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July 03, 2007
Thompson on Health Care
It's important to note that Fred Thompson isn't going to be just any Republican. He's going to be a hack Republican. This is not a guy like Romney or Giuliani who's had a period of substantial executive experience, and so, whatever their panders, actually possess some independent idea of how policy works. Thompson is a movement conservative with no particular policy specialties and a deep involvement in the oh-so-substantial world of conservative talk radio. It'll be like electing Limbaugh. If the court would be so kind, I'd like to turn their attention to exhibit A, Thompson's radio review of Sicko:
It used to be a lot easier to make the case for nationalizing health care before we actually started looking at the countries that have it. A lot of people don't seem to have noticed but, in recent years, the grand experiments in bureaucratic medicine are coming apart at the seams.
What a tantalizing start to an argument. As Thompson surely knows, we spend more than twice as much as any other developed nation on health care. We have 45 million uninsured, while they have full coverage. Our health outcomes are comparatively poor. These must be some seams to overwhelm all those other concerns. I only wish I'd noticed them sooner.
Nearest home, it was the Canadian Health Care system that lost its luster. Despite paying nearly half their incomes in taxes, and as much as 40 percent of each tax dollar on health care, many Canadian experts have recognized that their health care system’s in a state of crisis.
Who are these Canadian health care experts? Who knows! Good thing no one ever uses the word "crisis" in conjunction with our health care system (and certainly not 16,900,000 times). Meanwhile, why does Fred Thompson think it better to spend $6,102 per person on health care through private spending rather than $3,165 through public funds? Again, it's never explained.
Many Canadians have started coming to the US for treatments that they just can't get at home.
No.
Now, top officials of the British National Health Service, often held out as an example of the kind of socialized medicine America should adopt, have acknowledged that they have similar problems. One in eight National Health Service hospital patients has to wait more than a year for treatment. Thirty percent wait more than 30 weeks.
Think about it. This is what we're supposed to copy? The poorest Americans are getting far better service than that.
The Brits pay 41 percent what we do per person. If you want to purchase a $35,000 car, and I want to purchase a $14,350 car, who's going to get the better vehicle? And the Brits, again, don't have 45 million uninsured. Everyone there gets coverage. And despite what Thompson implies, you're far better off being covered there than uncovered here. Hell, you're better off there period. A recent study found that the English are far healthier than we are. Indeed, "in the categories of diabetes, blood pressure and cancer, England's poorest citizens -- those in the lowest one-third of income levels -- did better than the richest one-third of Americans." Some dystopia.
Look: Giuliani is wrong on health care. Thompson just doesn't know what he's talking about. He's spitting scare stories and conservative platitudes. There are no signs of sentience here at all. Put him in office and you'll get whatever the industry lobbyist's want.
All of which is to say, he's totally getting the nomination.
July 3, 2007 in Health Care | Permalink
Comments
--"All of which is to say, he's totally getting the nomination."
And he'll get destroyed.
Posted by: Ben | Jul 3, 2007 11:58:39 AM
Ezra,
Thompson uses poor examples and exaggerates something that does have some truth: both in Canada and UK, there have been significant discussions of fundamental problems and the necessary changes that need to happen in their systems.
For Canada, as I've written before, the Canadian Supreme Court has ruled that the degree of queueing was unconsitutional in maintaining a promise of providing quality care. For UK, there have been increasing level of discussions around the need for privatization.
Does that change the "crisis" nature of the US health care system? No. Are there advantages in other countries' health care systems? For sure.
But as I said in response to your Health of Nations piece, your inability to present an unbiased picture of comparative health systems and acknowledge the shortcomings of other countries' systems is an issue. Its demonstrates a clear bias in the facts you present, which then leads to questions about your overall insights.
Posted by: wisewon | Jul 3, 2007 12:00:56 PM
All of which is to say, he's totally getting the nomination.
FWIW, my boss is convinced that he'll win the nomination and that he'd beat any Dem but Gore (I disagree on the latter point)... she started out as a reporter and knows Nashville-- and by extension, state-- politics pretty well, so her take on Tennessee pols is usually interesting. She & I do agree that no Dem, not even a native son, can win southern states for at least the next cycle or two, though... so there's no point harping on either Edwards' or Gore's potential or past failures in the region.
Posted by: latts | Jul 3, 2007 12:10:04 PM
When its over in the primaries, Ezra's correct that Fred Dalton Law and Order Thompson will be the GOP candidate. He has Bush-like several varieties of know-nothingness slathered-on modern Republicanism's conservative-cant white bread. It's irresistable. Maybe they'll even call it compassionate conservatism.
Just heap on gobs of cash, rigged elections or three, and he might be #44. Trust Karl to work it out. They may even succeed in blaming the Iraq debacle on the Dems as well. Hope springs eternal in those quarters.
Posted by: JimPortlandOR | Jul 3, 2007 12:30:48 PM
But as I said in response to your Health of Nations piece, your inability to present an unbiased picture of comparative health systems and acknowledge the shortcomings of other countries' systems is an issue. Its demonstrates a clear bias in the facts you present, which then leads to questions about your overall insights.
So who do you think is paying off Ezra to skew the debate Wiseone? Or are you just taking the long way around to call him stupid and dishonest? For the record, I've seen where Ezra has recognized the "shortcomings" of other healthcare systems. He simply doesn't agree with you about their nature or their degree of seriousness. Said disagreement is no more sufficient to impeach his position than it is to impeach yours, much less to impugn his character.
Posted by: W.B. Reeves | Jul 3, 2007 12:31:59 PM
Ezra writes,
What a tantalizing start to an argument. As Thompson surely knows, we spend more than twice as much as any other developed nation on health care. We have 45 million uninsured, while they have full coverage. Our health outcomes are comparatively poor.
Yawn. Same old nonsense and irrelevance. Our "health outcomes" that are attributable to our health care system are good, not poor. We spend more because we get more. We may have 45 million uninsured, but insurance status has little effect on health relative to other factors. And in countries with "universal health care," people suffer and die while they're on waiting lists for services.
And the Brits, again, don't have 45 million uninsured.
No, but they do have about a million waiting for admission to NHS hospitals (in U.S. terms, 5 million). Brits have to wait about a year for heart-bypass surgery that in America they would get immediately. Delays in Britain for colon cancer treatment are so long that 20% of cases considered curable at the time of diagnosis are incurable by the time of treatment. There is such a shortage of oncologists in Britain's "universal health care" system that 40% of cancer patients never get to see one. And so on and so forth.
A recent study found that the English are far healthier than we are.
The authors of that study explicitly denied that the differences in health they found between Brits and Americans could be attributed to differences between the health care systems of the two countries, and suggested that differences in lifestyle-related stress are the primary cause of the differences in health.
Posted by: JasonR | Jul 3, 2007 12:51:07 PM
"The authors of that study explicitly denied that the differences in health they found between Brits and Americans could be attributed to differences between the health care systems of the two countries"
Read Jason's link. He's got you on that one, Ezra. Please edit your post.
Posted by: ostap | Jul 3, 2007 12:57:08 PM
Fred Thompson was, is, and will always be part of the Bought and Paid-for ethos that most people on the left and right despise. From the June 25 Boston Globe:
Republican Fred Thompson, who likes to cast himself in the role of Washington outsider, has a long history as a political insider who earned more than $1 million lobbying the federal government.As a lobbyist for more than 20 years, billion-dollar corporations paid Thompson for his access to members of Congress and White House staff. During that time he was close to two Senate majority leaders, both from his home state of Tennessee -- his political mentor Howard Baker and, more recently, his former colleague Bill Frist.
During Baker's tenure, Thompson lobbied for a savings-and-loan deregulation bill that helped hasten the industry's collapse and a failed nuclear energy project that cost taxpayers more than a billion dollars.
More recently, while Frist led the Senate, Thompson earned more than $750,000 lobbying for a British reinsurance company that wanted to limit its liability from asbestos lawsuits.
That history as a Washington insider is at odds with the image Thompson has sought to convey to voters.
Be careful what you wish for, wingnuts.
Posted by: litbrit | Jul 3, 2007 1:01:45 PM
Brits have to wait about a year for heart-bypass surgery that in America they would get immediately.
There are two types of heart bypass surgery-- emergency and non-emergency. Emergency heart bypass surgery is delivered immediately to save the patient. Non-emergency bypass surgeries do not really have much affect on health outcomes or life expectency, so they are a low priority, on the verge of elective, since one can get just as good outcomes with drugs.
And not only is it free for the patient, but the cost is, as ezra pointed out, less than half of the expenditures used to support the US system.
Posted by: Tyro | Jul 3, 2007 1:04:33 PM
As we've seen here and at MattY's blog, the rightwingers are increasingly favoring the Big Lie- simply insisting that everybody in the US actually gets the healthcare they need and the drugs their doctors want them to take.
Well, good luck with that one guys. When you have to pass a law to keep our grandmas and grandpas from going to Canada to get the drugs they need, you make a big impression on the family picnic.
So, Thompson will appeal to his "base"- the 25% of Americans who are such cowards that they will vote for whoever the Republicans tell to vote for, and then go out behind the woodshed so big business can give them the thrashing they so soundly deserve.
Harry Truman, being made of sterner stuff, apparently did not realize that "scaring the American public silly" would actually scare part of the American public into a gibbering lunacy that would be passed down, generation to generation, like the inbred faults of some isolated mountain community.
Being of a somewhat advanced age, I am not as implacably opposed to a Thompson presidency as some younger folk, for it would then raise the great question of "Death, where is thy sting?"
And, for the older residents of the Pacific NW, it would also answer the question of "Whatever happened to the Thompson Turkey?"
Ha! Betcha can't find that on Google!
Posted by: serial catowner | Jul 3, 2007 1:13:09 PM
Incidentally, what is this bit about "experts denied that differences between healthcare systems could be related to differences in outcomes"- some kind of game that only dogs can play?
Maybe the explanation lies in the suggestion by the same experts that "differences in lifestyle-related stress" explain the different outcomes.
You know, stress, the kind of emotion you feel when you're in pain and can't afford to go to the doctor and wonder if maybe you should go to the ER because it might be a heart attack at your age.
And then you decide not to go because the clerk will insist on getting your "payment information" before you can get a number for your wait in the lobby. That's the main reason Americans die of heart attacks- they delay calling for help.
If you don't know that, you haven't taken a good CPR course and really don't know enough about health to comment. But relax- ignorance isn't very stressful. Some commenters here will live forever.
Posted by: serial catowner | Jul 3, 2007 1:22:32 PM
When you have to pass a law to keep our grandmas and grandpas from going to Canada to get the drugs they need, you make a big impression on the family picnic.
Not just grandmas & grandpas-- Canada's good for us not-quite-geriatric types that use stuff like, say, Retin-A as well. Half to one-third the price, too... wish I'd known about it a few years ago, before I ended up using a much stronger (& more expensive) oral medication that has caused lasting side effects, just because my insurance at the time covered it.
Posted by: latts | Jul 3, 2007 1:23:39 PM
WB,
So who do you think is paying off Ezra to skew the debate Wiseone? Or are you just taking the long way around to call him stupid and dishonest?
No payoff, stupidity nor dishonesty. I think his fervor to counter the arguments from the other side has led him to overstate his own case too often.
For the record, I've seen where Ezra has recognized the "shortcomings" of other healthcare systems. He simply doesn't agree with you about their nature or their degree of seriousness. Said disagreement is no more sufficient to impeach his position than it is to impeach yours, much less to impugn his character.
If you read the updated Health of Nations as an example-- I agree the he does recognize others' criticisms in the piece-- as a rhetorical device to either refute their premise or minimize their importance.
Its a question on balance. He doesn't really identify any serious weaknesses of other health systems with a recommendation of something for us to avoid. I find it hard to believe that Ezra actually thinks there are no significant weakness in other systems.
Posted by: wisewon | Jul 3, 2007 1:27:58 PM
There are two types of heart bypass surgery-- emergency and non-emergency. Emergency heart bypass surgery is delivered immediately to save the patient.
Wrong. There are waits for both urgent and non-urgent surgery. There are also waits just to see a specialist who is qualified to evaluate the patient's condition. And the same problem exists in Canada's "universal health care" system:
In addition to their costs to the system, one must consider the costs of waiting lists to patients. Protracted treatment delays increase mortality and morbidity rates. In the Ontario example, 171 patients died while waiting for CABG, 121 were removed from the list permanently because they had become medically unfit for surgery, 211 were taken off the list temporarily (the usual reason for this is medical instability, in which case patients are often reinstated in a higher urgency category), 259 were removed from the list for unspecified reasons and 44 left the province and underwent CABG elsewhere.
Posted by: JasonR | Jul 3, 2007 1:28:44 PM
WB,
One other thought on my first point: its possible that Ezra's just playing the role of "liberal health care pundit" and looking to make a career of it (irrespective of his own views).
That would sure help define his blog to the outside-- and sure helps the Chris Matthews/Kudlow shows figure out when to put Ezra on the split-screen shouting segments-- reasoned, nuanced viewpoints just don't do well for ratings.
Posted by: wisewon | Jul 3, 2007 1:32:31 PM
catowner,
Incidentally, what is this bit about "experts denied that differences between healthcare systems could be related to differences in outcomes"- some kind of game that only dogs can play?
Huh? My statement was: "The authors of that study explicitly denied that the differences in health they found between Brits and Americans could be attributed to differences between the health care systems of the two countries." I don't know what you find hard to understand about this statement. Read the link.
Posted by: JasonR | Jul 3, 2007 1:34:10 PM
JasonR, that's actually, interesting regarding CABGs. That said, we're still in a situation where CABG doesn't produce better outcomes. How many patients who received CABG lived longer than the ones who didn't? That's why it's generally not a big priority in any universal health care system.
Also, please, please, don't shoot off your mouth like this:
There are also waits just to see a specialist who is qualified to evaluate the patient's condition.
If, God forbid, you ever need to see a specialist, you will realize pretty darn quickly that there are waits in the USA for this, as well. I suspect that you have never experienced this because you've never had to see a specialist. Next, what are you going to cry about, the fact that in Canada there are long waits in the emergency room? Seriously, that's the sort of argument only an 18-year old in good health could possibly use. No one who's ever actually been sick is going to think that Canada is so much worse because there's a wait to see a specialist just like everywhere else. The difference, of course, is that in Canada, I could choose my specialist, while in the US, I'd be limited to the ones my insurance company paid for, I'd suspect.
Posted by: Tyro | Jul 3, 2007 1:37:40 PM
Tyro,
JasonR, that's actually, interesting regarding CABGs. That said, we're still in a situation where CABG doesn't produce better outcomes.
We are? Heart bypass surgery doesn't produce "better outcomes?" Really? Evidence, please.
Posted by: JasonR | Jul 3, 2007 1:41:16 PM
I'm becoming convinced that JasonR is a paid troll with some free-market/insurnance industry think tank- he spends way too much goddamn time here sniffing out the healthcare posts. No normal person could spend that much time on a topic without it being somewhat related to their livelihood. Although he does seem like a real anti-social prick, so he may not qualify as normal.
Posted by: Waingro | Jul 3, 2007 1:44:33 PM
Waingro,
Then I guess we should assume you're a paid troll of the Socialist Workers' Party.
Posted by: JasonR | Jul 3, 2007 1:46:35 PM
He doesn't really identify any serious weaknesses of other health systems with a recommendation of something for us to avoid. I find it hard to believe that Ezra actually thinks there are no significant weakness in other systems.
Obviously I can't speak for Ezra, but from where I sit, there is no greater weakness than having our citizens die because they cannot readily access routine healthcare, or expire writhing in pain on the floor of a hospital while staffers step over them, or are dumped in ghettoes with leaking colostomy bags, or even just friggin' begging for spare change in quickshops so someone's kid can be treated. If you want to argue that some well-fed upper management types will be distressed at possibly not receiving the prompt medical service to which they're now accustomed, that's fine, but I'm not going to be that impressed with the point given the system's more serious failures. It's like arguing that the negative effects of living with a video-gaming slob should be carefully considered versus the repurcussions of living with an abusive heroin addict; you can do it as an intellectual exercise, but most sensible people won't see the point of the debate.
Posted by: latts | Jul 3, 2007 1:50:16 PM
latts,
Doesn't make much sense. The whole point of comparative health systems is to learn what other systems are doing differently than ours so we can do better. Those learning come from other systems' strengths and weaknesses.
Your point seems to be that if we are at the bottom of the list (heroin addict)-- there's no sense in discussing how we should be better (video-game slob is fine)-- just anything.
Posted by: wisewon | Jul 3, 2007 1:59:07 PM
Actually-- I see the difference.
You see the argument on comparative health systems as one to prove that our system is in crisis-- hence the lack of need to focus on others' weaknesses.
I see the argument on comparative health systems to be one of finding a solution-- so we need to learn from others' strengths and weaknesses.
Posted by: wisewon | Jul 3, 2007 2:02:06 PM
latts,
Obviously I can't speak for Ezra, but from where I sit, there is no greater weakness than having our citizens die because they cannot readily access routine healthcare, or expire writhing in pain on the floor of a hospital while staffers step over them, or are dumped in ghettoes with leaking colostomy bags, or even just friggin' begging for spare change in quickshops so someone's kid can be treated.
The problem is that you falsely assume that that kind of thing don't happen in other countries, too. But it does. It's not enough to point to problems in the U.S. health care system. You have to show that there's a better alternative.
If you want to argue that some well-fed upper management types will be distressed at possibly not receiving the prompt medical service to which they're now accustomed, that's fine, but I'm not going to be that impressed with the point given the system's more serious failures.
But it's the "well-fed upper management types" who are more likely to get superior health care in other countries, too. In some cases, superior care that makes the difference between life and death. The story of the British man with prostate cancer in this article is instructive. After having to wait seven months for a referral from his primary care physician before he was diagnosed, he then faced an additional wait of 8 weeks for a scan to check whether the cancer had spread to his bones before he was permitted to see a specialist. He was told that "the NHS scanning machine was reserved for private patients for a certain period each day and was often unused." The man jumped the queue and got his scan, but only because he was able to pay 180 pounds (about $360) for the privilege.
Posted by: JasonR | Jul 3, 2007 2:08:48 PM
wisewon and JasonR: Liars or paid liars, what's the difference?
Posted by: Captain Goto | Jul 3, 2007 2:11:01 PM
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