Back to Basics

1. Some people doubt there will be any savings without a draconian rationing system.

2. Other people don't like giving the federal government that much more leverage over our lives.

3. Most people are generally satisfied with their health care.

4. Many people see incremental reforms, such as tort reform, as a safer way to go.

Otherwise, you're right, there's no need for debate.

"Can someone remind me again why there's even a debate about whether we should put up with this?"

Deciding first things first is how our congress should work. They should vote first whether health care reform is needed. When it's decided that a reform plan is needed, the parties should alternate presenting plans until one of them gets a majority vote. Then they couldn't get away with pretending they wanted a bill just not this one.

"why there's even a debate." Because the US is still the country that believes from R. R. that the government isn't the solution; it's the problem. An economic disaster greater than this recession will be needed to change most Americans. Rick Santillie's "screw you" rant on CNBC a while back reflects the thinking of most Americans. Do you want to bet against a Republican revival in 2010 with a taste of violence thrown in?

Because we Americans have replaced the entrepreneurial "can do" spirit that made us leaders of the 20th century with a timid hand-wringing fear that we might make a mistake we'd be too feckless to correct. Just see the first two responses, and the fourth. We're a bunch of nail biting sissies putting up with mediocrity because action, as always, involves risk.

My good followers know the US's system is just what I want: "I got mine, frak the rest of you!"

Don't advocate change -- you will BURN IN HELL!

LOL, I find it quite funny that so many people think the only folks denied care are the uninsured. Most of us who are healthy and "insured" are just one bad diagnosis away from finding out exactly how many loopholes and limitations that coverage has. Hell, half of the reforms on the table are about actually giving people the insurance they only think they have now.

And it's worth noting that the waiting lines in Canada and Great Britain exist in a system that spends about half of what we do. So, the Brits and Canadians have waiting lines because they are cheap b**tards. And us? Well, we're certainly spending enough that no one should be in line. So, the reason we have wait lines is because we're a**holes, convinced that a healthcare system that is open to everyone is one that isn't good enough for us. Kind of the same principle as a line outside a nightclub--we all think if we're on that VIP list and other people have to wait outside, we're getting something really, really good.

It's ridiculous.

Someone explained on the radio that we have a 'fee for service' medical system. It would seems that makes the medical profession part of the service economy.

Auto mechanics are also part of the "fee for service" service economy but there is a major difference in the payment system. If he can't fix your car he doesn't get paid. But you will still get a bill from a doctor who has failed at providing you with the 'service' of healing your ailment. He gets paid for merely trying. The auto mechanic, for results.

Can someone explain just why this is?

Do you have any idea how fabulously wealthy Our American System is making some at the misfortune of others? It's the American Way.

"most people like their health care"

Say what? People I know hate dealing with the HMO / insurance company meddlers.

The people who like their health care are:

old people (because they are on a govt program)

ideological Republicans, because disliking the hassle our 'free market' system imposes causes too much cognitive dissonance, so they decide they like the system.

The health care industry, which revels in the mess, because it ives so much opportunity to rake in the cash.

I travel a lot, and the health care I get in places like Taiwan, Korea, and Italy was faster and easier to get in every case.

My typical US health care experience goes something like this.

1. Call doctor's office. Told I must see primary care doctor to get referral to ophthalmologist for eye infection or ophthalmologist will not be covered.

2. Argue primary care office down from appt in week to appt in days.

3. See primary care doctor who tells me to see an opthalmologist.

4. Argue primary care office down from appt in week to appt in days.

5. Get antobiotic at drugstore

6. Get better

Typical overseas experience:

1. Go to clinic, talk to nurse at counter. Wait in chair 10 minutes. See ophthalmologist. Get antibiotic at fron counter. Walk out an hour after I walk in.

2. Get better

American health care on a typical plan (I'm on Blue Cross) is great if you have some super expensive disease, but on the whole it is a huge hassle. The hassle factor is a great rationing tool. I for one put off seeing the doctor because it is such a pain.

Excuse me, Kevin, is that a nit I see? Please allow me:

Let's recap: the United States spends about twice as much on healthcare per person as any other developed nation in the world

(1) because HE'S BLACK AND HE'S GOING TO SPEND OUR MONEY ON TEH LAZY BLACK PEOPLE! (shorter form: "Socialism!")

(2) because Keep the government out of my Medicare!

(3) because while we always suspected that the middle clump of conservative/'blue dog' Senators and Representatives could be bought... now, tanks to AHIP, we know for sure, and we know their price.

(4) Obama's Waterloo!

Key: (1) & (2) are why this debate is still going on among voters; (3) & (4) are why this debate is still going on on the Hill.

There are two reasons.
First, I think most people understand how bad our system is, at least on a visceral level. Unfortunately, the system is so bad that the thought of falling through the cracks is terrifying. Personally, I never thought "Americans generally like our health care" would be an argument by any side in the debate. But we do prefer it to being uninsured, and being uninsured in this country is truly terrifying. So the current system takes the role of the devil you know.
The other day, a fellow told me his story: He was traveling in Dallas and felt bad. He ended up in the hospital for a week with double-pneumonia. Had his last course of drugs not held, he would have been on a ventilator.
"The total cost," he told me, "was $90,000. My out-of-pocket cost was just under $1,000. I think our health care system is working just fine, thank you very much."
Now anywhere else in the world, that treatment would have cost $30,000 and his out-of-pocket would have been zero. My friend would never believe this, nor would he care. He is happy to be alive, and the cost is proof of how sick he was.
When you have been sick, then gotten better, you think the system works, no matter how inefficiently it has been done.
Second, we are living out Monty Python's dead parrot sketch.