Health Insurance In the US Will Not Be Reformed

16 Dec

A libertarian extols the virtues of the French single-payer health care system, and declares it vastly superior to the American status quo, but doesn’t want to implement it here because I-Me-Mine:

when free marketers warn that Democratic health care initiatives will make us more “like France,” a big part of me says, “I wish.” It’s not that I think it’s either feasible or advisable for the United States to adopt a single-payer, government-dominated system. But it’s instructive to confront the comparative advantages of one socialist system abroad to sharpen the arguments for more capitalism at home.

For a dozen years now I’ve led a dual life, spending more than 90 percent of my time and money in the U.S. while receiving 90 percent of my health care in my wife’s native France. On a personal level the comparison is no contest: I’ll take the French experience any day. ObamaCare opponents often warn that a new system will lead to long waiting times, mountains of paperwork, and less choice among doctors. Yet on all three of those counts the French system is significantly better, not worse, than what the U.S. has now.

Need a prescription for muscle relaxers, an anti-fungal cream, or a steroid inhaler for temporary lung trouble? In the U.S. you have to fight to get on the appointment schedule of a doctor within your health insurance network (I’ll conservatively put the average wait time at five days), then have him or her scrawl something unintelligible on a slip of paper, which you take to a drugstore to exchange for your medicine. You might pay the doc $40, but then his office sends you a separate bill for the visit, and for an examination, and those bills also go to your insurance company, which sends you an adjustment sheet weeks after the doctor’s office has sent its third payment notice. By the time it’s all sorted out, you’ve probably paid a few hundred dollars to three different entities, without having a clue about how or why any of the prices were set.

In France, by contrast, you walk to the corner pharmacist, get either a prescription or over-the-counter medication right away, shell out a dozen or so euros, and you’re done. If you need a doctor, it’s not hard to get an appointment within a day or three, you make payments for everything (including X-rays) on the spot, and the amounts are routinely less than the co-payments for U.S. doctor visits. I’ve had back X-rays, detailed ear examinations, even minor oral surgery, and never have I paid more than maybe €300 for any one procedure.

The United States Senate has effectively killed off the byzantine centrist compromise called the “public option”, and is poised to pass some form of legislation that will, perchance, provide some sorely needed consumer protection in the health insurance industry, and, mayhaps, will insure more people, but the type of system such as that described above is denigrated as un-American socialism.

You know, a few weeks ago I saw billboards over in Ontario that were selling “fast-track your medical procedure” at Kaleida facilities in New York. Definitely there are problems inherent in the Canadian system, and those provincial health ministries are acutely aware of them and working to improve the speed of service. I’ve seen Canadian medical records in my line of work, and they depict excellent care, done efficiently, with no waiting list even for MRIs – if you go to the right facility.

But if you look at that Kaleida site, there are only a handful of procedures that are highlighted for Ontarian medical travelers – bariatrics (weight-control surgery), colonoscopies, orthopedics, pediatrics, and radiology. The United States could very well adopt a Canadian single-payer system and endeavor to avoid the mistakes that Canada has made. Look at the French experience, above. Instead, we reject the Canadian experience because it isn’t perfect.

I looked at the wait times for Mississauga, a busy Toronto suburb. 96 days for knee replacement surgery. But you can click a link to see the shortest wait times in the province, and find you can go to Mt Sinai in Toronto, where the wait is 61 days. Or you can go to a hospital in Chatham, where the wait is only 48 days. For lung cancer surgery, the wait is 22 days in Mississauga hospitals; the shortest wait time in the province.

The wait for an MRI is also 96 days for Mississauga hospitals. But click the link, and there’s a hospital in Toronto that will see you in only 28 days, which meets the Provincial target time.

The procedures are fully covered – no bills, no possibility of rescission. The care received is exactly what your doctor thinks you should get, regardless of cost. We can demagogue the Canadian system all we want – and frankly France does it better than Canada – but to reject single-payer out of hand because of wait times that can be more than halved if you’re willing to drive the equivalent distance between Millard Suburban and Buffalo General, is ridiculous.

Our system is far from perfect. In fact, it’s far more broken and expensive and wasteful than Canada’s. And wait times? I called my doctor for a checkup – a well visit – and had to pick a day 4 weeks away. For sick visits, I usually have to wait a day or two, and sit in a waiting room, feeling ill, for literally hours. Oh, huzzah.

Ideally, we’d let the doctors design the legislation. The system we choose to adopt should make their jobs easier. Instead, we leave the job to congress and the health insurance lobby.

Oh, and Joe Lieberman is a disgrace.

36 Responses to “Health Insurance In the US Will Not Be Reformed”

  1. Jonathan Wellinton-Fidrych III December 16, 2009 at 8:56 am #

    The imminent defeat of French Communist inspired health care reform (or ANY reform) is a great victory for the free market which has made this country the paradise it is today. Senator Joe Lieberman is one of the most dedicated and selfless public servants we have ever known. Like Sarah Palin, he speaks for those of us whose voices are so seldom heard above the rabble din. Thank God the prayers of our lobbyists and corporate media have been heard.

  2. Mark December 16, 2009 at 10:24 am #

    France does not have a single-payer system.

  3. STEEL December 16, 2009 at 10:42 am #

    The American health care system does not work. We could create a magnificent system based on the experiences of the rest of the world but refuse to because someone said “Socialism”

    We are a stupid stupid country.

  4. Ethan December 16, 2009 at 10:55 am #

    We’re getting pretty much exactly all the “reform” Obama et al. ever wanted.

  5. Mike In WNY December 16, 2009 at 11:18 am #

    You neglect to mention that the French health care system is one of the most costly in the world and threatens the financial health of their country. Their government has been steadily lowering reimbursement rates for medical care leading people to purchase additional private insurance to augment the government coverage.

    You also conveniently focused on one aspect of Matt Welch’s article, the “speed” of service and universal accessibility.. Comparable service is well within reach in the U.S. market without further cost escalating government intervention. Those same benchmarks can be acheived within the U.S. by implementing reforms without government invention and with lowered overall costs.

    While selling one’s soul to the devil may produce the achievement of some health care reform goals, it certainly does not come without tremendous costs and sacrifice. Instead, we need to focus on reform that produces similar results without the disregard for one’s quality of life.

    France has been increasing co-pays, which range from 10% to 40%, in an effort to combat the financial drain on the country. Mandated costs are equal to nearly 20% of one’s income through direct and employer taxes. The use of private insurance has been increasing to cope with costs and because providers are increasingly refusing to treat people strictly for the government reimbursement rates. Market reforms, of the private nature, have been increasingly necessary to cope with the costs.

    What our country needs is an honest discussion about health care reform that does not preclude market-based measures out of hand. The mindset that only government can provide the level of care desired is self-serving and destructive.

    • Eric Saldanha December 16, 2009 at 4:13 pm #

      Who will implement these magic reforms? The same managed care insurers which are currently jacking up premiums and jettisoning thousands from coverage? I think the free market in health care spoke some time ago and it said “don’t get sick.”

      • Mike In WNY December 16, 2009 at 6:45 pm #

        There hasn’t been a free-market in health care in this country during my lifetime. I don’t know what time period you are referring to.

    • Stan from OP December 16, 2009 at 4:37 pm #

      This year, U.S. spending is expected to near $8,000 per person, while French officials estimate spending there will come in below $5,000. SO if the French system is one of the most expensive, then the US system is 60% higher than the most expensive system.

  6. Gabe December 16, 2009 at 12:59 pm #

    Joe Lieberman obviously has a few screws loose. He needs to go.

  7. ethan December 16, 2009 at 1:48 pm #

    @gabe: he’s a little shit, indeed, but he’s only a small part of the problem. When’s the Democratic leadership and/or the White House goinng to lean on him, exactly? Oh, right: never.

  8. Ward December 16, 2009 at 2:36 pm #

    I dunno, Alan–those “new and improved” wait times you cite in Ontario seem pretty intolerable by our standards. That the Province has set a target of 188 days’ waiting time for a knee replacement is absolutely laughable.

    There must be a reason folks in Windsor go to Detroit for a coronary bypass–and pay. Could it be they don’t want to die first?

    You could charitably describe that as one of the “problems inherent in the Canadian system”. (Oh, wait–you did.)

  9. Eric Saldanha December 16, 2009 at 3:52 pm #

    The Atlantic nails it, re: Holy Joe Lieberman- He’s like a divorced dad refusing to pay for private school because it might please his ex-wife.

    He is a spiteful, bitter old man who finally sees his chance to wreak vengence on his “enemies” – meaning anyone who didn’t kiss his ring when he lost the Democratic primary in 2006. And to those who did support him, namely Obama and Biden? A hearty “fuck-you”

    Lieberman has been a lying, gutter weasel for 9 years….I blame Reid and the Senate Leadership for allowing this clown to stay in the caucus and retain his chairmanship.

    • Ethan December 17, 2009 at 11:32 am #

      I hope you blame Obama and Rham, too, b/c it’s not like they’ve done a damn thing to curtail Holy Joe, either; quite the opposite, in fact.

      • Eric Saldanha December 17, 2009 at 3:24 pm #

        Obama and Rahm Emanuel do deserve some blame for not addressing the Lieberman situation at the outset of the health care reform push, but it’s in neither of their job decscriptions to manage the Senate caucus (and independents who vote with the Dems). That’s Harry Reid’s job and he’s done a piss-poor job.

  10. Jon Splett December 16, 2009 at 5:09 pm #

    Remember a few months back when we had that election thing and you guys all got a hard on for that Obama dude and told me I was crazy for voting for Nader and how this Obama dude was totally different and how he was going to change things? How’d that work out for you again?

    This is why I’m not nor will I ever be a Democrat. 

    • Alan Bedenko December 16, 2009 at 6:13 pm #

      And Nader would have done what, exactly, all things being equal?

      • Jon Splett December 16, 2009 at 8:09 pm #

        Obviously, the political landscape wouldn’t be what it right now is if an anti-corporate president had been elected so trying to pretend all things would be equal is quite ridiculous and the question is a useless hypothetical. But if the majority of the country had voted for him, you can damn well bet it would have been a message from the American people that we get out of the wars and get a single payer health plan now. That was what his entire campaign was about. That ‘Democrat’ just means ‘Republican-light’ and that Obama wasn’t going to deliver on health care or ending any wars anytime soon, the ‘change’ was all lip service. Tell me how he was wrong on that?

        Need more proof? The guy who put the final nail in the coffin on meaningful health care reform is a former vice presidential nominee from the election Democrats like to say Nader lost them. His campaign back then was ‘the Republicans and Democrats are the same damn party’. It took 9 years, but the guy you guys wanted to be a heartbeat from the presidency just proved that. Everyone seems real comfortable with calling a failed Republican vice presidential candidate the standard bearer for her party but I never see the Democrats recognizing the fact one of their failed VP selections pretty much embodies where they stand these days, much further to the right than the left. 

    • Eric Saldanha December 16, 2009 at 8:48 pm #

      So, supporting a candidate and casting a vote for him means you have a “hard-on” for him?

      Mickey Kearns is going to be surprised that he gave me an erection.

      • Jon Splett December 16, 2009 at 10:12 pm #

        Yes, when the Obama marketing meme reaches a point where they start pressing the guy’s face on ecstasy, I’d say the nation had a hard on for him. 

        http://www.cbsnews.com/blogs/2009/12/02/crimesider/entry5864845.shtml

        And despite CBS just reporting the story, these started floating around during last year’s primaries. Word on the street is they give you a quick euphoric climb followed by a whole lot of nothing….much like the Obama presidency. 

      • Eric Saldanha December 16, 2009 at 10:20 pm #

        they start pressing the guy’s face on ecstasy

        “they” being drug dealers, right?

        Obama wishes he had an ounce of the megalomania that St. Ralph the Pure possesses

      • Jon Splett December 16, 2009 at 10:26 pm #

        Yes, they being drug dealers.

        That’s how pervasive the Obama pop culture phenomenon is.

        Even drug dealers think the guy is awesome…tell me the last president with that kind of Q rating. 

    • Eric Saldanha December 16, 2009 at 10:03 pm #

      BTW, Lieberman is no longer a Democrat. Hasn’t been since 2006.

      • Jon Splett December 16, 2009 at 10:21 pm #

        What does that say about the convictions of the people your party nominates for national office? You promote political opportunists and demonize people like Kucinich who refuse to sell out what you’re suppose to stand for.  

        The Democrats have majorities in the House and Senate and hold the White House and they can’t pass legislation they’ve been trying to get elected on for decades. That’s not inept, it’s corrupt. 

  11. ethan December 16, 2009 at 5:58 pm #

    @jon Not me, bro.

  12. mike hudson December 16, 2009 at 9:34 pm #

    i am shocked, SHOCKED to learn that President Barack Obama, who recently escalated the war in Afghanistan, cannot find a way to do what he promised. FAIL…

  13. mike hudson December 16, 2009 at 11:22 pm #

    hey splett, i backed clinton and was called a racist.

    right here.

  14. Peter A Reese December 17, 2009 at 12:03 am #

    I never expected Obama to accomplish everything he said. I did expect him to try. He has been AWOL of health care reform.

  15. mike hudson December 17, 2009 at 12:15 am #

    WASHINGTON — Less than a year after Inauguration Day, support for the Democratic Party continues to slump, amid a difficult economy and a wave of public discontent, according to a new Wall Street Journal/NBC News poll.

    http://online.wsj.com/article/SB126100346902694549.html?mod=WSJ_hpp_LEFTTopStories

  16. Eric Saldanha December 17, 2009 at 10:25 am #

    @ Jon – it says about the same as Nader taking GOP money and support to get on the ballot in swing states in 2004 and calling our President an “Uncle Tom” the night of the election.

    I was far from thrilled at Gore’ VP choice in 2000 and I thought he was pandering to some mythical bloc of voters who were swayed by the Clinton sex scandal. Instead of running away from the Clinton years, Gore should have held them up and said “Do you trust this tinhorn dunce who’s failed at every level in his life, only to be given a boost up by his daddy and his connected friends, to continue this record of accomplishment?” Alas, he didn’t and, as expected, Lieberman was an awful campaigner, he performed like a tame pussycat in the VP debate against Cheney and then, most audaciously, went rogue during the recount battle.

    I have never demonized Kucinich….I have a lot of admiration for the man’s courage, particularly during his tumultuous term as Mayor in Cleveland in the late 70’s. That he didn’t succeed as a national candidate has as much to do with the mainstream media’s obsession with anointing front-running candidates and framing primaries as “horse races” as anything in Kucinich’s platform.

    BTW, after Kucinich dropped out of the Presidential race last year, he supported Obama and even delivered an impassioned address at the 2008 DNC in support of the Obama-Biden ticket.

    • Ethan December 17, 2009 at 11:37 am #

      None of which actually defends the Democrats against Jon’s charge.

      • Eric Saldanha December 17, 2009 at 11:49 am #

        What’s the charge? The Democrats aren’t leftist enough for the ideologically pure, like Splett? Oh well…

      • Ethan December 17, 2009 at 12:12 pm #

        leftist “enough”? I’m sorry, didn’t you and the majority of Americans want a public option of some sort? So where is it?

  17. Ward December 17, 2009 at 12:18 pm #

    This thread makes me smile. Eleven months in, and the lefties are pissing on each other’s leg.
    Truly Obama will turn out to be Carter-Lite.

    • Alan Bedenko December 17, 2009 at 2:38 pm #

      Lucky the Republicans are the picture of unity, being subsumed by the teabaggers and whatnot.

    • Eric Saldanha December 17, 2009 at 3:28 pm #

      Ward – I’m glad that reasonable people arguing over how best to get out of the massive shithole Bush and the Republican Party left us in after 8+ years of the most inept and corrupt governance in our nation’s history makes you smile.

  18. scot December 17, 2009 at 3:54 pm #

    we are all more intrested in seeing the other party fail…..then to see our country succeed. i voted obama…i do wish he’d push more, fight. but i can’t but losing on the health care issue or any issue soley on him or the democrats. the only adjenda the right has…is to get in the way. thats as unamerican as you can get.

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