Dan,I haven't followed what Objectivists have written about health care reform in the blogosphere, but anyone who puts up a graph like that without explaining why American costs are high (newest and most expensive drugs and technologies, health insurance creates disjoint between customer and price sensitivity) and life expectancy is low (racial mix, high levels of obesity and other lifestyle diseases) should revisit this diagram after the legislation gets passed and we'll see if these were really the problems afflicting America. Want to take a Simon-Ehrlich bet amongst friends? Current value of $100 to be paid in 2022?Laj
Laj, it was more the socialism/altruism=inefficiency/death equation I had in mind. In fact the blue lines clustered around the base seem to indicate a reasonably successful mixture of cost efficiency and life expectancy, with obvious variations caused by differing policies and environments. It wasn't the specific example of America so much, tho this was the point of the Angy Bear post. I do take your points, but as I'm a betting man I'll take up you up on your offer - at 2022, and again at 2032.
Dan,I have a healthcare industry relationship, so I view such statistics too often.I'm a betting man too and $100 doesn't seem deadly (could hold it in escrow in an account), though we have to hope that the US's ballooning debt doesn't cause some kind of economic crisis before that time comes. I'm thinking the following:CostQualityAccessCost, we could use per capita spending on healthcare, but we would need some way to index it vs. inflation and another way to account for medical inflation.Quality, we could use life expectancy, but I think some other metric might also be required.Access - I think everyone agrees that access will become better, though I think that wait times might become higher and whether to put that under quality or access is open.Thoughts?
Interesting response to this National Geographic chart here: http://tiny.cc/U9rDW
There seems to be some debate about the reliability of the dollar figures in the graph. See the long comment by Milton Recht and follow-up comment by Sergio Carvalho on this thread:http://tiny.cc/97HTKBottom line is that there are layers of complexity to this issue that a simple graph cannot capture.
Guys,It's New Year's Eve here, I'm outta town, and as I don't want to post even more incoherently than usual I'll make this my last one for now....;-)I'm also going away camping to an Even More Remote Location (I'm on dialup as it is right now) for a week or so so sorry tomorrow, so probably won't be able to respond for a while.Laj: keen to work to pretty much whatever terms you choose. Michael P: Thanks for the links, it would be useful if critics of such a chart would redraw it using what they consider to be the corrected metrics. Would it really look so substantially different - say, with the USA suddenly well below all the other countries, pointing up, and all the other semi socialist ones suddenly all up in cost, pointing down in LE - with these other metrics? We can't really say until someone does the exercise. No doubt someone will, I will await with interest.Happy New Year all!Robert C: Good point re LP authenticity, has already come up on a thread on OL incidentally, will bear in mind.
If you guys are going to bet, you should actually bet on or against Mexico. They are also in the process of setting up some kind of Universal Health Care scheme. And unlike here, their politicians seem willing to pull it off.Our 'reform' is designed to enrich insurance companies, and will do that and little else.
What is a semi-socialist country? Is that the same as a semi-capitalist one? In a semi-socialist country they have abolished wages but not prices? LOL, or is it the other way round? As Marx said the ready made state cannot be made to work in the interests of the majority have they just abandoned half of it. Oh and stop calling state or free health care socialized or socialist health care. I cannot stress enough that state health care is a CONSERVATIVE idea! Yes, started by the conservatives in both Europe and America. You will struggle in vain to find either Marx or Engels advocating state medicine.
Laj wrote:“I haven't followed what Objectivists have written about health care reform in the blogosphere"Who can blame you? Only a masochist would try.
"it would be useful if critics of such a chart would redraw it using what they consider to be the corrected metrics."In the case of Milton Recht's criticisms, I don't think the chart could be redrawn, because his point is that we don't have accurate, up-to-date data. He's saying that the comparison of dollar amounts is misleading because a) instead of using the official exchange rate, the statisticians try to estimate relative purchasing power, which is problematic; b) some countries don't collect data in a timely fashion, so the numbers in some cases are out of date by a year or more, which means the US's 2007 costs are being compared to other countries' 2006 or earlier costs; c) some countries don't include nursing homes, rehabilitation, doctor training, etc., in the category of health care costs, but the US does, thus artificially raising the US numbers by comparison; and d) the organization that compiles these numbers is ideologically motivated to make developing countries look better relative to the US.In other words, he doesn't think these data can be taken at face value. I don't know if he's right or not. I do know that many people travel to the US from other countries (including countries that rank high on this chart) when in need of advanced medical care. I also know that the US is responsible for a great deal of medical innovation -- as opposed to, say, South Korea, which rates better than the US on the chart. Do we really think South Korea provides better medical care, and more medical breakthroughs, than the US?
Self-interest or self-centered seems to be the main concern with most who do not understand Ayn Rand. Those who admire and criticize Ayn Rand’s beliefs about people who stand on their own feet often say she promoted selfishness, thereby greed, which is self-centered and anti-individual creativity. That is anti-Rand. Rand admired the creative individual, people like railroad builder James Jerome Hill, on whom she was reputed to have based her character Nathaniel Taggart in Atlas Shrugged. If we look at Howard Roark’s summation to the jury, from Fountainhead, we do not see a self-centered individual destroying his work. If he was greedy he would have simply accepted his payment. We see an other- and outer-centered individual in love with his own dreams and creations, as one would love a spouse, child or family and refuse to allow them to be assaulted. That is the kind of self-interest that built America. Though love for anything spiritual may be missing, a great idea or vision also measures up to that which is spiritual, beyond self, and that view is not that inconsistent with Christianity. Claysamerica.com.
"If we look at Howard Roark’s summation to the jury, from Fountainhead, we do not see a self-centered individual destroying his work. "Earth to Clay, he is NOT REAL!
"Do we really think South Korea provides better medical care, and more medical breakthroughs, than the US?"Well 3/4 of a million Americans die each year from surgerical operations. I'm sure the figure is about the same in South Korea.
Gregg, the graph does not prove your point. Unlike many of the countries with socialized medicine, much of our money is used to pay for R&D. Furthermore, high prices are largely due to government collusion into and regulation of the medical industry. And let us not forget that, for the poorest segment of our economy, doctor's visits are often subsidized by the government.You also fail to take into account the inherent corruption in the food and drug industries which result from government collusion. Executives from both large pharmaceutical and food corporations tend toward prominent positions in the FDA and other government regulatory agencies. The FDA, for instance, proclaims in reference to health claims involving supplements that "The disclaimer must also state that the dietary supplement product is not intended to "diagnose, treat, cure or prevent any disease," because only a drug can legally make such a claim." Thus, due to law and the stifling of a free flow of information, drug companies technically have a monopoly on all "cures."http://www.fda.gov/Food/LabelingNutrition/LabelClaims/ucm111447.htmFor an introduction to the pharmaceutical industrial complex, I would suggest you read John Abramson's "Overdosed America."http://product.half.ebay.com/Overdosed-America_W0QQprZ44125267QQtgZinfohttp://www.overdosedamerica.com/
Jim, just for the record: this is not my post; it was posted by Daniel Barnes, who started and administrates the blog (and does a very fine job). That said, I largely agree with you, and think you've hit the nail on the head. But I think the nail can be driven in even farther. All statistics either about (1) health care, or (2) comparative life expectancies of Europe and America, are probably misleading, because they ignore important details that are smothered in statistical aggregations. In the first place, no country in the world as "universal health coverage" in the sense that everyone has same access to health care. What they have in some of these European countries is general health coverage. But we have that, too, in America. In many emergency rooms in America, it is illegal to turn away any patient. Here in California hospitals can be fined hundreds of thousands of dollars for not giving an individual a chance to see a doctor. So the different color lines in the graph are close to meaningless. They deal with the form of the respective health care systems, not with the substance of them.Now one the major reasons why health care costs are larger in America than else where is because we don't deny high-level health care to the age demographic that most needs it—namely, the elderly, who receive huge amounts of medical benefits from the government. The easiest way to cut medical costs is to deny all but the cheapest medical care to the elderly—which is pretty much what's done in Canada, for instance. In other words, if you want to keep medical costs down, you need to impose rationing. That means denying care to selected groups (e.g., the elderly) and putting others on waiting lists.
Yeah Jim, that's just what the workers of America need and unregulated medical industry and a return to the days of snake oil salesmen!At least city hall got rid of them, who says you can't trust the government?
In the UK 90% of the money that will be spent on a persons health care is used in the last 6 weeks of their life, making that transition for life to death as painless as possible? But that does not happen in Canada?
In the UK it is the Labour Party that is usually given sole credit for the NHS, but the real picture is slightly different. Like its companion, the Beveridge scheme for social security, it was implemented by the Labour Party but had the support of other parties, who generally recognised that some form of welfare was badly needed. So the NHS did not spring from nothing, as with the big bang theory of the Universe. There had been health provision for the working class before the war that was free of charge, but it had been very haphazard, with some areas over supplied and others very badly neglected. Also it relied upon charity. It was not there by right and most people saw a big difference. Bevan promoted a scheme that would abolish the stigma and unpredictability of charity and was comprehensive and open to all. And he had to fight for it, even against opposition within his own party, and from the British Medical Association, who saw a threat to their own power within a government run scheme. But once the scheme had been publicised there was no going back. Yet those were minor obstacles compared to a force that neither pro-welfare state supporters have ever properly understood, the forces of capitalist economics. Money problems.The NHS had to be paid for, and the money had to come from the capitalist class. Ever since its inception the history of the NHS has been a story of trying to provide adequate funding. Every government has looked for ways to find the money and cut the costs, and every government has failed. The original set-up has been modified, tinkered with or altered repeatedly, all, we are told in the interests of efficiency. Every government in the UK produces a fresh plan with a fanfare of trumpets that promises to solve all problems. The Labour Party initiated a reform that would prove to be one of the biggest headaches of all time not just for themselves but for any party trying to run capitalism, including Margaret Thatcher, who thought she had the magic formula to solve all problems, privatisation, but ended up by spending as much as anyone.
In truth there are many factors within capitalism which augur badly for the NHS. Although the trend for well-established capitalist countries is to gravitate from a production economy to a service economy, this can have problems. Manufactured goods, once they are into full mass production generally go down in price, notwithstanding inflation because they embody less labour. But not all wealth can be mass-produced. Many jobs that require intensive labour-power cannot be made more productive by technology. But wages paid have to come into line with those of production workers where fewer workers still produce as much or more. This is why it is so expensive to have such things as electrical or building work done. Nursing comes into this category: you can’t replace a nurse by a machine (although they do their best). So, if there are going to be enough nurses to run a health service the total cost of nursing care has to go up. In addition to which, nurses have to be trained to manage the increasing technical demands of modern health care. The government try to overcome this problem by the well-used tactic of recruiting from countries with lower wages, such as the West Indies, South Africa and Poland. Another tried and tested solution favoured by employers is that of up-grading, i.e. allowing some tasks to be undertaken by those not previously regarded as having the necessary skills; for example, encouraging nurses to undertake minor surgery, thus relieving some pressure on doctors. But this is minor, compared to the increasing costs of drug treatment, which have risen to astronomical proportions since the NHS was founded. When Bevan dreamed up his panacea for the working class of Britain, which was going to be the envy of the world, the practice of medicine was not as advanced as it is today. Drug treatment, as we know it today, apart from the heavy reliance on aspirin and the wartime use of penicillin, was unknown. Modern medical science was more or less born during the Second World War and it has made giant strides since, especially with regard to costs. Developing a modern medical drug can cost millions of pounds. And, as every reader of any newspaper must have noticed, new, ‘wonder drugs’ are launched with astonishing frequency, generally leading newspaper articles somewhere asking indignantly, “Why cannot this life saving drug be made available to anyone who needs it?” The pressures on the NHS are relentless, all of them making for increasing costs. Population trends are swelling the numbers of old in relation to the young, and as we all know older people tend to have more illnesses, and their illnesses are more likely to take the form of expensive operations such as hip replacements.
Of course you libertarians might be able to drive down health costs if you could make the drugs cheaper. But you never will as the amount of labor power required by the scientists in reseraching and developing these drugs is just not something you can mechanise to drive down the costs. That, coupled with the profits the drugs companies need to make will mean that medicines remain very expensive.How will you drive down not just the amount of medices we use today but the cost of develpoing them?Now I'm sure ever President in the US says that they will do both of these things, yet ever one has failed. Where did they go wrong?
Daniel Barnes,I will admit that it is an interesting graph. Its a bit hard to read through.
If you go to the Objectivist Centre you will able to view the front cover of the latest issue of their publication, The New Individualist. The front cover has the statement “Rand Renaissance”. Given that every year Objectivists state the same thing that this is the year of a ‘Randian’ renaissance and, well it never is. Isn’t this another example of objectivists being at odds with empirical reality? I was told by a UK objectivist that interest in Ayn Rand and her philosophy was growing every year. But when pressed he could say how many objectivists were being ‘created’ year in year out. In the UK, the ‘official’ objectivist organisation number roughly 300 and has been going for 20 years. Not much to write home about there, their founder admits he cannot even afford the £50 it costs to send out a mail shot to his members on a regular basis. I ask you, is this growth? Steven Johnston
Hi Damien, click on the graph and it should get bigger.
Hi StevenVery interesting comment you make. There is some talk from the ARI of attendance being up about a quarter at their conferences, but hard numbers are hard to come by.There's Atlas Shrugged sales, but historically despite the hype it seems reading Atlas only results in a tiny fraction of Objectivist conversions. Given it's the movement's main sales tool this is a worry. We at the ARCHNblog have tried to put some - I think generous - numbers on it here
Daniel Barnes,I did click on the graph earlier and saw the larger image. I think I know what its saying, but its little hard to read because of its unusual format.
Yes, I've have read the posts you mention, now I must confess to having read all of fiction of Ayn Rand and it did not convince me to be an objectivist. When you put that to an objectivist all you get is insults. I don't think they can quite grasp that novels, like Atlas Shrugged can drive people away from the philosophy.Though I did get some enjoyment out of the film the Fountainhead. In 1949 it was probably taken quite seriously, now it looks very camp.I guess every January they, the objectivists, must say, this year is our year! Then, come December, they must say, well the world is not yet ready yet for objectivism.But I've never been so insulted as I was when I told an objectivist I preferred 1984 and Brave New World to Atlas shrugged.
We need a TOC friendly objectivist or someone that has read the article in full to explain why this renaissance is different for those of every other year and why it will succeed where others have failed. As all they seem to do is moan about how bad things are and how America is descending into fascism/socialism/mysticism etc.Otherwise it is just another example of their inability to, well, reason.Steven Johnston
Well, just came back from the TOC webiste and just seen how much influence they have had in the World spreading the word of AR.Well, leaving aside the US for a moment as objectivism does seem to enjoy, the vast majority, of whatever popularity is has there.In Canada there are 4 'groups', in France there is only an e-mail address! There are also enteries for New Zealand, Norway and Turkey and thats it outside the US. Maybe at then end of this renaissance this will have changed?Perhaps another poster here can tell me what influence the ARI has, outside of the US.Steven Johnston
Anonymous Said:The UK NHS situation is worsened by the fact that the GDP per capita is about 30% less than France, Germany, US and Canada according to the Economist and therefore completely impossible to implement in its current format. According to statistics, 23% of employees in the UK are working for the NHS and this is just not cricket.
According to whose statistics?I doubt it is that many! Roughly one in 4 work for the NHS, you are having a laugh there mate. Quote your sourcesSteven Johnston
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