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Wednesday: [w] There are tradeoffs no matter where you go.

[Isolating panels from Mac Hall is kinda hard.]
(From Mac Hall #341.)

In this particular case, I'm not certain that socialized medicine would have been worse. It'd really depend on where we were talking about.

In the British model, once a prescription is issued for a drug covered by the NHS, this sort of thing doesn't happen. You might have to provide additional documentation if you meet one of the conditions for a free or discounted prescription, unless it's a contraceptive (always free when prescribed). Apart from that, you pony up your flat Ł6.40 for your refill on whatever it is, you wait around the shop for a few minutes until the 'scrip is ready, and there you are.

The pitfall would have been getting the bit of paper issued to begin with. Or possibly going through the slow chain of referrals (at least, in the case of anything a GP couldn't address) to obtain a diagnosis, let alone treatment. (This is often the worst problem; delays can contribute to the severity of the condition and, by extention, the nature of the treatment. For slippery, non-timesensitive things, you can go years without a useful diagnosis being made.) Or discovering that the drug that would have worked upon you isn't available because it's too expensive, so they've given you something which is cheaper but ineffective.

On the other hand, this doesn't sound too different from many HMOs.

In any event: socialized medicine can often be worse than what's being depicted here, but, at this stage of the game, at least he might have his refill.

(I can never bring myself to call it "nationalized" medicine. In Canada, this sort of thing is handled at the provincial level.)

Posted by Wednesday Burns-White at July 25, 2005 9:21 AM

Comments

Comment from: SeanH posted at July 25, 2005 10:28 AM

The whole concept of not being able to afford a doctor had to be explained to me by an American friend. Very strange.

Comment from: Will "Scifantasy" Frank posted at July 25, 2005 10:39 AM

Unfortunately, the primary reason the US won't consider sociaized health care isn't, the way I see it, its flaws, or the complexities of moving over to it.

It's that much of the country is still rabidly opposed to anything with even the slightest relationship to "socialism."

America really loves its symbols. Roland Barthes would have a field day.

Comment from: Eric Burns posted at July 25, 2005 11:10 AM

The situation's slightly more complex than that. And it all goes back to money.

As in, private health insurance is a multibillion dollar business. Possibly a trillion dollar business.

There are two sides to this as a problem. On the one side, nationalizing (or "statelizing") health care would cause many powerful, wealthy people to stop being so wealthy and powerful, and they oppose this. Insert plutocrat rant here. On the other side... taking a nigh-trillion dollar industry, destroying it, and then administering it through the government is an excellent way to throw the country's already tenuous economic standings into a full on horrific tailspin.

At the same time... this really shouldn't be an issue. Basic health care should just be something we do. Keeping the citizenry healthy is one of those minimum expectations that shouldn't be up for debate. It also makes the most economic sense, in the long run. A healthy workforce is a good thing -- it's a part of the national infrastructure.

Naturally, because it's a complex and nuanced situation with many potential pitfalls, it's been reduced to the most basic, black and white spun positions possible. "YOU WANT THE POOR TO DIE OFF!" "YOU'RE A DAMN COMMUNIST! A COMMUNIST!" "YOU WANT TO KEEP CHILDREN AND THE ELDERLY FROM GETTING VACCINES!" "YOU WANT TO BANKRUPT AMERICA!"

Yadda yadda yadda.

Comment from: gothfru posted at July 25, 2005 11:22 AM

having to deal with insurance companies can drive you batty.

I take meds for ADD. with the last incarnation of my insurance, they covered the regular form of my medication (adderall) but not the 12 hour version (adderall XR). can we see the flaw with requiring someone with ADD to remember to take a second dose halfway through the day? yeah.

the current incarnation of my insurance (same insurance company, different plan) now covers the XR but at a higher copay since there's no generic and is therefore more expensive (~$99/month). I'm good with that.

maybe a good interim step from private insurance to socialized medical coverage would be to enact federal regulations on how current companies cover medication, procedures, etc.

Comment from: Pseudowolf posted at July 25, 2005 11:22 AM

I've always been of two minds on the whole thing and I've never been able to decide one way or another.

On the one hand, people not being able to afford treatment they need is horrible and nationalized health care might solve that problem.

On the other hand, people might never get the proper treatment from the sheer amount of time it might take to see a doctor. Currently, you have to pay for a visit, so you aren't going to go to a doctor unless you think there is something really wrong with you. If the government is picking up the check under a national plan, however, then there's no need to go see a doctor for even the slightest pain. And so the waiting rooms fill up, appointments get harder to make, and you end up only seeing a doctor when you have some critically obvious ailment.

Comment from: SeanH posted at July 25, 2005 11:58 AM

Private healthcare does still exist in the UK, so if you can afford it then there's a way around the waiting lists.

Comment from: 32_footsteps posted at July 25, 2005 12:32 PM

America really loves its symbols. Roland Barthes would have a field day.

Most countries do, to be fair. It's just that each one has its particular symbols, and socialism is a particularly powerful negative one in the U.S.

This is also why I don't make any assumptions about nationalities when threads erupt about various archetypes. Or, if you want to use the word symbol in a slightly different context, in threads about punctuation and grammar.

Comment from: Polychrome posted at July 25, 2005 12:38 PM

Of course one of the upsides of private health care is that if you can afford it, the US has the best health care in the world. Because there's money in it the health care industry can afford to develop new and better products which they can then turn and sell for more money. Of course if you can't afford it you're SOL. But there are benefits to the consumer in a private health care system.

Comment from: JEisenberg posted at July 25, 2005 1:45 PM

I'd have to say that the US system is half-socialized.

As a student physician, I've dealt with the US medical system from several angles. My wife has even been without insurance for several months (due to switching colleges with pre-existing medical conditions) while I've been here learning to be a doctor. This summer I am working at the UCSD Student-Run Free Clinic, treating all sorts of people in San Diego who can't get insurance.

Currently, a person in the USA gets private health care if they are:

1) Rich enough to pay out-of-pocket;


2) Free of pre-existing medical conditions and able to pay for private insurance;


3) A full-time worker or student at a company which offers private insurance [ThatĚs me];


4) A dependent of (3), sometimes [Not us];


5) Injured in traffic collision, on the job, or anywhere someone can be held liable with the help of a clever lawyer.

The government pays if they are:


1) A citizen rejected for private insurance because of pre-existing conditions [ThatĚs my wife]


2) A citizen over the age of 65;


3) A disabled citizen;


4) A poor citizen (5) A government employee;


6) A military recruit or veteran;


7) A prisoner or detainee;


8) A former or current foster child 9) Any child (10) Any low-income pregnant woman


11) Any low-income woman with breast cancer;


12) Anyone with tuberculosis;


13) Anyone with end-stage kidney disease;


14) Anyone with HIV/AIDS;


15) Anyone with one of several other specific chronic conditions, united only by political considerations;


16) Anyone who calls 911 or comes to the ER in an emergency, until their condition is stabilized.

The government also pays for specific vaccines for children and the elderly, well-child check-ups for young children, school

The uninsured cannot get treatment without paying up-front, except in an emergency room:


1) Citizens who cannot afford private insurance but are not poor enough to qualify for state insurance;


2) Any who qualify for government-funded insurance, for 1 month to over 1 year after submitting the application;


3) Tourists from socialized-medicine countries;


4) Undocumented immigrants and some legal immigrants;


5) Homeless citizens (without a permanent address);


6) Citizens temporarily out of school or between jobs (My wife and I have fit under this category);


7) Anyone who required emergency care but is now "stable", even if they had surgery or require expensive medications to stay stable.

These categories add up to about 11% of the population in an average year; the number of illegal immigrants and homeless people may be underreported.

Dr. Beck, the director of our free clinic, likes to say that American is shuffling toward universal healthcare one disease at a time; now that the government has picked up the cost of kidney disease, breast cancer, HIV and TB, it is only a matter of time till the government covers liver failure, hepatitis, heart disease, lung cancer÷ you name it.

Until then, doctors and hospitals will have to keep track of each patient, each disease, each insurance company. Anyone want a promising career as an administrative assistant? Or a trial lawyer?

And they say Europe's system is too complicated.

Comment from: JEisenberg posted at July 25, 2005 1:47 PM

Sorry; how can I do line breaks instead of paragraphs? "BR" didn't work.

Comment from: kirabug posted at July 25, 2005 2:50 PM

Wow, and that doesn't even touch the "depending on the state" clause -- as in, "Depending on the state, your kid with Cystic Fibrosis may or may not have all his health care covered."

And to a certain extent, even then you can get stuff "covered" without insurance. When I was born I was hospitalized for a few days and my folks didn't have the money to pay the bill. My aunt (a doctor) called and Dad mentioned the problem - she said, "So send them whatever you have every month. What do you think they're going to do, reposess the kid?"

Ideally, everything that doctors and hospitals needed would magically appear on their doorsteps at no cost to anyone, and as a result, they could concentrate on healing people. Of course, they'd also be perfect at healing, so there'd never be malpractice issues, and they'd have perfect bedside manner and know exactly what was wrong.... and patients would go to the doctor when they need to and communicate well and get better, too ;)

If anyone knows where "ideally" happens to be located....

Comment from: Egarwaen posted at July 25, 2005 3:11 PM

From the point of view of someone whose life has been saved by it several times (asthma-related problems when I was younger), Canada's "nationalized" health care system is awesome. I cringe and think about how much my treatment would've cost my parents if we'd lived in the US.

Comment from: PatMan posted at July 25, 2005 3:35 PM

Did anyone notice Matt Boyd spelled ridiculous with an 'e'? That bastard should burn for that.

Or maybe I'm just being ray-diculous.

Comment from: quiller posted at July 25, 2005 3:53 PM

Call it what you will but when I look at health care in America, I see:

Hospitals going out of business providing emergency care to the uninsured.

Doctors spending huge amounts on billing with all the different insurance plans, government plans and trying to get money out of patients when the insurance fails.

Businesses unable to give raises or hire new people because of pumping money into health insurance costs or else having to drop people from insurance or increase employee contribution.

Private insurance getting charged huge amounts in order to make up for the fixed payouts for medicare and the cost of treating the uninsured. Private insurance therefore raises its premiums and more people wind up uninsured.

Yet another reason to look for job listings in Canada...

Comment from: gothfru posted at July 25, 2005 3:56 PM

I cringe and think about how much my treatment would've cost my parents if we'd lived in the US.

Odds are pretty good that if either of your parents were working, your insurance would have paid for it. I was hospitalized for asthma when I was 5 and we certainly would not have been able to afford it if we didn't have insurance!

Comment from: Chris Doucette posted at July 25, 2005 3:58 PM

What I took away from this comic was a sense of awe at the fact that I (and presumbly a great many others) can recognize "Daaa dah dah da dah da da daaaah" instantaneously. This is Mac Hall, so it's not totally without context, but... still. Catchiest song evar.

Comment from: Egarwaen posted at July 25, 2005 4:44 PM

Odds are pretty good that if either of your parents were working, your insurance would have paid for it. I was hospitalized for asthma when I was 5 and we certainly would not have been able to afford it if we didn't have insurance!

Gothfru: At the time, they were self-employed small business owners running a (rather successful) bookstore. From what I understand, margins were still thin enough that the business would not have been able to afford American health insurance prices for businesses.

Comment from: Jin Wicked posted at July 25, 2005 5:17 PM

I can't get to the comic because the site seems to be having problems, but I just want to say: Having used the Canadian health care system on many occasions when I was up there (I am honourary Canadian aeh?) I was never anything less than absolutely happy with it. If anything I preferred the beside manner and attitude of the doctors up there, to the few I have been able to see here in the US. They seemed much happier to listen to my concerns and suggestions than the doctors here; I have no idea why that is. Hell, my veteranarian listens to my opinions and concerns on treatments more than most of the doctors I've seen in the US.

Unfortunately being self-employed, I am without insurance for over two years now; make enough money to pay my bills but not enough to take out my own private insurance, and not poor enough to qualify for the government aid stuff, so I'm one of those ones that kind of falls through the cracks. I've had a friend that worked with the computers in a doctor's office, the amount of abuse and waste that goes on WRT to insurance cos and doctor's offices and such here is insane. One of my family members is near having to declare bankruptcy because of medical expenses. I've had heart palpitations/problems and panic attacks since a near nervous breakdown in 2001, but I have to exercise and deal with it by controlling my lifestyle very closely because I can't afford to see a doctor and find out if it's anything more serious - and am trying to keep whatever "it" is - if it is serious - from getting any worse.

Feh. Healthcare in the US is a disaster and really benefits no one but the insanely convoluted insurance and pharma companies.

Comment from: vilious posted at July 25, 2005 7:28 PM

I can't imagine a national health care system with more layers of bureaucratic obstruction than my wife's HMO. Basically, they keep costs down by making it an enormous, time-consuming pain in the ass to get care. I once spent an hour trying to hold a broken thumb in place with tape rather than call them.

At least they keep their premiums down. The HMO at my job has jacked the premiums up every year for the last five years. The premium increase is larger than the standard cost-of-living raise, so that everyone who has to use that plan has had a steady drop in real wages for the last five years. And you have to go through referrals to get care there, too.

Insurance companies don't exist to provide services. They exist to collect more money than they pay out. That's all they do, end of story. One might as well have 3-card-monte dealers provide medical care as insurance companies.

Comment from: deviant youth posted at July 25, 2005 8:11 PM

Whee, first comment here and it's on healthcare. Says it all, don't it?

I'm glad that I haven't had to tie up the British NHS (or specifically Scottish NHS trusts) that often over the years. But the few times that I have had to use it (for the usual childhood big cuts/scrapes/concussions/etc) I have been glad that the UK government foot the bill. I'd hate to think how much I'd have had to shell out for various treatments if I was based in America.

But I guess it could be worse. A few years ago I was on holiday in Spain and needed medical treatment for a stupid accident. The only reason I didn't have to pay for said treatment was because I had the correct paperwork to claim it on the NHS (dunno if this was an EU thing or not, but hey). I could only imagine what I would have had to go through if said accident happened in the US.

Or if I hadn't went through the policy of red-tape that Europe seems to like at the moment.

Comment from: SeanH posted at July 25, 2005 9:13 PM

My only evil-British-NHS-waiting-list-story is having to wait a year and a half to have somebody take a look at my flat feet as a child. That never did get corrected, but that's my fault, not theirs.

Comment from: gwalla posted at July 25, 2005 10:47 PM

Eh, America will eventually have public health care. More and more businesses are realizing that rising HMO premiums are eating further and further into their profits, and eventually they won't be able to lay more people off to make up the difference and still be able to operate. Once the political might of this group overtakes the political might of the insurers, there will be change.

Public opinion has nothing to do with it.

Comment from: JoeFF85 posted at July 26, 2005 1:05 AM

I don't know anything about insurance, I'm on my parents' policy. (See, correct posessive plaural form!)

All I know is now I wish I could have the Katamari Damancy theme as my cell phone ring tone.

"Daaa Dah Dah Da Dah Da Da Daaaah..." indeed.

Comment from: larksilver posted at July 26, 2005 2:56 AM

It's 3 AM, and your 18-month-old is running a 105 degree fever. He's wheezing, and has a racking, harsh cough. His voice, when he musters the energy to talk at all, is raspy and hoarse, but he's mostly just this listless, pitiful little guy who just sort of drapes there, struggling to breathe. Oh, ye gods, you think to yourself, what do I do?

Because, you see, you're a part-time employee in the U.S... 30 hours a week. That's right, just enough so that you're too high above the poverty line to get Medicaid, but not enough hours so you can be listed on the company health insurance plan (this, by the way, is one way employers avoid having to pay for benefits on their employees. It's actually cheaper for them to have an extra person on staff to cover all those 10-hour-shortages, apparently).

Sure, sure, EMTALA says that you can take your child to the hospital and they'll stabilize him, which of course is what you have to do. But that's all they have to do: stabilize him. Not hospitalize him, if what he has (in this case, Croup, which can kill a child if left untreated), but stabilize. Got monstrous asthma? okay, tada! Have an albuterol breathing treatment and get out.

In our case, we came away from the hospital, having spent 5 hours there, with a steroid treatment which, thank heaven, WORKED, and helped his little body fight off the virus... and a bill for $500.00 for just the hospital's portion of the services. We got another bill later, for $400.00 for the physician's services.. that's right. $400.00 for the 2 minutes she spent with him, not included in the hospital's fees, as Baylor leases out to the hospital.

My only consolation was that this is a children's hospital, and regardless of my ability to pay, if he'd been in need of hospitalization, they would have made it happen. Not because of the law, but because it's part of their mission statement.

Still.. socialized healthcare? After that 3 AM awakening to an emergently ill child, I'm for it. How many children die... or adults, for that matter, because they can't pay their medical bills?

Take it out of my taxes, damnit. I'd rather pay for healthcare than Bombers, for cryin' out loud. It's not a desire to be lazy, to go on the dole, nothing like that. I work hard to support myself and my child. I always have. But no family should be crippled with indecision over whether the child is "sick enough" to go to the emergency room because they know they can't pay. Hell, at that point in time (things are better now, thank goodness), we had a hard time scrabbling together the extra $5.00 to park.

Comment from: larksilver posted at July 26, 2005 3:12 AM

Hmm. I had a comment typed in, and it denied it for questionable content. I'm not sure WHAT that was about. hehe. So here's an abridged version of it, see if it blocks it again:

The physicians don't like being told what care they can provide for their patients, or how long they can SPEND with their patients, by someone who doesn't even hold a medical degree.

The patients don't like this either.

For hospitals, there is a constant struggle to provide excellent healthcare while not discriminating against those patients who are poorer than the others... They also struggle to receive payment, even to the point of having an entire department or more of staff with special training in dealing with insurance companies.

So who profits? Ah, the insurance companies. As long as they hold the power in the American Healthcare system? I don't see the socialization of it as likely. One thing is for certain, however: the American system is in need of a radical retrofit. I'm not holding my breath until the Powers That Be show the courage to do so, however. /sigh

Comment from: larksilver posted at July 26, 2005 3:13 AM

oh, good, that one went through. If the 2nd try didnt' go through, I might have gone all "Conspiracy!" since I was talking smack about the Big Guys with the Big Bucks. hehe

Comment from: Cass posted at July 26, 2005 3:14 AM

Argh, health insurance.. Personal anecdote time, hooray! I am one of the lucky few that tend to slip through the cracks - I'm too poor to afford regular care, but no plan I apply for will cover me as I am an independant college student with jobs in transit, etc etc. Recently, I had to pay $130 out of pocket for a doctor visit because I collapsed from a sinus infection that was eight months in the running. And that didn't even cover the cost of the antibiotics, either.

Oh, p.s., Eric, we decided it was high-time for you to be referenced. ^^ -> http://herodoll.keenspace.com

I feel bad for Wednesday, though. She always gets left out of the loop it seems, and we had already uploaded the blog before we could correct that egregious oversight. Sorry, Wednesday! Please forgive us, we Argh, health insurance.. Personal anecdote time, hooray! I am one of the lucky few that tend to slip through the cracks - I'm too poor to afford regular care, but no plan I apply for will cover me as I am an independant college student with jobs in transit, etc etc. Recently, I had to pay $130 out of pocket for a doctor visit because I collapsed from a sinus infection that was eight months in the running. And that didn't even cover the cost of the antibiotics, either.

Oh, p.s., Eric, we decided it was high-time for you to be referenced. ^^ -> http://herodoll.keenspace.com

I feel bad for Wednesday, though. She always gets left out of the loop it seems, and we had already uploaded the blog before we could correct that egregious oversight. Sorry, Wednesday! Please forgive us, we

I feel bad for Wednesday, though. She always gets left out of the loop it seems, and we had already uploaded the blog before we could correct that egregious oversight. Sorry, Wednesday! Please forgive us, we

Comment from: Cass posted at July 26, 2005 3:15 AM

... we love you, too. Odd how that part didn't go through. Larksilver's right, it's a conspiracy!

Comment from: Mitch Clem posted at July 26, 2005 3:27 AM

One time, several years ago, I was laying in bed and all of a sudden my side hurt. I found that, when I laid on my right side, I was fine. If I laid on my back, it hurt a bit and I was somewhat short of breath. If I laid on my left, I couldn't breathe at all and the pain was excruciating.

Eventually, my girlfriend at the time convinced me to go to the emergency room, where it was discovered that my left lung had collapsed completely, and that the condition was abnormally severe to the point where I would require immediate surgery to keep from dying.

Now, I am not a rich man. On the contrary, I am a rather poor man. Very rather poor. I've lived in cars and in tiny rooms at YMCAs in bad neighborhoods. My financial situation at the time of this surgery involved me living in a walk-in closet in the basement of a house occupied by eight or so other people. Needless to say, health insurance wasn't something I posessed.

So, for the past several years (four? five?) I've been in debt for thousands of dollars, a debt pretty much forced upon me, as the other option was, quite literally, death. Now, I cannot pay this off. I will never be able to pay this off, not unless I accidentally stumble upon the end of a rainbow and discover an immense pot of gold. Not only am I in a debt I am unable to pay, but I have lawyers sending me constant letters threatening to have me arested, telling me to appear in court, demanding money I absolutely don't have.

So yeah, what's so bad about having to wait in a fucking line again?

Comment from: Robert Hutchinson posted at July 26, 2005 3:44 AM

(Comment self-redacted to preserve civility)

Americans love socialism, just as long as it's applied to something they're used to thinking of as a government service, and isn't called socialism.

Healthcare in the US is a disaster and really benefits no one but the insanely convoluted insurance and pharma companies.

Despite my face twitching several times while reading the comments, I do wholeheartedly agree with the preceding.

Comment from: Brendan posted at July 26, 2005 4:39 AM

You realize, of course, that you may have been dead before getting to the end of that line.

Comment from: SeanH posted at July 26, 2005 5:03 AM

Brendan: no, he wouldn't have been. With an obvious emergency condition, he would have been treated as quickly as possible.

Comment from: Doc posted at July 26, 2005 9:00 AM

Prologue: This turned into a bit of a long post without much interesting in it, mainly odd details because I was interesting with how Aus compares with other countries, skip at your discretion.

We have a bit of a mix of national (Called medicare and costing everyone 2% of their income providing they earn over a certain threshold) and private over here in Aus, thanks to my parents I've been under private most of my life but I was admitted to the emergency room more than a couple of times as a kid (Asthma and Croup are FUN!) in both public and private hospitals and I've never had any complaints.

My girlfriend recently had to wait about 4 or 5 months for an appointment with an orthopeodic surgeon for knee pain in a public hospital (wasn't incredibly serious so the wait was more of an inconvenience than a real problem).

I guess I don't really have much of a point, just that the public system over here isn't incredible but I would feel I could rely on it in an emergency situation. Not sure whether it would be realiable for a long term illness or not.

Also curious as to how this sort of thing compares to you foreign folk.

That said a reasonable policy with one of the two or three larger insurance providers over here will set you back around 100 bucks a month for a single person, which is a noticable but (for me) generally affordable chunk.

I'm always fascinated by the way Americans speak about their medical system, insurance or not I would be genuinely suprised if someone couldn't get to see a GP over here and most medicines over here are subsidized, for another off the top of my head example last time I needed a course of anti-biotics it cost 17 dollars for a two week course.

Oh and just to start a flame war, I seem to recall in 2001 or 2002 a bill was approved in the USA for around 450 billion to defense, I've got to wonder how much it would cost to fund a decent national health care scheme. Not really criticizing, the federal government over here ran a huge campaign recently to get people into private healthcare, funded with money I'm sure could have contributed to Medicare.

Comment from: William_G posted at July 26, 2005 9:25 AM

Not to be a pest... But here's a bit of a reality check for any time we start considering ourselves "poor"

Comment from: Egarwaen posted at July 26, 2005 9:54 AM

Brendan: And even for purely elective procedures, the waiting lines here are never particularly long, unless the procedure is very complicated. (Like, say, a CAT scan) The line is a rhetorical device used by insurance companies anyway - you still have a line in any health care system. They just make theirs shorter, by denying people the ability to participate.

Comment from: Paul Gadzikowski posted at July 26, 2005 11:29 AM

What I took away from this comic was a sense of awe at the fact that I (and presumbly a great many others) can recognize "Daaa dah dah da dah da da daaaah" instantaneously.

Unfortunately I'm not one of them. What is it? Thanks.

Comment from: 32_footsteps posted at July 26, 2005 11:36 AM

I might've caught Katamari On The Rocks as his ringtone if he had used "Na," like the actual song does, instead of "Da". That, and if I hadn't had Katamari On The Swing stuck in my head the last several days. Oh, those sneaky remixes...

Given that health care costs seems to be a breaking point for quite a few U.S. firms (General Motors being one notable example) of late, I'm a bit surprised that there hasn't been more of a push already, especially from influential representatives (I'd have imagined something from either Carolyn Kilpatrick or John Coyners, Jr., the Democrats who represent the districts comprising Detroit, by now).

Comment from: 32_footsteps posted at July 26, 2005 11:37 AM

Paul - in case my previous post isn't quite clear, that's Katamari On The Rocks, the main theme to Katamari Damacy.

Comment from: Wandering Idiot posted at July 26, 2005 8:31 PM

Posted by Eric:

At the same time... this really shouldn't be an issue. Basic health care should just be something we do.

That's an interesting statement. Not so much the statement itself, which I agree with, just as I believe that not allowing anyone to die of starvation should be something we do, but in the unspoken assumption that it's up to the government (Federal presumably, although that is again unstated) to do so. I'm fairly certain "paying for the public's medical care" isn't a part of the government's proscribed roles in the US Constitution, unless you want to shoehorn such a broad meaning onto the "general welfare" clause as to make the entire idea of enumerated powers meaningless (after all, pretty much anything could be claimed by the government to be for the general welfare, so a broad reinterpretation of the clause means that the government can do anything it wishes, and that would have been the only power needed to be listed).



Of course, this is all me being a naive idiot and imagining the current government pays any attention whatsoever to the original intent of the Constitution (How about that kickass declaration of war Congress made before we went into Iraq and Afghanistan? Wasn't that totally schweet? Ohwait).

I just find it curious that almost no one who expounds on the things "we should of course do" ever suggests the idea of it being done through a private organization which they would donate their own money and/or time to. As if anything large-scale that needs doing, unquestionably needs doing through the government. It's not even a debate, it's an assumption, which is a bit sad considering the supposed original purpose of government in this country. Being as it is a document written by the hand of man, the Constitution is undoubtedly not perfect, and perhaps there really are necessary powers not given by it to the government which only it (and not private structures) can reasonably wield. But it would be nice if we added such powers using the official amendment process, rather than by relying on creative reinterpretations of so many clauses of the Constitution that the document nearly loses all meaning, and the usual public assumption is that the government can "do whatever".


(Also, you're all damn communists. COMMUNISTS, I say!)

Comment from: Wandering Idiot posted at July 26, 2005 8:33 PM

Auuugh, and one again I forget that I don't need BR tags...

*weeps, shakes fist impotently at Interweb Gods*

Comment from: siwangmu posted at July 26, 2005 11:48 PM

(For the record, I think your point about constitutionality is very interesting, but I'm going to respond to the practical side)

"I just find it curious that almost no one who expounds on the things "we should of course do" ever suggests the idea of it being done through a private organization which they would donate their own money and/or time to."

I think that the motive you're implying (not wanting to donate their own time/money) is a very small factor in the pattern you're describing. To begin with, the government is designed to be as transparent, accountable and responsively alterable in its operations as possible--I'm not saying it closely resembles that ideal, but there are many mechanisms in place that attempt to serve those design goals. Those are things that would, to me, seem like necessary qualities in any organization responsible for something as huge in scope and as high in stakes as the welfare of every citizen.

There's also the problem that while, in general, I'm one of those stupid folk who have faith in humanity, I do not believe that if a, say, national private take-care-of-everybody organization were founded, it would receive the financial support necessary to succeed. Perhaps I have faith in everyone except rich people, but I always felt that the experience of the Great Depression was a strong sign that private charity cannot be relied on when it comes to the general welfare. I'm not someone who thinks the government is smarter than the people, or that it should decide what to do with your money because you're not capable of it, or any of the other tropes about liberals, but I'm totally comfortable with the idea of living in a country where you don't have total freedom to be a selfish bastard.

Don't want to help pay for roads because you don't have a car? Don't want to help pay for education because you don't have kids and therefore think you have no investment in the future? Don't want to help pay for health care because you can afford your own private care? Too damn bad. Quibble about the amount, the details, demand that it be implemently more fairly, more efficiently, whatever, but on the basic question of whether you should have to pay at all, I doubt I can ever by swayed. And I think the only way to make the "everyone has to contribute what they can" thing happen is through the government.

It's not what the Founding Fathers had in mind, I know, but I can't think of a better way to do it that could actually work.

Comment from: Paul Gadzikowski posted at July 27, 2005 10:49 AM

Paul - in case my previous post isn't quite clear, that's Katamari On The Rocks, the main theme to Katamari Damacy.

Ah. That, then, would be why I don't recognize it. Thanks.

Auuugh, and one again I forget that I don't need BR tags...

I've stopped using hard returns at all and now rely entirely on code for paragraph breaks.

Comment from: SeanH posted at July 27, 2005 7:36 PM

Excuse me, please, for making a sweeping and likely inaccurate generalisation, but - what is the big deal with what the Founding Fathers wanted? They're dead. It's not their country anymore, it's yours now. Respecting them as political thinkers, yes, sure - but too often the logic I see seems to be along the lines of "Jefferson said this, so it's binding law" or "It's in the Constitution, and thus is the inerrant word of God". I don't know, maybe there's something I'm missing...

Comment from: siwangmu posted at July 28, 2005 2:33 AM

SeanH: I'm not going to say the vibe you get is wrong, but I think the reason it seems so obsessive to you is that "what the Founding Fathers wanted" can be an incredibly important factor in whether it is legal for us to do certain things with the goverment.

This is just my high school-level understanding you're hearing, but AFAIK, we consider it essential that the government's powers be limited in a way that's meaningful, and that limit is set wherever the Constitution currently stands, at least in theory. It's fine to make the government change to better serve our needs, but that sort of change needs to happen according to the amendment process, or the whole limitation is merely symbolic. Thus, when deciding whether we can make this law or establish that organization, we have to decide whether it's something the government can do under the Constitution as it stands or whether it's outside the scope of the document.

Since language and ideas are slippery things, we don't always know exactly whether a given phrase in the document should include the power to make the law we want, so we try to figure out whether the people who wrote it would have considered that sort of thing included, whether they'd consider it included if they were alive today, whether they would consider it included if they were alive today and not sexists/racists/landowners/from Virginia/fond of cheese/what have you... it's like the world's most boring Fanfiction circle that's been going on for 200 years (Founding Fathers FanFic? pFFFF. Or, now that I think of it, historical fiction. A marriage of two beloved genres! Groovy). Naturally, there are other factors, tons and tons of them, all about which my poor sister has to learn because she was silly enough to decide to go to law school, but hopefully the above serves to explain the obsession with What Would Jefferson Do-type thinking.

Comment from: SeanH posted at July 28, 2005 3:28 AM

Thanks, siwangmu, that makes a lot more sense now. Apologies for any inadvertent offense.

Comment from: siwangmu posted at July 29, 2005 2:04 AM

::blinks silently for a moment, taken aback::

Uh, you're welcome. Is it bad to be horribly shocked that I attempted to explain something even somewhat complicated and it actually came out making sense? You're my new favorite person, SeanH. And no offense at all! It is pretty funny sometimes.

Comment from: Sundre posted at August 1, 2005 11:44 PM

I'm currently employed in Ontario's health care system. I'm a clerk in an office that co-ordinates home care for the elderly and housebound.

The system has flaws. But I've seen it save people, though I'm mostly doing the paperwork.

There's also a Telehealth service in the province. People can call in and talk to nurses who give advice. "Go see the doctor tomorrow if it gets worse." "Drink lots of fluids and take a nap." "Get your ass to the ER now." Lots of help for those of us who can't tell the difference between the mildly-inconvenient and the potentially-life-threatening.

Comment from: Robotech_Master posted at August 4, 2005 9:51 AM

I don't expect anybody's going to see this by this late in the discussion, but here's an article about a British mother flying her son to India for a spinal operation that the British doctors said could have up to a 1-year waiting list in the UK.

I can just imagine the reservedly pained looks on the British doctors' faces as they reiterate,

"What [Mrs Knott] has been given are the worst-case maximum waiting time targets but hopefully things can happen earlier, depending on the individual clinical issues for Elliot.

"We understand how frustrating the situation feels for patients and their families. We are certainly not either inflexible or unsympathetic."

Comment from: Robotech_Master posted at August 4, 2005 9:52 AM

Why didn't it blockquote the second paragraph? Weird.

Comment from: Sundre posted at August 6, 2005 6:10 PM

Robotech Master: There should be a club. People who hang around defunct comment threads hopin to stir somethin up: hopefully interest, occasionally sparks.

I know a guy who knows a guy. We could have a secret handshake.

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