Thursday, August 20, 2009

Our Health Care System is the Best

...is I think what many of the commenters basically said in tearing apart my my post about Mark Steyn.

One back-and-forth in particular that I want to point out and respond to:

I said,
As for Anonymous' point that under a government-run system no one will be able to get a new hip even if they're willing to pay more, I'm not impressed. In the UK, you can still buy private insurance for better care if you don't want to go to the NHS. Wanna guess how many enterprising capitalists will line up to offer premium packages (pun intended)? And no, I have no problem with rich people getting better care. I'm more concerned that lower and middle class people get some level of care at all. See this article for a primer on the NHS: www.time.com/time/health/article/0,8599,1916570,00.html

Anonymous responded,
Every factual analysis of data says otherwise. Here's a great place to start: http://www.ncpa.org/pub/ba649. You can also do some research on the 'life expectancy' canard, and here's a great place to start: http://blogs.reuters.com/james-pethokoukis/2009/08/20/turns-out-us-healthcare-system-is-actually-like-really-good/

Me:
Unfortunately, I find those links less than stellar (we're depending on opinion polls now?). If we're spending far more of our GDP to get less than the very best in bottom line results (except for cancer where I agree with you), isn't there something wrong? You're answer is probably that we need less regulation to reduce costs. I'd like to see some data (not anecdotes) on that before I buy that. My point is that the right has based their objections on emotional anecdotes and the fear of government and by disparaging other systems where the govt is involved. So far, pretty shallow. The left has said (I agree), all you need is government. Not very convincing but not frightening to me. But let's knock one objection off the list...that about the crappy Euro systems. I prefer
Foreign Policy's take:
http://www.foreignpolicy.com/articles/2009/08/18/the_most_outrageous_us_lies_about_global_healthcare

Anon:


"Unfortunately, I find those links less than stellar" Well, of course you do - because they rebut your point factually, and you want to argue squishy 'moral' issues.
"we're depending on opinion polls now" Does it not shame you that you have to resort to lying? The '10 Surprising Facts' article points to real studies done by such publications as Lancet. The life-expectancy rebuttal uses real life-expectancy figures.
"If we're spending far more of our GDP" This is yet another canard. We spend more of our GDP _because_ of government involvement (Medicare alone used 3.2% of GDP in 2008!) and because we fund the innovation that drives the socialized medicine markets of the rest of the world.
"My point is that the right has based their objections on emotional anecdotes and the fear of government" Nonsense. I supplied you with two articles listing FACTUAL reasons why our health care system is equal- or superior-to socialized systems. And why is it that listing problems with
socialized systems - which are rampant - is 'emotional', but listing problems with our system is perfectly valid reasoning? 'Fear of government' is quite healthy and rational. It was the basis of the formation of this country, and any sane analysis of our health care system will show that government is the problem. More government is obviously not the solution.

OK, let's try this. Read these two articles on the ridiculous lies that have all-pervaded the conservative horror stories:

Economist: American health care. Keep it honest: http://www.economist.com/opinion/displaystory.cfm?story_id=14258877

Foreign Policy: http://www.foreignpolicy.com/articles/2009/08/18/the_most_outrageous_us_lies_about_global_healthcare


Finally, If you want my idea of what a sensible, factual, non-squishy analysis looks like, see the Economist's (I know, that liberal commie rag) comparison of the US and UK systems: http://www.economist.com/opinion/displaystory.cfm?story_id=14259044

Key excerpt:

Both health systems have their virtues and their faults. At its best, America offers extraordinarily good clinical care, but too many people lack insurance cover or fret about losing it. The NHS provides health care to all at a much lower total cost, but patients have less clout. Both countries are crying out for reforms to bring about better and cheaper care.
Now, that's a much more honest look at the issues. This idea that our system is better than anyone else's and we get the best health outcomes lacks all credibility to me (because, well, see above three links). A little more nuance might win conservatives more converts. Simply repeating over and over again that our system is the best strains the imagination and becomes some kind of weird substitution of patriotism for thought.

No one has YET addressed my main point of that post, which is, what is someone to do when they can't get insurance? There is no money to be made from covering sick people, only from covering the healthy. That's capitalism. Unfortunately, even people that have played by the rules and are decently well off can still be bankrupted by a prolonged illness if they lose their insurance coverage through no fault of their own. And they can't simply buy insurance because no one will cover pre-existing conditions.

Wednesday, August 19, 2009

Thank you, Mark Steyn

In my last post I attacked something that Mark Steyn said in (on? at?) The Corner, to which TdotTim commented:
"I think Mark Steyn, by opposing any change to our currently perfect system, is essentially saying..."
And I think Mark Steyn hardly needs an obscure blogger to tell anyone what he is essentially saying...we just read his actual words. But as blatant and shameless an attempt at being linked as his "reader of the day" as I've yet seen...and for that (and for at least having good taste in football teams), I congratulate you.
Now, as TdotTim correctly points out, I am indeed an obscure blogger. So obscure, in fact, that I had no idea who Mark Steyn was when I read what he said on a prominent conservative website. I simply read something I didn't like and talked about it. I still don't know (or care about) Mark Steyn's importance in this universe, but I do know that he selected me as his "reader of the day" today on his website and posted nothing more than my unflattering description of him and a link to my post:

For that and for the simple fact that Mark Steyn did not stoop to respond to my vicious attacks in an equally base tone, I admire and applaud him.

@TdotTim: Above all, I am honored that a fellow Cowboys fan visited my site. You are always welcome here.

Tuesday, August 18, 2009

Let Them Eat Insurance

Over at The Corner (Conservatism is dead; long live conservatism), this illuminating piece from Mark Steyn on the subject of these so-called "death panels":
What matters is the concept of a government "panel." Right now, if I want a hip replacement, it's between me and my doctor; the government does not have a seat at the table. The minute it does, my hip's needs are subordinate to national hip policy, which in turn is subordinate to macro budgetary considerations.
Mark Steyn, have you always been a moron, or did you have to work at it?

Right now, if you want a hip replacement, it's between you, your doctor, and your insurance company. 1) The insurance company must first approve of your need to get a hip replacement (presumably to stop you from wistfully eyeing that new designer, rocket-propelled Nike hip even when you don't need a new one). If they don't approve it after examining your medical records and talking to your doctor, you're out of luck buddy. Pony up the $40,000 you'll need to pay for it yourself. 2) If they did approve it (because, you know, they're compassionate and all), you and your family must think about your insurance deductible and whether you can afford the $3,000 copay at this time--i.e., your insurance company indirectly has a seat at your kitchen table because they wrote the rules for your policy. 3)Perhaps you could only afford a catastrophic health coverage policy...you would be exploring the possibility of "falling down the stairs" so that you could be rushed to the ER and get some treatment there. Again, the insurance company is a factor.

Nothing is "just" between you and your doctor. Health care is rationed to those that can afford the insurance premiums. Even when you have a policy, someone else reviews your major health treatment decisions with you and your doctor and your family. Whether that's my insurance company or the government, I'm not sure which is worse, but I certainly don't think of one as better than another. Besides, I already trust my government to secure my liberty, so if they want to secure my toothless gums, I don't give a crap.

All that is assuming you have insurance to begin with! If you're too poor to afford it, and/or you work for a company that can no longer afford to pay for your coverage because of crazily escalating premium costs, you're out of luck. Now, maybe Mark Steyn can afford to simply write a check for his brand new Nike hip. Maybe he doesn't even need insurance. In that case, I'm thrilled for him. Most everyone else depends on having health insurance, thank you very much.

None of this means that I'm anti-insurance companies. They aren't the devil incarnate, they're just looking to make sure they stay profitable. They're just businesses, which is why it's weird to me that folks like Steyn would waste time talking about how the current system is more compassionate! What's compassionate about a system where you can't be covered for a pre-existing condition? What's compassionate about a system where if you lost your coverage for a few months because your company went bankrupt and you couldn't afford the astronomical COBRA payments to keep your policy active, any new policy would automatically exclude any disease you had been getting treatment on until then?

I think Mark Steyn, by opposing any change to our currently perfect system, is essentially saying that those who can't afford health insurance need to...wait for it...buy insurance!!! If that isn't the pinnacle of elitism, I don't know what is.

The Madness of King Huck - Part II

In my last post, I slammed Mike Huckabee for saying America shouldn't tell Israelis where they can live. I mistakenly assumed he hadn't thought through what this would mean for the prospects of a free Palestinian homeland. I was wrong. Huckabee went off the deep end. In the same trip he also said this:
Former U.S. presidential hopeful Mike Huckabee said Tuesday while on a visit to Israel that establishing a Palestinian state in "the middle of the Jewish homeland" would be "unrealistic."

WTF?

What precisely does he want to do with the Palestinians already living there? Make them Israeli citizens? (FYI, they're not citizens. They're not citizens of any country.) Israel will never give citizenship to Arabs in the West Bank and Gaza because then Arabs would go from being 20% of the population to well in the majority. How do you like that?

Or, perhaps Huck thinks Israel should kick them all out. That would be the definition of ethnic cleansing.

If you have some time, please read around Haaretz and you'll see a vibrant debate and more balanced views within Israel. Huck has now planted himself in the far right of Israel! Is it sad that he's not seen as an extremist here in the U.S.?

One editorial note: in case you're wondering about my sudden focus on the Israeli-Palestinian issue, I just returned from a two week trip stay in Jerusalem. It was an eye-opening trip, mainly because I saw and heard a much larger variety of views among Israeli Jews than among Americans back home. Especially, among the evangelican Christian folks who, like Huckabee, have based their foreign policy on the Old Testament. If you think that Bible-talk about God giving Palestine to the Jews is archaic stuff, think again. It is current foreign policy for much of America. I wonder what they and Huck think of the fact that Palestinian Arabs also include lots of Christians. Do they even know? Did the Huckster go to a local Arab Christian service while he was there? I suggest he go to one the next time he's there and tell them what he thinks of their plight.

Monday, August 17, 2009

The Madness of King Huck

From The Atlantic:
Mike Huckabee is in east Jerusalem today, and he had some critical things to say about President Obama's posture toward Israel. The U.S. should not "be telling Jewish people in Israel where they should and should not live," Huckabee said according to The Jerusalem Post; his traveling partner, a New York state assemblyman, called U.S. Israel policy a "horror."
Sigh.

The key (unstated) point, of course, is that Israeli settlements are popping up in occupied lands. Now, if you want to argue that you don't consider the West Bank, Gaza, and East Jerusalem to be occupied lands, you'd be consistent. Loony, but consistent. To cloak that explosive viewpoint in language about not meddling in another country's affairs is bullshit.

That said, if Israel were to invade the Sinai peninsula tomorrow and start settling it, would we condone that? Israel did that starting in 1967 and only a peace settlement with Egypt led them to withdraw in 1979. What if Israel were to re-invade Lebanon and settle there? Jordan? Egypt itself? Any of these scenarios (well, ok, maybe not Egypt) are plausible, all in the name of security. Where might King Huck draw the line at interfering?

Lastly...the truly grotesque problem with the occupation is that Israel is now in the immoral position of having different legal regimes for Jews and Arabs. If things continue in this vein, Israel will have no choice but to either expel all non-Jews or give full citizenship to them, thus irrevocably discarding the "Jewish" character of the country.

This is why this is a struggle for Israel's soul.

[edit] Yes, I realize Sinai is part of Egypt. Substitute some other country name and my point remains, unsullied by your taunts.

Saturday, August 15, 2009

Bureaucratific


In what passes for conservatism these days, criticism of Obama's health-care plan has seemed to mainly be, "We don't want someone else, least of all, one of them Washington bureaucrats, making our life-or-death decisions for us." As if private insurance bureaucrats were somehow more compassionate than their lowly government counterparts. The "death panels" hysteria is comical given that insurance companies lay out in advance exactly what procedures they will or, more likely, won't, cover and at what price limits. Nevertheless, this ought to be entirely beside the point.

Today, since you can get as much care as you can afford, we don't think of it as rationing, but from a societal standpoint, it absolutely is. Health-care is rationed according to one's ability to pay. Basic economics. So long as resources are limited, no one can get everything. Things get costs assigned to them based on how much people need/want them. The left is being entirely consistent, and noble, in arguing that it is immoral to deny anyone care just because they can't afford it. I fully stand behind that sentiment. However, we still won't be able to afford unlimited care for everybody. We never will as long as resources are finite. The real question is which system best rations health-care while covering as many people as possible, not whether we need to ration. We already do. The fact that the right is babbling about the greater compassion of private insurance companies is mind-boggling.

Thursday, August 06, 2009

America's "solidarity" with Israel

Israel has been roundly condemned for recently evicting nine Palestinian families in East Jerusalem in order to let in Jewish settlers into an historically Arab neighborhood. The most important thing to note from this Israeli decision is not that Israel is exercising its (illegal) claim of sovereignty in Jerusalem by enforcing Israeli laws there, but that this is stark proof that Israel's laws are racist, with separate legal systems for Jews and Arabs. Not my words, but those of an Israeli Jew commenting in Haaretz:
Somewhere, perhaps in a refugee camp in terrible poverty, lives the family of the farmer who plowed the land where my house now stands. According to the Israeli judicial system, they have the right to get their land back immediately, destroy my house, return and grow Jaffa oranges for export on its ruins, and remove me by force if necessary. The Jerusalem District Court, which recently ruled that representatives of the Sephardi community committee had the right to take back the Hanun and Gawi families' apartments in East Jerusalem's Sheikh Jarrah neighborhood, has opened the 1948 file. That is, if Israel had an egalitarian system of law and justice, if the legal system were fair, because then millions of Palestinians would be able to applaud the court and demonstrate their joy in the streets at the ruling.

Of course, that is not how this issue as a whole is seen in some parts of America:
A U.S. delegation of Republican congressmen visiting Israel on Thursday said that the Obama administration's policy on Israel is misguided, puts too much emphasis on the issue of settlements and ignores the bigger threat of a nuclear-armed Iran.

And, the best part of all:
Cantor and others supported Israel's handling of the eviction of two Arab
families from a house in east Jerusalem earlier this week, a move criticized by the European Union and U.S. Secretary of State Hillary Clinton.

"I don't think we, in America, would want another country telling us how to implement and execute our laws," Cantor said.


My question: does the American public even know what Israeli laws and policies we're supporting?

That commenter, Gideon Levy, has been dismissed as a self-hating Jew. Perhaps we ought to consider for a moment whether he is actually right. If he is, how do we justify solidarity with such policies?