Since health care has become the NUMBER ONE domestic issue in the upcoming Presidential elections (and the Republicans know that the Dems are going to use this as a weapon against them), you are going to hear a lot of fear mongering from the Republicans about "socialised medicine!", "Hillarycare!" and other lies, lies, lies. They're going to bludgeon people over their heads about the dangers of offering single payer, universal health care and instead will urge people to keep their private insurance plans so that the insurance and drug company lobbies can continue to rake in their huge profits.

Republicans are going to continue to use fear mongering to keep their illegal war in Iraq going, too, and will doubtless use images of "mushroom clouds" to foment war against Iran before Bush leaves office. They've been very effective in using fear as a tool to subjugate us and will probably do so in the health care debate. Kucinich will need to keep hammering away at their platforms (and those of his fellow Dem candidates) until people realize that he's the ONLY one who's got it right on the health care debate.

But I foresee the continuation of the whole fear thing from the Republicans. Already, their front runner, Rudy "9/11" Giuliani, is using that very tactic as a very effective hammer to propel his campaign forward. 9/11 is their ace in the hole and they're going to use it for everything that it's worth, including health care.

Well, Americans are ready for change, but they can't allow themselves to be duped into continuing to pay mega-bucks into the private insurance and drug companies when they think that they're getting some kind of reform. All we have to do is to look at the sham that Medicare Part D has become. That was just free welfare for Big Pharma.

It hasn't saved seniors one dime. In fact, in many cases, it has cost them more money for the drugs they so badly need, and there are so many confusing plans that many seniors don't want to go through the bother of trying to untangle all of it in order to try to find a good deal. Well, the fact is, none of them are a good deal, especially with the notorious "donut hole" that was written into Medicare Part D.

Look for more false claims on health care. Americans are too lazy or too stupid to realize that they're going to get duped on this one, and will probably vote for a Presidential candidate who won't really change things all that much, if at all. Most folks would rather be left alone to sit their obese butts in front of their 200 channel flat screen home entertainment satellite TV systems and nosh on pop and chips all the while. And then they won't visit their doctors until they're so sick that they need expensive and extensive health care that costs all of us more money than if they'd taken good care of themselves in the first place and made informed choices about their health.

Never forget the primary reason the oligarchs don't want universal health care. It is an essential part of living the good life and they can't stand the thought of laborers and mechanics living the good life. We are supposed to be working - waking hours for room and board.

The number one reason the economically better off don't want health care reform is simply because they believe that there are just too many of us poor in the world. Better off if more of us were just dead, so they desire. 'I got mine!'

I thought privatization is supposed to be "The American Way" and any socialization of domestic need is a threat to the "freedom" of the individual? There are Americans who truly believe this, even those who are lower-middle class. It just makes me wonder if Americans really do deserve to go bankrupt as a result of their health care system because many Americans sure defend privatization, even though the negative results of privatized health care stare them right in the face.

Remember the propaganda blitz that took place in the USA after Michael Moore's new documentary was in theaters? All Mister Moore did was attempt to bring some understanding of what is happening and that there are many ways to change the heath care system of the USA. And he gets treated with contempt by Americans for offering suggestions to them. Increase of taxes may make some Americans feel uneasy but it depends on what most Americans want to have happen with the tax money in their nation. It depends on what is more important domestic or foreign programs and each has his opinion. However, to slander Michael Moore on TV for most people in the world to witness illustrates the American desire not to do anythhing about it but to "debate," "complain," and "argue." These actions will NOT change the status quo of you have/havenot society.

I live in Holland where most domestic programs are controlled by the Government - that is not bad. Some Americans seem to think so but, in my opinion as long as our taxes are going toward the common good of society than that is fine. Most people here agree also not only in Holland but throughout most of Europe as well.

Some Americans may ask, "Why should it mandatory to help the least among us in our society with my hard earned money as it is in nations of Europe?"

Well because it is the right action to do! You do not want to give impression that you are greedy, selfish, and uncaring for your fellow human beings. Do you? Seems like these feelings and personality traits are better left unexpressed. Does that make sense? Perhaps not to some but the point I am making is that socializing domestic programs is not bad. Should the Government be responsible for the care and well-being of its citizens or leave this responsibility up to people who just care more about money than the fact you have an illness?

To ease the cost factors in our medical system the government should allow H1b Visas to visiting foreign doctors. They will do for wages what the H1b Visas did for labor wages in the IT field. We could lower the cost of our medical care if U.S. doctors had to compete with foreign doctors, just like our nurses compete with foreign nurses. Not likely to happen because the other occupation protected by our government is that of lawyers. You know, the guys who make the laws. It reminds me of the Golden Rule. He who has the most gold makes the rules.
Hoa binh

This is a typically wonderful Krugman article, but he starts out with an assumption that's not correct:

"The United States spends far more on health care per person than any other nation. Yet we have lower life expectancy than most other rich countries." This is true, but it does not follow that "these facts would make the case for major reform of America's health care system ... irrefutable."

There's another factor in American society that needs to be accounted for: the vast social/economic inequities which are well known to play a major role in life expectancy. See Michael Marmot's "The Status Syndrome: How Social Standing Affects Our Health and Longevity".

Marmot makes an excellent case that the best way to increase average life expectancy is to flatten out the social structure, assuming adequate income, access to food, shelter, and the like. This is actually a much more damning critique of the American political system than Krugman makes.

However, Krugman's still right in his discussion of the failings of the health care "delivery system."

I despair of ever seeing true national health care in this country.

The reason is that the the problem is much more than just "we need national health care". There are several interlocking fundamental issues that keep this from happening:

the influence of lobbyists on congress

the corporate-controlled media

a general "me" attitude among most Americans i.e "screw the next guy"

Lack of national health care in the U.S., despite all the persuasive arguments for it in this and other articles, is a problem. Worse yet, it is a symptom of a much larger and fundamental problem in America.

best way for good health care for all is to remove the government from the equation.

let doctors and patients dictate their own terms and contracts.

get rid of the FDA so people don't need red tape for new types of treatments.

I promise you, stealing money from richer people at gunpoint won't solve the health care problem in this country. us wealthy folks will just find another loophole to keep the money from you moochers.

I repeat - the best health care is free market.

Didn't I read recently that according to a national poll over 60% of US citizens are willing to pay more taxes to insure that everyone has health coverage? Ithink it is another of the Big Lies that our citizens don't want or fear Universal coverage.

My dream is that Grorge Soros will donate millions to fund a national media blitz that exposes the distortions perpetrated by the medical industrial complex to defeat a single payer system. Hell if we can educate the other 40%.... then again, if they've manged to convince us that as a citizenry, we want to keep the broken system we have, guess it wouldn't make any difference if 99% wanted it. They would just ignore that fact and tell us otherwise and hope we can't find out what lying scheming criminals they are.

yes, starofthesea...

'willing to pay more taxes'...
Doubt it.

Guess where that money is going to go...
When you know where it goes, get back to me.

PCFD--good post. America's greater economic disparity compared to the other advanced nations, coupled with its lousy, fast-food diet, has quite a bit to do with our poorer health indicators.

This doesn't excuse our current health care "system" from blame. Even if the US was as egalitarian as Sweden (don't I wish), it is still intolerably expensive due to duplication of effort and built-in inefficencies.

Everyone over 60 years old off to the ice floe with you... oops sorry, they're gone...time to sink or swim!

starofthesea November 9th, 2007 4:22 pm

Most polls show a number closer to 70% and money saved from no more copays and premiums would be greater than any rise in taxes.

Here's another question to add to the mix: since the prime motive of the entire medical establishment is profit, can you even trust them to do what is right for an individual patient? I mean, how do you know what motivates a doctor's actions? Is he covering his ass? Is he earning bonuses from a pharmaceutical company? Is he covering for corporate interests over the health of individuals? Is he operating on some dogma that is decades old?

I have a friend who is in his mid seventies who just figured out on his own that he has been allergic to gluten for 35 years. This guy is a millionare, with the finest doctors available. He has been poked and prodded and cut on more times than I can count, and yet, not one doctor could figure out this simple problem.

I myself have no health insurance because I am self employed, and have been just recently crawling my way out of poverty level. I have had to take responsibility for my own health by thinking very carefully about what I eat and eliminating my vices. But if something catastophic happens, man I'm sunk. It's funny that the person who is just getting on top of their finances is virtually excluded from the medical system, because we actually have to pay 4 to 10 times what an insurance company would pay for the same services. I know, you don't have to explain it to me - we are being punished for not being good obedient slaves to the corporate profit machine.

Lack of universal health care, services and prevention is a failure of investment in ones own citizens, and one's own nation. Health care coverage is required from cradle to grave , when socially productive contributions to society may be for only half the lifespan. There are complex benefits from sharing the care, because chronic sickness, and even failure to achieve optimal well-being in some members of society is a drain on the economy for the rest. Ultimately society is the sum of the well being of all its members. Ignore the health of a large proportion of the population, and that nation will become sick. A Christian society is supposed to look after the sick and lame. No President who presides over your current system can call himself a Christian.

How can Paul Krugman challenge George Bush's logic. Does he not understand that Bush is guided by devine powers, which render economics and science irrevavent??

I am sitting here at 3:00 AM, after finally "coming out" to my conservative family that I'm a progressive. Or in their words, a "radical". I've never discussed politics with them before and I'm done now. My mom got miffed after she sent me yet another of her eternal Dem/Hillary bashes, and I finally broke and wrote her a "rant" back. The bash was the classic "Vote for Hillary and she'll give us socialized medicine! Horrors!"
My rant consisted of some choice facts about "socialized medicine" and the health insurance industry in America. I also pointed out to her that since she's on Medicare, she's on socialized medicine. My sister, who works for a big corporation, claims that she doesn't work for the government, they work for her, that people who work hard should get to keep the fruits of their labors and anyway there is Medicaid to cover the uninsured and she pays for it. In short, she's got hers and to hell with everyone else. I'm furious and depressed and pretty much done with talking to my family about politics ever again. The only good thing about it is that Mom knows better than to send me political stuff any more.

"Ultimately society is the sum of the well being of all its members."

I couldn't have said it better myself.

1.: It's not true that any emergency room must treat you if your are sick. The law says that any ER must treat you if you are dying, but that's up to the interpretation of the doctor on call. For routine procedures or non-life threatening diseases, the hospital can send you to the nearest hospital that will accept indigent patients, which can be hundreds of miles away. There have been scandals across the nation of doctors deciding, usually for economic reasons, that a patient, even one bleeding from a knife wound, can be safely shipped to the nearest free 'public' hospital for treatment. Many such patients have died on the way.

2.: I know a couple of Canadians working for US companies. Although they each have good health insurance through their respective companies, they prefer to receive treatment in Canada whenver practicable. They are absolutely flummoxed by the propaganda spewed by our media about the 'socialist' Canadian health care system. They tell me the only time you have to stand in line in Canada is for elective surgery and, in an emergency, you can see a doctor -- the nearest doctor -- right away.

3.: America is number 1 in the world in such things as heart bypass surgery, yet people in opther nations with 'socialized' medicine have fewer heart attacks and fewer bypass surgeries. While some of this may be related to diet, the French, for example, eat lots of dairy and fatty meat, and they have more smokers, yet have lower rates of obesity and longer lifespans. It might be the wine, but it might also be that French surgeons are less apt to recommend radical surgery that American MDs. Another thing: Poor heart patients receive far fewer bypass operations than wealthy, well-insured patients. A nurse friend confirms that poor heart patients are told to diet and exercise, while the wealthy with the same condition get the knife. An example where it might actually be to an Americans' benefit not to have good insurance.

Finally, I've started conversations at parties asking about health care; 4 out of 5 of the insured will tell you nightmare tales of dealing with their privatized HMOs and the like. It seems that only those who have never been sick want to preserve the present system in the US. Moonshadow, I hope none of your family, whatever their political persuasion, ever get seriously ill but, if they do, they'll find out what a byzantine, expensive fraud American medicine really is the hard way, as have some of the people I know.

Uh, luckingfame: the 'L' and the 'F' in your screen name are in the wrong place, and I hope it's a tribute to your sense of humor.

America's lack of universal health care and lack of interest in maintaining infrastructure is rapidly reducing America from its status as a second world country to that of a third world country. As for health care, even with full health insurance augmented by long-term health insurance, my mom had to wait almost a year to see the doctor that could diagnose her disease. Where I live now, there is universal one-payer health care. With this care, I can walk into most any specialist's or general practitioner's clinic, see that doctor within 10 minutes wait, and afford the cost of the visit (about US$6.00) and the cost of the medicine (ranges from about US$1.50 to US$8.00). The system works great! When I lived under the US 'system' not only could I not afford the medicine even if I could see the doctor, but I also had to keep track of an enormous pile of paperwork.

The health care debate in the US has always been about limiting access to health care. It has been successful in that about 50 million citizens are outside the health care system.

Not to worry about socialized Medicine if Hillary gets elected. Any health care proposal will follow the path of the Medicare drug coverage she supported. The drug companies and insurance companies will be guaranteed a profit and you, the consumer, will be guaranteed to be ripped off.

For foriegners reading these boards, remember when visiting the US that a M.D. treating you spends far more time with various drug company reps (who look suspiciously like call girls btw) than he or she does updating his knowledge of current medical practice. Your M.D. is also earning money based upon how many patients they can push through their office in a single day and are almost immune from medical oversight boards.

The U.S. is a failed state.

My friend's father is in his 80's and had heart bypass surgery a year ago. Since he worked for the government most of his adult life, he has excellent health care benefits, but that hasn't spared him from constant trips in and out of the hospital to correct various 'after effects' of the bypass surgery, plus the mountain of expensive drugs he must take, most of them prescribed to counteract the side effects of one of the other drugs he takes. Suffice it to say, he hasn't felt good since his surgery, although the doctors tell him it was very successful.

The final irony of his sad tale is that he is currently in the hospital once again for a partially-blocked carotid artery, but he can't see the physician he has been seeing over the years because of the rules of his health care insurance organization. (His physician isn't part of their group.) The upshot is that they nearly killed him by giving him a drug that his regular doctor knew would cause problems, but, of course, thanks to the hospital and HMO bureaucracy, he wasn't consulted. He's now recovering from that mishap, trying to get well enough so that they can unblock his artery. He's thinking of suing, and I hope he does. Unfortunately, his story is not unique, especially for senior citizens.

Every time I hear some neocon bleating about the horrors of 'socialized' health care, I wish I could send them to talk to my friend's father. He'd tell them anything would be better than the overpriced, and sometimes fatal, disaster that is the American health care system.

pangolin---this is the American sickcare system. The system is so sick that you better stay healthy.

John Butterfield---thanks for clarifying the stats. It seems so obvious that any increase in taxes would be more than offset by out of pocket savings to individuals. Too many people can only see "tax increase" but don't think it through to what their insurance ( if they are lucky enough to have it) costs them. Premiums their employers don't pay and as you said, copays and deductibles. Then there are those nasty surprises when a hospital sends the insured a bill for what the insurance company claims does not fit into their definition of "reasonable and customary." It's quite a racket really. It's a national disgrace.

As a lifetime broadcaster and advertising man, I can clearly see something that most people cannot see about the healthcare debate.

There are propaganda EXPERTS filling the nation with "disinformation" about government-sponsored healthcare programs... propaganda experts employed by the insurance industry, the drug manufacturers and the medical profession.

All someone has to do is hold up a sign calling for a national healthcare plan, and these hired guns come out of the woodwork and pounce on that person with lies and disinformation about "socialized medicine".

As Dr. Kruger clearly points out, Medicare has a long and successful history in this country... and despite the many arguments the opponents would have you believe, MANY other countries have BETTER healthcare than most of us do with their "socialized medicine" programs.