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Stossel Solves the Health Crisis with Capitalism

Okay, well lets suppose that everyone who needs heart surgery wants to have the operation performed by the best heart surgeon? How do you decide who gets the best and who gets the rest?


Their doctor.

OK, I simplify. But tell me, how does that work in the US at the moment? If everyone with insurance demands to have their operation done by Best Surgeon, who sorts it out?

In fact, if I need elective surgery in Britain, my doctor may offer me the choice of which hospital to go to . There are several within reasonable reach. I would be advised what level of service was available at each one, and what the relative waiting times were like. My doctor might also say which option he recommends.

If, however, I demanded to go to Papworth (top heart transplant unit, over 300 miles away in an unrelated health authority) to be operated on by Magdi Yacoub, I'd expect to be told where I got off. Unless I had a very unusual condition which Magdi Yacoub was the only surgeon capable of fixing - in which case it would be arranged for me.

Hey, I haven't got heart disease. Look at the advice available for patients who do.

As you have received this booklet, it has been decided that you need an angioplasty or a heart operation. From December 2005, patients who need an angioplasty or heart surgery will be given the choice of at least four hospitals in which to have treatment. The choices open to you will depend on the nature of your illness. If you are very ill or who have other illnesses as well it may be that some of the options on offer do not have the facilities or expertise needed to treat you. It will also depend on whether you are having a heart bypass operation, angioplasty or a heart valve operation.

The hospital could be within the NHS or a private hospital with the NHS paying for your treatment. This will vary depending upon the local arrangements that are in place in your area. This leaflet sets out how the scheme will work for you and what you can expect.

Once it has been decided that you need an angioplasty or heart surgery you will receive specialised advice to help you make your choice. This may be from your consultant cardiologist or another member of the healthcare team.

They will discuss the options that are suitable for you and help you to decide what you would like to do.

They should be able to tell you how long you can expect to wait for treatment at the hospitals available to you and will be able to provide you with other information to help you make your decision.

Whatever you choose, your treatment will be free.


You can read the rest for yourself.

Rolfe.
 
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There's conflation in the meaning of the word "right" in your post, GStan. In fact, this somewhat peculiarly American notion of "inherent" rights is often at the cause of European bafflement towards Amercian positions on a number of issues, from healthcare to gun control.

As Rolfe has pointed out, rights are not inherent. Rights are granted (or devolved) by government. If your government decides that its citizens have the right to healthcare, then they shall have that right. As such, I don't particularly understand your objections.

If you like Stossel, by the way, what arr your thoughts on the most egregious of his misrepresentations in the video in the OP? Liar, fool or mendacious ideologue?
 
Most people will want to be operated on close to home to avoid extra costs and travelling for family members. Also, the top surgeons will have long waiting lists for non urgent surgery, so most people will want to be operated on by someone who can treat them more quickly.
 
How would this be decided in a/the system that you propose?

That's obvious, isn't it? Market forces -- the "best" surgeon would charge the highest prices, thus ensuring that the rich get their routine, run-of-the-mill procedures done expensively, whilst the poor don't get their complex, novel procedures done at all.

The market solves everything.
 
Not entirely an appeal to popularity. I see a tendency in some US posters to declare that access to healthcare simply is not a human right, period. Jerome was coming from that point of view. "Your problem is that you think healthcare is a right when in fact it is a privilege."

<snip>

And how extensive should the provision as-of-right be? Again, a question for the citizens. Experience in other countries may suggest that some restraint is exercised. However, given that US healthcare spending is currently about 15% of GDP while in countries with universal systems it tends to average around 8% of GDP for pretty comprehensive coverage, I'd say there's a fair bit of wiggle-room there.

Rolfe.

Thanks for the response. With this post, (as well as your very compelling post I just read on the last page of the Universal Healthcare in the US thread), you've given me quite alot to ponder. I'm going to digest it all and probably won't be able to give a meaningful response until tomorrow (if at all :D). Thanks again.
 
hehehehe. awesome:D

I often think the best way to further a debate is not only to ignore those who reasonably disagree with you, but to actually simultaneously boast about one's wilful ignorance, don't you?

You put me on Ignore because you found my linking to statistics (on poverty levels in the USA) ideologically unpalatable. That you pretend that they do not exist, and that you have still failed to address their implications on your stubborn, selfish ideology speaks more profoundly on the validity of your arguments than you ever could, I'm afraid.

How will "money" ensure that these poorest of Americans, fully 17% of all Americans in any one year and more than half of all Americans for at least one year of their adult lives, gain access to the "best" heart surgeon?
 
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There's conflation in the meaning of the word "right" in your post, GStan. In fact, this somewhat peculiarly American notion of "inherent" rights is often at the cause of European bafflement towards Amercian positions on a number of issues, from healthcare to gun control.

As Rolfe has pointed out, rights are not inherent. Rights are granted (or devolved) by government. If your government decides that its citizens have the right to healthcare, then they shall have that right. As such, I don't particularly understand your objections.

Yes, I am uncomfortable with the notion that rights are merely granted and not inherent. I believe that some rights belong to me because I am a human, not because a government has granted them to me. However, as I mentioned in my post, perhaps a debate over inherent vs granted rights would be better off in another thread.

If you like Stossel, by the way, what arr your thoughts on the most egregious of his misrepresentations in the video in the OP? Liar, fool or mendacious ideologue?

I can't watch the video, but as a regular reader of his columns, I am probably aware of the themes presented therein. Are those my only choices? If so, I would say he is a fool, at least to the extent that he is foolishly optimistic and idealistic about the capabilities of a free market. In any case, I still like having him as a balance to those who are equally foolish in the opposite direction.
 
I know a lot of people were annoyed that Jerome got banned. However, it's a pleasure to be able to have this discussion without pointless degeneration into arguing his position that human rights are a constant absolute, which exist even in the absence of any facility for granting them, and even in the face of absolute denail of them. Conversely, anything Jerome didn't think was a human right, could never be a human right, even if every country in the world and the UN all agreed that everyone should have that right. The argument (sorry I can't find the threads because Jerome is no longer in the list of members) did provide some insight into some US patterns of thought, though, and as a result clarified my own thinking on the matter.

We do often hear US poster declaring that if we agree that universal healthcare is a right in the US, then this automatically implies some ridiculous and entirely impractical corollary involving access to "The Best Care" and being flown around the continent at public expense. Which of course it doesn't. Any US right to healthcare would be exactly what its legislature mandated it to be. I would no more expect it to mandate that every citizen should have the right to the individual surgeon of their choice regardless of clinical need or geographical practicality, than I would expect it to mandate that every child should have the right to be educated at any school its parents chose, with free transport, irrespective of distance or the child's ability.

We so often get sucked into this disagreement, when in fact it's totally peripheral to the subject. However, it does seem that the point is raised repeatedly because of some peculiar connotations the word "right" has for US posters.

Rolfe.
 


Come on, that doesn't make sense. Most of the population of the USA has its big-ticket items of healthcare paid for by an insurance company. So can every insured person demand that his heart surgery be done by the US equivalent of Magdi Yacoub? If so, who sorts it out?

Rolfe.
 
Yes, I am uncomfortable with the notion that rights are merely granted and not inherent. I believe that some rights belong to me because I am a human, not because a government has granted them to me. However, as I mentioned in my post, perhaps a debate over inherent vs granted rights would be better off in another thread.

There have been a few already, but I'm sure if you started one you'd spark some discussion.

In short, and on examination, I think you'll find that view rather untenable without resort to some rather torturous metaphysics, but let's save that for another thread. This particular position seems almost uniquely American (or at least, it is rather more prevalent amongst Americans than Europeans, as best I can tell), and really does underpin much of the bi-directional bewilderment that occurs in these types of discussions.


I can't watch the video, but as a regular reader of his columns, I am probably aware of the themes presented therein. Are those my only choices?
Rolfe provided summaries of the video up thread. I think you'll find them interesting rebuttals, as she inter-splices his claims (and his manner of presenting them) with her usual sharply-focused analyses. I think, yes, those are your only choices.

If so, I would say he is a fool, at least to the extent that he is foolishly optimistic and idealistic about the capabilities of a free market. In any case, I still like having him as a balance to those who are equally foolish in the opposite direction.
Well, it's not so much that he's foolish about what he proposes (true as that may be), more that he is foolish about what he opposes - he's tilting at windmills, really. In this particular discussion, he is ignoring the collective reality of six decades universal healthcare provision in every single western democracy on the planet. This isn't about fuzzy ideologies or utopias, it's about measurable, objective facts on the ground.

Does the world really need a counterbalance to reality?
 
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Their doctor.

OK, I simplify. But tell me, how does that work in the US at the moment? If everyone with insurance demands to have their operation done by Best Surgeon, who sorts it out?
.

On the point of travelling to visit a specific surgeon.

I was rushed to Liverpool hospital, which was around (just over I think) 100 miles from where I was born not because I or my family WANTED to go to the heart surgeons there, but because I NEEDED to. It was the only place available that performed the surgery I needed.

You don't, unless it is elcetive, get to pick and choose where you go. You go to the nearest available hospital that can provide the standard of care you need. This is almost always your nearest hospital, or at least large hospital. With me it was different because of my needs.

Once again Dan, you cannot just insist upon X Y and Z. You need to learn about what you are arguing against so passionately or you just look like an idiot.

In fact, having seen you in another area of these forums, I can provide an analogy. You are acting like a truther. Any evidence (and the posters that provide it) that conflicts with YOUR opinions and YOUR views can be ignored. You stick your fingers in your ears and scream "lalala I'm not listening". Well tough. It doesn't work with 9/11 and it won't work here, all it does is make you look intellectually dishonest and about 5 years old.

ETA: GStan on the other hand is listening to opposing arguments and considering them fairly. It's possible to have a discourse with him because he isn't acting like a coward.
 
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Yes, I am uncomfortable with the notion that rights are merely granted and not inherent. I believe that some rights belong to me because I am a human, not because a government has granted them to me. However, as I mentioned in my post, perhaps a debate over inherent vs granted rights would be better off in another thread.


I understand where you are coming from on this, and believe me, we've been over it before. I even found the bloody thread!

Basically, Jerome got his backside handed to him. The upshot of it all was that while many posters upheld the concept of right and wrong as absolutes, this was best translated as the proposition that people should have certain rights. Thus morality and basic human decency would suggest that your society ought to grant you the right to life, the right to own proprety and so on.

You can't tell a slave that he has the right to liberty, because in a society where slavery is legal, he hasn't. You can, however, declare that slavery is wrong and he ought to have the right to liberty.

You can't tell a man who is about to be murdered by a felon that he has the right to life, because clearly that is meaningless. You can however declare that he ought to have the right to life, and do everything you can to ensure that he gets it.

You may declare that the right to life is absolute - but then, how do you deal with capital punishment. You have to concede that the state has a right to remove that right if it sees fit.

And so on. Try reading that thread, from what I remember it was quite instructive.

However, the healthcare issue is simpler if this approach to rights is not followed up. Do you think that people ought to have the right to healthcare? Depends on a lot of things, perhaps principally on whether the ability exists within the society to deliver the right to healthcare. But given that it does, quite self-evidently, then granting that right is an option open to any government, subject to the agreement of its citizens.

Many people in the US declare that they wish to keep their own money and not be obliged to contribute to the healthcare of others. They see their "right" to their own property as paramount. However, when you get down to the specifics and the detail, these same people also don't want to see poor people with expensive illnesses dying for lack of care. It's a paradox.

It's a paradox that every developed first-world democracy (including the US) has solved by declaring, if you like, mandatory charity. Rather than rely on the voluntary contributions of the well-off to prevent the poor dying of expensive diseases, mandatory contributions are enforced. (Just like they are, even in the US, to fund a whole host of other public goods that nobody would even begin to argue are basic human rights, right down to those library books.) The advantage is that the burden of contributing is not entirely resting on the generous and the philanthropic.

You can't have it both ways. If contributions are not mandated then there is a very high chance that the poor will, in fact, die in the streets. The only way to prevent that is if some philanthropists are prepared to contribute way beyond their proportionate liability, to offset those of a miserly tendency. And that has a whole lot of extra problems we've already discussed.

The big difference is that in the US, this "mandatory charity" only covers the very poor and the elderly. It is not a universal system covering the entire population. And oposition to the principle of "mandatory charity" then leads not in the direction of universal coverage, but of opposition even to that level of provision - as we've seen with Dan.

If you stick with a two-tier system as you have at present, with "mandated charity" (taxes) funding the healthcare of the poor, while the better-off look after themselves, you create many problems. Most obviously, that the better-off cannot access the healthcare system they themselves are paying for - thus resentment and bitterness may ensue. Also, that anyone who falls between the cracks and finds themselves without entitlement, has to reduce themselves to penury before they can access the tax-funded system.

If on the other hand you have a system where everyone is entitled to access the tax-funded system, much of these objections disappear. The well-off may be paying quite a lot - but they are getting benefit from their contributions. The poor are not further disadvantaged by having to settle for a second-class system, constantly squeezed by legislators who don't have to rely on it themselves. And those who fall ill at inconvenient times, such as just after being made redundant from a well-paid job, don't have to spend every penny they have on private medical treatment before becoming eligible for publicly-funded treatment. And it's just the same system as funds those library books, dammit!

I seriously can't see who doesn't benefit from this. Even the rich person who doesn't fall ill (who has therefore paid in a lot more than he has taken out) has the advantage of not having to worry about healthcare, or falling into an impossible healthcare need in the future due to a change in fortune.

To reject all the practical advantages simply because of an ideologically-driven desire not to contribute to a system which will benefit you as much as the next guy, seems to me to be completely perverse.

Rolfe.
 
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On the "money" issue -- it occurs to me that another ideological axiom (again, peculiarly American) underpinning positions such as Dan's (and those of many AnCap or large-L Libertarians) is that all those who are rich deserve to be rich, and all those who are poor deserve to be poor, without exception. It's a very pervasive pre-supposition.

Fred Goodwin says you're wrong.
 
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I understand where you are coming from on this, and believe me, we've been over it before. I even found the bloody thread!
Ta for the nostalgia. I didn't perceive an issue with JEROME DA GNOME on the thread--JEROME more or less admitted that believing that rights were inherent was the only palatable option because the alternative was inescapable tyranny that was too horrific to contemplate. Except that pulling the "inherent" card just robs protected rights of the ability to stand or fall on their own merits.
 
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On the point of travelling to visit a specific surgeon.

I was rushed to Liverpool hospital, which was around (just over I think) 100 miles from where I was born not because I or my family WANTED to go to the heart surgeons there, but because I NEEDED to. It was the only place available that performed the surgery I needed.

You don't, unless it is elcetive, get to pick and choose where you go. You go to the nearest available hospital that can provide the standard of care you need. This is almost always your nearest hospital, or at least large hospital. With me it was different because of my needs.

Indeed, my niece was lucky that one of the local hospitals specalises in children's cardiac problems (the same hospital the figured in Rolfe's favourite example - Abigail) - so the family didn't have to travel very far. Very lucky as she had to be in hospital for months.
 
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Yes, I am uncomfortable with the notion that rights are merely granted and not inherent. I believe that some rights belong to me because I am a human, not because a government has granted them to me. However, as I mentioned in my post, perhaps a debate over inherent vs granted rights would be better off in another thread.

The problem with innate rights is that it is not a practical solution to any issue of rights. It is a philosophical position on what rights goverments should recognize and enforce, but the only way rights are protected is though action of some sort.
 

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