The Old Chestnut

[The Beatles]

Due to the recent film I won't name, healthcare is suddenly on many people's lips again. So this is kind of inevitable.

I know many of us agreed to disagree on some issues. I still stand by that. However, I do want to clarify the issues, and refuse to agree on matters of anything but opinion...

Therefore let me set out what we agreed to disagree on. Some of you don't want to see universal healthcare (UHC) in America, for various reasons: you don't want more taxes, you don't want government-run hospitals, you don't want to subsidize the poor, etc. I want to see UHC in America because I disagree with you there.

And now let me bash those arguments which fall outside these, and answer ancillary questions on the side.

but! terrorism is an...unnatural occurance whereas...colon cancer is not. the two arent even comparisonable. you think that its a clever little statement by some clever little person who thinks that being clever is ever so clever!

1. Who said terrorism? Bush declared a "War on Drugs". Drugs are fairly natural in that smoking random plants has been going on ever since humans invented fire, and they kill far fewer people than preventable illnesses.

but! terrorism is an...unnatural occurance whereas...colon cancer is not. the two arent even comparisonable. you think that its a clever little statement by some clever little person who thinks that being clever is ever so clever!

2. Evidently you believe that doing something or not preventing something it would be in your capacity to prevent are not the same. This is of course why passive accomplices are punished under the American legal system?

your not an American so it wont affect you in any sort or way...unless you wish to go to the doctor while your in this country and want a auto-free ride like you get else where.

3. I wouldn't be able to get care in America anyway, because I'm not a citizen, nor will I ever be one. Why I support UHC in America is why I would support UHC in every country from Azerbaijan to Zimbabwe: i.e. it's humane. But an argument that might hold more sway is of course the Almighty Buck ($$): it's cheaper too.

"(Because after all, lack of free screening kills tens to hundreds of more people than terrorism or drugs combined...)"\

You have absolutely no way to prove that.

4. Sure I do. Diseases like http://72.14.253.104/search?q=cache:205 ... =firefox-a

13. The British system, however rosily painted by a recent film, is actually fairly "third-world", with waitlists and conditions and all, which is indicated by its 18th rank. This is because it's vastly underpaid; from a recent WHO report:
http://www.photius.com/rankings/who_wor ... ranks.html

The United Kingdom, which spends just six percent of gross domestic product (GDP) on health services, ranks 18th.

It's still more cost-effective than private systems, U.S. spending for instance is 15% of a nearly twice-as-high per-capita GDP. Come on, you've beat the British in military before, can't you do it in medicine?


Anyway, there you have my points in a nutshell. All are eminently debatable, so I hope we can have an entertaining argument while agreeing to disagree on the three in the opening paragraph.

[Gen. Volkov]

4. Sure I do. Diseases like aortic aneurysms are the easiest example. But simply browse through the stats and costs at lifelinescreening.com or other screening websites.

I wasn't talking about diseases that could be caught with screening, I'm talking about YOUR statement. You said lack of FREE screening kills more than terrorists and drugs combined. So A) You'd have to have exact numbers of people who died because they weren't screened, which you don't have, and those numbers would have to be higher than deaths from drugs and terrorism together, which we also don't have completely accurate stats for. So in other words, your statement is a guess, not a fact. As I said, you have absolutely no way to prove it.

5. That doesn't go well with the "America is the greatest country evah111" philosophy. But anyways, it's silly. Most American public universisties are the best in the world; the American military is the most effective in the world; U.S.P.S. is world-class, etc. etc.

In certain areas, we excel, but in large social programs, I have yet to see fantastic results. Public universities are state-funded, and not entirely so. (I mean state as in one of the states that make up the Union) both the US military and the USPS are tiny in comparison to what would comprise a UHC system. Of course, the main reason I doubt the UHC system as implemented by the US government would be good is because people would actively be trying to make it not work. If the law got passed, it wouldn't be by a large majority, and there would be many opposed to it. I've no doubt that they would work to try and make it an unsuccessful undertaking as much as they could.

6. Don't ever bring Canada up in UHC discussions, as I've said before. It has a shoddy system that most Western Europeans call third-world (along with America's). It's better than nothing for the poor, but worse than what the American rich have.

I was using Canada as a comparison for a bad system. (No offense Devari.)

Why do you say American rich? You don't have to be particularly wealthy to get healthcare in this country. We are only rich in comparison to most of the rest of the world. The average lower middle class household has access to quality healthcare. Is it as good as what the super-rich get? No, but I doubt that it's any different anywhere else. I'm willing to bet cash money that the rich moguls of Europe receive higher quality treatment than the average Joe European.

Now, your main point, and the Western Europeans main point is that it doesn't serve everyone, not that the quality of care received is bad. That's why they call it third world. If it was bad qualitatively, then people would not fly here for experimental surgery, or experimental treatments. We also wouldn't have world-class doctors that lead their chosen field of medical profession. We wouldn't lead the world in many areas of medical research, and our medical universities wouldn't be the best in the world. (OK, no, not all our medical universities are the best in the world, but our best are better than everyone else's best.)

7. You don't, in countries in the top, say, 15 on the WHO list. Waitlists are either limited by law or don't exist.

And you don't wait in America, fancy that. I bet those top 15 countries also spend almost as much money per capita as America does.

8. Very few if any UHC countries (in, say, the top 30 of the WHO list) have such restrictions. You can choose your own doctor, just as you can usually choose your own school district, etc. This is a common misconception about UHC in America.

You mean UHC countries with quality systems. However, I'd like data about this one, exactly how many UHC countries in the top 30 have no doctor restrictions. Cause Britain does, and it's 18th. (As you talk about later)

10. The WHO list is based on statistics like infant mortality, child mortality, life expectancy, doctors, nurses, hospital beds, etc. Pretty objective statistics.

WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs). -From your own article.

Health inequalities, distribution of responsiveness, and distribution of financial burden are all going to bias it against the US because it does not have have "universal" system. So it's not really objective. The only objective bit is overall population health. Which of course, can be heavily influenced by cultural factors.

9. Yes, there is. Single-payer and even national health systems do not rule out a coexisting private system (indeed, they are well integrated in some countries like Spain) which is there for the rich, and also to reassure your unconscious belief that you will be rich one day. This is a common misconception about UHC in America.

I'll give you this one, but there is no guarantee that an American system would indeed incorporate a private system next to it.

11. Research has nothing to do with this discussion; it is independent of healthcare and spending on it is not usually included in cost discussions (either by the WHO or by debaters).

How is it independent of healthcare? New discoveries can and do have a huge impact on how the patient is treated, what the patient is treated with, and how diagnoses are made. The world leading position of US medical research has a direct effect on the treatment received by US patients.

Let's not argue this as I think it goes under "political willingness to pay", above...

Fine, but do you at least admit that the amount of money Western European countries receive from the US due to the trade imbalance probably does have an impact on the social programs they can afford to implement?

12. UHC is cheaper, i.e. more cost-effective. Nuke compiled a nice list a while back:

And as I pointed out, the best systems still cost a lot of money. Cheaper yes, but how much cheaper is debatable.

It's still more cost-effective than private systems, U.S. spending for instance is 15% of a nearly twice-as-high per-capita GDP. Come on, you've beat the British in military before, can't you do it in medicine?

I don't understand this. You are comparing % of per-capita GDP to % of total GDP. I do not think that is a valid comparison. It's apples to oranges.

One last comment, don't call the healthcare systems of Canada, the US, and Britain "third world". They are emphatically not. Third world is Haiti, or any country in Africa, except maybe South Africa. Those countries do not have a healthcare system worth the name. That, my friend, is a third-world healthcare system. What the US, Canada, and Britain have are merely not to great first-world systems.

[Devari]

I was using Canada as a comparison for a bad system. (No offense Devari.)

Aye. It's certainly better for lower-income people than the US system (shoddy care > no care at all), but it, indeed, is in a poor state. As Beatles says, not a great example of what UHC could potentially be.

[Freenhult]

I'd be nice to know how much we'd have to pay if there was UHC. Because quite frankly, my old man just had spine surgery, and we're paying for more than 60% of it...

What we got, barely qualifies. Volkov... You might be right. But for the rest of us that got nothing, and still pay like we do... UHC would be very nice. Cheaper HC thats better than what we got? Not like we can really switch companies anyway.

I'd pay more taxes to know that my whole family is going to have a good plan. Atleast something that pays a good deal for surgeries and ofcourse doctor calls. Most Americans don't need more than that.

[The Beatles]

4. Yes, I don't have detailed proof for you now, however, I will try to compile it when I have time
later on.

In certain areas, we excel, but in large social programs, I have yet to see fantastic
results. Public universities are state-funded, and not entirely so. (I mean state as in one of the
states that make up the Union) both the US military and the USPS are tiny in comparison to what
would comprise a UHC system. Of course, the main reason I doubt the UHC system as implemented by
the US government would be good is because people would actively be trying to make it not work. If
the law got passed, it wouldn't be by a large majority, and there would be many opposed to it. I've
no doubt that they would work to try and make it an unsuccessful undertaking as much as they
could.

5. It's quite true that there are vested interests against UHC which have a lot of the legislation
in their pockets. OTOH, this was often true in countries which did implement UHC. Personally, I
think the best approach is ground-up: some states like Louisiana or Massachusetts already have
rudimentary forms of UHC in place (that is to say, kind of hybrid systems, but the upshot is
people get taken care of at prices they can afford) -- it just needs to climb up to the federal
level, over time.

The average lower middle class household has access to quality healthcare. Is it as
good as what the super-rich get? No, but I doubt that it's any different anywhere else. I'm willing
to bet cash money that the rich moguls of Europe receive higher quality treatment than the average
Joe European.

6. The average middle class Americans do not in fact receive as good healthcare as the average
middle class in Europe, but you don't have to look farther than the WHO stats to see this.
Quality (which you spend a few sentences discussing) is irrelevant if it's not affordable.
Middle Eastern Arab countries are quite rich but the average living standards are appalling
precisely because resources are not equitably distributed. Of course, long-term prospects are
good: we only need look at our favourite topic, history, to see that distribution usually
becomes more equitable over time.

And you don't wait in America, fancy that. I bet those top 15 countries also spend
almost as much money per capita as America does.

7. They spend on average one-half to one-third. I was just dispelling your fallacious argument.

Health inequalities, distribution of responsiveness, and distribution of financial
burden are all going to bias it against the US because it does not have have "universal" system. So
it's not really objective. The only objective bit is overall population health. Which of course,
can be heavily influenced by cultural factors.

10. They "bias" it against the U.S. system because it is in fact shoddy. Except for "health
inequality", which is more of a moral issue, the others are quite valid. Financial burden is
important because those who can't pay for care don't get it (or have their lives wrecked to pay
for it). Distribution of responsiveness is and health inequalities are both also important,
because it is these that determine waitlists (yes, the U.S. has waitlists too) and screening
availability (which does influence health).

I'll give you this one, but there is no guarantee that an American system would
indeed incorporate a private system next to it.

9. Thanks. But actually I think it would
because all of those health workers are not going anywhere, or if they are, there would be massive
protest. Besides, there's precedents.

Fine, but do you at least admit that the amount of money Western European countries
receive from the US due to the trade imbalance probably does have an impact on the social programs
they can afford to implement?

14. Meh, not really... If you look at trade stats:
http://upload.wikimedia.org/wikipedia/e ... xports.PNG
http://en.wikipedia.org/wiki/List_of_th ... ted_States
then a. most money goes to Canada, and b. what goes into Western Europe is not really such a
significant percent.

And as I pointed out, the best systems still cost a lot of money. Cheaper yes, but
how much cheaper is debatable.

12. Yes, but they can still co-exist and make the whole thing cheaper without giving up quality.
Let's face it, the average middle-class American is not getting such exceptional value as to
justify the huge expense of a private system.

I don't understand this. You are comparing % of per-capita GDP to % of total GDP. I
do not think that is a valid comparison. It's apples to oranges.

18. No, I'm not, but I may have phrased it poorly. US spends around 15% of GDP, UK around 6%,
France maybe 10%, etc. Their GDPs are also lower, which only shows that you can in fact do a
good job on a lower budget, in percent and real terms. Note that I think the UK's 6% spending
is really poor and it does show in their health system...

One last comment, don't call the healthcare systems of Canada, the US, and Britain
"third world". They are emphatically not. Third world is Haiti, or any country in Africa, except
maybe South Africa. Those countries do not have a healthcare system worth the name. That, my
friend, is a third-world healthcare system. What the US, Canada, and Britain have are merely not to
great first-world systems.

Yes, fair enough. Only dramatizing.

Anyway, further points:

15. The U.S. system operates with 35-40% administrative overhead; most "socialist" systems with
2-5% overhead.

16. Isn't requiring everybody to have car insurance "creeping socialism" by your definitions?

17. 60% of Americans support higher taxes to provide "guaranteed health insurance for all".
http://www.fair.org/index.php?page=3124


This numbering system is convenient... we can argue small, well-defined points in sequence.

[Nuclear Raunch]

7. You don't, in countries in the top, say, 15 on the WHO list. Waitlists are either limited by law or don't exist.

And you don't wait in America, fancy that. I bet those top 15 countries also spend almost as much money per capita as America does.

Here it is, the US stacked up against the 26 other countries that rank as healthier than us.

Andorra
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  75.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  70.70 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  2453.1 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  1696.9 (2004)

Australia
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  71.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  74.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  61.60 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3123.3 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2106.8 (2004)

Austria
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  74.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  67.90 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3683.3 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2783.1 (2004)

Belgium
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  73.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  83.50 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3363.2 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2391.9 (2004)

Canada
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  74.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  49.40 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3037.6 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2120.9 (2004)

Denmark
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  71.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  81.30 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3896.6 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  3206.6 (2004)

France
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  75.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  34.90 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3464.0 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2714.6 (2004)

Germany
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  74.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  57.50 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3521.4 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2709.1 (2004)

Greece
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  73.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  95.70 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  1879.3 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  991.5 (2004)

Iceland
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  72.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  74.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  100.00 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  4413.0 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  3678.7 (2004)

Israel
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  72.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  75.00 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  1533.5 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  1073.4 (2004)

Italy
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  71.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  75.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  84.40 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  2579.6 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  1936.4 (2004)

Japan
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  72.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  78.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  94.90 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  2823.2 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2295.2 (2004)

Malta
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  73.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  90.20 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  1239.4 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  942.8 (2004)

Monaco
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  71.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  75.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  82.20 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  5329.5 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  4037.0 (2004)

Netherlands
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  73.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  20.60 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3441.7 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2146.2 (2004)

New Zealand
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  72.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  76.10 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  2039.6 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  1577.8 (2004)

Norway
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  74.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  95.20 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  5404.7 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  4512.1 (2004)

Portugal
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  67.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  72.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  79.40 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  1665.1 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  1192.8 (2004)

San Marino
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  71.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  76.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  96.80 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3355.7 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2651.6 (2004)

Singapore
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  71.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  96.90 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  942.9 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  321.0 (2004)

Slovenia
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  67.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  72.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  39.50 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  1438.2 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  1087.0 (2004)

Spain
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  70.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  75.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  81.00 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  1971.2 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  1396.8 (2004)

Sweden
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  72.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  75.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  92.00 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  3532.0 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2999.8 (2004)

Switzerland
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  71.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  75.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  76.70 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  5571.9 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  3260.5 (2004)

United Kingdom
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  69.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  72.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  91.80 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  2899.7 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2501.8 (2004)

United States of America
Indicator  Value (year)
Healthy life expectancy (HALE) at birth (years) males ?  67.0 (2002)
Healthy life expectancy (HALE) at birth (years) females ?  71.0 (2002)
Out-of-pocket expenditure as percentage of private expenditure on health ?  23.80 (2004)
Per capita total expenditure on health at average exchange rate (US$) ?  6096.2 (2004)
Per capita government expenditure on health at average exchange rate (US$) ?  2724.7 (2004)

[Gen. Volkov]

Nuke, that added exactly nothing, as it's something everyone involved has already seen.

Aye. It's certainly better for lower-income people than the US system (shoddy care > no care at all), but it, indeed, is in a poor state. As Beatles says, not a great example of what UHC could potentially be.

You know what, if you are going to continually say that the low income segment of the US population recieves no care at all, how about you back it up? Cause I don't believe it anymore, I've been looking at the stats for it, and while it's true they don't get alot of healthcare, (1 in 10 put off receiving it for various reasons) they do still get healthcare. In fact, even the poorest of the poor can still go to emergency rooms and get healthcare for free. It's not as much as they need, but it's still better than absolutely nothing at all. That's a common misconception about the American healthcare system.

4. Yes, I don't have detailed proof for you now, however, I will try to compile it when I have time
later on.

Good luck with that.

5. It's quite true that there are vested interests against UHC which have a lot of the legislation
in their pockets. OTOH, this was often true in countries which did implement UHC. Personally, I
think the best approach is ground-up: some states like Louisiana or Massachusetts already have
rudimentary forms of UHC in place (that is to say, kind of hybrid systems, but the upshot is
people get taken care of at prices they can afford) -- it just needs to climb up to the federal
level, over time.

Just out of curiosity, what countries was this true in? Were they anything like as conservative as America is? Was there a broad public base of support for a UHC system that helped them overcome the vested interests against it?

6. The average middle class Americans do not in fact receive as good healthcare as the average
middle class in Europe, but you don't have to look farther than the WHO stats to see this.
Quality (which you spend a few sentences discussing) is irrelevant if it's not affordable.

The stats like doctors per 1000, nurses per thousand do partially support your claim, but while they are lower, that doesn't mean that the quality of care received is any worse when they do get to see a doctor, and furthermore, the ratio we do have is plenty adequate, because we don't have long waitlists, and other things that indicate a lack of doctors. So basically what you have to go on is life expectancy and such, which are heavily influenced by the culture.

7. They spend on average one-half to one-third. I was just dispelling your fallacious argument.

How is it fallacious? 15 is a small percentage of the total countries with UHC systems, and they pay through the nose to achieve it. One-half to one-third is still a damn lot of money. Cheaper yes, but the question is, is it a smaller percent of their per capita GDP as well? Remember the US has the highest or second highest per capita GDP in the world. (If we aren't on top, it's not by much, and I think it's some little postage stamp country with little population that does top the list)

10. They "bias" it against the U.S. system because it is in fact shoddy. Except for "health
inequality", which is more of a moral issue, the others are quite valid. Financial burden is
important because those who can't pay for care don't get it (or have their lives wrecked to pay
for it). Distribution of responsiveness is and health inequalities are both also important,
because it is these that determine waitlists (yes, the U.S. has waitlists too) and screening
availability (which does influence health).

Distribution of responsiveness is a completely subjective factor. Health inequalities is a moral issue, as you said. Financial burden, simply because we don't have a UHC system, is going to be a point against the US system in the WHO assessment. The waitlists in the US aren't long, though you are right, they do exist in some cases. The biggest waitlists are for organ transplants, but that's going to be an issue no matter what health care system we have, unless we make a law that says that once someone dies, his body is no longer his and belongs to the state. Which is not going to happen. Screening availability is an issue, I'll give you that. And quit calling the US system shoddy, third world, or anything that makes it seem like we are down there with Haiti and the Ivory Coast. Even in the WHO rankings, we are 37th. It's near the end of the first world countries systems in the rankings, but it's 100 places above the truly bad systems. I'm really getting tired of it, and the shock value, at least for me, is now gone. Now it's just annoying, and seems like a deliberate tactic on your part to bring emotion into the argument. In an argument that is already as tied up with emotion as this one, does it really need more dramatizing?

9. Thanks. But actually I think it would
because all of those health workers are not going anywhere, or if they are, there would be massive
protest. Besides, there's precedents

What you think is no guarantee of it actually happening. It's not something I'm just prepared to just take on faith either. I prefer as little government interference in my life as possible.

14. Meh, not really... If you look at trade stats:

That's just what the US sends there, I'm talking about the imbalance between what we get from them versus what they get from us, i.e, the difference between what we import from them versus what we export to them, which is quite a large difference.

12. Yes, but they can still co-exist and make the whole thing cheaper without giving up quality.
Let's face it, the average middle-class American is not getting such exceptional value as to
justify the huge expense of a private system.

Again, how much cheaper is debatable, and where would most of the financial burden fall anyway? I suspect on the middle and upper middle classes, just like it does now.

18. No, I'm not, but I may have phrased it poorly. US spends around 15% of GDP, UK around 6%,
France maybe 10%, etc. Their GDPs are also lower, which only shows that you can in fact do a
good job on a lower budget, in percent and real terms. Note that I think the UK's 6% spending
is really poor and it does show in their health system...

Well, I just did an off the cuff calculation, and I come up with about 7% of GDP expenditure on healthcare. So as a percent, we actually spend less than France. As a percent only though, in real terms we spend a lot more. But then we have a lot more people than France. We have something like 5 times France's population.

15. The U.S. system operates with 35-40% administrative overhead; most "socialist" systems with
2-5% overhead.

Fair enough, that is a point in favor of a UHC system.

17. 60% of Americans support higher taxes to provide "guaranteed health insurance for all".

1. Not a UHC system. 2. The phrasing of the question has a lot to do with how the question is answered. Pollsters are adept at getting the answers they want through careful framing of the question. Notice how they didn't mention how much higher the taxes would be, for instance.

16. Isn't requiring everybody to have car insurance "creeping socialism" by your definitions?

Nope, not state-run, and this isn't about creeping socialism anyway. The US is already partially socialized.

I'd be nice to know how much we'd have to pay if there was UHC.

For a quality system? About 20-30% more in taxes than you currently pay.

[The Beatles]

4. Yes, I don't have detailed proof for you now, however, I will try to
compile it when I have time later on.

5. The countries in which it was introduced varied on the political
spectrum. None were as socially conservative as America, that's true.
As I said, this is irrelevant because some states have already
introduced UHC, so there are actually concept examples out there.

The stats like doctors per 1000, nurses per thousand do 
partially support your claim, but while they are lower, that doesn't mean
that the quality of care received is any worse when they do get to see a 
doctor, and furthermore, the ratio we do have is plenty adequate, because
we don't have long waitlists, and other things that indicate a lack of
doctors. So basically what you have to go on is life expectancy and such,
which are heavily influenced by the culture.

6. I'm sorry, but if you state that less doctors per patient doesn't mean
lower care, you have to imply that American doctors and nurses are
somehow better-equipped or more intelligent than European doctors.
That's patently silly. You do have less waitlists (not nonexistent, but
less), but that is due to the fact that there are less doctor visits.
Doctor visits, even insured, are expensive, so people tend to go less
often, that's all. On life expectancy, see point 20...

And quit calling the US system shoddy, third world, or
anything that makes it seem like we are down there with Haiti and the 
Ivory Coast. Even in the WHO rankings, we are 37th. It's near the end of
the first world countries systems in the rankings, but it's 100 places
above the truly bad systems. I'm really getting tired of it, and the shock
value, at least for me, is now gone. Now it's just annoying, and seems 
like a deliberate tactic on your part to bring emotion into the argument.
In an argument that is already as tied up with emotion as this one, does
it really need more dramatizing?

7. Calling it shoddy is my honest and thought-out opinion, gathered from
firsthand experience and statistics. It just doesn't work well for
screening, profits and administrative overheads suck a lot of money out
of it, it's very easy to go bankrupt over care, switching employers
once you get an illness is practically impossible (because of insurance
conditions), etc. The fact that it is only 37th, yet the country is the
richest (in top 3 anyway) for per capita wealth; that alone should tell
you it is inefficient (and hence shoddy). Don't get me wrong, I am not
deprecating anything about America inherently. It is just that powerful
lobbies have stifled all previous attempts at UHC here.

What you think is no guarantee of it actually happening. 
It's not something I'm just prepared to just take on faith either.

9. Well, why don't you look around at other systems? There isn't a single
democratic country with universal healthcare that leaves the private
sector (either providers or insurance companies) out! Isn't that
convincing enough? Germany's care for instance is all private, the
state just insures. Switzerland is 100% private, the state just pays
for insurance. The UK's system happened because a very significant
chunk of the population (soldiers) had just been put out of a job by
WWII ending, and it was thought a good idea to put them to social
projects. This is much like what FDR did with his "New Deal". Only
except having people do public construction, Attlee's government had
them do public healthcare.

That's just what the US sends there, I'm talking about the
imbalance between what we get from them versus what they get from us, i.e,
the difference between what we import from them versus what we export to
them, which is quite a large difference.

14. I'm willing to admit that could help the politics in many countries,
but certainly not all... I think lobbies (or lack thereof) have more
to do with it.

Again, how much cheaper is debatable, and where would most
of the financial burden fall anyway? I suspect on the middle and upper 
middle classes, just like it does now.

12. Practically all current taxes are graded so the rich pay
proportionally more (aberrations like the 2000-2004 administration's
wealthy tax cuts notwithstanding). Why would it be different for UHC
taxes? It wouldn't; the rich would foot proportionally more of the
bill as usual.

Well, I just did an off the cuff calculation, and I come up with
about 7% of GDP expenditure on healthcare. So as a percent, we actually
spend less than France. As a percent only though, in real terms we spend a
lot more. But then we have a lot more people than France. We have
something like 5 times France's population.

18. According to the WHO, 15%. You'll forgive me if I am readier to trust
the WHO's calculations than your off-the-cuff calculations. In real
terms and percent terms, the U.S. spends way more on actual medical
care (excluding all things like research, training, etc.)

1. Not a UHC system. 2. The phrasing of the question has a
lot to do with how the question is answered. Pollsters are adept at
getting the answers they want through careful framing of the question.
Notice how they didn't mention how much higher the taxes would be, for
instance.

17. Yes, it certainly is a UHC system. You seem to be confusing universal
healthcare with state hospitals. While some countries have taken the
latter route for most of their healthcare, not all have.

For a quality system? About 20-30% more in taxes than you
currently pay.

19. To put it in perspective, not terribly much. Current federal income
tax brackets range from 10-35%, Volkov's calculations would move that
to 13-45%.

20. Disabled people are cared for by the state. It's often their fault
that they got disabled. Why should buildings be forced to have ramps
and automatic doors, as that costs money and means property developers
subsidize private citizens? Isn't that evil socialism? This rhetorical
question is aimed less at you, Volkov, than at those extreme
conservatives who believe UHC would mean society subsidizing the idle
unemployed...

21. On health and culture: Australia has one of the highest incidence
rates in the world (unsurprising, given the climate and ozone
hole), but one of the highest life expectancies notwithstanding.

[Kraken]

Um...President Bush did NOT declare a "War on Drugs", that was President Nixon.

and your opinion doesnt matter because as you stated: your not an American nor will you ever be one. Its up to us Americans to decide what we want.
And Cheaper by whose standards? Higher Taxes to pay for the damned thing is NOT cheaper.
When and IF America goes to UHC, then i will go along with it: what choice do I have when and IF it comes to a vote between the poloticians we elect?
But to rant and rave about it is moot.
you missed many of my points.
Nuke: your silly stats prove nothing.
I think that by NOT counting Canada's flailing system is a copout.
you do not want to include it into it because it is a prime example of what can go wrong with UHC.
But, Humain or not, its not up to people to wipe the asses of all of those who cannot wipe thier own. that is my opinion and im sticking to it.

[The Beatles]

Then why do we care for disabled people? The state wipes their arses, right? Mandating ramps and buttons and toilets and everything in buildings. Who says Joe American ought to wipe their arses?

[edit] I should add, America's care for the disabled is just one of the things I was very impressed by when visiting America. Really top-notch consideration is given to disabled people.

[Nuclear Raunch]

I bet those top 15 countries also spend almost as much money per capita as America does.

*posts stats showing that the top countries actually don't spend nearly as much per capita as we do*

Nuke, that added exactly nothing, as it's something everyone involved has already seen.

I think I'm misreading this or something but if not here's my response: If you already knew it then why post a knowingly false statement?

Kraken: Cheaper by a calculators standards, YMMV.

Firstly the question was not about how all UHC stacked up but rather the top 15. It was easier for me to just post the ones ahead of us so that's why there's more than 15. Secondly I don't care about the places that are worse than or relatively equal to us, they are not the ones to model after. Thirdly a comparison between the top non-UHC country (USA) and the top UHC countries seems reasonable to me. The discussion is about how much better we could make it not how much worse we could be.

[Gen. Volkov]

5. The countries in which it was introduced varied on the political
spectrum. None were as socially conservative as America, that's true.
As I said, this is irrelevant because some states have already
introduced UHC, so there are actually concept examples out there.

But if none of them were like the US to begin with, how can they be used as good examples for what we should do? How can they be good examples of how we can overcome the vested interests against a UHC system?

6. I'm sorry, but if you state that less doctors per patient doesn't mean
lower care, you have to imply that American doctors and nurses are
somehow better-equipped or more intelligent than European doctors.
That's patently silly. You do have less waitlists (not nonexistent, but
less), but that is due to the fact that there are less doctor visits.
Doctor visits, even insured, are expensive, so people tend to go less
often, that's all. On life expectancy, see point 20...

That wasn't what I was stating. You seemed to be implying that when an individual goes to a doctor in America, the treatment and care he receives is less than the treatment an care received by Europeans. You were implying that European doctors were better-equipped and more intelligent than American doctors, which just is not the case. Less doctor visits? Prove it, because I doubt it. Despite the expense, people still go to the doctor a lot. Now, it is true that we are on the low end of the scale in terms of doctor to patient ratio, for first world countries. But that doesn't mean the number of doctors we have is not adequate. Even if people DO go the doctor less here, if there weren't enough of them, we'd have long waitlists, which is simply not the case.

7. Calling it shoddy is my honest and thought-out opinion, gathered from
firsthand experience and statistics. It just doesn't work well for
screening, profits and administrative overheads suck a lot of money out
of it, it's very easy to go bankrupt over care, switching employers
once you get an illness is practically impossible (because of insurance
conditions), etc. The fact that it is only 37th, yet the country is the
richest (in top 3 anyway) for per capita wealth; that alone should tell
you it is inefficient (and hence shoddy). Don't get me wrong, I am not
deprecating anything about America inherently. It is just that powerful
lobbies have stifled all previous attempts at UHC here.

Can you just say inefficient then? Because, for me, shoddy has a whole set of connotations that just don't fit the US system. I agree that UHC has been stifled here, and I think it will continue to be stifled, unless the US citizenry drastically changes it's viewpoints on UHC.

9. Well, why don't you look around at other systems? There isn't a single
democratic country with universal healthcare that leaves the private
sector (either providers or insurance companies) out! Isn't that
convincing enough? Germany's care for instance is all private, the
state just insures. Switzerland is 100% private, the state just pays
for insurance. The UK's system happened because a very significant
chunk of the population (soldiers) had just been put out of a job by
WWII ending, and it was thought a good idea to put them to social
projects. This is much like what FDR did with his "New Deal". Only
except having people do public construction, Attlee's government had
them do public healthcare.

I'll give you this one, but I still say there is no guarantee of the US following the same path as other UHC states.

14. I'm willing to admit that could help the politics in many countries,
but certainly not all... I think lobbies (or lack thereof) have more
to do with it.

Lobbies are certainly a factor, but I don't know if they are the biggest factor. So let's just say that both are part of the equation.

12. Practically all current taxes are graded so the rich pay
proportionally more (aberrations like the 2000-2004 administration's
wealthy tax cuts notwithstanding). Why would it be different for UHC
taxes? It wouldn't; the rich would foot proportionally more of the
bill as usual.

But they don't, because the rich are few in number, so even though they are taxed more heavily, they aren't really paying much of the total contributed. The middle tax brackets are the ones contributing the main portion of the money. And they are also the ones affected by it the most. The rich get a lot of money taken, but they are also making a lot of money. The poor aren't making much, but they aren't getting alot taken either, the middle and upper middle class are getting the most taken out of their earnings, proportionally speaking, of any of the groups.

18. According to the WHO, 15%. You'll forgive me if I am readier to trust
the WHO's calculations than your off-the-cuff calculations. In real
terms and percent terms, the U.S. spends way more on actual medical
care (excluding all things like research, training, etc.)

From your original statement, it seemed like you were saying 15% of the per capita income. Not 15% of the GDP, please either clarify or link me to where you got those figures. Your original clarification just muddled things more.

17. Yes, it certainly is a UHC system. You seem to be confusing universal
healthcare with state hospitals. While some countries have taken the
latter route for most of their healthcare, not all have.

Maybe I am a little confused, but it would be easy to see where the confusion stems from. However, guaranteed health insurance for all is not necessarily a state health insurance program, or by extension a UHC system. As I said, the phrasing of the question is ambiguous. For example, some people could have thought that it just meant a law forcing insurance companies to insure everyone or the government paying the insurance companies to provide for all, thus meaning slightly higher taxes.

19. To put it in perspective, not terribly much. Current federal income
tax brackets range from 10-35%, Volkov's calculations would move that
to 13-45%.

]

Uh no, my numbers would move it to 15-55%, on the low end, 45% would be a middle bracket. On the high end, it would be like 20-65%, which some countries do have. France tops out at 55% I think. Denmark at 60%, others go as high as 65%, I don't know if any go to 70%, but it wouldn't surprise me if they did.

20. Disabled people are cared for by the state. It's often their fault
that they got disabled. Why should buildings be forced to have ramps
and automatic doors, as that costs money and means property developers
subsidize private citizens? Isn't that evil socialism? This rhetorical
question is aimed less at you, Volkov, than at those extreme
conservatives who believe UHC would mean society subsidizing the idle
unemployed...

Actually, there are disabled people who don't like our laws regarding them, and some who are taking advantage of them to make money. I don't know it the government has the constitutional right to make that law even. Basically, they are legislating niceness. However, in general I think it is a good thing because it's not really adding that much cost, and most wouldn't do it if they didn't have too. Even if it's a disabled person's fault that they are disabled, we shouldn't penalize them for their stupidity. (Even though I would sometimes like too penalize people for stupidity, I'm also a big fan of the Darwin Awards.)

21. On health and culture: Australia has one of the highest incidence
rates in the world (unsurprising, given the climate and ozone
hole), but one of the highest life expectancies notwithstanding.

Screw the ozone hole, I'm more concerned about 8 of the world's 10 deadliest snakes living in Australia, as well as the world's deadliest spider. Besides, the ozone hole is closing, that's one environmental catastrophe that we did manage to fix. However, with the advent of anti-venoms, snake bite deaths have gone way down, and skin cancer risks have also diminished greatly. In general, the Australians are healthier than the US in terms of obesity and such.

[Kraken]

I have a Quote here to share:

"It is difficult to distinguish fact from legend ... I have
found no consensus on what is fact; it depends on the
viewpoint. Interestingly enough, legend-which is by
definition disorted-gives a far more acceptable view of
events. Everyone agrees on legend, but nobody agrees
on facts."

-Michael Coney, The Celestial Steam Locomotive


i read this in a book. it is a very interesting thought. does it pertain to this discussion? i dont know.

just thought i would share.

[The Beatles]

Kraken: that little Quote was a Great Way to evade my Question.

4. Still haven't had time to look up stats for you.

But if none of them were like the US to begin with, how can they be used as good examples for what we should do? How can they be good examples of how we can overcome the vested interests against a UHC system?

5. Because Louisiana has done it?

The stats like doctors per 1000, nurses per thousand do
partially support your claim, but while they are lower, that doesn't mean
that the quality of care received is any worse when they do get to see a
doctor, and furthermore, the ratio we do have is plenty adequate, because
we don't have long waitlists, and other things that indicate a lack of
doctors. So basically what you have to go on is life expectancy and such,
which are heavily influenced by the culture.

6. If you have less doctors per patients, and no waitlists, that means less visits or shorter visits to the doctor. That is fairly black and white.

7. Sure, I'll say inefficient instead of shoddy. And inequitable. Actually I won't use any adjectives at all in future.

But they don't, because the rich are few in number, so even though they are taxed more heavily, they aren't really paying much of the total contributed. The middle tax brackets are the ones contributing the main portion of the money. And they are also the ones affected by it the most. The rich get a lot of money taken, but they are also making a lot of money. The poor aren't making much, but they aren't getting alot taken either, the middle and upper middle class are getting the most taken out of their earnings, proportionally speaking, of any of the groups.

12. When you say "the burden falls on the middle class", I assumed you meant they'd pay the most per capita. As that's not the case, I think thread #12 is pretty irrelevant. Who cares where it falls on; "the middle class" doesn't exist, just average people like you and me. We pay proportionally.

From your original statement, it seemed like you were saying 15% of the per capita income. Not 15% of the GDP, please either clarify or link me to where you got those figures. Your original clarification just muddled things more.

18. Sorry, percent of GDP.

Maybe I am a little confused, but it would be easy to see where the confusion stems from. However, guaranteed health insurance for all is not necessarily a state health insurance program, or by extension a UHC system. As I said, the phrasing of the question is ambiguous. For example, some people could have thought that it just meant a law forcing insurance companies to insure everyone or the government paying the insurance companies to provide for all, thus meaning slightly higher taxes.

17. You're quite correct that it's ambiguous. Massachusetts has a new law that requires everyone to have health insurance. The result has just been that everyone's (yes, everyone's, at least the whole middel class') health insurance has gone up. People under a certain limit have always had access to free basic healthcare, of course. I wouldn't consider this an UHC system for several reasons: A. not everyone is insured completely, B. it haemorrhages money to private insurance companies, thus making many people poorer, C. the market is almost completely unregulated. These points are rather subtle, though. Switzerland has something similar, but it works there, due to higher market regulation, state insurance companies, guarantees on insurances, etc. So it is a good-faith effort, just not very well implemented.

Uh no, my numbers would move it to 15-55%, on the low end, 45% would be a middle bracket. On the high end, it would be like 20-65%, which some countries do have. France tops out at 55% I think. Denmark at 60%, others go as high as 65%, I don't know if any go to 70%, but it wouldn't surprise me if they did.

(0.10, 0.35) * 1.3 = (0.13, 0.45)

Even if it's a disabled person's fault that they are disabled, we shouldn't penalize them for their stupidity.

20. Aha, but you're not. You're subsidizing, i.e. rewarding them for their stupidity! Socialism, n'est ce pas?
(Note that I just brought that up to ridicule the argument that UHC means subsidizing the idle unemployed. I know most disabled people aren't disabled through their own fault, and I fully support subsidizing all of them...)

22. One more reason not to look at Canada: "In availability of advanced medical technology, Canada ranks last out of the 29 OECD countries."

23. By the way, Kraken, the discussion does also affect me, because I pay taxes. If UHC were implemented in America while I was still here, I would be subsidizing public care without receiving it. But I'd be happy with that.

Hey, nice, a lot of points are dropping off, we are seeing more agreement.

[Gen. Volkov]

4. K then.

5. Because Louisiana has done it?

As you said, Louisana is a limited form of it, and what's more it's small scale.

6. If you have less doctors per patients, and no waitlists, that means less visits or shorter visits to the doctor. That is fairly black and white.

You don't have the stats to prove it though?

Also, we have fewer doctors per patient, but not that many fewer. Our numbers aren't anything like as abysmal as Canada's. We have 2.5 per 1000, Canada has less than 1 per 1000, I think the EU average is like 3.0 or 3.5 per 1000.

7. Sure, I'll say inefficient instead of shoddy. And inequitable. Actually I won't use any adjectives at all in future.

Aren't adjectives rather necessary to make good sentences? Inefficient is fine though. Even inequitable, just don't call it shoddy.

(0.10, 0.35) * 1.3 = (0.13, 0.45)

Where'd you get the 1.3 from?

12. When you say "the burden falls on the middle class", I assumed you meant they'd pay the most per capita. As that's not the case, I think thread #12 is pretty irrelevant. Who cares where it falls on; "the middle class" doesn't exist, just average people like you and me. We pay proportionally.

No, I meant as a proportion of total income, the average Joe is getting the most taken. Say a rich guy makes 500k a year, he is in the highest bracket of 45%. He get's 225k taken. Not that big a loss, he still has 275k left to spend a year. Now let's look at a middle class guy who makes, say, 60k a year. His tax bracket is say, 35%. So 21k is taken, leaving him with 39k a year. Who do you think feels it more? The rich guys pays more, but he feels it much less. That's what I meant when I said "the burden falls on the middle class." (Using the numbers you gave, using my numbers it's different end result for both, but still winds up with the middle class guy feeling it more)

17. You're quite correct that it's ambiguous. Massachusetts has a new law that requires everyone to have health insurance. The result has just been that everyone's (yes, everyone's, at least the whole middel class') health insurance has gone up. People under a certain limit have always had access to free basic healthcare, of course. I wouldn't consider this an UHC system for several reasons: A. not everyone is insured completely, B. it haemorrhages money to private insurance companies, thus making many people poorer, C. the market is almost completely unregulated. These points are rather subtle, though. Switzerland has something similar, but it works there, due to higher market regulation, state insurance companies, guarantees on insurances, etc. So it is a good-faith effort, just not very well implemented.

Thanks for a concrete example of exactly what I was talking about. *laughs*.

20. Aha, but you're not. You're subsidizing, i.e. rewarding them for their stupidity! Socialism, n'est ce pas?
(Note that I just brought that up to ridicule the argument that UHC means subsidizing the idle unemployed. I know most disabled people aren't disabled through their own fault, and I fully support subsidizing all of them...)

Right, well, that's not one of my arguments against a UHC system. It's one of my arguments against socialism in general, but in that instance I'm more concerned with the welfare state where the government is paying for all the needs, not just healthcare. I don't think we are really in disagreement about the disabled though. Heh.

22. One more reason not to look at Canada: "In availability of advanced medical technology, Canada ranks last out of the 29 OECD countries."

Yeesh. I knew Canada was bad in that department, but I didn't know they were THAT bad. So yes, let's not look at Canada, unless you are trying to group the US with Canada as a "shoddy system". *laughs*.

Hey, nice, a lot of points are dropping off, we are seeing more agreement.

Indeed.