We continue to hear how wonderful it is as compared to the horrible US system.
But is it? One of the fundamental truths of any health care system is you have infinite demand meeting finite resources (beds, doctors, availability, etc). Whatever system a country has, that truth doesn’t change.
So, regardless of system, there is going to be some sort of rationing. It is unavoidable and inevitable.
Now add a desire to control and cut costs associated with the provision of health care to the mix (the promise of every one of these government systems). On the one side, as European nations have done, access to health care is expanded to include everyone. On the other hand, these same nations attempt to control health care costs.
The result? Very mixed. France is always held up as the exception to the rule that government health care can’t be both good and inexpensive. But a closer examination seems to indicate that it isn’t an exception at all:
A World Health Organization survey in 2000 found that France had the world’s best health system. But that has come at a high price; health budgets have been in the red since 1988.
In 1996, France introduced targets for health insurance spending. But a decade later, the deficit had doubled to 49 billion euros ($69 billion).
“I would warn Americans that once the government gets its nose into health care, it’s hard to stop the dangerous effects later,” said Valentin Petkantchin, of the Institut Economique Molinari in France. He said many private providers have been pushed out, forcing a dependence on an overstretched public system.
Why have private providers been “pushed out”? Because government has provided health care “cheaper” than do private providers (and obviously at a loss given the deficit). Notice I said “cheaper”. That doesn’t necessarily mean “better”.
And the same thing is being seen in other European health care systems which are considered “models” of government run health care:
Similar scenarios have been unfolding in the Netherlands and Switzerland, where everyone must buy health insurance.
“The minute you make health insurance mandatory, people start overusing it,” said Dr. Alphonse Crespo, an orthopedic surgeon and research director at Switzerland’s Institut Constant de Rebecque. “If I have a cold, I might go see a doctor because I am already paying a health insurance premium.”
Cost-cutting has also hit Switzerland. The numbers of beds have dropped, hospitals have merged, and specialist care has become harder to find. A 2007 survey found that in some hospitals in Geneva and Lausanne, the rates of medical mistakes had jumped by up to 40 percent. Long ranked among the world’s top four health systems, Switzerland dropped to 8th place in a Europe-wide survey last year.
Dr. Crespo’s point is simply an astute observation of human nature. If something doesn’t directly cost the user, why would the user ration the use of such a benefit?
The use, however, still costs someone or something. The doctor must be paid, the institution must be paid, etc. So in the end, the only way to control costs is to cut payments. Eventually, the incentives to enter the health care field become less attractive (unless you like long hours, overrun waiting rooms, minimal time with patients, being second-guessed by a bureaucracy and making much less than a private system allows for compensation) and there are fewer that enter the field. Hospital beds then drop, hospitals merge and there are fewer specialists available to serve the population as Switzerland is discovering.
And then there’s the lack of innovation to face.
Bureaucracies are slow to adopt new medical technologies. In Britain and Germany, even after new drugs are approved, access to them is complicated because independent agencies must decide if they are worth buying.
When the breast cancer drug Herceptin was proven to be effective in 1998, it was available almost immediately in the U.S. But it took another four years for the U.K. to start buying it for British breast cancer patients.
The promise that has been made in the US is health care reform will return the decision making to the doctor. But that’s simply a false promise given the priorities of the reform we’ve been promised. It is to cut cost and make care “affordable” to all. Somewhere is a bureaucracy in waiting which will decide what “affordable” means – and it won’t include your doctor.
So you can expect innovation to begin to slow. Why invest billions when a bureaucracy will decide whether or not it’s a medicine or treatment worth the cost. The same bureaucracy will also decide what it will pay for your innovation. Of course, if the innovator can’t recover the cost of development and make a profit as incentive toward more innovation, the probability exits the developer will simply stop such research.
“Government control of health care is not a panacea,” said Philip Stevens, of International Policy Network, a London think-tank. “The U.S. health system is a bit of a mess, but based on what’s happened in some countries in Europe, I’d be nervous about recommending more government involvement.”
Words of wisdom most likely to be ignored by our legislators here. And the unfortunate thing is it will not only destroy an excellent health care system here, but, given the level of government spending forecast, tank the rest of the economy as well.
[HT: Carol D]
Well if the UK is any example, “green jackets”, a sort of environmental police force with the power to enter and search (with a blanket “warrant”) any company it so chooses to inspect. Is “Gestapo-like” tactics a stretch?
The boys in green are coming as the Environment Agency sets up a squad to police companies generating excessive CO2 emissions.
The agency is creating a unit of about 50 auditors and inspectors, complete with warrant cards and the power to search company premises to enforce the Carbon Reduction Commitment (CRC), which comes into effect next year.
Decked out in green jackets, the enforcers will be able to demand access to company property, view power meters, call up electricity and gas bills and examine carbon-trading records for an estimated 6,000 British businesses. Ed Mitchell, head of business performance and regulation at the Environment Agency, said the squad would help to bring emissions under control. “Climate change and CO2 are the world’s biggest issues right now. The Carbon Reduction Commitment is one of the ways in which Britain is responding.”
The formation of the green police overcomes a psychological hurdle in the battle against climate change. Ministers have long recognised the need to have new categories of taxes and criminal offences for CO2 emissions, but fear a repetition of the fuel tax protests in 2000 when lorry drivers blockaded refineries.
Criminal offenses for “CO2 emissions” – Orwell saw this coming but clearly he didn’t understand that it would be based in criminalizing a natural byproduct of respiration and trace atmospheric gas, did he?
Again, it’s the precedent this sets which is both upsetting and dangerous. Probable cause? Green Jackets don’t need no probable cause!
Let freedom ring.
I assume, since China is a totalitarian state, that the US won’t have anything to say about the violence there for at least 10 days:
The official death toll in riots in China’s northwestern Xinjiang region rose sharply Monday, with the government saying that 140 had been killed in what appears to be one of the deadliest episodes of unrest in China in decades.
Police said at least 828 other people were injured in violence that began Sunday in Urumqi, Xinjiang’s capital. Witnesses said the conflicts pitted security forces against demonstrators, and members of the region’s Turkic-speaking Uighur ethnic group against members of the country’s Han Chinese majority. Many among the predominantly Muslim Uighurs have chafed at Chinese government rule.
As evening fell in Urumqi Monday, witnesses said that paramilitary troops of the People’s Armed Police, backed by armored personnel carriers, were patrolling largely calm city streets. Many businesses remained shuttered and gates of the city’s central bazaar, which was the scene of unrest Sunday night, were closed.
Police said they were still searching for dozens of people suspected of fanning the violence. Several hundred people have already been arrested in connection with the riot, police said, and the government said it was bringing “ethnic officials” from nearby areas to help with interrogations.
Of course the reason given by the Chinese government is much the same as that given by the Iranian government concerning the problems there –
The government blamed the unrest on a prominent exiled Uighur leader, Rebiya Kadeer, president of the World Uyghur Congress, an activist group. Sunday’s demonstration was “instigated and directed from abroad,” according to a government statement cited by Xinhua.
Given that statement, you can expect silence from the Obama administration as they’ll want to ensure they’re not seen as “meddling” in China’s internal affairs. And I can promise you that the Uighur dissidents being rounded up by China’s police forces will not be offered a vacation in Bermuda.
Apparently the only country in which the “no meddling” policy is waved is Honduras.
In this podcast, Bruce, Michael, and Dale discuss the meaning of the 4th of July, Honduras, and Sarah Palin’s resignation.
The direct link to the podcast can be found here.
The intro and outro music is Vena Cava by 50 Foot Wave, and is available for free download here.
As a reminder, if you are an iTunes user, don’t forget to subscribe to the QandO podcast, Observations, through iTunes. For those of you who don’t have iTunes, you can subscribe at Podcast Alley. And, of course, for you newsreader subscriber types, our podcast RSS Feed is here. For podcasts from 2005 to 2007, they can be accessed through the RSS Archive Feed.
He took off a few hours ago from the US in – wait for it – a Venezuelan plane. Naturally the UN has actually gotten off of its rear-end and taken what, for it, is “action”. The UN General Assembly President Miguel D’Escoto Brockmann and a number of journalists are accompanying former Honduran president Mel Zelaya.
Honduras, naturally, has said Zelaya isn’t welcome and has stated they will arrest him should he try to reenter the country. The OAS, in the meantime, has suspended Honduras from the organization.
The interim government (which some news organizations are characterizing as a “military government”) pleads for the rest of the world to back off and let Honduras work this out.
But, with apparently everything under control and in tip top shape in their respective countries, the presidents of Argentina, Ecuador and Paraguay, along with the head of the OAS have time to fly to El Salvador to “monitor events.”
Meanwhile it is reported that Nicaragua is moving troops toward the Honduran border. All of this tacitly green-lighted by the Obama administration’s stance.
The Venezuelan plane carrying deposed president Mel Zelaya landed in El Salvador, according to Honduran daily El Heraldo. Venezuelan chancellor Nicolás Maduro verified that the airplane was Venezuelan and identified it as YV-1496.
But that’s not meddling – no siree.
Honduras has reported it will not allow the landing of the Venezuelan aircraft carrying Zelaya in Honduras. My guess is they’ll now try to drive into Honduras from El Salvador.
For new readers, the title is what the shortened “QandO” means.
- Whether you love her, hate her or really don’t care, it is hard too argue against the assertion that Sarah Palin effectively ended any national aspirations she might have had by announcing her pending resignation (assuming there isn’t some extremely compelling private family reason for doing so). The first thing any political opponent is going to say is “she quit on the citizens of Alaska, will she quit on you?”
- The story about the Washington Post selling access to the Obama administration isn’t just about the WaPo. Seems to me there had to be some a) knowledge of the plan and b) cooperation from the White House for it to have been as far along as it was. After all, the first “salon” was scheduled to be held at the publisher’s home in 2 weeks. Is anyone exploring that angle?
- How concerned is Saudi Arabia with the probability of Iran acquiring nuclear weapons? Apparently enough to make it known they’ll turn a blind eye to any Israeli incursion which crosses the kingdom in order to strike Iran.
- Apparently the scales have finally fallen from Colin Powell’s eyes concerning Obama and the direction he’s taking this country. Formerly Powell’s message was that American’s wanted more government and were willing to pay for it. He now says he’s concerned with the number of programs, the legislation associated with them and the cost of the additional government they’ll entail. “We can’t pay for it,” he’s now saying? Better late than never, I suppose, but this just underscores my disaffection with Powell politically.
- Speaking of Sarah Palin, apparently the federal investigation rumors (FBI looking into irregularities concerning the sports complex in Wasilla, etc.) and pending indictment are false. An FBI spokesman in Alaska has said there is no pending indictment or ongoing investigations of her. Concerning the ongoing rumor he says, “it’s just not true”.
- The after effects of the recent “election” in Iran continue to eat away at the foundation of the “Islamic Republic”. The Association of Researchers and Teachers of Qum split with Ayotallah Khamenei declaring both the election and the new govenrment “illegitimate”. That is a very public and unprecedented challenge to Khamenei’s power. Additionally Moussavi’s campaign has released a report that outlines the election violations in detail. These are very serious challenges to the regime’s legitimacy.
- Speaking of Iran, it appears that while the world is ready to ratchet up the pressure on the regime in light of its brutal put down of pro-democracy protesters, the Obama administration is apparently prepared to block any sanctions agreed upon at the G8 summit. I swear I can’t figure that bunch out – support the dictator in Iran and mischaracterize a legal use of constitutional power in Honduras in support of another would-be dictator there.
- Did you know that Hitler had a 600 mph stealth bomber almost ready for production when the allies overran Germany? Check out the pics and description of the HO 2-29.
- The law of unintended consequences continues to operate unabated. Governments, desperate for revenue, have raised property taxes all across the country. Homeowners, knowing their home values have plummeted, are filing an unprecedented number of appeals. Those appeals are costing the governments huge amounts of money in refunds and attorney’s fees. However, homeowners should note that if they don’t appeal, the government will gladly screw them to the wall with an unjustified tax increase. Makes you feel all warm and fuzzy inside, doesn’t it?
We spent the 4th of July in Ocean Beach. Below are some pics of the fireworks display and other…festivities.
The fireworks show was pretty, as these sorts of things usually are.
Immediately after the fireworks show ends, another OB tradition begins. The 4th of July Marshmallow fight. It started 40 years ago as a friendly marshmallow fight between some OB neighbors, but every one else quickly took up the tradition.
It’s now become like a soft-candy-based Festival of Landru.
Happy Independence Day, everyone.
I‘m sorry, but the more I get into the monstrosities coming out of Washington DC, the less I see “independence” as a reality. Just a quick read through Waxman-Markey (and a quick read in anything but easy given the size of the bill) will tend to make you a bit pessimistic about “independence”. Consider the mundane topic of shade trees:
SEC. 205. TREE PLANTING PROGRAMS.
(a) Findings- The Congress finds that–
(1) the utility sector is the largest single source of greenhouse gas emissions in the United States today, producing approximately one-third of the country’s emissions;
(2) heating and cooling homes accounts for nearly 60 percent of residential electricity usage in the United States;
(3) shade trees planted in strategic locations can reduce residential cooling costs by as much as 30 percent;
(4) shade trees have significant clean-air benefits associated with them;
(5) every 100 healthy large trees removes about 300 pounds of air pollution (including particulate matter and ozone) and about 15 tons of carbon dioxide from the air each year;
(6) tree cover on private property and on newly-developed land has declined since the 1970s, even while emissions from transportation and industry have been rising; and
(7) in over a dozen test cities across the United States, increasing urban tree cover has generated between two and five dollars in savings for every dollar invested in such tree planting.
So now the federal government will issue guidelines and hire experts to ensure you plant shade trees properly:
(4) The term ‘tree-siting guidelines’ means a comprehensive list of science-based measurements outlining the species and minimum distance required between trees planted pursuant to this section, in addition to the minimum required distance to be maintained between such trees and–
(A) building foundations;
(B) air conditioning units;
(C) driveways and walkways;
(D) property fences;
(E) preexisting utility infrastructure;
(F) septic systems;
(G) swimming pools; and
(H) other infrastructure as deemed appropriate
And Waxman-Markey is indeed a “green-job creator” of a bill – it creates an entirely new job category – Federal House Inspector. Yes, that’s right, in order to sell your house in the future you must passed a federal housing inspection which will certify your home has the minimal energy rating necessary. And if not, you’ll be required to bring it up to par by replacing appliances (water heaters, air conditioning, etc) or repairing (leaky windows, etc) whatever the inspector finds before you can put it on the market.
Have a candelabra in your dining room? Don’t you dare put any more than a 60 watt bulb in there. You need to also bone up on what you’ll be allowed to do with outdoor lighting, water dispensers, hot tubs and other appliances, not to mention wood burning stoves and water usage.
Yup, if this piece of legislation makes it through the Senate, we need to seriously rethink the name we give the 4th of July. “Independence” will no longer apply. And, given the level of intrusion this bill brings to our lives, you can just imagine what’s in store for us in any health care legislation passed by this administration.
Happy Dependence Day, folks.
A friend has started an organization called the 1776 Project, which he’s kicking off today “hoping to inform and educate voters by promoting the values and principles of a Constitutional government.” Here’s press release explaining the motivation:
The 1776 Project stresses that our Constitution is the single most important civic document in governing our nation. Its provisions, protections and prescriptions are all that is necessary and sufficient to the operation of a good, just and efficient government.
Organizers of the 1776 Project reject the notion that rights are given by government, instead believing the Bill of Rights protects the basic, individual liberties that are derived from natural rights that promote the pursuit of happiness.
Further rejecting the idea that the Constitution can be interpreted and changed however any political party wants to suit their needs, the organizers of the 1776 Project believe the document that created this Republic can only be changed by the process specifically laid out in Article V of the Constitution.
“Government cannot provide happiness, that is not its purpose,” says Jorge Gonzalez, founder of the organization. “It is up to each one of us, as individuals, to pursue our own desires and versions of happiness. This is the only way that we can really be a country united in one purpose.”
The 1776 Project will be announcing more events and providing information, resources and offering solutions on how Americans can take back their government through peaceful revolution and community outreach. Organizers welcome anyone who agrees with these values, regardless of political party, to join the 1776 Project to bring back a Constitutional government.