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De-mything Liberal Talking Points

Episode 1

“Americans Want Free Healthcare”


Click on Picture to see larger image

Not only do Americans spend more on healthcare privately, we also spend more than all but three other nations in public expenditures providing healthcare to our citizens. Our free market economy has produced more wealth to spend on our health and we do so in abundance. We spend more per capita on subsidized healthcare than either Canada or Britain. We want to mess with American healthcare why?

H/T and graph supplied by Captain Capitalism

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9 Responses

  1. I’m not sure what this table proves, other than we’re spending a whole lot of money on health. But spending more money than most other countries doesn’t mean we’re getting the same value. Take, for example, the cost of a particular medication, such as Campath, a cancer drug. In 2003, the price in the US was $2400 (not sure what the unit measurement is, but it doesn’t matter for the purposes of this argument), while the price in Canada was $660. When you’re spending nearly 4 times as much per unit of medication, it’s pretty easy to see why we would be spending more money overall. It doesn’t mean we have a good healthcare system.

    Incidentally, isn’t it conservatives such as yourself who have been arguing for years on the education front that just throwing money at the problem doesn’t improve it? I wholeheartedly agree with that sentiment, and would extend it to the American health care system as well.

  2. Americans spend about 14% of their anuual “health budget” on medication. According to research I pulled up, we spend about 100% more on drugs than do the Canucks. This means you can safely add 7% of the size of the American bar total to the Canuck bar on the graph, or remove 7% of the American total. Either way, the Canuck savings on drugs do not account for the difference between the two. That takes care of your first point.

    Your second point is interesting attmept to turn a conservative argument against a conservative. Spending more money on education is not correlated to better test scores. However, when we’re talking about education we are talking about public subsudies. So you’re right, we spend too much on healthcare through government subsidies. However, I am uninterested in how much we spend privately on healthcare, as that’s a private decision. People should be allowed to spend their money how they wish.

    As for the effeciency of our health system, it’s probably better than you think. I guess I’m going to have to write another full post to completely unwrap all of your distortions.

  3. Well, I may as well attempt to provide you with some more fodder for future posts, so here goes.

    Starting with the first point, you’ve now conceeded that, if differences in the cost of medication are taken into account, the “public spending” bar must be adjusted. This is just medication, however, and does not take into account the cost of medical care itself. You’re the blogger, not me, so since I’m just an anonymous commentator I get to be lazy and not be too rigorous with my research. Nevertheless, I would argue that if you factor in the higher cost of medical services in general you’re going to get a much greater than 7% change between the comparative US-Canada rates.

    Really, though, this is all besides the point. To restate and elaborate upon what I said in the first post, I don’t think that simply controlling for all of the differences in cost and then comparing is going to get you much either, because expenditures don’t really tell you much about what’s going on with the health care system. It is necessary to look to what results are being obtained by a given system in order to see whether that system is a “good deal” for its citizens.

    And here is where the United States system demonstrates its failings. Let’s keep with Canada for a moment and compare life expectancy, a potential proxy for overall health care. All of the following figures can be found in the CIA World Factbook. The United States has an overall population life expectancy of 77.85 years. Canada’s rate is 80.22 years. How about the rest of the developed world?

    UK – 78.54
    Germany – 78.8
    France – 79.73
    Japan – 81.25
    Italy – 79.81
    Australia – 80.5
    Sweden – 80.51

    I’ll stop there, because the pattern is clear. If you want some good news, at least we beat out China, with a life expectancy of around 72 years.

    But if life expectancy doesn’t satisfy you, how about infant mortality? Surely the great medical systems can effectively keep their babies alive?

    US – 6.43/1000
    Canada – 4.69/1000
    UK – 5.08/1000
    Germany – 4.12/1000
    France – 4.21/1000
    Japan – 3.21/1000
    Italy – 5.83/1000
    Australia – 4.63/1000
    Sweden – 2.76/1000

    Hmm…looks like we lose that one too, and pretty much by a longshot.

    So, now, the chart that you posted starts looking a little undesirable. We’re spending the fourth most in the world publically, and by far the most when private expenditures are taken in to account, and these are the results that we’re getting? We die sooner, and we’re more likely not to make it out of infancy? Sounds to me like we’re being ripped off pretty handily.

    One final remark before I end this ridiculously long comment. If you are a person in the upper middle class or up, the American health care system is fantastic, I would guess that it is by far the best in the world. But you and I both know that the reason the numbers above are the way that they are has to do much more with how the poor and lower middle classes fare in the system. Since these groups are far larger, they drag the system down. If our health care system was not providing inferior protection to these groups (who certainly exist in every one of the countries above), then America’s health care system would not be so bad.

    You asked why anyone would want to reform the system? Simple; we’re paying a heck of a lot for very inferior results.

  4. I’m obviously not going to demand my commenters to put as much effort into a thread as I do. I’m just addicted to numbers. Just ask any of the guys in my baseball threads.

    I would like to answer your point about US life expectancy. Those numbers have a lot of confounds. The US life expectancy is dragged down by several factors, among them immigration (immigrants often have recieved lower than average care in their home countries and thus have a lower life expectancy), AIDS (for some reason AIDS hit the US a lot harder than most European coutries), Tobacco use (Americans smoke more of it than Europe, probably because it grows here and is a lot cheaper), Obesity (in fact, Americans make a lot of bad personal decisions when it comes to their health but this doesn’t demonstrate a lack of efficiency in our medical system), Violence (America has a large and violent black market for drugs). If you control for these differences between us and “The European Ideal” the 3 year variation between our life expectancy and theirs disappears.

    Americans pay a lot more for medical care because we abuse ourselves. This is more a reflection of our culture than of our medical system.

    So, I’ll take issue with you. Americans pay more for more effective care. But even the money we spend doesn’t stop diabetes, AIDS and lung cancer. It certainly doesn’t help undo the damage done for immgrants from Africa and South America who are suffering from many preventable diseases.

    I’m still searching for the numbers regarding the various economic classes in the US controlled for criminality. My guess is the numbers aren’t going to haunt me.

    Some of these issues are discussed in this UN release:

    http://www.who.int/inf-pr-2000/en/pr2000-life.html

  5. Responding in a comment is a lot like playing chess, especially where there is a one-on-one style debate as we are having here. My opening was weak, and you countered effectively. My next move was slightly better, and made with full knowledge of where the discussion would be going next.

    As I mentioned in the second post, life expectancy is only one possible proxy for the adequacy of health care, and you are of course correct that there are a lot of factors that go into LE. In fact, I won’t take issue with any of the factors that you raised, because they are all valid (especially lifestyle choices, such as smoking and, especially, obesity).

    We’ve talked ourselves into a bit of a corner, because there isn’t a really satisfactory way to resolve the question of whether American health care is really good or not, absent some significant econometric analysis that I’m not willing to perform, and I doubt you are either at this point.

    So, I’ve about exhausted myself on this one, and will tip my king. I’ll end this by saying, however, that I will forever and always be suspicious of health care in the hands of private entities; enough so that it overcomes my fear of inefficient, inflexible management that comes with government control. My reasons are quite simple; the goal of any corporation is to make money, and the way to make money for, as an example, the pharmaceutical industry is to keep us alive as long as possible, and as sick as possible. If they could turn every malady into a chronic illness, they would be in perfect shape. There is absolutely no incentive to find actual cures, because it’s just not cost-effective to do so. As a result, when a cure is discovered, the charge is astronomical, far beyond what the average individual can pay. This, alas, is where the system as it is now fails miserably.

    Capitalism is a brilliant mechanism; without it, the United States would never have become what it is today. Where there are market failures, however, it must be reigned in. The pharmaceutical industry, and arguably more aspects of medicine, are essentially operating in what is a market failure condition. Here, more government intervention is necessary, not less. The system IS flawed (guess my king tipping didn’t last too long), and this is one of the major reasons why.

    And so I end, for now. I look forward to seeing what, if anything, you have to say in response.

  6. This was a good thread. This is why I still allow anonymous commenters (I don’t know why so many liberal readers wish to remain completely anonymous, oh well).

    I will end with this:

    You are right to admit the government’s ability to manage healthcare is flawed. I still think it is wrong to say it is necessary. You fear corporations, because you see their financial incentive is to keep you sick. I would tell you that personal health is a personal choice. It is a personal endevour to eat right, excercise and limit risky behaviours that can cause illness.

    It is not the job of the pharmacuetical companies to keep you healthy. Their charge is to keep you alive when you get sick. Doctors are the same way. How often do you doctors telling people to not wash their hands, not wear their seatbelts or not brush their teeth? They don’t, even though if people stay healthy it means less work and less money for them.

    If capitalism has failed in healthcare, why then do I get lecture about flossing every time I go to the dentist? It’s easy to say the drug makers are trying to keep you sick. It’s hard to prove it true. It takes a cynic to see the world in the way you describe.

    I don’t believe the market in healthcare as a bad thing. Americans choose to live in ways the world scoffs at due to its inherent risk to health. For this, Americans pay a great deal out of their own pockets to keep themselves “healthy.” Those Americans who can’t afford healthcare have a plethora of government options, as proven by the fact that America spends more publicly per capita than all but three nations in the world.

    Capitalism is what happens when people live free. Americans choose to live the way we do. Pharmaceutical companies aren’t the ones preventing us from excercising. They’re not the ones forcing Bon Bons down our throats. They’re not the ones forcing us to have unsafe sex and exposing us the HPV, AIDS, Herpes, etc. We are doing those things, and we are paying for it.

    I found out a long time ago that I didn’t need to stop by McDonalds every other day. So I stopped going at all. I found out that the only thing preventing me from doing a set of sit ups each morning was me. So I do them now.

    Personal choices is what matters. Sure, there will be accidents. Broken bones, cuts, burns. I doubt the pharmaceuticals are trying to get you into accidents at your work. When accidents do happen, we have excellent hospitals that give excellent care regardless of ability to pay (though they do try to get you to pay later).

    As we age, our health is a reflection of a lifelong string of choices. I would say to make the right ones. If you do, your health bill will be much lower. If you don’t, expect to pay. There are consequences to bad decisions.

    There is also help. Bush has worked (to even my chagrin) to provide prescription drugs to those who need it. We have medicaid and midicare and minnesota care, plus private charities. Healthcare in the U.S. is not broken. We have plenty of it. Too bad we live in a way that forces us to need it so much.

    The cost of freedom I guess.

  7. If I might interject for a moment.

    The cost of drugs are going to be recouped regardless of which country has nationalized health care or not.

    There has often been the argument that since it is largely American pharmaceuticals that have been developing the drugs and European/national health care systems that just buy them, the costs should be spread to the nationalized health care systems.

    What it boils down to is that the “CANADIAN GOVERNMENT” has a lot more bargining power than say, “Hospital Joe Schmoe” and can negotiate cheaper drugs from the patented pharmas.

    All that being said, it doesn’t matter what system you have in place, health care is going to cost what it’s going to cost, no matter what system you put in place.

  8. Another good reason for allowing anonymous commenting, such as mine above, is that when one of your old friends chooses to have a debate with you on a particular topic, he can do so without you resorting to your store of knowledge about the individual in question…which is much more fun for both of us. :)

  9. Unless you owe me money, I don’t see how I could abuse any personal information…

    But I’ll keep thinking anyway

    CappyCap: Good point, I had never thought about how governments have such a stronger bargaining power.

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