But the overall scheme has merit and should be a part of the national discussion.

Most of Judy Dugan’s arguments hold very little water.

Now, if “the premise that people are stupid and need to be told how to spend
their money” is false, then why is so much money spent on advertising in our
culture? A liberal, elitist idea? Liberal, perhaps, but hardly elitist. I
think rather because it has proven very profitable!

Thanks for your thoughtful post. My apologies for not adding more of my own
comment to my original post, rather than just posting Judy’s blog post in its
entirety. I hope you realized that is where this post originated. I thought
that it might inspire thought and comment and appreciate the effort that you
put into yours.

Your comment about Singapore is an interesting one. I lived there for a year
in 1993 and found it to be a Rebublican utopia in its user payment approach to
both social security and health care. It is interesting that it is the
opposite of a libertarian utopia politically, however, where the opposition
candidates get one hour per election cycle of TV time and other media are
totally controlled by the government. It is interesting that as Singapore has
developed, the percentage of health care expenses paid by government has gone
from 42% in 1995 to 34% in 2006, while general adult mortality has dropped
from 123 per 1000 per year to 67/1000/year. Over the same period the
government percentage of the health care system for the United States has
remained constant at 45% while mortality has gone from 132 to 109/1000/year.
For the UK the government percentage has stayed at around 80-85% and mortality
has gone from 104 to 80/1000/year over the same period. Also interesting that
the total expense on health care per capita in 2006 was $6700 in the US, $3400
in the UK, and only $1035 in Singapore. So the UK gets much better outcomes at
half the price of the US with more government sponsorship, but Singapore gets
even better outcomes at a dramatically lower price and much less government
participation. These data from the WHO website.

It is really not fair to compare Singapore, which is a single city, to the UK
and the United States which have so much more diversity in geography,
populations, and climate. But the comparison is interesting. It is also good
to note that 45% of health care in the US is already government funded
(medicare, medicaid, military, veterans administration). So our high cost and
poor outcomes seem to be part of our unique system, rather than who pays for
it.

I would prefer to see a system in which doctors worked on salary rather being
paid per procedure. Clearly we have created a system with an unseemly
percentage of “administrative” expense. Should we go towards Singapore’s model
or towards England’s?

muirgeo – The ideas that you have already memorized, I am sure are readily accessible. I sympathize with you, though, as far as the ones you have to go look up.

Since I have read a number of your posts and not yet found an independent thought, I will save myself the trouble in future.