So my adled brain needs your assistance.

I am having a hard time remembering what the objections were to universal healthcare to begin with. I know there were things like: You don’t get to choose your own doctor, you have to wait for appointments or surgeries for extended periods of time, the quality of care starts to suck, etc. And for the life of me right now I am trying to figure out how that is any different from our current system.

So if y’all wouldn’t mind- please throw some of the objections you have or have heard about why we shouldn’t have universal healthcare so I can renew my arguments against them.

Thanks

After MDH’s post about Unfucking the Donkey, I knew I had to sit down and actually write the Healthcare thing.

Last summer I spent several weeks cooped up with Dilettante and he grilled me endlessly on healthcare. It was painful and tedious, but after three days of nothing but healthcare discussion, I think I had a decent solution to healthcare for all and good arguments as to why universal healthcare is good not just for people but for business too. It was actually from this (and a conversation a while back with MDH) that The White Papers was conceived.

This is a really long post- so it will be done in installments.

First- The Current Cost of Healthcare

We massively outspend countries with comparable standards of living on healthcare.

The latest numbers I can get are from the OECD report of 2003 using numbers from 2001 (the same numbers my political science textbook uses, by the way) and does not (obviously) include the increase in spending from the new Medicare prescription drug plan or inflation.

Of the 30 countries analyzed in the report, we spent the most at 13.9% of GDP on healthcare. The other top two were Switzerland (10.9) and Germany (10.7) but the average was 8.4%. If you look to the UK, they spend 7.3% and Mexico spends 5.6%.

If you look at the numbers for PPP (purchasing power parity- or the lumping of similar goods and services into one basket across different economic systems so that different systems can be examined together) Americans spend $4887 each to get the same types of care that Brits get for $1992 and Mexicans get for $586 (add that little number to your immigration debate). We spend more than twice the average of all the countries surveyed if you use PPP numbers.

All that spending and privatization hasn’t made us any healthier.

Let’s compare the UK and the US. We know that they spend about half of what we do on healthcare either by PPP or GDP. From that we would expect them to have worse health statistics (if the idea that spending more improves services is true). However they have slightly higher life expectancy rates (UK 80.6 years for women and 75.9 years for men compared to US 80 years for women and 74.6 years for men) and lower infant mortality rates (5 deaths per thousand for the UK, 7 for the US). Stats are from the UN Statistics Division

Switzerland and Germany are kicking our ass in the life expectancy and child mortality rates. Germany and Switzerland both have infant mortality rates of 4 per thousand).

Mexico doesn’t do as well. Their life expectancy is lower (72.4 for men and 77.4 for women) and child mortality is 21 deaths per thousand.

What all this shows is that we could certainly reduce the cost we spend on healthcare (though not to Mexico’s level) while maintaining or even improving life expectancy and child mortality.

All that spending, and 15.7% of the population is without healthcare. And that number is growing.

From the US Census of 2004, 45.8 million people in the US are without health insurance. That’s about 5.8 million more people without health insurance than in 2000 and 13.8 million more people than in 1988. But we spent $1.9 trillion on healthcare in 2004.

So some simple math:
If there are about 300 million people in the US and we spent $1.9 trillion covering everyone then the average healthcare payout would be about $6330 per person per year.

If you remove 46 million from the population for the people who aren’t covered then that spending increases to about $7451 per insured person per year.

Most people that did have insurance had it through private employers (58.9%) but those numbers are decreasing while numbers of people receiving health insurance through government programs (particularly Medicaid) are increasing.

If most of the population is insured by employers, hiring new employees is expensive and employers are looking to cut those costs

So it’s about $7500 to provide an employee health care on top of wages and taxes. Large employers are increasingly not offering healthcare (Wal-Mart) or requiring employees to shoulder a greater burden of the cost. They are also cutting plans that include insuring dependants and spouses, or promised benefits to retirees.

Small businesses (a large portion of the businesses in the US) either can’t offer health insurance because the cost is too high or can’t hire new employees and expand because they can’t pay for coverage on the new employees.

In the last recession, the biggest challenge to hiring new workers (and decreasing unemployment) was the cost of health benefits for new employees.

Next Time: What would universal healthcare look like in the US

From Salon’s How the World Works.

I guess my own opinion (and not just on immigration but on everything) is that expansive and incusionary are better than restrictive and exclusionary.

If I were thinking solely as an economist, then the more information generated by more people making small decisions the better the value of that information is and the more competive the market is. So while we are all hemming and hawing about those immigrants using up resources- let’s not forget that they don’t live in a bubble. They buy food and cars and housing and clothes and, and, and. They pay sales tax. They pay income tax and social security (that goes into the system under fake social security numbers so there is a pool of money contributed by immigrants- especially into social security-) for which no tax return or benefit ever has to be paid out. We also need them to keep the age of the population lower. The older the general population is, the more a country’s economy stagnates (go see Germany or any other european country with falling birthrates).

If markets are free, then labor should be as unrestricted as goods are when it comes to flowing across borders. Though if markets were actually free (no more crop subsidies!) then labor would get less benefit from moving across borders because they would have a chance at moving up in their own country.

Locking up condoms- preventing theft or encouraging the spread of AIDS in poor neighborhoods?

From the Washington Post. Consider this one more for the reading list Redd.

“I’d rather see them locked up,” said Phil Burress, president of the organization. “It’s a lie that condoms prevent all sexually transmitted diseases anyway. People should be educated about that and practice abstinence.” But there is little impartial evidence of measurable benefits from abstinence-only policies, say scientists.

Burress pointed to a 2001 National Institute of Allergy and Infectious Diseases report showing that condoms aren’t effective in preventing the spread of the human papillomavirus (HPV). But, according to the NIAID report, condoms are considered effective against unwanted pregnancy (86 to 97 percent), HIV/AIDS (85 percent) and gonorrhea in men (49 to 74 percent).

And what does locking up condoms do?

At this point, Dominguez, the Hyattsville teen mom who was frustrated in her efforts to buy condoms at her local CVS, doesn’t much care whether her local pharmacy locks up its condoms.

“I don’t think I’ll ever buy them for myself,” she said. “That experience turned me off.” ·

As for me, in the future I will be buying all of my condoms at Rite-Aid, or Babeland.

Here’s an interesting piece on what the Dems need to do in order to become the dominant party in America. I won’t throw in my spin yet (we’ll wait for the comments to roll in:) Here’s a bit…

“It’s simple. Barack Obama put it exquisitely in his victory speech: “Government can help provide us with the basic tools we need to live out the American dream.”
Here’s a dirty little secret. The Republicans know this. Nothing scares them more than us returning to our simple answers…

Democratic congressmen can do that, for example, by making a credible collective pledge that if you vote Democrat enough you will never pay another medical bill as long as you live. You really think people wouldn’t stop voting Republican then?
It makes a virtuous circle. The most important exit poll finding from last year’s election was not about moral values. It was all the people who said they disagreed with Bush on the issues, but they were voting for him anyway because they knew what he stood for.

What I call “superjumbos”—grand policy commitments that span generations—add value by the very credibility of the commitment.”

http://www.villagevoice.com/news/0531,perlstein,66378,2.html

I’ve taken some flack over highlighting the risks from a pre-emptive strike against Iran using nuclear weapons, without indicating what approach the US should pursue on this issue. Our middle-east policy in the current context cannot be extricated from Iraq. Until Iraq has been resolved, taking on the Iran issue is premature. We’ve already bitten off more than we can chew…& Iran knows it.

We need to make it clear to the Iraqi government that we’re leaving, & that it will be sooner (potentially much sooner) rather than later. The process should begin immediately (although I think it’s unlikely). If they make me dictator tomorrow, our approach would look something like the proposals advanced by Zbigniew Brzezinski. Once we’ve consulted with the Iraqi government we should invite regional countries to participate in a regional Iraqi peace process. The US should express their willingness to leave immediately or to stay for a limited period (no longer than a year) with the additional understanding that we will begin to draw down almost immediately if the government doesn’t take immediate measures to address the militias & sectarian violence.

There are people who will argue that we would be signaling failure. The blunt truth is that we don’t have to signal it. We’ve failed. There’s no way to salvage the situation militarily without a MASSIVE commitment of new troops (about a half million), there’s no chance the American people will stand for that kind of investment, the rest of the world has shown no interest in seriously supporting the effort. So if the implication is that if the country descends into civil war, while that’s not an outcome we hope for, without a dramatic increase in multinational interest, there isn’t a damn thing we can do about it. Best to pull our troops sooner & mitigate the loss of American lives & spending.

A similar story holds true in Iran. Rather than saber rattling & threatening…we should be pursuing constructive engagement. The bottom line is that we couldn’t possibly sustain any kind of ground campaign, & that absent that, there is no unilateral option short of nuclear weapons that could check any ambitions that Iran might have for nuclearization. The consequences of such a unilateral action by the US would be an unmitigated disaster. We should speak very bluntly with our European allies that the US is NOT willing to carry the torch on this one alone. It will be a very long time before Iran has the technical delivery capabilities to menace the continental US. If Europe wants to play ostrich head in the stand…the brutal truth is that they’ll be in the nuclear crosshairs long before we will. If they want to get serious about shutting down the Iranian program, they need to get clear about how far their willing to go so that Europe & the US can present a united front when we sit down to do some serious horse trading with Russia & China in the UN security council.

The US has become too reliant on “hard power” or our military might & technology. While there are clearly contexts in which a military stick is important, it should be used on a VERY limited basis. Right now, the US is facing the very real danger of watching our “soft power” our economic & technological dominance that has powered our position as a superpower slip away. Constructive engagement is ALWAYS vastly cheaper than almost any kind of military conflict. The cost of one month in Iraq is more than the entire State Department budget for the year.

Our general approach should be to significantly increase (I’m talking about tripling the budget of the State Department within a year) our funding & commitment to diplomacy. We will be very aggressive militarily on issues that impact the continental US (Terrorism for example) & will continue to deploy special-forces & pursue air missions against training camps etc. (allowing the Democrats to continue to be tough on terror) But we’re unwilling to play peacekeeper for the world. Regional problems like Iraq, Iran, Taiwan, & Korea should be referred to the UN. That doesn’t mean that we won’t act outside the scope of the UN, but we will not move to solve distant regional problems unilaterally. If our international partners (Europe, Israel, Japan) aren’t on board, meaning willing to pony up the cash & send troops into harms way, then they can face the music.

We should move diplomatically to pursue negotiations with Russian & China on nuclear exports. But, perhaps most significantly, we should attack one of the crucial items that tie us to conflict ridden out of the way places. I presented a part of this in one of my comments earlier. “Declare a war on fossil fuel dependence. The reason the middle east has become so influential in our policy making is this dependence. Katrina & it’s costs are just a taste of the longer term implications of a warming planet. Propose a massive package/policy (comparable to the moon program) of tax incentives, legislative requirements (make California’s 10% zero emis. Law national, progressively stricter CAFE standards). The correct spin is that while moving away from fossil fuels won’t be great for the huge petroleum companies that have been raking in record profits it will be great for middle class jobs to support the construction of new alternatives infrastructure, maintain the systems etc. I’m talking about a massive program with billions of dollars in new incentives & direct investment.

Cross posted from The Red Queen Strikes Again

I was hanging out with The Kid yesterday and we had to go downtown so I could buy some books for a class. We happened to hit the end of the the immigration protest and the streets were filled with people. But not your regular patcholi and piercings protesters, the streets were filled with families, brown families. It was nice, like a parade day but with political impact.

So this led the kid and I to a discussion about the immigrants and the law. Kid was horrified and said “I’ll never be racist”. Huhm. I do my best to make sure that’s true, but I did point out to The Kid that he happens to have been born really lucky. I said “Kid, you were born a white male with American citizenship- this is just luck. There are lots of people who are born lucky and think that because they have luck they somehow deserve the privledges they get and that anybody else can have the same experience they do if they tried hard enough, but the truth is- it’s just good luck”.

Kid thought about it for a while. Then we went into Left Bank books and I got a fantastic little comic book called Addicted to War (I have a 2 page paper on it due tomorrow) and Persepolis. After spending all day reading for my macroeconomics class, I needed something non-school issued to read so I read Persepolis on the bus and Kid read the war comic. He was mortified.

“Mom, we are evil! We are sooooooooo evil!”

“Oh kid, all societies are evil, we just don’t usually hear about how our own society is evil”.

And that’s the truth. We can idealize or romanticize all we want, but all societies have histories (past and present) of violence and war and inequality. And because society is stratified (and will always be. See Michels’ Law of Oligarchy) that won’t change much.

Don’t go thinking I’m all pessimism and hopelessness though. Someone once said to me “The world isn’t fair, but sometimes people can be”. So we work in little bits to make it better. sometimes we take one step forward and two steps back in a weird little dance for justice. But we have to keep on dancing. That was what made me so happy about the protests, people who are usually afraid to dance because of the costs to them (deportation for coming out of the shadows and demanding to be treated fairly) joined the dance.

Welcome to the dance.

Who, generally, are the poorest people in the world? Women. Why? Too many answers to list. In this case the reality matters more than the result.

Unless we, meaning our entire population, can come to grips why our mothers, our wives, our girlfriends, our friends, sisters, co-workers and equal contributors (actually women probably work harder, but I have no evidence) to our economies have been and remain such targets of hate, we cannot consider ourselves living in a progressive society.

The only justification I can determine for women’s lesser status is that men are physically 1/3 stronger. Women think differently than men, but difference does not better or worse make. I could list other differences, but the point has already been made.

A major “disadvantage” women have is that they have and continue to be responsible for children. I don’t simply mean that women bear our offspring, I mean that if a man chooses to walk away from his prodigy, generally, the woman must, for many socially justified reasons, assume the feeding, development, clothing, education etc., of her minions. For some reason this glaring inequity is lost on about half of the population. Whether it is from physical prowess, tradition or nature does not matter, women are tied to their offspring. That men have an advantage is indisputable. That they exploit it is unexcusable. It is this same mentality that encouraged trans-Atlantic slave trade: the slavers and its consumers because of geographical luck stood in a better position to exploit a group of people. No matter how defenders of the institution try to justify its use, slavery wronged millions.

In a way the hate men still show women is worse. Slaves were hidden from the view of most, a distant problem that few saw. Women are such an integeral part of our lives, the parties who determine the survival of our species far from hidden from view. The only explanation is that we are still so filled with self-loathing that we need to destroy or at least control the beings that bring us life.

So no matter how many distant planets we discover, what we do with quasars, whether or not we leverage nano-technology, until we progress to the point where women do not have to constantly live in fear, we are no better than the primitive peoples we think we are so much better than