5 Myths About Health Care Around the World

Yes, but SOCIALISM. Better dead than Red!

I'm sure we'll will hear that this article is chock full of inaccuracies; you know, facts that contradict the lobbyist driven talking points.

The last two paragraphs of Mr. Reid's "5 Myths About Health Care Around the World" sums up the problems we are facing:

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.

Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.

The health care industry continues to pump $1,400,000 / day into defeating ANY reform and the "other side" is working for them for free because they don't want a Democrat President and a Democrat Congress to succeed.

Actually Steve, there's plenty of money for both sides when it comes to lobbying money. Anybody who can throw up a roadblock or print a distortion is receiving "contributions."

The current lobby-driven, bucks-for-votes form of government is not what the founding fathers had in mind. It may one day be pointed at as the single most salient factor in the demise of US predominance.

While the children whine, and permit themselves to be stampeded into stupidly rushing to do whatever makes them feel better, NOW!, smarter people know better.

All other systems have their shortcomings as well as their attractions, and a more authehtically American derivative with a primary or exclusive federal government role in health care (few are patriotic or principled enough even to pay token lip service or even given much, if any thought to the state and local governments, instead) will mean the exchanging of the set of problems we now have for another.

There are no instant, magic miracles, children, nor is government your parent, nor private parties evil.

Not one of the alternative systems are paradises. And your delusionally beloved Europe faces even worse problems in the future than our nation will face already with its current health care and elderly social-spending program model.

Stop, think, and look before you childishly and stupidly insist that we all leap, we informed adults say.

Hopefully what ever we end up will have had some purposefulness in its final construction and keep the defects, and other threats interventionism and the politics of those pushing it threaten, limited.

And (in the USA and other models for health care revision in addition to continental Europe, such as the UK, Canada, Australia, and New Zealand), the pre-1980 dream of Anything Is Possible is doomed.


http://csis.org/program/global-aging-vulnerabil...

http://www.capco.com/files/pdf/79/01_MACRO-ECON...

http://www.twq.com/02spring/hewitt.pdf

http://assembly.coe.int/Documents/WorkingDocs/d...


(Do the kiddies here really believe European health care is monolitic and static?)

http://www.europesworld.org/NewEnglish/Home/Art...


http://www.sustainhealthcare.org/

http://www.futureofprimarycare.com/?opt=5

The status quo folks had twenty years to come up with an answer, but they saw no problem. Now they say, "Don't rush into anything!."

Even China, who tried free market reforms in the medical biz starting in the '80's, has decided that it makes good economic sense not to screw their most productive citizens with a third world style health care system. People don't work very hard when they are sick, lame or dead, thus they can't contribute to the GDP.

Some people need reminding that the Chinese government doesn't do much out of the goodness of their hearts, nor do they think their citizens have rights to very much.

http://www.time.com/time/world/article/0,8599,1...
"China is laying out plans to dramatically reform its health care system by expanding coverage for hundreds of millions of farmers, migrant workers and city residents. To fix a system plagued by rising costs and diminishing access, the country is moving away from the market reforms introduced in the 1980s and returning to a more socialist health care system."

HemmD wrote: "Actually Steve, there's plenty of money for both sides when it comes to lobbying money."

Are you saying that you think there is some sort of parity in the amount of money being spent by each side on this issue?

Last week David Adesnik wrote a post about the nearly $300,000 dollars that was raised by progressives in a week long fundraiser. For some reason some people commenting in that thread seemed to think $300k ($60 average contribution) was the same as the $42,000,000 a MONTH being spent by the Health Care Industry.

I'm probably going to regret replying to you but here goes...

You used to be a commenter that I would always read, whether I agreed with you or not (more often not) because you were more reasoned & thoughtful and I'd sometimes even learn something new. Now you're insulting and condescending to those who don't agree with you and often long-winded and incoherent in your postings. I used to respect that your aim seemed to be to help illuminate & change minds but now your goal seems to be to endlessly rant at anyone even slightly left of yourself (and you definitely do not strike me as center-right by any stretch) that they're stupid and to get off your damn lawn. If you were to tone down the insults and condescension, that would be a significant step in the correct direction. This is in a spirit of constructive criticism so I would hope that you'd take it as such. If not...then we're all a bit worse off for it.

SteveK: Are you saying that you think there is some sort of parity in the amount of money being spent by each side on this issue?

I agree with HemmD on this one. There is so much money going into this right now by whoever seems to have a stake in it. As far as parity goes:

These opposition groups appear to have spent at least $10 million so far on ads attacking the Democrats' plans. Still, supporters of a health care overhaul have outspent opponents by about 2-to-1 so far, according to Evan Tracey of the Campaign Media Analysis Group, which tracks ad spending. Supporters include drugmakers angling for their own protections, unions, the American Medical Association and AARP, the seniors lobby.

As far as where it comes from:

As the Congressional debate heats up ... records show money from doctors, insurers, pharmaceutical firms and hospital and nursing home groups has been flowing increasingly into Democratic coffers - jumping from $36.9 million in the 2006 campaign to $90.7 million in 2008.

So, basically those of us without the cash to buy off anyone are pretty well left out in the cold.

I just don't get this clinging attitude towards the greatness of our heathcare system. Its not working, its dying, and millions don't have coverage. Some things the free market system doesn't do well, and this is one of them. Free market is based around the idea that consumers have choices. You don't have a choice about healthcare, when your leg is broke, you need to see a doctor. Food is not an option, it is subsidized by the gov't and as a result, even though we all pay farmers in taxes, we don't have to worry about a famine. How is medical care any different?

Anti reform folks seem to mostly be scared of a faceless gov't bureaucrat pulling the plug on grandma. Newsflash, thats already happening. Except that faceless bureaucrat works for the insurance company and gets a bonus check for it. Been to the hospital lately guys? Know what a "wallet biopsy" is? You will excuse me if I am not willing to give a shot to a system that seems to work fine in so many other countries. Pharma companies are charging americans up to 10x as much for products than they do in other countries because they know with the current system they can stick it to us. The numbers are right out in the open, look at them and ask why.

"The status quo folks had twenty years to come up with an answer, but they saw no problem"

"Status quo" is dishonest when referring to opposition to the current health care reform effort; the GOP as well as the Blue Dog Dems all say that reform is needed, but of course "reform" is not defined as the House Dems' legislation, and "needed" of course has no honest application to that.

On the other hand, your statement is 100% accurate of Dem failure to do anything to rescue Social Security or Medicare. (As if everyone were foolish enough to believe Obama's vow of Medicare reform!)

* * *

"Now you're insulting [...] If you were to tone down [...]"

The pro-effort crowd has misbehaved routinely as well as being routinely wrong in their positions and I'm simply pushing back, in a form where plain language is more useful and appropriate in many cases rather than more elaborate, loquacious, or removed language. I've also taken the time to provide the facts that matter, to list constructive, true reform measures and other recommendations that are better than what is being done currently, and provided links to other sources that are revelent and what should be timely reading.

Your language is constructive and your views and advice did not go unnoticed or unrespected.

"I just don't get this clinging attitude towards the greatness of our heathcare system."

There never has been this. There has never been a Status Quo straw man brigade. There is a growing concern and oppostion among the public to more and more of what they're seeing, and that includes a fear of being faced with a worse, not better, situation than they are facing now. This is true not only with seniors who have been given numerous reasons for concern, but also for the non-elderly who face growing concerns they won't be able to keep what's good currently, or face new problems.

"If you like your doctor, you can keep him" as Obama said omits the real concern that people may not still have that doctor after new legislation is passed, for example and "can" would be conditional.

jchem quotes the Sun News: "These opposition groups appear to have spent at least $10 million so far on ads attacking the Democrats' plans. Still, supporters of a health care overhaul have outspent opponents by about 2-to-1 so far, according to Evan Tracey of the Campaign Media Analysis Group, which tracks ad spending. Supporters include drugmakers angling for their own protections, unions, the American Medical Association and AARP, the seniors lobby."

Well, that certainly sounds definitive... Unless you know who the "Campaign Media Analysis Group" is:

Campaign Media Analysis Group

The Campaign Media Analysis Group (CMAG) is, according to its website, "a division of TNS Media Intelligence" and "the leading provider of data and analysis for political, public affairs and issue advocacy advertising. Campaign Media Analysis Group provides customized media research services to national trade associations, foundations, Fortune 100 companies, national media organizations, academia and hundreds of national, state and local political campaigns."

Interesting... Now just who is "TNS Media Intelligence"?

Taylor Nelson Sofres (TNS)

TNS Healthcare provides advanced market research consulting and custom advisory services to the worldwide pharmaceutical, biotech and medical device industries, as well as health-focused ad agencies, media and financial analysts.

The company says it has supported the launches of 18 of the top 20 global pharmaceutical brands; that it has experience performing studies in 54 therapeutic categories; and has performed studies with more than 200,000 patients worldwide since 2000.

So the question is... Just how much of Evan Tracey of the Campaign Media Analysis Group lobbyist talking points should a reasonable person believe?

Getting the Sun News to quote an industry shill is all part of the $42,000,000 a month being spent by the Health Care Industry. And a lot of people believe it without looking at the source.

jchem quotes The Kaiser Family Foundation: "As the Congressional debate heats up ... records show money from doctors, insurers, pharmaceutical firms and hospital and nursing home groups has been flowing increasingly into Democratic coffers - jumping from $36.9 million in the 2006 campaign to $90.7 million in 2008."

All true but this was for the years 2006 to 2008 when Democrats went from being the minority party to being the majority party. a) That's to be expected the majority gets a bigger slice of the pie... they're the majority. And, b) These numbers don't really affect the current debate.

Three paragraphs above jchem's quote Kaiser Family Foundation reports:

Drug companies "boosted their lobbying in Washington during the three months (that) ended June 30 amid a flurry of congressional action on health care," while overall, "Washington's lobbying business continued to slump as the economy pinched budgets at some big companies and trade associations," The Wall Street Journal reports. "Drug manufacturers increased lobbying spending 13% to $68 million in the second quarter from a year earlier, according to the data … Overall, the health-care sector reported a 5% increase in lobbying expenditures to $133 million, making it the single largest spender on lobbying of the 10 major industry sectors tracked by the Center for Responsive Politics. Health-insurance companies increased lobbying activity by 11% to $7.8 million, according to the data" (Mullins and Farnam, 8/3).

That's $140,000,000 in the first quarter of 2009... That's $46,666,666 a month.

Amen Anna

SteveK: Getting the Sun News to quote an industry shill is all part of the $42,000,000 a month being spent by the Health Care Industry.

I would be interested to find out if the Sun News got some of this money, but I doubt that's anything we will ever know. Besides, if supporters are spending double what those against are, then there is a tremendous amount of money being wasted, given the mood of the public.

My main point ties into what HemmD had mentioned earlier and perhaps what all of us can agree on: influence and positions (read votes) are bought and paid for. This isn't anything new, of course, but it just seems to me that we all just let it continue. Imagine what could happen if this $42M/month you mention ($46.6 now) was thrown into R&D instead of lobbying. That's a lot of jobs and a lot more research (and maybe lower costs?). I'm certainly no fan of the insurance giants, but let's face it, they're getting what they want, and the powerful folks in Washington don't seem to have any problems giving it to them. Interesting article from McClatchy, concerning what the Blue Dogs are getting:

Health care industry contributes heavily to Blue Dogs

No surprises then that at least one liberal House member calls these moderates "brain dead".

Steve

Mt theory is easy to prove. The current crop of Blue Dogs receive half of their campaign donations from private health care groups. Coincidentally, it was Blue Dogs that required that any public plan negotiate medical costs instead of setting prices like is done in Medicare. They also used this to kill any possibility of a single payer system.

Consider that blue dogs all espouse fiscally conservative values. Explain to me why negotiation lowers cost more effectively than price controls. It doesn't. What it does do is keep the biggest threat to private health profits out of the picture.

The Republicans did the same type of thing \with the medicare pharmacy bill. They effectively made the US pay retail of billions in senior drug payments. There's only one conclusion I can draw from these two examples, money buys hypocritical political positions, money buys votes, money buys loyalty.

jchem wrote: "My main point ties into what HemmD had mentioned earlier and perhaps what all of us can agree on: influence and positions (read votes) are bought and paid for."

On that we certainly can agree, sorry if I misread your first comment.

HemmD wrote: "The current crop of Blue Dogs receive half of their campaign donations from private health care groups. Coincidentally, it was Blue Dogs that required that any public plan negotiate medical costs instead of setting prices like is done in Medicare. They also used this to kill any possibility of a single payer system."

Seems I misread you earlier comment too because it seems we're on (or close too) the same page.

Good article from the WaPo. Thanks for linking to it, Joe.

All the arguments I've seen against hc reform, including here, are based on ideological and fabricated distortions. On this thread DLS claims European plans are headed for trouble. But a country like France, that spends less than half what we do, could pay 60% and the problems go away.

I've seen lots of claims that Medicare is going broke and is unsustainable. According to the very articles posted as proof, they're concerned about the viability 75 years out. At today's private insurance increase rate (7%), private insurance at that time will cost $ 1,664,000 a year for a family policy. That's right, over $1.5 million ! So criticizing Medicare's long term sustainability happens in a vacuum of pretending that private insurance cost will not be worse -- it will be much worse.

As noted above, waiting lines for *elective* procedures are a form of cost control in France. If you don't care about the cost, as DLS appears not to, no reason for the lines. Just bump the amount you pay and bingo, no more lines.

Rather than defend our broken system by claiming the other systems are broken too, we need to get serious about finding every shred of unnecessary spending and eliminate it. The 35% waste of private insurance is the lowest hanging fruit. The ability to negotiate down prices for drugs is another. The same people here who blast attempts to keep manufacturing jobs here through protectionism, happily support protecting big Pharma as it gouges us. Hey, if you're OK with us buying cheap stuff from China, why not cheap drugs from Canada?

Thought we may have been. The problem is I said not one of one party or the other, it's all about needing money to stay in office. If someone will do or say exactly what you want for payment, isn't there another name we usually call them? I'd say it, but I don't want to insult hookers.

"On this thread DLS claims European plans are headed for trouble."

I know that both health care and pension plans there are headed for trouble, as do those in charge of these programs, as the material I liked to shows, unless one views these facts in a distorted manner.

"If you don't care about the cost, as DLS appears not to"

Mistaken assumption, perhaps based on distorted perception or interpretation (again?).

"Rather than defend our broken system by claiming the other systems are broken too"

Which is not what I''m doing, obviously. (And what's more broken by far is the current "reform" effort.)

I'm afraid that DLS is lost to us. CStanley, Jazz, Pete, Polimom (sp?), and other conservatives around here are worth a much better read.

Joe, you'd be wise to solicit CS as a regular contributor... but you probably already know that. :)

Rambie, I only hope you and others aren't Shocked, Shocked! if much of DemCare is lost, too.

It also is worth visiting those sites I linked to, even if it's about what many don't want to face. [sigh]

You couldn't be more correct.

I've said before, we have a three-way political system; Republicans, Democrats, and Capitalists. The problem is that the Capitalists are a sub-set of the other two parties so no matter who is in office, the control remains with the money brokers.

This is the one thing we need to get changed.

"I've said before, we have a three-way political system; Republicans, Democrats, and Capitalists."

That might explain why I feel so party-less. But capitalists are relentlessly losing ground. Government controlled 8% of the economy 100 years ago, over 40% today. If you don't like the way things are going, you'll need to blame one of those other two parties--or if you're more circumspect, the system they operate in and the decisions it encourages.

Drj-You seem to be missing that the capitalists want it this way because that extra gov money goes into no-bid or near-no-bid contracts for them. The US Gov the biggest money pinata of them all. Small and private business do not want it that way but the capitalists do, actually as long as we socialize their risks and have no cut in their profits I dont think they much care what we do.

SkyFather, you're right, capitalists swing at the pinata as enthusiastically as everyone else when it comes to their own income. If the government is handing out free goodies, you'd have to be pretty dumb to turn them down.

But these labels better describe what policies groups support in general, and especially for other people. On the whole, capitalists support capitalism, not socialism.

DrJ- But by "supporting" it via gaming the system and having us socialize their losses over and over again they have given capitalism a bad name. I no longer trust americas version of capitalism, I will not support it, vote for it or speak for it and I certainly will not invest in it if we cant get accurate investment news. I will let the suckers with 401k's support the next bailout since its their money that is being used to threaten the rest of the economy into doing wall streets bidding which is exactly what I said 401k's would be used for 15 years ago.

Its also not "their" money the tax revenue is all of our money its just they get a cut and we do not.

Are you saying you are one of the lucky few sucking off of nanny states tit or are you saying you dont mind your money misused by someone as long as that someone has a large bank account?

This is precisely why I am no longer a believer in libertarianism in america and if I cant have that, screw it I am a socialist. In those extreme's the common man has a chance in this current system, we really dont.

We have two parties fighting tooth and nail over social issues(abortion, gays and the like) because those are the only actual choices we have. The dems hand over the check book to a list of their favorite industries and reps do the exact same thing. This is not capitalist vs socialist its my socialism vs your socialism while one side fails to call bullshit on the other. If you want capitalism then melt the fed and go all Ron Paul otherwise you are just catering to your favored industries over the other sides and trying to do so with a straight face.

"They have given capitalism a bad name"

No, they've given pinatas a bad name.

DrJ- So you are giving the lobbying/gov version of "she was asking for it though." Maybe our gov should not dress in such a garish and whorish way and all would be well.

A telling analogy, as it suggests you see government as the helpless victim rather than the sovereign power with ultimate authority over all these groups that come a-lobbying.

Make up your mind. If government is a powerful, trustworthy champion of the people's interests, hold it to account when it betrays those interests rather than blaming its failure on someone else. If it's a weak and vulnerable victim likely to be mugged by special interests, quit sending it on errands with its pockets stuffed with billion-dollar bills.

DrJ- You are also playing both sides of this field sir. I prefer to vote for freedom/libertarianism when ever it is truly offered otherwise I will side with gov and fight to get all lobbying money out of the game. You know exactly the opposite of what the mega-corps want. I would like to note though that you see mega-corps as victims which amuses me as from my point of view they are and have been riding our federal gov taxes like a rodeo cowboy since mega-corps have existed. You cant have small gov with large mega-corps, this is why reps do not shrink gov nor gov spending. This is actually why it grows under their leadership. If you want small gov then the path is through small business but if you want an ever larger gov we are on the right track rep or dem.

I prefer to vote for freedom/libertarianism when ever it is truly offered otherwise I will side with gov and fight to get all lobbying money out of the game

I can't make sense of this at all. You side with the people who are taking what amounts to bribe money, while claiming that you're fighting to get the money out of the game?

Dr. J is right in that you are incorrectly attributing victim status to our elected officials. Neither the big corp lobbyists nor the politicians are the victims in those transactions- the voters are.

No I am attributing victim status to the citizens those people represent and seeing as how both reps and dems are taking money from the same people I see little to no chance of shrinking gov.

Who exactly shrunk government since Reagen began inflating the balloon? Talk about crazy why do we keep voting in the lower taxes and grow gov party??

If you can't shrink gov what freedom choices do I have? Voting rep just shifts money to prison or military industrial complex investors instead of the corps that get a cut of any welfare or healthcare payouts. Those prisons need people to fill them and those laws that are and will be put on the books are not to imprison other people but the citizens of this country.

I just refuse to vote rep because I happen to be a libertarian since they give me nothing for my vote other than taking away or threatening to take away rights from women or gays, oh yea and running on the southern strategy while smiling and calling the other side race baiters. I think we need more freedom not less and voting for the supposedly economic freedom party that still tells me what I can and cant spend my money or investment dollars on is a joke.

I will vote for either side that is not taking the bribes but if both sides are I will at least vote for the side that says they want the money out of the system as opposed to the side that equates lobbying money to free speech. Its about as sane as the christian conservatives voting for the party that will never regulate tv morality all while they scream about the horrors of it. If they wanted something to be done they would vote dem but of course the religious right flipping to the dems is a long time nightmare of many people in this country me included for that reason.

The gov in this country equals the people. Our habit of separating the two is greatly advantageous to certain peoples interests but it does nothing to fix either sides problems with the system.

amen, CS. Sadly the ONLY way I see to end the corrupting influence of money in politics is through citizen referendum to change the state constitutions. Legislators won't willingly give up their pork and the porkers won't willingly give up their pay to play access.

To Dr J's point, the % he cites is deceptive, though maybe not intentionally. Privitazation has been all the rage for decades, which is why, instead of FEMA delivering emergency services, we have tens of thousands of private contractors adding their profit and overhead to what FEMA used to do, in Medicare, we have thousands of contractors, who as DLS noted, were responsible for the lion's share of fraud and waste, as well as overhead and profit. In national defense, we have $900 a day mercenaries fighting alongside our own service men and women. All of this is a transparent attempt to privatize public wealth while nationalizing private debt. It's also a dandy smokescreen to allow administrations of both parties to claim they're "trimming government" by lowering or freezing government employees while actually increasing payroll through contracting. We now have as many mercenaries in Afghanistan as US troops, but those numbers are never included when the media reports how many soldiers we have there.

"Instead of FEMA delivering emergency services, we have tens of thousands of private contractors adding their profit and overhead to what FEMA used to do."

That's just crazy talk, GreenDreams. FEMA and Medicare are big single payers, generally their contractors' most important customer, which drive out excess costs through their negotiating power. According to a noted internet sage:

Thus it is possible for a big payer to negotiate lower prices, which has to be a part of “cost containment” in health care, and our government has done better than any other (domestic) source.

DJ, nonetheless, Bush managed to use Katrina to privatize the delivery of emergency services, driving up the costs. As I've noted many times, Medicare has negotiated lower prices for doctors (19%), hospitals (25%) and drugs (?%). I think government employees are as capable of assessing claims as contractors, and of writing checks. Most government databasing and checkwriting, though is now done by Lockheed. BTW, Mrs. Cheney is on their board.

To minimize if not avoid any remarkably odd and worse reactions I'll keep this posting short here.

First, Medicare has plenty of fraud and abuse, probably one of the most notorious examples of what is associated with large, complex, bureaucratic programs and governments themselves (as well as big businesses, the subject of another thread). This, at the same time when what people have already seen, and fear more of, exists, namely cost-shifting and cram-downs on exploited providers in the name of "cost control" or "reduction," not to mention the slandered specter of rationing or denial.

Second, even the Clinton administration and other Dems took halting steps at reform and privatization that was long overdue. It was during the Bush years that we were most recently and greatly subject to embarrassment and disgrace with the stories about Halliburton and Blackwater, etc. (not typical!).

All of these are highly exemplified (if not exaggerated) currently by the failing Detroit government.

"All of this is a transparent attempt to privatize public wealth while nationalizing private debt."

In fact(!), we all need to look instead at the reverse record associated with the welfare state.

It's only a fine point that we owe debt increasingly to China rather than to government insiders and their intimate private pals.

Neither Mr. Bush, Mr. Cheney, nor Mrs. Cheney was in power for the 100 years shown in that graph. Either private contractors' costs are driving that number (as you said), or government can manage those costs through its negotiating power (as you also said). Which is it?

DLS-I agree that the "third way" was a problem. Either gov does it OR private industry does but public private partnerships is part of what is destroying this nation and destroying capitalism.

Wrong, DLS. Medicare fraud, though not trivial, is 13%, same as private insurance.

Government at all levels is fully capable of writing and posting checks. The concept that we can do so more efficiently by letting a huge and hugely connected military contractor do it is absurd. DJ, I'm not excusing Clinton's contribution to the Chicago School mantra - privatize, deregulate, cut social services. But that is a FAILED strategy, in every single place in the world it has been tried. The result is always the same, the same as here: shift public wealth to private hands, shift private debt to public hands, increase the wealth gap. Hit Reject.

The facts are what they are, GreenDreams. The public sector is growing relentlessly larger. Far from being cut, social services are steadily expanding.

If all this public spending results in a net transfer of wealth back to the hands of sneaky contractors, that simply confirms what I've been saying all along: cost savings through monopsony negotiating power is a crock, and the government cannot be trusted to manage our money effectively.

DrJ-Neither can bankers, wall street or large corporations. The question is where do we turn to fix the problem then?

What problem? How to keep the big pool of money we confiscated from taxpayers from being stolen? How about we not confiscate it to begin with?

DJ, you continue to conveniently ignore the facts. Medicare costs 35% less than private insurance. It's meaningless to say "the public sector is growing relentlessly larger". So is the private sector. For example, Medicare is said to be unsustainable in 75 years. Private insurance by that time will cost $1.5 million for a family policy by then. What's growing relentlessly larger?

Another false assertion, DJ. It's not our money being confiscated from us. It's our kid's money being borrowed from China and put on their credit card. Reagan, Bush and Bush used that lie all the time. "Let us keep our own money" they said while borrowing trillions and shoveling it into the pockets of the already rich.

DrJ- What party is talking about an end to taxes? Sorry but both sides need our tax money and I also note that you are asking them to stop taking tax money but seem to have no interest in revoking the gov invention of corporations? If you want to go live in a legal and regulatory black hole you can always move to Somalia it seems to be working so nicely for them. Sorry if this sounds nasty but you have devolved into arguments that break down into big corp good big gov bad which is no more insane than my stance which is big is bad but to shrink one we have to shrink both. Tax is not theft by the way and if you feel that way why would you vote for anything than an ever losing libertarian ticket. You are just another talking head at this point saying free free and then giving us more of the same because its working fine by you and yours.

No, it's actually my money being confiscated. And no, insurance companies would go out of business long before they got people paying them $15M a year. You're arguing way beyond the realm of facts.

So I don't know what to tell you, GreenDreams. Your beliefs about the effectiveness of the public sector are flatly contradicted by its track record. Yet you keep bringing up demons like insurance companies or Cheney's wife, as if they were relevant. You're apparently convinced that if it weren't for those few bad apples, government would be a terrific engine of benevolent growth.

DrJ-Just as you seem to think that with the exception of Enron and our financial sector and wall street the capitalists have been a great bunch of trustworthy guys no matter that the track record does not reflect that either. Gov nor the private sector can do it all, they both need their places and roles. When we blend them we get what we have here and when we exclude one in favor of only the other we again end up near here. The answer is balance and a blend but you are not calling for balance you are calling for "the free market do or die" which is similar to the fantasy land that believes that gov can do anything and the private sector do nothing yet I do not see the crowd that says that on this site.

DJ, my "argument" is based on the exponential function. It's irrefutable. I've noted this many times. Insurance goes up at 7% a year. Doubling time is 10 years. It doubled in the last 9 years. It will double the doubled amount in 10 or less. The insurance industry admits this won't vary by more than "a percent or two." Case closed, unless private insurance will do what it has NEVER done; lower rates.

And no. It was never your money. When Reagan took the debt from 1 to 3 trillion, that was borrowed from our children. When Bush Sr. took it to 4, that was our kids' money. When Bush Jr. took it to 11 trillion, that was our kids' money. It went up under Clinton, but went down as a % of GDP.

Once again, the national debt is a Republican creation. See?
http://zfacts.com/p/318.html

"Once again, the national debt is a Republican creation"

So? If I want the party who will leave me with the least debt right now which way should I go?

" instead of FEMA delivering emergency services, we have tens of thousands of private contractors adding their profit and overhead to what FEMA used to do"

That's just absurd. FEMA was supposed to write checks after a disaster and help plan before. That's it. People have tacked on all kinds of stuff to them that shouldn't be there and would be better served handled by someone else.

"we have $900 a day mercenaries fighting alongside our own service men and women"

No we don't. We do have $250 a day cooks and laundry workers so solders don't have to wash sheets instead of , well, soldiering

"DJ, my "argument" is based on the exponential function. It's irrefutable. I've noted this many times."

So it is and so you have, it's just not relevant to this discussion. Which, I'll remind you, started with me claiming the public sector is crowding out the private over the past century. You denied it, asserting that the growth in government spending really reflects gouging by the government's private sector contractors. I pointed out the bald contradictions with your usual promises that government will negotiate costs down, and that both can't be true.

Now you're throwing up smoke about Bush and Cheney and Mrs. Cheney and rising health care costs and how the taxes I pay out of the salary I earn actually comes at the largess of the Chinese and how the 40-percentage-point drop in the national debt since WWII proves Republicans created it. You sound like a man with an ax to grind.

But none of it dents what I said to begin with: the public sector has expanded dramatically over the past century and continues to do so. Therefore HemmD's claim that capitalists call the shots is either wrong or a major black mark against the government we hire to keep them working for us.

MSF: "You seem to think that with the exception of Enron and our financial sector and wall street the capitalists have been a great bunch of trustworthy guys no matter that the track record does not reflect that."

Trustworthy? Not at all. They're a bunch of greedy assholes who have the inconvenient virtue of providing us jobs and cell phones and big-screen TVs.

I merely think that for the most part, competition is a more reliable way to keep them in line than nearly-always-hijacked government regulation.

DJ, as I said, with the exception of 3 Republican presidents, Reagan, Bush and Bush, EVERY president has paid down the debt as a percentage of GDP. That's a fact.

Government has increased as a % of national budget since WWII precisely because of what the CEO of GE called for at the close of that war, "a permanent war economy". It has certainly not been health care costs. In fact, Bush raided the Medicare trust fund to pay for tax cuts for the wealthy: $1.6 trillion.

Let me also point out that the Medicare deficit has not cost you or any taxpayer anything yet. Just the opposite. The GOP has raided that trust fund. A big part of the current deficit is caused by the GOP requirement that Medicare not negotiate lower drug prices under Part D. This was done with the intention of protecting big business, just like the current flap about keeping "a level playing field" to keep from harming the insurance industry. I've made it really clear that I don't give a damn about the profitability of either the insurance industry, which I'd just as soon see belly up and soon, or big Pharma. If they can't make it without us paying 10 times what other countries do for drugs, let them fail too. European and Asian drug makers are doing just fine without government anti-competitive protection, and in fact have overtaken US drug makers steadily. US drug makers are no longer the leading researchers, developers or marketers of pharmaceuticals, despite the GOP requirement that they not be forced to make it on their own. We have intentionally crippled Medicare drug price negotiation, negotiation that every one of their other customers is free to do.

So you and everyone who argues against government's ability to care for its citizens, do so with the apparent intention of protecting the greedy against the legitimate needs of the nation.

I have no idea what a permanent war economy is, nor was I aware we have one. And I don't see the relevance. Like I said, the public sector has grown immensely over the past century (though it's below the WWII spike).

The relevance is very specific, DJ. Despite the end of the world war, despite the end of the Cold War, no matter what, war or peace, defense spending goes up. And not just a little. The GOP, its "military industrial complex" (Eisenhower), its prison industrial complex, its rich and greedy, have successfully bribed politicians to shovel tax dollars into their pockets, thus increasing the federal budget. Meanwhile, for the benefit of their next quarterly report, they got tax breaks for offshoring jobs, hiding their profits in tax havens and all sorts of other sweet goodies that COST US MONEY.

The "permanent war economy" comment came in a meeting of defense contractors after WWII. The gist of it was "this war was great for us. We all did very well. Now what can we do to make it permanent?" The Cold War was born, which like the GWOT, would never end but would scare generation after generation to open their wallets.

I'll give you credit for trying GreenDreams but it's sounding more and more like Dr J is really Mr H... if you know what I mean! :-)

So you're not really disagreeing that government spending has risen, you're saying it has and blaming a right-wing conspiracy. Have I got that right?

What I'm pointing out is that "public displacing private" is false. Of "foreign aid" it's typical for 80% of the money to go to private American contractors. USDA money goes to farmers, DOD to Blackwater, Haliburton, etc. The dollar increase in federal budget is real, but there's no displacement. For-profit companies love to suckle at the federal teat.

Yes, what you're describing is displacement. Decisions based on market signals and economic efficiency are being displaced by decisions based on politics. Agribusiness is being paid based on how well it suckles the USDA, not on how efficiently it feeds people.

We have differing opinions of what should be, in America, the basic rights of citizens. Classically, what is defined as "the commons" are those resouces that are considered the property of the people. It has been shown repeatedly that corporations with their focus on short term gain and a preference for private gain over the public good, do not manage the commons well. This is especially evident in environmental issues. Corporations will externalize every cost they can, while keeping the profit to themselves. That's a big problem of "market forces" as they are very rarely concerned with the future, though they should be. The decline of commercial fish (down 95% currently) shows that even though fish marketers depend on fish for their commercial existence, they never act on that by self-limiting what they take. The same happened with the classic case of commons, Boston commons, pasture land used by area ranchers for grazing. Commercial interests said, why should I limit myself to 20 cows. I'll just put 40 on the commons.

With respect to health care, I believe it is in our best interest as a nation for our citizens to have guaranteed access to health care. You apparently do not. So the GOP answer, as in the Ryan bill, is to guarantee the profitability of the insurance business, instead of the health care of our citizens. Forcing citizens to give profit to businesses is worse than forcing them to share the cost of national health care, in my opinion, because whether they can see it or not, a healthy citizenry serves us better and ultimately lowers costs while increasing our competitiveness. Neither private insurance nor public health care payments do anything at all to improve actual health care--that's doctors, nurses, clinics and hospitals. I just want the most efficient way to pay for it, and nonprofit is more efficient economically because profit is an unnecessary expense when all you want to do is manage the assessment of claims and issuing of checks. The counter-argument, that private enterprise in health care PAYMENT delivery is more efficient and can lower costs, is simply not borne out by the historical facts. Insurance companies are not effective in lowering costs. Government is (lower rates for doctors and hospitals plus lower overhead.) I've documented this repeatedly.

I'm familiar with the tragedy of the commons, and it has nothing to do with corporations per se. It was originally about individual cow herders, but it applies to any rational economic actor. Governments are similarly disinclined to champion the common good when it doesn't align with their interests. Look at disputes over international fisheries, or the current wrangle over C02 reduction.

You will probably say, "yes, but that's only because corporations are lobbying them" and I will say (again) that besides smacking of paranoia, that's in practical terms a lame excuse for failure. If failure is inevitable, due to corporate lobbying or union lobbying or heavy traffic on the beltway, we should keep more decisions for ourselves and not hand them to government.

With respect to health care, "guaranteed access to health care" is a too vague to debate. I believe it is in our best interest to build the best system we can, and that demands we stop excusing failure and insist that people do their jobs. Health care providers need to find better, cheaper ways to treat us. Individuals need to take at least as much responsibility for their own health as they're expecting random taxpayers to. Government needs to make decisions it can be trusted to make well and relieved of the ones it can't.

Your mileage may vary, of course. You're welcome to keep thinking the path to success lies in rewarding incompetence and inefficiency. You're also welcome to keep thinking we disagree about goals rather than means. I don't believe either.

And BTW, I do believe health care could easily get 5 times more efficient than it is in even your best foreign examples. But only if we aim higher than what they're doing.