I love reading David Brooks' columns in the NY Times, and enjoy his "Conversations" with Gail Collins even more. Today he took the well known quotation "Power tends to corrupt, and absolute power corrupts absolutely." and turned it into: The whole conversation is well worth reading if you are interested in the health care "reform" being proposed in the States, otherwise just enjoy his insight.

An interesting read, thanks for posting. I liked this closing comment:

By the way, your optimism is contagious. I’ve moved from Sylvia Plath levels of despair all the way up to Dostoyevsky.

What next Solzhenitsin's "Cancer Ward"?

The theory of the Democratic bills seems to be that 98 percent of Americans can party on, with the latest and costliest health care imaginable, no matter how ineffective, and the top 2 percent will pay for it all.

Boy this is not an exaggeration. Obama is really putting the squeeze on the small business owners and entrepreneurs in this country. It's going to end up putting the brakes on a lot of SBOs.

The thing that really kills me is that Pelosi is saying that health care reform will encourage more doctors to enter the profession. In what reality? The bill will gut docs' salaries to the point that medical education will not even pay for itself, and then what? You remove the high earnings and leave just the high debt and horrible hours, and no one will enter medicine.

So what will they do then? Legislate that doctors HAVE to continue to work? Reduce training times? Any way you look at this thing, it's going to kill the quality of health care in the USA, if it's passed.

Morg

I find the debate on health care reform interesting. As a Brit I grew up with a National Health System and whilst I agree it's not perfect, it's not bad either. I've since also got used to buying private health care. I've not experienced American health care systems and have no first hand experience to relate - my knowledge of it is limited to Micahel Moore's "Sicko" and watching Dr House.
May I ask, what are the views on the US system from US citizens here on the Forum? Is Michael Moore being over melodramatic? Especially in describing the American reaction to the word "Socialist"?

A slight majority of the people here in the US do not support a public health care system. Last I heard, something like 49% don't like it, 46% say they do, and 5% are ambivalent.

http://www.rasmussenreports.com/publ...an_46_favor_it

I think most people are smart enough to see that government run anything is of horrible quality here in the US. Our postal service, social security system, medicare, etc. is all rubbish. In addition, I think people see the government adding more bureaucracy to an already complicated system, and dislike that added complexity.

As to what other US citizens on this forum feel, I'm not really sure. I only know what I feel, which is, like you said, despair on the deep, dark level.

Morg

EDIT: How does Moore describe the reaction to the word "socialist"? I think about a third of our society would love going socialist, and the rest at least somewhat opposed.

In the International Herald Tribune (sister / subset paper of the NYT) we also get David Brook Vs. Gail Collins. Interesting banter, but I always wondered why David always seems to go first and Gail is almost on the defensive after reading what he publishes.
Find it slightly contrieved - but still interesting. You get the feeling that it is a journalistic contest - but keeping the gloves on. Maybe it is just me.

I can't remember exactly, it was equating the term to commie pinko whatever, reds under the bed McCarthy style fear of communism.

I have more friends without healthcare or with woefully inadequate healthcare in the US than do have it.

A friend, talking about declaring bankruptcy or living in agonizing pain as a result of the American healthcare system once told me:

Another friend's husband died because he waited too long to get a suspicious lump checked out because they had no health insurance. It was a curable cancer, but because he waited so long, by the time he saw someone it was too late.

I could go on and on with this. The state of healthcare in America is deplorable and shameful.

The stories you cite are similar to those related by MM in "Sicko", many tales of folks that can't afford to go to a doctor with a problem. What turned my stomach was the comment from one health service worker (not sure if it was a doctor or what) commenting on the practice of dumping patients that can no longer afford to pay, leaving them on a stretcher in Skid Row near a hostel, the comment was "Right now, this is the best medical solution we can offer them" - I found the capitalistic view point, wholly devoid of ethical or moral comment to be deplorable. I'm sure it's possible that MM used this for dramatic effect but it was heavy stuff. The film is worth watching if you can stand MM.

The problem IMO is most people aren't interested, so long as their bills are low.

I used to have humdinger discussions with an American ex-collegue about such matters; his standard response was "I don't care, F-them." He battered me, in his opinion. In my eyes he was just a sad man who didn't know what love was. What can we do? Oh, yeah, badger our political representatives...

I agree with you, that's certainly a part of the problem, complacency on the part of those currently unaffected by a defunct system - it's not important as long as they don't need it. A slight reversal of fortune could see some of them changing their opinion when they can no longer afford health services.

What a lot of people don't realize is that the public plan won't make things any better. Look at the health care plans in Canada and in the UK, both public plans. Now look at the long waits it takes to get any kind of medical treatment. That's were we're headed with this public plan.

Morg

There is alot of exaggeration in MM movies. But, mentionioning the word socialism or mentioning that Europeans do something better, is a huge bugaboo in America.

Regarding universal care, most Americans hear is how terrible the UK and Canadian systems are. Not having lived under either, I have no idea if that is true.

I do know the Swiss system works great and if we could import that system from a country of 7 million to a country 50 times larger with a much more ethnically diverse population, it would be heaven. I know the American political system and realize this is a pipe dream.

What is my opinion of the US system?

- If you have coverage, it is incredibly good.

- the tie between employment and healthcare is one of the worst ideas ever invented and seems to be something we cannot get out of

-the US system is far from a pure capitalistic system as the government is very much involved in it currently.

-The reforms being proposed do little to actually solve any of the problems with the current system

- the end result of the reform, will be very heavily watered down due to lobbying influence.

- our system will eventually look like the Uk system, whether we do something now or in the future. morally, most Americans are not going to support a pure capitalistic system that allows people to die on the streets outside the hospital if they do not have money. More and more government involvement as cost of healthcare increases is the likely long-run outcome as the population ages.

So we can either try to reform it now, or just let it naturally happen because it will.

The NHS is always there when you need them in my extensive experience and it's preferable to standard private treatment. For non-essential work, there's a delay, which can be worked on.

There's a lot the public can do to help, such as leading healthy lifestyles, not treating the ambulance service as free taxi ride, being responsible patients, not running to the local Doctor's with every little cut finger... but you'll never hear a politician blaming the electorate (in fact, I'd readily vote for anyone who's manifesto was "Grow Up"!) but Private Health Insurance companies can do just that, with sinister effect. Bang! You're out.

I completely agree with you on prevention - the public needs to learn how to live healthier, and not abuse emergency room services. That's not even being addressed in the current debate, unless I'm mistaken. An ounce of prevention is indeed worth a pound of cure!

Also, there is a small part of the population who just abuses the CRAP out of ER services. Here in the US, if you go to the ER, you MUST be treated medically, you CANNOT be turned away, even if you have no insurance - the hospital just absorbs the cost. Something like 5% of the population nationwide uses 50% of the ER services. I'll have to dig up more facts, but if abusers could be blocked somehow, that would go a long way to reducing costs.

Morg

I agree, the NHS isn't perfect but it does has the major plus point that even if you may have to wait, you will receive treatment. Of course there are stories of people expiring whilst on an NHS waiting list but equally, there are stories of people dying because they had no medical insurance or had a pre-existing condition that excluded coverage - that's a crap idea too, yes of course the insurance companies do it for profit but to deny coverage because of the cost of the health care isn't the best solution. The Workers' Paradise solution isn't perfect either. Has anyone here experienced Cuban health care? it's supposed to be good.

If I break my arm, come down with Swine Flu or have a suspicious lump, using the NHS in the UK, I can (and will) get treatment for (mostly) free. It isn't perfect, but at least there's coverage. A far state better than the US alternative.

I'm moving to the UK early next year, and that's one thing I'm glad about - I may pay for health care in my taxes there, but at least I'm covered and don't have to worry if I can afford to go to the doctor or not. (something which I really can't afford to do here at the moment, even with insurance).

Maybe that's why they go to the emergency room - because they can't afford to go to the doctor otherwise.

Not everyone in the States has a rosy job with fantastic health insurance. And the income to supplement what insurance won't pay and the premiums.

I've lived with the British, Swiss and now American health care plans. My ideal (which I think the Swiss are nearest to) is that healthcare cost is deducted at source, but you choose your provider. That there is no prescreening i.e. a provider cannot refuse you for prior record. For those unemployed healthcare is free.
My family here in the US enjoys excellent company healthcare, however I would prefer state run healhcare for everyone instead of the system we have.

However healthcare needs to be comprehensive and it needs support from other agencies- regular screenings, free clinics, free healthy meals and milk in school.

The last time I went to the hospital, I realized that if you have insurance you get processed a lot faster, also there were a people who were homeless but looked sick and were refusing to leave until they got a bed.

My reason for preferring state-run fully comprehensive healthcare, that is closely regulated is selfish- I want to live alongside healthy people, I don't want to think that I might risk mixing catching TB by with sick people who can't afford coverage.

Also I am fed up with doctors who pander to people who have made themselves sick through being overweight or other bad health habits. They won't tell them the truth becase these people are customers and every service they use means a fee their way.

The problem with US politics are the lobbyists or politicians who have financial incentives (like the Bush's investment in Pharamceutical companies) For example why is the incentive money for education not being spent in NY?

I am presently reading shock doctrine by Naomi Klein, hioch seems to put a lot into perspective.

Funny that you mention breast cancer...
UK cancer survival rates are among the worst in Europe

http://www.timesonline.co.uk/tol/new...cle2296368.ece

EDIT: Originally I thought this was only breast cancer stats, hence the following statement: You should really check this out, since you're female.

These people go to the ER because they, in large part, choose not to purchase health insurance, and instead rely on the ER as their "primary care physician", in effect. The one thing I agree with in the new healthcare bill is that every citizen would be mandated to pay for their health insurance - too many citizens feel that medical care should be free and of the highest quality. Like everything else, it needs to be budgeted for.

Morg

EDIT: From the same article:

Europe’s survival rates are lower than in the US, where 66.3 per cent of men and 62.9 per cent of women survive for five years, compared with 47.3 per cent of European men and 55.8 per cent of women. These figures may represent earlier diagnosis.

Bill Maher on Lobbyist, special interest groups and heath care reform