As far as your post, I agree with alot of it, and believe it or not, I also believe in ‘universal healthcare’. My disagreement would primarily be in how it is done, than with the concept itself. My solution would involve (much more!!!) the private sector as opposed to the government. I’ll blog on it more in the next few days or so, but for now, I’ll let you have the last word.

I’ll stand by the assertion that it became widespread in the 60s. My wife’s father was a doctor, and she remembers him complaining about it bitterly back then–he agreed with you, HP, that it was a terrible idea.

After sleeping on it, I have to rephrase some of my comments from yesterday. (I have a bad habit, when in a political argument, of reflexively disagreeing with my opponent, even when, in fact, I don’t disagree with him–I only do it occasionally now, but I used to do it habitually, and it’s one of the reasons I didn’t get in political arguments for years.)

Anyway, yesterday I found myself arguing in favor of government healthcare, and against free-market healthcare. In fact, I have no opinion on the subject–I’ve seen studies indicating that government healthcare is worse, and other studies indicating that private healthcare is worse. This is one of the reasons I tend to be skeptical of statistical surveys.

I’ve talked to English and Canadian friends about this, as well as Americans expatriated to those countries, and most of them say thaty they find the Canadian and British healthcare systems better. This includes an American friend who became ill while visiting Great Britain.

I’ve talked with one expatriate American, living in Britain, who says that the British government is gutting their healthcare system, and will then turn around and use the resulting poor healthcare as “proof” that privatization is better.

(Of course, if I were you, I would use that very argument as an argument why healthcare should never have been provided as a government service in the first place. If HealthCo A guts its services, then its customers can go to HealthCo B. But if the government has a monopoly on providing healthcare, and corrupt officials decide to gut it, then the people have nothing to do but get sick and die.)

If there were to be government healthcare, I would not favor a system that prohibited private health services. What’s the point of that? My proposal would be that the government provides healthcare for everyone, but if people want to pay for private services, they are free to do so.

Finally, I think you and I are entirely in agreement about the current system of third-party payee healthcaree: It sucks. As I said initially, it combines the worst elements of free enterprise and government service.

When and why did health insurance, paid by third parties, become widespread in the American economy? Like so many things that the government does, third-party health insurance grew out of problems created by previous government policies.

During World War II, the government imposed wage and price controls. This meant that employers who wanted to hire more workers were forbidden to offer higher wages to attract them. So employers started offering various benefits instead. One of these benefits was employer-paid health insurance.

Since these benefits were not taxed as income, and could be treated as a business expense by the employer, everybody seemed to be better off. But, long after the war was over and wage and price controls were gone, the idea that third parties ought to pay for health insurance continued on. Eventually the government itself got into the business of providing health insurance and now some politicians depict it as a scandal that not everyone has health insurance paid for by third-parties.

More here, and here.

Employer-based health insurance was instituted in the 1960s, not as a result of World War II.

As far as Canada’s health care system, I wouldn’t be so quick to bet on it, if the preliminary data is any indication, here, here, here, here and here, it is a health care system on its way to its death.

As for the Sowell article: He makes a number of broad, sweeping assertions, without any support. Countries with national health care face shortages of home-grown doctors? Says who? Healthcare is more expensive in that country than otherwise expected? Again, says who? And is that necessarily a bad thing–everything costs more than anticipated. And, even so, is that a bad thing if the people are healthier?

Sowell criticizes third-party payment programs because it encourages people to go to the doctor for trivial ailments. However, that’s not a bad thing–serious conditions start out as trivial ailments. People shouldn’t be going to the doctor less, they should go more, and earlier.

I have a friend who is a doctor in Wisconsin, one of the things that make him want to leave his job is the multiple layer of bureaucracy imposed by multiple insurance companies. He envies his colleagues to the north–in Canada–who only need to worry about one insurance company (the Canadian government) and who spend the bulk of their time practicing medicine.

Earlier, you posted a chart providing life expectancies for people who live in countries with free-market economies vs. those that live in countries with tight government controls. I be the countries that scored highest are those like Great Britain and Canada, that combine free markets with government health care.

I have thought recently that our own system, in the U.S., where most people have healthcare provided by their employers, combines the worst elements of government service and the free market–as we get older and need healthcare more, we end up making our employment decisions more and more based on which employer provides the best healthcare, as opposed to more reasonable criteria, like salary, job responsibilities, and working conditions. Likewise, people with chronic ailments–or whose family members hav chronic ailments–have trouble finding jobs, even when they are quite fit to do the work.

Perhaps we should get out of the middle here and go to one extreme or another–either provide national healthcare, or somehow find a way to annul the unnatural marriage between employer and health insurance, and just provide national healthcare, or leave health insurance entirely up to the individual, as we do now with other forms of insurance.

You also wrote,

Likewise, unions forced employers to institute the 40-hour workweeks and health insurance for workers.

This is another myth that has been repeated constantly yet is disputed by historical facts. The 40-hour work week, including health insurance, came not because of unions but despite unions.

I believe that unions should be able to form, just as corporations should be able to form, but I also believe that laws shouldn’t be created that benefits one over the other, laws should remain neutral.

Likewise, unions forced employers to institute the 40-hour workweeks and health insurance for workers.

When people with money gather together to pool their resources, we call that a “corporation,” and conservatives applaud that effort as the backbone of civilization. When people with the ability to work band together to bargain collectively, we call that a “union,” and conservatives get their knickers in a twist about it.