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April 24, 2006

Ramesh Ponnuru Isn't Making Sense

He writes:

Right off the bat, Mitt Romney chose the wrong goal. The Republican governor of Massachusetts, like many other health-care reformers, wants to achieve "universal coverage." Unfortunately, universal coverage is impossible.

I think France, Canada, Germany, Japan, Switzerland, the Netherlands, Sweden, Britain, and a handful of others would probably disagree, seeing as how they've actually done it. Now, universal coverage -- which Romney's plan doesn't offer -- may not be desirable, but it's certainly possible.

It's interesting. During the run-up to the Iraq War, you heard much about how incoherent Democrats sounded because an appetite for foreign adventurism wasn't a common motivation for young liberals. Maybe so, maybe not. But watching the right comment on the Romney plan has certainly proved that precious few folks enter Republican politics to talk about health care. It's been downright embarrassing. Someone should alert Ponnuru to the bill's "affordability clause", which exempts folks for whom purchasing health insurance would not meet some yet-to-be-defined test of affordability from the mandate. They should also let him know that nearly every other industrialized country has true universal health insurance. That's not to say their plans are good or desirable (though I certainly think they are), but the goal is clearly achievable.

For more misguided commentary on the MA bill, check here.

April 24, 2006 | Permalink


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Tracked on Apr 26, 2006 9:55:14 PM


In my dreams, right-wingers in France talk about the impossiblity of any national government building a nationwide highway system and how we'll just have to be satisfied with the highways the market brings us.

Posted by: alkali | Apr 24, 2006 1:48:59 PM

Seems like he's talking about "universal coverage" by some form of insurance, and you are comparing this to (what we used to call) "socialized medicine".

Apples and oranges....

Posted by: zomby woof | Apr 24, 2006 2:37:00 PM

Except not. Socialized medicine works off -- get this -- insurance. Often provided by employers (as in Japan, Germany, etc). And he uses the term "universal coverage" which, given the meaning of coverage (guaranteed access to medical care with limited financial liability), is as applicable to Canada as MA.

Posted by: Ezra | Apr 24, 2006 2:44:34 PM

Once again I must agree with Ezra. However you word it, socalized medicine or universal coverage is needed in the US.
A huge proportion of healthcare is spent in the first few years of life or in the last few years of life making it difficult to treat the remaining patients. This is a huge difference from other countries where this for the most part is not the case.
A thought...Can we contain the excessive costs of neonatal and geriatric care? Now I know there is always hope and I clearly convey this to my patients. But I also clearly convey to them when things are bleak. At these times the family cannot let their love one go even though chance of recovery is slim. (Yeah I don't wanna to be the one deciding who in this group gets treatment. That's a tough decision. But unfortunately there will be no easy decisions regarding healthcare reform)
However, redirecting funding could assist with providing healthcare to a larger percentage of patients. This rings clear in my practice...I'm at an inner city teaching hospital. We recently reported that African American men in the inner city were four times more likely to present with advanced (i.e., non-curable) prostate cancer than middle class Whites. There are other factors involved here but one thing rings clear...the majority of these men with advanced prostate cancer were either uninsured or poorly insurance which could effect their ability to obtain adequate, comprehensive healthcare. This divide between insured and uninsured have victims. The victims I see are the 50 year old men (with at least another 15 years of potential work years and 25 year life expectany) dying of prostate cancer.
We must do something to help these and other healthcare victims.

Posted by: Joel | Apr 24, 2006 10:35:37 PM

Universal coverag is impossible????

Damn - then who the hell patched up my head when i busted it open playing american football in the UK.

I shoulda taken it easy on those 'snakebite and blacks' There's obviously a gang of vigilante medical providers wandering around the UK undercutting those poor insurance companies and i didn't even realize it.

Thank god i wasn't hurt badly. I only wish i coulda been back here in the good ole u.s. of a, where i coulda given those poor-underpaid docs the god knows how much it would been for one emergency visit, numerous tests and numerous follow-up visits. Sure, i had no insurance b/c it was either tuition or healthcare, but my parents would have had the honor of donating their house to the greatest healthcare system in the world!!!!

Posted by: DL | Apr 25, 2006 1:58:13 AM

Hmm. So, on the basis of treatment for an acute, minor injury to a young, healthy individual (playing football generally not the province of invalids), you decide National Health is for U.S.? Idiot.

You'd sing a different tune if it were a chronic, expensive illness or complication. Ask some of your UK friends what happens to people over 55 with kidney failure. Or anyone who needs a bone marrow transplant in a timely fashion. Or someone who has a form of cancer which can only be treated through a cutting edge (read: expensive) treatment.

Its easy to provide "universal" healthcare, if you simply put sick babies, old people and the inconveniently chronically ill on ice floes and push 'em out into the ocean.

Posted by: Qualitas | Apr 25, 2006 1:48:03 PM

Check out this URL for an insider's (doctor's) view of the British NHS:

Posted by: Qualitas | Apr 25, 2006 1:55:24 PM

Idiot? wow. Sorry i gave my little anecdote now. But it encapsulates for me a lot of the argument here. I waited for four hours after the triage nurse saw me to see a doc. All of my return visits were immense hassles. I have a scar right in the middle of my forehead now. Would i have that scar if I had been injured in the US. Probably not. I probably would have seen a doc sooner, and been stitched up sooner. But the goal of decent healthcare for all is worth a few scars.

Is the NHS or Canadian system perfect. Absolutely not. But Accessiblity rates for elderly dialysis improved greatly. I've heard the horror stories about the NHS. I've seen some of them. There are plenty more right here at home. You seem to believe we don't 'ration' healthcare. Got news for you, we do. It's just the market that does the rationing. I've got health insurance. I don't make much money. I pay 80 dollars a month for two prescriptions.

SO here we are. Medicare is one of the most efficiently run programs in the country, and next door to me there is a dingbat 24 year old gal with a marketing degree, who made something like 80K last year telling docs (far and away the highest paid docs in the world) what medicines they need.

Yeah, I'm the idiot for suggesting we try something different. Lll this stink about a healthcare problem in america is just rather-esque lib media bullshit.

There are problems with universal coverage, so let's not even try. Let's just let big pharma keep doing what they do.

Posted by: DL | Apr 25, 2006 2:43:48 PM

You didn't mention Cuba. Free health care for all! As always, there's a bit of a catch.

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