8 Responses to “National Healthcare”

1. 

   Harry June 23rd, 2009 at 9:50 am

   I guess you’ve probably read the Atul Gawande article in the New Yorker:

   http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

   but if you haven’t, it’s interesting.

2. 

   sherry June 23rd, 2009 at 1:04 pm

   Thanks for the link, Harry. I have not read the entirety of this article but I’ve heard this argument and don’t disagree with it. (Is that litotes? Aarrggh, here comes Dinsdale.) Medicine, it seems, like U.S. culture in general has become all about consumption and profit-taking.

   On the other hand, I don’t often look to The New Yorker for working class sympathies.

   Would a NHS solve that problem? I don’t know. I’m pretty sure Humana won’t. And at the very least, I think we need a “public option.” What I worry is that merely requiring people to have “coverage” doesn’t mean they’ll get healthcare.

   Here’s a counterargument to the New Yorker argument against NHS.

3. 

   Harry June 24th, 2009 at 10:35 am

   I didn’t actually read it as an argument against a government-run health system, exactly, just that there is an enormous amount of variation within the US which is quite separate from any question of funding structures and which needs to be investigated and understood. Controlling healthcare costs is something relevant to all of us, however our treatment is funded.

   FWIW, you won’t be surprised to hear that as a European, I think that some kind of government-guaranteed universal healthcare provision is a baseline expectation of living in a wealthy democracy. I can’t see it’s any different than schools, roads or policing in that respect.

   I wouldn’t necessarily suggest you look to the NHS as a comparison, though — I’m happy to defend it as a good service, but other European countries manage to provide healthcare without quite such a vast monolithic central bureaucracy.

4. 

   Harry June 24th, 2009 at 10:57 am

   I was trying to remember where I was reading about the historical reasons behind the various differing healthcare systems in Europe and it turns out it was another article by Gawande in January this year:

   http://www.newyorker.com/reporting/2009/01/26/090126fa_fact_gawande?currentPage=all

   If you read it you can see, I think, that he has entirely the right priorities: “medical debt must disappear as a cause of personal bankruptcy in America” and “a glimpse of American health care without the routine cruelty” both strike me as telling phrases. But he has (it seems to me) a basically pragmatic, non-ideological approach to the question of how to achieve them.

5. 

   sherry June 24th, 2009 at 4:19 pm

   Hmmm, you haven’t heard about what’s been happening to our schools, have you? I’m not sure we any longer qualify as “a wealthy democracy.” There is, of course, vast wealth here but you no doubt know the figures on its distribution.

   And yes, I see your point about Gawande’s argument. But it’s nuanced and we don’t do nuance over here.

   Thanks for even talking about this Harry. I appreciate your input.

6. 

   sherry June 24th, 2009 at 6:13 pm

   Re-thinking all this on the drive home, Harry. I don’t like to think of myself as an ideologue but I think I must confess to being reactionary. I am really weary of all the hyped-up rhetoric from a right wing that seems to be willing to let the country go down if they can’t have power. I’m tired of my kids’ lives being narrowed because they have to pay exorbitant insurance premiums and then can’t afford to go to the doctor. I am worried that a bill that requires people to have health insurance won’t make any fundamental changes in this situation. My kids have health insurance but it’s pretty much worthless. So when it comes right down to it, while I know that cost is a big factor here, it isn’t what motivates my opinion. What worries me is availability! And I know that high costs curtail availabiltiy but I’m not that objective.

7. 

   Harry June 24th, 2009 at 7:36 pm

   “So when it comes right down to it, while I know that cost is a big factor here, it isn’t what motivates my opinion. What worries me is availability! And I know that high costs curtail availabiltiy but I’m not that objective.”

   Don’t get me wrong, I think that the important battle is over availability. Health worries are quite scary enough without the financial dimension; and financial worries are quite scary enough without the chance that they will stop you looking after your own health or that of your family.

   But at some point costs have to be an issue because the US already spends far more on healthcare per person than countries like the UK and France. The main objective has to be universal coverage, but combining that with a bit of political outrage over costs would be no bad thing at this point.

8. 

   sherry June 26th, 2009 at 10:17 am

   The main objective has to be universal coverage, but combining that with a bit of political outrage over costs would be no bad thing at this point.

   Agreed.