The French are striking again... But they do have socialized health care

In all fairness, what have you seen from me on this board regarding the ridiculous amount of debt the Bush administration has saddled us with and what I believe it means for the oncoming recession when the dollar sinks so low that foreign investment can no longer prop us up? You'd think from a comment like that, that I am inconsistent about this stuff somehow. Stupid is stupid, whether it is the U.S. running $600 billion wars at a time that we were cutting taxes... or potentially taking nearly 20 percent of its enormous GDP and placing it under government auspices.

To put it in perspective, though, our war spending has been about 1 percent of our GDP (we are however borrowing heavily to forgo paying for it, so if you evaluate it fairly, you have to conclude that if we put the future payments into current dollars, we may be spending more like 2 percent of our GDP. It's part of the problem. Those payments are going to be like an anchor on our economy. It's sort of like running a health care system and putting off paying for what you are consuming until later).

I think it is already having bad consequences for our economy and it is more a matter of when than if when predicting the nasty recession we have created for ourselves. Now consider what I think government spending the equivalent of nearly 20 percent of our GDP would do to our economy. To me, it's like trying to recreate 1970s Eastern Europe. Of course we won't do that. We'll get political false promises, a series of bad decisions, a crappy system that leaves everyone dissatisfied and a debt level that doesn't totally decimate our economy but creates some major headaches.

 

Stoney, I certainly didn't mean to imply that he didn't say that. When I discuss this, though, I prefer to compare apples to apples. What the British have is not what the Canadians have. What Canada has is not sustainable. Everything runs through the government, and they have gone into debt and created a false appearance for years by offering what they could not pay for. They are now facing the problem that they have nothing left to mortgage and they have serious problems. Despite the non-arguments I have gotten about this, their system has been failing--each year they need to cut more. They've been living a lie and the lie can't go on. We can't emulate them. They can't even emulate themselves anymore.

The British have a two-tiered system. They pay their X (I think it is in the 10 to 20 percent range, but I am not positive of the exact number) percent in taxes and get a government-run system that doesn't promise the world and doesn't even come close to delivering the world. You get put in a queue for everything, and if you are unhappy with how they have rationed out the care those taxes pay for, you have the right to go to a private system. This means that anyone who can afford to gets private treatment (very often in the United States), because you get placed on ridiculously long waiting lists for most things (can be more than a year) unless it is something acute. One way it has been put into perspective for me (and I am not making this up) is that 22 percent of the time a pizza will arrive faster than an ambulance in Great Britain.

Their government-run system isn't very efficient, and frankly, I personally (although I may be in the minority) would balk at that kind of tax bill relative to what they get in return--I can pay out of pocket here and do much better for my spending, although I understand that doesn't help someone poorer than I am. The NHS almost collapsed 7 or 8 years ago when there was a winter flu epidemic, for example. Brit can confirm that. And although he might be happy, and I know the British in general feel pride that at least what they have is egalitarian (the queue has nothing to do with how rich or poor you are), very few British people really think they have a great system. They are fairly open about acknowledging the fact that the rich get a different system than the poor.

Few people hold up the British system as what we should be emulating, is the main problem. It is usually the unrealistic systems that promise the world, instead of the more sober British approach that at least sort of acknowledges that you have to make choices when it comes to something this expensive. As I asked, are you willing to pay 10 or 15 percent more in taxes, NOT get universal coverage for it--very long waiting lists for everything--and basically have a two-tiered system in which those who can afford it, pay for immediate, private care? It's a choice, I guess. Apparently Brit prefers that way. I have no argument with him. At least the British haven't destroyed their economy, the way the French have, with an unsustainable pipe dream that has stagnated growth.

 

Stoney, Our defense budget is chump change relative to how much of our economy is consumed by health care. Even waging a war, we spend about 4 percent (a bit less) of our gross domestic product on defense (it was down around 3 percent in the late 90s, prior to 9/11). In contrast, total health care spending is around 16 or 17 percent of our GDP right now, and because costs are rising so much faster than general inflation, it is projected to pass 20 percent of GDP within the next 10 years. We have a huge economy compared to a country like Canada. That 20 percent will account for about $4 trillion. It's a ridiculous amount of money. And the crazy thing is that it doesn't even come close to how much we'd need to take care of everyone.

That is $4 trillion we will be straining to spend and get the most out of, with tens of millions (possibly in the hundred million plus range) uninsured if we continue with what we have right now. It's easy to say we are getting gouged. But we have an aging population availing itself of record numbers of innovations, medicines and new technologies that have been expensive as hell to develop. It's just costly--we have more treatments for more things, and we are older and less healthy. We have a lot of inefficiencies built into our backward-ass system of intermediaries. No arguments. But this is not a just simple case of us getting gouged. There is only so much you can squeeze out in cost savings (by giving people incentive to consume less, for example), when you are looking at a shortfall of trillions of dollars to give everyone timely, quality, universal health care. It's an impossibility. And no country has figured it out any better. Don't be fooled. They don't have the huge economies and large population we do. But if you scale it to the size of the country, there isn't an industrialized country that isn't dealing with the same fundamental problem: not enough resources to give everyone everything they need. Some are more honest about it than others and have set up two-tiered systems with rationing and the rich paying for better care than the poor get. Some have run up huge debts to create the appearance of some sort of universal, plentiful, egalitarian coverage. But we are seeing those countries pay the price now, depending on how long they have been doing it. Eventually you have to pay your debts, and worse, when you get people used to the unsustainable and costs are rising twice the rate of inflation, you have a whole lot of splaining to do when the system inevitably starts to collapse and services get cut and all of a sudden it isn't universal and plentiful.

I know I am a broken record. Just being honest and straightforward about something that fascinates me.