To: Elephant
From: Rog
Dear Mr Pachyderm,
I appreciate your energy on the issue of health care in a country with which
you seem pretty unfamiliar.
ELEPHANT:
so many millions of Americans aren't covered
by the system at all,
ROG:
But they can get emergency care. The poorest in America do get paid
coverage, and emergencies get covered for anyone. What is your real point
here?
EL:
One might also mention the fact
that in the US the payment incentives for Doctors are similar to the
incentives for Lawyers, ie they are paid by the disease, not by the cure.
ROG:
The US payment system? Sorry, but Dr's are still free here. Some charge by
the operation, some by the visit, some have chosen to work in organizations
(HMO's PPO's) that pay by the disease/problem as a way to reduce
"overcuring." Some are salaried. Some go into research. Some decide to
teach.....
EL:
And then we can add up the number of life saving proceedures that were
invented in the NHS as against those that the states have pioneered, the
incentives towards US medical researches concentrating on relatively
insignificant health-problems that are cheifly suffered by the rich as
against bread-and butter health care (e.g. the disasterous slow-down in the
antibiotics race) etc etc.
ROG:
No argument here that antibiotics are important. Is your point that US
corporations are not making a HUGE contribution to this admittedly
inadequately funded area? Are you sure of this? And more importantly, what
are these *insignificant* diseases? Cancer? Heart disease? AIDS? Diabetes?
Sickle Cell anemia? Are you really aware of where most medical research
money in America goes?
EL:
But of course you *haven't* tried what works well in 21st Cent. Europe. You
have tried what worked exceedingly badly in 19th Cent. Europe, with roughly
the same results.
Any system which included the US private sector heath-insurance system would
be hugely expensive. Why do you think they got Clinton's health programme
stopped - paid for all those campaign adds when it was going through
congress? - it would have lost insurers a hellava lot of money. You are
callculating the cost of 'welfare' health-care on the assumption that it
will remain *additional* to private provision.
ROG:
So you are saying the Clinton (Hillary) plan excluded private insurers? Are
you sure?
EL:
Well, I can tell you the
historical four-point 'social pathology' of that pay-or-die system in the
UK, and you can tell me whether that describes the US:
1. The Doctors made a lot of money and kicked up a fuss whenever the
government tried to interfere.
ROG:
I would kick up a fuss if they forced me into servitude too. Saving lives is
a very valuable commodity that requires decades of intense dedication for the
brightest and potentially most productive people in a society. They deserve
to be compensated. Don't they?
EL:
2. The poor suffered disproportionately bad health and substantially higher
mortality (ave. life expectancy varing by as much as 20 years by economic
class).
ROG:
Perhaps we can lower the high end of the spectrum and make every country as
low (but equitable) as the true socialist states? (who the argument could be
made benefited greatly from the knowledge gained via the funds allocated in
wealthy free countries to curing disease and injury)
EL:
3. The rich suffered indirectly by dying of diseases like TB that were
cultivated amougst those without access to proper heathcare (or indeed
housing).
R:
Huh? We are pretty well housed here, and don't have much in the way of
rampant diseases going through the states. Flu shots are 'made available.'
EL:
4. Rich and poor alike paid the economic price attached to death and
ilnness on an unnecessarilly large scale . Any situation in which potential
workers die or lose efficiency or take time off or leave the labour market
due to illness puts the real cost of labour up, wastes investment in
training and education, and can lead to localised economic deserts where no
form of honest economic activity is possible.
R:
People are really pretty healthy here. They tend to live a long time and not
miss much work.
EL:
Does this describe Africa? Or New York?
R:
I've been to New York, and this is only a silly caricature of socialist
propaganda on the place. I live in Chicago, and find the caricature darn
right amusing. I do acknowledge that I truly can't speak for Africa or Great
Britain.
I respect the solution your country is experimenting with. Please respect
ours. Continue to give us accurate suggestions and feedback too. Thanks!
Rog
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