Strange Criticisms of French Health Care
Eiffel Tower, Paris, France (wikimedia)
As every good conservative knows, France is bad and universal health care is bad. This the sneering condescension in this Dennis Boyles post at the Corner must secretly make sense:
A couple of things you can learn if you’re in France:
First, the meaning of “universal.” It doesn’t mean what you think if you’re a poor person in France, where “universal” health care is arguably better than elsewhere in the EU. It means about 75 percent. Le Parisien reports this morning that, as in the U.S., the more money you have the better care you get. Shocking. The paper backed up a recent study with a small-scale sting of their own and discovered that if you rely on France’s medical insurance alone, 25 percent of French doctors will refuse to treat you. That’s how you say ObamaCare in French.
For one thing, Obama’s proposed reforms—unfortunately—wouldn’t actually make American health care much like French health care. That said, the moral of the story is that in France no matter how poor you are, or what pre-existing conditions you have, or what happened to your job amidst the latest recession, or whatever else if you get sick 75 percent of doctors will treat you and the government will pick up the tab. In the conservative free market utopia, as I understand it, what would happen to you is that you would just die.*
The reality is that France provides a very high standard of health care to its citizens:
Some researchers, however, said that study [from the WHO, proclaiming French health care the best in the world] was flawed, arguing that there might be things other than a country’s health care system that determined factors like longevity. So this year, two researchers at the London School of Hygiene and Tropical Medicine measured something called the “amenable mortality.” Basically, it’s a measure of deaths that could have been prevented with good health care. The researchers looked at health care in 19 industrialized nations. Again, France came in first. The United States was last. [...]
“There are no uninsured in France,” says Victor Rodwin, a professor of health policy at New York University, who is affiliated with the International Longevity Center. “That’s completely unheard of. There is no case of anybody going broke over their health costs. In fact, the system is so designed that for the 3 or 4 or 5 percent of the patients who are the very sickest, those patients are exempt from their co-payments to begin with. There are no deductibles.”
There’s a lot that could be said about the relevance of France’s success in health care policy to the American debate. But to argue that the French system is unsuccessful is totally untenable. And to argue that it’s somehow worse for the poor than America’s “good luck with that!” approach is ridiculous.
* Now in the current American status quo you might be able to sign up for Medicaid (socialism!) or else go to the ER and get some unpaid-for health care once your condition deteriorates enough. But it is worth being clear that the free market solution to someone being poor and sick is for them to die. If you’re too poor for HBO, you go without watching True Blood. If you’re too poor for a MacBook Pro, you make due without one. And if you’re too poor for statins you get a heart attack. And if you’re too poor to get your heart attack treated you die. Whether or not anyone in the United States actually wants to implement such a system isn’t clear to me, but that would be what a free market health care system looked like—like free markets in other things.
67 Responses to “Strange Criticisms of French Health Care”
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July 13th, 2009 at 5:34 pm
you know, if conservatives like Dennis Boyles didn’t exist, it wouldn’t occur to anyone to invent them.
July 13th, 2009 at 5:42 pm
The fewer links National Review gets, the sooner it dies.
Aren’t there any honest critiques that could be linked?
July 13th, 2009 at 5:44 pm
71% of American doctors accept Medicare.
July 13th, 2009 at 5:48 pm
So, does dumbass not know what “coverage” means, or does he not understand percentages?
July 13th, 2009 at 5:49 pm
First, the meaning of “universal.” It doesn’t mean what you think if you’re a poor person in France, where “universal” health care is arguably better than elsewhere in the EU. It means about 75 percent. Le Parisien reports this morning that, as in the U.S., the more money you have the better care you get. Shocking. The paper backed up a recent study with a small-scale sting of their own and discovered that if you rely on France’s medical insurance alone, 25 percent of French doctors will refuse to treat you. That’s how you say ObamaCare in French.
The willful ignorance here just kills me. Treatment from “only” 75 percent of doctors – does *anyone* in this country have health insurance that good? I have pretty good insurance coverage, and it’s not even close to that. Just bizarre.
July 13th, 2009 at 5:50 pm
And if you’re too poor to get your heart attack treated you die. Whether or not anyone in the United States actually wants to implement such a system isn’t clear to me…
Speak for yourself, Yglesias, you commie bastard. EVERYBODY knows death is good for you. It builds character. Which apparently liberals like you care not a fig about.
July 13th, 2009 at 5:55 pm
The paper backed up a recent study with a small-scale sting of their own and discovered that if you rely on France’s medical insurance alone, 25 percent of French doctors will refuse to treat you.
Meanwhile, if you’re an American poor person without insurance and walk into an American doctor’s office asking for free treatment, about 99% of American doctors will refuse to treat you.
July 13th, 2009 at 5:57 pm
Wow, just wow!
It seems that he thinks “universal health care” means getting treatment from every doctor, rather than everyone getting treatment. How did this guy graduate high school?
As other commenters have pointed, how many of the great private insurers will pay the full cost of treatment for more than 75% of doctors? Are there any?
July 13th, 2009 at 6:00 pm
A few days ago Megan McArdle wrote one of her periodic posts on how US healthcare is so awesome in comparison with European:
I guess the following fall among the figures she doesn’t really trust:
July 13th, 2009 at 6:00 pm
The problem with American health care is that we use too much of it. The way to use less is to die early. If poor people were true patriots, they would die happy. If they don’t do that, they are sniveling traitors, and they deserve to die.
Rich people on the other hand can afford to pay for their own health care, so when they get treatment it’s a contribution to the GDP and good for the country. So they’re patriotic, too! Kind of like the Circle of Life, where it doesn’t matter if you eat or get eaten, it’s all good.
July 13th, 2009 at 6:01 pm
It seems that he thinks “universal health care” means getting treatment from every doctor, rather than everyone getting treatment. How did this guy graduate high school?
Although there’s plenty of stupidity observable on the right today, my guess is this particular winger doesn’t “think” this — but rather, he’s lying. But what’s a few lies in the service of saving the country from socialism?
July 13th, 2009 at 6:02 pm
The free market utopia vision assumes that some form of charity would step in to prevent people from “just dying”. That might not be a realistic expectation, but that is the expectation.
July 13th, 2009 at 6:03 pm
That’s a metric fucktonne of bullshit from Boyles.
The Le Parisien story — about people who earn less than EUR 621 a month, and so are covered by the CMU — makes a few points. First, that this kind of up-front discrimination is illegal, and that the government needs to crack down on it. Second, that the majority of refuseniks are specialists who can set their price freely, but can only claim the standard tarif. Thirdly, that there’s an element of class (and implicitly race-based) discrimination involved: “Il s’agit des praticiens dits du secteur 2, autorisés à fixer librement leur prix, en premier lieu des spécialistes, souvent installés dans les quartiers huppés.”
So, even with this kind of two-tier treatment, emergency room and primary care remain open to all. The issue is primarily one of specialists — the French consider it a basic right to see specialists of their choice without a referral — where CorporateProfitCare in the US already bars the door.
It’s really not that different from the story a month ago, where a Canadian women is suing for her province to pay for her treatment at Mayo Clinic, and American wingnuts think this means Canada sucks.
July 13th, 2009 at 6:05 pm
And, dammit, they SHOULD be happy, since they have all those kindly conservatives looking out night and day for their interests!
July 13th, 2009 at 6:09 pm
Boyles has just pointed out that far from “rationing” health care or limiting people to one standard of mediocre service while forcing a substandard rate upon providers at the barrel of a gun, under a universal health coverage like France’s, doctors and other medical professions would be free to refuse to accept the government plan and its rates and either charge their own fees due out of the patient’s pocket or bill supplemental insurance providers?
So, Boyles has, in other words, proven that conservative critiques are a lie.
Well, that was fun.
July 13th, 2009 at 6:12 pm
Can the French really get good health care anywhere in the Universe? Huh? Huh? Never thought about that, did you? NR wins the debate, again.
July 13th, 2009 at 6:12 pm
Re: Meanwhile, if you’re an American poor person without insurance and walk into an American doctor’s office asking for free treatment, about 99% of American doctors will refuse to treat you.
The problem isn’t so much with the poor in the USA– they can get Medicaid, though they may have trouble finding doctors who accept it. The uninsured aren’t generally poor, they usually are working or even middle class people whose employers don’t provide it. And secondly even many people who do have health coverage have such crappy coverage that they are still exposed to massive debts if they have suffer a major illness of serious injury. Some conservatives tout the idea of universal catastrophic coverage to at least cover everyone in case of major healthcare costs. But the US insurance system does a very poor job in that area: “catastrophic” often applies to the subscribers’ finances after their still-quite-pricey catastrophic policy refuses to cover their costs in full.
re: The free market utopia vision assumes that some form of charity would step in to prevent people from “just dying”. That might not be a realistic expectation, but that is the expectation.
It actually is fairly realistic, although “charity” doesn’t mean that people aren’t still dunned for unpaid bills and driven to bankruptcy. Yes, they get healthcare in extremis, no one is just left to die, but there’s no such thing as an unpaid bill and even “charity” is coming out of someone’s wallet.
July 13th, 2009 at 6:20 pm
Boyle misrepresents Le Parisien’s reporting. He claims: “..if you rely on France’s medical insurance alone, 25 percent of French doctors will refuse to treat you.” Not so. Le Parisien’s reporters found that the doctors wouldn’t treat patients covered by the CMU, a special type of cover for the unemployed and indigent. Everybody else in France also has public medical insurance, provided through a range of different Caisses, mostly employment-based. Many employers also provide workers with private complementary medical insurance that often picks up surcharges by doctors. So the Parisian doctors weren’t turning away patients with public medical insurance, even ones without such complementary insurance; they were turning away poor people more likely to be smelly, lower the tone of the waiting room, not keep appointments, and speak bad French.
July 13th, 2009 at 6:24 pm
There is a disaster/tragedy. Rolling up to the scene comes the police, the fire department, and some EMT’s.
If the first two save your life, you pay nothing, your taxes already cover it. But, if the third one does, you have to pay.
Makes perfect sense, right?
July 13th, 2009 at 6:30 pm
How about India Care? India is pretty much the most fucked country on the planet. But a dalit beggar can walk into a clinic with a broken arm, and they set it and give him a cast. What does it cost? Well, they don’t really operate that way. They treat people in need, and find the money somehow. I have no idea where they come up with that money, my donations surely aren’t enough. And the government gives them less than they need. But they do come up with the money to keep going. I’m guessing Catholic charities make up the difference. Who knows? But it doesn’t matter, a man with no money can get treatment. And when we talk about no money, understand that we’re talking about people who live on 20 cents a day. Eating is a challenge for these people. But they can get medical care. Granted, if they get cancer, they don’t get chemo. But neither will I.
July 13th, 2009 at 6:31 pm
to complete the rebuke: “le parisien” is the local newspaper of, guess which city?
Paris.
I would venture their house-made enquiry is centered on Paris, with the most expensive real estate, and the most competitive and rat-race prone specialists. The number are likely better than 70%”en province” for the specialists, and anyway I would expect that over 90%, maybe 95% of the GPs accept people with the basic coverage CMU.
July 13th, 2009 at 6:46 pm
I just think a country of our wealth and sophistication should allow immigration. That has been the way it’s worked for hundreds of years. For the US to cut off immigration to prevent the Social Democratic state from failing is a greater injustice than people dying of catastrophic conditions that would likely kill them with or without care.
July 13th, 2009 at 6:52 pm
Maybe for Sasha Baron Cohen’s next film, he can play a Frenchman looking for health care in America. Have him walk in to clinics around America and ask for treatment for something or other. My guess is that more than 25% would refuse him.
July 13th, 2009 at 6:59 pm
“Il s’agit des praticiens dits du secteur 2, autorisés à fixer librement leur prix, en premier lieu des spécialistes, souvent installés dans les quartiers huppés.”
Brother, you said it. Ain’t that the truth.
July 13th, 2009 at 7:00 pm
The problem isn’t so much with the poor in the USA– they can get Medicaid, though they may have trouble finding doctors who accept it.
You know, it’s not even the case that you can get Medicaid if you’re poor. The states put up a lot of hoops and hurdles, and many who should be eligible in theory never receive coverage in practice.
July 13th, 2009 at 7:04 pm
“I just think a country of our wealth and sophistication should allow immigration.”
Um, we do. My family may have come here in the 1720s, but we’re still immigrants. We fought the war that created this country, but we’re still immigrants. How many of you have actually met the people who originally lived here? Not many, I’m guessing. I have, and I have a Lakota name to go along with my Anglo-Saxon name and my Celtic name. My soul has a name too, but I can’t pronounce it. This is America, and we’re a bunch of immigrants who were kicked out of other countries. We may not like the Mexicans coming to our neighborhood, but nobody liked the Scottish coming in back then. And they liked the Irish even less. But we blended in eventually, and so will the Mexicans. This is nothing new.
July 13th, 2009 at 7:56 pm
If being poor didn’t put you in danger of premature death, then no one would have any incentive to make money.
July 13th, 2009 at 8:01 pm
My mom is from France. When my cousin had an emergency delivery of her son about 5 years ago and things were touch and go for both her and the baby, she got top notch care. The kind of surgery and care my cousin received would have bankrupted people here.
My cousin, her boyfriend, the rest of my family did not have to think twice about bills or costs, ect. Only about her and the baby and getting well.
I had surgery a couple months ago and had to rush having it because we were looking at possibly losing our insurance and needed to have this done before hand and I had to forego another one that we originally were going to do at the same time because of insurance.
And republican sneer at France…
July 13th, 2009 at 8:12 pm
In NZ we have a state-owned health care insurer who funds all care related to workplace and sporting accidents called ACC (We also have free public healthcare but ACC has similar structure to a private insurer). ACC consistently operate with costs around 12% of claims paid.
Our major private insurers operate with a loss ratio (claims/premiums) of 80% (similar to the US). Therefore have profits and operating costs of 25% over claims paid.
The point is that private healthcare is very inefficient at turning premium money into healthcare. State-owned insurers, if well managed and regularly audited, can provide much more healthcare for less money.
July 13th, 2009 at 8:15 pm
Just thought I should point out that with university health insurance in Los Angeles, I drove to an urgent care center just this Sunday and literally drove past more than one urgent care center that weren’t in network — that is, they’d “refuse to treat” my not-poor self with American health insurance. Only being turned away by 25% of providers would be a dream for most Americans, to say nothing of the poor!
July 13th, 2009 at 8:17 pm
Unless every American can get health care, there is no reason why any American should get health care.
July 13th, 2009 at 8:22 pm
I’ve lived in Canada, America and France.
The USA is the only one where I expereienced treatment was refused without money up front.
In Canada and France its the physician/hospital that diagnoses you and determines the necessary course of action.
In the US its too often insurance company bean counters who impersonate doctors.
Great care in the US, no doubt, if you are rich or insured. If not, tough, wait until you’re 65 and qualify for Medicaid or whatever its called.
July 13th, 2009 at 8:47 pm
Re: You know, it’s not even the case that you can get Medicaid if you’re poor. The states put up a lot of hoops and hurdles, and many who should be eligible in theory never receive coverage in practice.
As a rule though anyone who really needs healthcare can spend down their assets until they qualify as poor*. Hospitals even employ social workers who will guide people through the process (hospitals after all want to get paid). Moreover the recent stimulus bill extended Medicaid to people who are laid off and for whom COBRA is not an option– in fact I’ve never understood why coverage for the unemployed was not made an automatic qualification for Medicaid right from the start. Even in 60s I can’t imagine why the insurance companies would have objected since unemployed people tend not to have enough income to buy insurance. But all in all, nothing better describes the whole shuck-and-jive dance people have to go through with the system than just plain old “fucked up”
.
* This assumes of course that said people are not working, though most really sick people aren’t. Sometimes if a spouse is working a divorce may be necessary. I don’t usually swear on blogs, but the only way I know to describe this system is indeed “fucked up”.
Re: How many of you have actually met the people who originally lived here?
Oh, good grief, if you mean people who lived here in 1492 (or maybe 1607), then none of us have. Those folks have been dead a long, long time.
I was born here so I do not consider myself an immigrant. Which makes abundant sense. Otherwise we’re all immigrants, including the so-called natives– their ancestors came from elsewhere originally too. The only place where humans are really, truly native is eastern Africa.
Re: Unless every American can get health care
Every Ameican can get healthcare– but too many of us are left with horrible, unpayable bills afterward. Universal healthcare in the USA involves bankruptcy court as an integral part of the system.
July 13th, 2009 at 9:07 pm
In the conservative free market utopia, as I understand it, what would happen to you is that you would just die.
As another commenter has said, in the free market utopia, you presumably fall back on charity. Maybe you believe that in the absence of government-provided care, charity will be insufficient to provide for health care for those who cannot afford to pay for it, and you may be right, but your accusation is dishonest on its face.
July 13th, 2009 at 10:06 pm
Health care is interesting. If you have nothing to lose, you really have nothing to lose. But if you have money, you won’t have it anymore if you want treatment. It’s possible that you might have half your money if you have good insurance. But who knows what good insurance is? It might seem good now, but how good is it going to be thirty years from now when you really need it? Don’t know that, do you? I have no insurance and I have a simple plan when I’m in a hospital: Want me to sign that? I’ll have my lawyer look at that first. He’ll get back to you in a few weeks, but you will treat me now. And that price you’ll charge me? Cut it by two thirds like you do for the insurance companies. Do that, and I’ll pay it next week. Don’t do it, and I’ll pay you three years from now after a nasty court battle. When you self-insure, you have to be ruthless. And let’s face it, you have the edge in the fight when you’re bleeding all over their desk. They really do what you out of their space.
July 13th, 2009 at 10:08 pm
It seems pretty clear that charity is insufficient since so many people who cannot afford to pay for healthcare die from lack of it. And it also seems pretty clear who is really being dishonest.
July 13th, 2009 at 10:17 pm
Well, this has all been very entertaining. (And I agree with pretty much everything here, at least in general.) But the piece that precipitated this entire thread is so deliberately mendacious, and so cynically slanted (and, as everyone has demonstrated so well, so easily refuted) that it occurs to me that the right wing free market idealogues must have developed a new type of contest to see who among them can advance a perfectly ludicrous free-marketeer talking point and yet festoon it with enough rational-sounding strands of argument that it almost–almost–stops smelling like shit for a brief second.
And of course, that’s all it is. Bad-faith arguments, cynically constructed; trivial flights of fancy advanced with the seriousness of death. These clowns need to be emptying bedpans in a nursing home,working for a $10-per-hour nurse’s aide who’ll run their asses ragged, and hopefully despise them as much as they already clearly despise her and her peers.
July 13th, 2009 at 10:18 pm
Can you stop bleeding on my desk? No, I need a doctor for that. In fact, that’s why I came. If Kafka didn’t write my hospital experiences, I don’t know who did.
July 13th, 2009 at 10:20 pm
Glaivester, they may as well be expecting a cleric to pop out a fucking D&D book and cast cure light cancer on them.
It’s either an insane argument or a dishonest one. In either case, it’s an assumption that is itself an inherently dishonest attempt to avoid the fact that death is the logical outcome of their proposed policies.
July 13th, 2009 at 10:49 pm
“Meanwhile, if you’re an American poor person without insurance and walk into an American doctor’s office asking for free treatment, about 99% of American doctors will refuse to treat you.”
I don’t think this is true.
Back in the late 1990s, my cousin, who lived with me at the time, had a job. It did not provide insurance. He could have afforded it, but he chose to buy beer with the money instead. Which was a ton of fun until he had some kind of weird bowel problem which required major surgery and a 30-day hospital stay. He lost his job. He was completely destitute.
But they did the surgery and did not charge him a dime for his care.
Last year I was working on a landscaping crew. One of the guys, a 45-year-old heavy drinker/smoker type up and had a heart attack. He went to the hospital and, since he was poor and had no insurance, they kicked him in the nuts and tossed him out into the street…
Wait. No. They performed an angioplasty for free, gave him a week of free hospital care, and a boatload of free medication.
They didn’t charge him a dime.
Our system really might not be the most rational one in the world. But if you get sick and go to a hospital, someone will take care of you. At least that’s been my experience.
July 13th, 2009 at 10:49 pm
“The only place where humans are really, truly native is eastern Africa.”
Fair enough, but I’ll put a five thousand year limit. If your culture is five thousand years old, you get to stay there. If you’re not, you’re a bunch of wetbacks like me. And if your ancestors didn’t fight in the Revolution, don’t even think about claiming to be American. Unless you’re native.
Obviously, I’m joking here. But really, what right do recent Americans from Europe have to say that nobody else can come here? You came here when my family had that same right. And we let you in. You didn’t fight the Revolution, but my family did. And you want to say that people can’t come here when you did? We are a nation of immigrants, and that’s a beautiful thing. And guess what? Like always, we won’t actually like the newcomers. I have an “Irish Need Not Apply” sign, and I’m Scots-Irish. I enjoy the irony. And I recognize that I am an immigrant just like everyone else. You should too.
July 13th, 2009 at 11:04 pm
“And we let you in.”
That a concept that so many Americans don’t get. If my ancestors had an anti-immigration attitude, you wouldn’t be here. Because we wouldn’t have let you in. And let’s face it, most Americans are descended from people who came here after the Revolution. I’m one of the rare ones who aren’t. But I’m no better than anyone, and I have no problem with people coming here. But I do have a problem with people who think the door needs to be shut just after they go through it.
July 13th, 2009 at 11:04 pm
If health care was baseball France would be leading the majors in batting average, homers, and RBI’s -on their way to a Triple Crown.
The United States would be a talented but fatally flawed Double A player who is destined to spend his remaining days riding buses in the Bush Leagues.
July 13th, 2009 at 11:23 pm
Glaivester, they may as well be expecting a cleric to pop out a fucking D&D book and cast cure light cancer on them.
It seems pretty clear that charity is insufficient since so many people who cannot afford to pay for healthcare die from lack of it. And it also seems pretty clear who is really being dishonest.
I’m not denying that some lifesaving treatments would be denied. My objection was that I was interpreting Matt as saying that those who can’t afford it will get no health care at all (e.g. if they are taken into the emergency room with a heart attack the doctors will shut the door and let them die).
July 13th, 2009 at 11:27 pm
But really, what right do recent Americans from Europe have to say that nobody else can come here? You came here when my family had that same right. And we let you in. You didn’t fight the Revolution, but my family did. And you want to say that people can’t come here when you did?
Should we let in everyone who wants to come here? That would likely be about a billion people (or even more).
We need to put sane limits on how many people we let in, based on what we can support. It’s not that we need to shut the door, but leavng it completely open to everyone only make sense if you don’t believe in borders and don’t want us to have a country.
July 13th, 2009 at 11:49 pm
“Should we let in everyone who wants to come here? That would likely be about a billion people (or even more).”
Yes. It’s already happening anyway. In fact, a lot of Mexicans are moving back to Mexico because there aren’t any jobs here. The Chinese seem to be staying, but they paid a lot more money to get here. They have more sunken costs. And the know how to work the identity thing better. It seems the Chinese never really die, someone else just takes their identity.
July 13th, 2009 at 11:54 pm
Steven Says:
July 13th, 2009 at 6:02 pm
The free market utopia vision assumes that some form of charity would step in to prevent people from “just dying”. That might not be a realistic expectation, but that is the expectation.
————————
The problem with this theory though is that the modern conservative movement is also chock full of Rand enthusiasts, which believe altruism is a sin.
So we go back to the original premise of the free market. You don’t have a right to anything you can’t buy. Can’t afford healthcare? Pray. or Die.
July 14th, 2009 at 12:14 am
A rare spelling error from Matt:
“Make do”?
July 14th, 2009 at 12:44 am
@45 Sam M wrote:
Our system really might not be the most rational one in the world. But if you get sick and go to a hospital, someone will take care of you.
The reason that your cousin and your co-worker received care was due to the fact that they had life-threatening injuries and would have died if the ER had not treated them. Hospitals have a duty to act when presented with such cases and while they may try to get payment in most cases it is a complete write-off for the hospital which they recover by padding the cost for other services (e.g. passing the cost to those patients who were insured.) This is also why ERs across the country are overwhelmed with cases and losing money hand over fist: the uninsured basically have to wait until their health deteriorates to the point where the ER is forced to treat them and then hope that they do not die in the process.
One thing that you can be certain of is that your cousin and your co-worker did not receive any long-term post-operative care. After reaching the point where your co-workers health had stabilized he was turfed out and would have had no access to statins, ACE inhibitors, beta-blockers or other drugs that would prevent another heart attack. Odds are he is dead now.
July 14th, 2009 at 1:20 am
Okay, so fostert does not believe in such things as countries and borders. I’m glad we cleared that up.
He also would have no problem with the U.S. being flooded with a billion desperate third-worlders, to the point where the country collapses (which is what would happen with no immigration restrictions whatsoever).
July 14th, 2009 at 1:21 am
The problem with the “appeal to charity” (a fave of glibertarians) is that it’s basically an appeal to capricious personal judgement. Doctor had a good day, feeling like he’ll dip into his pro bono quota? You’re in luck. Doctor had a shitty commute? Bankruptcy awaits. Go to the First Baptist Church of North Bumfuck? The congregation will pass the hat for your kidney dialysis. A regular at the Second Baptist Church of South Bumfuck? Sorry, there was a kidney appeal just a few months ago, and everyone’s got giving fatigue.
It re-establishes master-servant relationships and standards of “worthiness” for assistance. It’s not much different from the glibtard argument that it’s somehow morally preferable for restaurant servers to be paid $0.95/hr and work for tips than be paid a decent base wage.
July 14th, 2009 at 1:35 am
evgen is right. To put it bluntly, the best way to show up at a hospital is unconscious and bleeding. They don’t worry about money or insurance forms at that point. But if they can charge you on the back end, they’ll charge you three times as much. They expect two out of three of their patients to skip out, and if you’re that third one, you have to pay for those two who skipped out. Unless you have a lawyer. Then you pay for yourself, one other guy, and your lawyer. I’d kill myself, but I don’t think I can afford it.
July 14th, 2009 at 1:41 am
“Okay, so fostert does not believe in such things as countries and borders. I’m glad we cleared that up.”
Not at all, I simply believe that if you are here, you should understand what it is to be American. And that means you fake your identity until you get citizenship and then start complaining about everyone who isn’t a citizen. Just like everyone else. Granted, my family took a different approach, but America wasn’t a country back then.
July 14th, 2009 at 1:53 am
“which is what would happen with no immigration restrictions whatsoever”
Umm, there are no restrictions now, only shipping fees. And somehow, we haven’t collapsed.
July 14th, 2009 at 2:17 am
Of course, we outperform the rest of the world in every measurably way when it comes to healthcare, because we’re just inherently better human beings. Don’t ask us to explain it or prove it, it just IS. Funnily enough, we will suck just as much as everybody else if you ask us to actually try to implement some form of universal healthcare or government safety net. THAT, we just can’t do, and shouldn’t even try. — Conservative movement
July 14th, 2009 at 2:35 am
Tangentially, we now have evidence that Matt is telling the truth that he’s reading infinite jest. The casual footnote in his writing is a dead giveaway.
July 14th, 2009 at 7:38 am
One way of interpreting Matt’s point is that almost no one is really willing to defend a free-market system for health care, and I think this thread is a good illustration of that fact.
A federal law, the Emergency Medical Treatment & Labor Act, requires hospitals participating in Medicare to provide emergency medical services to the public regardless of the ability to pay. Accordingly, the resulting unpaid treatment isn’t charity, but rather it is a legal obligation. Therefore, to the extent people are relying on this unpaid treatment to answer objections to their health care policy preferences, they are not really defending a purely free-market system.
July 14th, 2009 at 8:31 am
c’mon fostert
we all know most of your ancestors were loyalists and the one who was a patriot ended up siring a line of confederates
July 14th, 2009 at 8:45 am
NRO always proves that Conservatism is a disease of the mind, a rotting of the heart, a wasting of the soul.
July 14th, 2009 at 9:44 am
I have big fancy-pants federal employee insurance from a big health insurance company and if I try to go to the Dr. using only that insurance, MORE than 25% of them would refuse to see me. (or they’d see me and charge me way more to pay in cash than they’d get from any insurance company). Many are not preferred providers in the big PPO network. it would be an even higher number if I were in the HMO version of this insurance. So, someone with some of the best coverage available to an American has fewer choices than a poor french citizen. Awesome. Way to advocate your position, Boyle. imbecile.
July 14th, 2009 at 9:54 am
[...] Matthew Yglesias offers perspective: [...]
July 14th, 2009 at 9:54 am
If you’re too poor for HBO, you go without watching True Blood. If you’re too poor for a MacBook Pro, you make due without one.
This is a point generally worth noting about free markets and the claim that by making the market “free-er”, i.e. by removing the tax break for employer-provided care and throwing everyone into the individual market is the way to achieve universal or near-universal coverage. Where supply meets demand is not the point where everyone gets to buy a product or service. Rather, it’s the lowest price at which producers can clear their marginal costs. No matter where that intersection happens, there are people priced out of the market. Not everyone gets a TV or a car. So they make do without or find a cheaper substitute, etc.
The question is whether we, as a society, want people to be priced out of health care. The GOP doesn’t want to actually say that this outcome is actually OK with them.
July 14th, 2009 at 11:07 am
My dad was hit by a drunk driver 35 years ago on his way back from work in France. Since it was a work related accident, the French Social Security has paid since and for life his salary at 100 % re-adjusted to the cost of living every 6 months. They give a full time salary to my Mom to take care of him for life, they pay for doctor’s visits (at home), medication, hospitalizations, taxis costs to and from eye doctors, dentists, etc. They pay for half of their rent, they pay half of their moving costs if they want to move home. Nurses, physical therapists, home help come daily and are paid by the Social Security.
Of course, the draw back is that France does not send people to the moon and gas is about $ 7.00 a Gallon but we do not need to go to war to steel it from Iraq or others.
France consider Health Care and Education as a Human Right (not a source of profit. How can one be free if he has to pay for the education he needs to appreciate freedom and democracy ?
A doctor visit in France cost 20.00 Euros, and free if you can’ afford it. In the US a basic doctor visit in San Francisco is $ 280.00.
Until the People of the United States understand that those should not been considered as a source of profit but instead as a basic human need/right. Nothing will change. The philosophy “Anything to make a buck” must end here in order for care to prevail.
At least, as we hear all other the country god bless America so he will pay or medical bills
July 14th, 2009 at 11:47 am
The problem with the “appeal to charity” (a fave of glibertarians) is that it’s basically an appeal to capricious personal judgement.
But that’s just a collective action problem. Advanced societies have already solved many collective action problems – the solution is called “taxes”. You collect them from everyone regardless of their mood and then do what needs to be done. Everyone pays a fair share of the burden (if your tax system is set up properly) and the collective disaster (foreign invasion, lack of drinkable water, people dying in the streets, global climate change) is averted.
You can readily imagine the fate of a country that relies on voluntary contributions for its national defense. There actually used to be countries that relied on the free market for water infrastructure – this was useful in discovering the etiology of cholera because some water providers were more tainted than others. Of course that discovery came at the cost of lots of people dead of cholera, which is one reason free-market water infrastructure can now be found only in the history books.
Taxes are unpopular – with people who wanted to free ride. They don’t want the free rider problem solved. Or with people who don’t believe the problem exists, don’t believe that it is a problem, or think the cost of action exceeds the cost of inaction. Nobody seems willing to advance any of those propositions with regard to the problem of people dying from inadequate health care (except Adam Kotsko @27, but I think he’s joking).
July 14th, 2009 at 1:39 pm
Sam M is lying through his teeth if he claims his cousin was treated for free at thte emergency room. They cwon’t turn you away, but they WILL send you a bill ranging from $10′000 to $100′000.
July 14th, 2009 at 7:10 pm
This is about as disingenuous as claiming we treat people without health care. Would we be doing more positive good in the world by allowing more immigrants to come here, or by giving everyone universal health care? I’m fairly sure that we can’t afford both. This begs the question “Do liberals really care about altruism and social welfare?” I’m beginning to think it’s more a matter of I want your money, and I will use whatever justification I can think of to take it.
July 19th, 2009 at 10:06 am
Just cant stop my self to comment on your blog. Good post.