The other Awards Obama will will this year...

[kandrathe]

You need good healthcare for everybody, and of course that is going to cost. The probelm here is not with the government, the problem is with the mentality of the people. People need to understand that a more social healthcare system, will benefit the entire country, and is not a slippery slope into communism. (I know the propaganda they feed you)

Actually, everyone has good health care. Perhaps, too good. The problem is that due to layers of control, mandates, and the separation of patients from health accountability has driven the price of health insurance beyond what we are comfortable paying. How do you know that the government's interference in the market hasn't driven up the costs?

And you were happy with that?

No, of course not. But, it is my responsibility to resolve it. It would be nice if my health insurance were as affordable as my auto insurance, or my life insurance. Those are markets that the government has not hosed up.

I pay for other people's health care. Me and my wife both have a nice income and are hardly ever ill. Likely during our life we will contribute more than 3 times the money that we will 'get back' by using health care. And I seriously couldnot give a ***. It also doesn't give me a warm or righteous feeling, and probably when these contributions were not obligatory I wouldn't pay so much.......and that is exactly the reason why I am in favour of social health care system (I mean social, not socialist). You and me, are already lucky we were born in a rich country.....we can live a good life solely because we were born where we were born. On a smaller scale I think it is a good thing that parents who get a handicapped child don't have to slip in to pverty but are supported through common money. Again, it doesn't give me a warm feeling, it is just what a developed country should do.

But, the plans on the table eppie are not designed to take care of the poor, and those unable to care for themselves. The plans are designed to insert government into the model for everyones health insurance. The outcome will be more people will pay more money to pay for the additional administration required, and it will not be rich people who pay for it.

I believe all pharma companies work in a free market.

Not really. Drugs are heavily regulated.

If also medical personell salaries were market conform they would probably be lower. Anyway that is not the point. The point is making sure everybody can get the treatment he needs.

Currently, everyone gets the treatment they need. Have you heard horrible tales of people being turned away from hospitals? I think it is quite the opposite. Hospitals in the US are usually required by law to treat anyone who comes to the door.

That is a problem of how you wish to receive tax money. This has nothing to do with how you spend tax-money. On president uses the money to go to war (although he actually just uses it to pay, via a different route, his oil and wepons selling friends) and another president uses it for health care. But both are cases of spending. You are talking about your problems with receiving taxes......your point is the less taxes teh happier I am, and that is your right, I just think that the US if they wanted could invent a working system for health care.

Yes, and no. I want our US government to focus on the problems of a republic, and to try to live within a balanced budget. Any money they tax is a sap on productivity (otherwise would be spent or invested). I want what taxes they do need to be equitably administered, and not on products that are required for sustenance (food, medicine, health care, your first X-KWh a month).

If they choose to do so is up to the voters.

Perhaps. I doubt the vast majority of American voters care or know as much as you or Jester do.

[eppie]

I doubt the vast majority of American voters care or know as much as you or Jester do.

I have the idea I don't know enough about the health care reforms that are now proposed in the US, so before looking even more stupid I will just make a short summary of what I think it going (based on what I hear from you and what I thought before), please just point where I am wrong.


My idea was simple; healthcare reforms to make sure nobody is uninsured and everybody can get the medical treatment he needs even the people without jobs.

The idea I get from you is that there is not such a problem at the moment, the only reason to reform is to have more government control, which then shows itsself through a heavy administrative burden costing lots of money.
I am sure I am wrong because I don't see why a government wants to get more control on healthcare as goal. The point is that they are trying to help a group of people, right?

[Jester]

Currently, everyone gets the treatment they need. Have you heard horrible tales of people being turned away from hospitals? I think it is quite the opposite. Hospitals in the US are usually required by law to treat anyone who comes to the door.

They are required to suture you up if you're bleeding to death. They aren't required to give you any long term treatment, diagnostics (beyond what is necessary to identify what's immediately killing you), or treatment for chronic conditions. Once your organs aren't rotting, your heart is pumping, and you're not going to fall over dead, they can send you on your merry way until the next emergency.

This is a staggeringly inefficient way to provide health care. If you proposed it to either a doctor *or* an economist in the abstract, it would cause them to spit their morning coffee. It drives up costs, it provides very little benefit relative to effort, and it only barely covers the ethical and humanitarian issues with last-minute emergency care.

So, if what concerns you so deeply are the costs to your dear Republic, then you need to do one of two things: stop treating emergencies at hospitals for free (highly unethical, but very cheap), or come up with a system that accomplishes the same goals for everyone at less cost. Conveniently, a wide range of such systems exist, and are in widespread use around the first world. Their costs and benefits are public knowledge.

Or, alternately, you can keep repeating the hopeful mantra "private costs less", and hope the data decide to invert themselves to suit your preferences.

-Jester

[--Pete]

Hi,

My idea was simple; healthcare reforms to make sure nobody is uninsured and everybody can get the medical treatment he needs even the people without jobs.

I think the main problem with what is being worked out is that it will combine government inefficiency with insurance company greed to generate a system which will cost more and do less. I think that either a nationalized health system or a free market system heavily regulated would be more efficient and less costly. However, the first is virtually impossible because of the strong opposition by the insurance companies, the health care providers, the pharmaceutical companies, and a large segment of the population. The second is doable, but would face opposition by many of those same groups. And regulation is a large, additional expense. Besides, as long as the situation is left in the hands of the free market, there will always be a large segment of the population who, through poverty, apathy, ignorance, or greed, will not be insured.

I'm in favor of change, not because I think it will improve the situation, but because it may break it enough that a real solution will eventually emerge. And, who knows, the horse might learn to sing.;)

--Pete

[--Pete]

Hi,

Not always. You are right if the product price has little or no effect on demand.

For products whose demand is based on price, as is the case for the product of a monopoly or for a prestige product only made by one manufacturer. In this case, the price is set to an optimum-profit value that often has little to do with the cost of making the product.

You are quite right, I implied the universal qualifier when I should have used the existential qualifier. I contend, though, that my statement is true a majority of the time. Fiat contributes to the economy of Italy much more than does Ferrari.

Also, in your example, consider the possibility of being able to produce the product cheaper elsewhere. The differential might not be enough to pay for itself in the tax free case, but could become large enough with the imposed taxes to make the move attractive. Although this is not an argument in support of my statement about passing on the cost of the taxes, it is an argument in favor of eliminating B&O taxes in general.

--Pete

[kandrathe]

Hey pot! That kettle over there called you black!

First... I would need to see some facts or logic. Mostly, (myself included) people here give opinions. I think I'm mostly likely around here to actually try to back up my "claims" with a source.

[kandrathe]

They are required to suture you up if you're bleeding to death. They aren't required to give you any long term treatment, diagnostics (beyond what is necessary to identify what's immediately killing you), or treatment for chronic conditions. Once your organs aren't rotting, your heart is pumping, and you're not going to fall over dead, they can send you on your merry way until the next emergency.

Basically, that is correct. If you have a debilitating condition, eventually exhausting your savings and retirement funds, you will qualify for Medicaid, and then the government will take care of you. The place where people are uninsured is usually that boundary between employable and destitute. Much like a road runner cartoon, once you hit bottom, (*thud*) then the safety net comes out. Which actually is more of an indifferent nanny from hell.

This is a staggeringly inefficient way to provide health care. If you proposed it to either a doctor *or* an economist in the abstract, it would cause them to spit their morning coffee. It drives up costs, it provides very little benefit relative to effort, and it only barely covers the ethical and humanitarian issues with last-minute emergency care.

Right. It really is not a system, so much as it is that last stop gap between allowing people to die on the street.

So, if what concerns you so deeply are the costs to your dear Republic, then you need to do one of two things: stop treating emergencies at hospitals for free (highly unethical, but very cheap), or come up with a system that accomplishes the same goals for everyone at less cost. Conveniently, a wide range of such systems exist, and are in widespread use around the first world. Their costs and benefits are public knowledge.

The objective should not be to force everyone to have medical insurance. The objective should be to insure that everyone has the opportunity to be as healthy as they are capable and willing to be. People should take responsibility for their health and safety.

On a personal level, I'm looking at a plan right now that has a combination of high deductible ($5000), plus health care savings account. Money gets deducted each pay period and accumulates in the tax exempt HSA, and once you consume the deductible level in a calendar year, then the insurance plan kicks in. The funds in the HSA can still cover what the insurance does not. If you don't consume all the HSA, it just keeps growing (and portions can be invested) for that future time when you will need it.

Or, alternately, you can keep repeating the hopeful mantra "private costs less", and hope the data decide to invert themselves to suit your preferences.

No, the only way that governments who run socialized medicine control costs are by rationing care and regulating the medical establishment. I could bring down the overall amount spent on food by the same manner by rationing the type and number of calories that each person could consume in a day. You would be sustained, but have less and fewer choices.

We could use the same technique to solve wasteful energy consumption and homelessness as well, where the government builds and assigns people to energy efficient housing.

If you make me dictator in chief, I could solve all these problems with a command economy and the force of government behind me.

[Jester]

Right. It really is not a system, so much as it is that last stop gap between allowing people to die on the street.

And yet, an ethically necessary system, and the system of medical ethics is not something I would want to damage. Until those people have actual health coverage, the system will continue to have to pay the spillover costs of their emergency treatment - driving up prices. Rather than buying the ounce of treatment, you'll be forking over time and time again for the pound of cure.

The objective should not be to force everyone to have medical insurance. The objective should be to insure that everyone has the opportunity to be as healthy as they are capable and willing to be. People should take responsibility for their health and safety.

In a democracy, people can take responsibility for things collectively. The military is everyone's responsibility, and it works (more or less) fine. Roads work that way. So does education. Why not health care? It works well in other countries. It's not like this is untested speculation.

On a personal level, I'm looking at a plan right now that has a combination of high deductible ($5000), plus health care savings account. Money gets deducted each pay period and accumulates in the tax exempt HSA, and once you consume the deductible level in a calendar year, then the insurance plan kicks in. The funds in the HSA can still cover what the insurance does not. If you don't consume all the HSA, it just keeps growing (and portions can be invested) for that future time when you will need it.

I hope it works out for you. Being without health care coverage is a serious gamble.

No, the only way that governments who run socialized medicine control costs are by rationing care and regulating the medical establishment. I could bring down the overall amount spent on food by the same manner by rationing the type and number of calories that each person could consume in a day. You would be sustained, but have less and fewer choices.

If it were even remotely true that countries with public systems had inferior outcomes, then I'd agree with you that this is the trade off. But it's not true. People in most first world countries are not getting poor quality health care - instead, wasteful excesses are constrained, coverage is extended to everyone, and treatment is prioritized according to medical criteria, rather than capitalistic ones (IE: MRIs go to people who need MRIs, not people who can afford MRIs.) It saves money, and it does the job. The evidence is all out there.

Health care ain't like other products. Kenneth Arrow figured that out ages ago. The uncertainties are too large, the potential costs too enormous (or zero, luck of the draw), the nature of medical ethics too important to let markets work effectively. (See: entire other thread.)

-Jester

[kandrathe]

And yet, an ethically necessary system, and the system of medical ethics is not something I would want to damage. Until those people have actual health coverage, the system will continue to have to pay the spillover costs of their emergency treatment - driving up prices. Rather than buying the ounce of treatment, you'll be forking over time and time again for the pound of cure.

Well, you are seeing only the one side of ethics; the obligation of society to be compassionate. There is also the part of ethics where society should expect a level of citizenship, lawfulness, and self reliance from those who are seeking that compassion. But, here again, you are trying to suck me into the lie that we need socialized medicine to keep people from dying in the street. That simply is not true. We will not solve any social ills suffered by the poor by nationalizing health insurance. They are the ones who have health insurance now, as well as the elderly. The people who have the gaps are people who have lost their job and don't qualify for any social programs, or young adults who fall off their parents insurance, who don't have a job that offers health insurance, and cannot afford to pay for it out of pocket. Oh, and those who are in the country without documentation who work for cash.

In a democracy, people can take responsibility for things collectively. The military is everyone's responsibility, and it works (more or less) fine.

I think it is often misused and our military personnel are taken advantage of and often under appreciated.

Roads work that way.

It would be fairer if the costs for roads were levied locally, however, for ports and airports it would make sense for more blended federal support.

So does education.

It should be a local issue.

Why not health care? It works well in other countries. It's not like this is untested speculation.

I don't think it works well in other countries. Again, by anecdote, I've heard of many ways that it doesn't work well, and some where it does work. Care is rationed, and costs are controlled by fiat. And, like I said, if you did that with food, or housing, or motor vehicles, you could drastically drive down the costs and implement the governments ecology strategies overnight. But, if you want to give people choices, like those offered by a "free" market, then you need to accept that the market drives the price. Things were pretty stable in the health care insurance market until the government stepped in and took over half the market about 50 years ago, and since then, the prices have spiraled out of control. The more the government does to try to fix the problem, the more they hork it up worse.

I hope it works out for you. Being without health care coverage is a serious gamble.

I'm getting out of consulting and IT, and I landed a full time very stable job in academia doing research at a local private college. I think the job is a very good fit for me. I'm going to also finish my graduate degree and then maybe do some teaching. My insurance starts at the 1st of November. It's only gambling if you have a choice, and my family didn't have any choices. Our country really needs to focus on decoupling insurance from employment, and in my opinion, having government run it is not the right option either.

If it were even remotely true that countries with public systems had inferior outcomes, then I'd agree with you that this is the trade off. But it's not true. People in most first world countries are not getting poor quality health care - instead, wasteful excesses are constrained, coverage is extended to everyone, and treatment is prioritized according to medical criteria, rather than capitalistic ones (IE: MRIs go to people who need MRIs, not people who can afford MRIs.) It saves money, and it does the job. The evidence is all out there.

Health care ain't like other products. Kenneth Arrow figured that out ages ago. The uncertainties are too large, the potential costs too enormous (or zero, luck of the draw), the nature of medical ethics too important to let markets work effectively. (See: entire other thread.)

Health care, no. But, health insurance, yes. Think of any other common insurance product (home, car, life, liability) that people would willing choose to skip. They don't unless the costs are way out of wack with their perceived benefit. If auto insurance cost at the rate that health insurance did, then many people would be uninsured. If life insurance cost $6000 a year, then people would go without it. There is a point where people will decided to take risks, with their health, with their home, or with their families security. Usually, it is when you need to figure out how to buy groceries, and make the house payment. Starvation and homelessness are two situations that are known to be bad for your health.

[DeeBye]

Why not health care? It works well in other countries. It's not like this is untested speculation.

I don't think it works well in other countries. Again, by anecdote, I've heard of many ways that it doesn't work well, and some where it does work. Care is rationed, and costs are controlled by fiat.

This is what really bugs me about your arguments kandrathe.

There is incontrovertible evidence that a universal health care plan is both cheaper and better than what the USA has going on. I'm not even going to provide links because it has been done to death (forgive the terminology). Every other country that has universal health care pays less for health care and has a better quality of care.

Then you resort to the "I don't think it works well" rebuttal.

[kandrathe]

There is incontrovertible evidence that a universal health care plan is both cheaper and better than what the USA has going on.

Incontrovertible? That makes the debate simpler.

Every other country that has universal health care pays less for health care and has a better quality of care.

As, evidence, I've been shown that the amount paid by those governments in total is less than what is paid by the US where workers pay for their own health care, and then also for government health care for others. Of course it's more expensive, and its also "unfair" when some people pay nothing, and others (not the rich) pay well more than their fair share. Then, you also say you have better quality of health care, and to prove that statistic you point to birth and death statistics, while ignoring how those statistics are calculated, or by what social forces generate them (e.g. obesity rates, heart disease, teen pregnancy resulting in more infant mortality) . So, no, I don't believe you've convinced me that its incontrovertible.

So, are we talking about Canada? Britain? France? Where is this Nirvana of health care where they do everything better and cheaper, and where the system breaks even? Where they don't put people on waiting lists for months or years. Where people have a choice in what care they get, but then they let the government pay for it? Where they treat patients with equality, rather than judging their potential contribution to society. Where people are not deathly afraid of being put into the hospital for fear of lethal staph infections?

[Jester]

So, are we talking about Canada? Britain? France? Where is this Nirvana of health care where they do everything better and cheaper, and where the system breaks even?

What is "breaks even"? Does the miltary "break even"? Do roads "break even"? The government collects X taxes, and spends Y on expenses. Does the Canadian government break even? Federally, it does. (Some provinces do, some don't, and some health care funding comes from them.) So, does that mean Canadian Health Care breaks even? That question doesn't even make sense. It's a public good.

Where they don't put people on waiting lists for months or years.

If you have non-essential treatment, you get put on a waiting list. For major (non-essential) surgeries, months is probable, years is not probable. If you need *essential* treatment, where urgency is an issue, you get moved to the front of the list and get treatment almost immediately. Are you really so opposed to anyone, at any time, waiting for any treatment?

Where people have a choice in what care they get, but then they let the government pay for it?

There are countries where you can pay for an "upgrade" to snazzier conditions. But, by and large, the nature of a public system is that everyone gets roughly the same level of treatment, so no, you don't get a total range of choice in your care. TANSTAAFL.

Where they treat patients with equality, rather than judging their potential contribution to society.

I know this whole line of reasoning is a fun piece of rightist paranoia with a splash of sci-fi dystopia, but is there actually a real example of a socialized medical system that treats patients according to their "potential contribution to society?" If so, I've never heard of it. In Canada, you get treatment according to how much you need treatment. Nobody asks about your "contribution."

Where people are not deathly afraid of being put into the hospital for fear of lethal staph infections?

Because that totally doesn't happen in private hospitals. MRSA is very ideologically discriminating.

One might point out that the huge scare about MRSA in British hospitals was all the result of some very poor testing by a total incompetent. The actual rates are much lower - although this remains a major problem in *all* systems, for reasons that have absolutely nothing to do with how the hospitals are funded. So, a red herring.

In sum, there ain't no Utopia (Eutopia?), not on this planet. (Maybe on Saturn.) But if that's what you're arguing against, you're up against a strawman. Nobody is proposing any system to solve all ills, maximize all values. You don't get maximum choices, maximum care, maximum coverage, maximum safety, maximum outcomes, with minimum cost, minimum hassle, minimum unfairness, minimum delay, minimum governmental intrusion, zero triage, and no screwups, ever. But some systems work a heck of a lot better than others.

-Jester

[--Pete]

Hi,

. . . but is there actually a real example of a socialized medical system that treats patients according to their "potential contribution to society?"

There is at least one, but it is *not* socialized. In it, scientists and senators have great health insurance, skid-row bums and seasonal farm workers have none. I don't remember where it is, but it's probably a third world nation someplace. :whistling:

--Pete

[Jester]

There is at least one, but it is *not* socialized. In it, scientists and senators have great health insurance, skid-row bums and seasonal farm workers have none. I don't remember where it is, but it's probably a third world nation someplace. :whistling:

I presume the argument is that, in comparison to non-productive Senators, skid-row bums are not getting their fair shake?

-Jester

[--Pete]

Hi,

I presume the argument is that, in comparison to non-productive Senators, skid-row bums are not getting their fair shake?

Had you not put "potential contribution to society" in quotation marks, I would have actually used another example of a useful profession.:)

--Pete

[kandrathe]

What is "breaks even"? Does the miltary "break even"? Do roads "break even"? The government collects X taxes, and spends Y on expenses. Does the Canadian government break even? Federally, it does. (Some provinces do, some don't, and some health care funding comes from them.) So, does that mean Canadian Health Care breaks even? That question doesn't even make sense. It's a public good.

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.

If you have non-essential treatment, you get put on a waiting list. For major (non-essential) surgeries, months is probable, years is not probable. If you need *essential* treatment, where urgency is an issue, you get moved to the front of the list and get treatment almost immediately. Are you really so opposed to anyone, at any time, waiting for any treatment?

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.

There are countries where you can pay for an "upgrade" to snazzier conditions. But, by and large, the nature of a public system is that everyone gets roughly the same level of treatment, so no, you don't get a total range of choice in your care. TANSTAAFL.

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.

I know this whole line of reasoning is a fun piece of rightist paranoia with a splash of sci-fi dystopia, but is there actually a real example of a socialized medical system that treats patients according to their "potential contribution to society?" If so, I've never heard of it. In Canada, you get treatment according to how much you need treatment. Nobody asks about your "contribution."

Well, not to shatter your delusions... It is happening, and this article was written in 1999. The age based discrimination of health care is very well known and documented.

Because that totally doesn't happen in private hospitals. MRSA is very ideologically discriminating.

One might point out that the huge scare about MRSA in British hospitals was all the result of some very poor testing by a total incompetent. The actual rates are much lower - although this remains a major problem in *all* systems, for reasons that have absolutely nothing to do with how the hospitals are funded. So, a red herring.

It still appears that the rate of infection is almost double in the UK. There is a known relationship between hospital MRSA infection rates and the patient to health care worker ratio.

In sum, there ain't no Utopia (Eutopia?), not on this planet.

But there is an Ethiopia, which is where we are all headed.

Nobody is proposing any system to solve all ills, maximize all values. You don't get maximum choices, maximum care, maximum coverage, maximum safety, maximum outcomes, with minimum cost, minimum hassle, minimum unfairness, minimum delay, minimum governmental intrusion, zero triage, and no screwups, ever. But some systems work a heck of a lot better than others.

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

[Bun-Bun]

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

Um, that's a press release, not a news report.

[kandrathe]

Um, that's a press release, not a news report.

"Hailing from Liverpool, Kenneth now lives in Welwyn garden city with his adoring wife after retiring from British rail. He has suffered from knee pains since long due to bow legs.
He had been placed on a British waiting list for knee replacements for the last couple of years. This year, after turning 81, he felt that he deserved better and wanted to enjoy a better quality of life. He was not keen on surgery in NHS hospitals. His daughter located a Knee surgeon in Chennai on the internet in her search for “Knee replacement surgery in India”.


Do you think it it false? Do you think it is unusual for people to wait two or three years for this type of "non-critical" surgery?

[ShadowHM]

Do you think it is unusual for people to wait two or three years for this type of "non-critical" surgery?

Yes. It is unusual here.

And for a nice recent example, my own mother (76 years old) went to see her family doctor three weeks ago to discuss the knee problem she had noticed growing over the summer, which was affecting her gait enough that she was also getting low back pain.

She had her surgery last week. :D

But carry on worrying, if it pleases you. :)

[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