Yessssssssss. We want the last dollar!

Paul Krugman writing in the New York Times has a great article about the supposed benefits of the private health insurance industry. Ostensibly as part of defense of the movie Sicko, it’s a very good read.

The persistence of that myth puzzles me. I can understand how people like Mr. Bush or Fred Thompson, who declared recently that “the poorest Americans are getting far better service” than Canadians or the British, can wave away the desperation of uninsured Americans, who are often poor and voiceless. But how can they get away with pretending that insured Americans always get prompt care, when most of us can testify otherwise?A recent article in Business Week put it bluntly: “In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.”

A cross-national survey conducted by the Commonwealth Fund found that America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice (although Canada was slightly worse), and that America is the worst place in the advanced world if you need care after hours or on a weekend.

Hip replacement surgery in the US is more available than in Canada. But, there’s a little catch you probably didn’t know.

On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding – end of story. The alleged virtues of private insurance have nothing to do with it.

Here’s one of his examples of health-care treatment through an insurance company;

This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. “It was only later,” writes Mr. Kleiman on his blog, “that I discovered why the insurance company was stalling; I had an option, which I didn’t know I had, to avoid all the approvals by going to ‘Tier II,’ which would have meant higher co-payments.”

He adds, “I don’t know how many people my insurance company waited to death that year, but I’m certain the number wasn’t zero.”

One of the little discussed issues with private health insurance discussed is the cost it adds to businesses in the US. Countries with state health care allow businesses to pocket that expense directly, or add a supplementary insurance option for things that are not covered via universal coverage. In Soviet Cannuckistan, my employer offers medical benefits of pharmaceuticals and dental care. All my other needs are met by the universal medical care. And those costs are a fraction of the cost of complete health care. How much does a business save when they don’t have to foot the bill the government could and probably should? You may not like this source, but the facts are strong.

In 1988, Chrysler’s CEO Lee Iacocca reported that each car his company produced in the U.S. cost $700 in health benefits alone, while the same car produced in Canada by Chrysler cost only $233 in health benefits.

The situation hasn’t changed much since then. In 2005, General Motors of Canada’s CEO Michael Grimaldi reported that each U.S.-produced car cost $1,500 in health benefits, compared to less than $500 in Canada. And in 2006, the Conference Board of Canada reported that in the U.S., health care and pensions add between $1,400 and $1,800 to the price of each vehicle – a major reason Toyota cited for building its newest plant in Ontario.

The carmakers aren’t the only ones bearing the burden. Wal-Mart’s annual bill for health benefits is $1.5 billion, even though fewer than half of the company’s 1.3 million U.S. employees are actually insured.

One of the top advocates for public health care in the U.S. is Howard Schultz, the chairman of Starbucks. He has been outspoken about the “moral responsibility” of businesses to provide health coverage. But he also knows that this is one of the best ways for companies like his to retain employees. Given that 45 million people in the U.S. have no health coverage whatsoever, even a low-paid job slinging coffee is desirable if it includes health benefits.



  1. Peter says:

    #27 – I’m completely with you on that. I just disagree that the problem is with the social services the government provides. There’s much more evidence that the problem with the US government is campaign contributions leading to pork barrel programs, political paybacks, a run away military industrial complex, and unjust military action that have nothing to do with maintaining and improving the quality of life for our citizens. That’s why it’s perplexing to me when people automatically criticize a plan for a purely citizen-oriented social service as if it’s going to mean the veritable destruction of our federal government.

    Shouldn’t we be more outraged that oil company execs are determining our energy policy? Why aren’t we livid when Chenney’s corporate buddies are getting no-bid contracts for activities related to a war that was waged on utterly false pretenses (not to mention the thousands of lives that are lost in the process)? Why do we sit back and let our country interfere militarily with other countries (I’m talking about older historical events like Iran and Venezuela, not Iraq) solely so US corporations can maintain their existence and profits in countries that don’t think those corporations are benefiting their citizens?

    If you want to fix the rotting foundation of our government, demand publicly funded elections so the politicians aren’t serving special interests instead of the people.

  2. MikeN says:

    >Until Dumbya came along and eviscerated the system that provides medical care for veterans, the VA was emerging as a shining example of what government-run health care COULD be

    John McCain was complaining about the VA when he was running against Dumbya before he was president.

    As for health care, I wouldn’t call Krugman at the NYT reliable about anything. He’s a partisan hack, 2nd only to Ann Coulter, and a lazy one to boot, far more error-prone than Ann. He should go back to being a regular economist and maybe he would get that Nobel Prize he’s capable of.

  3. Mister Mustard says:

    >>you don’t believe in limited government

    Sure I do, Shylock. I want it limited to doing what it’s supposed to be doing, providing services for its citizens that can’t be provided in any other way. I don’t want to start my own army, I don’t want to build my own highways, I don’t want to have my own police force.

    And it’s been shown so that even the dullest among us should be able to recognize, the “free market” cannot provide adequate health care. All the money that should be going to lung x-rays and MRIs is instead going into the $100,000,000.00 annual salaries and $1,000,000,000 golden parachutes for executives who excel at denying health care to those who need it.

  4. malren says:

    30 & 32: Unless you know why the numbers are so different, you’re arguing something you don’t even understand. Key word; methodology.

    Oh well. I shouldn’t expect you to want to research anything. I suppose I should learn that lesson by now. You can give a man a fish…etc.

    Simple answer for simple people: We count more. We don’t throw numbers away to improve the statistic. We count them ALL. Our methodology is more strict.

  5. Mister Mustard says:

    >>far more error-prone than Ann

    Well, Ann never actually SAYS anything. She just makes smarmy double-entendre “witticisms” about blow jobs and faggots and the horde of commie pinko creeps that are about to take over the country. Then she flashes a little of her chicken-stick leg, and all the DittoHeads run off to the bathroom to masturbate.

    And as to Paul Krugman, I’m not basing my opinion only on what he has to say (although he’s worth about 6.02*10^23 Ann Coulters); it also comes from veterans who have been in the VA system for years, and a wide variety of other sources. As to the Nobel Prize, I guess Krugman thinks there are other things that are more important. Ann Coulter couldn’t win a Nobel Prize in Nicorette-Gum-Chewing. If they offered one in “Ignorance and Stupidity” though, she’d be a shoe-in.

  6. Gregory says:

    and you can back up that assertion I assume Malren? Not just with your word, but with cold hard data and independent stats?

    Cite please, because that’s a bold claim: that out of all developed nations only the US reports their infant mortality correctly…

  7. Sea Lawyer says:

    #35, why would you think I would ever be in support of taxpayers being forced to pay the cost for people they don’t agree with to seek political office?

  8. Mister Mustard says:

    >>Oh well. I shouldn’t expect you to want to research anything.

    You’re the one making the claim, Malren. YOU research it, and post the link. Or STFU.

    And if you don’t like the statistic that the US has the SECOND WORST infant mortality rate in the developed world (note: DEVELOPED WORLD, not some East Bumfuck where kids are dying like flies but nobody reports it), then how about this: As of 2004 (4 years into Dumbya’s Purloined “leadership”), infant mortality ROSE IN THE USA for the first time in 45 years.

    Is that methodology too? Did we just start counting the dead kids better after Dumbya put on his crown?

  9. ECA says:

    I have to say this…
    1. I was born crippled with 12 years of surgery, from Shriners…
    Only 1 complaint was there was LITTLE if any follow up to what they did to me or others, to see WHAT worked and What didnt.
    2. I worked for a Large company called Fred Meyers.
    NO dental coverage, NO eye/glasses coverage, NO specialty doctors, and insurance DONT cover PRE-EXITING CONDITIONS(understand that wording), and you STILL paid 20%.
    3. I lived on the streets for 5 years.
    Oregon health plan, and had Everything covered, and FREE medicines, Glasses, and Teeth cleaned, and Psychiatric.. I got things FIXED…including what the Doctors suggested, as WELL as being able to go to OHSU to see 1 of my Past Doctors from when I was younger for an evaluation.

  10. Sea Lawyer says:

    #38, well obviously healthcare is being provided, and at some degree of profit to those who provide it, so that hardly meets any classical standard of why it should be provided by the government. Additionally, you have heretofore provided no insight as to why it can’t be provided “any other way” in the first place. As it is, you don’t seem to have any problem with what’s provided, you just don’t want to have to open up your checkbook when they provide it.

  11. Peter says:

    #42 – LOL! Actually, I was going to add a comment about you probably not supporting it because it’s another government-run program, but I was trying to limit my sarcasm and be nice. No, I don’t expect you to support it at all. It does say something about the predicament we’re in, though. We don’t like how corrupt the people running our government are, and yet we’re not willing to do anything about it out of false sense of how inherently evil the government is. It’s the people who are corrupt, not the abstract concept of government.

    Publicly funded elections aren’t about supporting candidates you don’t agree with. It’s about citizens reclaiming their determination of government policy like a proper democracy. Elections are a necessary, public activity in a democracy. Why shouldn’t the public fund them? Are you simply against publicly funding anything related to government and public welfare? Do you object to the idea that tax payers should fund public schools, post offices, fire departments, and police departments? If so, you sound like an anarchist to me.

    How are you more comfortable with corporations and rich people paying for the elections and as a result procuring favors from the politician if they win? Wouldn’t it be better to pay for the campaign of someone you don’t agree with (*do not * forget that you are equally paying for candidates that you do agree with) if you know that politician owes *all* citizens for his election *equally*? Call it the lesser of two evils if you need to. Regardless, the better choice seems pretty obvious to me. I’d love to hear why the opposite makes more sense to you.

  12. Mister Mustard says:

    >>well obviously healthcare is being provided, and at some
    >>degree of profit to those who provide it,

    And a MUCH higher degree of profit to those who deny it.

    I have no problem “opening my checkbook” (in the form of taxes) to provide basic human rights to me an my fellow citizens.

    What I DO have a problem with is paying thousands (tens of thousands, for some people) of dollar for “health insurance”, so that some asshole in a corner office can decide I don’t need diagnostic tests or adequate medical treatment. And I don’t even have individual health insurance (group coverage thru my company). If I had to deal with that nightmare (I know many people with individual coverage who just don’t go to the doctor because they’re afraid of having their policy cancelled), I would probably be better off dead.

    As to why it can’t “be provided any other way”, I’m open to suggestions. Obviously this US Healthcare model has turned out to be a complete abortion (except for the $100,000,000.00/yr executives). Other than government funded universal health care, what do you recommend? What we have now is clearly working like shit. Even people who DO have health coverage are all too often fucked.

  13. Misanthropic Scott says:

    #39 – badren,

    I see you’re still ignoring direct requests for information. If you’re going to make the claim that the world standard for infant mortality numbers is somehow flawed, post a damn link!!

    You can’t leave everything as an exercise to the reader. Whenever I search for this information, our numbers come up as crap on every single site I check.

    For example, on this list:

    http://tinyurl.com/8jgeq

    We come out worse than Cuba and South Korea, but better than Croatia and Belarus.

  14. Sea Lawyer says:

    #47, how about you deal with it in a more intellectually sound way — corporations and unions are not natural people, and they don’t possess the same rights as people. Their status and rights are defined exclusively by statute. So knowing this, just deny them the right to give money to political campaigns. Real people on the other hand should be able to give as much or as little as they desire; this is a simple matter of free speech and property rights. Now, if you also want to require candidates to declare their contributions, then go for it.

  15. Sea Lawyer says:

    #50, and now you are making the leap that a service provided by somebody else can be claimed as a right by you. This is obviously a philosophical point that neither will agree on.

  16. Mister Mustard says:

    >>and now you are making the leap that a service provided
    >>by somebody else can be claimed as a right by you.

    Not at all, abogado. I’m saying that basic health care is a basic human right in a civilized society.

    If someone WERE providing it, then I would STFU.

    I guess it all depends on your definition of “providing it”. If you’re in the Senate or the Congress or the Executive Branch (including non-Executive Branch member Dick Cheney), you’ve got it made in the shade.

    On the other hand, if you’re dependent on Bill Maguire’s minions to provide it (with the money they have left over after his 1.6 billion-dollar golden parachute, in gratitude for his years of hard service at the slave wages of $100,000,000.00/yr), or if you’re one of the 85,000,000 Americans who DON’T have health insurance, then it’s not being provided.

  17. Mister Mustard says:

    >>how about you deal with it in a more intellectually sound way

    How about this: No campaign contributions at all. From anybody. A series of publically-funded debates on TV, where anybody who cares, can watch and find out what the candidates think. Then we vote. No “swift boat ‘veterans'”, no smear campaigns, no nothing. Just some information from the candidates, and then an election.

  18. Bill says:

    Krugman didn’t point out that universal health care systems operate more like Medicaid than Medicare.

    If it has a billing code, you can get it paid for under Medicare.

    My 80 year old grandfather had his chest cracked for a cardiac procedure, fully paid for by Medicare (and Medigap policy).

    That’s simply not going to happen under a universal health care system for someone that old (he’d have been shunted off to Hospice)

    OTOH, people with expensive, chronic conditions, like diabetes would probably receive better care than they do today.

    Just understand the trade-offs that universal coverage entails.

  19. Peter says:

    #52 – While that would certainly be a step in the right direction (and I completely agree with your reasoning there for the first half of your argument, “intellectually sound” comments aside), you’re forgetting all of the rich-people networks that organize to collect stacks of $1,000 checks to candidates. This effectively circumvents contribution limits. That means that you still have a situation where some citizens get special favors just because they have the money to buy such favors. in business that might be acceptable given their hierarchical, non-democratic operational model, but not for a democracy.

    Furthermore, as I alluded to above, we already have campaign contribution limits. If those don’t interfere with “free speech” and “property rights”, then how could publicly funded elections do so? Think of it this way: we don’t call it a violation of free speech if tax money goes toward putting out a fire in someone else’s house. You may even hate the owner of that house. Why don’t you object to that? The answer is because paying taxes for such a service is mutually beneficial to all citizens, meaning you’re guaranteed of equal treatment if your house ever catches fire. It’s no different for elections, with the exception that you have a 50% chance (assuming the two-party system) of benefiting every four years (ignoring that a politician you generally disagree with might do things that you support). Talk about an excellent ROI!

    In fact, this brings this divergent discussion full circle back to health care. Publicly funding health care is also mutually beneficial to everyone as well. If you don’t want to give your tax money towards that program, perhaps you should lobby for the abolition of fire departments, police stations, post offices, public schools, and military bases. Let corporations that are legally obligated to maximize profits handle not only how to put out the fire in your house, but also whether they should even bother.

  20. Mister Mustard says:

    >>Let corporations that are legally obligated to maximize profits
    >>handle not only how to put out the fire in your house, but also >>whether they should even bother.

    Don’t say that, even in jest! Dumbya has already facilitated that with the prisons, the Iraq war, and many other things. He tried it with Social Security, and he’s succeeding with health care.

    The guy still has over a year left in office; there’s a whole lot of damage he can do in that time. “Yeah…privatize the police and fired departments? Great idea! Dick/Karl, make this happen!”.

    Ugh.

    2008. Bring it on.

  21. malren says:

    Wow. Between the namecalling, the moonbatty hatred and the unbridled ignorance in this thread, it’s no wonder nothing ever goes right in this country. I guess we do get the government we deserve.

    2008 is going to be so much fun. If you’re an idiot or a masochist.

  22. Mike Strong says:

    In 1984 I was a supervisor/computer-operator for a tax prep company. They did seasonal hires, me and the data-entry staff. They often had other day jobs and one of them worked for a health insurance company as her day job.

    She had zero medical knowledge but it was her job to screen claims and in particular to deny certain kinds of claims. That was a little more than 23 years ago and it was when I found out how the claims process worked. I had already learned that legally we all get charged the same for services but that in practice the insurance companies tell the doctor how much of any bill they are going to pay (usually two-thirds or a little less).

    That means us poor honest schmucks who try to pay directly (no insurance) are paying 50% more than the insurance companies who are already gouging the hell out of us.

    In other words the insurance companies are not providing a money-pooling service to a community, they are providing a con-job claiming to serve the community while they are taking (not earning) all the money they want.

  23. Mister Mustard says:

    >>2008 is going to be so much fun. If you’re an idiot or a masochist.

    Well, 2000-2008 were a lot of fun, for those who seek to destroy American, its citizenry, and everything it stands for. I guess every dog has to have their day.

    I see you STILL have not responded to any of the direct requests for hard information, Malren. Instead, falling back on the ad hominem attacks against those you disagree. with.

    Tsk.

  24. Peter says:

    #55 – Although it might be a little better than what we have now, by banning campaign funds altogether it would shift the problem to whoever had the most pocket money to spend. Banning campaigns completely would undoubtedly fail a constitutional challenge. Better to regulate campaign funds to assure any serious candidate who can muster enough grass roots support a chance. The public financing laws that have been passed in some states make it completely optional, but if the politician does take the money (s)he must promise not to use any other money.

  25. Mister Mustard says:

    60 – What I actually had in mind was also banning the spending of any money on the candidates’ part to pimp themselves to unwitting voters. Maybe that would fail a constitutional challenge; not being a constitutional lawyer, I can’t say. Bummer if so. This whole “how much money can I get and how much smear advertising can I buy?” thing has totally fucked the whole election process.

    As a fallback strategy, campaign finance laws should be mandatory. wtf good is a “law”, if it’s completely optional wether or not you follow it?

  26. Peter says:

    #61 – Well, first of all it’s optional because of the unconstitutionality of forcing people into silence. It also shows who is willing to sacrifice their old ways in the spirit of honest service to the democracy. Personally I’d discount anybody who didn’t take the money since they’ve clearly demonstrated that they’d rather be corrupt than be an honest civil servant. Assuming a significant number of people hold the same values, that’s a strong impetus to take the money.

  27. Mister Mustard says:

    >>This is the essence of how fucked up things are. We’ll pay
    >>for strokes but not BP meds that cost pennies.

    That’s because the millions come out of the government coffers; the same ones that pay for the war in Iraq. The one nobody notices.

    The pennies come out of Bill McGuire’s 1.6 billion dollar golden parachute, and you can bet your ass that that HE was noticing. Just like he notices the costs for your lung x-rays, MRIs, and everything else that goes into preventative care. Once you’re actually SICK, they just deny payment, and then you die.

    God bless the American Health Care Denial industry.

  28. Thomas says:

    #54
    The problem is in our definition of “basic”. If you are dying, it is already the case that all US hospitals are obligated to provide you care. However, that is clearly not what you discussing. So we come to what I call the Splint Analogy:

    Suppose you break your arm and go into the hospital. In addition, suppose there is a super spiffy high tech cast that will heal your arm in two weeks or a standard split made from two pieces of woods found out in the back of the hospital that will take three months. Does the “basic human right” of “basic human health care” cover the fancy solution or only the solution that will eventually help heal you?

    This analogy can extend to other types of procedures. The short version is whether “basic” care extends to the “best available” care.

    My biggest issue with universal health care is that it should not be a Federal issue. Let the States create their own health care systems and let’s see how it goes for a couple of decades.

  29. natefrog says:

    #58, malren: 2008 is going to be so much fun…

    This thread would be so much more fun if you would actually stop dodging all the requests for you to cite your claims and provide us some concrete facts to debate.

    And, if you actually do respond, do so in the form of a coherent argument, not a flimsy straw man…

    Yes, 2008 will be great if the best the Republicans can muster are candidates that equal you in mental prowess.

  30. Mister Mustard says:

    >>Let the States create their own health care systems and let’s
    >>see how it goes for a couple of decades.

    Yeah, they did such a great job with slavery, let’s let them see if they can stage an encore presentation with health care.

    Just pray you’re not one of the ones who dies from shitty health care in East Bumfuck while we “see how it goes”.


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