Tuesday, June 14, 2005

Gassy Communists, Hatin' Socialized Medicine (redux), and Wacky Nigerians

I am back and scatterbrained. However, in my absence, such nuggets of goodness have accumulated in the browser and inbox that I have much to share. Thanks to April and the Scrivener especially. While I was narrowly focused on the trivia of local landscapes, the international world blazed with interest.

1) British expats who've retired to the cheap, sunny eastern coast of Spain are losing their patience for being repeatedly gassed in their homes and robbed by feuding international criminal gangs while unconscious. Do tell. Vigilante patrols are the result. (Registration to the Telegraph may be necessary to read this, but the process isn't too intrusive and worthwhile since their content is reliably provocative.) Do you think that Europeans might ever become concerned enough with the condition of their own communities that they stop ignoring decay or fainting into the spindly arms of the Barney Fife-like state at every sign of lawlessness?

2) Since you've already registered, you can read this piece by Mark Steyn on the fascinatingly and innately camoflaged nature of Chinese society and how the Communist Party may yet puncture the illusion of the industrial powerhouse. This reminds me of a friend from Hong Kong who described to me how schoolgirls from the wealthiest families had special silks and even fur sewn into the linings of their uniforms. The richness was for secret and personal delectation, not public knowledge. This canny reticence about revealing the true nature of things is inculcated from childhood, and only underscores how confident prediction about the future of this world power defies the prudent.

3) HA! And HA again! It's unkind to dwell on I-Told-Yous while people suffer needlessly, but I applaud the Canadian Supreme Court's landmark decision slamming their national health care. George Zeliotis of Quebec, a patriot in my view, was denied replacement of a painfully arthritic hip for a year (shades of Sweden's Prime Minister anyone?) and was also informed that it was illegal to leave the coutry for health care or to pay for surgery through private insurance. Instead of quietly skirting the system as so many do- including Canada's Prime Minister who visits a private clinic- Zeliotis took a stand and sued. Canada is the only nation besides Cuba and North Korea to ban private insurance. You'd think the company alone would give the Canucks pause. Noting the deficiencies of quality and timely treatment endemic to their system, the court determined that "access to a waiting list is not access to health care." Three of the seven judges actually wanted to declare the entire national health-care system unconstitutional. This is progress.

As an exercise in contrast, read Michael Barone's article about how in the current American marketplace, HSAs (Health Savings Accounts) are being rapidly adopted by businesses despite Congress' impotent wrangling over absolutely everything. I suppose we should be grateful that while they're deadlocked, they can't make anything worse. Meanwhile, affordable, self-directed health coverage, especially for serious conditions, is quickly and measurably increasing for Americans while overall costs have begun to drop.

4) What would a newscast be without ending on a wacky kicker? In that spirit, I give you an international update from Nigeria where local businesspeople attended seminars at the new Abuja Sheraton ("the running water was a nice touch!) to enhance their effectiveness in e-mail marketing. Topics included:

Are 10 Million e-mails a day Too Many?
Grammatical Errors: What's the Optimal Number?
The effectiveness of using all UPPERCASE letters

With a continental breakfast of two slices of bread, a hard-boiled egg, and a cricket, this five-star event was a slam dunk. More details here.


April said...

Please tell me how "actual" healthcare costs have dropped when my "actual" healthcare costs went up 12% last September? This was an "actual" 12% less on my paycheck.

If "actual" healthcare costs are going down...why is GM currently negotiating with the UAW to have the members pick up more of the healthcare cost? Why did a spokes- man for GM say yesterday that the biggest problem facing American corporations is rising healthcare costs for it's workers?

I have friends who live in Canada...and their healthcare needs are met quite nicely...from childbirth to dental to coronary bypass. No wait, no muss, no fuss.

I guess it depends on the priorities...do you want to spend $10 bill a year propping up Isreal? Forgiving tens or hundreds of billions of debt to Africa? Another $220 bill a year on a stupid war in Iraq? Or do you want to take a PORTION of that money and prop up your very own citizens?

45 million plus Americans have no health insurance what-so-ever. Them's the facts. My own boyfriend doesn't have ANY healthcare.

Whereas..here in Amurrica the allegedly Great...I have been turned down for healthcare because I couldn't pay. Unless I went to Cook County Hospital..where I had to wait DAYS for INADEQUATE and BS healthcare. Or, I could have gone to an ER, and bleed the system...if they would take me. ER's often dump indigent patients on other ERs.

You neglected to mention how long someone in America who didn't have health insurance would have to wait until they got their painful hip replaced. The answer is: they would have to wait until their next life, when they were re-born young and free of creaky hips.

In Canada, you're put on a waiting list...In America, you're put on a go to hell list. Sorry...I'm totally in favour of National Health Care.

Henway Twingo said...

Thanks for the juicy response, and I think you raise lots of interesting issues. I outlined my broadest objections in my original socialized medicine post http://senseofsoot.blogspot.com/2005/05/sharin-hate-of-socialized-medicine.html

I disagree that one person's rise in costs means they're going up for everyone, but part of GM's health costs are the aging of their entirely subsidized retirees, and the structure of much union-mandated health care (which is bankrupting their employing companies) includes items that people might not select if paying themselves.

A big problem with employer or union or state selected, not self-selected coverage is that it doesn't fit. A young family might be willing to pay for HMO type coverage for immunizations and children's check ups, dental, vision, etc. But a single, healthy person might opt to pay less for simply catastrophic coverage and pay for occasional costs out-of-pocket. By putting health dollars into your own account that follows you for life and by encouraging the development of cooperative price bargaining for small companies and individuals, we could allow (at much lower costs than current) for people to pick the coverage they want and not lose it when their employment changes. But each person would still be in charge of his own health care decisions and that's my main issue.

I would agree in general we're talking about priorities, but what state should value our lives more than we do? I think the priority for personal good health should come from people not the state. Many people don't even consider budgeting or saving for their own health care and have become conditioned to think this most personal issue is the state's duty or their employer's duty. But it won't be their heinies on the line if I get sick- why should they make the decisions? Many people will happily bargain hunt and then spend their disposable income on a three hundred dollar pair of shoes or purse rather than six months of catastrophic care insurance. That reflects their priorities. Daily, people devalue their health care, because they don't see themselves as consumers who can shop the health marketplace for better prices and make choices for themselves.

We know that certain behaviors deteriorate health. If you put paying for your health in someone else's hands, the natural outgrowth is they will decide which risks you can take with their pot of money. (And it doesn't seem to matter how the money got into the system, once it's in the central kitty, it's theirs.) Recently, a Michigan employer mandated that all his employees quit smoking in order to get health insurance. Why should he bear the burden of their bad decisions, he thought? I understand it, but I don't like it. I want people free to choose, even badly, and I don't want someone else telling me what is appropriate for my life or how I should behave. Putting decisions in individual's hands makes them more responsible and careful about them.

One of the commenters in my main medicine post argued that the current ER system IS already socialized medicine. In a way, perhaps, but I think of it as a final safety net. And I don't see why anyone who wants state-provided care would then consider using the ER "bleeding the system". You're a citizen who pays for the system. You can use it, I think.

Almost weekly there are new stories from nat'l medicine countries about deaths due to central management dictates or accounting principles or lack of central funds (like the children's hospital closure in England). There are painful and dangerous delays in treatment and inability to choose what kind of treatment you'll get, even if you can afford to pay for it yourself! But across America today, in every town, there are raffles and fundraisers and collections for people with unusually costly or tragic afflictions. Doctors, hospitals, charities, churches, and drug companies make donations of goods and services daily. This happens because our system is private and we can chip in where we see an opportunity. It doesn't happen in countries with socialized medicine, in fact it's usually illegal, but also the culture becomes conditioned to think that the state, not individuals, should help other people. So a system that was supposed to let everyone take care of each other has led to passivity and apathy while lots of people fall through the cracks just the same.

Meanwhile, the medical advancements are primarily generated from America where the chance to gain from your efforts and investment encourages people to innovate. I haven't met a single foreign physician who hasn't said that the best medical training and service is available here. People want artificial hips because the products and process is so good now. That development has been happening here, and has been greatly accelerated by the capitalistic field of sports medicine. Taking care of pampered pony athletes has led to advancements that now help arthritic, working-class grandmas.

For sure, some Americans currently get subpar or no care, and I think that situation can be helped by allowing HSAs and stocking the accounts with starter funds for the indigent. But I believe socialized medicine would result in worse care affecting more people, not to mention the bloated, inefficient, and corrupt bureaucracies that always seem to develop around centralized honey pots of public funds.

April said...

I was happy to pay the extra 12%..I have excellent health insurance, I need it, and I feel VERY fortunate to have it. So many people I know don't. They go to cook county. Bleeeeeaaaaaaaaugh.

But..what happens when your private healthcare dollars run out? You're left to die on the street? I don't like Social Darwinism...we're supposed to be better than that. Otherwise, we may as well all be either cats or mice.

My insurance fits me fine. I agree that young, healthy people should be able to opt for "hit by a truck" health insurance, i.e., the insurance is really only useful if you get hit by a truck or something major like that. I also believe when you are employed for 20 or 30 years plus at a company that promises life-time health benefits...that promise should be honoured. Companies shouldn't make promises they can't keep/have no real intention of keeping. I've often found companies to be more concerned with their shareholder's returns, than they are with their employee's well being.

I had the "hit by a truck" variety insurance when I was in a horseback riding accident. It took care of most of the bills. I was still stuck with a $3000 dollar hospital/doctor bill, which, on my salary, was very difficult to pay off. It was a good thing, I was glad to have that 80% covered..but now I need more.

My health insurance costs go up about 10% a year...and the same happens to everybody I know, those who are lucky enough to have insurance...so I think healthcare costs ARE actually rising every year.

The Insurance companies over invested heavily in the stock markets in the '90's...and were too stoopid to get out before the bubble burst, and they lost their behinds. And we're all paying the price now. That's what the whole tort reform thing is about, too, IMO.

I don't know anybody who works for a company that doesn't offer a health insurance plant that can afford to buy one on their own. I know mostly low wage musician types, as you know. I don't feel that they're failures in life.

I feel it is the state or nation's or employers duty to insure my health. It's a moral AND financial issue, IMO. After all, if I'm healthy, I can show up for work everyday, make money, buy things, pay taxes on my purchases, and pay payroll taxes, too, which help fund a myriad of other things I would prefer not to fund. If I'm dead...I'm not earning, and I'm of no use tax dollar-wise. April