From: tcox@ssrl01.slac.stanford.edu (Tony Cox - (415)926-3105)
Newsgroups: talk.politics.medicine
Subject: Re: HIAA and Reform
Date: 14 Dec 92 14:27:36 -0800
Organization: SSRL, Stanford Synchrotron Radiation Lab
NNTP-Posting-Host: ssrl01.slac.stanford.edu

In article <50392@shamash.cdc.com>, rjv@a2.cim.cdc.com (Rene Valdes) writes:
> In article <1992Dec8.171033.1@ssrl01.slac.stanford.edu>, 
> tcox@ssrl01.slac.stanford.edu (Tony Cox - (415)926-3105) writes:
> |>
> |>    What makes you think that federal health insurance will work...?
> 
> The fact that it works rather well in Canada, in France, in Germany,
> in Great Britain, in Sweden, etc.  In fact, all industrialized countries
> except the USA and South Africa enjoy some form of national health
> care system.  All of them spend a lower percentage of GNP than the
> USA and have higher life expectancy and lower infant mortality.  In
> all of these countries the population is much more satisfied and
> less concerned with their health care system than Americans are.
> 

   Well, I cannot speak for the other European countries, but I do
   know a lot about the UK system.

   Now, I am no admirer of big government (no surprise here eh?) but
   the roots of big government in the UK differ in a substantial way
   from the US.

   In the UK, the growth of government was spawned by the ILP, the
   WEA, the Fabians, and a number of other socialist groups which
   finally became the Labour Party. Misguided though I would claim
   them to be, there were many of good heart in the movement, and
   perhaps the crowning achievement for them was the National Health
   Service or NHS which started in (correct me if wrong) 1948.

   The NHS was introduced against the lobbying efforts of the
   physicians, and surprisingly, against many in the trade union
   leadership (they were worried about loss of influence over their
   members, health care often being a benefit of union membership).
   For all its faults, it was the result of a populist movement, with
   limited involvement from special interest groups.

   I just do not see the same populist tradition within the US
   political system. Big government developed in the US along lines
   more closely identified with fascism than socialism. Whereas any
   British politician who attempts to mess with the NHS does so at her
   peril, in the US, I would see the whole mess becoming a political
   football. The entire debate is being _driven_ by special interest
   groups - just look at who Clinton is assembling to decide our future!
   Want to see the abortion debate played for big stakes? Introduce a
   single-payer healthcare plan.

   Who says the system works well in any case?

> As Perot put it, if these countries have a health care system that
> works better than ours, that yields better results at lower cost,
> why don't we just copy their system?  Sure, we need to adapt some
> details to specific American conditions, but the gist of his thought
> was that we should stop pretending that we can find our own better
> way of doing everything when good solutions are staring us in the eye.
> 
> |>    By the way, were I involved in your national health plan, I
> |>    would be extremely worried, when approaching old age, that the
> |>    state didn't start to change the rules on me.
> 
> Heck!  Millions of Americans are extremely worried NOW with the
> system we have and that's one of the reasons they voted for Bill
> Clinton.  They want our government to start to change the rules
> immediately so that the system is fair and reliable.  Many Americans 
> are ashamed of the dismal performance of our health care mess.  We 
> sure can do better.    

   Yes. And when I get old they'll change the rules again! When I am
   old, I'll be in the political minority. The crisis then will be the
   inequitable distribution between young and old, sapping our nations
   productivity. The masses, in search of a more 'fair and reliable'
   system, will be recruited to that bandwagon. My benefits will be
   reduced in the national interest. 
   Face it. Many Americans are ashamed of the `dismal performance' of
   the health care mess because that is what they have been lead to
   believe. Are there any Americans out there who have had NHS
   treatment? Where do the others get their information?

   The fact is, that the health care system in the US is one of the
   finest in the world - it is just more expensive than it should be,
   for reasons discussed at length here. 


Tony Cox, Stanford, CA