Real Changes in US Healthcare (Euro members please share your opinions)
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Mbira
Well-known member
Cool. And it's funny to that such a big thing is something I never remember even hearing about during all the debates, etc...
The problem is that Big Insurance is part of the problem. They colluded with state and federal politicians to eliminate competition and raise costs. They are already wasteful and inefficient and now they are forced to be even more so. GREAT! KABOOOM! HOORAY! The unintended results of this are going to be schplattered on the faces of those who passed it into law. Should be a real mess by next summer.
On a personal level, my insurance will be 50% higher in January than it was before the Patient Protection and Affordable Care Act was signed. It's already 40% higher since. 18 grand per year. That's 6 large that I do not spend or invest in my micro company. It all goes to Big Insurance. Neither Protection nor Affordable, and no way to steer an economy. The bomb has already gone off months ago in my world.
Mike
On a personal level, my insurance will be 50% higher in January than it was before the Patient Protection and Affordable Care Act was signed. It's already 40% higher since. 18 grand per year. That's 6 large that I do not spend or invest in my micro company. It all goes to Big Insurance. Neither Protection nor Affordable, and no way to steer an economy. The bomb has already gone off months ago in my world.
Mike
This was widely discussed at the time and I am not defending the insurance companies, but this rule is just a a little sleight of hand to drive the private sector out of the insurance business so the government ends up with the whole shebang. All part of the grand plan.
We need more competition and free market forces., not the government running heath care like another post office, or motor vehicles.
When I saw this thread I thought the explosion they were talking about was the budget gimmickry that allowed them to score this legislation as reducing cost finally blew up...a few months ago. The CBO had to score the legislation cost as written, and many at the time complained about how it was front loaded with more receipts than disbursements in the front end to make it look like it worked long term, but it doesn't. They finally acknowledged the budget gamesmanship a few months ago, but the friendly press mainly missed or ignored it.
This is slowly moving towards the supreme court, but faster than I expected. We could have a decision in time for next years little presidential vote. The bad news is we are now a few years down the road and not only is the health care system not improving, but getting worse.. The longer we wait to actually fix this stuff the harder it gets.
Of course some people probably think this is all wonderful. Opinions vary.
JR
We need more competition and free market forces., not the government running heath care like another post office, or motor vehicles.
When I saw this thread I thought the explosion they were talking about was the budget gimmickry that allowed them to score this legislation as reducing cost finally blew up...a few months ago. The CBO had to score the legislation cost as written, and many at the time complained about how it was front loaded with more receipts than disbursements in the front end to make it look like it worked long term, but it doesn't. They finally acknowledged the budget gamesmanship a few months ago, but the friendly press mainly missed or ignored it.
This is slowly moving towards the supreme court, but faster than I expected. We could have a decision in time for next years little presidential vote. The bad news is we are now a few years down the road and not only is the health care system not improving, but getting worse.. The longer we wait to actually fix this stuff the harder it gets.
Of course some people probably think this is all wonderful. Opinions vary.
JR
riggler
Well-known member
Right on John Roberts. They want government healthcare to be your ONLY option.
= socialism??JohnRoberts said:
Not saying that there are not problems and some sort of reform needed but this is not the answer. I said this on FB and the typical Obama lover/dem's flamed me but how long until the government tells me how much or how little I can make at my store? That is the direction this is heading.
Doesn't this go against our constitution?
jsteiger said:
The supreme court is reviewing it pretty narrowly wrt the commerce clause, and they may or may not allow it based on that. I heard a mention the other day that the original framers of the constitution considered using the phrase, "life, liberty, and property" instead of pursuit of happiness, in the original wording.
This does seem a rather unconstitutional federal taking of personal property in making us pay and participate in their version of healthcare. This whole scheme revolves on a variant of the social security ponzi scheme making young healthy people pay into the system, to support the old, unhealthy who incur the bulk of the expense. I could almost accept this (I'm old after all) if it wasn't for the fact that every time the government gets involved in anything it results in massive waste, massive fraud, and rampant inefficiency.
I believe I should be allowed to purchase health services for a fair price, not what happened in the recent past with collusion between large insurance and large health providers to inflate costs paid by uninsured. In the future that option will likely get even more expensive as the government takes over more of the private healthcare sector. I figure if I run out of money, it's time to die. There isn't enough money in the honey pot to keep everybody on life support forever, so why leave the decision to government pukes.
The private insurance industry was already broken, but replacing that with an even more centralized, all powerful government run single payer system, just goes from bad to worse.
JR
Folks must love competition if they're willing to see such a big chunk of their monthly premium go to marketing and sales costs that enable the insurance companies to compete against each other. This doesn't include the redundant administrative costs and the cost of lobbying to prevent me from having a government health care option.
The fact is we pay more and have worse health outcomes under our system...
New York Times
OP-ED CONTRIBUTORS
To Fix Health, Help the Poor
By ELIZABETH H. BRADLEY
and LAUREN TAYLORPublished: December 8, 2011
It’s common knowledge that the United States spends more than any
other country on health care but still ranks in the bottom half of
industrialized countries in outcomes like life expectancy and infant
mortality. Why are these other countries beating us if we spend so
much more? The truth is that we may not be spending more — it all
depends on what you count.
In our comparative study of 30 industrialized countries, published
earlier this year in the journal BMJ Quality and Safety, we broadened
the scope of traditional health care industry analyses to include
spending on social services, like rent subsidies, employment-training
programs, unemployment benefits, old-age pensions, family support and
other services that can extend and improve life.
We studied 10 years’ worth of data and found that if you counted the
combined investment in health care and social services, the United
States no longer spent the most money — far from it. In 2005, for
example, the United States devoted only 29 percent of gross domestic
product to health and social services combined, while countries like
Sweden, France, the Netherlands, Belgium and Denmark dedicated 33
percent to 38 percent of their G.D.P. to the combination. We came in
10th.
What’s more, America is one of only three industrialized countries to
spend the majority of its health and social services budget on health
care itself. For every dollar we spend on health care, we spend an
additional 90 cents on social services. In our peer countries, for
every dollar spent on health care, an additional $2 is spent on social
services. So not only are we spending less, we’re allocating our
resources disproportionately on health care.
Our study found that countries with high health care spending relative
to social spending had lower life expectancy and higher infant
mortality than countries that favored social spending. While the
stagnating life expectancy in the United States remains at 78 years,
in many European countries it has leapt to well over 80 years, and
several countries boast infant mortality rates approximately half of
ours. In a national survey conducted by the Robert Wood Johnson
Foundation, four out of five physicians agreed that unmet social needs
led directly to worse health.
Unfortunately, instead of learning from countries like Sweden and
France, we prefer the frantic scramble to recover money from one part
of the health care system only to reallocate it toward retreads of
previously failed reforms. We pretend that the fresh schemes are
innovative, but they are usually long on promises, short on details
and often marked with an annoying acronym: H.M.O., F.S.A., A.C.O. and
so forth.
It’s time to think more broadly about where to find leverage for
achieving a healthier society. One way would be to invest more heavily
in social services. This may be difficult for many Americans to
swallow as it suggests a potentially expanded role for government. Out
of respect for individuals’ rights, our current social programs are
mostly opt-in, leaving holes for the undocumented, uneducated and
unemployed to slip through cracks and become acutely ill. Emergency
rooms, though, are not allowed to opt out of providing these people
extraordinarily expensive medical treatment before discharging them
back to wretched conditions and their inevitable return to the E.R.
The impact of sub-par social conditions on health has been well
documented. Homelessness isn’t typically thought of as a medical
problem, but it often precludes good nutrition, personal hygiene and
basic first aid, and it increases the risks of frostbite, leg ulcers,
upper respiratory infections and trauma from muggings, beatings and
rape. The Boston Health Care for the Homeless Program tracked the
medical expenses of 119 chronically homeless people for several years.
In one five-year period, the group accounted for 18,834 emergency room
visits estimated to cost $12.7 million.
We can learn from the star pupils in our analysis. Other countries
have created government ministries that marry health and social care.
Earlier this year, the Department of Health in Britain released plans
to create health and well-being boards comprising local government
representatives, primary care physicians, hospital administrators,
children and adult-services specialists and public health directors,
who will coordinate care for their constituencies across the health
and social care spectrum. We should think expansively about how to
construct similar programs that enable much needed integration of
these mutually dependent sectors. The Department of Veterans Affairs
is leading the way, with programs called “stand downs” that
simultaneously address the health and social needs of retired service
members.
It is Americans’ prerogative to continually vote down the encroachment
of government programs on our free-market ideology, but recognizing
the health effects of our disdain for comprehensive safety nets may
well be the key to unraveling the “spend more, get less” paradox.
Before we spend even more money, we should consider allocating it
differently.
Elizabeth H. Bradley is professor of public health at Yale and faculty
director of its Global Health Leadership Institute, where Lauren
Taylor is a program manager.
The fact is we pay more and have worse health outcomes under our system...
New York Times
OP-ED CONTRIBUTORS
To Fix Health, Help the Poor
By ELIZABETH H. BRADLEY
and LAUREN TAYLORPublished: December 8, 2011
It’s common knowledge that the United States spends more than any
other country on health care but still ranks in the bottom half of
industrialized countries in outcomes like life expectancy and infant
mortality. Why are these other countries beating us if we spend so
much more? The truth is that we may not be spending more — it all
depends on what you count.
In our comparative study of 30 industrialized countries, published
earlier this year in the journal BMJ Quality and Safety, we broadened
the scope of traditional health care industry analyses to include
spending on social services, like rent subsidies, employment-training
programs, unemployment benefits, old-age pensions, family support and
other services that can extend and improve life.
We studied 10 years’ worth of data and found that if you counted the
combined investment in health care and social services, the United
States no longer spent the most money — far from it. In 2005, for
example, the United States devoted only 29 percent of gross domestic
product to health and social services combined, while countries like
Sweden, France, the Netherlands, Belgium and Denmark dedicated 33
percent to 38 percent of their G.D.P. to the combination. We came in
10th.
What’s more, America is one of only three industrialized countries to
spend the majority of its health and social services budget on health
care itself. For every dollar we spend on health care, we spend an
additional 90 cents on social services. In our peer countries, for
every dollar spent on health care, an additional $2 is spent on social
services. So not only are we spending less, we’re allocating our
resources disproportionately on health care.
Our study found that countries with high health care spending relative
to social spending had lower life expectancy and higher infant
mortality than countries that favored social spending. While the
stagnating life expectancy in the United States remains at 78 years,
in many European countries it has leapt to well over 80 years, and
several countries boast infant mortality rates approximately half of
ours. In a national survey conducted by the Robert Wood Johnson
Foundation, four out of five physicians agreed that unmet social needs
led directly to worse health.
Unfortunately, instead of learning from countries like Sweden and
France, we prefer the frantic scramble to recover money from one part
of the health care system only to reallocate it toward retreads of
previously failed reforms. We pretend that the fresh schemes are
innovative, but they are usually long on promises, short on details
and often marked with an annoying acronym: H.M.O., F.S.A., A.C.O. and
so forth.
It’s time to think more broadly about where to find leverage for
achieving a healthier society. One way would be to invest more heavily
in social services. This may be difficult for many Americans to
swallow as it suggests a potentially expanded role for government. Out
of respect for individuals’ rights, our current social programs are
mostly opt-in, leaving holes for the undocumented, uneducated and
unemployed to slip through cracks and become acutely ill. Emergency
rooms, though, are not allowed to opt out of providing these people
extraordinarily expensive medical treatment before discharging them
back to wretched conditions and their inevitable return to the E.R.
The impact of sub-par social conditions on health has been well
documented. Homelessness isn’t typically thought of as a medical
problem, but it often precludes good nutrition, personal hygiene and
basic first aid, and it increases the risks of frostbite, leg ulcers,
upper respiratory infections and trauma from muggings, beatings and
rape. The Boston Health Care for the Homeless Program tracked the
medical expenses of 119 chronically homeless people for several years.
In one five-year period, the group accounted for 18,834 emergency room
visits estimated to cost $12.7 million.
We can learn from the star pupils in our analysis. Other countries
have created government ministries that marry health and social care.
Earlier this year, the Department of Health in Britain released plans
to create health and well-being boards comprising local government
representatives, primary care physicians, hospital administrators,
children and adult-services specialists and public health directors,
who will coordinate care for their constituencies across the health
and social care spectrum. We should think expansively about how to
construct similar programs that enable much needed integration of
these mutually dependent sectors. The Department of Veterans Affairs
is leading the way, with programs called “stand downs” that
simultaneously address the health and social needs of retired service
members.
It is Americans’ prerogative to continually vote down the encroachment
of government programs on our free-market ideology, but recognizing
the health effects of our disdain for comprehensive safety nets may
well be the key to unraveling the “spend more, get less” paradox.
Before we spend even more money, we should consider allocating it
differently.
Elizabeth H. Bradley is professor of public health at Yale and faculty
director of its Global Health Leadership Institute, where Lauren
Taylor is a program manager.
Yes, the system is broken but our government can never fix it, only make it worse. Like John said, look at the USPS. They also did a fine azz job overseeing Fanny and Freddy didn't they?
Meathands
Well-known member
JohnRoberts said:
IIRC, that was John Locke's original formulation, but the framers chose not to go with it because, well, there were a lot of people at that time to whom they didn't want to grant property rights.
I would love complete change. I think we must be minorities though with this thinking.
I may also be a tad more bitter than most. After all, I have just seen the 4th IL governor be convicted and sentenced to prison. http://en.wikipedia.org/wiki/Governor_of_Illinois
Anybody see a pattern here? Let us not forgot where our current president came from. One can only assume that the apple does not fall far from the tree. Tree = Chicago political machine.
I may also be a tad more bitter than most. After all, I have just seen the 4th IL governor be convicted and sentenced to prison. http://en.wikipedia.org/wiki/Governor_of_Illinois
Anybody see a pattern here? Let us not forgot where our current president came from. One can only assume that the apple does not fall far from the tree. Tree = Chicago political machine.
Meathands said:
According to my readings that would be correct. Specifically, "pursuit of happiness" appeared in the Declaration Of Independence and was dropped and "property" was added when the Constitution was adopted. And more than just property rights - suffrage rights, exclusions from any meaningful participation in policy making, pay wages, etc. Call it an exclusion from "Democracy".
Alexander Hamilton was blunt about it - "All communities divide themselves into the few and the many. The first are the rich and well-born, the other the mass of the people - Give therefore to the first class a distinct and permanent share in the government" Adam Smith ad nauseum.
You may interpret "government" however you wish but it seems obvious to me.
And how much has really changed? Certainly enough to not give up IMHO. Things will have to get worse before they get better.
I think that's an interesting distinction, saying "our government" can't fix the broken system instead of saying that "government" can't fix it. The latter being a principle held by many Republicans and the former a recognition that, basically, the people of this country (the U.S.) are not able to find a workable solution to a broken system. In other words, we, the people, are the problem. Not surprising, really, given our declining education system, our simplistic and polarized political conversations, and the fact that too many people seem to only know what they do based on what they've seen on Fox News. But it doesn't have to be that way.
This loss of confidence in "our government" may be coming at a time when we look to it more and more to rescue us from an increasing number of disasters: natural, financial, social, and more.
A quote from the article below:
"All change is disruptive. We have seen that the specter of terrorism is enough to cast stable democracies into turmoil. Climate change will have even more dramatic consequences. Men and women will be thrown back upon the resources of the state. They will look to their political leaders and representatives to protect them: open societies will once again be urged to close in upon themselves, sacrificing freedom for “security.” The choice will no longer be between the state and the market, but between two sorts of state. It is thus incumbent upon us to reconceive the role of government. If we do not, others will."
So, here's an long excerpt from a longer piece that I think is worth reading. I only copied half of it. The link:
http://www.nybooks.com/articles/archives/2010/apr/29/ill-fares-the-land/?pagination=false
Ill Fares the Land
by Tony Judt
"Something is profoundly wrong with the way we live today. For thirty years we have made a virtue out of the pursuit of material self-interest: indeed, this very pursuit now constitutes whatever remains of our sense of collective purpose. We know what things cost but have no idea what they are worth. We no longer ask of a judicial ruling or a legislative act: Is it good? Is it fair? Is it just? Is it right? Will it help bring about a better society or a better world? Those used to be the political questions, even if they invited no easy answers. We must learn once again to pose them.
The materialistic and selfish quality of contemporary life is not inherent in the human condition. Much of what appears “natural” today dates from the 1980s: the obsession with wealth creation, the cult of privatization and the private sector, the growing disparities of rich and poor. And above all, the rhetoric that accompanies these: uncritical admiration for unfettered markets, disdain for the public sector, the delusion of endless growth.
We cannot go on living like this. The little crash of 2008 was a reminder that unregulated capitalism is its own worst enemy: sooner or later it must fall prey to its own excesses and turn again to the state for rescue. But if we do no more than pick up the pieces and carry on as before, we can look forward to greater upheavals in years to come.
And yet we seem unable to conceive of alternatives. This too is something new. Until quite recently, public life in liberal societies was conducted in the shadow of a debate between defenders of “capitalism” and its critics: usually identified with one or another form of “socialism.” By the 1970s this debate had lost much of its meaning for both sides; all the same, the “left–right” distinction served a useful purpose. It provided a peg on which to hang critical commentary about contemporary affairs.
On the left, Marxism was attractive to generations of young people if only because it offered a way to take one’s distance from the status quo. Much the same was true of classical conservatism: a well-grounded distaste for over-hasty change gave a home to those reluctant to abandon long-established routines. Today, neither left nor right can find their footing.
For thirty years students have been complaining to me that “it was easy for you”: your generation had ideals and ideas, you believed in something, you were able to change things. “We” (the children of the Eighties, the Nineties, the “Aughts”) have nothing. In many respects my students are right. It was easy for us—just as it was easy, at least in this sense, for the generations who came before us. The last time a cohort of young people expressed comparable frustration at the emptiness of their lives and the dispiriting purposelessness of their world was in the 1920s: it is not by chance that historians speak of a “lost generation.”
If young people today are at a loss, it is not for want of targets. Any conversation with students or schoolchildren will produce a startling checklist of anxieties. Indeed, the rising generation is acutely worried about the world it is to inherit. But accompanying these fears there is a general sentiment of frustration: “we” know something is wrong and there are many things we don’t like. But what can we believe in? What should we do?
This is an ironic reversal of the attitudes of an earlier age. Back in the era of self-assured radical dogma, young people were far from uncertain. The characteristic tone of the 1960s was that of overweening confidence: we knew just how to fix the world. It was this note of unmerited arrogance that partly accounts for the reactionary backlash that followed; if the left is to recover its fortunes, some modesty will be in order. All the same, you must be able to name a problem if you wish to solve it.
I wrote my book Ill Fares the Land for young people on both sides of the Atlantic. American readers may be struck by the frequent references to social democracy. Here in the United States, such references are uncommon. When journalists and commentators advocate public expenditure on social objectives, they are more likely to describe themselves—and be described by their critics—as “liberals.” But this is confusing. “Liberal” is a venerable and respectable label and we should all be proud to wear it. But like a well-designed outer coat, it conceals more than it displays.
A liberal is someone who opposes interference in the affairs of others: who is tolerant of dissenting attitudes and unconventional behavior. Liberals have historically favored keeping other people out of our lives, leaving individuals the maximum space in which to live and flourish as they choose. In their extreme form, such attitudes are associated today with self-styled “libertarians,” but the term is largely redundant. Most genuine liberals remain disposed to leave other people alone.
Social democrats, on the other hand, are something of a hybrid. They share with liberals a commitment to cultural and religious tolerance. But in public policy social democrats believe in the possibility and virtue of collective action for the collective good. Like most liberals, social democrats favor progressive taxation in order to pay for public services and other social goods that individuals cannot provide themselves; but whereas many liberals might see such taxation or public provision as a necessary evil, a social democratic vision of the good society entails from the outset a greater role for the state and the public sector.
Understandably, social democracy is a hard sell in the United States. One of my goals is to suggest that government can play an enhanced role in our lives without threatening our liberties—and to argue that, since the state is going to be with us for the foreseeable future, we would do well to think about what sort of a state we want. In any case, much that was best in American legislation and social policy over the course of the twentieth century—and that we are now urged to dismantle in the name of efficiency and “less government”—corresponds in practice to what Europeans have called “social democracy.” Our problem is not what to do; it is how to talk about it.
The European dilemma is somewhat different. Many European countries have long practiced something resembling social democracy: but they have forgotten how to preach it. Social democrats today are defensive and apologetic. Critics who claim that the European model is too expensive or economically inefficient have been allowed to pass unchallenged. And yet, the welfare state is as popular as ever with its beneficiaries: nowhere in Europe is there a constituency for abolishing public health services, ending free or subsidized education, or reducing public provision of transport and other essential services.
I want to challenge conventional wisdom on both sides of the Atlantic. To be sure, the target has softened considerably. In the early years of this century, the “Washington consensus” held the field. Everywhere you went there was an economist or “expert” expounding the virtues of deregulation, the minimal state, and low taxation. Anything, it seemed, that the public sector could do, private individuals could do better.
The Washington doctrine was everywhere greeted by ideological cheerleaders: from the profiteers of the “Irish miracle” (the property-bubble boom of the “Celtic Tiger”) to the doctrinaire ultra-capitalists of former Communist Europe. Even “old Europeans” were swept up in the wake. The EU’s free- market project (the so-called “Lisbon agenda”); the enthusiastic privatization plans of the French and German governments: all bore witness to what its French critics described as the new ” pensée unique.”
Today there has been a partial awakening. To avert national bankruptcies and wholesale banking collapse, governments and central bankers have performed remarkable policy reversals, liberally dispersing public money in pursuit of economic stability and taking failed companies into public control without a second thought. A striking number of free-market economists, worshipers at the feet of Milton Friedman and his Chicago colleagues, have lined up to don sackcloth and ashes and swear allegiance to the memory of John Maynard Keynes.
This is all very gratifying. But it hardly constitutes an intellectual revolution. Quite the contrary: as the response of the Obama administration suggests, the reversion to Keynesian economics is but a tactical retreat. Much the same may be said of New Labour, as committed as ever to the private sector in general and the London financial markets in particular. To be sure, one effect of the crisis has been to dampen the ardor of continental Europeans for the “Anglo-American model”; but the chief beneficiaries have been those same center-right parties once so keen to emulate Washington.
In short, the practical need for strong states and interventionist governments is beyond dispute. But no one is “re-thinking” the state. There remains a marked reluctance to defend the public sector on grounds of collective interest or principle. It is striking that in a series of European elections following the financial meltdown, social democratic parties consistently did badly; notwithstanding the collapse of the market, they proved conspicuously unable to rise to the occasion.
If it is to be taken seriously again, the left must find its voice. There is much to be angry about: growing inequalities of wealth and opportunity; injustices of class and caste; economic exploitation at home and abroad; corruption and money and privilege occluding the arteries of democracy. But it will no longer suffice to identify the shortcomings of “the system” and then retreat, Pilate-like, indifferent to consequences. The irresponsible rhetorical grandstanding of decades past did not serve the left well.
We have entered an age of insecurity—economic insecurity, physical insecurity, political insecurity. The fact that we are largely unaware of this is small comfort: few in 1914 predicted the utter collapse of their world and the economic and political catastrophes that followed. Insecurity breeds fear. And fear—fear of change, fear of decline, fear of strangers and an unfamiliar world—is corroding the trust and interdependence on which civil societies rest. Yet we may find ourselves depending on government more in the future:
"All change is disruptive. We have seen that the specter of terrorism is enough to cast stable democracies into turmoil. Climate change will have even more dramatic consequences. Men and women will be thrown back upon the resources of the state. They will look to their political leaders and representatives to protect them: open societies will once again be urged to close in upon themselves, sacrificing freedom for “security.” The choice will no longer be between the state and the market, but between two sorts of state. It is thus incumbent upon us to reconceive the role of government. If we do not, others will." Tony Judt
Here's a long piece that is provocative reading. I only copied the first half (long!), the entire article is here:
http://www.nybooks.com/articles/archives/2010/apr/29/ill-fares-the-land/?pagination=false
Something is profoundly wrong with the way we live today. For thirty years we have made a virtue out of the pursuit of material self-interest: indeed, this very pursuit now constitutes whatever remains of our sense of collective purpose. We know what things cost but have no idea what they are worth. We no longer ask of a judicial ruling or a legislative act: Is it good? Is it fair? Is it just? Is it right? Will it help bring about a better society or a better world? Those used to be the political questions, even if they invited no easy answers. We must learn once again to pose them.
The materialistic and selfish quality of contemporary life is not inherent in the human condition. Much of what appears “natural” today dates from the 1980s: the obsession with wealth creation, the cult of privatization and the private sector, the growing disparities of rich and poor. And above all, the rhetoric that accompanies these: uncritical admiration for unfettered markets, disdain for the public sector, the delusion of endless growth.
We cannot go on living like this. The little crash of 2008 was a reminder that unregulated capitalism is its own worst enemy: sooner or later it must fall prey to its own excesses and turn again to the state for rescue. But if we do no more than pick up the pieces and carry on as before, we can look forward to greater upheavals in years to come.
And yet we seem unable to conceive of alternatives. This too is something new. Until quite recently, public life in liberal societies was conducted in the shadow of a debate between defenders of “capitalism” and its critics: usually identified with one or another form of “socialism.” By the 1970s this debate had lost much of its meaning for both sides; all the same, the “left–right” distinction served a useful purpose. It provided a peg on which to hang critical commentary about contemporary affairs.
On the left, Marxism was attractive to generations of young people if only because it offered a way to take one’s distance from the status quo. Much the same was true of classical conservatism: a well-grounded distaste for over-hasty change gave a home to those reluctant to abandon long-established routines. Today, neither left nor right can find their footing.
For thirty years students have been complaining to me that “it was easy for you”: your generation had ideals and ideas, you believed in something, you were able to change things. “We” (the children of the Eighties, the Nineties, the “Aughts”) have nothing. In many respects my students are right. It was easy for us—just as it was easy, at least in this sense, for the generations who came before us. The last time a cohort of young people expressed comparable frustration at the emptiness of their lives and the dispiriting purposelessness of their world was in the 1920s: it is not by chance that historians speak of a “lost generation.”
If young people today are at a loss, it is not for want of targets. Any conversation with students or schoolchildren will produce a startling checklist of anxieties. Indeed, the rising generation is acutely worried about the world it is to inherit. But accompanying these fears there is a general sentiment of frustration: “we” know something is wrong and there are many things we don’t like. But what can we believe in? What should we do?
This is an ironic reversal of the attitudes of an earlier age. Back in the era of self-assured radical dogma, young people were far from uncertain. The characteristic tone of the 1960s was that of overweening confidence: we knew just how to fix the world. It was this note of unmerited arrogance that partly accounts for the reactionary backlash that followed; if the left is to recover its fortunes, some modesty will be in order. All the same, you must be able to name a problem if you wish to solve it.
I wrote my book Ill Fares the Land for young people on both sides of the Atlantic. American readers may be struck by the frequent references to social democracy. Here in the United States, such references are uncommon. When journalists and commentators advocate public expenditure on social objectives, they are more likely to describe themselves—and be described by their critics—as “liberals.” But this is confusing. “Liberal” is a venerable and respectable label and we should all be proud to wear it. But like a well-designed outer coat, it conceals more than it displays.
A liberal is someone who opposes interference in the affairs of others: who is tolerant of dissenting attitudes and unconventional behavior. Liberals have historically favored keeping other people out of our lives, leaving individuals the maximum space in which to live and flourish as they choose. In their extreme form, such attitudes are associated today with self-styled “libertarians,” but the term is largely redundant. Most genuine liberals remain disposed to leave other people alone.
Social democrats, on the other hand, are something of a hybrid. They share with liberals a commitment to cultural and religious tolerance. But in public policy social democrats believe in the possibility and virtue of collective action for the collective good. Like most liberals, social democrats favor progressive taxation in order to pay for public services and other social goods that individuals cannot provide themselves; but whereas many liberals might see such taxation or public provision as a necessary evil, a social democratic vision of the good society entails from the outset a greater role for the state and the public sector.
Understandably, social democracy is a hard sell in the United States. One of my goals is to suggest that government can play an enhanced role in our lives without threatening our liberties—and to argue that, since the state is going to be with us for the foreseeable future, we would do well to think about what sort of a state we want. In any case, much that was best in American legislation and social policy over the course of the twentieth century—and that we are now urged to dismantle in the name of efficiency and “less government”—corresponds in practice to what Europeans have called “social democracy.” Our problem is not what to do; it is how to talk about it.
to continue: http://www.nybooks.com/articles/archives/2010/apr/29/ill-fares-the-land/?pagination=false
This loss of confidence in "our government" may be coming at a time when we look to it more and more to rescue us from an increasing number of disasters: natural, financial, social, and more.
A quote from the article below:
"All change is disruptive. We have seen that the specter of terrorism is enough to cast stable democracies into turmoil. Climate change will have even more dramatic consequences. Men and women will be thrown back upon the resources of the state. They will look to their political leaders and representatives to protect them: open societies will once again be urged to close in upon themselves, sacrificing freedom for “security.” The choice will no longer be between the state and the market, but between two sorts of state. It is thus incumbent upon us to reconceive the role of government. If we do not, others will."
So, here's an long excerpt from a longer piece that I think is worth reading. I only copied half of it. The link:
http://www.nybooks.com/articles/archives/2010/apr/29/ill-fares-the-land/?pagination=false
Ill Fares the Land
by Tony Judt
"Something is profoundly wrong with the way we live today. For thirty years we have made a virtue out of the pursuit of material self-interest: indeed, this very pursuit now constitutes whatever remains of our sense of collective purpose. We know what things cost but have no idea what they are worth. We no longer ask of a judicial ruling or a legislative act: Is it good? Is it fair? Is it just? Is it right? Will it help bring about a better society or a better world? Those used to be the political questions, even if they invited no easy answers. We must learn once again to pose them.
The materialistic and selfish quality of contemporary life is not inherent in the human condition. Much of what appears “natural” today dates from the 1980s: the obsession with wealth creation, the cult of privatization and the private sector, the growing disparities of rich and poor. And above all, the rhetoric that accompanies these: uncritical admiration for unfettered markets, disdain for the public sector, the delusion of endless growth.
We cannot go on living like this. The little crash of 2008 was a reminder that unregulated capitalism is its own worst enemy: sooner or later it must fall prey to its own excesses and turn again to the state for rescue. But if we do no more than pick up the pieces and carry on as before, we can look forward to greater upheavals in years to come.
And yet we seem unable to conceive of alternatives. This too is something new. Until quite recently, public life in liberal societies was conducted in the shadow of a debate between defenders of “capitalism” and its critics: usually identified with one or another form of “socialism.” By the 1970s this debate had lost much of its meaning for both sides; all the same, the “left–right” distinction served a useful purpose. It provided a peg on which to hang critical commentary about contemporary affairs.
On the left, Marxism was attractive to generations of young people if only because it offered a way to take one’s distance from the status quo. Much the same was true of classical conservatism: a well-grounded distaste for over-hasty change gave a home to those reluctant to abandon long-established routines. Today, neither left nor right can find their footing.
For thirty years students have been complaining to me that “it was easy for you”: your generation had ideals and ideas, you believed in something, you were able to change things. “We” (the children of the Eighties, the Nineties, the “Aughts”) have nothing. In many respects my students are right. It was easy for us—just as it was easy, at least in this sense, for the generations who came before us. The last time a cohort of young people expressed comparable frustration at the emptiness of their lives and the dispiriting purposelessness of their world was in the 1920s: it is not by chance that historians speak of a “lost generation.”
If young people today are at a loss, it is not for want of targets. Any conversation with students or schoolchildren will produce a startling checklist of anxieties. Indeed, the rising generation is acutely worried about the world it is to inherit. But accompanying these fears there is a general sentiment of frustration: “we” know something is wrong and there are many things we don’t like. But what can we believe in? What should we do?
This is an ironic reversal of the attitudes of an earlier age. Back in the era of self-assured radical dogma, young people were far from uncertain. The characteristic tone of the 1960s was that of overweening confidence: we knew just how to fix the world. It was this note of unmerited arrogance that partly accounts for the reactionary backlash that followed; if the left is to recover its fortunes, some modesty will be in order. All the same, you must be able to name a problem if you wish to solve it.
I wrote my book Ill Fares the Land for young people on both sides of the Atlantic. American readers may be struck by the frequent references to social democracy. Here in the United States, such references are uncommon. When journalists and commentators advocate public expenditure on social objectives, they are more likely to describe themselves—and be described by their critics—as “liberals.” But this is confusing. “Liberal” is a venerable and respectable label and we should all be proud to wear it. But like a well-designed outer coat, it conceals more than it displays.
A liberal is someone who opposes interference in the affairs of others: who is tolerant of dissenting attitudes and unconventional behavior. Liberals have historically favored keeping other people out of our lives, leaving individuals the maximum space in which to live and flourish as they choose. In their extreme form, such attitudes are associated today with self-styled “libertarians,” but the term is largely redundant. Most genuine liberals remain disposed to leave other people alone.
Social democrats, on the other hand, are something of a hybrid. They share with liberals a commitment to cultural and religious tolerance. But in public policy social democrats believe in the possibility and virtue of collective action for the collective good. Like most liberals, social democrats favor progressive taxation in order to pay for public services and other social goods that individuals cannot provide themselves; but whereas many liberals might see such taxation or public provision as a necessary evil, a social democratic vision of the good society entails from the outset a greater role for the state and the public sector.
Understandably, social democracy is a hard sell in the United States. One of my goals is to suggest that government can play an enhanced role in our lives without threatening our liberties—and to argue that, since the state is going to be with us for the foreseeable future, we would do well to think about what sort of a state we want. In any case, much that was best in American legislation and social policy over the course of the twentieth century—and that we are now urged to dismantle in the name of efficiency and “less government”—corresponds in practice to what Europeans have called “social democracy.” Our problem is not what to do; it is how to talk about it.
The European dilemma is somewhat different. Many European countries have long practiced something resembling social democracy: but they have forgotten how to preach it. Social democrats today are defensive and apologetic. Critics who claim that the European model is too expensive or economically inefficient have been allowed to pass unchallenged. And yet, the welfare state is as popular as ever with its beneficiaries: nowhere in Europe is there a constituency for abolishing public health services, ending free or subsidized education, or reducing public provision of transport and other essential services.
I want to challenge conventional wisdom on both sides of the Atlantic. To be sure, the target has softened considerably. In the early years of this century, the “Washington consensus” held the field. Everywhere you went there was an economist or “expert” expounding the virtues of deregulation, the minimal state, and low taxation. Anything, it seemed, that the public sector could do, private individuals could do better.
The Washington doctrine was everywhere greeted by ideological cheerleaders: from the profiteers of the “Irish miracle” (the property-bubble boom of the “Celtic Tiger”) to the doctrinaire ultra-capitalists of former Communist Europe. Even “old Europeans” were swept up in the wake. The EU’s free- market project (the so-called “Lisbon agenda”); the enthusiastic privatization plans of the French and German governments: all bore witness to what its French critics described as the new ” pensée unique.”
Today there has been a partial awakening. To avert national bankruptcies and wholesale banking collapse, governments and central bankers have performed remarkable policy reversals, liberally dispersing public money in pursuit of economic stability and taking failed companies into public control without a second thought. A striking number of free-market economists, worshipers at the feet of Milton Friedman and his Chicago colleagues, have lined up to don sackcloth and ashes and swear allegiance to the memory of John Maynard Keynes.
This is all very gratifying. But it hardly constitutes an intellectual revolution. Quite the contrary: as the response of the Obama administration suggests, the reversion to Keynesian economics is but a tactical retreat. Much the same may be said of New Labour, as committed as ever to the private sector in general and the London financial markets in particular. To be sure, one effect of the crisis has been to dampen the ardor of continental Europeans for the “Anglo-American model”; but the chief beneficiaries have been those same center-right parties once so keen to emulate Washington.
In short, the practical need for strong states and interventionist governments is beyond dispute. But no one is “re-thinking” the state. There remains a marked reluctance to defend the public sector on grounds of collective interest or principle. It is striking that in a series of European elections following the financial meltdown, social democratic parties consistently did badly; notwithstanding the collapse of the market, they proved conspicuously unable to rise to the occasion.
If it is to be taken seriously again, the left must find its voice. There is much to be angry about: growing inequalities of wealth and opportunity; injustices of class and caste; economic exploitation at home and abroad; corruption and money and privilege occluding the arteries of democracy. But it will no longer suffice to identify the shortcomings of “the system” and then retreat, Pilate-like, indifferent to consequences. The irresponsible rhetorical grandstanding of decades past did not serve the left well.
We have entered an age of insecurity—economic insecurity, physical insecurity, political insecurity. The fact that we are largely unaware of this is small comfort: few in 1914 predicted the utter collapse of their world and the economic and political catastrophes that followed. Insecurity breeds fear. And fear—fear of change, fear of decline, fear of strangers and an unfamiliar world—is corroding the trust and interdependence on which civil societies rest. Yet we may find ourselves depending on government more in the future:
"All change is disruptive. We have seen that the specter of terrorism is enough to cast stable democracies into turmoil. Climate change will have even more dramatic consequences. Men and women will be thrown back upon the resources of the state. They will look to their political leaders and representatives to protect them: open societies will once again be urged to close in upon themselves, sacrificing freedom for “security.” The choice will no longer be between the state and the market, but between two sorts of state. It is thus incumbent upon us to reconceive the role of government. If we do not, others will." Tony Judt
Here's a long piece that is provocative reading. I only copied the first half (long!), the entire article is here:
http://www.nybooks.com/articles/archives/2010/apr/29/ill-fares-the-land/?pagination=false
Something is profoundly wrong with the way we live today. For thirty years we have made a virtue out of the pursuit of material self-interest: indeed, this very pursuit now constitutes whatever remains of our sense of collective purpose. We know what things cost but have no idea what they are worth. We no longer ask of a judicial ruling or a legislative act: Is it good? Is it fair? Is it just? Is it right? Will it help bring about a better society or a better world? Those used to be the political questions, even if they invited no easy answers. We must learn once again to pose them.
The materialistic and selfish quality of contemporary life is not inherent in the human condition. Much of what appears “natural” today dates from the 1980s: the obsession with wealth creation, the cult of privatization and the private sector, the growing disparities of rich and poor. And above all, the rhetoric that accompanies these: uncritical admiration for unfettered markets, disdain for the public sector, the delusion of endless growth.
We cannot go on living like this. The little crash of 2008 was a reminder that unregulated capitalism is its own worst enemy: sooner or later it must fall prey to its own excesses and turn again to the state for rescue. But if we do no more than pick up the pieces and carry on as before, we can look forward to greater upheavals in years to come.
And yet we seem unable to conceive of alternatives. This too is something new. Until quite recently, public life in liberal societies was conducted in the shadow of a debate between defenders of “capitalism” and its critics: usually identified with one or another form of “socialism.” By the 1970s this debate had lost much of its meaning for both sides; all the same, the “left–right” distinction served a useful purpose. It provided a peg on which to hang critical commentary about contemporary affairs.
On the left, Marxism was attractive to generations of young people if only because it offered a way to take one’s distance from the status quo. Much the same was true of classical conservatism: a well-grounded distaste for over-hasty change gave a home to those reluctant to abandon long-established routines. Today, neither left nor right can find their footing.
For thirty years students have been complaining to me that “it was easy for you”: your generation had ideals and ideas, you believed in something, you were able to change things. “We” (the children of the Eighties, the Nineties, the “Aughts”) have nothing. In many respects my students are right. It was easy for us—just as it was easy, at least in this sense, for the generations who came before us. The last time a cohort of young people expressed comparable frustration at the emptiness of their lives and the dispiriting purposelessness of their world was in the 1920s: it is not by chance that historians speak of a “lost generation.”
If young people today are at a loss, it is not for want of targets. Any conversation with students or schoolchildren will produce a startling checklist of anxieties. Indeed, the rising generation is acutely worried about the world it is to inherit. But accompanying these fears there is a general sentiment of frustration: “we” know something is wrong and there are many things we don’t like. But what can we believe in? What should we do?
This is an ironic reversal of the attitudes of an earlier age. Back in the era of self-assured radical dogma, young people were far from uncertain. The characteristic tone of the 1960s was that of overweening confidence: we knew just how to fix the world. It was this note of unmerited arrogance that partly accounts for the reactionary backlash that followed; if the left is to recover its fortunes, some modesty will be in order. All the same, you must be able to name a problem if you wish to solve it.
I wrote my book Ill Fares the Land for young people on both sides of the Atlantic. American readers may be struck by the frequent references to social democracy. Here in the United States, such references are uncommon. When journalists and commentators advocate public expenditure on social objectives, they are more likely to describe themselves—and be described by their critics—as “liberals.” But this is confusing. “Liberal” is a venerable and respectable label and we should all be proud to wear it. But like a well-designed outer coat, it conceals more than it displays.
A liberal is someone who opposes interference in the affairs of others: who is tolerant of dissenting attitudes and unconventional behavior. Liberals have historically favored keeping other people out of our lives, leaving individuals the maximum space in which to live and flourish as they choose. In their extreme form, such attitudes are associated today with self-styled “libertarians,” but the term is largely redundant. Most genuine liberals remain disposed to leave other people alone.
Social democrats, on the other hand, are something of a hybrid. They share with liberals a commitment to cultural and religious tolerance. But in public policy social democrats believe in the possibility and virtue of collective action for the collective good. Like most liberals, social democrats favor progressive taxation in order to pay for public services and other social goods that individuals cannot provide themselves; but whereas many liberals might see such taxation or public provision as a necessary evil, a social democratic vision of the good society entails from the outset a greater role for the state and the public sector.
Understandably, social democracy is a hard sell in the United States. One of my goals is to suggest that government can play an enhanced role in our lives without threatening our liberties—and to argue that, since the state is going to be with us for the foreseeable future, we would do well to think about what sort of a state we want. In any case, much that was best in American legislation and social policy over the course of the twentieth century—and that we are now urged to dismantle in the name of efficiency and “less government”—corresponds in practice to what Europeans have called “social democracy.” Our problem is not what to do; it is how to talk about it.
to continue: http://www.nybooks.com/articles/archives/2010/apr/29/ill-fares-the-land/?pagination=false
Say Bobine, could you maybe just post links instead of wholesale cut and paste.
I am always interested in members own thoughts.
JR
I am always interested in members own thoughts.
JR
As noted in the modified title - So far there have been zero European or Canadian members participating in this discussion.
I'm asking for your opinions because I think it is valuable and relevant to hear firsthand from those who live in countries with a nationalized health care system.
What do you think of the current healthcare system in America? Do you wish you were here instead of where you are now in regards to healthcare?
I'm asking for your opinions because I think it is valuable and relevant to hear firsthand from those who live in countries with a nationalized health care system.
What do you think of the current healthcare system in America? Do you wish you were here instead of where you are now in regards to healthcare?
Perhaps the clearest & most persuasive advocate for a National Health Service, Tony Benn.
http://www.youtube.com/watch?v=xwfiz3AQmjs
http://www.youtube.com/watch?v=OnserZOf1-4
Not being an ex Rebel Colonial, I rarely follow US politics. But the recent venom of the Republican campaign against President Obama and his policies, beggar belief .. even to someone prepared to believe anything of American politicians. Do they really want the rich to pay less tax than the poor? Are party politics really more important than people and the good of the nation?
On whether this government or any government is capable of running an efficienct health service, it is clear that some governments are not. The arch Republican, Baroness Thatcher, increased the number of administrators by 10x while halving the number of doctors & nurses in the NHS. But we are foolish to believe that a system run for the profit of insurance companies has efficiency as a goal. Indeed American evidence clearly confirms this fallacy.
The rest of the world saw the best of America in Kennedy's Peace Corp. To us aliens 50 yrs. on, that they elected Obama to the White House, says there is again hope for America. If they re-elect him next year, perhaps there is hope for the world.
http://www.youtube.com/watch?v=xwfiz3AQmjs
http://www.youtube.com/watch?v=OnserZOf1-4
Not being an ex Rebel Colonial, I rarely follow US politics. But the recent venom of the Republican campaign against President Obama and his policies, beggar belief .. even to someone prepared to believe anything of American politicians. Do they really want the rich to pay less tax than the poor? Are party politics really more important than people and the good of the nation?
On whether this government or any government is capable of running an efficienct health service, it is clear that some governments are not. The arch Republican, Baroness Thatcher, increased the number of administrators by 10x while halving the number of doctors & nurses in the NHS. But we are foolish to believe that a system run for the profit of insurance companies has efficiency as a goal. Indeed American evidence clearly confirms this fallacy.
The rest of the world saw the best of America in Kennedy's Peace Corp. To us aliens 50 yrs. on, that they elected Obama to the White House, says there is again hope for America. If they re-elect him next year, perhaps there is hope for the world.
peter purpose
Well-known member
As an Englishman in my 6th decade and one who has never set foot in a hospital, I shudder to think of the amount of cash I would have put in the hands of private insurance companies were I an American.
Sure we contribute a small portion of our income through the national insurance scheme, but nowhere near that demanded by the greed of those cnuts creating vast wealth out of thin air.
I'm safe in the knowledge that if I broke my leg today, it would be fixed today and no bill would be presented.
Sure we contribute a small portion of our income through the national insurance scheme, but nowhere near that demanded by the greed of those cnuts creating vast wealth out of thin air.
I'm safe in the knowledge that if I broke my leg today, it would be fixed today and no bill would be presented.
living sounds
Well-known member
I find it kind of ironic that the bill gets called "Obamacare". It's an industry-bill. A few good provisions and intentions and a huge giveaway to the insurance mafia. A reflection of the broken for-sale electoral system. Instead of Iraq the US Army should have levelled K Street...
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