Socialized Medicine
Here’s some historical data on female life expectancy in Russia:
My understanding is that the post-Soviet collapse had more to do with lifestyle factors (vodka got cheaper) than problems in the health care system. But the point, broadly speaking, would be that the dread U.S.S.R. actually did a perfectly decent job of providing the sort of goods—health care, basic education, subways, nuclear missiles, vast prison camps, satellite launch vehicles—that in most democracies are provided by the state. It did a bad job of providing things like appealing clothing, consumer electronics, popular entertainments, cars, etc. that are generally provided by the private sector. In Cuba everyone’s dirt poor and generally leave crappy lives with few goods, but the literacy rate is high and the state of public health is excellent considering the poor overall economic situation. And even in the United States, about half of health care is financed by the state—a free market approach to senior citizens would be a disaster.
85 Responses to “Socialized Medicine”
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July 8th, 2009 at 8:47 am
“My understanding is that the post-Soviet collapse had more to do with lifestyle factors (vodka got cheaper) than problems in the health care system.”
Well, it wasn’t just the vodka. The entire economic system collapsed during the transition to capitalism, and economic system collapses are a negative for basically every health and happiness factor for the median citizen.
—–
“In Cuba everyone’s dirt poor and generally leave crappy lives with few goods, but the literacy rate is high and the state of public health is excellent considering the poor overall economic situation.”
You don’t even have to consider the overall wealth level. Cuba simply has a lower infant mortality rate than the US, despite us being richer by an order of magnitude.
Socializing certain sectors of the economy really is a no-brainer. So is adequately regulating the bulk of economy that shouldn’t be socialized.
July 8th, 2009 at 9:01 am
Holy non-sensical extrapolations, Batman!
July 8th, 2009 at 9:09 am
Call me crazy, but I don’t think that bringing up the examples of Cuba and the USSR are going to help those who support health care reform to get it through Congress. I don’t think there’s been much argument that the USSR and Cuba deliver(ed) poor health care services, so I’m not sure who Matt is arguing against here.
The Right is against socialization on moral grounds, and efforts of the Right to tie access to high quality health care to market economics is an effort to capture the moral high ground. Bringing up Soviet Russia or Cuba is not going to help the Left retain that high ground. The fact is that the U.S. is at core a country committed to liberalism and free enterprise; what the Left has to do is convince enough people that their changes are not a threat to that, or at least are merely a humanistic tweaking of that, rather than an effort to deliver the heights of health care delivered in Soviet Russia or Cuba.
July 8th, 2009 at 9:13 am
Yeah, right, the datas provided by totalitarian states are trustworthy. Did you know that most diseases are now eradicated in North Korea ? Or that life expectancy is very long in Libya, Jordania, Saudi Arabia or Cuba ?
July 8th, 2009 at 9:13 am
“The Right is against (medical) socialization on moral grounds”
Ha!
The “right” has pretty abysmal morals.
July 8th, 2009 at 9:20 am
Petey – yep, in terms of personal morality, I couldn’t agree more. I guess I am referring more (in my highly inarticulate and poorly informed way) to the sort of Adam Smith turn where he was able to tie free trade to justice. I don’t like it, but I think that’s the way this debate is being framed.
July 8th, 2009 at 9:24 am
EES NEXT: Svimvear
July 8th, 2009 at 9:32 am
…life expectancy is very long in Libya, Jordania, Saudi Arabia or Cuba?
True, but of course on any broad quality-of-life index, Jordania looks like a shithole compared to Omania, Irania, or even Pakistania.
July 8th, 2009 at 9:37 am
No, it wasn’t just the vodka: it was the support system for the elderly that fell apart.
I do think it’s somewhat pointless to respond to people who argue that moving from “most dysfunctional health provision in the developed world by a large margin” to “most dysfunctional health provision in the developed world by a small margin” is the Sovietization of the USA by providing data from the USSR. They’re working from an mental model in which Bismarckian social insurance and the NHS and French single-payer is all mashed into a “Soviet healthcare” that has nothing to do with anything on the earth, past or present..
The correct response is “don’t be so fucking stupid”.
July 8th, 2009 at 9:42 am
The fact is that the U.S. is at core a country committed to liberalism and free enterprise
In which case, you argue that healthcare corporatism is a threat to the model of individual-scale free enterprise that has political resonance. Stuck in a shitty job because it has health coverage? Can’t realize your ambitions or potential because you have kids and the insurance quotes are absurd? Can’t hire someone full-time and pay insurance? Bankrupted because you got sick? Well, it’s time to change that.
July 8th, 2009 at 9:44 am
Recent decades have proved that in the US our private sector is perfectly capable of running vast prison camps.
July 8th, 2009 at 9:55 am
No, a purely free market approach to health care for the truly poor would have outcomes no one is happy with. For people of reasonable means, it would likely mean cheaper care in the general case (as market pressures drove prices to an affordable level), with the expense where we would all expect:
– catastrophic care
– end of life care
What we are trying to do now is control the costs of those two items in a way that will screw up the simpler stuff that could be far better provided by the private sector.
And no, we don’t do it that way now. What we have right now is a half-assed socialized system that infuriates both free market advocates and socialists alike.
July 8th, 2009 at 9:55 am
Dear Matt,
You are obviously a very intelligent dude and I admit that my accomplishments in life thus far pail in comparison to yours. But holy shit – your “understanding” of the USSR, especially for someone who claims to be a Russophile, are astoundingly ignorant and detatched from reality.
Sincerely,
Russian Immigrant
July 8th, 2009 at 10:03 am
Does anybody know if this data is any good? If it’s govt data, I don’t know whether or not it should be trusted.
July 8th, 2009 at 10:14 am
– catastrophic care
– end of life care
What we are trying to do now is control the costs of those two items in a way that will screw up the simpler stuff that could be far better provided by the private sector.
Yes, why not just have the public sector involved in catastrophic and end-of-life coverage and, maybe, preventive services?
I have no idea but I’d want advocates to point to some actual nation where this model is successful. When it comes to vast and complex issues like health care, its not enough to simply put forward reasonable sounding arguments.
July 8th, 2009 at 10:16 am
@statatheleft – while the Soviet-era data might be a little suspect, I think it’s more or less accurate. And the post-Soviet decline is pretty widely accepted, even if the exact numbers are off.
That said, MY’s theory that *female* life expectancy is vodka–related is almost certainly wrong. That has had a huge impact on *male* life expectancy, but with women it’s more likely due to the general decline of the state, shortages of medical supplies, corruption in the healthcare sector, decline of traditional support structures, etc. Plus, I believe emigration has been greatest among academics and professionals like doctors.
July 8th, 2009 at 10:19 am
# 14 “Does anybody know if this data is any good?”
Matt Yglesias said : “but the literacy rate is high and the state of public health is excellent“. And Yglesias has no bias and knows everything on every subject.
And he is right : Kim Jon-Il or Fidel Castro are bad to provide ipods or fancy clothes, but health and education are better than in the so-called Free World. The datas they show the world is a proof.
Among the countries with the higher literacy rate in the world, are Bielorussia, Turkmenistan, Cuba, Tadjikistan,… Those countries are better than some Europeans like Portugal.
July 8th, 2009 at 10:27 am
According to the link, this is the source of the data. I confess I find it unilluminating. But here’s a summary of a JAMA paper that discusses the increased mortality in Russia after the end of communism. Conclusion:
“The striking rise in Russian mortality is beyond the peacetime experience of industrialized countries, with a 5-year decline in life expectancy in 4 years’ time. Many factors appear to be operating simultaneously, including economic and social instability, high rates of tobacco and alcohol consumption, poor nutrition, depression, and deterioration of the health care system. Problems in data quality and reporting appear unable to account for these findings. These results clearly demonstrate that major declines in health and life expectancy can take place rapidly.”
July 8th, 2009 at 10:30 am
I wonder if the phenomenon of liberals quoting communist propaganda in furtherance of their own agenda at home will ever end. Obviously without knowing what he’s talking about, Matt repeats the lie that Cuba has quality health care (”excellent” no less!). Have you been there Matt? It’s not a place you want to get sick in.
July 8th, 2009 at 10:35 am
Among the countries with the higher literacy rate in the world, are Bielorussia, Turkmenistan, Cuba, Tadjikistan,… Those countries are better than some Europeans like Portugal.
Previously I had thought Jessica Biel was born in Minnesota but obviously I was mistaken.
July 8th, 2009 at 10:36 am
After the USSR failed, Yeltsin invited the” Chicago School” economists in to advise on restructuring the economy.
Those morons proceeded to advise a “blitz” privatization of state-run commerce and the oligarchs took over oil and all other sectors. Whereupon the economy collapsed. But the oligarchs made billions.
It’s a good thing those morons have no influence in the good ole USofA.
July 8th, 2009 at 10:39 am
#21 “It’s a good thing those morons have no influence in the good ole USofA”
Indeed.
http://www.youtube.com/watch?v=B6Hf4M956Yk
July 8th, 2009 at 10:41 am
What we have right now is a half-assed socialized system
I’ll give you the half-assed, but not the “socialized” or the “system”. It’s only slightly more systematic than the gathered masses outside Wal-Mart on Black Friday morning, and driven by the same every-man-for-himself instinct.
July 8th, 2009 at 10:44 am
“Petey – yep, in terms of personal morality, I couldn’t agree more. I guess I am referring more (in my highly inarticulate and poorly informed way) to the sort of Adam Smith turn where he was able to tie free trade to justice.”
I’m actually a pretty big fan of Adam Smith. He was quite clear that there are areas of the public good that aren’t best served by markets.
I don’t the modern right is very good at reading Adam Smith. I actually wish they were better at reading him.
Markets are wonderful things in most places, but there are significant exceptions to the rule. Basic medical services are one of those exceptions.
—–
And it’s also worth noting that Smith was pretty clear about the necessity of the government regulating markets, another thing the modern right isn’t too fond of.
Markets and trade in their proper place are wonderful things for increasing human welfare. They just have to be kept in their proper place, which is why we need strong and competent government. In modern America, Adam Smith would vote Democratic.
July 8th, 2009 at 10:49 am
“After the USSR failed, Yeltsin invited the” Chicago School” economists in to advise on restructuring the economy. Those morons proceeded to advise a “blitz” privatization of state-run commerce…”
Poland tried the same basic strategy, and Poland is actually a real success story today.
The difference is that Poland was committed to having a competent and democratic government, while Russia went down the path of government according to semi-fascist mafia principles.
July 8th, 2009 at 10:56 am
Petey-
The biggest difference was that Poland was run by a union movement (Solidarity) and didn’t swallow the neoliberal BS like the Russians did.
Naomi Klein’s book “The Shock Doctrine” has a good history of the Chicago School misadventures around the world.
July 8th, 2009 at 11:01 am
Petey at #24 – thanks for a much better explanation than I could provide. I couldn’t agree more that the Right has abused Smith to their own perverted and immoral ends.
July 8th, 2009 at 11:10 am
“The biggest difference was that Poland was run by a union movement (Solidarity) and didn’t swallow the neoliberal BS like the Russians did.”
I think Poland and Russia went down very similar “neoliberal” paths.
I’d argue the difference is that Poland, with a competent and democratic government, channeled the rewards into the public good, while Russia, with a semi-fascist mafia government, channeled the rewards to a bunch of plutocrats.
July 8th, 2009 at 11:15 am
#24 “Markets are wonderful things in most places, but there are significant exceptions to the rule. Basic medical services are one of those exceptions”
The monopoly of social security in european states leads to the rationing of health spendings (”médicaments génériques” (i don’t know the translation), impossibility sometimes to choose his doctor, or to see a specialist without consulting a priori a general practionner,…). And who says rationing, said clerks to rationing. Who will play this role ? The administration ? An official of the State ? The doctor ? The nurse ? The pharmacist ? The social worker ? The family of the patient ? Or even the patient himself, whom “we” asked to be “reasonable” in its spendings ?
The fact, my friend, is that we have those discussions in Europe, and this debate has lasted for years and will never be settled. The fact is that life has a price, and that each does not accord infinite price to his own life. Some people smoke for example. If we all give infinite price for our own life, we dare not cross the street. Moreover, today, it is not only to heal and repair the patient’s body, but also to reduce suffering and extend life as long as possible. But in the struggle against death, there is no limit. This is at the core of the conservative critic of the monopoly of social security in the hands of the state. Everyone should be free to spend as much as he wants for what he believes to be his health, at the condition he assumed himself the expense. And thus to choose the company of his choice (which creates new problems for the budget of social security). I really doubt that the American mentality accepts the rationing costs and limitations involved by a european-style health system.
July 8th, 2009 at 11:16 am
This is an oversimplification. The first-stage privatization (the voucher-based one, sale of smaller enterprises) went decently, with a lot of smaller outfits ending up in the hands of the people who worked there. It was the second phase sale of the large state enterprises that ended up being a real giveaway to the well-connected. But in any case the economy collapsed a year prior to privatization; there were other factors to blame, such as monetary policy.
Also, it’s not like other countries (e.g. Ukraine) that didn’t privatize ended up finding some better way to handle the situation.
I also think it’s worth pointing out that while Jeffrey Sachs (prime advocate of shock therapy) is identified with the Chicago School, he’s actually a Harvard guy. Just like Larry Summers, who also carries some of the blame for the kleptocratic looting that took place in later privatizations…
July 8th, 2009 at 11:19 am
I think Matt’s point is pretty simple, “the state” can be and often is a more efficient provider of certain necessary nation-wide functions than the private sector. The old Soviet Union, as inefficient and dysfunctional and evil as it was, actually deliverd reasonably efficient (and certainly affordable) healthcare -for every single citizen.
I don’t think he is saying we should all wear red T-shirts with C.C.C.P. printed in bold white type above a white hammer and sickle with a five-pointed star.
Compare and contrast. It is a simple concept. Call it “relative inquiry.” If you make an impartial comparison between the United States and the U.S.S.R., a failed totalitarian state, and find the US comes up lacking in certain departments, then this country needs to make deep and fundemental changes. Out of embarrassment, if nothing else.
I give Matt credit for making a fair, honest, and yes, in this current moronic environment, a courageous argument.
July 8th, 2009 at 11:51 am
The fact, my friend, is that we have those discussions in Europe, and this debate has lasted for years and will never be settled.
Indeed. But that argument takes place explicitly in the political arena: opposing parties can set forth their visions of how to address issues of cost and access, and one vision wins out. In the US, the most important discussions take place in board rooms and on Wall Street, where the people with votes are often driven by interests that run against the public good.
July 8th, 2009 at 11:57 am
Excluding males hides just how bad health was in the USSR, considering the unusually large gender gap in life expectancy, but even looking at the female numbers alone, life expectancy peaks around 74.6. This is not a good number, compared to countries like, say, Mexico or Thailand.
The USSR had a quite bad health care system, in addition to a bunch of lifestyle issues outside of health care which left Russia on the whole around Indian levels of health. This is not a point applicable to state-run health care in general, or even state-run health care systems in communist regimes in general. State-run health care systems can be excellent, average, or bad. The USSR’s health care system happened to be a pretty bad one. Maybe not as bad, on a dollar-for-dollar basis, as the US system, but certainly down there.
July 8th, 2009 at 12:01 pm
BTW, I think that if you wanted to make the case that the USSR could provide high-quality basic services, I think that the education system, which was genuinely quite good, would be a much better place to make that case than health care. Health care is one of those areas, like “appealing clothing, consumer electronics, popular entertainments, cars, etc,” where the USSR did a pretty bad job. Education, on the other hand, was generally comprehensive, rigorous, and high-quality (leaving aside propaganda, which we can when dealing with things like math, chemistry,etc).
July 8th, 2009 at 12:17 pm
bbartlog made the point I was going to make about Sachs and Harvard; another Harvard guy who was prominent in the privatization was Andrei Shleifer, who was a pretty big crook about it. (As you can see, his misadventures cost Harvard a $26.5m fine, and in return they gave him the hardest slap on the wrist they could give, yesindeedy.) Daniel Davies had more, which was where I got the JAMA article I linked (I don’t necessarily vouch for the rest of d-squared’s analysis).
Anyway, I think it’s pretty much a scholarly consensus that the Yeltsin years were a disaster for Russians, from the standpoint of life expectancy.
July 8th, 2009 at 12:28 pm
Here’s the archive of the article Davis links about Shleifer and Harvard.
July 8th, 2009 at 1:12 pm
impossibility sometimes … to see a specialist without consulting a priori a general practionner
Oh no! Good thing something like that is unheard of in the US! (/sarcasm)
That is the standard practice in the private (HMO) plans in the US, in case you were wondering.
July 8th, 2009 at 2:38 pm
“In Cuba everyone’s dirt poor and generally leave crappy lives…”
That’s just nonsense. As a Canadian who has been to Cuba–and knows plenty of other people who’ve been to Cuba–everything I’ve ever heard from or about Cubans is that they are very proud of their country and generally quite happy.
Of course they’re poor by Western standards, but even with the embargo and the collapse of the USSR they are still the richest of the four major Caribbean countries (Cuba, Dominican Republic, Jamaica, Haiti). And greater political freedom isn’t everything in life–not for most people.
I think it’s offensive to say that Cubans “lead crappy lives”.
July 8th, 2009 at 2:39 pm
If you get government health care, you will get rationing. If you get rationing, you will get delays. If you get delays, your cancer will kill you much, much faster. But it’ll be cheaper. And since we’re all going to die anyway, isn’t it better that people on the whole can get free treatment for broken arms?
Or maybe we should stick with the capitalist system that has made the United States the most medically advanced nation in the world. No one goes to Canada for cutting-edge cancer therapy, but the middle class CAN get it in the US. Oh, what about the poor? Well, they’re not exactly getting paid the same as the middle and upper class either, now are they? We gonna “fix” that next?
July 8th, 2009 at 2:44 pm
One difference between Poland and Russia was that Poland had much fewer opportunities to loot enormous amounts of money from the state owned industries. The corruption level was big and many made “fortunes”, but those fortunes were not creating world-class billionaires instantly dominating the political system.
In Russia, oil, gas, nickel, platinum and other extraction industries were looted, creating billionaires who would be rich enough to have enormous influence in USA, let alone in much smaller economy of Russia. Of course, the mentality of the political class in Russia was never overly pre-occupied with the concerns of the little people, while in Poland every single government was basically a coalition of neo-liberals and populists (and moderately cleptocratic), thus avoiding extreme bullshit in either direction.
July 8th, 2009 at 2:55 pm
Jim, we already have rationing with private health care. We’re spending twice as much per person as other countries to deliver health care that is inferior to what prevails in France and no better than what prevails in Canada. That’s ridiculous and it’s unsustainable if we are to be competitive in the global economy.
July 8th, 2009 at 3:04 pm
Shorter Yglesias: The Soviets were awesome! …y’know, except for all the gulags. And the secret police. And the executions. And the oppression. And stuff like that.
But they had dental!
July 8th, 2009 at 3:17 pm
Wow. I can’t believe that this is even serious. I suppose history really does repeat itself. I think all of you here arguing that the communist russian healthcare system may have some validity as a model ought to ask Russian Imigrant comment #13.
Excuse the hyperbole, but this is quite possibly most misguided statement I’ve ever seen from a seemingly intelligent person.
July 8th, 2009 at 3:24 pm
First, nobody is arguing that the health care system of the U.S.S.R. has validity as a model, except in the broadest sense that governments can be good at providing public services. If you want to dispute that argument, do so on its merits, not by building strawmen.
Second, nice attempt at appealing to the “authority” of FreddyBak, but again — why not try engaging the actual argument? FreddyBak offered no substantive critique of Matt’s post, other than claiming to have superior “understanding,” so why should his or her post carry any weight?
July 8th, 2009 at 3:25 pm
If you think we’re getting healthcare that’s inferior to any other country in the world you’re completely out of your mind. We may be the least healthy nation in the world – but our relative unhealthiness is a function of what we eat and how we live – NOT the quality of the healthcare services provided. When it comes to actually delivering healthcare – despite what has somehow become the latest meme – the US is years ahead of every other country. Sure we have many problems in the system we’ve set up, but be very very careful what you wish for.
July 8th, 2009 at 3:31 pm
Indeed, no doubt Russia and Cuba are just as good as, oh say (to pick two private instructions) Matt’s $30,000 a year Manhattan prepschool or alma mater Harvard!
Public, private, USSR, Castro’s Cuba, the U.S. — it’s all the same!
My Lord! Few, if any, of Matt’s readers have benefited more from eschewing public services (schools, colleges, etc.) for the very pricey and very private than the Dalton Kid has — yet here the boy is with this preposterous post!
Considering the fact Matt’s whole whole life has been a privatized coast past the huddled masses, he might really want to think twice before spouting embarrassing, historically ignorant and hypercritical sentiments. Either that or check out Cuba. Or the Soviet Union. (Oh, wait — Matt only travels when he’s on a junket. Well, then . . . maybe he can check out one of the public schools in New York that his parents pulled every connection and spent close to a half million in total to keep him out of.)
I realize Matt’s very young and has lived his life in a cocoon, but, frankly as progressive I’m somewhat mortified.
A pathetic and telling post.
July 8th, 2009 at 3:36 pm
Don’t forget the millions that starved in the USSR. China had a similarly heartbreaking problem of not feeding its people.
July 8th, 2009 at 3:39 pm
[...] Yglesias, a blogger for the liberal Center for American Progress, cites Soviet-era life expectancy data to argue that, “the dread U.S.S.R. actually did a perfectly decent [...]
July 8th, 2009 at 3:48 pm
Well Nadav, I think it’s quite relevant to ask someone who may have actual experience under the USSR system as opposed to the majority of jabronies here who seem to have no understanding of what living in communist Russia was actually like or about healthcare economics in general.
To your first point, um, so you say I’m wrong because I put up a straw man that someone is pointing to the USSR model as having any validity….and then you go on to say that no one is saying that “except in the broadest sense”…so basically you ARE saying the model has some validity – in the “broadest sense”. So you’re contradicting yourself within the same sentence. I don’t think i’m putting up straw men at all and your response just proves my point.
Anyway, enough semantics. I’d love to argue the actual facts about healthcare. I’ve been studying and working in healthcare and economics for a decade now, and it really amazes me that anybody with any knowledge on the subject concludes that the government can provide healthcare better than the private sector. Just look at Medicare – it’s a program on the verge of bankruptcy (less than 10 years of solvency remain according to the governments own estimates). If you know anything about the Medicare system you know that the amount of waste is incredible (probably 30% per year or so based on most estimates). People love to point to administrative costs being low – but I could save 5% in admin costs too if all I did was cut checks to whoever asked for them (of course then i’d have 30% waste too)!
I could go on for weeks on this, but basically I look at Medicare and see what a horribly broken system it is, and ask why anyone would want to extend this model to the rest of the country.
July 8th, 2009 at 4:02 pm
@Brad – have you ever gotten sick in Cuba? I haven’t but I know someone who had a severe asthma attach in Cuba and received excellent treatment. The system lacks in material goods not in quality of medical professionals.
Meanwhile, @Jim doesn’t know what he’s talking about. If rationing leads to faster deaths (and sorry, Jim, virtually all Canadians with serious illnesses like cancer are treated at home, no matter what lies the GOP is feeding you), how come Canadians have better infant mortality, better maternal health, better overall health rates and longer life expectancies than American? Moreover, the most conservative (and I mean that politically) analysis of healthcare disparities between the US and Canada could manufacture a result no better than men had a 4 per cent better chance at five-year survival after cancer in the US vs. Canada. With odds like that, I’ll stick to with my “rationed” healthcare, thanks.
July 8th, 2009 at 4:04 pm
MY is fond of making the claim that the USSR did a fine job of providing services normally provided by the state. Trouble is, I don’t think it’s true, at least in the area of defense. As an example I’m familiar with, consider the Soviet navy. Their ships absolutely bristled with weaponry, and were very formidable… on paper. But the intel indicated that the reason for all these weapons was that their reliability was so poor that you needed several copies of each system to ensure at least one would work when you needed it. Not sure if this problem applied to their health system, but it’s dubious to me that all of the typically state-provided services in the USSR were good or even acceptable.
FWIW, I’m strongly in favor of the public healthcare option for the US, so I hope no one will conclude that I’m just USSR bashing out of ideological motives
July 8th, 2009 at 4:16 pm
this post was written for the lulz, right?
July 8th, 2009 at 4:44 pm
@Katie – an asthma attack? Really? So Cuba can treat an asthma attack just fine, and we’re supposed to what – extrapolate that to cancer treatment? What a joke.
There should be some sort of rule – anyone who offhandedly points to Cuba or communist Russia to backup their argument for government control of healthcare should be promptly laughed out of the room.
July 8th, 2009 at 5:34 pm
Didn’t Mussolini’s trains run pretty well?
Socialism is fundamentally flawed because it’s goal is to eliminate innovation and efficiency in order to keep the system from decreasing or changing.
Europe is basically a glorified retirement community. It is like a giant day-care center for adults- the people there think of themselves as children because they are dependant on the government to take care of them. We are not children- we can make our own decisions and we can handle the consequences.
Also: You can romanticize communism when you are a college student, but get real- Cubans are prisoners. Wanna know how you can tell? It’s illegal to own a boat! Wanna know why? Because if the people were allowed to own boats they would all leave!
July 8th, 2009 at 5:52 pm
PT, if Cuba can treat an asthma attack just fine always, that’s a good sight better than the USA.
It’s widely agreed upon that, given its resources and position, Cuba’s made a mighty good go at a healthy healthcare system. If you want to throw a hissy fit because that offends your sensibilities, well, bugger to you.
July 8th, 2009 at 6:57 pm
Cuba’s health care system is generally acknowledged to be excellent. Read what Paul Farmer, who should know, says about it. As for political freedom, I think most people in the developing world would gladly give up the chance to vote for Tweedledum or Tweedledee, in excange for not seeing their kids die of preventable disease.
July 8th, 2009 at 6:59 pm
WTF, by the way? Yglesias appears to have banned my screen name (Hector). How come? Just what justifies banning me but not SLC, Myles SG, Richard Steven Hack, or Steve Sailer?
July 8th, 2009 at 8:13 pm
“dread U.S.S.R.”
Usually when you use “dread” as an adjective you’re being sarcastic. But the USSR actually was a dreadful political regime, and it had much worse aspects than not providing fancy toys to people.
During the 1990s, the Soviet Union did not have a working system of “socialized medicine” anymore. But they didn’t have a working system of free-market medicine either! So I fail to see the point. And alcoholism, violence and accidents were in the top-5 causes of death during that time. Not exactly stuff that awesome Cuban hospitals would have fixed.
“Yglesias appears to have banned my screen name (Hector).”
Join the club. I stopped reading regularly for a year or so when I was blocked. Still don’t know why I was blocked or why I’m back on, though. I had the same thoughts about the trolls (though it’s clear they drive hits)…
July 8th, 2009 at 8:33 pm
Colatina, in all fairness, in the USA we don’t have a working system of free-market medicine either.
If Hector were banned, that would be utterly inappropriate, and make me wonder WTF is making decisions. Interesting guy, which is more than you can say for most commentators.
July 8th, 2009 at 8:39 pm
Freddy Back @13 appeal to authority has a huge, pretty obvious problem. Any expatriate is, almost by definition, unhappy with their old homeland.
They most probably have something interesting to say, but are almost certainly completely biased observers. This should be obvious, but if you have doubts, imagine the situation reversed. Would anyone hold an ex-American who repatriated to communist Russia as high authority on American society?
July 8th, 2009 at 8:42 pm
I agree that Hector should not be banned. I’ve enjoyed reading his comments (though often I disagree).
Hector, why not post with a “Hector” variant, preserving your identity somewhat?
July 8th, 2009 at 10:46 pm
What a pathetically embarrassing post with pathetically embarrassing individuals making comments on it. Every time one thinks the Western left has learned their lesson from being so catastrophically wrong on the issue of socialism, one continually has to correct themselves.
July 8th, 2009 at 11:17 pm
Matt: Maybe you need to expand on and maybe re-contextualize, or something, this initial thought. It has that sour, contra-CW for contra-CW’s sake type taste which doesn’t tend to go down so hot. Your post is pretty thin and does not demonstrate much of anything. Maybe you’re just trying to piss people off? or something.
July 8th, 2009 at 11:33 pm
Surely this is written in jest.
July 9th, 2009 at 12:20 am
OK, Castro flew in surgeons from SPAIN!!! And the old joke in my beloved CCCP was that the cardiac specialist’ office was on the fifth floor of a building with NO elevator. If you make it up, you don’t need him.
July 9th, 2009 at 12:22 am
Ah, I see the conservative f*cktard brigade is out in force. You can cite statistics till the cows come home about how Russian life expectancy fell after the end of Soviet socialism, which would tend to imply that they knew what they were doing in the health care front. Doesn’t matter to the f*cktards. They know what they know, and thats that.
I cannot vouch for the quality of Soviet health care but there is no doubt that in Cuba, and in many other socialist countries, health care was excellent (as was education).
July 9th, 2009 at 12:56 am
If you look at overall Russian life-expectancy, you could see that there was a (not very high) peak around 1965, and that there was a downward slide that continued for about 40 years. There were basically two interruptions from the bleakly downward trend line: the 1985-7 period, when there was a bump above the trend, and the 1992-95 period, when there was a dip below it. After the late-ish ’90s, Russian LE was back on the depressing trendline the USSR had been on since the mid-1960s.
http://i263.photobucket.com/albums/ii139/tolsdogg_photo/ru_lifexpct1.jpg
The decline in life expectancy from 1965 to 1980 was smaller than the decline between 1980 and 1995, but not dramatically.
This is, of course, a damning indictment of both the Soviet regime which seems to have given up on improving the lives of its subjects after it kicked Kruschev out until Gorbachev, and of the post-Soviet Russian regime, abetted by crooks, ideologues, and incompetents like Shleifer, Chubais, Yeltsin, who made things worse.
I think, though, that the story of health in the USSR/Russian Federation in the transition from communism to capitalism is one of “bad to worse,” not one of “perfectly decent to bad,” as MY implies. Cuban health care is perfectly decent. Soviet education was perfectly decent. Soviet health care was bad.
July 9th, 2009 at 1:51 am
Maybe Matthew got tired of being called a hippie, postmodern, etc. And worse.
Name calling is not civil. Neither are the tiresome invidious remarks about where people live or went to school which appear here regularly. Wny not judge people on their merits instead of resorting to snide personal innuendo and attacks?
July 9th, 2009 at 2:30 am
Speaking as someone who works in a hospital in Europe, I am totally amazed by the ignorance inherent in this debate. France has the best healthcare system in Europe precisely because they have private insurance and the ability to go to private clinics. Why do you think so many wealthy Brits leave GB upon retirement? staying in Old Blighty nearly guarantees that you will be denied care for some kind of problem. Check the breast cancer cure rates to compare, for example.
Might I also suggest that you look at US health and life expectancy rates with immigrants removed from the mix? The US welcomes more immigrants than the next 10 countries combined. This is a good thing, but it does skew the statistics on literacy and healthcare until the following generation. And a final note, even where I work, it is widely recognized that the quality of American healthcare is the best in the world–even if there are problems with the model.
July 9th, 2009 at 2:47 am
I’ve had significan personal experience in Russian hospitals. They are extremely scary, and I would be extremely surprised if any American would be happy to stay in one. I’d much rather stick with the expensive, bureaucratic American system.
July 9th, 2009 at 4:43 am
this is really stupid article, even by this blog standards. soviet health care was nightmarish, ridden with bribes, corruption, incompetence, negligence, antisanitary
conditions and malpractice. i grew up in it.
second, all soviet time statistics, without an exception, are lies, from the first to the last word.
July 9th, 2009 at 4:48 am
and, anyone who praises cuban health care system, should talk with actual cubans. from what i heard from them, it is even worse than the soviet one, and by far – and no wonder, it was modeled after it and built by soviet “experts”.
July 9th, 2009 at 6:08 am
I vaguely recall the Trotskyite club back in my university days. They would run around the campus telling everyone who would care that the health and education systems in the Soviet Union were superior. Amazingly, they did so in the mid 1990’s, after these two systems – that never functioned all that well in the first place – collapsed completely. Back then, as a recent Russian arrival, I was astounded at the levels of ignorance. I still am.
July 9th, 2009 at 11:04 am
[...] When smart people write really stupid things. [...]
July 9th, 2009 at 12:59 pm
#26 Naomi Klein’s book “The Shock Doctrine” has a good history of the Chicago School misadventures around the world.
ron, any book which describes the Chicago School folks and Milton Friedman as “neocons” (the equivalent of describing southern Baptists as “social liberals”) deserves to be utterly ignored. Anyone who, like Klein, dishonestly and repeatedly describes Friedman as having supported the invasion of Iraq, also deserves to be ignored.
I don’t agree with Friedman (who Paul Krugman described as “a great economist and a great man”) on everything (or maybe most things), but dishonest ideologues like Klein contribute almost nothing to the conversation.
July 9th, 2009 at 1:08 pm
Limiting caloric intact will increase your life expectancy by about 20%.
We need a study to see if being dirt poor with no food but basic vaccines, like in Cuba, is ultimately the most healthy way to live.
Would you volunteer every American to caloric restriction to improve longevity?
July 9th, 2009 at 1:58 pm
Re: Limiting caloric intact will increase your life expectancy by about 20%.We need a study to see if being dirt poor with no food but basic vaccines, like in Cuba, is ultimately the most healthy way to live.
Marc,
Er, wrongo. Cuba had a life expectancy higher than the US way back in 1989, before the Special Period, when the average caloric intake was high (I believe above 3,000 per day, but I’d have to look that up). And anyway, the restructuring of Cuban agriculture over the last 15 years did much to address the problems of the special period. It isn’t an especially malnourished country today. See the FAO country summary:
“In the last MICS survey of 2000, the prevalence of malnutrition among pre-school age children, based on the three main anthropometric indicators, was below 5% at national level, with minimal differences among regions. The highest prevalence rates were see in rural areas and in the Occidente region where stunting was 7%. These remarkably low percentages of child malnutrition put Cuba at the forefront of developing countries.”
July 9th, 2009 at 2:16 pm
3000 calories?
I assume they must of had an obesity epidemic, any pictures lots of fat cubans sitting around smoking cigars?
I forgot cigars are only for party elders and export.
Any pictures of lots of fat cubans from the period?
July 9th, 2009 at 2:18 pm
You of over looking the fact that the USSR’s ability to supply those services were unsustainable. Sure the US government could offer free top notch health care, free college and a puppy to everyone in the country for a few years, but then what?
July 9th, 2009 at 5:49 pm
You are all idiots. I used to live in USSR and know first hand its health system. God help us all if we have it here. No, even he wouldn’t help. Anyone of you at least looked at their life expectancy???!!! And if you want to know the examples of how the system works read “Novoya Gazeta” (there’s an english version as well) and follow the story of a little boy of 10 who recently died and why.
July 9th, 2009 at 6:37 pm
“Socializing certain sectors of the economy really is a no-brainer.”
That is correct – it is indeed a no-brainer, for anyone using their brain would say “Oh hell no” or perhaps if they were more polite, “Oh, no hell for me please”.
July 10th, 2009 at 2:25 pm
Didn’t the Soviets boast 100% employment also? Even though they were all broke unless they were a party official.
July 10th, 2009 at 4:26 pm
Didn’t Mussolini’s trains run pretty well?
No, actually they didn’t. He just roughed up or imprisoned anyone who reported otherwise.
July 10th, 2009 at 4:35 pm
Cuba had a life expectancy higher than the US way back in 1989,
Correction: Cuba reports a higher life expectancy than the US. See the question about Mussolini’s trains above.
July 14th, 2009 at 3:25 am
Good god, I shudder to think of the education that produced this kind of thinking