Don’t mistake my arguments as support for the current system. I know the current system is flawed. What I object to is that the most vocal supporters of universal healthcare justify it will poor and flawed arguments that are designed to be emotionally appealing.

That is not “explaining away” infant mortality. Sorry, but variations in statistical methodology matters whether you choose to believe it or not.

This uninsured are contributing to the high cost of healthcare, because when they can’t pay their hospital bills, the costs are distributied among the rest.

If they were insured tomorrow those costs would still be distributed “among the rest” because those previously uninsured would not be paying a lot into the system but they’d be using a lot more services.

And no one who supports universal health care here seems interested in discussing the very real problem of the SHORTAGE of doctors, nurses, beds, etc. If you add 50 million people and no doctors under a universal healthcare system, what do you think is going to happen? Nothing good.

I could easily support universal healthcare coverage. I want to support it. But so far the arguments and justifications used to support it are rather weak and proponents seem incapable of addressing legitimate questions opponents raise. Nationalization cannot magically create more doctors, bring costs down and provide timely and quality service equitably without solving underlying problems of the system. Why is it that the most vociferous proponents of universal healthcare show no interest in even acknowledging such conditions exist?

The fact is, that 17 million don’t have insurance, and the consequences of that are apparent without knowing the why’s and wherefor’s.

This uninsured are contributing to the high cost of healthcare, because when they can’t pay their hospital bills, the costs are distributied among the rest.
We should actually add the millions who have ‘bare bones’ insurance, because when they. too rack up hospital bills they can’t pay, it adds to the cost of health care for everyone.
Add also that the number one reason for bankrupcy is health care bills.
Add also that that the sick con’t work and don’t contribute, etc.etc.

There is an attitude that universal health care is a means of doing some people an undeserved favor. From another viewpoitn, the nation would be doing its economy a favor by finally dealing with this problem.

Even if our higher stats on infant deaths could all be attributed to the mother’s alcoholism or drug abuse (and you’d need some comparative figures to make the case), the uninsured and the costs they bring to bear on the economy would not disappear.

There are 47 million Americans without health insurance and another 17 million with coverage that will not pay for the treatments necessary to fight cancer and other very serious diseases.

The bottom line, said Mr. Seffrin, is that “the number of people who are suffering needlessly from cancer because they don’t have access to quality health care is very large and increasing as I speak.”

Wow. Those 17 million (and counting). That’s a real shocker.

As was mentioned by domajot there are some other factors that are not considered when you are talking about household income.

If a family is making $50,000 to $60,000, let us say, by having both parents work they have to have day care. Do you know what that costs in this country with no government subsidy? I live in the Kansas City area, far from the most expensive place in the U.S. and here it costs at least $150 for a child who isn’t in school and half that during the school year. So one child who hasn’t entered school will cost $7800 a year for day care. This also means that every child in day care will cost $150 a week at least part of the year, when school isn’t in session. That means over two months in the summer and during any holiday periods that long. And of course there is a pro-rated increase when you have a holiday of less than a week.

In addition there is little mass transit in much of the United States and if you want a job you’d better have a car, which means car payments, insurance (mandated by law), gas and maintenance. A very common job interview question here is whether or not you have reliable transportation to work. Being late often enough even if it is really due to breakdowns will get you fired. How much that might cost you varies tremendously but just gas and insurance will get you into several thousand a year.

So anyone who tries to make $50,000 for household income sound like something that leaves lots of money to spare is either being disingenuous or is hopelessly ignorant of the real world of the American middle class.

When it comes to private insurance versus public the figure that American conservatives hate to hear is that administrative overhead for Medicare and Medicaid is about one-quarter of that of the corporate health insurance that they admire so much. Public spends 3% and the private ones are between 12% and 14%. They do their best to spin it and make excuses for it. Think about it. When you consider the huge amounts spent 12% is a huge amount. And that amount doesn’t even take into account the number of people that doctors and hospitals have to hire to wade through the insurance red tape maze they create. And were you aware that these companies actually have employees whose only full time function is to examine claims looking for a loophole to help them avoid paying out the money they’ve agreed to pay? They also take months to pay the doctors and hospitals the money they are owed, a practice they would never tolerate on the part of those who owed them money. Then there is the question of acceptable profits and growth for publicly held companies in the United States. They’d better be big. Very big. And the executive compensation will match. For those reasons I do not believe that there is any way for corporate health care to provide less expensive health care that will still actually do what it is meant to do.

The title of your post is “Is Health Care Unaffordable or do Millions of Americans Just Have Other Priorities?” I added some emphasis there, to indicate that presented just two possible choices.

Reading it, I see that you come down on the side of Americans having other priorities:

Perhaps some households with $50,000 cannot afford health care, if they want to save money for the college education of their two kids? But that would still be their free choice, right?

In response to this, Jim Satterfield (Comment #1), discusses the misleading $50,000 income threshold. Brother Alpha (Comment #3) discusses costs in the US versus Canada (where costs are lower). In other words, they suggest the issue may not be as either/or as you indicate.

Of course you don’t have to follow up if you don’t want to.

As for statistical differences and methodology, I don’t normally like Wikipedia much, but I think it condenses and highlights some of the very real problems in making comparisons between the US and other countries.

Also, I did not argue that infant mortality would not be improved by some kind of universal healthcare program – my argument relates to the degree that it would be improved and the implication – or assumption – that the principle reason the US lags behind is because we don’t have nationalized/universal healthcare. If the implication so often given is true, then I expect to see some definitive evidence for it instead of unsupported claims of causality. Instead, the evidence for such causation is weak and problematic.

Also, as Dave has mentioned frequently on his blog, a big problem here in the US is a shortage of healthcare at almost all levels. Nationalization will not, by itself, solve that fundamental problem. In the “International Dialog” post which you linked, two of the metrics the US ranked last in on the chart in that post are significantly, and possibly even primarily, influenced by this shortage and are likely factors in the other metrics as well.

So, one might wonder what would have the bigger impact – a nationalized system, or an end to the healthcare shortage. I would argue that both would be good, but it seems to me that implementing universal healthcare without solving the shortage could be disastrous. There are only a few possible outcomes from a large increase in patients with no corresponding increase in providers and none of those outcomes are good.

Manchmal ist das mit dem Web2.0 ja nicht so ganz einfach, deshalb hier meine Linkliste zu Greg Mankiw’s Artikel “Beyond Those Health Care Numbers” in der New York Times von heute (?):
Ist es schlimm, wenn 47 Millionen Amerikaner nicht…

Re #2: So what explains the difference?

There are any number of possibilities. One, mentioned by Mankiw, is babies whose weight is low at birth. This, in turn, is correlated to maternal drug and alcohol use during pregnancy.

Yes, that’s Mankiw’s point.

Re #2: So what explains the difference?

Re #3: Maybe not eliminated, but improved. What else explains the difference? The US climate?

“One might argue that longevity and infant mortality are poor measures of the “quality” and efficacy”

There are plenty of more measures. See the link in the post above r click here

To start with, data collection on infant mortality is not standardized – the US counts deaths that other countries do not.

Secondly, there are many causes for infants to die in their first year of life – many have nothing to do with a health care system.

Third, data show there are strong social and demographic factors at play – factors that would not be eliminated through universal health care.

So while one might argue that universal health care would lower the US infant mortality rate, exactly how much it would be lowered is a topic of some dispute. No one who makes the claim that the “high” infant mortality rate is caused by the health care system has bothered to run the numbers – perhaps because they realize the findings might not buttress their rhetoric as they would like.

How do you want to increase the supply of healthcare?

Educate more physicians and nurses. Remove anti-competitive restrictions on hospitals. Increase the use of technology. Change work rules.

Thanks for your comment. Great to be debating with you again.

“We’d still be paying more than twice as much per capita as the next highest-spending country (Switzerland).”

Wow, that’s even more expensive than I thought.

How do you want to increase the supply of healthcare? Should the government (or the Buffett/Gates/Soros foundations) set up insurance companies and hospitals?