If you have a right to health care, who has the responsibility to pay for it? The initial clause has been talked to death. The one following it has been, until now, been largely ignored. President Obama and his congressional allies plan to impose a 5.4 surtax on wealthy people to pay for his grandiose vision of state-subsidized health care. Those who carry the struggling economy will be burdened with more weight, ensuring that the struggling economy will struggle more. Some residents of California, New York, and Rhode Island will face tax rates approaching sixty percent. At what point do enthusiasts of big government lose their enthusiasm? Seventy-five percent tax rates? Ninety percent? One-hundred and five percent? The message from the nanny state is clear: You don't have a responsibility to feed yourself, provide shelter for your family, secure your retirement, or insure yourself against medical expenses. Somebody wealthier than you does.

The enthusiasts will not reason with you. They will not read these blog entries and change their minds.

They will lose their enthusiasm when supporters of freedom use the statist's own weapon against him, and fight fire with fire. Or force with force, I should say.

The question is: When will you make them lose their enthusiasm? Will you do it before it's too late?

Somebody important recently said "We're out of money". Maybe that somebody should mention that to Obama.

It could be argued that Obama is out to intentionally bankrupt the country to knock us down a notch. In fact, everything Obama does seems to be to knock us down a notch and to downplay American exceptionalism.

He is the ultimate centrist statist and refuses to recognize the fact that ‘rationed’ government health care (like many of his other socialist policies) has and will fail and has becomes out of control expensive in every model country it’s been tried in.

So now, as he has stated, we are out of money and out of fresh workable ideas.

If he installs just any one of the big three: National Health Care; Immigration “Reform”; Cap and Trade – we as a nation are screwed.

But then again, it’s all about control, isn’t it? And the Saul Alinsky tactic to keep the public confused and irritated.

This ain’t your Daddy’s America anymore!

Check it out.....

http://www.nytimes.com/2009/07/16/us/16hospital.html?_r=1

"will fail and has become !out of control! expensive in every model country"-asdf

Sounds like the modern military, not health care. Mountain goats with Ak's and journalists can defeat our military. Why not cut their budget?

Can we pause at "If you have a right to health care". Do we have any right to health care or for that matter public education? After you make your case on that,we should discuss who and how to pay for it. Just like we discussed who was paying for Iraq and the tax cut.

So, let me get this strait. We might have a right to healthcare--even if other people have to pay for it. But, the government has to pay for giving us our own money back, as if it were frivolous.

Justin, the only reason we live in relative comfort and maintain the freedoms we have left is because of our superior military. And, yes, to protect us and our way of life, it's worth the dough. That has nothing to do with our will to win as dictated by the sub-intellectual pandering politicians who are currently running the show.

In the richest and formerly most productive nation on the planet, things like healthcare can better be managed by the free market and people's willingness to support a private system. If we continue to choose, our high priced military makes that possible.

Guess what the USA didn't have a great military until after WW2. Before WW2 our military had mostly British and French armaments. Read about it, our military was pathetic before 1940 and we were free then were we not? Now would you say our country has gotten better since 1940? You have been brainwashed into thinking the massive military is nessecary. What would happen without them? Iran will invade us...hahahhaha or wait there is mexico!!!!

Sea King
We all should have to pay for health Insurance much like we pay for public education. It is for the common good. The tax cut wasn't our money. The USA went further into debt to "give back" what they didn't have. Our taxes finance the operation and infrastructure of our country. if you resent paying taxes - pick a better country that has a lower tax rate.

It's real simple Rc - tax cuts work as long as spending is controlled. Econ 101, don't you know.

The USA is further into debt because it outspends what it produces and taxes.

I don't know why this is so difficult for many to understand.

Like 40% of GDP isn't enough? It isn't. And what's happening now and more importantly in the future is unsustainable.

Which is what happens when Ivy League academics and career politicians with zero real world experience run the show.

And I don't think the Founding Fathers had "free" (read-entitlement) education and/or healthcare in mind when they were discussing "rights".

I just don't feel I, or my government, have the right to demand someone else pay for my medical care. My health is not in the interest of anyone but me and mine. I am happy to contribute to the charities that look after such matters, but I don't see the right anyone has to demand (tax) that I pay for others.

Who deserves health care and how can it be provided most efficiently?

Mainstream conservatives, including the vast majority of American Christians, would say that those who can afford health care are the ones who deserve it. Those on the secular left would say everyone deserves it. It's fairly simple to determine which position is closest to that of Christ if you have even a cursory knowledge of the Christian holy book. Yet again the moral and intellectual bankruptcy of the botched and bungled Christian conservatives is on full display, dressed in hypocrisy, extreme ignorance, and detestable selfishness.

The "free-market" for-profit health care industry in the U.S. has proven its incompetence and inadequacies in stunning fashion over the past decade. "The CIA World Factbook ranked the United States 41st in the world for lowest infant mortality rate and 46th for highest total life expectancy. A recent study found that between 1997 and 2003, preventable deaths declined more slowly in the United States than in 18 other industrialized nations. The National Health Interview Survey reported that only 66% of survey respondents said they were in 'excellent' or 'very good' health in 2006." These are extremely poor outcomes once it's recognized that the US allocates TWICE THE RESOURCES per capita to health care compared to other industrialized nations. Only through ignorance could someone believe that the US for-profit health care system is superior or efficient.

"The "free-market" for-profit health care industry in the U.S. has proven its incompetence and inadequacies in stunning fashion over the past decade."

I love it. So, where does everybody on the planet come to when they require life saving healthcare and the cutting edge technical procedures that make it possible? Exactly.

Nothing is perfect. That needs to be understood. But I wouldn't trade my healthcare and my ability to get the treatment provided to me that gives me a better quality of life for any other. And where else in the world does the average person have available medical treatment typically reserved for elites in other countries? Exactly.

I was commenting on the entire system of care versus other systems. If mutli-millionaire patient x visits multi-millionaire doctor y, and x happens to be from outside the US and y is based in the US, that doesn't prove that the US healthcare system is superior or efficient. It proves that some of the best doctors are mercenaries who can draw wealthy international clients. This is a piece of anecdotal evidence that amounts to a straw man logical fallacy.

"And where else in the world does the average person have available medical treatment typically reserved for elites in other countries?"

Taiwan, UK, Switzerland, Canada, Japan, France, Germany, Australia, Italy, the Netherlands, etc. Btw, unless you're willing to pay well above and beyond the average cost for a procedure, you will not be receiving "medical treatment typically reserved for elites". You'll be wait-listed visiting a doctor willing to perform the procedure for the normal compensation, not a world-renowned doctor.

You didn't mention nor refute any specifics in my post, you ignored the specifics and brought up an anecdotal straw-man logical fallacy.

Who deserves health care? Who has done something or possesses qualities worthy of health care? Deserves got nothing to do with it. People want health care and they want someone else to pay for it, a natural desire even if entirely selfish. Here democracy may well serve as an adversary of liberty as well as the economy.

"Here democracy may well serve as an adversary of liberty as well as the economy."

This shows a profound lack of knowledge of economic history. Let's take a look at what has served as an "adversary of liberty as well as the economy". Massive corporate bailouts after 3 decades of funneling wealth upwards and decimating the manufacturing sector has served as an "adversary of liberty as well as the economy." The golden era of state capitalism in the U.S. was 1945-1979, when we saw the most dramatic productivity gains with commensurate median wage gains. Median wages have stagnated or declined depending on the sector since 1979. One of the biggest complaints of small businesses and corporations has been the wildly inflating costs of health care, which has led to either the rescinding of health care benefits or the bankruptcy of companies, which serves as an "adversary of liberty as well as the economy."

It's amazing to me that mainstream conservatives will grab their ankles and willingly receive for Wall Street multi-trillion dollar bailouts, but will bray, bleat, whine, and scream if workers receive decent wages or needy mothers receive living assistance which benefits their innocent children. How do you like your free-market and efficient-market theories now? Your precious Wall Street institutions are welfare cases and your precious theories which amount to a religion are in shambles.

Let's take a look at the cost of one health care reform idea versus a conservative cost estimate of the Iraq War.

"How Big Is $239 Billion Over 10 Years?

Readers might be asking that question when the NYT told them that CBO's ana1ysis implied that the House's health care bill would raise the deficit by that amount. It is equal to about 0.13 percent of projected GDP over this period.

By comparison, the Iraq War at its peak cost more than 1.0 percent of GDP. Put in per capita terms, it is a bit less than $80 a year. This would have been useful context for this article.

--Dean Baker"

Btw, Dr. Baker, along with Nouriel Roubini, Nassim Taleb, George Soros, and others of their ilk all predicted the recession. They all have one thing in common. They aren't Wall Street tools and worshipers of "free" and "efficient" market theories.

U.K. and Canada? Now I know you're talking nonsense because in those countries rationed government health care does not offer the services to care for or save many of those who are not well. And, in most cases, because of shortages due to the inferred cost savings associated with the government rationing, people often times come out of the system sicker than they went in even for the most basic services. The more serious cases just wait and die.

Will the rich and powerful always get the best care? Well, yeah. Welcome to a little something that we call reality. Will their be some who do not benefit from the inquities? That would again be a yes for the same reasons.

One needs to come to grips that the free market increases competition and grows the technologies that improve business and industry. Medical care is no different.

So, do we live with and improve the system we have or do we go with the same over priced over-managed system here in the U.S. that has been such a failure around the world?

It's already true that Medicare and Medicaid costs are trending out of control and are dominating more of our economy. It does not appear that the solution is to put all healthcare cost burdens on the people while looking to decrease the level of quality care and remove the choices for coverage. Especially considering that there are only around 10 to 16 million Americans who supposedly don't have health care.

But, ultimately, the boondoggle of government taking over health care is about some warped liberal concept of fairness and equity. The kind that diminishes the services of those today who have decent care and makes it equal so that everybody is subject to lousy sub-par services that will cost more .

Democracy may well serve as the adversary of liberty in that government confiscation is on the rise as a result of popular vote. Ditto the disastrous effects on our economy of the insane increase of the budget deficits.

Don't expect to ever see me applauding government bailout of banks or business. Businesses that can't make it need to go through bankruptcy and reform along more efficient lines and without government funding.

Again, I'm surprised that none of the indisputable facts were acknowledged or specific points refuted in my previous posts. Your precious "free" and "efficient" market system has done nothing to rein in health costs compared to other industrialized nations with community-based health systems and the outcomes are extremely poor relative to per capita spending. I suppose platitudes and rhetorical placebos allow you to continue the "free" and "efficient"-market fairy tale delusion, but it does nothing to further the discussion within the arena of ideas.

Here is a link showing per capita spending of the U.S. and other industrialized nations in 1970, 1980, 1990, and 2003. Enjoy!

"http://www.kff.org/insurance/snapshot/chcm010307oth.cfm"

Your indisputable facts have no bearing on my dislike of the government compelling me to give what is mine to others or compelling others to give what is theirs to me. Freedom may be a placebo to you, but I thoroughly enjoy liberty and I despise those who would deny it to anyone. What fact could you possibly cite that would cause me to enjoy depriving people of the control of their lives and property?

The only indisputable fact that I care about PMA is that the kind of healthcare management that you cite as curing our existing supposedly ailing, cost our of control system is ultimately more expensive, less effective, and creates more government bureaucracies that will work very hard to take away my freedom as an American to make my own decisions about my life and in the process will extract more of my money to help spread the misery.

I’m very excited that you cite statistics and quotes to support your argument but all of the good academician government planners have done the same before they saddled us with huge expensive inefficiencies. Why don’t’ we try a little common sense? Look around, and recognize what doesn’t work before we take it on as an expensive experiment?

I once had a minor medical procedure done in Mexico. The doc wanted to be paid in cash, and I obliged. Then I asked for a receipt. What followed was Keystone Cops. It took a while for me to realize I was being stupid. By asking for a receipt in the double economy of Mexico I was asking the doc to sign a confession to the tax police. He was right, I was wrong, and I learned something about the underground economy in socialized medicine.

Welcome to Mexico, friends, where the people are warm and wonderful, the drug gangs ruthless (but mostly gun for each other), and the medical profession is a sign of things to come in the US of A. Rich people get pretty good medical care in Mexico. Poor people? So-so to dreadful. Same thing in Italy, and most of the Left-dominated world. Want to get pretty good medical care in Russia? How many dollars you got?

The trouble with socialized medicine is that it corrupts the doctors. They start living a double life. So do the patients. And irony of ironies, it doesn't hurt the rich one little bit.

One thing is perfectly clear: the jamming down our throats of government rationed health care is just another step being taken to position us as just another a third world country.

I think this discussion has gotten off topic a bit. Anecdotal evidence about a trip to Mexico and conflicting definitions of liberty don't prove anything. The US for profit healthcare system has horrible outcomes for the per capita cost proving its relative inefficiency. Additionally, if one truly cared for liberty then one would recognize the abomination that is state capitalist price-controlled quasi-government health care, which is what we have in the US. Health care should never be a for-profit endeavor, and it's disgusting that it is in our "free" country. The for-profit system has proven itself incompetent and unable to control costs relative to inflation. Poor outcomes, and double the price.

The hypocrisy of conservatives is overwhelming. They're big fans of corporate healthcare subsidies, but god forbid a poor person receive health care they desperately need. Better to put that taxpayer cash in the pockets of health care executives flying in private jets than for it to actually go to fulfilling an indisputable human right.

RC,

I'm mainly talking about the disconnect between having a right to what costs other people's money vs. "paying" for giving them their money back. One of the problems with lib soft thinking is that if they call something a "public good" then they lose track of who put the money in.

Yes, many of us do, in a sense owe a portion of our income to the upkeep of public goods and services. But that doesn't mean that it equals whatever will pay for whatever new goods and services somebody wants to add. We live in a republic that supposes not a sourceless, endless public pool of good but an agreement among private citizens as to what we need, what we owe and what we owe it for.

There are a bunch of things that don't go together. You threw a formless blanket over "health care" called "public good", just like education. Well, right now considering our schools, it's doubtful that we are funding the type of education that fits the public interest. So accepting any old equivocation on the word "education" doesn't make paying for something called "education" a public good. I'm not saying that there is a definite equivocation there; I'm saying that unless we get into the specifics of what type of education fits the bill--the margin for equivocation is huge.

Secondly, the founders assented to an "educated public" (but also to a "religious" or even "Christian" public) being necessary for our type of government. But they didn't fund it. We did that in the 1800s for similar reasons. But essentially it was that an educated, voting public was necessary for a prudent republic.

Healing people, saving lives may be admirable but it presents a quantitative outcome, not qualitative. The education of the founders provides a qualitative. We don't get more, we get better. So when you say "like education", they may yet fall into the same class, but it's like saying that Michelangelo was an Italian, "like Mussolini".

Last, it's highly disingenuous to both 1) cite healthcare as a "public good" and 2) cite other country's rationing models. What? Is healthcare only a public good so far as that it controls costs? Are we calling it "healthcare" when we say to a 60-year old heart patient "You've had a good life" simply because it comes from a program bearing that name, and thus since he's been denied actual care from something called "Heathcare" that he's essentially reaped the benefits of this "public good"?

When we're talking about who Jesus would think "deserves" "care", don't we mean "effective medical treatment"? If a healthcare system doesn't always involve treatment, but also cost-controlling withholding of effective (expensive) treatment, are we saying that Jesus would have us withhold expensive treatment from the elderly? Who, I guess, ought to just accept that it is their turn to die.

Here's an examination on "deserve". Truly nobody deserves to be murdered. Thus, we should fund a No-crime initiative, because "the old system has failed" and there are still crimes in the street. Saying that you aren't going to pay x more dollars for the zero-crime rate each time it is deemed that we can "do more", is effectively saying that those who can't defend themselves adequately enough "deserve" to be murdered.

To me killing the elderly is more liberal restructuring. The underclass can be easily discontented into their causes, the elderly are more likely not to have quite as progressive a view.

Just a little anecdote of my own here. I’m in the process of making a decision of where to send my daughter to high school – public or a private catholic. The public schools in my town are quite good. Some say excellent by all state standards. But, we got the summer reading list for both and in our public school, right at the top of the list, is a 400 page book about Obama. I’m already smelling the leftist agenda.

Public education was never meant to be a ‘right’. And as an example of the mixed results of dumping more millions into another government program where you have no choice but to pay for it, it irks me even more that there is always the inferred agenda that big brother is good and that we must follow.

Sea King,

You've managed to confuse yourself over what is meant by controlling costs. Private insurers and for-profit health care industries are engaging in price-gouging by inflating the costs of procedures. By lowering the prices charged by unethical and greedy health care executives, taxpayer money will be saved. For example, instead of charging $10 for aspirin, hospitals will only be able to charge $0.10. The only way to do this is to offer a community-based non-profit public option. The debate over this is instructive because your precious, vaunted, glorious "free" and "efficient" marketeers are scared senseless over having to compete with it. Why? Because they know they're too inefficient and incompetent to compete with it. Without their corporate welfare subsidies, they'll be going the way of the buffalo.

This is a great post about free-market inefficiencies as they relate to health care from Dr. Dean Baker, one of the few economists who diagnosed the $8 trillion housing bubble and predicted the recession. The NYT, who has been a cheerleader for the health insurance industry (health industrial complex generally), has written another misleading article about pharmaceuticals. Dr. Baker sums it up brilliantly.

"Can the NYT Ever Talk About Free Trade in Pharmaceuticals?

The NYT discussed the debate over providing extensive periods of data exclusivity to biotech drugs in order to prevent generic competition. As the article notes, prescriptions of biotech often sell for tens of thousands of dollars per year.

While the article discusses the debate over the best length for periods of exclusivity, it does not ever discuss alternatives to patent financing for pharmaceutical research. As the price of drugs diverge further from their marginal cost of production, the inefficiency of the patent system gets much larger. (The inefficiency increases in proportion to the square of the gap between the patent protected price of the drug and the free market price.) Therefore it would be reasonable to discuss alternatives, such as direct public funding or the prize system advocated by Nobel Laurette Joe Stiglitz, in the context of very expensive drugs."

--Dean Baker

An interesting "free" market fact. The pharmaceutical industry annually spends over 2x more on advertising than it does on r & d. There's an efficiency for you. No wonder America is over-medicated! Good thing conservatives passed that price-controlled "free" market solution called prescription drugs for seniors, which allows big pharma to price gouge, at taxpayer expense of course.

Dr. Baker's blog can be viewed at http://www.prospect.org/csnc/blogs/beat_the_press.
Additionally, Dr. Baker is the author of "The Conservative Nanny State: How the Wealthy Use the Government to Stay Rich and Get Richer" which details the collusion between government and multi-nationals to fleece the taxpayer and funnel wealth upwards which has contributed to the destruction of the middle class in America (median wages stagnated or declined since 1979).

"The World Health Organization ranked the United States No. 1 out of 191 countries for being responsive to patients' needs, including providing timely treatments and a choice of doctors. Among those currently insured, 84% are satisfied with their healthcare."

So let's adopt a bloated costly inefficient government health care system and just throw that number one status out the window and be like every other banana republic in the world. Eh?

Personally, I think being numero uno is worth the cost. Call me crazy.

I'll give you that. If someone is able to throw money at a mercenary doctor they'll receive speedy treatment. Not necessarily effective treatment, not necessarily provided in an efficient manner, but they'll get treatment. Also, America's ERs are not what are being questioned. The entire system is.

Good job cherry picking facts, btw. That same WHO study, which was conducted in 2000, listed the US as #37, ahead of Slovenia and behind Costa Rica. You're not #1 simply by a single measurement, in this case "responsiveness" (whatever that means), but by overall levels of care, cost efficiency, and patient outcomes.

"Among those currently insured, 84% are satisfied with their healthcare."

Among those currently insured, many of whom never have to use their insurance, I'm sure 84% are satisfied. I've had the good fortune of being healthy and insured my whole life, but talk to somebody who actually has had to use health insurance and you get a much different picture. This doesn't account for people who don't even have health insurance. It would be interesting if that statistic also took into account the under-insured, those with only catastrophic insurance.

Again, #37 for two times the per capita costs is pathetic, but keep cherry-picking facts. Keep doing everything you can to protect your free market religion, denegrate the working poor, and keep fighting for Wall Street elites and the Establishment. How does it feel being their cheerleader?

Of course it's just some vast right wing medical industrial complex and Wall Street plot to charge the average 'covered' American exorbitant fees for the best medical care on the plant.

I mean, why would we want to pay the best doctors in the world the most money for the best services?

Screw em'. M.D. candidates only need to attend school and residency between 13 and 20 years and dump between $500,000 and $1 million into their training depending on their specialty. Certainly wouldn't want them to be compensated for their work. So I think to save money, we should expect the medical standards of Mexico and the rationing of Canada.

No thanks.