I think that entire "that's socialist" mantra came from people who have no idea what they are talking about, rallied up by Fox News and Glenn Beck. Then, the U.S. is already corrupt, the government, so who trusts a government who reneges on campaign promises, goes to war on lies and so on.
I have no idea why health care isn't looked at as a right and a moral issue, for it is to me. But the point is these countries have different systems and it doesn't matter which one, all of them are way cheaper than the U.S.
No one, in the U.K. for example, would even think the government has "death panels" out to "kill old people". Here, if the government is involved, they do, so there is almost no trust for the U.S. government here.
I was working the US last year and some Americans asked me about health care. There are a lot of misconceptions and deep prejudices about health care in other countries borne of a lack of understanding and experience.
The first accusation is that I'm 'socialist' and anti free market because I value the notion of the 'commons' and contract between the people and the State. Sorry, but many Americans don't understand what socialism is nor can they really relate to terms like the tradition of 'social democracy' that underpins the notion of the 'welfare state' if they have not experienced it. This is evidenced by the fact that no one in other advanced countries goes bankrupt as a result of ill health - this is the value of a 'community' approach to health.
The next accusation is that I have no choice. Hardly, in Australia and the UK (where I grew up) I also have access to highly competitive private health care if choose to use their services as I do for some services. This does not mean I cannot use the public health system. Whilst the US may have pockets of medical excellence general provision is very poor with many millions having no or very limited access to health care. This is also reflected in things like infant mortality and other health statistics that put the US near third world countries.
Next point is one of simple economics and efficiency as many elements of the health system simply cannot be competitive (morals, ethics and who should live and die and at what cost soon lock in) and are best deployed and managed on a national basis - this also includes reducing input costs such as drugs and the cost of medical systems through national purchasing schemes set up with the drug companies. To support this approach Australia, UK, Canada, NZ, etc, have what is a 'single payer' system which means instead of layer upon layer of administrative costs/salaries/profits claimed back by multiple non value add insurance companies there is one national insurance scheme that reduces support costs and enables national health planning - the drivers in the US are the wrong way -incentivised for the insurance companies to offer more policies and so it is better for then that people are unhealthy (well the ones that can pay). In Scandinavian the health of a country is managed 'cradle-to-grave' and this lowers the overall cost of health to the State via pro active health educations and treatments, dietary advice, less obesity, reduced smoking and moderated alcohol consumption.
The other issue for the US is that post WW2 many US companies had a young workforce and provided healthcare and the argument was that why do we need that 'socialist' stuff when capitalism provides the service via companies. Unfortunately, as time has gone past many of these schemes have collapsed as the workforce has contracted and the health liabilities of retired workers has grown. To get around this a number of companies, I believe, went into Chapter 11 and the liabilities were taken over by the State and this contributed to the 'patchwork' of health care provision in the US.
I am not saying that these other systems of health care are perfect as they all will come under funding stress as the population of these countries ages. What I would say is that I would always support the notion of a national 'contract' for health care for all as aside from the issue of securing value for money without this life can become quickly brutish and short. There is also a massive cost to society of having people that are ill.
From what I see, he's all of these same things, whatever multinationals want and his unlimited migration is also something multinationals want.
This is really out of control at this point, the corruption is overwhelming and they are also heading towards destroyiung any social safety net left in the U.S., that's Medicare as well as social security.
It makes my hair stand on end to think how much worse things would be if President Obama didn't wake up and go to sleep thinking about our economy.
Isn't it funny, with things so bad, that no Third Party candidate is on the sidelines this time. Maybe Bloomberg, but he keeps saying not and I'm not sure I want him either, given his disasterous immigration views. Probably the huge costs of running are making a credible third party run just about impossible. Supposedly the Democrats expect to hit the "B" for billion mark for 2012.
I am ready for change that will be change, though -- and this time, for the better. Where oh where, when oh when will we find such a thing?
Actually my recent, true and honest fantasy is to resurrect any President and Cabinet from FDR-Carter and put them in charge. We'd be better off with any of them, for sure.
It's pretty clear the majority in Congress as well as the White House pay no attention to statistics and facts.
Case in point on health care, they have a good 20+ countries to learn from. That come up as a starting point? Pretty much not.
This is why the left hates "Obamacare", the lobbyists made sure they got theirs. That said, the right seems to want to give the lobbyists even more in locked profits, lack of coverage an inefficiency.
Honestly, I don't think most in Congress can add two numbers together and I really question most abilities to read a bill, never mind write a section.
We do live in a world of many unknowns and yet technology as well as research and development are a bigger part of cost than ever.
There's no great white hope and I would love to see all members looking at the same numbers at the same time and put away this thought that one party or the other has the life saving hook here, because they don't.
Here's a good example of digital illiteracy with spending, mind you we just cut tons of money and now we have one senator who wants to put MD Medicare payments on line, a cost that would be in the millions and data would be flawed as even straight MD referral sites can't get it right either, it's lot of work and time and some just think all of this grows on trees. Anyway you can read my thoughts and by having some unified intelligence we could certainly do a much better job with fewer unintended circumstances.
Using business type intelligence as business does would help our lawmakers come to better decisions and conclusions and might just force them to truly collaborate.
So many new drugs and medical breakthroughs originate here but so many don't even have coverage.
I am afraid I cannot agree that the lobbyists are entirely to blame. There's the resistance that I outline above. The employed and the retired focus on keeping what they have (although there are some big holes in that too, especially things like private coverage of mental health) instead of what they could have and should have -- them and everybody else.
Many of our lifestyle choices are bringing us down, too. From what I understand, though, things like obesity are becoming more common in many countries, which would eventually force their costs way up too.
not by a long shot. We have people going as medical tourists to get operations in India, but even by "1st world" countries we're coming down in the bottom.
That's one of my points, you cannot even get basic facts out there, understood on U.S. health care. The lobbyists won't allow it.
All the cuts by all levels of government -- even the trillion dollar ones -- mean nothing, as healthcare costs continue to eat us alive. For more than 10 years, every year they leap up to another unprecedented level and there are thousands of articles like this written about it.
Just like all those other years, this year most people will find their raises at work are less than the rate of inflation because their companies had to kick in another $500 for individual and another $1,000-$1,800 for family coverage.
And on top of that, if they read their healthcare signup packages, they'll see their payroll deduction for insurance has increased enough to wipe out much-most-all of their aftertax raises. Chances are that they'll find at least one thing that what was covered last year no longer is, or at a much lower rate of reimbursement.
And yet -- and yet -- I don't hear many howls of protest, do you? Those we do hear are often from businesses, not the employees. I don't know why, really.
My best guess is that despite all the information out there, most Americans feel nothing can be done.
They practice selective deafness.
We've all grown up hearing that we have the best medical care in the world. The older folks have heard about the perils of socialized medicine for decades and pass the dire warnings on to the younger generation without really knowing what they're talking about.
Then of course as you point out, there's all kinds of pressure from the many beneficiaries of the current system for us to keep on doing what we're doing.
But with the selective deafness in effect, people don't make the connection between their stagnant wages and increasing insurance costs. They don't say to themselves "we can't go on like this, we have to find another way." All the facts and figures about doing things another way -- all the evidence from abroad where people are happy with their systems, where private insurance companies still exist in national health plans, from our own experiences of Medicare's low administrative costs -- so far have come to nothing.
They just don't make it through the collective resistance in the American consciousness.
I hope to God this changes because if it doesn't, we're sunk as a First World nation. We cannot sustain a First World life for most Americans while we pay so much for healthcare as well as interest on the debt that our out-of-control healthcare costs will lead us to incur. That probably would have been true regardless. God knows the last 30 years of mass migration of low income immigrants and our subsequent much higher population of needy people makes that a dead certainty now.
While people forgo medication and services, the economics of healthcare get crazier. This is a criticl article that points to the need for rational analysis. If you break down health care costs by function, the inflation is not nearly as bad as the aggregate. But that's not done. This presentation shows that we're well beyond fiddling around, as Obama did. First stop: medication prices. Nationalize these firms, period. They aren't nearly as brilliant as they claim and their pricing will kill more people than their drugs will cure.
Also figure out a way to get my re candidates, get rid of advertising and make it all about candidate debates, create laws that take news organizations off the air for blatant bias; and make the candidates sign a contract promising honesty and providing for immediate removal they steal or engage in nepotism.
The center cannot budge, as well. I like the comparison to "No Country for Old Men." The Republicans would like to think that they are the Javier Bardem character, Anton Chigurh, but they're really Josh Brolin's Llewelyn Moss. They think they've got the goods but they simply snagged the contraband and are headed for some real complications. I'm struggling to fit in Bardem to this event so I'll get back to you. Oh wait, he's the omnipresent representative of The Money Party!
Austerity means nothing, when you consider that Portugal was implementing its toughest austerity program in thirty years and still got downgraded by the credit agencies. The question is always going to be, vaguely, how much austerity is enough for the agencies to put down their canons?
Funny thing is that the credit agencies then used, not Portugal's lack of austerity, but lack of growth as a reason for downgrading them further, talk about a catch 22, doomed if you do and doomed if you don't.
One thing is for sure, Spain is next, and then who else? Belgium? The UK isn't doing too well, nor is France, how bout the eastern bloc, Latvia is stuck in a debt bog, well I say just downgrade everyone, including the good ole US of A, don't think it can't happen.
Well I guess the biggest sleepwalker is American workers. With the recent exception of state unions e.g. teachers protesting very narrow issues e.g. collective bargaining, American workers are not only passive but keep reelecting the politicians you take issue with. Last I heard, AFL-CIO and Black folk are still supporting the Democrats and a great mass of workers support Republicans and Tea Party. So it seems that American workers have the government and economy they want.
Gee, imagine that, giving more tax cuts and giveaways to the super rich and corporations equals making sure people have nothing in retirement and die on the street because they cannot afford health care.
I mean referencing a host of papers ignoring the reality that most of the funds for green jobs went straight to China, do not pass go, is a prime example of public relations sounding great juju with no hire American, buy America conditions.
No doubt G.E.'s "green job plant" is a PR response to the growing pressure to get G.E. out of the white house, but that does not negate the fact G.E. offshore outsources and labor arbitrages even their R&D engineers, severely. (and notice that fine engineering result over to Japan, Q.E.D.).
The AAM has the Buy American, Hire America conditions required in their infrastructure recommendations. As a result, one can trust their GDP multipliers much more than others. While the statistical measurement debate is raging on just how much labor arbitrage, globalization, outsourcing is skewing various economic metrics....it sure looks guaranteed they are being skewed at this point, from researching the latest research.
The China currency manipulation is very real and it's amazing how badly it affects the trade deficit. Do something about that, immediately and it has support on all sides of the political spectrum, except of course for U.S. multinationals, their lobbyists and their corresponding bought and paid for politicians, including the White House.
But you need to tone down the links. While we're fine for self promotion, there are limits here.
But hosting a group of 'white papers' without considering the source, one golden rule on EP, no economic fiction and that especially implies lobbyists' white papers, either side, any flavor of agenda. We'd no more allow budget fiction from the Heritage foundation any more than we allow biased mathematical equations, which happen to set a few variables to zero in order to claim some sort of fiction, or put some absurd, not on this planet conditions, from even the NBER.
If it doesn't hold water by the theory or the statistics, it's not something we wish to promote. Thanks.
Fundamentally it's "buy American and hire America". They need to quit this insanity of bad trade deals, offshore outsourcing jobs and yes, acting like illegal immigration doesn't lower wages (it does indeed!), also stop displacing professionals through foreign guest worker Visas.
We railed on the stimulus. Grants, tax incentives and even venture capital, it's all skewed towards moving to EEs (emerging economies) on some belief of cheap labor and better returns.
Just a case in point, what good is it to award a contract to an Indian offshore outsourcer in Ohio? They outsourced jobs and even when done locally by that Indian company, the reality is that company imported foreign guest workers instead of hiring local Ohioans.
Stuff like this goes on every day and this is assuredly not the situation in say Germany, which has a great export driven economy plus high wages, say Japan (who right at the moment is screwed due to disasters).
Another clear and major example of corporate money completely owning the politicians and the agenda.
I think that entire "that's socialist" mantra came from people who have no idea what they are talking about, rallied up by Fox News and Glenn Beck. Then, the U.S. is already corrupt, the government, so who trusts a government who reneges on campaign promises, goes to war on lies and so on.
I have no idea why health care isn't looked at as a right and a moral issue, for it is to me. But the point is these countries have different systems and it doesn't matter which one, all of them are way cheaper than the U.S.
No one, in the U.K. for example, would even think the government has "death panels" out to "kill old people". Here, if the government is involved, they do, so there is almost no trust for the U.S. government here.
I was working the US last year and some Americans asked me about health care. There are a lot of misconceptions and deep prejudices about health care in other countries borne of a lack of understanding and experience.
The first accusation is that I'm 'socialist' and anti free market because I value the notion of the 'commons' and contract between the people and the State. Sorry, but many Americans don't understand what socialism is nor can they really relate to terms like the tradition of 'social democracy' that underpins the notion of the 'welfare state' if they have not experienced it. This is evidenced by the fact that no one in other advanced countries goes bankrupt as a result of ill health - this is the value of a 'community' approach to health.
The next accusation is that I have no choice. Hardly, in Australia and the UK (where I grew up) I also have access to highly competitive private health care if choose to use their services as I do for some services. This does not mean I cannot use the public health system. Whilst the US may have pockets of medical excellence general provision is very poor with many millions having no or very limited access to health care. This is also reflected in things like infant mortality and other health statistics that put the US near third world countries.
Next point is one of simple economics and efficiency as many elements of the health system simply cannot be competitive (morals, ethics and who should live and die and at what cost soon lock in) and are best deployed and managed on a national basis - this also includes reducing input costs such as drugs and the cost of medical systems through national purchasing schemes set up with the drug companies. To support this approach Australia, UK, Canada, NZ, etc, have what is a 'single payer' system which means instead of layer upon layer of administrative costs/salaries/profits claimed back by multiple non value add insurance companies there is one national insurance scheme that reduces support costs and enables national health planning - the drivers in the US are the wrong way -incentivised for the insurance companies to offer more policies and so it is better for then that people are unhealthy (well the ones that can pay). In Scandinavian the health of a country is managed 'cradle-to-grave' and this lowers the overall cost of health to the State via pro active health educations and treatments, dietary advice, less obesity, reduced smoking and moderated alcohol consumption.
The other issue for the US is that post WW2 many US companies had a young workforce and provided healthcare and the argument was that why do we need that 'socialist' stuff when capitalism provides the service via companies. Unfortunately, as time has gone past many of these schemes have collapsed as the workforce has contracted and the health liabilities of retired workers has grown. To get around this a number of companies, I believe, went into Chapter 11 and the liabilities were taken over by the State and this contributed to the 'patchwork' of health care provision in the US.
I am not saying that these other systems of health care are perfect as they all will come under funding stress as the population of these countries ages. What I would say is that I would always support the notion of a national 'contract' for health care for all as aside from the issue of securing value for money without this life can become quickly brutish and short. There is also a massive cost to society of having people that are ill.
From what I see, he's all of these same things, whatever multinationals want and his unlimited migration is also something multinationals want.
This is really out of control at this point, the corruption is overwhelming and they are also heading towards destroyiung any social safety net left in the U.S., that's Medicare as well as social security.
Great article as usual.
It makes my hair stand on end to think how much worse things would be if President Obama didn't wake up and go to sleep thinking about our economy.
Isn't it funny, with things so bad, that no Third Party candidate is on the sidelines this time. Maybe Bloomberg, but he keeps saying not and I'm not sure I want him either, given his disasterous immigration views. Probably the huge costs of running are making a credible third party run just about impossible. Supposedly the Democrats expect to hit the "B" for billion mark for 2012.
I am ready for change that will be change, though -- and this time, for the better. Where oh where, when oh when will we find such a thing?
Actually my recent, true and honest fantasy is to resurrect any President and Cabinet from FDR-Carter and put them in charge. We'd be better off with any of them, for sure.
It's pretty clear the majority in Congress as well as the White House pay no attention to statistics and facts.
Case in point on health care, they have a good 20+ countries to learn from. That come up as a starting point? Pretty much not.
This is why the left hates "Obamacare", the lobbyists made sure they got theirs. That said, the right seems to want to give the lobbyists even more in locked profits, lack of coverage an inefficiency.
Honestly, I don't think most in Congress can add two numbers together and I really question most abilities to read a bill, never mind write a section.
We do live in a world of many unknowns and yet technology as well as research and development are a bigger part of cost than ever.
There's no great white hope and I would love to see all members looking at the same numbers at the same time and put away this thought that one party or the other has the life saving hook here, because they don't.
Here's a good example of digital illiteracy with spending, mind you we just cut tons of money and now we have one senator who wants to put MD Medicare payments on line, a cost that would be in the millions and data would be flawed as even straight MD referral sites can't get it right either, it's lot of work and time and some just think all of this grows on trees. Anyway you can read my thoughts and by having some unified intelligence we could certainly do a much better job with fewer unintended circumstances.
http://ducknetweb.blogspot.com/2011/04/digital-illiteracy-is-killing-us-...
Using business type intelligence as business does would help our lawmakers come to better decisions and conclusions and might just force them to truly collaborate.
It's a crying shame.
So many new drugs and medical breakthroughs originate here but so many don't even have coverage.
I am afraid I cannot agree that the lobbyists are entirely to blame. There's the resistance that I outline above. The employed and the retired focus on keeping what they have (although there are some big holes in that too, especially things like private coverage of mental health) instead of what they could have and should have -- them and everybody else.
Many of our lifestyle choices are bringing us down, too. From what I understand, though, things like obesity are becoming more common in many countries, which would eventually force their costs way up too.
not by a long shot. We have people going as medical tourists to get operations in India, but even by "1st world" countries we're coming down in the bottom.
That's one of my points, you cannot even get basic facts out there, understood on U.S. health care. The lobbyists won't allow it.
All the cuts by all levels of government -- even the trillion dollar ones -- mean nothing, as healthcare costs continue to eat us alive. For more than 10 years, every year they leap up to another unprecedented level and there are thousands of articles like this written about it.
Just like all those other years, this year most people will find their raises at work are less than the rate of inflation because their companies had to kick in another $500 for individual and another $1,000-$1,800 for family coverage.
And on top of that, if they read their healthcare signup packages, they'll see their payroll deduction for insurance has increased enough to wipe out much-most-all of their aftertax raises. Chances are that they'll find at least one thing that what was covered last year no longer is, or at a much lower rate of reimbursement.
And yet -- and yet -- I don't hear many howls of protest, do you? Those we do hear are often from businesses, not the employees. I don't know why, really.
My best guess is that despite all the information out there, most Americans feel nothing can be done.
They practice selective deafness.
We've all grown up hearing that we have the best medical care in the world. The older folks have heard about the perils of socialized medicine for decades and pass the dire warnings on to the younger generation without really knowing what they're talking about.
Then of course as you point out, there's all kinds of pressure from the many beneficiaries of the current system for us to keep on doing what we're doing.
But with the selective deafness in effect, people don't make the connection between their stagnant wages and increasing insurance costs. They don't say to themselves "we can't go on like this, we have to find another way." All the facts and figures about doing things another way -- all the evidence from abroad where people are happy with their systems, where private insurance companies still exist in national health plans, from our own experiences of Medicare's low administrative costs -- so far have come to nothing.
They just don't make it through the collective resistance in the American consciousness.
I hope to God this changes because if it doesn't, we're sunk as a First World nation. We cannot sustain a First World life for most Americans while we pay so much for healthcare as well as interest on the debt that our out-of-control healthcare costs will lead us to incur. That probably would have been true regardless. God knows the last 30 years of mass migration of low income immigrants and our subsequent much higher population of needy people makes that a dead certainty now.
While people forgo medication and services, the economics of healthcare get crazier. This is a criticl article that points to the need for rational analysis. If you break down health care costs by function, the inflation is not nearly as bad as the aggregate. But that's not done. This presentation shows that we're well beyond fiddling around, as Obama did. First stop: medication prices. Nationalize these firms, period. They aren't nearly as brilliant as they claim and their pricing will kill more people than their drugs will cure.
Great article.
"all falls apart"
Also figure out a way to get my re candidates, get rid of advertising and make it all about candidate debates, create laws that take news organizations off the air for blatant bias; and make the candidates sign a contract promising honesty and providing for immediate removal they steal or engage in nepotism.
The center cannot budge, as well. I like the comparison to "No Country for Old Men." The Republicans would like to think that they are the Javier Bardem character, Anton Chigurh, but they're really Josh Brolin's Llewelyn Moss. They think they've got the goods but they simply snagged the contraband and are headed for some real complications. I'm struggling to fit in Bardem to this event so I'll get back to you. Oh wait, he's the omnipresent representative of The Money Party!
Austerity means nothing, when you consider that Portugal was implementing its toughest austerity program in thirty years and still got downgraded by the credit agencies. The question is always going to be, vaguely, how much austerity is enough for the agencies to put down their canons?
Funny thing is that the credit agencies then used, not Portugal's lack of austerity, but lack of growth as a reason for downgrading them further, talk about a catch 22, doomed if you do and doomed if you don't.
One thing is for sure, Spain is next, and then who else? Belgium? The UK isn't doing too well, nor is France, how bout the eastern bloc, Latvia is stuck in a debt bog, well I say just downgrade everyone, including the good ole US of A, don't think it can't happen.
Well I guess the biggest sleepwalker is American workers. With the recent exception of state unions e.g. teachers protesting very narrow issues e.g. collective bargaining, American workers are not only passive but keep reelecting the politicians you take issue with. Last I heard, AFL-CIO and Black folk are still supporting the Democrats and a great mass of workers support Republicans and Tea Party. So it seems that American workers have the government and economy they want.
Gee, imagine that, giving more tax cuts and giveaways to the super rich and corporations equals making sure people have nothing in retirement and die on the street because they cannot afford health care.
So nice. Krugman's post here.
What can we do?
I mean referencing a host of papers ignoring the reality that most of the funds for green jobs went straight to China, do not pass go, is a prime example of public relations sounding great juju with no hire American, buy America conditions.
No doubt G.E.'s "green job plant" is a PR response to the growing pressure to get G.E. out of the white house, but that does not negate the fact G.E. offshore outsources and labor arbitrages even their R&D engineers, severely. (and notice that fine engineering result over to Japan, Q.E.D.).
The AAM has the Buy American, Hire America conditions required in their infrastructure recommendations. As a result, one can trust their GDP multipliers much more than others. While the statistical measurement debate is raging on just how much labor arbitrage, globalization, outsourcing is skewing various economic metrics....it sure looks guaranteed they are being skewed at this point, from researching the latest research.
The China currency manipulation is very real and it's amazing how badly it affects the trade deficit. Do something about that, immediately and it has support on all sides of the political spectrum, except of course for U.S. multinationals, their lobbyists and their corresponding bought and paid for politicians, including the White House.
But you need to tone down the links. While we're fine for self promotion, there are limits here.
But hosting a group of 'white papers' without considering the source, one golden rule on EP, no economic fiction and that especially implies lobbyists' white papers, either side, any flavor of agenda. We'd no more allow budget fiction from the Heritage foundation any more than we allow biased mathematical equations, which happen to set a few variables to zero in order to claim some sort of fiction, or put some absurd, not on this planet conditions, from even the NBER.
If it doesn't hold water by the theory or the statistics, it's not something we wish to promote. Thanks.
Fundamentally it's "buy American and hire America". They need to quit this insanity of bad trade deals, offshore outsourcing jobs and yes, acting like illegal immigration doesn't lower wages (it does indeed!), also stop displacing professionals through foreign guest worker Visas.
We railed on the stimulus. Grants, tax incentives and even venture capital, it's all skewed towards moving to EEs (emerging economies) on some belief of cheap labor and better returns.
Just a case in point, what good is it to award a contract to an Indian offshore outsourcer in Ohio? They outsourced jobs and even when done locally by that Indian company, the reality is that company imported foreign guest workers instead of hiring local Ohioans.
Stuff like this goes on every day and this is assuredly not the situation in say Germany, which has a great export driven economy plus high wages, say Japan (who right at the moment is screwed due to disasters).
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