One of the strongest argument against single payer is that government rationing is the worst kind. The British healthcare system is an example:
DAMNING reports on the state of the National Health Service, suppressed by the government, reveal how patients’ needs have been neglected.
They diagnose a blind pursuit of political and managerial targets as the root cause of a string of hospital scandals that have cost thousands of lives.
The harsh verdict on the state of the NHS, after a spending splurge under Labour between 2000 and 2008, raises worrying questions about the future quality of the health service as budgets are squeezed.
One report, based on the advice of almost 200 top managers and doctors, says hospitals ignored basic hygiene to cram in patients to meet waiting-time targets.
The full article from the Times is here.
Yes, clearly Great Britain is the wrong country to emulate. Instead, let’s pattern our health industry after a country with a free and unfettered health care industry, one with virtually no government intervention. Hmmmm… What nation would that be?
Eric Martin over at Obsidian Wings suggests Somalia.
Yes, the Somalian free-enterprise health care system must be just wonderful.
Free and unfettered does not mean anarchy. It presupposes a stable government with the ability to enforce and create contracts, maintain rule of law, and enforce property rights.
Should I use North Korea’s healthcare system as an example of a failed single payer healthcare system?
Yes, you should. Feel free to use North Korea’s healthcare system as the worst example of a single payer healthcare system in existence.
So, now we can compare the worst of “free-market” healthcare in Somalia, and the worst of “socialist” health-care in North Korea. And I assume you agree with me that we would both prefer to be treated in North Korea, right? So, if that’s the way you want to make the comparison, single-payer wins.
But that’s not the way I would make the comparison. I would ask people who live in the best free-market health care system (ours, I presume) how they feel about their health care. Then I would ask people the same question who live in Sweden. And “socialist” health care wins again.
But I know from a previous discussion that you don’t want to compare health care in different countries that way either.
Which makes me wonder why you even bring up the subject of health care in other countries. It seems entirely unproductive. You keep bringing it up, then I point out that people that actually live in those countries clearly enjoy their health care (much more than we do). Then you disavow comparisons between countries.
Even though you were the one who brought it up the comparison in the first place.
It’s not really getting us anywhere.
First off, let me just say that its not so clear to me that North Korea’s healthcare system would be a better choice than Somalias. With that said…
This is what I wrote regarding national comparisons:
My point now is the same as then: when comparing healthcare systems, you have to compare them in steady state, meaning when tax revenues match benefits. The post is a glimpse of what the British healthcare system will be like in steady state. The Massachusetts healthcare system is a glimpse of what our healthcare system will look like in steady state. It’s ugly.
In summary, my point is that you can make anything look good when all you see is the benefits and delay the costs. Its when benefits and costs are aligned that a true comparison should be made. So of course, while the United States is running huge budget deficits to expand healthcare, it looks great. All people see and feel are the benefits. But what happens in 30+ years from now when these benefits have to be aligned with costs? When taxes have to be raised, or more fearful, when politicians have to start rationing healthcare for us? Thats the part I am focusing on.
OK, I’ll play along for a bit.
It sounds like your argument is “Sure Swedes have great health care, but it’s bankrupting the country.” Fine, that’s a reasonable argument if you can support it with the data.
In particular, you might want to make the case (if you can) that Sweden is headed towards bankruptcy. Or at least has budgetary issues. Can you make that case? Because otherwise, your argument doesn’t really appear to hold water.
I wasn’t referring to Sweden per se, just in general.
If we are to talk about Sweden specifically, I would argue point 1: different culture.
For example, Sweden can get away with paying its doctors much less than we could because of their cultural differences, see here.
Second, the USA would not tolerate Swedish wait times, see here.
In short, what works in Sweden would not work here.
On the subject of North Korea and Somalia:
Finding data is more work than I’m willing to do, but the ratio of doctors to people in North Korea is reportedly about 1 to 750. In Ethiopia it is 1 to 48,000. It’s fair to assume Somalia would be worse than that.
If I was sick I would definitely take North Korea over Somalia. I’m very, very surprised you don’t agree. On what data do you base that decision?
I’m still going to play along, but your argument is getting harder and harder to swallow.
You agree with me that Swedes are much happier with their health care than we are with ours.
You agree with me that this does not come at the expense of future prosperity.
Now your argument is that Swedes are just not capable of recognizing how inferior their system is. Not to be insulting, but… Is that really all you’ve got? Is it worth debating? How could I possibly counter such a subjective argument?
My hunch that Somalia might be better than North Korea is that Somalia atleast has some access to the outside world. I would assume that in both situations you are pretty much screwed if you walked in to a hospital with anything more than a flu, but atleast in Somalia, if you have enough money, they can fly a more experienced doctor in. Probably not the case with North Korea.
Regarding Sweden, this is my point: their healthcare system, given the trade-offs of cost, equality, and even technology, is likely better on net than ours.
But, and this is a big BUT, its better for uniquely Swedish reasons. To say it another way, the reason their healthcare system works is unique to their culture and environment, the same healthcare system would not operate the same here.
Can I make a suggestion?
Too late!
I think those of you who are opposed to Obamacare, might want to stick to finding the numerous faults with it, rather than pretending that the current HCR proposal is equivalent in any way to universal government health care as implemented quite successfully in a number of foreign countries and then nitpicking this or that fault with country X’s health care system.
Just my two cents.
Who asked you?!?!
Be nice now, or I’ll take my unsolicited, condescending advice elsewhere.
No, no, dont do that! You are my favorite commenter.
Btw, just got back from Monterrey, Mexico…:-)
Amazing! no one still has gotten it? I will hold off till after the elections to make a very simple straight forward point “No matter what the thread at the time will be”.
Considering the way information travels on the net? It’s best that I hold off.