Will Collier notes that many trusts in the British National Health Service are instituting mandatory waiting times in an effort to control usage of the NHS healthcare system:
Doctors are also resigning. One gynæcologist said that he spent more time doing sudoku puzzles than treating patients because of the measures. Since January, West Hertfordshire NHS Trust, with a deficit of £41 million, has used a 10-week minimum wait for routine GP referrals to hospital. Watford and Three Rivers PCT, £13.2 million in the red, has introduced “demand management”: no in-patient or day case is admitted before five months.
Despite the Democrat’s constant clamoring for more and more socialized medicine, such a system would be an unmitigated disaster for this country. Not only do such schemes have a tendency to fail, but they don’t scale well at all. A system like the NHS scaled up to try and meet the healthcare needs of 300+ million people would collapse even faster than the NHS has.
It’s not that the American system is perfect – it’s that we still try to divorce users of healthcare from providers of healthcare. Employers don’t provide food, housing, or utilities to their workers – nor should employment and healthcare coverage be linked together. The more one tries to separate users and producers, the more distorted the market becomes. Putting the government into the mix only makes things infinitely worse. Imagine if healthcare in this country were imbued with all the efficiency and compassion of the typical DMV office – it is rather hard to argue that such a system is really desirable.
Moving further towards the broken NHS model will provide the illusion of coverage without meeting the actual goal of making medicine more affordable without sacrificing quality of treatment. Medical care will always be expensive by nature – trying to pretend that Uncle Sam can foot the bill without sometime giving way is a fool’s errand, and the massive structural problems with the NHS in the UK demonstrate precisely why.
“Despite the Democrat’s constant clamoring for more and more socialized medicine, such a system would be an unmitigated disaster for this country. Not only do such schemes have a tendency to fail”
Huh? If they have a “tendency to fail”, why does every civilized country in the world except the US have such a “scheme”?
“It’s not that the American system is perfect – it’s that we still try to divorce users of healthcare from providers of healthcare. Employers don’t provide food, housing, or utilities to their workers – nor should employment and healthcare coverage be linked together. The more one tries to separate users and producers, the more distorted the market becomes. Putting the government into the mix only makes things infinitely worse.”
So employers AND government should be held harmless from funding health care coverage? That’s definitely in keeping with the “ownership society” values of sub-Saharan Africa, but perhaps expecting a country whose largest employer is Wal-Mart to have 290 million self-financing health insurance consumers is less than practical.
“Imagine if healthcare in this country were imbued with all the efficiency and compassion of the typical DMV office”
It is now. Big Insurance is hardly a favorable alternative to Big Government, something you will probably discover if you have to deal with these barons following a major health care expenditure.
Talking with a fellow from Canada the other day he said the government run healthcare system isn’t too bad, unless you need an MRI and then that can take upwards of 6 months (based upon his experience).
The one thing about a government run system is that everyone has the same potentially mediocre level of care.
The best medical plan I ever had was working for a company who was self-insured. They paid 80% until the deductibles were met and then paid 100% and it didn’t cost an arm and a leg. My daughter’s chemo and bone marrow transplant were completely covered.
That company’s plan also took into account smoking and other aspects of lifestyle that were not healthy so that the smoke-hole gang paid more for their premiums. But I’m afraid those days are gone forever.
“That company’s plan also took into account smoking and other aspects of lifestyle that were not healthy so that the smoke-hole gang paid more for their premiums.”
It’s just that kind of disconnect from reality that makes divided insurance providers (private insurers for most working-age Americans, government insurance for retirees) so dysfunctional. The bottom line is that those smokers (along with the obese) run up the lowest lifetime health care bills because they die several years earlier on average than those living “healthy lifestyles” who are constantly lavished with praise by private insurance companies. Considering that the “healthy lifestyles” promoted by our privatized health insurance business end up foisting a lifetime of health care bills on Medicare, our entire system ends up being a sham since it shifts an ever-higher percentage of actual health care expenditures to government anyway….and given that we’re an aging society with a growing life expectancy and the creeping tyranny of puritanical lifestyle mandates, expect that the share of private insurance company outlays to rapidly diminish (at the expense of taxpayers) even if the health care status quo holds up.
Except that they run up massive health care bills before kicking the bucket, more than enough to make up the gap. several studies have determined that smoking does have an economic effect and increases overall health care costs.
Which is why Medicare badly needs reform. Too bad the Democrats want to expand Medicare coverage instead of managing it.
Smoking does cost insurers extra money – and a lot of extra money. Insurance companies track mortality and morbidity rates very closely, and there’s a reason why smokers pay extra premiums. If it really reduced health care costs for people to smoke, insurance companies would be giving away cartons with every policy.
“Except that they run up massive health care bills before kicking the bucket, more than enough to make up the gap.”
And other studies have contradicted that claim. http://www.brookings.edu/press/review/winter98/viscusi.htm
As life expectancies grow and the diseases of old age become increasingly expensive and prevalent, the smokers and obese will be even more of a bargain in terms of lifetime health care bills compared to the “healthy”, even if that fact continues not to be reflected by insurance company health care premiums which only cover working-age Americans and thus have a vested interest in deferring their clients’ health care costs into old age where people other than themselves have to pay the bill. Who do you think ran up higher health care bills in his lifetime? Ex-President Ronald Reagan or ex-Beatle George Harrison?
“Too bad the Democrats want to expand Medicare coverage instead of managing it.”
And here I thought it was the Republican-controlled Congress of 2003 and a Republican President that expanded Medicare. For all practical purposes, national single-payer health care at least has the potential of taking the dishonesty out of our patchwork health care system, particularly the ridiculous premise that “healthy people” who live to 95 and spend the final 10 years of their life in a nursing home run up lower lifetime health care bills than the 65-year-old who dies of lung cancer or a heart attack.
“Smoking does cost insurers extra money – and a lot of extra money.”
Of course it does. Smokers are more likely to require health care services in their working-age years than those who live “healthy lifestyles”. If private insurers were on the hook for the health care financing of people of all ages, however, they’d be singing an entirely different tune and would likely be promoting smoking as a means of diminishing long-term outlays.
Of course, by that logic, we should also be encouraging a dramatic rise in infant mortality, since that would really reduce health care costs. Then again, maybe that’s why the Democrats are so pro-abortion…
A very bad idea indeed.
There are two serious problems with this argument. The first is that the a “single-payer” system works. It doesn’t. It’s failing everywhere, and it’s failing in countries with smaller and more homogenous populations than ours. Trying to scale it up to a heterogenous population of 300+ million people would bankrupt the system in years.
Furthermore, if you want to argue that a public policy designed to kill people is something to shoot for, go ahead. However, the idea that a public policy designed to promote a product that causes a host of medical problems is even remotely a good idea strike me as abhorrent. Why not promote alcoholism? Suicide? Murder? All those would reduce health care expenditures too…
“Of course, by that logic, we should also be encouraging a dramatic rise in infant mortality, since that would really reduce health care costs. Then again, maybe that’s why the Democrats are so pro-abortion…”
Strawman. I’m simply lobbying on behalf of people putting into their bodies what they choose without dishonest and predatory surchages on their behavior allocated for the financing of non-existent “additional health care costs”.
“Furthermore, if you want to argue that a public policy designed to kill people is something to shoot for, go ahead. However, the idea that a public policy designed to promote a product that causes a host of medical problems is even remotely a good idea strike me as abhorrent. Why not promote alcoholism? Suicide? Murder? All those would reduce health care expenditures too… ”
That strawman could make it into the Guinness Book for its sheer size and density. I simply support people exercising personal freedoms, and prefer an honest discussion of health care expenditures rather than a manipulation of acturial tables with the endgame of a health-and-wellness police state hybrid crafted by Big Brother and Big Insurance. The consequences of the current course of anti-tobacco (and in the long term, anti-obesity) posturing will be terrorist-financing black markets, designed to evade supersized excise taxes, that are far costlier to America than whatever financial toll may hypothetically emerge from simply letting smokers smoke and obese people eat. I would think you would support getting the nanny state bootheel off of the necks of the peasants, but apparently only if it doesn’t threaten the profits of insurance companies.
Shame on you, Mark! It’s the job of the Republicans to promote public policies designed to kill people prematurely!
Except those healthcare costs are quite real. Smokers get sick more often than others. The treatments they require are exceptionally expensive. Sick people are less productive and contribute less to the economy. Again, peer reviewed studies have shown that 6-8% of healthcare costs in this country are a direct consequence of smoking.
Now, if you want to argue that cigarette taxes are a dumb idea, there’s a legitimate argument there. Personally, I don’t smoke anything but the occasional cigar, and if the government wants to tax cigarettes, let them. Will it create a black market in cigarettes? The level of taxation would have to be prohibitively high before that would happen – and cigarettes aren’t that addictive.
And you’re a Democrat why then?
The actuarial tables don’t lie. Smokers create costs that impact everybody. Society has an interest in promoting health. Insurance companies have an interest in keeping costs down. And most people have an interest in staying alive. Smoking hurts all those interests.
“Peasants”?! When did this become Tsarist Russia?!
Look, Big Tobacco knew that smoking causes cancer decades ago. They systematically sold a profit they knew to be harmful. If there’s ever a posterchild for corporate malfeasance, the cigarette companies would be it.
Smoking has social costs, and that makes it a legitimate target for regulation. I don’t necessarily support smoking bans and the like, but the argument that anyone should encourage smoking is simply wrong.
“Except those healthcare costs are quite real. Smokers get sick more often than others. The treatments they require are exceptionally expensive.”
A premise that requires one to believe that non-smokers never get sick, despite nursing homes full of geriatric, nominally-functional seniors whose generally “healthy lifestyles” have turned them into long-terms wards of the state. Again, I ask you who you expect ran up the highest lifetime health care bill? Ex-President Ronald Reagan or ex-Beatle George Harrison.
“Will it create a black market in cigarettes? The level of taxation would have to be prohibitively high before that would happen – and cigarettes aren’t that addictive.”
It ALREADY HAS! http://www.washingtonpost.com/wp-dyn/articles/A23384-2004Jun7.html And it’s getting infinitely larger with every artificial tax hike the gluttonous states impose on tobacco products. Apparently you weren’t paying attention last month when cigarette smuggling in America was cited as Hezbollah’s number one source of fundraising.
“And you’re a Democrat why then?”
There are tons of progressive libertarians who favor a laissez-faire approach to issues of personal freedom but a progressive approach to meat-and-potatoes governance.
“The actuarial tables don’t lie. Smokers create costs that impact everybody. Society has an interest in promoting health. Insurance companies have an interest in keeping costs down. And most people have an interest in staying alive. Smoking hurts all those interests.”
The cold demographics of a society aging beyond the historical rate of human lifespans is the biggest domestic threat to quality of life in the civilized world as services and resources, public and private, will strain to accommodate a growing and aging population. Pretending that the early deaths of smokers and obese people is a bigger problem, as opposed to financial salvation, will only accelerate and increase the magnitude of the problem. It may be politically incorrect to say that the premature deaths of smokers and overweight people serve the long-term financial interest of the world, but pretty much every financial and demographic obstacle on the horizon would cease to exist if everyone started smoking and overeating tomorrow.
“Look, Big Tobacco knew that smoking causes cancer decades ago. They systematically sold a profit they knew to be harmful. If there’s ever a posterchild for corporate malfeasance, the cigarette companies would be it.”
No argument. Their sins are well-documented and repugnant, but it’s not them being hurt by legislation and regulations making life more expensive for consumers of their product, just as tougher drug laws against coke addicts don’t punish the Medellin cartel.
“but the argument that anyone should encourage smoking is simply wrong.”
I didn’t make that argument, but I’m saying that if insurance companies had to cover ALL Americans’ health insurance costs rather than merely working-age Americans, they would have a vested interest in promoting smoking to save on more expensive ailments of old age.
Which assumes that the productivity losses incurred by someone dying early mean nothing. Someone who works for 50 years (which is probably going to be the norm soon enough) produces a hell of a lot more than someone who keels over after 20-30 years in the workforce.
Quite frankly, I think that’s the ATF trying to justify themselves. It doesn’t cost zero to transport large amounts of cigarettes across state lines – and there’s a hell of a lot more lucrative things that can be smuggled.
Which is in itself a contradiction, but that’s a discussion for another time.
That’s been happening since the dawn of human history.
Why not just kill the elderly more directly? That would ensure that we didn’t have to pay for millions of cancer cases and really make things efficient.
It’s not just politically correct, it’s monstrous.
Not only is it morally abhorrent, it’s wrong. An economy can’t function when everyone has cancer. Your argument would be much more efficient if you’d just advocate everyone shooting themselves in the head. The effect is the same, only slower and less costly.
“Which assumes that the productivity losses incurred by someone dying early mean nothing. Someone who works for 50 years (which is probably going to be the norm soon enough) produces a hell of a lot more than someone who keels over after 20-30 years in the workforce.”
Let’s go with the most dire projections and say that smokers live an average 10 fewer years than non-smokers. If median life expectancy is 77 and we subtract 10 years from that, the average smoker still perishes as a senior citizen when they are not productive…or at a minimum, extract far more services from the economy than what they contribute.
“Quite frankly, I think that’s the ATF trying to justify themselves. It doesn’t cost zero to transport large amounts of cigarettes across state lines – and there’s a hell of a lot more lucrative things that can be smuggled.”
Ah, sounds alot like “we’re not really getting warmer”. Even the facts are irrelevant if they’re simultaneously inconvenient to one’s pre-determined worldview. If you want to make two million dollars in a weekend, there’s no easier way to do it than to smuggle a truckload of cigarettes from North Carolina to New York City. I’ve heard from New Yorkers that at least a quarter of cigarettes sold there are smuggled in illegally, either by organized crime or terrorists. You cannot artificially inflate the price of a good or service far above its market value and not expect a black market to respond in kind. As a disciple of the free market, I would think you of all people would realize that.
“That’s been happening since the dawn of human history.”
Not in correspondence with a diminishing number of productive members of society (think lower birthrates) to be providers for the geriatric and unproductive.
“Why not just kill the elderly more directly? That would ensure that we didn’t have to pay for millions of cancer cases and really make things efficient.”
How many times are you gonna wield that boneheaded strawman before accepting that I’m simply arguing on behalf of the personal freedom of consumption and real-world actuarial figures that legitimately determine health care costs? So long as private health care providers have an interest in deferring the health care costs of their customers onto Medicare’s nickel, we’ll never have an honest discussion on this matter. My argument is let people smoke and overeat at their own risk, but do so without the science fiction of the millions of dollars we’ll save because of their “healthy lifestyle” when in fact the opposite is true for everybody EXCEPT their working-age insurance company.
“Not only is it morally abhorrent, it’s wrong.”
Just yesterday, you made the argument that both government and employers be held harmless from financing their employees’ health care tabs. Spare me the moral indignation. In your open market utopia, the majority of the population would be unable to afford health care of any kind. That, my friend, would be monstrous.
Because a country has socialized medicine does NOT mean it is succeeding, Mark! Socialized medicine has bankrupted Canada’s economy, and they are trying to find a way to change to a private health care system like we have in the U.S. One doctor in Canada said patients are going blind because they have to wait four years to see an ophthamologist! Others are waiting up to 18 months for some diagnostic tests such as MRIs. Early diagnosis is key to treatment and survival. In Germany, a friend of mine had to wait a year for an operation. Even then, she had to return to the hospital three times before they had a bed for her on her scheduled surgery date!
Countries with socialized medicine have higher tax rates, poorer economies, and the worst health care.
Remember Walter Reed Hospital? The media recently reported the horrific conditions there. Folks, this is a government-run medical facility! Imagine if Hillary is elected and institutes socialized medicine as she has promised and EVERY hospital in America is government-run! And to think that three-fourths of Americans are asking for this. That’s simply ignorant and assinine!