The USA is getting ripped off with health care. I spend $3600 a year on health insurance that only covers myself and my three children, have a $700 family deductible, pay 80% of office visit costs, get huge deductibles on certain procedures or treatment options, and I can STILL wind up going medically bankrupt if my insurance company decides to find a way to dance around coverage of a dread disease, heaven forbid I should get one. I spend about $5000 a year on health costs in a normal year and I’m not getting treatment for everything I need treatment for.

The solution to our health care problem really does lie outside our borders.

Frontline recently ran a documentary on health care around the world. (I highly recommend watching it online if you haven't already seen it.) If I spent the same $5000 per year on taxes to support health care, I could get my entire family covered, pay no deductibles, and have zero chance of being turned away for a dread disease, let alone going bankrupt for having one.

And before the Republicans jump up and scream blue murder over socialism, I want them to shut up for a second and realize that one of the rightest of the right-wingers, a guy that makes Rush Limbaugh and Glenn Beck look like a bunch of Commie preverts, the very OTTO VON BISMARCK himself, created the idea of a government-run health care system.

That’s right. The guy that made conquering France cool and who popularized helmets with spears on them cooked up government-run health care. The German system has short wait times, lower costs, plenty of drugs, plenty of care, house calls, you name it. It’s awesome, and it’s so far to the right, it’s ridiculous.

Listen to Bismarck’s impeccable right-winger credentials: not only did he invade France and militarize Germany, he also said all kinds of horrible racist stuff about Poles. He passed the Anti-Socialist Laws in Germany. He didn’t just argue against Socialism – he outlawed it! He used a secret slush fund to bribe journalists and rip apart his political enemies. Bismarck persecuted the Catholics, imprisoned the Liberals, and ran roughshod over any sort of hippie socialism that dared raise its head. He survived a democrat’s assassination attempt – that’s right, a democrat tried and failed to kill him, he was that right-wing.

And he cooked up nationwide government health coverage in 1883, the first system of its kind in the world. From a right-winger who not only owned guns, he used them in combat against the enemies of his nation. Eat your heart out, Charlton Heston.

And if that’s not good enough for you, there’s the Taiwanese system, which was made up by the ultra-right Nationalists under Chiang Kai-Shek.

We in America could learn a lot from the ultra-right extremists. So there ya go. Discuss.

posting in an epic thread.

Bismarck: Chancellor of Awesome

Otto von Bismarck may have been "right-wing" in the sense of being militarist, nationalist, and racist, but he was also economically authoritarian. Germany underwent a rapid period of state-led industrialization under his rule in an attempt to catch up with its already developed neighbors Britain and France with the ultimate goal of developing a colonial empire. Rightist or center-right parties in other countries have also been economically protectionist and authoritarian - notably Japan's Liberal Democratic Party. This is one of the reasons why political ideology should really be measured on at least a two-dimensional scale, and why Bismarck's form of the "right wing" can't really be compared to the U.S. Republican Party, which is economically libertarian and espouses the free market.

Just as you can't neatly divide the political spectrum into left and right, you can't neatly divide health care systems into "government-run" and "other". The problem with our current health care system is that it has too much of the wrong kind of government interference. In the 1950s, largely due to lobbying from organized labor, Congress passed a law giving a tax exemption to employer-sponsored health insurance. Ten years later it created Medicare, which it modeled on the employer-based insurance system, and then Medicaid. Health care costs have been skyrocketing ever since. Why, you might ask?

Insurance is an extremely inefficient method of paying for anything. It places massive bureaucracies in between the customer (in this case, the patient) and the seller (the doctor, hospital, or other provider). When a patient has to rely on insurance, his/her market power is greatly reduced; there is no accountability to make sure the patient receives quality service at a reasonable cost. The only reason we use insurance to pay for all our medical expenses is because decades of poor government policy - the insurance tax exemption, followed by the creation of Medicare and Medicaid - have made insurance the primary means. The massive inefficiencies inherent to insurance have, in turn, driven up costs to the point where no one can afford to pay out of pocket or even out of a health savings account.

Now we've got a health insurance "reform" bill pending in Congress that's supposedly going to lower costs by creating a new government-run program to "compete" with private insurance plans and spend a ton of federal money to subsidize medical care for low-income Americans. News flash: handing out free money does not provide an incentive for health care providers to lower costs. All this bill will do is continue to entrench the nation in the insurance-based system that creates a vicious spiral of high costs and lack of accountability. It's true that the federal government may not pull the same kind of shenanigans that private insurance companies do - denying coverage right when someone gets sick, etc. - but that won't be much use if this new program bankrupts the Treasury, which Medicare, Medicaid and Social Security are already doing.

What we need in this country isn't a "government-run" health care system; it's a free-market system, with policy safeguards to protect against the problems posed by asymmetric information, that will allow the health services industry to be directly accountable to patients instead of placing massive labyrinths of bureaucratic red tape in front of them. Health savings accounts - set up either through the government or through private banks - should be the main method of paying for medical expenses, and insurance should be used only for catastrophic expenses. I had hoped that Republicans would propose some genuine ideas to this effect, but they seem more concerned with trying to score political points against the Democrats by derailing the effort entirely. Still, on health care issues in America, the right has got it much more right than the left.

In the Frontline documentary, the common theme in other systems was that no insurance company could run a profit. Instead, they competed with each other in order to stay in business. This benefited the consumers with that regulative help.

Another common theme was having everyone be part of an insurance plan, nobody could be refused, and none of it tied to a job. Where government did not run the system, it regulated it in the interests of the people governed.

I am no longer a believer in the rationality of the market. Too often, that's an excuse to turn something into a casino. We need regulations to the point of restraining the nastier aspects of the markets. Yes, this introduces inefficiencies and problems. However, it also makes sure that social goals are met - goals that should have a higher priority than monetary gains.

Well, I think we can agree on that; completely unregulated markets usually don't function quite properly (in this case due to asymmetric information, as I said above). Regulation can actually improve efficiency. And certainly health insurance should not be tied to employment; that's just a relic of World War II wage freezes and lobbying by the organized labor movement. However, I still don't think that insurance is an efficient method of paying for health insurance at all. Paying directly would make the system far more accountable to the customer?

What do you mean, "no insurance company could run a profit"? An outright prohibition on profits seems like a pretty terrible idea.

Not-for-profit does not mean it goes broke. It just means it accepts limits on its corporate function.

Nonprofit cooperatives are a solution that's been proposed in the U.S., both in the current bill and the Wyden-Bennett bill, which is the only real reform attempt offered so far. I think this is a far better solution than a government plan, but prohibiting profit still dampens incentives to provide quality services.

Is our healthcare the best in the world? No.

Is letting 535 people under the direction of nancy peolosi and harry reid come up with a new plan a good idea? No no oh dear jesus in heaven no...

I'll post a more solid argument later, but for now I leave you with a short summary:

The middle class americans who go yell at their congressmen at town hall meetings see the plans floating around congress as mechanisms to take the health benefits they receive as a part of their compensation and give that same coverage to people who didn't make the effort they did to get educated and find a job that provides for them. Put another way, how would ms. pelosi feel if someone told her that mr. joe smith of "that alley behind the arby's, San Francisco", would be replacing her as congresswoman? We are 'Merican, and we don't really take kindly to other people getting for free the same things that you've worked hard for, all in the name of equality. Don't get me wrong, the current model for health insurance isn't great, but you don't fix it by tearing everything out and making another entitlement program that will run out of money in 10 years (or less!).

Oh, and I'm pretty sure OvB and the taiwanese were a little more truthful and transparent about their government run plans. None of this "some subterfuge is necessary for the betterment of society" crap...

A more solid argument would be much appreciated, Captaink...especially one that avoids the fallacy of "poor people are poor because they deserve to be poor." (Hint for ideas: the one I posted earlier. )

I never said that. I just said that the haves would rather the plan for helping the have-nots didn't affect the haves so much. Also, that wasn't so much my argument as an explanation of why some many people are all of a sudden pissed off.

And my full response may be a while, btw...I'm super busy with work through saturday night.

Legitimate, but this is much more than a debate about "haves and have-nots", redistribution of wealth, etc. and you do the issue a disservice by treating it as such. It's more about the pragmatic policy goal of lowering health care costs and increasing access for all Americans. By framing it that way we can at least agree on a common purpose and avoid vague philosophical debates.

The Taiwanese model with higher price points would present a sustainable model for the USA. Same for the Japanese. Lots of private options, but with regulation of prices and prohibitions on profits at the public expense.

Think fire departments... they're not run for profit, and that's a good thing for the rest of us.

Well obviously in a free market everybody who works hard and plays by the rules wont end up poor. Failure doesn't happen to people who actually work hard, everyone knows that!

A constituency currently obsessed with refusing scraps of medical care to the poor should remember that they benefit from social welfare policies as well-in fact, they receive more government funding and face fewer budget cuts than poor people do-77% of non-means tested public assistance spending goes to middle income people.