The other Awards Obama will will this year...

[Jester]

I meant that the government doesn't spend more money than it taxes. You are right, break even is not the right term. Balanced budget is more what I was looking for, and avoid deficit spending unless it is an emergency.

Okay. And the Canadian government is in fine fiscal health, generally running modest budget surpluses, and also has fully functioning single-payer health care. So, obviously, that's not impossible. It's just a matter of taxation plus spending priorities. If the US swapped to a single-payer system, even if the per-capita costs were as bad as the worst-case other system (Switzerland, probably), there would be enough savings for either a thousand-dollar-per-head-per-year tax break, or a substantial reduction on the deficit.

Non-essential depends on if you are the poor sap who is in daily pain waiting 24 to 36 months to get your knee replacement surgery. So, no, they are not dying. Yes, they can live with a pain killer cocktail, and constrained to almost zero mobility.

Ah, anecdotes. Do you have average waiting times? Because those would actually be useful for gauging the effectiveness of the system. Here, we have a single case for which we have zero context not provided by someone with *financial incentives* to play up the "horror story" aspect - to generate medical tourism sales. If you want equally (or more) convincing horror stories from the US' system, they sure aren't hard to find. But they don't tell you how well the system works - they just tug at your heartstrings and create perceptual bias.

The UK system is almost certainly underfunded, especially when it comes to non-essential treatment. They get by on substantially lower costs (and lower outcomes) than nearly any other socialized system. (Thanks, Maggie! Thanks a bloody lot.) Want to reduce wait times? That's pretty much a problem that can be solved by funding. However, if someone wants to go to India, or wherever, to get their *non-essential* surgery, all the power to them. But, in the aggregate, even the poorly funded UK system delivers quality care to the inhabitants of Britain.

So, if you happen to be wealthy, then you can buy what you want. But, if you are a worker, then you pay high taxes, and probably cannot afford additional money out of pocket, or for additional private health insurance.

Generally speaking, in countries with some kind of socialized or single payer system, you can buy: cosmetic or non-invasive treatment (nose job, LAZIK, dental work, etc...), and in some systems you can buy improved conditions in hospitals (nicer bed, meals, etc...). Very few socialized systems allow differences in the actual nuts-and-bolts medical treatment, which is maintained at the same level for everyone.

Well, not to shatter your delusions... It is happening, and this article was written in 1999.

Oh. My. God. A philosophy grad student somewhere is outraged by using age as a medical criterion. That's it, we'd better shut down the public system. My delusions surely are shattered.

Could you maybe point me to the part where they're gauging someone's "contribution to society"? Because that's what you were talking about, no?

The age based discrimination of health care is very well known and documented.

Age is a perfectly relevant medical criterion, especially for prognosis. When deciding how to treat patients, prognosis is important. An organ transplant for a 20-year old could lead to half a century or more of increased lifespan. An organ transplant for an 85-year old is, most likely, not going to lead to more than a decade at the outside, accompanied by a significant QOL decrease. That's important. "Contribution" is not - and yet, it is about "contribution" that you are arguing.

It still appears that the rate of infection is almost double in the UK.

Do you have a source for this? From what little I understand, it is an extremely difficult thing to track, and the data are plagued by reporting problems and other serious biases. But a clear source showing the two countries' infection rates (preferably, with other comparable countries' data as well) could offer some needed perspective here.

There is a known relationship between hospital MRSA infection rates and the patient to health care worker ratio.

Probably. And if the UK would stop being so stingy with its health care funding, the rates would probably improve. Funding tends to solve problems. But are MRSA infection rates higher in socialized systems generally? In all such systems? The problems of one system are not necessarily an argument against the general model - especially when that system is notoriously cheap.

Besides, they are apparently making quite a lot of progress on that front - problems can be fixed.

That all depends on who decides what "success" means.

In a totally private system, that tends to be "people with lots of money".

-Jester