besides, we’re Americans. Why can’t we remember that. We did the Marshall Plan at a time when we were in great debt and thus stopped the spread of Soviet influence. We went to the moon. Surely we can some up with a reasonable single payer system. We once led the world. Will we now decline into insignifigance?

And as Michael Moore pointed out in Sicko, the UK was able to establish the NHS in the face of uge WWII debts and decolonization. Surely we could do just as well.

There are some great models for publically fnded health care in the US. The VA was incredibly efficient and did not leave anyone with inadequate care until its funding wasn’t raised to cope with returinng Iraq war vets. Some local Medicaid programs like Harris County Gold Card are pretty good. I used to have a Gold Card until I started making better money.

All I’m tryin to say is “Yes We Can!”

I await the Churchilling-up by the wingnuts:

“American healthcare is the worst system ever, save for everything else.”

PS Ring the bell for another Kinsley gaffe. The man ought to be getting royalties.

And this has always been the GOP’s real objection to universal healthcare. It doesn’t matter whether it’s good for the people, if it’s good for the Democrats, it must be destroyed. Party over country every time.

Bacopa, single payer is just off the table right now.  Part of the problem with the discussion, I’ve found, is that most conservatives believe that we’re arguing about single payer.  I bet we could take a lot of piss out of the opposition if we could just get even 15% of people in a panic about “socialized” medicine to just read the fucking plan.

Bacopa—I don’t want to hear any complaints about how we can’t afford it from people who are putting us on the hook for $7 trillion dollars to bail out the financial industry from the consequences of Republican deregulation policy.

And of course, rational, universal health care would go a long way toward solving the country’s economic problems

But it does help to point out that 45% of Americans are already covered by public health care.

This is not change we can believe in. Not if Robert Rubin or his protégé, Lawrence Summers, get to call the shots on the economy in President-elect Barack Obama’s incoming administration. Both Clinton-era treasury secretaries deserve a great deal of the blame for the radical deregulation of the financial industry that has derailed the world economy. They both should, along with former Federal Reserve chief Alan Greenspan, perform rites of contrition and be kept at a safe distance from the leadership of our nation.

from The Nation, Nov 19 2008, by Robert Scheer

Seems that not all deregulation is the fault of the republicans.

Yes, the NHS would be an improvement, but we can do better than it. One of the “advantages” of starting late is we can learn some of the pitfalls and advantages of various systems.

“Kinsley”??  Where’d he come into it?  (He’s only mentioned once on this page--???)

Do you have a point, Marie?

On the top of her head, perhaps.  Maybe Obamacare will fix that.

“Blocking Obama’s health plan is key to the GOP’s survival.”

Motherfuckers.  Could they be more clear that they don’t give a shit about anyone except those rich enough to pay for doctors out of pocket?

Killing the middle class is the key to the GOP’s survival...except that it isn’t.  You would think they would realize, like the real Marie Antoinette, that when there is no safety net and the bottom rung of society is pathetic, that the proletariat riot and bring out the guillotines.

Bring it on, GOP.  Keep holding tight to your social conservatism and fuck all y’all I got mine idealism.  No reason to behave as if we were all created equal or entitled by birth to life, liberty, and the pursuit of happiness.

Bacopa—I don’t want to hear any complaints about how we can’t afford it from people who are putting us on the hook for $7 trillion dollars to bail out the financial industry from the consequences of Republican deregulation policy.by Redshift

Just another viewpoint.

In order for them to get rid of universal health care once it is established, they would have to do the same things they have been doing for the last two decades with social security, medicare and other social programs. They lie to pass legislation to cripple social programs and hope to eventual leave them so gutted that no one cares when they are ended.

Frito touched on my point, which is that the conservatives have, if nothing else, learned the lessons of Medicare and Social Security--if you really oppose a program, you have to kill it in the earliest stages, because if even a pilot program gets a toehold in the American consciousness, it’s over. You’ll have it forever. That makes me happy, because it seems to me that some sort of universal plan is nearly inevitale now. Businesses can’t sustain their current health care costs and stay viable. Hell, I’d like to see some enterprising Congresscritter tie the Big 3 bailout to health care reform--dump that fucker in their laps and see how quick they jump at it.

Lets face facts: many of the Wingnuterria already know somebody or have themselves lived through the consequences of our fucked up health care system.  The first time they or somebody they love DOES NOT have to deal with the mess is the first time they will see the light.

I love how the Rethugs are so bloody messed up that they don’t even mince words on searchable media about this - hurting people is the key to their party survival.

What fascinates me about this is how thoroughly it showcases the GOP’s failure of imagination. If republicans weren’t such assholes, they’d recognize that universal healthcare (in addition to be pretty damn profitable for a lot of big companies) could also be a springboard for a long list of social changes they claim to want. Entrepeneurship can flourish at all levels when people aren’t betting their own and their families’ lives on the results. Defensive medicine and stultifying product-safety regulation start being less attractive when everyone knows they’ll get care without spending years in court. Even wages and job security stop being such killer issues when health care just happens instead of being tied to a limited class of jobjob or a higher-than-median income.

But no, the GOP has decided they’d rather be rich in a third-world country than slightly-less-rich in the civilized parts of the world. They’re taking the politics of resentment into the territory of the old scorpion-crossing-the-river story.

This Pethokoukis fellow has no idea what the “Investor Class” is, or what true fiscal conservatism is. He confuses the former with the Overpaid Greedhead Executive Class (including those who ran AIG ... into the ground), and the latter with supply-side fantasism and the MBA mindset that can’t or won’t look beyond the end-of-quarter numbers.

In other words, he’s a typical neoCon pundit who foolishly imagines he’s just like the people he covers and who sign his paycheques. It’s not far off from Joe the Plumber and his imaginary wealth.

In their desperation to protect their masters in public, courtiers sometimes overcompensate and let the uncomfortable truth out. This is one of those cases.

They’re taking the politics of resentment into the territory of the old scorpion-crossing-the-river story.

I expect I will be using this without attribution in my real-life discussions for many years into the future. Fair warning.

“I love how the Rethugs are so bloody messed up that they don’t even mince words on searchable media about this - hurting people is the key to their party survival.”

...or so confident in their ability to manipulate “low information” voters they aren’t concerned the truth will harm them…

Speaking as a huge single-payer advocate (in theory), there’s a crucial reason why single-payer is off the table.  Strange thing is, I’ve heard Obama say pretty much the exact same thing.

If you were going to design the best system from scratch, knowing what we know now, it would be a single-payer type system for sure. No ands ifs or buts. HOWEVER, what it would take, and I’m not talking just politically, but organizationally and economically to make a rapid switchover to a single-payer system would be incredibly destructive.

A good portion of the economy is built into the health insurance industry. To eliminate that industry basically overnight would be a massive economic and social disaster. That’s the reason why single-payer is off the table.

I expect I will be using this without attribution in my real-life discussions for many years into the future. Fair warning.

And here I was hoping to dine out on it into my dotage.

I feel a little sad for past generations of republicans—the current crop have done for the brand what the fundies did for the word “christian”.

Incertus wrote:

Frito touched on my point, which is that the conservatives have, if nothing else, learned the lessons of Medicare and Social Security--if you really oppose a program, you have to kill it in the earliest stages, because if even a pilot program gets a toehold in the American consciousness, it’s over.

As someone who lives in a country with universal* healthcare, albeit one which operates alongside private healthcare, this is sort of true. The electorate here are very attached to their healthcare system and the majority will not support any party with abolition in their platform. However, this has not stopped conservative (and labour to be fair) governments from whittling it away at the edges through insufficient funding, stupid planning decisions and outright bribing the middle class to get private health insurance. The private health insurance system here is very regulated (e.g. they cannot raise rates without getting permission from the government first).

So just saying, even if you get universal health care, you will still have to be vigilant to make sure it doesn’t get destroyed through stealth.

* all sorts of qualifiers in that, dental for example is not covered in my country.

True right-wingers never go away, even under democratic socialist regimes. E.g. in France, Jean-Marie Le Pen and Brigitte Bardot*. . . They just lose all rational basis.

* Ann Coulter Syndrome, cf. Sarah Palin, Atlas Jugs, Michelle Malkin, et al.

The issue here is fear: Conservatives want people to be afraid that a quirk of fate or genetics will ruin them. They want people to keep shitty jobs for the insurance rather than do stuff on their own. Or they’ll phrase it differently and say that running the risk of a bankuptcy-causing illness is part of the entrepreneurial spirit. Fear has a great ability to make people accept things as they are.

It’s Calvinistic: if you’re sick, being able to get good treatment is a sign of being among the elect; if you can’t, then you’re damned anyway.

Blocking Obama’s health plan is key to the GOP’s survival.

Which is one reason (of many) why blocking the GOP is the key to America’s survival.

Little-known fact: in the early 1960s, a greater proportion of Canadians than Americans attended church regularly, and the attendance rate in Canada was, if anything, rising. In 1964 universal health care was instituted, and at about the same time, church attendance began to level off. The next four decades saw the leveling turn into a catastrophic collapse, and now the number of regular attendees at religious services of any kind (not just Christian) is nominally 20% and tends to be closer to 10% when you actually count heads in places of worship. It wouldn’t even be that without first-generation immigrants.

Coincidence? Perhaps not, seeing the fate of religion in Europe as well. When pain, misery, and uncertainty lessen, the priest finds himself out of a job.

You get a Republican sounding that alarm every time we try to fix health care.  It was Bill Kristol back in 1993:

The Republicans knew in 1993 that they were not just engaged in a fight over health care but over the future of their own party. In a memo, conservative operative Bill Kristol warned Republicans that they had to “kill” rather than amend Clinton’s proposal. Its success “will re-legitimize middle-class dependence for ‘security’ on government spending and regulation,” he wrote. “It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle-class by restraining government.”

Last spring, my Republican mother comes home from a trip to Paris. I go to see her. We have an argument about Hillary (whom she despises for reasons that were never clear) and I suggest that if Clinton’s elected, we’ll at least have decent universal health insurance. “Are you kidding?” says Mom,"Public health care? It would be horrible! Filthy! Long waits! Incompetent! Ghastly! A huge suck on the public economy!” (I’m paraphrasing.)

I ask about her trip. “Oh, it was wonderful. We walked all over--but then I slipped and twisted my ankle.” How was the French medical service? I ask. “Fabulous! An ambulance came right away, they took me to this beautiful hospital, found me an English-speaking doctor, X-rayed my ankle, wrapped it in some high-tech splint, gave me some pain meds, and sent me back to the hotel with your stepfather.” I ask about the cost.  “Free . . . and don’t say it. I still don’t like Hillary.”

Molly, is your mother delusional?  How big does the cluestick have to be?

Universal healthcare frees employees to quit and start their own businesses - particularly older people, who are most likely to succeed in the attempt as they have more experience. And there’s nothing big business hates like small businesses.

Eric, I suspect that La Mére de Molly thinks that the French still owe her one for what Americans did during the war.

But, like I said, the impulse is primarily Calvinistic: access to healthcare is taken as an index of worth and worthiness in the US, and if you end up in medical-bill-induced bankruptcy, then you probably weren’t worth shit to begin with, so there. Fear is a great controller, as the last eight years—in particular, the insanity between 2001 and 2004—have proven.

It seems to me that there is a common misapprehension in America that private health care has been abolished in countries such as Britain and France. Nothing could be further from the truth. Private health provision and insurance flourishes in both countries, and makes vast amounts of money for the insurance companies. The point is, you don’t need it to survive. Four categories of people go private:

1. Seriously rich people, who probably believe they’re middle class but in fact earn 5 x the median salary, and can afford the premiums without noticing. These, I imagine, correspond to those Americans who can’t see where the present system is broken;

2. People who get health insurance as part of their remuneration package from work. A few companies offer this as a status symbol, which is welcomed by the sort of people who work for them, who are all about status symbols;

3. People who have savings and want to jump the queue as a one off. If you’re critically ill, you don’t queue (I was admitted for heart surgery within 15 days of being referred for preliminary tests), but conditions can be seriously unpleasant without being life threatening, and people occasionally judge it worth while to use their savings to get an intervention now, rather than in 3 months time;

4. People who want non-essential treatment. In the NHS, there isn’t much that isn’t covered, but if, for example, you have no injury or respiratory problems, but want a nose job because you want your nose to look like [insert film star here], you can pay for it yourself.

So there’s plenty of room for private practice. Most consultant physicians/surgeons in the NHS make huge sums doing private work on the side. But the NHS offers a fairly reliable, stripped down solution for most problems, good enough that the middle class are generally happy with it, whine though they will. And everybody benefits from that.

I retired to a small country in Europem10 years ago. I am on their health care system. I contribute about $80 U.S. a month as I am not a citizen but a permanant resident. The medication I use would cost me double that in the U.S. I have had quite a bit of dental work done which depending where I lived would have been between 3 and 5 thousand dollars, cost to me here 0. The care I have recieved has been excellent, the Doctors are first class as is the dentist I go to. The system is not perfect but it is sure as hell is better than what the U.S. has now. One thing I don’t have to look forward to is bankrupcy if I get a serious illness.

The issue here is fear: Conservatives want people to be afraid that a quirk of fate or genetics will ruin them. They want people to keep shitty jobs for the insurance rather than do stuff on their own. Or they’ll phrase it differently and say that running the risk of a bankuptcy-causing illness is part of the entrepreneurial spirit.

Bingo. If the Republicans really cared about the “entrepreneurial spirit,” they’d take the significant burden of benefits administration off the backs of business owners and simultaneously increase the ability of employees to be free economic agents.

But that’s not the real agenda of the neoCons: they’re crony capitalists and promoters of the Human Resources Culture, which means they want to preserve barriers that favour incumbent corporations and long for the days of the company town. Universal basic healthcare is a huge threat to their dream of returning the economy to Gilded Age conditions.

I wish that when people write about the situations in the country they live in that they would identify the country.  It would be really helpful.

Getting decent health care is a problem in this country, the USA, even with health insurance.  You can wait for hours if you have to go to the emergency room, doctor’s offices are overcrowded and the HMO’s have so many restrictions and deny so many charges.  Health insurance costs go up and the policies cover less and less every year. 

We need a real national health care plan.  Maybe the O’bama plan is a good start, but as long as we continue to insist that the health insurance companies be included we’re still just throwing money out the window.  Some things should be nationalized and one of them is health care.

Of course, that’s both an unbelievably callous attitude, but more to the point, it means that most of us are on the short list of “better off dead than clogging the hospitals”.

Except actually this “short” list is a very very long list. Which is your point, Amanda…

Sorry I’m doing this random posting-and-running w/o reading the comments first, but I had no Net access last night and now I’m running late for work.

But the general point of Amanda’s post, more general even than healthcare, is how reactionary “talking points” must rely on sheer rhetorical deterrence, because their policy positions, especially when they are actually being “conservative” in the sense of keeping something we’ve been doing a long time or forever (like having as little socialized medicine as possible, or forbidding gay marriage, or the like) really don’t make sense on their merits.

And so, even their rhetoric itself has long departed the realm of common sense and relies extensively on sheer conditioned reflex.

So I am reminded of a guy on Thom Hartmann yesterday, who was denouncing Thom for wanting to raise the standard of living of working people lowest on the economic rung. First he said “you can’t build a pyramid from the top down,” then when Thom rephrased that as “so the rich need to oppress a lot of poor people to be rich?” he started to rant about Sweden.

Did he rant about high rates of alcoholism (which can better be attributed to climate) or how poor put-upon entrepreneurs and other odd people feel all oppressed and limited by a culture of egalitarianism (which is something I’ve heard from several emigrants from Sweden)? Nope, he was verbally rolling his eyes at those stupid, despicable Swedes because they only work four days a week!

Well, I doubt that can be true of all Swedish workers--but good for the ones who can swing it, I say, and great for Sweden if indeed they have lowered the workweek to 32 hours.

But it just cracks me up that he said that like it was a bad thing!

I’d love me a 32 hour workweek. What’s wrong with these people, that they think that’s a good rhetorical blow to strike when speaking to an audience that includes working people?

As I say, now I’m running late for work…

Great, let’s put it through! If having affordable healthcare for all means more liberal-leaning people in America, then that alone is a good enough reason to have it. It’s like a 2 for 1 sale. You get inexpensive healthcare for all, PLUS, they throw in a bonus of making America lean more towards where the rest of the civilized world is leaning.

The way the “investor class” has ruined America, they deserve fewer friends.

Gracchus:

Just curiosity, but Gaius or TIberius?

So, if a universal coverage system is really great because it will give the party which passed it a long-standing congressional majority, why didn’t the Republicans pass one during the six years in which they controlled both Houses of Congress and George Bush was president?  That way, the GOP copuld have taken complete credit for the whole thing.

If that was the Republicans’ real objection, they had every chance to lock in a long-term majority.

Count me as another American expatriate that is thrilled with “socialized” medicine.  When I first moved to the UK, I got really sick and ended up going to the emergency room.  They hospitalized me for 3 days to do tests and keep an eye on me.  I was worried about how I was going to pay for it, because I’m not a UK citizen (yet) and so I don’t have a national insurance number.  I also am unemployed and have no health insurance.  I hesitantly asked the nurse about it one day during my hospital stay, saying that I was really worried about it, and was there any way to find out how much I was going to owe?  She looked at me like I was crazy.  After I told her about how it works in America, she thought the United States was crazy.  She said, “How can you charge people for getting sick?!”

As it turned out, the tests showed I needed to get surgery.  Once again, during the surgery, I got the best of medical care and spent 3 days in hospital.  I saw the doctor twice for after-care.  And get this!  in an ill-advised attempt to get back to normal too fast, I ripped one of my incisions doing housework.  My husband called NHS 24 (the 24-hour talk-to-a-nurse line) and they sent a couple of nurses to our house to check me out and re-close the wound!  At NIGHT!  They have HOUSE CALLS here, people!!!

I have yet to hear a single thing about paying, owing money, insurance, or anything like that.  They fixed my problem, and that’s it.  Nothing more to talk about.  That’s just how they roll at NHS Scotland.  If any of my American relatives or friends came to visit me here and (god forbid) got sick or had an accident, they would get free healthcare too.  They see it as a human right here.  You don’t have to worry about whether you’re going to go bankrupt if you need medical care.  Also, the Scottish NHS is now making prescription medications free.

After experiencing all of that, all I can wonder is, “What the hell is wrong with America that we can’t seem to convince people that nationalized healthcare is a good thing?”

So, if a universal coverage system is really great because it will give the party which passed it a long-standing congressional majority, why didn’t the Republicans pass one during the six years in which they controlled both Houses of Congress and George Bush was president?

Because, Dana, Republicans are fanatical believers in the cult of Republicanism. It’s much like asking why southern segregationist Democrats didn’t support voting rights and civil rights for blacks in the 20th century. In part because they were fanatics, and in part because their voting base depended on not doing it. Dana, if the Republicans passed universal health care, die-hard Democrats like myself would probably still support Democrats for other important reasons (eg, torture, the war, the economy, etc), while you would throw a temper tantrum and begin a fanatical crusade along with the chamber of commerce to condemn and defeat any Republicans who supported such a thing, which would then likely alienate the middle class voters who would have otherwise been inclined to thank and be loyal to the Republicans for doing them a big favor.

So, there: the reason Republicans wouldn’t support universal health care? You, Dana. you are the reason. And, by extension, you are the reason that the Republicans today are a maligned party in the minority, having faced stinging defeats in Congress and the presidency.

The thing is, Molly, because of people like your mother (or mine) who freak out about any progress in the right direction, we won’t be getting anything like the French have.  In fact, what kills me is that for most Americans---especially people comfortable enough with their own insurance they can afford to be babies about this---things won’t change much at all.  For those of us who will get security, we still have to pay for our insurance, and of course for all those things insurance doesn’t cover.  What will we get is the chance to have insurance. 

I wish we were getting national health, but not even close.  We’ll be lucky if we get insurance.

Dana, abortion rights are wildly popular, but Republicans won’t stand for that.  I know---it’s really, really, insanely, nosebleed-causing hard to do this---but think a little.  Maybe the Republicans are the party of a rich minority against a working majority, and they need to please their constituents?  I know, crazy.  Next I’ll be saying that the Democrats can’t throw black people under the bus because they’re part of their base, even though black people are, after all, a minority.

Or perhaps you think the Republicans could do great with absolutely no money at all?  You do believe in a god that hates women; you’ve opened yourself up to all sorts of ridiculous fairy tales.

We have to stop being so willing to settle for less.  We should keep replacing our legislators until we get some who will give us universal health care.  It can’t happen overnight, of course, but we need to work on it.  There’ll be mid-term elections in two more years.

Just curiosity, but Gaius or TIberius?

More Tiberius—as you’ve probably surmised from my comment, I’m not a fan of the latifundia in any form. There are elements of Gaius, too—especially in re: the middle class. There are other reasons for choosing the monicker, but I’ll leave it at that.

stultifying product-safety regulation

Damn those people who insist on cars that don’t explode!  And their greedy trial lawyers*, too!  They’re stifling critical product innovation in the explosive-car industry!

*Actually code for “tort plaintiffs’ lawyers”.  Every trial has a lawyer on *both* sides, but only one is a Trial Lawyer trying to destroy America.  The fact that a tort plaintiff’s lawyer, pretty much by definition, cannot possibly be involved in a case unless someone has *already* been injured by someone else’s carelessness and/or malice has no impression on people calling for the heads of “trial lawyers”.

Chris, for some reason almost everyone can understand the need for government protection against muggers and bank robbers, but for some reason conservatives can’t see the need for people to be protected from companies that maim and kill with their products.  It’s one of those brain glitches that seem unexplainable to me.

Coincidence? Perhaps not, seeing the fate of religion in Europe as well. When pain, misery, and uncertainty lessen, the priest finds himself out of a job.

I think one of the fears about universal marriage is that it will result in clergy being stripped of their legal power to solemnize marriage.  Oh sure, people will still do the church wedding thing, but they make a pretty penny on the one-stop-shopping when people don’t also have to go to a civic authority to make it legal.

A good portion of the economy is built into the health insurance industry.

This is a very important point--a huge part of our national economy goes NOT to health care, NOT to research, NOT to prevention, but to an industry whose sole purpose is to interfere in the process of individuals obtaining health care and of other individuals in providing health care.

There is no logical reason for the current private insurance system in the US: all it does is suck money out of the transaction.  Americans pay twice as much per capita for much much less.

Don’t even try to go there about ‘waiting in lines’ or ‘can’t see a doctor of your choice’ or ‘bureaucrats interfering with doctors’--that the reality NOW for most INSURED Americans.

Right now?  Delta Dental, one of the largest and best reviewed dental insurance agencies, is going out of its way to avoid paying our claims.  My husband avoided the dentist for over a decade thanks not only to fear of dental procedures, but lack of insurance.  Now that he’s gone back and needed a root canal and the accompanying crown, Delta Dental is rejecting us in the most creative fashion!  They’ve switched his social security number and mine in their computers.  Not only do we show up as “ineligible” and “not covered”, but we can’t get through the voice mail to talk to a human b/c their system has crossed our information.

After finally getting through to a human, explaining how they had screwed up our information--that the error was on Delta Dental’s side, not my dentist, I was told to resubmit and all would be take care of.  I get 4 EOBs.  The first, with correct info, claims it was already paid.  The second gives my SSN to my husband.  The third invents a new birthday for me--now I’m born in March!--making me unknowable and ineligible.  The fourth gives my husband my ssn, my birthday, and MY LAST NAME.  As there is no such person in existence, this fictional person is ineligible and the claim is denied.

Yeah, I’ve kept my name.  He kept his.  So what the fuck? 

They don’t want to pay is the fuck.

---------

Dana, go read my first post.  Republicans are full of “I"ve got mine, fuck all y’alls” along with their Libertarian patsies who think that they are going to get their own imminently, so ‘fuck all y’all’.

Why would they institute national health?  They had to kill HillaryCare to preserve themselves once; their base isn’t going to understand an abrupt about-face.  Helping others, even if it helps you, is not part of the program (I’ve GOT mine--Fuck all y’all).  They’d rather live high on the horse in a gated community than forfeit a small percentage of their wealth to live in a 1st rate civilized nation.

Don’t even try to go there about ‘waiting in lines’ or ‘can’t see a doctor of your choice’ or ‘bureaucrats interfering with doctors’--that the reality NOW for most INSURED Americans.

One way or another, when it comes to medical coverage you’re always going to be dealing with a massive and frustrating bureaucracy. The only difference is, one bureaucracy serves at the behest of private shareholders whose primary concern is profit, and one serves at the behest of private citizens whose primary concern is maintaining their health.

Lines? When people stop using the E.R. as their and their kids’ G.P., it’ll more than make up for longer lines.

And physicians will be as happy as the entrepreneurs that they don’t have to carry a full-time benefits administrator on payroll.

I’m not claiming socialised medicine is perfect: there are several downsides. But over-all it beats what we currently have.

“There is no logical reason for the current private insurance system in the US: all it does is suck money out of the transaction.  Americans pay twice as much per capita for much much less.”

Caren, why is it so hard for people to understand this?  I try to explain this to people I know, and they have all these automatic responses against socialized medicine.

why is it so hard for people to understand this?

The biggest block I find in these discussions is the perception that private industry is more efficient and innovative than the government. That holds true for the majority of industries, but when we’re comparing a private bureaucratic middleman with a public one it just doesn’t stand up to examination. So it’s in the GOP’s interest to make sure it goes as unexamined as possible.

I’m not sure what the counter is—people who give the sort of automatic responses you describe aren’t really systematic thinkers to begin with. They have to experience the problems of the current system head-on (either personally or through a family member) before they start questioning it and wondering if there’s a better way. In that way, the path to universal healthcare in the U.S. has been more of a time-and-pressure process than anything else.

No discussion of nationalized health care is complete without bringing up the inarguable point that it is a whole lot cheaper than the American system.  So much cheaper that it makes a considerable difference between the dollar-per-hour productivity of American workers versus the productivity of European workers.  This is great for the American health care industry, and bad for every other industry we’ve got.  An American company, paying our exorbitant rates for employee health insurance, has to compete with European companies paying much less for health care that nevertheless delivers outcomes (e.g. life expectancy, infant mortality, patient satisfaction, etc.) which are as good or better than ours.

Here’s a good article by the Kaiser Family Foundation with charts (especially Exhibits 4 and 5) that make the cost difference clear.

Your healthcare system is THE reason I refuse to move to the US,despite the number of jobs available in my field. I’m middle class and mobile enough that your various anti-woman laws can be avoided, but no way in hell am I going from Canada’s free healthcare on demand to your torturous system of HMOs and denial of claims.
(Sent from my blackberry, so pls ignore spelling and grammar quirks)

I lurve the idea of single-payer, ever since I watched/read about the Clinton healthcare reform plan and thought “Well, why not just get rid of insurance companies altogether?” (I was a precocious child).  But I think the best kind of incrementalism is to expand all the publicly funded programs-- Medicare, S-CHIP, the VA, and hey, remember Medicaid?-- and expand preventive care, private coverage for young people, and disability coverage as well. And when hoisting up this new federal plan they’re going on about, decouple it from employment and make it so competitive that it drives private insurers out of business. I wonder what it would take to re-tool insurance companies to employ all their people as healthcare workers or industry administrators, instead of claims-deniers? We claim to be able to re-train our entire auto industry workforce every time we threaten to lay them off, so why not eliminate a useless sector and re-train its workers to do useful stuff, instead of the other way around?

G Porgy:  “...for some reason almost everyone can understand the need for government protection against muggers and bank robbers, but for some reason conservatives can’t see the need for people to be protected from companies that maim and kill with their products.  It’s one of those brain glitches that seem unexplainable to me.”

It’s because the free market will cause the producers of deadly products to go out of business, and a new company will form that won’t create deadly products.  I have a coworker who explained this to me.  When I pointed out that reality doesn’t seem to reflect this (i.e. poisonous fertilizers getting into groundwater) I was told that any flaws in this logic are because the market isn’t truly free.  Also, “it’s a conspiracy”.  The unfortunate death needed to demonstrate the product deadliness is ignored.

This from someone with a M.S. in engineering.

Whatever.  If it hadn’t been for FDR and the Dems, the area once known as the Dust Bowl would be completely uninhabited.  FDR saved the asses of the people who lived there despite plentiful evidence that that land isn’t fit for human habitation.  Now, that area (the western half of Kansas and the panhandles of Oklahoma and Texas) is among the most conservative areas of this country.

Additionally, rural areas and red states get much more in federal tax dollars than they pay in.  Yet, those parts of the country are very conservative.  You can count on Americans’ not giving credit where credit is due, especially when the government is involved.

And physicians will be as happy as the entrepreneurs that they don’t have to carry a full-time benefits administrator on payroll.

A while back I was watching an America channel and caught a commercial for some trade school and one of the diplomas they offered was something like medical accounting specialist or billing or somesuch.

And I thought at the time, and still do...that is totally fucked up.  When a country thinks it’s reasonable to need experts in dealing with medical billing, that country has some serious issues with its health care system.

When a country thinks it’s reasonable to need experts in dealing with medical billing, that country has some serious issues with its health care system.

How exactly do medical offices bill the government in single-payer systems? I’m virulently anti-American health system, but I’m not sure this isn’t at least a bit of a straw man.

I think one of the fears about universal marriage is that it will result in clergy being stripped of their legal power to solemnize marriage.  Oh sure, people will still do the church wedding thing, but they make a pretty penny on the one-stop-shopping when people don’t also have to go to a civic authority to make it legal.

Even (especially) the most liberal, secular Americans would never go for this. The reason is that it is a trendy thing these days in secular ceremonies for their best friend get registered as an officiant to perform the wedding. So as long as anyone can serve as an officiant to perform the civil functions of a wedding, clergy are going to end up retaining their status here. Quite the opposite from being a power grab on the part of the clergy, it would require a massive power grab on the part of the state to demand that only public employees can perform legal unions.

How exactly do medical offices bill the government in single-payer systems? I’m virulently anti-American health system, but I’m not sure this isn’t at least a bit of a straw man.

One of the things about the American system is that there is significant overhead dedicated to doing accounting and invoicing for lots of different insurance companies, all of which have their own standards, forms, and demands. In a single-payer system, all of this would be handled in an identical fashion.

How exactly do medical offices bill the government in single-payer systems?

In general, on the billing side it’s an additional duty of the secretary/receptionist/office manager. Since they’re dealing with only one insurer, and because coverage policy is consistent throughout the country or region, it’s considered a minor clerical task that doesn’t require a full-time dedicated staff member costing at least $35k a year.

The medical billing clerks in the US are dealing with at least 2 different insurance companies, with inconsistent policies within each company. It’s a big time and money sink, as any doctor will tell you.

“If it hadn’t been for FDR and the Dems, the area once known as the Dust Bowl would be completely uninhabited.  FDR saved the asses of the people who lived there despite plentiful evidence that that land isn’t fit for human habitation.”

I’d just like to point out that the area once known as the Dust Bowl was inhabited perfectly fine by humans for thousands of years before FDR or the Dems existed. Just because it doesn’t support commercial cropping doesn’t mean it’s uninhabitable by humans.

/derail

You pathetic LIEbrals always expect Big Government to save you, when you should be saving yourselves.  There’s no health problem that can’t be cured by eating wild berries and briars, so stop wasting my tax dullars on fancy-shmancy doctors that are just another DEMONcrap lobby group.

The efficient and effective delivery of tangible public goods and services will, of course, influence the public to accept these goods and services as good governance. This is why the establishment is so very much concerned with having a competent moderate Democrat as president.

Just so y’all know: My mother voted for Obama. She worked “men’s” jobs long before it was cool.  And the upshot of the Paris trip is that she’s mellowing on universal health care

Republicans are full of “I"ve got mine, fuck all y’alls” along with their Libertarian patsies who think that they are going to get their own imminently, so ‘fuck all y’all’.

Hey Caren!  I would have to agree with that, having been one of those Libertarian patsies about 10 years ago.  I absolutely resented paying Social Security taxes.  The way I figured, if I didn’t have to pay Social Security, I could put all of that money into my retirement accounts and be a millionaire in no time.  Eventually I grew out of it and embraced the idea of interdependence.

Caren, SBC of APs: I don’t know if this would work in your case, but a detailed letter (with names) to the CEO, with ccs to some of these people (and possibly a selected few of these people), with--and this is important-- something to the effect of: I hate litigation more than I can say, as I’m sure you do, but if this matter is not resolved, I don’t see that you leave us any choice. sometimes does the trick. Complaints are one thing, but everybody hates being dragged to court.

I don’t know if Delta has always operated this way, but for what it’s worth, suddenly coming up with screw-the-customer policies like this is usually a sign of impending bankruptcy. So if you’re going to threaten them with a lawsuit (remember, it’s just a threat at this point), do it soon, before they get those Chapter 11 protections.

I’d just like to point out that the area once known as the Dust Bowl was inhabited perfectly fine by humans for thousands of years before FDR or the Dems existed. Just because it doesn’t support commercial cropping doesn’t mean it’s uninhabitable by humans.

By that definition, there’s no land on earth that’s uninhabitable.  You can go by that definition if you prefer, but what I mean by inhabitable is: being able to subsist on that land and live on that land throughout the year, preferably with a minimum of deprivation.  People who inhabited the high plains before whites showed up did not do so throughout the year and were mainly there to stock up on food.

G Porgy for what it’s worth, the country I live in is Australia. And, as some others upthread have noted, the private system and the public system work alongside each other.

Auguste in terms of billing, as someone said above, it is a clerical function undertaken by the general clerical staff at a medical practioner’s. All billing is either a) an invoice provided direct to a patient (they pay and claim back from either the government or their health insurance or direct claim from their health insurance who then pay out to the health care provider) or b) a bulk claim to the government. Whilst there are many (many!) forms* and a range of consultation types which can be claimed, it’s more like billing in a legal office (saw client for x minutes for consultation type y = charge rate z). A small suburban General Practioner’s office with maybe 3 GPs will typically have only one clerical staff member.

* Forms are a product of large bureacracies both public and private, not an evil associated particularly with universal health care systems.

How exactly do medical offices bill the government in single-payer systems?

I’m not sure exactly how the money gets pushed around in the UK NHS, but I don’t think anything equivalent to billing happens here at all. The government owns the hospitals and doctors practices (although private ones exist as well), and pays the salaries involved. As far as I know, nobody is billed for any individual patient’s care, although hospitals and health care trusts obviously must prepare budgets and costings in order to get the correct amount of government funding overall.

For those who are interested I live in Croatia. We also have private working along side the publicl plan. I have on a occasion used private and just lets say the costs were very reasonable.

As a Brit and lifelong labour supporter (who’s right now wearing a brand new pair of Free NHS glasses) that Healthcare wont kill of the GOP.  From 1945 to 2000 the Labour party were in power for only 17 years.  All Atlee’s government did was introduce the NHS and shift the political centre slightly to the Left for 50 years.

The NHS was promised to the People as a reward for all their efforts and sacrifices in keeping the ruling class in place during the WW2 and winning it for them.  There was a genuine fear the the communists would take over the UK after the war and NHS was part of the unspoken “deal” to maintain the status quo.

Still, it is nice that left-wing and right-wing parties argue about who will support the NHS more