I’m not dead!

My absolutely favorite Python scene of all time!

And how fitting, and I didn't even think of it before.

Ok, I have to go to bed (I have a long day ahead of me of making sure that those eeeevil corporations are still able to give the people what they want at a reasonable price, while employing thousands of people); but I would like to share my own experiences with the NHS:
1. As a Briton I am forced to look with pride upon an institution that became a model for the world.
2. As a honest man I am forced to tell my adopted (American) countrypersons what a failure it is.
3. I was borne into the NHS, where a mistake nearly cost me my life (some babies are considered too great a risk of long-term cost to the state)—oh, and spare me the Sarah Palin death commission crap—there is no formal death commission—it is much more informal than that. Also, I turned out fine (Mission Accomplished!)
4. My parents (both NHS doctors) loved it so much that they left to come to the USA (note: saying goodbye to your family, selling your practices, and saying goodbye to all your friends and family is a really, really big deal—especially since US immigration laws send you to the most crap places available).
5. The British doctor moving to the US is a continuing stereotype in British popular culture.
6. Other than a few well-borne American doctors wishing to ponce around the islands for a few years (practicing medicine while making copper rubbings of tomb statuary), I am aware of few American doctors who have moved to the UK. Those who have stayed must enjoy sleeping standing up (and yes I have pictures of my parents doing the same—they did not enjoy it).
7. As a result of many doctors leaving, the NHS has had to rely on foreign doctors coming with questionable degrees. Many of these doctors are good, but cheap medical care in the UK (for rich white folk ) comes at the expense of good care in poor countries (uhhh, this is assuming we care about the folk in other countries).
8. The NHS has refused to care for relatives of mine when they got sick. If healthcare is a human right, then can I sue in the ICC for crimes against humanity?
9. I took a friend to the emergency room on a visit. I observed a man with a bloody bandage on his head having a smoke outside—was his rights violated?
10. I have more, but I must go now. I feel a migraine coming on—thank God some eeeevil drug companies will come to my rescue.

I saw Michael Moore's 'Sicko' and it seems t me that you should have nothing to complain about.

Michael Moore would never lie would he?
/sarc

The word "seems" is especially important when you are watching a Michael Moore documentary.

In any case, the intrusions of government have ruined the healthcare industry almost everywhere, so there is a lot to complain about for everyone.

Yet, you know Moore will never talk about the root cause for health care malfeasance, Government regulation and interference.

Here's a similar one:

http://www.youtube.com/watch?v=8tmLvzubP3I

What's anti-capitalist about selling your liver? Someone could theorectically sell their organs which would result in death but would give relatives a cash boost.

On the other hand, poor l'il babies left to die because they're deemed too much of a burnden? So? Child abandonment is a right under traditional Libertarian law as a one person cannot force another to sustain them. Abandoning a child is no more heartless than passing a drowning man or passing someone who's lost in the desert and will dehydrate.

"Abandoning a child is no more heartless than passing a drowning man or passing someone who's lost in the desert and will dehydrate."

Your point would be more interesting if it weren't for two insurmountable facts:

1. Babies only result from a well-known complex deliberate unambiguous baby-making activity.

2. The bun typically has to cook for several pretty obvious months before it is ready.

Even without those facts, biology has programmed almost all of us to fiercely WANT to protect our spawn--so the exceptions really are anecdotal, even if interesting.



"What's anti-capitalist about selling your liver?"

It's only anti-capitalist when one party gets something he didn't agree to--like premature death.

Here's another insurmountable fact:

Despite laws against it and overburdened (and utterly useless) child protective services sucking taxpayers dry in every village, people STILL stuff unwanted babies in dumpsters and beat their children to death.

What makes you think that a similar practice doesn't or couldn't happen in the USA ?

What do you expect when the institution paying the bills is the same one rationing out the care, and making the laws? It is a deadly conflict of interest with no recourse.

So, isn't there a NHS in the USA, spending around 8% of GDP out of tax money on socialised medicine ? (just like the NHS)


If yes, why then couldn't such practice occur in the USA?

Since most of the country pays out of pocket or through private insurance, we don't have the shortages common in the British system. Thus, we aren't as eager to help people shuffle off this mortal coil.

Also, we sue.

I have no problem with the NHS story. Similar tragedies (misdiagnosis leading to premature death) occur in any conceivable healthcare system, and worse tragedies occur in the U.S., where practically dead bodies are kept alive for years at incredible cost, and the costs are not simply financial.

I'm continually amazed when opponents of socialized medicine oppose it on the grounds that everyone doesn't get every conceivable dollar's worth to anything labeled "healthcare" Providing everyone healthcare at taxpayers expense is a terrible injustice and withdrawing this healthcare in particular circumstances is a terrible injustice too.

Basically, the argument goes like this. In my proprietarian system, a few people receive practically unlimited health care, while in a socialist system everyone doesn't receive practically unlimited health care, so my proprietarian system is superior. The argument simply ignores all the people who don't receive practically unlimited care in the proprietarian system.

So here's the solution for the NHS. Include the queen and the rest of the nobility in the NHS and entitle them to practically unlimited health care. Common people might complain, but at least the system is immunized against the proprietarian argument.

That said, I don't advocate a single payer health care system. I rather advocate mandatory, catastrophic insurance (true insurance spreading risks that actually can be spread) plus tax deferred health savings accounts and some limited (as the NHS is limited), charitable support for people with uninsurable ills.

And if people want "health care" withdrawn in the waning hours of life, that's fine with me. This "health care" is not the solution to our "health care problem". It is the problem.

Nothing unreasonable about your thoughts except this: "I rather advocate mandatory, catastrophic insurance (true insurance spreading risks that actually can be spread) plus tax deferred health savings accounts and some limited (as the NHS is limited), charitable support for people with uninsurable ills."

One can not advocate mandatory and pretend to support choice.

I have a better idea. Rub people's noses in the hard lessons of life, like we do with little puppies and their poop when we are trying to house break them.

We had no choice in the when, where, how, or to whom of our birth, but virtually all of us without exception have a choice in the when, where, how, and by whom of our death. We can take the choice seriously and prepare for possibilities by intelligently taking care of our bodies through proper diet and exercise, we can prepare for disabilities by saving and investing in the proper financial tools such as insurance, we can refrain from making insanely high risk decisions such as bungee jumping without checking to see if the cord is securely tied and the distance of the jump is adequate to do so safely, and we can stay out of dark alleys late at night.

Or,

We can blithely ignore all of those as something the future will take care of as if by magic, not our problem ya know!

Survival and long life is self selecting by Nature's dictate. Those who pay attention typically live well and long; those who do not pay attention typically die early.

My better idea is let the self selection process work, and for those who wind up in boxes in the ground, we stand around and say, "Sad, but he should have listened."

One can not advocate mandatory and pretend to support choice.

When I advocate mandatory, I don't pretend to support choice. I don't advocate anyone's choice to shoot me or move into my house without my consent either.

I have a better idea. Rub people's noses in the hard lessons of life, like we do with little puppies and their poop when we are trying to house break them.

So I'll be around to your house with my pistol tomorrow? Just you and me, brother. No pigs allowed.

Just(ice is only between) you and me. That's anarchy, and it works well enough in the state of nature, but I'm not an anarchist, and neither are you.

While you sit in your house with your state pension check, a phone call away from the enforcers of established, artificial propriety, your advocacy of natural selection rings hollow.

You see no similarity between 'anyone's choice to shoot' you (which probably wouldn't have been your choice) and your advocacy of mandatory catastrophic insurance? In both cases the choice of one party overrides the will of the other.

You see no similarity between 'anyone's choice to shoot' you (which probably wouldn't have been your choice) and your advocacy of mandatory catastrophic insurance?

Not only do I see the similarity. I point it out myself.

Now, will you concede that advocating some forcible propriety, like title to a house or entitlement to a state pension check, is also similar to advocating a mandatory insurance policy?

In both cases the choice of one party overrides the will of the other.

Of course, both override choice. I don't deny it. I clearly oppose your choice not to bear the very real cost of your own risk of accident or illness, because I don't want you leaving me to bear this cost when I find you lying along the road someday. You know I won't leave you there. Why exploit the good will of your neighbors this way?

I also oppose a driving license without liability insurance.

I'm not an anarchist. I do advocate some forcible propriety, and I won't deny it, precisely because I value liberty and want only a minimum of force. The "libertarians" who go around denying the force they advocate are no better than any other politician dealing in his own self-deception.

Stripped any facade of intelligence away from you, did I brother Martin?

That was about as asinine and fucked up a reply as I have ever seen to anyone's post. Completely immaterial and totally irrelevant to my post.

But, then I knew it was in you, and have known that for a long time now.

Thank you for letting it all hang out.

Martin, I assume you have no problem with people keeping bodies on life support for as long as they're willing to pay for it?

I find it as distasteful to dictate to a family when they must let go of a brain dead individual as being forced to pay for keeping them hooked up to "life support" indefinitely.

I don't think you'll get a lot of compliance on the mandatory insurance front. Car insurance is mandatory and compliance is abysmal.

I would buy a health insurance policy with no coverage for extraordinary life support, and I oppose any coverage for extraordinary life support in a mandatory policy. If you want to spend on this life support what I'd rather spend on skydiving and travel, that's none of my business, but if you want to carry no insurance at all, that is my business, because you won't just lie in the street and die if you're hit by a car or contract cancer.

I don't expect perfect compliance with any standard. Compliance with property rights isn't all that great, and even most murderers get away with their crime.

If we're approaching a time when medical science can extend life almost indefinitely for a price, then we're approaching a time when the sufficiently powerful will extract that price from others at almost any cost, and however they extract it, they'll call it "freedom".

"because you won't just lie in the street and die if you're hit by a car or contract cancer"

It still isn't any of your business, because (1) it isn't the choice of the person you are forcing mandates on to get that medical attention, and (2) the cost of the mandates you impose will undoubtedly exceed the <2% of health care expenditures that go to cost shifting to the uninsured.

I don't force mandated medical care on anyone. I force people to pay for the medical care that they almost certainly will consume when the time comes, regardless of their denial presently. Medical insurance doesn't require you to accept any medical care, but I'm not buying the flimsy pretense that you'll willingly lie down and die when your appendix bursts.

1) The line you draw around "your property" is not my choice either, but you'll threaten to shoot me for crossing it without your consent, so any general objection to "forcing mandates" is clearly nonsense. You accept no such general objection yourself.

2) I'm skeptical of the 2% figure, but if the figure is so low, then an insurance mandate need not cost more. It likely will cost more in fact, but enforcing property rights also costs far more than necessary. The entire standing, military-industrial complex is practically all waste, and so is much of domestic law enforcement.

I'm not a utopian, and the forcible mandates you prefer need not exhaust my list.

"I don't force mandated medical care on anyone."

It doesn't matter if you are forcing them to buy health care, insurance, or candy bars. IT IS NOT YOUR RIGHT. You have the right to refuse to buy them things. If someone is denying you that right, then go after the right-deniers, not the innocent parties. You also don't have the RIGHT to require that private providers not cost shift to you to covered their nonpaying or underpaying customers. You only have the right to avoid those providers altogether. Or if you like, become a provider yourself and offer a cheaper product without cost shifting.


"1) The line you draw around "your property" is not my choice either,"

MB, people have been pointing out your specious property argument for months now. Your argument can be used to justify any manner of rights violations. And I'm not going to go through all the same diversions again.


"I'm skeptical of the 2% figure, but if the figure is so low, then an insurance mandate need not cost more."

You are skeptical because you have been unskeptically passively soaking up the lies saturating the media. Why don't you just check with the CBO:

See page 5:
http://budget.senate.gov/democratic/documents/2...

The 2% figure is hardly enough for you to get all upset about--it is likely not much different than cost shifting 100 years ago, or than cost shifting in many other industries that you currently purchase from. And it is certainly not enough for anybody with a passing concern for liberty to institutionalize a whole new form of thuggery.

And of course it will cost more. Why do you think people choose not to buy insurance? However, the cost is irrelevant. All that is relevant is that YOU HAVE NO FRICKING RIGHT!

IT IS NOT YOUR RIGHT.

The caps aren't persuasive. Of course, I have no right to compel anyone to carry health insurance or auto liability insurance or anything else, but the statesmen have the right, because they have the might. I can only propose for the sake of argument.

MB, people have been pointing out your specious property argument for months now.

Writing "specious" is no more persuasive than the caps.

Your argument can be used to justify any manner of rights violations. And I'm not going to go through all the same diversions again.

My argument doesn't justify any rights violation, because nothing I say is "justice". Men in black robes decide "justice", not me.

The diversions are yours. You simply refuse to acknowledge your own forcible impositions, but your simple denial is persuasive only to you and your choir.

There are no "rights" to violate without some agreement on the rights and the correponding obligations, and ultimately there are no standardized, forcible rights without a state. Rights don't exist just because you feel that they should. The idea is childish.

You also don't have the RIGHT to require that private providers not cost shift to you to covered their nonpaying or underpaying customers.

Of course, I do. I may choose a different provider, and I wouldn't have it any other way.

You only have the right to avoid those providers altogether.

Of course.

You are skeptical because you have been unskeptically passively soaking up the lies saturating the media. Why don't you just check with the CBO:

No. I'm skeptical generally, but I'm not familiar with every fact ever published. Possibly, you think you are, but then you also think yourself the lord of what's rightful.

Your link leads to "Sorry, there is no www.senate.gov web page matching your request.".

All that is relevant is that YOU HAVE NO FRICKING RIGHT!

As much as you envy the megalomania of statesmen, you don't actually declare rights, even when you shout.

Rights are just what the armed men say they are, and I give them just the respect they merit, not a bit more.

"Of course, I have no right to compel anyone to carry health insurance or auto liability insurance or anything else, but the statesmen have the right, because they have the might."

MB, you know why intelligent people cannot stand to argue with you? It is because your diversions, your context dropping, and your entanglement of semantics with concepts are so frequent that any coherent communication with you is futile.

You advocate forcing people to buy health insurance. That is the topic. Not yelling, not megalomania, not whether or not senators can make laws, not whether my opinion of your body of cafe writings is persuasive to you.

And your unending conflating of concepts like rights and justice with particular stipulated definitions of "rights" and "justice" is ultimately nihilistic. It is as though you haven't quite reached the age of conceptual awareness yet. That states define and enforce "rights", is derivative to the concept of rights--an abstraction that is assumed by most people on this forum, but never grasped by you.

I cannot argue with someone who denies the existence of rights (beyond what might be stimulated by some entity called "the state"), that it is not right to force people to buy health insurance. Or to force people to cut off their feet, or to murder their sisters. The argument must start deeper than that.

I can start by asking you, by what standard would you judge the actions of state to be right? If you were founding a new state, how would you construct the laws? With a random number generator and the Oxford English Dictionary?

MB, you know why intelligent people cannot stand to argue with you?

Now, you fancy yourself the spokesman of "intelligent people" too.

Your cries of "diversion" are reflective. I haven't diverted from anything. I asked you very explicitly and repeatedly to acknowledge the fact that you advocate forcible proprieties yourself. It's all still on the record above. You never address the point.

By contrast, I acknowledged your source. I followed your link, even though the forum doesn't render it properly. I found the statistic you cited, even though you cited the wrong page of the study. I quoted the passage myself and commented on it. The idea that I'm avoiding your keenly intelligent rebuttal of my diversionary points is absurd on its face. You can believe so only because you're projecting your tactics onto me.

You advocate forcing people to buy health insurance.

That's right. I never deny it. I repeatedly assert it. I'm hardly avoiding the point.

That is the topic. Not yelling, not megalomania, not whether or not senators can make laws, not whether my opinion of your body of cafe writings is persuasive to you.

No. When you start yelling and declaring my "rights", like rights are handed down to you personally on stone tablets, you make it the topic. I respond to what you write.

And your unending conflating of concepts like rights and justice with particular stipulated definitions of "rights" and "justice" is ultimately nihilistic.

I don't conflate anything. I adhere to a single, coherent definition of "rights" and "justice", and the words as I use them do not describe whatever you happen to feel ought to be established propriety. If I used the words so, then I would conflate many meanings, because people don't agree on precisely what ought to be established propriety.

I'm not a nihilist. I understand legal rights to be what lawmakers decree. If you want to discuss my personal ethics we can do that too, but you'll only tell me that my personal ethics aren't "right". You should go into politics yourself.

It is as though you haven't quite reached the age of conceptual awareness yet. That states define and enforce "rights", is derivative to the concept of rights--an abstraction that is assumed by most people on this forum, but never grasped by you.

I'm aware of concepts, and I'm also aware that judges laugh at people like you telling them what your "rights" are. They tell you to get a lawyer or offer to appoint one for you if you can't afford one.

You have this other concept of "rights", that you derive from Locke or Rothbard or someone else or your own habitual usage. The trouble is: I'm not inside of your head, so I don't know what you presume to be "right", so I couldn't concede your assertion of "rights" even if I wanted to, unless I want to concede whatever you think before I even know what it is. Who are you? Moses? I don't even like Moses very much.

I cannot argue with someone who denies the existence of rights (beyond what might be stimulated by some entity called "the state"), that it is not right to force people to buy health insurance. Or to force people to cut off their feet, or to murder their sisters. The argument must start deeper than that.

I don't deny the existence of rights. Rights (as in "right of way") are what statesmen say they are. If I say I "have a right", I'm discussing an objective possession, like title to a parcel of land, not some personal sense of how things ought to be. If you want to discuss my personal ethics, we can do that too, but I don't decide your rights or even my own rights, except insofar as we may legally contract. Your rights can be "wrong" (or "unethical") in the terms of my personal ethics.

I can start by asking you, by what standard would you judge the actions of state to be right? If you were founding a new state, how would you construct the laws? With a random number generator and the Oxford English Dictionary?

Well, "being right" differs contextually from "having a right". I avoid phrases like "X is right" precisely to avoid conflating two very different notions. I rather say, "X is my personal ethics".

I don't imagine founding a state, but I will say that legal decrees ought to be clear and comprehensible, as unambiguous as possible, so a dictionary is not a bad place to start. Maybe your state would simply decree "whatever Viking declares 'right'". I wouldn't want to live there.

I've advocated very specific reforms in the forum. I accept many common proprieties. I accept Lockean propriety, the propriety of laborers governing their own means of production, as a starting point for constructing forcible propriety, but if you want a few simple rules to be exhaustive "rights", regardless of any consequences I might not intend when I construct my state, I just can't satisfy you, because I don't pretend to know the consequences of imposing some simple system I imagine. I'm not nearly megalomanical enough.

"I'm not a nihilist. I understand legal rights to be what lawmakers decree"
"I avoid phrases like "X is right" precisely to avoid conflating to very different things. I rather say, "X follows from my personal ethics"."

I know. I've read what you've written before. And in all that I've read, you still provide no way, outside of unambiguous stipulation, of how laws should be constructed. You claim to follow the Lockean notion of rights, but you are a complete subjectivist on the matter. You have no objective theory of rights. You have only your own "personal" ethics, and whatever arbitrary decrees emanate from whomever you recognize as "the state".

But that isn't a concept of rights. That is a dodge. It is laziness or inability to identify a rational concept--a concept which precedes and underlies the creation of laws. You leave your ethics open to any arbitrary notion ranging from the peaceful to the monstrous. You give yourself no objective way of determining what your own ethics are. You HAVE your personal ethics, I'm sure, but god knows where they came from--you sure don't.

Rights in the Lockean sense is not "whatever the state stipulates". It is instead at least an effort at identifying a concept derived from observations in nature--universal and objective. And it is such a higher nonsubjective notion that those in this country--and certainly in the context of the founding of the USA--typically use. It isn't always clear and consistent the way people use it, but unlike your completely subjective stipulated notion of rights, it is relevant and useful.

... you still provide no way, outside of unambiguous stipulation, of how laws should be constructed.

I've often accepted the "utilitarian" label, and I'll discuss what the word means in my case if you want, but it doesn't imply "how laws should be constructed". Ethics has something to say about what laws ought to be. How laws are constructed is politics. I have little faith in any political system, but I can tell you, always tentatively, why I favor one positive rule over posited alternatives.

You claim to follow the Lockean notion of rights, but you are a complete subjectivist on the matter.

I accept certain Lockean principles as starting points, like the propriety of a man governing (owning) his own means of production. I don't subscribe to any deductivist ethics. I don't believe that we know what's ethical by positing a few simple rules of conduct and then judging all conduct following from repeated application of these rules "ethical". Rules are means. Ethics is about ends.

You have no objective theory of rights.

Right. I don't. I don't use the word "rights" as you do, because your usage confuses your sense of what ought to be with established legal rights. When you tell me that Bill Gates has some "right" as a wealthy founder of the Microsoft Corporation, I understand only the positive legal sense of the word. I know nothing of any Lockean propriety, because Lockean propriety doesn't govern Bill Gates, whether or not you or I think it should.

You have only your own "personal" ethics, and whatever arbitrary decrees emanate from whomever you recognize as "the state".

Yes, I have my personal ethics, and I don't pretend that it's handed down by God or rigorously deduced from indisputable first principles. I know too little of God and too much of rigorous deduction to pretend either.

My recognition of the state is irrelevant. States exist as a matter of fact. A particular state governs me, whether I recognize it or not.

But that isn't a concept of rights. That is a dodge.

No. It's facing reality.

It is laziness or inability to identify a rational concept--a concept which precedes and underlies the creation of laws.

No. You're reverence for some simple system of "rights" is laziness. You're just like every other statesman who would impose the One, True system of forcible propriety, because you cannot or will not question your own assumptions.

You leave your ethics open to any arbitrary notion ranging from the peaceful to the monstrous.

No, I don't. Repeating this falsehood doesn't substantiate it. You're just another politician peddling straw men. I'm a "monster", and you juxtapose yourself with my monstrosity, so you must be more saintly. How incredibly simple.

You give yourself no objective way of determining what your own ethics are.

You just go on and on with this nonsense as though you have a clue what my ethics are or how I determine them, when you plainly don't.

You HAVE your personal ethics, I'm sure, but god knows where they came from--you sure don't.

I know their history well enough and can discuss it with you, but you aren't really interested; otherwise, you'd ask me about them rather than presuming to tell me, only revealing your ignorance.

Rights in the Lockean sense is not "whatever the state stipulates".

I never say it is.

It is instead at least an effort at identifying a concept derived from observations in nature--universal and objective.

Locke says nothing about "universal and objective" rights. He has a notion of "natural rights", but I don't think much of it. I can observe the natural world easily enough, and Lockean rights clearly are not natural. They are artificial instead. They don't exist in the natural world outside of human culture, and they don't even exist in human culture very much. I hardly live in a Lockean utopia.

And it is such a higher nonsubjective notion that those in this country--and certainly in the context of the founding of the USA--typically use. It isn't always clear and consistent the way people use it, but unlike your completely subjective stipulated notion of rights, it is relevant and useful.

Regardless of your dull repetition, my stipulation of rights is not subject at all. Nothing I advocate is a "right" unless and until it is actually enacted as forcible propriety. What I call "a right" is objectively what any proper attorney at law will tell you, insofar as a rule of law operates effectively, and one does operate effectively in my neck of the woods. You're the one with a subjective notion of "rights", not me. Your "rights" are whatever you say they are, whatever follows "logically" from some first principles that you accept.

Enough. You may have the last word here.

"Right. I don't. I don't use the word "rights" as you do, because your usage confuses your sense of what ought to be with established legal rights"

Of course it is a dodge. You dodge the issue at hand--rights, as a concept guiding how people interact and how laws are made--for a childishly simple 'rights as the state defines it'. BOTH exist, whether you care to think about it or not. And YOU follow such a higher concept, whether you care to recognize its influence or ground it rationally, or not. Whether you "ground" your ethics in some mystical notion of "god", or in some arbitrary or simply undiscovered source, they do have a source. Likely the source is just as nonsensical and capable of justifying any number of contradictory and unreal ethics. And the conscious acceptance of an arbitrary grounding (rather than merely a failure to recognize it) is nihilistic.

You think by asserting such stipulated simplicity that you have somehow obtained intellectual security, but you haven't. You've merely found a replacement concept to arbitrarily sink your hooks into--your own kind of floating god, that permits you to avoid the harder intellectual work of identifying the actual concepts you are following, and determining what, if any, grounding they have in reality.

Ultimately your problem is that you haven't thought about it enough. Either because of laziness, or because if inability. I suspect the latter--not as a lack of intelligence, but because your emotional needs are more satisfied by the comfort of even a false intellectual grounding (as is the case with all mystical groundings) than by the satisfaction of real understanding.

I can't follow your link from the forum, but I can follow it from the email. Here it is again. I read page five of the document, and your statistic doesn't appear there, but I found this statement on page 3.

"According to one study, hospitals provided about $35 billion in uncompensated care nationwide in 2008—less than 2 percent of national health expenditures—and the estimates are much smaller for other providers."

This statement refers only to one study, and the study refers only to hospitals, not to doctors, clinics, insurance companies, state benefit programs and other actors shifting these costs. I doubt that the source includes state benefit programs in "other providers".

Again, I don't simply advocate compelling people to buy existing insurance policies. I advocate a standard policy with minimal, prescribed benefits, covering genuinely insurable risks to health, not a bill paying service for anything anyone wants to call "health care".

I don't advocate a single provider of these policies. Any insurer could offer the policy at any price, as with auto liability insurance now. I've had similar policies myself for a hundred dollars a month.

Other medical expenses could be paid with tax exempt dollars from a tax deferred savings account, and I expect most, routine health care to be purchased this way, not by insurance companies.

I'm sorry you had so much trouble with the link. I'm not sure why it didn't work.

"This statement refers only to one study, and the study refers only to hospitals, not to doctors, clinics, insurance companies, state benefit programs and other actors shifting these costs. I doubt that the source includes state benefit programs in "other providers"."

Insurance programs (including state benefit programs--people on Medicaid are NOT uninsured) cannot be counted, because that would be double counting once the provider costs are counted. Just who do you think providers cost shift to?

You are right to point out that clinics are not counted, but the costs compared to hospitals, and particularly emergency departments, can be expected to be quite small. Clinics by requiring appointments, have a much better opportunity for screening out those uninsured who cannot pay. Additionally, their fees, compared to hospital fees, are much more affordable and therefore more likely to be ultimately collected.

The number is likely considerably less than 2%, because it is well known that prices for the uninsured (the number reported by hospitals as cost shifting) are higher, and frequently MUCH higher than any of the various negotiated rates with various insurance companies, and certainly higher than Medicare/Medicaid rates.

Cost shifting from the uninsured simply is not very significant. If you want to get mad about cost shifting, then why don't you target the source of almost all of it--Medicare and Medicaid.

The number is likely considerably less than 2%, ...

You have one study that concedes its own limitations. Your source doesn't even name the study in context. That's not powerful evidence of anything, but I'll take your two percent figure for granted. I don't say that uncompensated care is the largest part of extraordinarily high health care costs in the U.S. Minimal, mandatory coverage is only part of the reform and addresses calls for "universal coverage", not calls for anything anyone ever wants.

I also doubt that prices charged the uninsured (and reported as uncompensated) are higher. Maybe you have one unnamed study to back that one up too. I suppose hospitals might include the cost of collection in their reported costs, and these costs are obviously higher for care that is ultimately uncompensated.

If you want to get mad about cost shifting, then why don't you target the source of almost all of it--Medicare and Medicaid.

I don't want to get mad about anything, and I do target Medicare and Medicaid, particularly Medicare. I want individuals to bear the cost of their own health care, except in extraordinary circumstances, and to use the market to control costs. Some events are rare but very costly, so health insurance is part of this responsibility to bear the cost of one's own health care, but routine medical care is not the stuff of "insurance", i.e. it's not sharing the cost of unlikely but costly events among many people subject to the same risk.

Much of the high cost of health care is a matter of choice, the choice of providers and of recipients who share the cost regardless of any risk calculation. These people are insured, but their insurance covers too many costs, because they don't really choose a policy themselves as individuals, and their corporation doesn't really have the necessary economic incentive either.

The Medicare problem is more complex than that. Technological progress does permit ever greater life expectancy. Maybe, if we could all spend endless sums on our health care, half of us could live to be a hundred. Maybe, medical science has reached this point already, but do we really want to pay half of our paychecks for a 50-50 chance of living to be a hundred? If you ask me when I'm twenty, I might say "no", but if you ask me when I'm 95 and on death's door, I'll more likely say "yes".

MB, I admire your skepticism, but if you would apply the same level to your own preconceived notions, you'd do a lot better--or be completely paralyzed.

I don't know how, after reading the Hadley paper, that you can think that the evidence is not at least up to par with evidence for other health care statistics. I mean, if you are going to hold to your preconceived notion that uninsured cost-shifting is expensive, I would ask what your evidence is, and how it compares with the Hadley paper that the CBO itself references. Then ask how you can justify greater skepticism of Hadley over your point of view.

BTW here's another relevant quote right from the Hadley study:

"Private insurance premiums are at most 1.7% higher because of the shifting of the costs of the uninsured to private insurers in the form of higher charges"
--p.5 http://content.healthaffairs.org/cgi/content/ab...


"I also doubt that prices charged the uninsured (and reported as uncompensated) are higher."

Why on earth would you doubt that? Do you think insurance companies negotiate for HIGHER rates? I don't know of any studies looking into it, nor do I know why anyone would waste their time, because it is a well known uncontroversial fact to those in the industry who see the actual list and insurance reimbursement prices. I thought it was uncontroversial outside the industry as well, until I just heard from you.

I agree with many of your points about insurance, but I reemphasize that it is irrational to show such disproportionate concern for the cost shifting by the uninsured. At <2% (which is what our best evidence shows), it will almost certainly cost more to have the government cover them and NOT cost shift (e.g., look at Medicaid and current Congressional proposals to cover them). Additionally, that 2% is a pittance compared to cost shifting from government insurance, and likely isn't much (2% isn't "much" more than even 0%) different than the cost shifting you pay for your local bank, grocery store, gas station, or Best Buy.

BTW, besides misdirecting people like you, the politicians' focus on the uninsured also maligns the uninsured. The uninsured DO pay the majority of their health care bills. Not everyone who is uninsured wants or needs insurance, and not everyone cost shifts.

Great video. Proponents of free health care are driven by compassion. They forget the reality of opportunity costs. Who wants to wait until Thursday?

One of my favorites is the Ministry of Silly Walks, but that's not quite as timely...or maybe it is.

It's a little outdated. Today we call them "Silly Walks Czars" instead of "Ministers."

True.

Shouldn't be alarming that our leaders refer to them as czars? I wonder if that's a "hide-in-plain-sight" strategy?

The price of Life. Documentary discussing the NHS system in the UK and the debate surrounding it. We see the decision process first hand and learn of the draw backs of such a system. For more info visit: http://www.bbc.co.uk/programmes/b00l9dmw . The marginal cost of keeping a person alive form one more day goes beyond any cost benefit analysis.

The problem with using cost-benefit analysis is that the analysis from the perspective of the individual being treated is unlikely to be the same as from the perspective of the state.

The value set of the state cannot match the values of each individual.

Agreed. Every dime spent is a cost-benefit decision. Friedman taught us when we spend other people's money on other people, we do so much less carefully than when we spend our money on ourselves.

It also sends bad signals to suppliers. If they never get the message on just how valuable certain things are to people, they won't know to make something better in that regard.

I wonder if those who advocate a socialist medicine system would agree to voluntarily band together with other like-minded people to form their own system and leave me, and all the others who want nothing to do with state-controlled medicine, alone? I doubt it, seeing as how they want our money to make their system work. Just wondering.

If it were something that people really wanted, and that could work, then they would. But the fact of the matter is that it is something that people have to be forced to do (because people realize it is bad for them), and that never has enough funding.

Your point is a great one. It is the 800# gorilla in the socialists' room.

Isn't that sort of the idea behind private insurance? If you want to participate in a risk-sharing pool.

This is from a local news report about an incident in a local diner:

A Republican in a wheelchair entered a restaurant one afternoon and asked the waitress for a cup of coffee. The Republican looked across the restaurant and asked, 'Is that Jesus sitting over there?' The waitress nodded 'yes,' so the Republican requested that she give Jesus a cup of coffee, on him.
The next patron to come in was a Libertarian with a hunched back. He shuffled over to a booth, painfully sat down, and asked the waitress for a cup of hot tea. He also glanced across the restaurant and asked, 'Is that Jesus over there?' The waitress nodded, so the Libertarian asked her to give Jesus a cup of hot tea, 'My treat.'

The third patron to come into the restaurant was a Democrat on crutches. He hobbled over to a booth, sat down and hollered, 'Hey there, honey! How's about getting' me a cold glass of Miller Light?' He, too, looked across the restaurant and asked, 'Is that God's boy over there?' The waitress once more nodded, so the Democrat directed her to give Jesus a cold glass of beer. 'On
my bill,' he said.

As Jesus got up to leave, he passed by the Republican, touched him and said, 'For your kindness, you are healed.' The Republican felt the strength come back into his legs, got up, and danced a jig out the door.

Jesus also passed by the Libertarian, touched him and said, 'For your kindness, you are healed.' The Libertarian felt his back straightening up, and he raised his hands, praised the Lord and did a series of back flips out the door.

Then Jesus walked towards the Democrat. The Democrat jumped up and yelled, ’don’t touch me ... I'm collecting disability.'

Whiff of a red herring? Shame this had to be state-sponsored television. Awkward that the Daily Telegraph report about a funding-agnostic but grossly flawed healthcare protocol was accompanied by a report about a breakthrough in the development of public financed flu vaccines

And interesting that the CIA world factbook rates the UK 35th in life expectancy, and the US 50th, just above Albania. Better organized universal coverage systems irritatingly top the list of life expectancy: Japan, Singapore, Australia, Canada, France, Sweden, Switzerland and Israel. Same confusing state of affairs for child mortality - inexplicable correlation between low numbers and universal health coverage. But at least the US famously gets value for its health care expenditure.

No, i am not a socialist. No more than the taxpayer funded CIA whose state sponsored publication of the state sponsored statistics quoted here...