See my proposal on the reform:
http://hoothoothoot.wordpress.com/2009/09/15/health-care-reform/

It is equally disheartening to see the Club for Growth go after Sen. Bennett and by extension, the Wyden-Bennett bill, which is the best piece of health care reform legislation out there. It would be so nice to stop playing this game for awhile….

You can get a kidney transplant, fly first class and stay in the nearest Ritz-Carlton for a fraction of what it costs in this, the best of all possible systems.

Setting aside specific procedures, if I could trade our system for the French system I would do it in a flash. So would any American who looked at the facts.

Actually I have actively considered using European or other foreign health care should the need arise.

I’m in the individual market — and shut out by virtue of being over 50. I have no pre-existing conditions of any seriousness, but I cannot get health insurance. I have a temporary policy that expires in a month. I have now formed a corporation so that I can create a group plan for myself and my wife (and potential employees.) So we may be able to remedy the situation. But we may not.

But if I learned that one of us had a condition that could be dealt with elsewhere you bet I’d consider it. The American choice often comes down to bankruptcy or death. I hope I don’t sound too unpatriotic if I say I don’t much like that choice.

You don’t know what you’re talking about on this. Homeless shelters are full of families who had the bad taste to get sick.

Before it comes to that you bet I’ll hop a plane to France or for that matter India or Mexico where I can get the same treatments — up to and including organ transplants — for a quarter of the price.

Uhh…

According to official budget figures all European governments spend less, per capita, than we do. Right now I’m just talking federal expenditures. Federal expenditures on the VA, Medicare, Disability, insurance for federal employees, Medicaid, etc. adds up to more per capita than any European country, or Canada.

So you’re implying that, in several advanced Democracies, a) the government is lying about it’s health expenditures for no reason, and b) non-Federal health spending in the US is trivial.

Good luck with that one.

and it is absolutely clear that they do not get our quality of care. Again, those who can choose choose American healthcare, and revealed preference is a far better indicator than rhetoric.

Dude, there is no mass movement of French people demanding American Doctors. My Swedish cousins inquired about getting into US Universities, but have never asked about US health care. And one of them needed multiple liver transplants.

You’ve read horror stories from Canada and the UK, and applied them to the European mainland. It simply does not work.

I truly doubt that any American would choose to seek care abroad, given the choice, and your own observation that private care to augment government-run systems is widespread demonstrates the perceived inadequacy of the latter.

For one thing Cuba has quite a few hospitals catering to Westerners. As a Detroiter I know several people who could use either the US health system or the Canadian, and most of them choose the Canadian.

For another if you actually read my post you’d know that the French private system is the only system. It’s universal because they pay all premiums for the basic package through tax revenue, not because some pinhead in the Health Ministry approves every heart transplant.

Nick, stripped of its pretense, your reply is that the rest of the world wants the quality of our healthcare system, they just don’t want to pay for it.

Really?

I thought my reply said the opposite. The rest of the world gets our quality of care while paying less.

No, they don’t. It’s not clear that they pay “less,” all in (free at point of access is not the same thing as free, the cost is simply diffused across more payers across longer tranches of time), and it is absolutely clear that they do not get our quality of care. Again, those who can choose choose American healthcare, and revealed preference is a far better indicator than rhetoric. I truly doubt that any American would choose to seek care abroad, given the choice, and your own observation that private care to augment government-run systems is widespread demonstrates the perceived inadequacy of the latter. As Margaret Thatcher said twenty years ago, asked why she had private insurance rather than relying on the NHS, she wanted to be able “to go into hospital on the day I want; at the time I want, and with a doctor I want.” Why so many Americans are hell-bent on diving into a hole whence so many are trying to escape is truly puzzling.

Really?

I thought my reply said the opposite. The rest of the world gets our quality of care while paying less.

Take France. It’s cheaper by every measure, provides better overall outcomes by every measure, has lower wait times than us, and costs them a lot less. Remember the French aren’t exactly cheap to care for. They love smoking and drinking. They don’t do Cooking Light. They think “heavy legs” are legitimate medical ailment:
http://news.bbc.co.uk/2/hi/programmes/from_our_own_correspondent/7779126.stm

BTW the last link shows you precisely why nobody wants to recreate the British system, despite it’s wonderful numbers:

“Oh for goodness sake,” the nurse said brusquely. “Anyone would think you were dying. You’ve only got suspected leprosy.”

Well, as Marian Call says, I want a smaller waist, but I want doughnuts, too. If you adopt the structure of European healthcare, you adopt its deficiencies, too. Or did you think that it was sheer coincidence that America leads the world in quality of care? It’s a package deal, and ours is better.

You got a number that proves that our overall package is better? This is overall package we’re talking about, so stats on cancer treatment are only a tiny part of the picture.

And it only counts if you haven’t cooked it by ignoring major causes of death in the US.

“…selling pain is poor salesmanship. Promise nothing but pleasure — for now. Make health insurance universal and permanently protected. Tear up the existing bills and write a clean one — Obamacare 2.0 — promulgating draconian health-insurance regulation that prohibits (a) denying coverage for preexisting conditions, (b) dropping coverage if the client gets sick and (c) capping insurance company reimbursement. What’s not to like? If you have insurance, you’ll never lose it. Nor will your children ever be denied coverage for preexisting conditions.“

So – he invokes the poor Obama salesmanship theme as in the post linked here, the recommendation to move from ObamaCare 1.0 to ObamaCare 2.0 as in the embedded slide presentation above, and then there is a striking similarity to this quote from this post:

“Universal coverage for all, catastrophic illness protection for all, no increase in the deficit and no net new taxes. What’s not to like?”

.
Weird.

As to content – He does not specifically mention Wyden Bennett, but he sure seems to be describing it. Of course, he comes to a very different conclusion, implying that even this would be a trojan horse for single payer. As we said in the post, some on the right, like some on the left, will oppose this act regardless of merit. The question is whether there is enough of a coalition to support it.

Nick said no such thing. Your post on this is amazingly fact free.

I must also add, on a personal note, that unlike most Americans, I have been in the care of Her Majesty’s National Health Service. For example, I’ve had dental surgery in Britain, and I’ve had dental surgery in America, and all I can say is (to paraphrase Bob Reich) that statistics don’t always reveal the most telling realities. Actually experiencing the two systems reveals a reality that statistics don’t always capture. Qualitatively, American healthcare is not merely superior, it is in another league superior.

The misleading nature of statistics means that when I see people suggesting that America move toward a European system, I’m reminded of the days where the Soviet Union would claim the superior efficiency of its economy based on statistics of outputs with absolutely zero economic utility. They would claim that their economy produced more steel, for example, and they could prove it! But the statistics failed to take account of the quality of the steel, or the actual demand for it. It wasn’t that the statistics were wrong, it was that they missed the point. Busy != productive. Similarly, you can cite statistics that make the American healthcare system look problematic, but if you’re producing oodles of steel that just sits and rusts on a pallet in Siberia, or healthcare a mile wide and an inch deep, that isn’t progress.

Of course, it was impossible for me to leave well enough alone, so there is also a somewhat more complicated 12 slide presentation linked here, and embedded in a somewhat more allegorical post at Donklephant. Yes, we are tilting at windmills… …

You can claim that all you want. But there are two health systems nobody, in the entire world, barring true extremists, wants replicated in their countries: ours and the UK’s. Many people want to adopt individual elements of out system (typically the wide avaliabiloity of specialists), but replicating the whole thing? Nope.

The Brits, for their part, are convinced their system is much better than ours. And in terms of dollars and cents it clearly is, because it’s ridiculously cheap but provides overall results conmparable to our own.

(No matter now much Europe may sneer, revealed preference says otherwise: those who can afford to do so invariably escape their own healthcare regimes, either “going private” at home or by coming here. Senator Kennedy, it should be noted, did not go to Canada to be treated.)

When people actually go abroad for treatment they go to Europe most of the time. Aging African dictators are notorious to flying for Paris for medical treatment because they know France has the best health care money can buy.

BTW, in most of Western Europe everyone is in a private plan. Germany and France use lots of private non-profits to provide insurance. The Swiss use non-profit arms of for-profit companies. Single-payer proper is only used by Canada and the Scandinavian countries. And like I said nobody wants to import the UK’s NHS.

The extent to which we have not tried it, by contrast, is the enactment of programs such as medicare, and how have they worked out? Well, they now represent a massive, all-but unreformable and demonstrably unsustainable chunk of mandatory government expenditures. It turns out that whether something is working depends a lot on what you use as the measure.

The problem with Medicare expenditures is that they’re in America’s health sector. As such they start out extremely high, and are growing at a ridiculous rate. The same thjing happens to every private policy, but companies can just dump good (expensive) ones for worse (cheaper) ones when they need to balance the books.

Other countries have the problem, but it’s not as severe as ours, which implies that our wait and see approach is not working.

The problem I have with the wait argument is simple: we tried it.

That is a disputable point, but to the extent it holds, it has worked out pretty well. We have a healthcare system that is the envy of the world. (No matter now much Europe may sneer, revealed preference says otherwise: those who can afford to do so invariably escape their own healthcare regimes, either “going private” at home or by coming here. Senator Kennedy, it should be noted, did not go to Canada to be treated.)

The extent to which we have not tried it, by contrast, is the enactment of programs such as medicare, and how have they worked out? Well, they now represent a massive, all-but unreformable and demonstrably unsustainable chunk of mandatory government expenditures. It turns out that whether something is working depends a lot on what you use as the measure.

It may be true that “Very smart people adeptly analyzed what would happen” if Clinton’s plan was enacted, but the ability of very smart people to predict the future, controlling for variables foreseen and unforeseen, is not great. Event studies can help, but only to an extent. Skepticism of human ability to predict how a comlpex system will be affected by a change that may itself be complex is conservative bedrock. And we see it reaffirmed every day in every case that identifies statutory ambiguity. I can think of no reason to suppose that those who drafted Hillarycare (and who are drafting Obamacare) have better foresight than those who drafted ERISA, and as I’ve mentioned above, the volume of litigation involving ambiguities that one might expect to have been plugged if the drafters noticed is substantial. Simply put, “unforeseen consequences” is an iron law.

America has Checks and Balances. This is a fancy way of saying it’s easy for small groups to kill new ideas. The system does not distinguish between good ideas and bad ideas.

I would omit the word “new” (there are few ideas that are new, and those that really are new are usually the most dangerous ones), but, mutatis mutandis, quite so. Likewise, Victor Hugo observed that “[n]othing is as powerful as an idea whose time has come” – a maxim that also does not distinguish between good ideas and bad ideas.

@Nick
I am not questioning or underestimating the difficulty of maintaining partisan fidelity in the Senate, even with a 58-60 vote Democratic plurality. I am questioning your knee-jerk reaction of blaming Republicans for obstructing Democratic ambitions, which – given the numbers – is on the face of it absurd.

@Simon
I’d love the Senate to carefully and slowly deliberate this legislation. My point is that this freight train is barreling down the track fueled by that “public mood for change.” Fiscal conservatives have two choices – 1) Stand in front of it and yell “Stop!” -or- find a switch and throw this train on a track that won’t blow an additional $1-2 trillion dollar hole in the deficit. I’ve chosen my strategy.

@Chris
You are at a level of granularity that I am not, and cannot begin to answer what would happen to you specifically with this plan. My general understanding is that some or all of what your employer is paying for your health care insurance would transfer to you or put under your control, perhaps in the form of a raise, perhaps in the form of a voucher. You would then be able to select the same Employer plan or from a wide range of other plans – including a functional match to the plan our congress-critters get, or potentially a state controlled public plan. Depending on your income and tax status you may be eligible for subsidies or credits, or you may indeed be paying a tax on the plan you select. From what you describe, you’ve got what many in Congress are calling a “Cadillac Plan” that is far better than most Americans. so I suspect you are right and will wind up paying more than you are now if you choose the same plan, (unless you qualify for subsidies and credits). That’s the best I can do. The devil is in the details, as it is with all these schemes.