By the numbers: what the polls show.

Democrats to lose big time

The latest poll data shows the Obama-led Democrats will suffer as badly as did the Bush-led Republicans. Obama has proven himself to be another Bush, albeit more articulate—but I have plants that are more articulate than Dubya.

Poll data shows that the Republicans may have reached the "tipping point" where the House of Representatives changes hands, back to the GOP. Over at Gallup they say:

Last week the re-percentaged share of the vote for Democrats among registered voters was 47%. Again, that’s among registered voters. If things go as usual, the percentage of the vote for Democrats among likely voters would be even lower. In other words, if the voter sentiment we picked up last week was to prevail up to Election Day, the Democratic control of the House would indeed be in peril.

I think it very likely that voters will punish the Democrats for Obama's power-grab in health care, a very unpopular move with around 2/3rds of voters wanting the measure repealed. Writers at Gallup were saying that 47% share of the vote the Democrats were on the cusp of losing the House. But since then, Gallup's own poll shows that support for the Democrats dropped down to 43%. Republicans are now 6 points ahead in the generic poll and with likely voters the spread would be even higher.

My own guesstimate would be that the Republicans are going to pick up 40 to 50 seats, given them comfortable control of the House of Representatives.

Other signs of Democratic weakness is that voters are now split three ways regarding party identification. Equal numbers say they are Democrats, Republicans and independents. The modern mugwumps are the independent voters, who have been vacillating between the parties, voting for whichever party least disgusts them at the moment, but never really voting for anyone. With independents the Republicans have a 14 point lead.

As far as I'm concerned, if you want a short cut method of predicting poltiical trends look at where the independents are on the issue. They are the swing voters and which way they swing determines elections. I still believe they are also the most libertarian of the three main voting blocks, but neither party gives them someone to vote for, only candidates to vote against.

The tipping point in gay acceptance.

Another milestone was reached, according to Gallup. For the first time a majority of Americans say that it is morally acceptable for someone to be gay—how nice of them! I find the whole idea that such a poll is necessary to be absurd. As I see it we don't ask if it is morally acceptable to be a Catholic, though with the actions of the Vatican, we might want to. The recent annual Values and Beliefs poll found that 52% of Americans say that being gay is morally acceptable while 43%, no doubt the god-besotted, say it is morally wrong for someone to be gay. In 2001 the numbers were 40% to 53%, so tolerance has gained 12 points in the meantime.

What is particularly interesting is that the gains have come predominantly from men, who tend to be less tolerant on such matters—perhaps less secure, but I won't go there. Since 2006 the percentage of men saying being gay is morally acceptable has increased from 39% to 53%, and for the first time men are more accepting of gay people than women, 53% to 51%. Where acceptance gained 14 points among men, since 2006, the gain among women was just 2 points.

The largest gains were among men under the age of 50, or those 18 to 49. Younger men are now the most gay-friendly of the gender/age groups, with 62% saying being gay is okay. For men older than 50 the number is just 44% but this is still a 9 point gain from 2006. Among women under 50 those who are tolerant has grown by 4 points in the last four years, to 49%, and for women over 50 it is 43%. Even among older people men are now more tolerant than women.

As for the bellweather independent voters, they are in tune with the younger voters: 61% of them of them say it is morally acceptable to be gay, which puts them in a tie with Democrats. Republcians, once again prove themselves to be the organized force of intolerance in America, with just 35% of them saying it is morally acceptable to be gay.

The religion split is also interesting. The most anti-gay group in religious terms would be Protestants, as a generic group. This is where we would find the fundamentalists, of course, so this is no suprise. Only 42% of Protestants saying being gay is morally acceptable, where 62% of Catholics, 84% of non-Christians and 85% of the non-religious say it is morally acceptable. Gallup reports:

There is a gradual cultural shift under way in Americans' views toward gay individuals and gay rights. While public attitudes haven't moved consistently in gays' and lesbians' favor every year, the general trend is clearly in that direction. This year, the shift is apparent in a record-high level of the public seeing gay and lesbian relations as morally acceptable. Meanwhile, support for legalizing gay marriage, and for the legality of gay and lesbian relations more generally, is near record highs.

Support for marriage equality is also approaching the tipping point. Already 56% of Democrats are on board, a gain of 23 points since 1996. Bellweather independents are at 49%, a gain of 17 points, and Republicans are at just 28%, which is still a gain of 12 points since 96. In the East and the West support for marriage equality is at 53%, in the Midwest it is at 40% and in the Bible-belt South support is just 35%. The tipping point on this issue is not far away.

Iowa is an interesting case on this issue, and seems to be following the Massachusetts pattern. Marriage equality enrages the religious who organize and shout, foam at the mouth, and spit venom. But most people just sit back and watch the events unfolding. As time progresses what they see worries them less and less. KCCI television in Des Moines polled Iowans recently and found that the majority now supported marriage equality: 53% to 41%. This comes after one full year of marriage equality in the state.

Health deform still very unpopular.

Obama's health care power-grab is highly unpopular among voters. Rasmussen polls show that 60% want it repealed and only 36% say they want to save the program. Most believe it will increase the federal deficit and most think it will increase health care costs, a small majority also being it will reduce the quality of care in the United States. I side with the majority on this one.

Time tells the truth: stop the presses.

Wow! I can't say I expected to find a column on economics in Time that I agreed with, especially one on health care.

Barbara Kiviat says she went to a doctor and "and asked how much my office visit and X-ray would cost. Staffers told me that they didn't know and, since I have insurance, I shouldn't care." That's it! That is one of the main reasons for spiraling health care costs in nutshell. As Kiviat wrote: "We are left with the same opaque system of perverse incentives—paying providers for more tests and procedures, not necessary effective ones. And we lack even the most basic element of the free market: price information."

I will take a minor disagreement. Kiviat says that the lack of price information for most health care consumers means we lack the most basic element of a free market. True, but more broadly, we lack one of the two basic feed-back signals in economics. The other being profits. Prices and profits are the two feedback loops that send signals to consumers, in the case of prices, and producers, in the case of profits. Socialism attempted to abolish prices and profits both, in other words, it attempted to abolish economics entirely. Socialism was never an alternative economic system—it was the abolition of economics entirely.

Kiviat notes that in field after field consumers shop around and this drives innovation and lower prices. But this is not the case in health care. Of course not! Most consumers don't pay directly for their care so they don't both with prices. I pay for my own care and I am very price aware.

When I had a bad tooth ache two years ago I went to a local dentist who started telling me that I first had to have an examination. Then they would send me to specialist who would outline a treatment plan. Then I would return to the detist who would perform a root canal and put a crown on. As he rattled off numerous needless steps I saw dollars flying out the window. So I asked for cost estimates. I was told that altogether I should expect to pay $2000. And it would take at least two weeks to finish everything. And, no, in the meantime I was not allowed any pain killer sufficient to dull the awful aching in my mouth—we have to protect people from drugs you know.

I was not intending to suffer needlessly due to the asinine war on drugs nor was I going to wait two weeks or pay $2000. I called one of my readers here, who is in Mexico, and he arranged a dental visit for me. The next day I flew down. I was in to see the dentist that afternoon. He did all the analysis on the spot and began the root canal. It would take 24 hours for the crown to be prepared so I had to come back the next day to finish up. And he was happy to prescribe a good pain killer which allowed me to eat for the first time in days. Total cost for the care was around $400. Add in the airfare and hotel and it still comes in well under $700, compared to the $2000 I was expected to pay in the US.

If more health care operatives had patients leave for other, less expensive services, prices would come down. Those health care outlets that didn't do that would go out of business, or work exclusive for government funded patients, who never care what something costs.

I've also used some of these drop-in health clinics and found them quite affordable. Why is that? Because most of their patients are not covered by insurance. I had a lung infection that didn't want to clear up. The practitioner nurse prescribed the medication I needed and then spent 10 minutes checking for low price alternatives. After she found a low priced alternative she also suggested I cross the street to buy it, instead of in the pharmacy where this clinic was operated, because on this drug the competitor was half the price.

I sent an employee in there to have a problem looked at and he had the exact same sort of price searching done for him. Apparently this is routine because the patients in this clinic care very much about prices since they are paying directly out of their own pockets.

But most Americans have insurance and they pay a flat rate each month regardless of what care they receive. They tend to be lazy and uncaring when it comes to prices. They might want cheaper insurance rates but they don't particularly care about cheaper health care. Whatever the cost, they reason, the insurance company pays for it. This is true of all systems where payment is separated from consumption—people will over-consume and not worry about prices.

This is one reason that forcing more Americans to buy insurance won't help bring down health care costs—no matter how many times Obama tells us it will. The newly insured, who will be forced to buy insurance by Obama, will have the same perverse incentives as the already insured. And because fewer people will be paying out of their own pockets for care, few people will pay attention to the actual costs of the care. That means fewer questions will be asked.

Imagine you are diagnosed with a problem. The physician says that the tests show it to be very likely that you have this particular problem. But he will have some additional, more expensive and more accurate tests done "just to be sure." Are these tests really necessary? If you are paying out of your own pocket you might ask that question. If you are "insured" and someone else pays the bills you may not only NOT ask that question, but you may well demand some further unnecessary tests as well.

Obamacare forces millions of uninsured people to buy insurance. In doing so it moves them from being price conscious consumers to working with the same lack of price information and the same perverse incentives as the rest of the population. So adding more people, who are not price conscious, to the health system can only help drive up costs even more.

Consumers who pull out coupons at the grocery line, in order to save $1 on coffee never bother to ask the costs of various medical care they receive. They never ask for information on less expensive alternatives that might exist. They tend not to query if a cheaper, generic prescription is available. But they will cross town to buy a gallon of milk for ¢50 less than normal. But then none of us pay at the grocery store with our "food insurance" coverage. So we shop around to save a few pennies here or there when it comes to food, and then spend as if were Bill Gates when it comes to our health care.

The other side of Obamacare: Bend over and take it.

The Obama Administration and the Democrats pumped the health deform legislation as a god-send. To do so they had to cook the books in way that would make Enron envious. They intentionally low-balled the costs, pretended it would create jobs (like their other fake job creation bills) and even went so far as to claim it would create revenue and bring down the deficit.

Let's look at some of the distortions about this bill. I say some, since no one really knows what is in this encyclopedic size piece of legislation. Certainly not a single Congressvermin who voted for the bill actually read it. These days bad politicians like Bush and Obama push through massive laws with intricate clauses, publish them at the last minute, push them through under "urgency" and pretty much guarantee that no one knows precisely what they are voting for. Obama promised transparency in legislation but then Obama made all sorts of promises that reneged on almost immediately.

First, consider the claim that 32 million uninsured Americans will get insurance. How will this be done? The government is making it illegal for you to not purchase insurance. This is not the old carrot and the stick routine—it is pure stick and the person being beaten up is anyone who makes the decision to not have health insurance. Government will fine individuals who do not have health care. People will be punished for not purchasing a product that they don't want, for one reason or another. Never before has the federal government forced people to directly buy a product against their will.

A second feature is that insurance companies will not be allowed to "discriminate" on the basis of pre-existing conditions. This basically destroys the fundamental nature of insurance. Insurance is risk based and Obama says risk can't be considered. So people who are already ill will be able to go buy hospital insurance covering their illness. It will be huge losses for insurance companies. They don't worry so much, for the time being, because those costs will be passed on to everyone else who is being forced to buy their product.

What will this mean? For most people it will mean much higher health insurance costs. The big lie from the Democrats was that their policies will reduce health care costs. That is bullshit. By bringing in 32 million people to the system, some of very expensive health care required, the Democrats are imposing huge costs on the insurance system. And that can only mean higher premiums for everyone.

The people most hurt by that will be the young. Young people tend to be poorer but much healthier than average. In a risk based system they would pay much smaller premiums. Older people, who tend to wealthier and less healthy, pay higher premiums. In the Obama system the young people, who often rationally decide to forgo health insurance due to their low risk and low wealth status, are forced to pay for it. Their premiums are used to help subsidize the risk of the older, wealthier, less healthy individuals. It is a transfer of income from poorer individuals to wealthier individuals.

Short term the insurance companies will have millions of extra, unwilling customers, who are coerced into buying policies they don't want. If they wanted the policies they were free to buy them already. And the costs of pre-existing conditions pushed into the system will be passed on to all individuals holding policies. So, in the short term it means higher profits for insurance companies. Who would be wise to take that money and invest it in non-insurance related businesses because long-term it is a destructive policy.

Why is that? Remember that the costs of health insurance for everyone will be forced up by Obamacare. The very poor will be given care by the government, as they are today. But with health insurance rates driven up artificially by the law it will be pushed out of reach of millions more Americans, who nonetheless, will be fined if they don't buy it. The political pressure will be to expand the definition of low-income to cover more and more Americans.

In other words, the increased costs will force more people out of the private insurance and onto the state roles. Politicians will heed the demands for expanding Obamacare to include wealthier people simply because Obamacare will push up health insurance costs so significantly that people who can afford insurance today won't be able to afford it tomorrow.

Over the long term the numbers who are privately insured will diminish and the numbers on state programs will increase. As that happens the risks will be spread over a smaller and smaller number of policy holders, pushing up private insurance rates even further. And the vicious cycle of Obamacare begins. Private rates are pushed up, which makes it unaffordable to more people who, being penalized for not buying it, demand an expanded state system to include them. The Democrats will continue scapegoating insurance companies and will pander to these demands in the name of compassion—compassion for career politicians who want to be reelected to cushy, overpaid positions. This double-blow forces more and more Americans to demand fully state-controlled health-care, but that is what it was intended to do. Obama has not hidden the fact that he wants state control of health care from cradle to grave.

Private businesses were told that their rates will go down. This is false and true depending on dynamics that no one can predict. Businesses that pay for health care for employees will be forced to pay for the pre-existing conditions of non-employees as well, via the increased rates for insurance. So for them, health insurance will be come more expensive. No worries to Obama, that is what he wants. It will force more and more business to line up behind state health care. Some business might see costs reduced as more of their workers end up with state provided health care instead. Of course the savings are illusionary: insurance premiums might go down to be replaced with taxes that will go up.

In the phase where they are paying high insurance costs it means the cost per employee has gone up. That will slow down any hoped-for recovery as employers will be less likely to expand the work force. Increased taxes will further reduce employment—the welfare state/tax system is one one reason Europe has been plagued by perpetually high unemployment rates.

Obama, appealing to the envy of many, said not to worry as some of these extra costs will be obtained by heavily taxing insurance companies. And how does Mr. Obama think the insurance companies will recoup those costs? Blank out. Of course, they will be recouped through higher premiums which will again push more people into the state-controlled system. The insurance companies will reap higher profits for as long as they can, before the system collapses because Obama intentionally made private insurance too expensive for the masses. Then everyone will be forced into the state-run system that was his original goal.

In addition to heavily taxing insurance companies Obama promised to impose heavier taxes on pharmaceutical companies. Again, how will those costs be recouped? By forcing up the prices of pharmaceuticals—that's how. Heavy taxation in many European companies forced pharmaceutical developers to the United States. Apparently Mr. Obama believes they will sit here and take what they wouldn't sit still for in Europe.

I spoke with a friend and regular reader of this blog who is working for a pharmaceutical company in Switzerland. She was thinking of coming out to spend a couple of weeks visiting me and we were looking at going up to the Bay Area because the company she works for has bought out a major research company in Silicon Valley. We talk every weekend and she told me that the company is already looking to move significant sections of their acquisition out of the United States completely. If I were advising pharmaceutical companies I would be urging them to move as much of their company outside the reach of Obama as possible.

Of course, they already know this, whether I had advised them or not. So in those fields jobs will be destroyed. No doubt the Obamacare will create jobs for government bureaucrats who will do half the work as their private counterparts at twice the pay. I imagine Obama will call that economic stimulus.

In a nutshell I predict the following:

• Higher health insurance rates for everyone, with the young hit by the steepest increases.
• With involuntary customers forced by Obama to buy insurance the insurance companies will see short term profit increases.
• Because they know they are short-term they will pump the customer for as much as possible to maximize profits before the long-term negative impact is felt.
• As insurance rates increase more and more individuals will be forced to abandon private insurance plans.
• Facing penalties for not having insurance these people will lobby to be included in the "low-income" category for government provided care.
• Politicians will heed those calls and expand the "low-income" category on a steady basis.
• As more people are forced into the state system fewer private policy holders are left paying the bills forcing even higher rates starting the cycle over again.

A cautionary tale

One point I've made is that nationalized health systems can be cheaper because they deny access to their system of "universal" care. Here is one such tale.

I do find it absurd that the advocates of state-run care argue that it will provide "universal" care when it does no such thing. As far as I know every single nationalized health system rations care. What they mean by "universal" care is that everyone gets some care just not all the care they need. But that is also the case in the United States under the current, screwed-up, mixed system of care.

Health Care BS from the Unions

Whole Foods has one of the best formulas for health care around. Yet it is under attack by the Left because John Mackey, the CEO, has written about private alternatives to state control. It is astounding to watch the protesters claiming that the Whole Food employees are just ignorant. What Mackey and Whole Foods offers is precisely the kind of policy I would want. It combines cash to the employee to cover small health care issues and then an insurance policy, with a higher deductible, to cover the rest. Employees are saying it is the best health care they ever had and the union hired picketer just calls them ignorant of the facts. All in all, who do you think cares about the health care of the employees most? Is it the union picketer or the employees?

I suggest the union moron just has another agenda and it isn't the health care of the employees. The other flash protesters doing their little dances just seem uninformed especially the one going on about how Mackey doesn't want his "Latino-based" workers to have health care. All the employees have health care. That is just Left-speak --- anyone who disagrees with their desire to have state control is merely a racist. Rubbish.

Is this the future we will face?

The drive to impose a nationalized health system on the US is a major goal of the far Left. They really are quite rabid about it. I've previously discussed the failures of all health systems and why I think the US is the least worst of the lot. I'm no defender of the muddled system we currently have where various laws and regulations horribly distort the system and limit choice. But I couldn't possible embrace the nationalized system that the UK has, for example. Consider these two recent cases in the British press.

Matthew Millington enlisted in the British military at the age of 16, some 15 years ago. While stationed in Iraq he was diagnosed with a lung illness and it was determined he needed a double lung transplant. But the National Health Service gave him the lungs of a man who had been a heavy smoker and which contained cancer. Because Millington was taking drugs to surpress his immune system the cancer had a field day and spread rapidly.

Remember, the NHS hospital gave Millington lungs infected with cancer during his transplant. They also gave him drugs to suppress his immune system which allowed the cancer to grow. And when the cancer was discovered they said he was ineligible for another lung transplant because the hospital's rules. I quote the Times of London: "Because he was a cancer patient, he was not allowed to receive a further pair of lungs under hospital rules." The cancer he had, which made him ineligible for a second transplant, was literally given to him by the hospital.

The Times reports: "The cancer was discovered only six months after the operation, because of a lack of communication between radiographers and consultants. The tumour had grown from 9mm to 13 mm in that period." The hospital admits "a string of problems, including difficulties with communication, record-keeping and patient handover."

Hazel Fenton, 80, came down with pneumonia and was placed in the local NHS hospital. Doctors determined immediately that she was terminally ill and placed her in a controversial NHS program "to east the last days of dying patients." The program is actually something else entirely. When a patient is placed in the program the hospital ceases to feed the patient and given them care, allowing them to die.

And that is what the NHS was doing to Hazel. They refused to feed her, to ease her last days, by ending her life. Hazel's daughter, Christine Ball, was there to fight for her mother. She fought the hospital for days before finally getting them to begin feeding her mother again. Nine months later, the woman the NHS deemed in her "last days" was alive and well in a nursing home near her daughter.

The Times reports: "Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS, denying treatment to elderly patients who are not dying." Miss Ball was equally blunt: "My mother was going to be left to starve and dehydrate to death. It really is a subterfuge for legalised euthanasia of the elderly on the NHS."

Ball says that while she was trying to convince the hospital her mother was not dying a nurse asked her for instructions on what to do with her mother's body.

The Times also writes: "In a separate case the family of an 87-year-old woman say the plan is being used as a way of giving minimum care to dying patients." The daughter of the woman in question says that her mother was put on "the plan" and "her medication was withdrawn. As a result she became agitated and distressed." Justified as a way to make the last days easier for the patient it appears "the plan" is a way to make medical care cheaper and meet budgetary restraints by denying treatment to old people.

Meanwhile another scandal is brewing in regards to NHS staff members who become sick. It appears that the National Health Service doesn't trust its own care when it comes to their staff members. Recent documents reveal that over the last three years the NHS spent £1.5m (about $2.4 million) so that their staff could receive private treatment outside the NHS system. Some 3,000 NHS employees received private care paid for by the NHS, care denied to patients of the NHS. Norman Lamb, Shadow Health Secretary for the Liberal Democrats said: "If the NHS thinks it necessary to pay for private treatement for its staff to jump waiting lists then it raises serious questions about whether the current system is working as it should."

One local newspaper looked at how the NHS paid to have ambulance staff receive private care and was told by a spokeswoman for the amubulace service that "we want to get [our staff] back o work as quickly as possible so they can continue to provide services to the people of the east of England..." Apparently to give quick service they have to scuttle the NHS and go private.

The BBC recently reported that a report on NHS procedures show that: "More than 5,700 patients in England died or suffered serious harm due to errors lastest figures for a six-month period show." And another NHS report shows that one in 50 patients are receiving treatment to undo the harm done by the NHS with previous care. This includes those with reactions to medication, those suffering from "misadventures" during surgery and "adverse incidents" related to medical equipment.

Another example of how nationalized systems lower costs comes with the drug tocilizumab. This drug appears to work very well for patients with rheumatoid arthritis who have not responded well to other medications. But nationalized systems are known for being cheap and being cheap means not offering medical care deemed too expensive. The NHS has an agency called the National Institute for Health and Clinical Excellence (which they abbreviate as NICE). NICE is not nice when it comes to recommending drugs. NICE said that the medication is too expensive and has advised against its use, not because it is ineffective or dangerous, but because it costs too much. The National Rheumatoid Arthritis Society says the decision is "extremely bad news."

However, while they can't afford to pay for medication that would ease the pain of patients, the NHS can afford to continue to pay executives who no longer work for the NHS. A publication in Wales reports: "The Western Mail understands that chief executives and finance directors displaced by new arrangements that came in last week have a guarantee that their existing salaries will be protected for 10 years." So, a job is ended, but the staff member stays on salary for 10 years at full pay.

Photos: Upper left, Lester Millington with a photo of his deceased son, Matthew. Mid right: Christine Ball with her still quite alive mother, Hazel Fenton.k

Taking on the myth of life expectancy.

Periodically I have taken on the myth that American life expectancy, being lower than many Western nations, is proof that the American health system is failing. This is clearly one of the more bogus claims that advocates of state controlled health care propagate.

I was glad to see John Tierney in the New York Times, take on the issue as well. (I have never met Mr. Tierney directly though we did sit in on the same press conference with Matt Stone and Trey Parker (South Park) in Amsterdam a couple of years ago.) Tierny basis his column on research published in Health Affairs. Here is the synopsis of that article:

The United States spends more on health care than any European country. Previous studies have sought to explain these differences in terms of system capacity, access to technologies, gross domestic product, and prices. We examine differences in disease prevalence and treatment rates for ten of the most costly conditions between the United States and ten European countries using surveys of the noninstitutionalized population age fifty and older. Disease prevalence and rates of medication treatment are much higher in the United States than in these European countries. Efforts to reduce the U.S. prevalence of chronic illness should remain a key policy goal.

What this means is that Americans have specific problems more often than Europeans do: in particular cancer and heart disease. Both problems are strongly related to lifestyle choices NOT to health care. As Tierney explains:

there are many more differences between Europe and the United States than just the health care system. Americans are more ethnically diverse. They eat different food. They are fatter. Perhaps most important, they used to be exceptionally heavy smokers. For four decades, until the mid-1980s, per-capita cigarette consumption was higher in the United States (particularly among women) than anywhere else in the developed world. Dr. Preston and other researchers have calculated that if deaths due to smoking were excluded, the United States would rise to the top half of the longevity rankings for developed countries

Dr. Samuel Preston, a demographer at the University of Pennsylvania did the study with several others. Tierney writes: "Dr. Preston says he saw no evidence of the much-quoted estimate that poor health care is responsible for more preventable deaths in the United States than in other developed countries." Tierney notes that the findings of the study show that Americans who do become ill tend to get better care in the United States. This shows up in statistics like the cancer survival rate. Tierney notes that: "Americans also do relatively well in surviving heart attacks and strokes, and some studies have found that hypertension is treated more successfully in the United States. Compared with Europeans, Americans are more likely to receive medication if they have heart disease, high cholesterol, lung disease or osteoporosis."

Preston is basically saying that Americans have a shorter life-span due to bad decisions they make, not due to bad health care. They do get sick more often and earlier in life as a result. But when the health care they receive is compared to that of Europeans with the same problem, the Americans do quite well. Preston believes that the difference in life spans will close very rapidly primarily as a result of the decline of smoking in the United States.

Dr June O'Neill, and Dr. Dave O'Neill of Baruch College, City University of New York, did a study comparing the actual treatment that Americans receive, on average, to the actual treatment that Canadians received from their nationalized health system. This was not studying the promises the two systems made but the actual delivery of care given to people with specific illnesses. In disease category after disease category they found Americans were more likely to be receiving treatment not less, with a couple of minor exceptions. In each case the compare Americans with a specific medical problem to Canadians with the same problem and then calculated the percentage who were actually receiving treatment.

Their study found that: "Out of eight conditions they investigated Americans have higher treatment rations in six categories with Canada leading in asthma and angina." But they found that for angina this was only true for younger patients not older patients. When it came to individuals over 64-years-of-age Americans had higher treatment rates than their counterparts in Canada. Their conclusion: "the U.S. generally performs better with respect to treatment of all conditions except that of asthma."

They also found that Americans are more likely to undergo preventative testing such as PAP smear, mammograms and PSA test for prostate cancer. For instance, 74.9% of all American women had a mammograpm in the last two years where only 54.7% of Canadian women did. For older men 54.2% have been checked for prostate cancer. In Canada is was only 16.4%. When it came to checking for colorectal cancer, Americans were six times more likely to be checked than Canadians. The O'Neills found that Americans had better cancer survival rates than did Canadians. A study in Lancet found the same thing when comparing American survival rates to those of Europeans -- the U.S. was well in the lead when it came to survival rates.

The O'Neills found something quite similar to what Dr. Preston found: Americans have higher incidences of health problems than do Canadians but they also had higher treatment rates. And Americans, when asked how happy they were with their care, had a satisfaction rate higher than the Canadians as well.

How Obaman and the Radical Left are creating a Republican resurgance.

The socialist Left, as opposed to the classical liberal Left, is apoplectic about the criticism concerning Obama’s health care power grab. There are two reasons for this. First, they really, really want to nationalize health care so public opposition to their take-over is upsetting to them. Second, they stupidly assumed Obama’s electoral support was support for the candidate’s more authoritarian measures.

This blog argued that Obama was supported by independent voters for one reason: they were sick and tired of Bush and the Republicans. Any right-thinking person was sick and tired of the fumbling Dubya and his Jesus-drunk Amen chorus in the Republican Party. I prevously wrote that the Democrats were being foolish to interpret disgust with Bush as the same thing as support for Obama’s more extreme policies. Democrats don’t listen so they assumed the world was rallying around Obama, as opposed to rejecting Dubya.

When their first big power grab came up they expected it would be a cakewalk. They imagined that most voters worship the water that Obama walks on. That's just not the case. Polls continue to show that the bulk of the voters are NOT supporters of Obama’s health care legislation—whichever version of it may be current at the time.

So the statist Left has been foaming at the mouth and screaming that opposition to Obama is a “fringe” movement. To them it has to be “fringe” since they remain convinced that Obama was elected to expand state control of health care. Their initial error, in assuming that votes for Obama meant support of Obamacare, is leading to their current error: assuming that only “fringe” nut cases can oppose their regulatory orgy. That is leading to a second error in tactics.

Because the statist Left assumes the opposition is just the fringe, they are insulting the opponents of Obamacare. Instead of grappling with the concerns of the majority of the public the Left is attacking them. But, opposition to Obamacare wouldn’t go anywhere it if were limited to Republicans. The bulk of American voters see themselves as independents and the independents, by the standards of the classical liberal, are pretty decent folk.

When polls investigate the independent voter certain things stand out. They do tend to like low taxes and don’t want big government. They sound pretty conservative. But they also tend to support marriage equality and don’t want to enforce Biblical law, unlike the theopublicans. In other words, the independent voters tend to drift in a libertarian direction, and not toward either the authoritarian Left or the authoritarian Right.

The strategic error the Democrats are committing is that in insulting and attacking these people they are laying the groundwork for a Republican resurgence in next year’s Congressional election. Independent voters are not pleased by either the socialist Democrats or the theocratic Republicans. They aren’t drawn to either party. But they still vote, so they tend to look at which party disgusts them the most, and then vote for the other one. Bushian Republicanism absolutely nauseated them, so they voted Democrat. But now the Democrats are attacking them for not supporting Obamacare. My prediction is that this desperate strategy to save socialized medicine will push the independent voters back to the Republican Party. How long they stay there will depend on whether the Republicans are stupid enough to take that resurgence as support for their campaign to Christianize America.

One of the methods used to demonize opponents of Obamacare has been to not just insult the opponents to this care but to claim that they have been violent. Mary Katharine Ham, at The Weekly Standard, investigated these claims. She notes that there were more than 400 town hall meetings in August. Yes, there was violence in a only handful of these meetings. But most of that came from the statist Left, not from critics of Obama. Ham writes of one incident:

In St. Louis, several video cameras captured an altercation between Kenneth Gladney, who was selling "Don't Tread on Me" flags and buttons outside, and several purple-shirted SEIUGladney, who is black, was addressed by an SEIU member using the "n-word," who then assaulted him. Gladney went to the hospital with minor injuries, and two SEIU members, including the local SEIU public service director Elston McCowan, were among the six people arrested in St. Louis that night. An unidentified female was arrested in connection with the same altercation. A video of the event shows her approach an Obama critic filming the Gladney incident, and then smash the camera into the filmer's face. The female assailant was later cuffed by police at the scene, also on tape. The SEIU later claimed that Gladney was the aggressor, but a video shows a different picture. Gladney is outnumbered and visibly shaken as one SEIU member yells on tape, "He attacked America!" before challenging Gladney's defenders to a fight and hurling profanities at the filmer.

Ham itemized other such incidents. At a Pelosi meeting: “A Denver Post photographer caught one of those sign-bearers, a grim-faced woman in a "HOPE" Obama shirt, ripping a homemade anti-Pelosi sign from Obama critic Kris McLay's hands as she yelled in protest. The Obama supporter declined to be identified for the photo.” In Durham, NC, an Obama opponent was punched in the face for speaking against Obamacare. His attacker was from the local union.
Ham outlined all the documented cases of violence at these town hall meetings:

That's the full list of documented violence from the August meetings. In more than 400 events: one slap, one shove, three punches, two signs grabbed, one self-inflicted vandalism incident by a liberal, one unsolved vandalism incident, and one serious assault. Despite the left's insistence on the essentially barbaric nature of Obamacare critics, the video, photographic, and police report evidence is fairly clear in showing that 7 of the 10 incidents were perpetrated by Obama supporters and union members on Obama critics. If you add a phoned death threat to Democrat representative Brad Miller of N.C., from an Obama-care critic, the tally is 7 of 11.

To mischaracterize these few incidents as part of the strategy of Obama critics, and to attack those unhappy with the so-called “reforms” of health care as extremists, only strengthens the Republican Party. The far Left in the Democratic Party is doing what the Far Right in the Republican Party did – drive the great middle of American voters into the arms of the other guy.

One year after Obama’s election, let me quote this blog to remind you of my predictions regarding Obama’s performance in office.

I don’t expect Obama to make any major withdrawal from Iraq. In other words, I don’t expect he will end this illegal and unconstitutional war. Equally disastrous will be the likely “reluctant” support he will give to keeping the authoritarian Patriot Act in place. Do not expect Obama to do much to protect civil liberties, or to reclaim those stolen by the Bush Administration. What you can expect is lots of speeches with the same unspecified, vague rhetorical flourishes that Obama loves. What he won’t do is give any substance to them. George Bush was a bumbling speaker who gave specifics -- although his specifics were almost entirely evil. Obama will be a brilliant speaker who will use his florid style to cover up his lack of substance. I do think Obama will try to implement some policies -- all of them bad. I fully expect him to put bureaucrats and politicians in control of more our medical care than ever before.

So far I have no reason to revise advance estimation regarding Mr. Obama and his disastrous term in office. What has changed has been how badly the White House has bungled things. I expected them to be smoother than they have been. The shrill response from the Democrats has been a godsend for the Republicans.

I will reiterate my view that the Republicans, if they want to be a party of government for the long term, will still have to scuttle their links to the Christian lunatic fringe. Of course, the Democrats could do the same thing if they rejected the old tax, spend, regulate policies of their socialist ideologues. Until one of the two major parties wises up, and abandons the ideological albatross around their neck, the independent voters will swing the elections. But that is not necessarily a bad thing since these are people who tend to want sound economics, aren’t interested in Christian moralism, and aren’t too keen to police the world.

How to cut your health care costs sensibly.

In the last week I made one of my rare visits to American health care provider. I say rare because most of us, including myself, rarely actually need to see a physician or go to a clinic. I know lots of people do it at the drop of a hat—certainly that is their right—but they do drive up health care costs needlessly.

Generally my policy is to watch my health myself. I regularly monitor things like heart rate and blood pressure. And when I get sick I try to rest, take an appropriate medication, and wait out the illness. Of course, you can’t always do that—though you can most of the time. I knew I was going to get a cold. I had some small sliver of popcorn aggravating my throat. I knew that would lead to a sore throat and when that happens I end up with a cold, which progresses over several days before clearing.

This time, things went as normal except at the end of the period when the lungs stayed congested. So, after a couple days of this, I decided it was time to have it looked it. I was driving past a clinic down the road from the house and decided to go in, with no appointment.

It is one of those small clinics that are now cropping up in shopping malls and stores to provide basic health care. I checked in using a touch screen. The only staff is the Advance Practice Nurse. I know a lot of people get worried because a nurse is not a doctor. But we really rarely need a doctor. If people got that through their heads they could cut health care costs substantially.

I don’t worry about an APN handling things. In hospitals nurses do the bulk of the routine work anyway. Most of the actual health care I had over my lifetime has come from nurses. My mother was a nurse. And I can’t remember a single time in childhood when she took me, or any of my three siblings, to see a physician because we were ill. We had all the normal childhood diseases from colds, to the flu, to measles (which I guess aren’t that normal anymore). Mother never saw any of this as a reason to bother with a doctor’s appointment. I’m sure if the situation got worse, or took unusual turns, she would have done so.

But my mother knew that 90% of the time a doctor’s visit is not warranted. And it wasn’t the cost. She worked in hospitals as well as in private practices. She worked for quite a long time for one doctor in particular and we could have had him check us over at no cost. But even when it was free, it was also unnecessary. Unfortunately a lot of people don’t think that way.

And that puts a burden on health care that drives up costs. A large number of Americans now routinely see a doctor over the slightest sniffle. I was reading an article in the New York Times that spoke of an over-stressed free clinic in a poor area. The article was praising a woman who did what “she was supposed to” by taking her child, with a case of a runny nose, to the clinic for care. I wanted to scream. It is precisely that sort of needless visits that means the free clinic is stressed. The article was lamenting how the clinic can't pay its bills, while praising the public for over-using the clinic. The fantasy that the Left, like the New York Times, has is that we can have unlimited supplies of medical care. We can’t. You can encourage people to rush off to the clinic at the drop of a hat but when you do it will mean that resources get used to treat sniffles and then aren't there later on.

My check-up went about the way I figured. The nurse was able to write a prescription, which is useful. I’m not up on the facts here, but I suspect in many places that wouldn’t be allowed—which is daft. She prescribed an antibiotic for the lungs as well as a cream for a skin rash. She suggested an over-the-counter drug as well. She did a basic check-up and said things looked good but that the infection was trying to make a home in my lungs. Basic stuff really, no physician was necessary. Total cost for everything, including the medications, $88.00. Total waiting time at the clinic, about 15 minutes. I spent more time than that with the nurse as she checked me over. I can only compare that to one visit to the National Health Service in the UK when I was staying there. Wait time there was about an hour, time with the physician about 10 minutes. I also got a follow-up phone call three days later to see how I was doing.

People today spend a lot on health care that needn’t be spent. A cold is not a reason to see a doctor. A kid claiming to have a sore throat is not a reason to rush down to hospital or make an appointment at the clinic. So why do people do it? Simple, third party payment schemes give people the incentive to over-consume. If you pay a flat rate per month for health insurance, and that covers the bulk of the cost for a visit to the doctor, then the way to maximize your “profit” from the insurance is to use it, even when you don’t really need to. You will pay that rate even if you don’t visit the doctor once in the year—that is how insurance works.

But health care insurance isn’t like other forms of insurance. You aren’t going to crash your car just to put in a claim. Nor are you likely to burn down your house. But health depends on how you feel. To a large extent it is subjective and not easily verifiable. So, if you are a bit under the weather, and your co-payment is relatively low, you may rush down to the doctor. The doctor will tell you to rest, drink plenty of fluids, and might prescribe an over-the-counter medication that you knew about anyway. But the co-payment was low so you didn’t mind spending a little bit for the assurances. Of course, the total cost went to the insurer and premiums are pushed upwards as a result. But when consumption of a good, including health care, is divorced from payment of the good people will tend to over-consume.

People are notorious for not putting two and two together, and getting four. They don’t realize that little issues, that really don’t need a physician, drive up the total cost of health care. So mothers drag their kids with the earaches, runny noses, sniffles, and little coughs off to clinics. Most of the time they would be better off putting the kid to bed, giving him some medication, and pampering him. In most cases this is what the doctor would suggest. But the cost of having a doctor tell you is much higher—but people don't worry about that, the insurance will cover it. But they will bitch when the insurance premiums go up. The truth is that most people could cut out much of what they spend on health care without any measurable impact on their health. In other words, all that extra money people spend, isn’t making them healthier. One reason Americas spend so much extra on health care is because they want to.

There are, of course, some people, who really do need constant care. But that isn’t the case for the bulk of the population. With basic hygiene, a reasonable diet, and common sense most of us avoid the need for any intensive health care. Of course, if we choose to smoke, get drunk, or overeat and become obese, then our health care needs will dramatically increase.

One of the things I like about health savings accounts is that they understand this problem. Under those schemes the individual has a flat rate per year that they can spend on routine visits. If they don’t spend it they can roll it over to the next year. It is their money. That covers routine visits but encourages the consumer to consider the costs. If they go to the doctor it comes out of their savings account, it is their money they are spending. Suddenly the sniffles are not a reason to rush off to the doctor’s office. At the same time these policies usually provide catastrophic insurance for the unlikely, but serious illnesses that may crop up. The total cost for such policies are low compared to routine health insurance.

They are low because they encourage people to think rationally about the small problems but this plan also allows for care when things get serious. This is what Singapore basically does with their health care system. Individuals put a percentage of their income into a health savings account, which they own. That money is put aside for routine care but it belongs to the individual, not to the system. Out of that they also pay for major insurance to cover the major illnesses. The poorest people are put into the system by the government. But you are free to choose from any doctor and clinics are required to advertise prices to encourage competition. Only about 10% of the population requires state help to pay for the care. In the end Singapore spends much less per person on health care than any of the socialized systems of Europe, with better results.

So why isn’t that popular with the “universal health care” crowd? May I suggest that it doesn’t give the state control of medicine as the reason? I have concluded that many on the Left don’t give a damn for health care; they just want state controlled health care—much like they want state-controlled everything.

This is why they attacked Whole Foods for offering a generous health program to their employees. Whole Foods uses the same sort of health savings account plan that is used in Singapore. Employees are given a basic amount per year for routine visits and covered for all serious illnesses. The incentives mean they don’t over-consume on the small issues since what they don’t use belongs to them. But when John Mackey, of Whole Foods, wrote an opinion piece about how the Whole Foods health system was good for workers and could be emulated in other industries, the rabid Left started demanding a boycott. That alone was almost enough to make me buy from Mr. Mackey’s stores, but I’m not into organic.

If you are self-employed or don't have insurance then you can set up a similar plan for yourself. For routine visits pay 100% out of your own pocket. Then purchase catastrophic insurance that kicks in at some relatively high level, say $5,000 or even $10,000. You will be surprised at a cheap your health care will become. Put a small amount aside each month for the routine visits and keep saving it. Only use it when you have to and you could quickly save the deductible for the catastrophic insurance. Really, if you don't waste your resources on the small issues, which are unlikely to impact your health, you can have them later for when you really need them.

How nationalized health care victimizes immigrants.

Evangeline Stanner is a victim of nationalized health care. As is her husband and two children.

Evangeline, 35, was born in the Philippines. She is married to Richard Stanner of New Zealand. The couple, who met over the internet, have been married since 2006, together they have two children, a two-year-old and a six-month old infant.

After her marriage in 2006 Evangeline was given a work permit in New Zealand so she could be with her husband. That work permit was renewed twice but is due to expire in January. You would think that as the legally married spouse of a Kiwi that she'd be able to stay in New Zealand. And Kiwis are allowed to sponsor their spouses for citizenship—something Evangeline and Richard have put into motion.

But the Stanners were told that Evangeline must leave her home, her husband and her children and return to the Philippines. Evangeline says: "Immigration is tearing our family apart." But she is wrong. It isn't actually immigration that is doing it, it is nationalized health care.

Evageline's only crime was that she got sick. New Zealand has a nationalized health care system and immigrants are not allowed into the country if they might impose costs on the system. It doesn't matter that Evangeline only became ill while in New Zealand. Immigrants are allowed in provided they fund the system, as Evangeline did with the taxes she paid from employment, but they must not collect from the system into which they are forced to pay. Their only purpose is to keep the system funded for aging Kiwis who don't have private insurance, thanks to the crowding out that happens when government provides this care.

During her first pregnancy, with son Josh, she developed a slight kidney problem. With the birth of her second child the condition became much more severe. Her application as the mother of two Kiwi children was scrutinized by medical bureaucrats who wrote her "that you do not meet the acceptable standard of health... on the basis that you are likely to impose significiant costs or demands on New Zealand's health services."

Evangeline has until January 10th to be with her children and then she will be exiled for the crime of being ill.

Immigrants going into New Zealand are taxed for the health care system. Many immigrants simply can't afford to purchase private insurance on top of the heavy taxes they pay for the "free health care" which they better not use. So, if they use the national health system they may end up getting deported, but they can't purchase private care either since the national health system eats up a good portion of their income. Its a case of damned if your well, double damned if your sick.

On top of kidney problems Evangeline has to cope with the stress of being exiled from her husband and children just so the illusion that "nationalized" health care is cheap can be kept alive.

Evangeline, and other immigrants, are not allowed to forgo the nationalized health system, the purpose of such a system is to guarantee "equality" not improve people's lives. So while many would find a better life in New Zealand, even without the socialized health care, they aren't allowed to have it. That would undermine the real principle at work, equality of outcome. So to pretend that the system grants equal access to health care, anyone who might get sick is deported.

You will also find that older people are also routinely discriminated against by New Zealand Immigration, even if those people are quite capable of funding their own health insurance. The system is set up so that nationalized health care trumps everything so anyone who could conceivable use that care is forbidden from moving to New Zealand.

Oddly this has nothing to do with a Kiwi fear of people taking advantage of the welfare state. People can immigrate and join the welfare rolls, that isn't the problem. The problem is that health care is a more precarious situation. Most Kiwis will never be on welfare, so the government can tax them to pay for those people who are on the system. But everyone eventually needs health care and the Kiwi system, like all socialized systems is costly with demand exceeding supply. So anything that strains this already over-strained system has to be cut out.

The result is the rationing which I have spoke about on numerous ocassions. Some medines simply are forbidden. Some procedures are simply banned. Hospital beds are rationed, as are doctors and health care in general. And, some people are simply banned from having health care. If you ban enough people then you can offer "universal health coverage" albeit not very honestly.

Evangeline Stanner had the misfortune of becoming ill under nationalized health care before her residency was approved. So, for that, she will be deported. Chances are also good that she will die in the Philippines because of her illness. She did pay into the health system for three years, her husband paid in for his entire life, but under socialized health care rationing takes place. Nameless bureaucrats decided where to draw lines over who is, or isn't allowed to have care. They drew the line and Evangeline was on the wrong side of it.

Of course, it is possible that lots of negative publicity will ge the politicians to step in and change the ruling. But that won't change the system. All it will mean is that lots of other people, good people who won't get the publicity, will still be excluded because the national health system is only looking for immigrants that can be plundered, not immigrants who may need health care.

In a rational immigration system health, in the sense of communicable diseases, may be an issue. But Evangeline posed no threat to the health of others. I would suggest her presence, with her children, would lessen risks they may have in life. But she was a "liability" not an "asset" to a system that she had no choice in joining.

National health care systems impact on freedom in more ways than meet the eye. It won't just be the reduction of freedom of choice in medical care, and it won't be just a reduction in the amount of the wages you earned which you are allowed to keep. It will also mean greater restrictions on freedom of movement between countries. Nationalize health care makes it harder for would-be immigrants to find a better life. And that means that they, and everyone else, is made poorer because of it.

Under nationalized health care immigrants are an invisible victim of the system. Evangeline is one of those victims, albeit one that has managed to received some publicity.

Socialized health care: the equal right to wait, and wait, and wait.

While Americans were debating the Obama administrations attempt to have government grab the health care sector no one was paying attention to the news from Canada. Canada is one of those state-controlled health care systems that is lauded and praised by those who want a form of health care fascism in America.

The article in question appeared in the Vancouver Sun and mentioned a document that was leaked from the local Health Authority. In Canada, health care is run by the provinces on behalf of the federal government. I should mention that a couple of years ago the Canadian Supreme Court legalized private health insurance, which had been banned by the government, saying that the government was doing such a poor job of providing care, that banning private care on top of what they were doing, was a violation of the rights of Canadians. Since the state was unable to provide decent health care as promised it could not also ban private care as that put the lives of people at risk.

The document that the Sun mentioned was a report from the health authority on the number one problem of socialized care: the inability to pay for it. The problem is that once you announce care is “free,” by which they don’t actually mean free, just that payments are divorced from consumption, the numbers of people wanting more and more care explodes. The demand for care exceeds the supply of care. That is how it is with any good or service that people desire: demand will always exceed supply.

AS the demand explodes so do the costs. But the big slogan of the advocates of nationalized care is that they offer “cheaper” care. So, with exploding demands they have to ration the care to keep costs down. Unfortunately, as they keep trying to reduce the supply of medicine the demand continues to escalate. That leads to budget shortfalls. They don’t have the funds to pay for it.

The Fraser Health region in British Columbia is facing a $160 million shortfall so they were trying to figure out what health care they could end. The document discussed included more rationing of care. A representative of the New Democrat Party (socialists) said this indicated cuts to: “Diabetes clinics in Delta and Mission, regional maternity and pediatric services, and seniors’ aid and mental health programs….” The bureaucrats admit the report is genuine but say it is misleading to allow the public to read it. They admit discussing “a potential 10-per-cent drop in the number of elective surgeries… and longer waits for MRI scans.” Remember, that under government health care programs they decide what is elective surgery not you, not your physician.

Canada’s Health Minister Kevin Falcon said “We’re in the situation right now where there is no more money” and that cutting care is necessary to keep the system sustainable.

The article mentions one hospital that will be forced to close its emergency ward entirely requiring patents to be taken to hospitals another 20 minutes away.

One way that the state health systems keep costs down is to limit the number of people who can have care at any one time. The result is waiting lists, patients are told they are on the list for treatment or surgery and that in some week’s time they will get the care. If you only have one MRI machine, which is expensive, then only so many people can use it in a day. Reduce the capital expenditure on health care, which socialized systems do, and you end up with patients waiting, and suffering longer, in order to get that care.

In Canada the Wait Time Alliance monitors the waiting lists that result from rationed care. The WTA is not a batch of “right-wingers” or “tea party activists” or whatever other stereotype one may use to describe opponents of nationalized care. It is an alliance of groups like the Canadian Association of Emergency Physicians, Canadian Association of Radiologists, the Canadian Medical Association and ten other associations of health care professionals.

In their June, 2009 report, Unfinished Business: Report Card on Wait Times in Canada, they attempted to measure the average waiting time for patients. Under the Canadian system an individual must first see a family physician. That physician acts as a gatekeeper, you don’t get see a specialist unless you are recommended by your physician. The waiting period includes the time period between seeing your physician to get permission and the time you actually see the specialist. In addition a second layer of waiting is then measure: that is the period between seeing the specialist and having access to treatment. What is not included “is the wait patients may experience to access their family physician or the fact that nearly 5 million Canadians do not have a family doctor.” (p.3)

In particular they tried to measure the waiting time in comparison to “benchmarks” set by the government. WAT, however, notes that the government benchmarks for waiting periods “represent maximum acceptable wait-time targets and should not be viewed as desired wait-time targets.” In other words, the benchmarks the government set for itself are absolute minimum possible before getting a failing grade completely. Sometimes, what the government considers “acceptable” wait-times, are considered highly undesirable by the actual physicians involved. WTA and the Canadian Cardiovascular Society argued that, with cardiac bypass surgery, no more than six weeks should pass from the initial doctor’s visit and surgery. The government is quite happy with a target of 26 weeks. (p. 4)

Even with somewhat loose targets the government system fails: “Based on the… target of 18-weeks from initial referral by a family physician to start of treatment, a majority of patients had wait times that exceeded the 18-week target.” For cancer patients “the median wait for radical (curative) cancer care was 46 days or nearly 7 weeks… the majority of these treatments exceeded the CARO [Canadian Association of Radiation Oncology] benchmark for curative cancer treatment of 4 weeks (2 weeks for the consult wait and 2 weeks for treatment). This is troublesome given the clear link between delay in radiation therapy and a chance of cure.” (p. 7)

This sort of waiting is routine even for emergency treatment. The report said that “the media wait time for patient [in emergency care] presented at the ED to the time they were admitted to an inpatient bed was 19 hours (average is 23.5 hours or nearly one full day,) which is substantially higher than the CTAS [Canadian Triage and Acuity Scale] thresholds (e.g., more than three times the 6 hour guideline for high-level acuity patients). The longer wait for patients to be admitted is often due to the inability to find an available hospital inpatient bed.” That inability is because hospital beds are expensive to maintain (not just the bed but the care that goes with it) and one way to reduce costs is to limit availability to that care by limiting the available of hospital beds.

These wait-times are critical. Whatever flaws the US system has, and most of those are due to political interference, the US stacks up quite well for actual treatment needed and received, compared to Canada. A report by June O’Neill and Dave O’Neill, Health Status, Health Care and Inequality: Canada vs. the U.S., investigates the percentage of people, with particular conditions, receiving care for those conditions in the United States verses Canada. As previously reported here:

In Canada 84.1% of those with high blood pressure were receiving treatment for it. In the United States the number was 88.3%. Those with emphysema or related illnesses are far better off in the US where 72% are receiving treatment versus 52% in Canada. In the US 69.6% of individuals with heart disease receive treatment while in Canada the rate is 67.2%. When it comes to coronary heart disease 84.8% of American sufferers receive treatment as compared to 88.9% of Canadians with the problem. Out of eight conditions they investigated Americans have higher treatment ratios in six categories with Canada leading in asthma and angina. These were for individuals age 18 to 64.

But these differences remain fairly consistent for individuals over the age of 65 as well. The only change was for angina where the U.S. now has a higher treatment rate than Canada: 77.7% to 73%. The report noted that “the U.S. generally performs better with respect to treatment of all conditions except that of asthma.”

What about preventative procedures like PAP smears, mammograms and PSA tests for prostate cancer? Again higher percentages of the American public receive such tests than do Canadians. In the U.S. 88.6% of women ages 40 to 69 have had a mammogram. For Canada it was 72.3%. In the U.S. 74.9% of the woman had the test within the last two years where only 54.7% of Canadian women had a recent test. For PAP smears the rate was, over the last three years, was 86.3% for American woman versus 88.23% for Canadian women. The men get a worse deal in both countries when it comes to testing for prostate cancer. In the same age group, 54.2% of men have been tested while in Canada the rate was an abysmal 16.4%. And testing for colorectal cancer is done, both for men and women, about six times as often in the United States as in Canada.

When the study looked at survival for cancer in both countries they also found that Americans were slightly better off. They looked at the ratio of the mortality rate to the incidence rate for cancers and found that Americans are ahead. They concluded, “in terms of the detection and treatment of cancer, the performance of the U.S. would appear to be somewhat better than Canada’s.”

The use of MRIs and CT scans are also much, much rarer in Canada. Canada has 5.5 MRI scanners per million people as of 2005. The US, in 2004, had 27 per million. When it came to CT scanners the US had 32 per million in 2004 while Canada, for 2005, had 11.3.

Considering that one of the alleged virtues of Canada’s health system is the “equality” factor it is interesting to see that more individuals in the US, with specific conditions, are receiving treatment than do their counterparts in Canada. The report also found that the poor in the United States reported as much, or more health care, than those in Canada did.

Life expectancy and infant mortality: a rerun

Because the hard Left, who favor state control of medicine (and almost everything else) are conducting a bogus campaign in favor of nationalizing care, I want to rerun a piece I wrote some time ago. The proponents of bureaucratic control of medical care insist on using bogus statistics to prove their case. They continue to resort to two numbers. One is the life expectancy rate and the other is infant mortality. Both measure many factors completely outside the control of the health system. Here is something I wrote almost two years ago to the day—so it was written long before Jesus Obama walked across the reflecting pool to the White House. Everything that follows is from the older article. A few minor typos were corrected but the article was not changed.

Life expectancy is the result of dozens of factors. At best it is a general indicator of life in a specific area. In and of itself, it does not tell you much about any specific policy.

I am convinced that life expectancy is only tangentially connected to health care, with the exception of birth. Once an infant survives the first year or so of life, health care is almost secondary. Prime factors include diet, safety, clean water and sanitary conditions, and lifestyle choices.

If you look at the history of the rise of life expectancy it was basic improvements in life that caused much of the increase. The problem our ancestors had was to survive birth and the first year or two of life, and then to have food to eat, clean water and to avoid disease. Get that out of the way and life expectancy shot up.

The second great advance in life expectancy was when we discovered how to immunize people against diseases like flu, polio, measles, small pox, etc. It should be noted that the great advances in this field predated nationalized health care systems for the most part.

Most of the major medical expenses in the world today actually have little impact on life expectancy. While for some people we are talking about adding a few years to the life of a person, for most we are talking of adding weeks or months at best.

The reality is that spending a bit less on expensive care, and a bit more on basic, preventative care and check ups, will do a lot more good. Americans could reduce their health spending dramatically without having much, if any, of a negative impact on their life. Individuals could easily repriortize their concerns. It isn’t that health care is too expensive as much as it is that Americans are over buying expensive care and under consuming basic, preventative care. A major factor that puts US spending, per capita, above that of Europe is that Americans tend to prefer to solve problems with expensive care rather than taking cheaper precautions in advance. That is a problem of individual choice, not health care systems.

Americans, no doubt, do overspend on health care for the benefits they receive. On the other hand the nationalized systems intentionally under spend on care. They brag they are cheaper but they are cheaper because they deny care that people want and often need. Cheaper is not necessarily the determinate of good care any more than more expensive is. Both could be serious misallocations of resources.

This said, I should get back to the main point, which is the role of health care on life expectancy. Life expectancy is only a general indicator regarding the qualify of life. It is not an indicator that says much about specific policies. And that is where some advocates of nationalized care get dishonest. They will argue that Americans have a slightly lower life expectancy than do people living in nations with nationalized health care.

Normally they are very selective as to which countries they choose. The truth is that Americans live, on average, longer than people in many countries with socialized care, but not as long as people in some countries. If one were to compare the EU average life expectancy to that of the average American the difference is only a matter of weeks.

But that small difference is used to champion socialized care. Somehow turning health care over to the people who run the post office is supposed to add a few weeks to our life expectancy, and this is supposed to be a vast improvement.

But are the differences in life expectancy between the US and some European countries (and not others), actually the result of different health care systems? Or are there other factors that directly lower US life expectancy?

Everyone knows that obesity, a result of affluence, is rampant in the United States. And this problem is worse in the US than in Europe. Having lived on both continents I can verify that observation personally. The size of some Americans is astounding to me. Micheal Moore is becoming far more the norm than the exception. This is having a major impact on life expectancy. Americans are still living longer than ever, but the rate of improvement has slowed allowing less obese nations to surpass the US average. This is a personal choice issue, not a health system issue.

Another cause for lower life expectancy can be crime. This is especially true for one group of American -- black males. The average life expectancy of black Americans is five years shorter than that of white Americans. And crime is a major reason. One study showed that a white male of 15 years of age had a 1-in-345 chance of being murdered before he turned 45. For black males those odds were 1-in-45. And in Washington, DC, the city in America with more politicians than any other, the odds were 1-in-12.

This study says that ending the criminal carnage in the black community would bring the average life expectancy of black males up by three years. This is not a health system issue. Yet, it severely impacts US life expectancy rates which is then used to “prove” nationalized care is better. In addition, the African-American community has higher rates of various unhealthy lifestyle choices, such as drug use, smoking and consumption of alcohol. All these factors drag down the life expectancy in that community and reduce US rates as well. While some European countries have similar communities with similar problems they are a smaller percentage of the population and thus have less impact on the life expectancy average.

A study out of Harvard says: “young black men living in poor, high-crime urban America have death risks similar to people living in Russia or sub-Saharan Africa.”

One study I looked at recently, from the Commonwealth Fund, showed that if you reach the age of 60 your life expectancy, in the US is another 17 years. Under the nationalized health systems in the UK and New Zealand the remaining years are also 17 years. No difference. Canada was higher at 18 years but there are still various factors that impact this, which are outside the health system -- as already mentioned.

MSNBC repeated an Associated Press report stating that “A relatively high percentage of babies born in the U.S. die before their first birthday, compared with other industrialized nations.” What they refer to is the infant mortality rates. Again this is slightly dishonest since different nations define infant mortality differently.

The U.S. has a much broader definition of "live birth" than does other nations. They aren’t measuring the same thing. US News & World Report explained the differences:

First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country.

Infant mortality in developed countries is not about healthy babies dying of treatable conditions as in the past. Most of the infants we lose today are born critically ill, and 40 percent die within the first day of life. The major causes are low birth weight and prematurity, and congenital malformations. As Nicholas Eberstadt, a scholar at the American Enterprise Institute, points out, Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in weight at birth.

Infant mortality rates are also connected to many factors not related to health care. For instance, teen mothers are more likely to give birth to sick infants. Mothers who smoke, or are obese, or simply lack education, have riskier pregnancies. And the U.S. has more of these problems than some other nations, yet these are not directly linked to the health system.

Nationalized health care won’t reduce crime rates. It won’t reduce obesity. The Harvard study indicates this. The main reason some communities, in the U.S., have lower life expectancy is due to injuries and some chronic diseases “including heart disease, cancer, and diabetes. These killers, in turn, are a consequence of well-known and largely controllable risk factors such as smoking, alcohol use, obesity, high blood pressure, and high cholesterol. In high-risk urban black communities, male mortality is increased by homicides and exposure to AIDS.” These are “largely controllable risk factors”. Controlled by whom? By the individual at risk, not by the health system.

The Harvard study looked at eight distinct groups of Americans and concluded: “"The variation in health plan coverage across the eight Americas is small relative to the very large difference in health outcome. It is likely that expanding insurance coverage alone would still leave huge disparities in young and middle-aged adults." Universal coverage, as envisioned by advocates of socialized care, will have little direct impact on U.S. life expectancy. But cheaper, if not free, individual changes in life style can have a major impact.

Another Harvard study found that Americans could add 6.7 years to their life expectancy by following healthier guidelines for living. Europeans could add only 5.5 years, implying that 1.2 years of the current difference in life expectancy rates between the US and Europe is due to lifestyle factors, not to health care systems. That difference would put US life expectancy on par with the UK and Germany, indicating that the differences in life expectancy rates is due to lifestyle choices not health systems.

Another indicator that health systems are not the main issue is that Hong Kong, not known for socialized health care, or much of a welfare state at all, has one of the highest life expectancy rates in the world, at 80.2 years. That exceeds all the European socialized states. Switzerland also has a high life expectancy, yet most health care is provided privately and covered by private, individual insurance policies. Recently, Swiss voters rejected a single-payer health proposal.

Singapore also has a high life expectancy yet they have little in the way of nationalized health care. Individuals in Singapore are expected to establish their own private, health accounts which belong to them or their heirs when they die. These private accounts pay for most care in the country. Out of these accounts citizens purchase catastrophic insurance to cover major problems and draw down the account for minor problems. About 10% of the population is deemed impoverished and are directly helped in health care by the state, but the bulk of the population pays for their care out of their own resources. They also have health care expenditures that are far lower than any of the nationalized systems.

Some countries, often with very little in the way private or public health care, have life expectancy rates that are still rather impressive. Costa Rica has a higher life expectancy than Luxembourg. And two U.S. territories, Puerto Rico and Virgin Islands, have higher life expectancies than the U.S. mainland. Yet, I know of no one who attributes this to greater access to health care, socialized or not.

Another indication that life expectancy is only tangentially tied to health systems is that every nation in the world, no matter their health care system, sees dramatic differences in life spans between men and women. And much of that is due to life style differences tied to biology. Men are more violent, on average, than women. That means they get killed more often. They also tend to be risk takers, more so than women, and that also means they are more likely to die young.

In most socialized health systems women live five to seven years longer than men, on average. Yet this is not because women receive superior health care. At least I’ve yet to hear that claim.

Life expectancy is primarily a matter of factors outside the health care systems. As such it can not be considered evidence, one way or the other, that nationalized care is superior to private health care.