The British are revolting!

The BBC (British Band of Communists) has created an appalling piece of propaganda suggesting that the American health care system is an unfair mess. And they’re not exactly too polite about the rest of America, including setting up some doubtless fake multi-millionaire with a spendthrift wife to look ridiculous while saying that we shouldn’t be sharing the wealth.

And if you want to watch it, luckily it won’t be shown here on TV. But those communists have now invented something call YouTube, so you can see it there. But I’m sure none of you realists will want to watch it, and instead will join my call to make sure that these tax-subsidized radical extremists are banned from these shores.

And of course, these are the fools who claimed that spaghetti grows on trees.

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  1. @andrew To me, there couldn’t be a more wasteful way to spend money than to purchase health insurance. However, since your point seems to be that people shouldn’t look to others to pay for their care, I have another solution. Although I think this discussion is likely moot, because as usual, when things are done wrong, correcting them becomes extremely expensive. And we are on the verge of change that must come and will come. The alternative could have been to dispense NO FREE CARE to anyone (excepting ER), and removing the insurance companies entirely from the picture. Outlawing them, because they did not fulfill their responsibility and were run without honesty or integrity, just greed. With no insurance companies, and every household paying for its care, the market would take care of things. That actually would have been a real overhaul.
    I still don’t understand why people choose to begrudge others what should be a basic entitlement and claim to be paying for their care when they are gouged by the system. It is the system that will forever exploit unless it is brought down.

  2. Yana, I do not care if you choose to spend money on something frivolous as opposed to healthcare, I just think its morally questionable that when you do need something done, you look to others to pay for it.
    Matthew, the BBC, that bastion of impartiality continues to empploy Jeremy Vine who I find almost as annoying as Sarah Kennedy (reference may be lost on non Radio 2 listeners, that said I can not get my head around the attitudes and beliefs of someone like Foster Fries (spelling?).
    This is someone who is so divorced from reality, that he’s actually got no concept of what life is like for 99.9999999% of the population.
    I simply do not understand it.

  3. I have a couple of points to add to the discussion:
    1. Having medical insurance is not the same thing as obtaining medical care. Many people are denied care because an insurance company has determined their situation does not warrant it – pre-existing condition, did not notify before treatment, experimental treatment, hit lifetime maximum, etc. Some of the SCHIP people fall into this category regardless of their income level.
    2. You talk about paying for medical coverage for non-citizens as if there is a choice. When an ill or dying person appears at an emergency room, they are treated. If they are a non-covered citizen or non-citizen we pay for it one way or another. All people are talking about is finding a cheaper way to cover this rather than paying the more expensive way – when people are so ill they need to seek emergency assistance. What is a Chicago hospital supposed to do with a Mexican immigrant with a burst appendix – send them to Mexico for treatment? Send the bill to the Mexican government? Seriously?

  4. Matthew – I agree with David MD that some of your attacks of late do not suit you. I’ve read some of your earlier posts, interviews, etc. and you clearly have a solid understanding of the healthcare system. You’ve taken a more divisive approach lately and I think we all, including yourself, would agree that our healthcare problems are of a magnitude that will require a lot more buy-in and input than one side of the ideological divide.

  5. David, rich people may fly here for top notch medical treatmen, but those that live here are forced to pay way too much for no better care, even you admit that forcing small employers to pay for insurance would bankrupt them, including those that hire illegals. Your solutions for containing use or at least paying for bad habits will take much longer to enact than healthcare reform (if we ever see that), as it will be a cultural shift. Can’t argue with need for better child care as most now is just warehosing kids, especially for the working poor. As for the poor and their diet you should check the WIC approved food list, lots of sugery cereals, mostly fat peanut butter, tuna containing mercury (for nursing mothers) and NO fresh fruits or vegetables or organics. The other problem the poor have is being trapped in unsafe neighborhoods. If we fix the illegal latino problem, who come here to work and are hired by Americans, we will still need a program to make them legal workers, unless you want to cut your own grass, clean your own toilet, pick your own food and build your own homes. That being said I don’t think we can look at them as disposible workers, they will need healthcare and their kids will need education. So you either pay them more to afford that and suffer with higher costs, or you also add them to some sort national healthcare plan.

  6. Matthew, you made an ad hominem against Greg Mankiw and his NY Times article.
    “And I’d forgotten about Manikw, a newer member of the Mark Pauly complete idiot brigade. Thanks for reminding me about one of the stupidest pieces ever printed in the NY Times.”
    and I said in a previous comment:
    “Matthew, Greg Mankiw is a peer reviewed Harvard Economist and I don’t understand what is wrong with the NY Times article cited. Could you please be specific?”
    You put together a wonderful blog and you are very dedicated to health care which is wonderful and ad hominem attacks don’t suit you. I am genuinely interested in what Grew Mankiw said in the NY Times article was wrong. The NEJM article I cite addresses one of his three points in more detail. So what are the specific issues in the Grew Mankiw NY Times article that you have problems with and please cite references? Thanks.
    Please read the article I put in my previous post:
    “Laws, regulations, and litigation, particularly at the state and community levels, led to smoke-free public places and increases in the tax on cigarettes — two of the strongest evidence-based tobacco-control measures.14,17,18”
    “….indicate that as many as 200,000 of the 435,000 Americans who die prematurely each year from tobacco-related deaths are people with chronic mental illness, substance-abuse problems, or both.22,25”
    “The United States is approaching a “tobacco tipping point” — a state of greatly reduced smoking prevalence. There are already low rates of smoking in some segments of the population, including physicians (about 2%), people with a postgraduate education (8%), and residents of the states of Utah (11%) and California (14%).25 When Kaiser Permanente of northern California implemented a multisystem approach to help smokers quit, the smoking rate dropped from 12.2% to 9.2% in just 3 years.25″
    As I stated in my earlier comment New York City Mayor Mike Bloomberg has passed a plan that works and we should begin by adopting it in the more liberal states in the nation starting possibly with Massachusetts which has already made a special commitment to health care.
    I never said that smokers and people with other lifestyle habits that incur additional medical costs should not get health care. I stated quite clearly that part of the cost of use of cigarettes needs to be paying for the additional health care costs incurred by consuming the cigarettes. Extra health care, like gasoline for automobiles, is a resource that is consumed for by use of cigarettes as gasoline is consumed with use of automobiles. To have a health service fee added to the cost of using cigarettes so that people pay for the additional health care costs is semantically not a tax any more than using gasoline for driving automobiles is a tax.
    And that is important to understand. Right now, it is as if we are paying for someone elses gasoline for driving their automobiles.
    But it is worse than that because it is well known that when cigarette prices increase fewer teens start smoking and it helps adults to quit. What this means is that by subsidizing the overall costs of use of the cigarettes by paying for the additional health care costs ensued we are actually encouraging people to make their health worse which is exactly what any person wants to do that cares about others. Why would anyone who cares about health care want to encourage people to continue with their unhealthy habits?
    State estimates of total medical expenditures attributable to cigarette smoking, 1993.
    L S Miller, X Zhang, D P Rice, and W Max
    (there is a link to download the entire article)
    “RESULTS: In 1993, the estimated proportion of total medical expenditures attributable to smoking for the U.S. as a whole was 11.8%….”
    $2.6 trillion health care budget of which 11.8% is caused by smoking is about $307 billion this year and more next year. In the next decade that would be well over $3 trillion…
    $307 billion for about 18 billion packs of cigarettes were smoked per year so the health care costs are $307 billion/18 billion or about $17/pack. Read the article.
    Now, smokers should be paying that $17/pack rate otherwise other people are subsidizing them.
    By using tobacco health fees and sugar coke health fees that simply compensates for the additional health care resources consumed (and no more than that) then one induces healthier lifestyle choices particularly among the nation’s poor.
    If you read the NEJM article above that I have cited and if you read Greg Mankiw’s NY Times article you can understand that health care outcomes are impacted by lifestyle and environmental issues which are independent of the health care quality of the nation. That is why Canadians and people throughout the world come to America for health care even though America has such a bad health care system rating.
    Regarding quality of health care, America is first in the world and the way to demonstrated that is that the world’s wealthiest people come to America for health care. Ask most doctors which health care system they or their family (e.g. their mother) would they like treated and they’ll say the American system. Doctors are the people who understand the health care system in a way others cannot (just as lawyers understand the courts in a way others cannot).
    As a medical student I spent 3 months in London in a tertiary medical center and I saw the short cuts being taken, especially with older (in their 60’s) people. I can assure you that you would not want these shortcuts taken with your own mother.
    I am also intimately aware of the Israeli health care system which in many cases is top notch but by and large does not compare with American care.
    In terms of numbers, according to a study by the Commonwealth Fund, 80% of American men survive a prostate cancer diagnosis vs. about 50% in France and Germany and less than that in the UK. So, if you’re diagnosed with prostate cancer (a relatively common one in men) then which country would you rather be in?
    The stats for prostate cancer are not unique. Among many other cancers and other care US rates are far better than often quoted health care systems.
    What can happen when you have a health care system where people voluntarily consume health care resources through their lifestyle habits (recall warnings against smoking have been in place for about 45 years so nobody should not be aware of the health care problems) then you can get into a system where people who have chosen to live a healthy lifestyle can get rationed health care and be penalized for those who voluntarily consume health care resources.
    There is no way we should be subsiding health care costs of non-citizens. People brought in this country on H1-B visas generally have their health care paid by their employers and this should be true of all non-citizens. There isn’t enough resources for US citizens so why should we pay for non-citizens.
    France has a wonderful program that supports women to be able to stay at home and take care of their children and I would much prefer our tax money go to this wonderful system (Israel has a similar system but not as much) than for subsidizing non-US citizens and the consumption of health care resources induced by smoking cigarettes. It should be noted that one reason for additional childhood (“epidemic”) obesity is that children are no longer getting healthy home cooked meals and instead getting fed more junk food (e.g. McDonald’s, Pizza Hut). Everything is interlinked.
    There are some people that have an agenda of socialized health care because they think that is the solution to the health care problem. But if one really cares about the health of others one needs to address the lifestyle issues that (especially) poorer people have chosen.
    (See end of article)
    When both women’s twins reach 3 years of age, they will qualify for the free government preschool programs that most French children attend until kindergarten.
    “The child-care system in France is very well thought out,” said Staub, sitting on a sofa on a recent Saturday afternoon with feverish 8-year-old Margaux on one side, fidgety 6-year-old Jules on the other, and one of the twins on her lap. “Everything is organized to make mothers’ lives easier.”
    The French system also fosters different attitudes about working mothers. French working moms say they feel far less guilt than friends in the United States or Europe because French society recognizes children are well cared-for while mothers are at work.
    As a result, French women are not only having more children than their European counterparts, but far more of them work outside the home than in most European countries. Three-fourths of all French mothers with at least two children are employed.
    “In Mediterranean countries and Germany, it’s work or children,” said Marie-Therese Letablier, research director of the Center for Employment Studies. “In France, it’s work and children.”

  7. “The revenues from increasing the taxes on cigarettes can go into helping to pay for health care for the uninsured.”
    In California, the Managed Risk Medical Insurance Program (MRMIP) is funded by tobacco taxes. Smokers are highly taxed, but it is through MRMIP that my husband and I would be paying approximately $1,500 monthly for insurance. The smokers are being exploited just as much as victims of America’s medical system. Our lottery motto was “Our schools win, too”, but we don’t have air conditioning in the local high school yet, as far as I know, and the schools endlessly beg for money. They get the money, and they do not provide the basics. Smokers might be more likely to be taxed to death than to get sick from smoking, but their tax dollars will most likely not be wisely used. It’s all lies, excuses and phony promises.
    “I am all for paying for people’s health care costs that they have no control over such as the genes they inherited, I just don’t want to subsidize people’s unhealthy lifestyle decisions.”
    So, some people are worthy of care and some are not. I hate to tell you this, but I know of a woman who died of lung cancer at age 40, and had never smoked. I work with a woman who is 87, has smoked for over 60 years and enjoys gin very much. She has outlived her husband and many of her clean-living friends. These instances are not that rare, and demonstrate that science cannot make successful predictions or prescribe a lifestyle that will inevitably result in good health and longevity for everyone.
    I don’t believe that employers should provide health care benefits at all. Health care should not be tied to an employer, and employers should not be exploited anymore than anyone else by the insurance companies and the pharmaceutical industry. Some companies pay a higher wage to employees who decline the health benefits package.
    The American economy is very damaged by the medical system and its high costs, and the people are damaged financially and by the system’s lack of accountability – that is, if they manage to get the care in the first place.

  8. Matthew,
    I don’t know why I bother responding to you. You just have this way of getting under my skin. I love how your shallow thought and minimal comprehension of complex issues means I hate poor people. Talk about framing the debate, you have it down to a science.
    I don’t think SCHIP should subsidize insurance for kids in families making 80K plus, so I hate poor kids?
    I don’t think someone that can afford $180 a month for a pack a day smoking habit should get free insurance, if you can afford to smoke then you can afford your own insurance, but that means I hate poor people?
    As a simpleton you apparently can’t grasp opposing a bill for one of its parts doesn’t mean you oppose the purpose of the entire bill. But boy do you use it to death in debate, sad that this is always your strongest argument.
    As I showed Hummers are not cheaper then health insurance. And I see people every month declining insurance because it is to expensive drive away in a hummer or beamer. There are plenty of studies showing how many million uninsured make over 80K, this isn’t an unknown fact, only an ignored one.
    As I have displayed countless times I know more about healthcare cost and insurance then your entire leftwing blogger tribe.
    Care to show where they retracted the study? It’s easy to claim a study I linked to was retracted why don’t you share the link?
    Love how long the civil debate lasted, apparently only conservatives are to be encumbered by the rules of polite discourse.

  9. “but I think it would be too much of a burden on smaller firms and may force them out of business.”
    Maybe a lot of the people being helped by Remote Access Medical are employees of small companies that cannot afford health insurance.
    David, much of what you say I agree with, but taxing polluting firms for either causing bad health or bad environment has been a multi-decade fight with few victories. Poor people have a harder time being able to eat healthy than finding daycare or even a safe neighborhood. They also many times stuck in old stock housing with lead paint which does not give their kids much of a chance. I support a calorie tax and pollution tax as well as higher cig. taxes, but while we wait for legislation (blocked by lobbyists) on those issues and the time when the positive effects of the taxes takes hold, people are still needing healthcare. Other countries have those same problems but still are able to provide healthcare for 1/2 the cost. Don’t shift blame for high health costs onto poor people and non-citizens fleeing a country that has failed them, (alone with free trade) from a healthcare industry that lavishes millions of dollars on politicians to keep the money flowing in their favor.

  10. Please read this very important article and I wish someone would write a post in THCB to emphasize it…
    We Can Do Better — Improving the Health of the American People
    The key to improving health care in America is focusing on individual health habits (smoking, obesity, lack of exercise) which is especially prevalent in the poor that Matthew cites and environmental problems such as air and water pollution, violence in neighborhoods, lead paint, which is also prevalent in lower socioeconomic classes.
    This requires passing legislation much like that done by New York Mayor Mike Bloomberg which has helped to lower the teen smoking rate to 8.5% from 21% and helped 200,000 (20% of smokers) adult smokers to quit smoking by 1) banning smoking in public places 2) raising the cost of cigarettes through taxes to $10/pack, 3) rigorous enforcement of the law prohibit sale of cigarettes to minors with a 93% compliance rate, 4) rigorous anti-smoking legislation, 5) periodic free nicotine replacement patches.
    The revenues from increasing the taxes on cigarettes can go into helping to pay for health care for the uninsured.
    Please read the NEJM article as it is very, very informative about what to do if one really wants to improve health care. It demonstrates that 40% of health care costs are caused by behavior, 30% by genetics, …. http://docs.google.com/View?docid=dc9j3ksm_898fmw9q4gm
    I am all for paying for people’s health care costs that they have no control over such as the genes they inherited, I just don’t want to subsidize people’s unhealthy lifestyle decisions. Raising health children is a key part of normal daily living and I believe in the SCHIP program to ensure all children get health care as well as free public education and I add to this that it would be helpful, especially for single parented moms, to have taxpayer assisted day care and I much prefer this than to pay for health care costs of non-citizens. When I travel overseas it is not the local government that pays for my health care costs but my insurance policy or a locally purchased one.
    I do believe that either the non-US citizens themselves should pay for their health insurance, or the country that they are from (e.g. Mexico) or their employer since their employer made a decision to hire them. I would gladly pay the higher food costs (as I do higher Starbucks coffee costs because Starbucks pays for health insurance for its employees) for health care for non-US citizens.
    I am for mandating large firms (e.g. Wal-Marts) for supplying health insurance for employees but I think it would be too much of a burden on smaller firms and may force them out of business.
    Matthew, Greg Mankiw is a peer reviewed Harvard Economist and I don’t understand what is wrong with the NY Times article cited. Could you please be specific?
    In summary, though, one reason why health insurance is not affordable is because we are cost shifting health care costs caused by lifestyle choices and environmental issues such as pollution and paying for citizens of other countries onto those who have chosen a healthier lifestyle and do not pollute and are US citizens. By having the individuals who have chosen a certain unhealthy lifestyle or who pollute pay for the health impact of that voluntary lifestyle choice or choice to pollute then it will significantly lower the costs of health care. Moreover, it will induce people to have healthier lifestyles and to clean up the pollution.

  11. “there are other things that are needed for US citizens such as better government provided day-care for working mothers with young children.”
    David, isn’t there an argument that says, “Why should I be forced to pay for a person’s conscious decision to have a child?” You may not want to pay for non-citizen healthcare, but you certainly benefit from the low wages/benefits they receive. If you say employers should be paying for healthcare for their non-citizen employees would you be in favor of mandatory employer health insurance?
    I’ll give you that Democrats in tobacco states also oppose cigarette taxes.
    Given that you say there is no real overall problem with healthcare affordability why all the fuss then? Is this just some con game? We can assume that if people did buy health insurance over other things then those other industries would suffer given that we are paying 16%+ GDP for healthcare. Is that reason enough to be concerned about costs and affordability?

  12. Looks kids. The reason I made a joke about this is that it’s not exactly the world’s most thoroughly researched documentary, and of course it’s biased.
    But step back and consider what they’re saying. You can be poor in America, get sick, and the attitude of some of the wealthiest is “screw you–you should have chosen your parents better”. And as ably demonstrated by David MD, Nate and others here, the documentary is right about that.
    And even though Hummmers are cheaper than health insurance, how do you know it was a patient’s hummer? Might have been a volunteer doctor who’s not of the David MD let them eat cake opinion.
    And I’d forgotten about Manikw, a newer member of the Mark Pauly complete idiot brigade. Thanks for reminding me about one of the stupidest pieces ever printed in the NY Times. Nate meanwhile needs to learn about the difference between health care costs and the charges for underwritten insurance premiums (quoting the ehealthinsurance studies that even that company has now retracted! Good grief!). But I’ve decided that as a capitalist I need to stop his free education, unless he drives and waits outside my house starting at 2 am.

  13. I don’t understand why anyone would begrudge someone a Hummer, if that is what they want, or a roof over their head in favor of that person putting out funds for health insurance premiums from which there may be no return. Insurance for my husband and me would cost about $1,500 monthly. We would be required to pay the premiums, but the insurance company could reject claims and would do so if we were not profitable. There is no warranty on services provided and no guarantee of results, much less a diagnosis. I believe in getting value for the dollar and not being foolish with money. If we pay cash for our new vehicles and do not own a home because we cannot pay for one outright, you can safely assume we are not going to throw money down the toilet to finance America’s exploitative health care system. “Your money or your life” no longer seems to be a believable threat to me.

  14. I found it pretty funny that the ad under the third video was for treating yellow teeth, maybe the British should address their national dental catastrophe before making documentaries on our system?
    You’re mixing up your data. You quoted average family cost for a group policy, of which employees only pay about 3600 of on average with the cost of a family individual policy.
    It’s dated but in 2004 the average family individual policy was only $4,424 according to AAHP.
    According to an eHealthInsurance study based on their block of business;
    “More than half of all family policy holders pay less than $300 per month.”
    “The range of average monthly premiums across the U.S. falls between $98 for Iowa
    residents and $338 for New York residents. This represents a monthly disparity of
    $240, or $2,880 per year. New Yorkers pay on average 3.5 times as much as residents
    of Iowa for health insurance.”
    “Fifty-six percent of major medical plans sold to individuals have a deductible of less
    than $2,000, with 32% having a deductible of less than $1,000. Of family plans, 44%
    have a deductible of $2,000 or less.”
    “More than 80% of all plans purchased through eHealthInsurance have preventative
    care benefits like OB/GYN, periodic exam, and well baby coverage.”
    The average family, either paying $300 a month for their group policy or $344 for their individual policy pays substantially less for health insurance then they do for a Hummer, and your analogy didn’t include gas.
    80% of people with private insurance are happy with it, the claim of high likelihood of errors is just not accurate. You only hear stories from the unhappy but they are far from the majority.
    Contrary to Peter’s claim the problem is regulation. What we need to be asking ourselves is why does an individual policy cost 1/3 that of a group policy? Some of that is surely due to better risk but not 3 times the cost. How in the world can NY screw their system up so bad it cost 3.5 times as much as Iowa? And they are still cheaper then MA. Which should instantly raise the question why in the heck are we letting people from NY and MA reform our healthcare system? Are Clinton and Kennedy truly the most qualified individuals to tell is what we are doing wrong?
    “I’d also bet that the 20 percent of people who are not healthy are not driving Hummers.”
    You would be surprised how many unhealthy uninsured are driving Hummers living in nice houses. Far more then should be.

  15. @Peter,
    It was Harvard Economist Gary Mankiw who himself was citing studies that demonstrated that only a few million US citizens are uninsured and can’t afford to pay for health insurance. See the link posted in my first comment.
    I don’t feel that the US taxpayer should pay for health care costs of non-citizens when there are other things that are needed for US citizens such as better government provided day-care for working mothers with young children. Perhaps the countries where the people are citizens should have to pay their insurance or medical bills or perhaps the people who employ these non-citizens should pay not only wages but health insurance, but I would prefer my tax money go towards US citizens rather than non-citizens.
    As for Republicans and taxes, it is a health service fee that simply has people pay for their own cigarette smoking associated lifestyle (e.g medical) costs. Warnings have been on cigarettes starting in 1964 or about 45 years ago. So the vast majority of smokers started smoking when they knew of the bad health effects. Many states have Democrats in state government who should be levying the health service fees for smoking and drinking sugar coke. NY State has proposed taxes of 18% for sugar soft drinks. If people in other states want good health care (and I’ve heard that is important to them) then they need to elect representatives who feel good health care is important and will levy health service fees on people who smoke cigarettes and drink sugar cokes. It is really up to the citizens of the state whether they want good health care or not.

  16. Rick, you’ve hit the the nail on the head, but I’d like to expand on Joe six-pack economics. Not only do people realize what you’ve said about the cost/benefits of health insurance being hard to value, but they understand a harder truth. You end up paying the insurance company back anyway for all your simple health needs through premiums, but when you really need insurance you won’t have enough reserves for co-pays and yearly deductibles along with not being able to work and maintain insurance as well. So you’ll end up in the same place you would have been anyway without insurance, but in the meantime you’ve taken money that could have been spent on fun stuff for you and given it to the insurance company.

  17. Andrew,
    I get your point, and I’m not trying to be obtuse, but for the typical short-sighted American, the mental conversation probably goes something like this:
    Monthly payments on a Hummer are probably around $600, but the amount stays the same throughout the life of the loan, and eventually you pay it off. For that, you get a high utility item that you use every day, and makes you feel good every time you get in it.
    Health insurance for a family of four costs, on average, $1,000 a month, will go up anywhere from 6 to 20 percent a year, and you’ll pay it until you turn 65 and become eligible for Medicare. You’ll get a little break when the kids are old enough, but the rates will still go up every year. For that you get something that you, if you are like 80 percent of us, use rarely, and is nothing you look forward to (i.e. going to the doctor or hospital), and has a high likelihood of some flaw in the processing of the claim, resulting in further aggravation.
    I’d also bet that the 20 percent of people who are not healthy are not driving Hummers.
    In short, what I’m trying to say is that for 80 percent of Americans, there is a greater perception of value in a car or some other consumer good than there is in a crappy health insurance policy. That’s short sighted — better to have it and not need it than to need it and not have it. But to people who don’t study this stuff for a living, it’s rational on some level.
    Instead of railing against human nature, I think our time would be better spent in coming up with ways to deliver something that people find value in.

  18. 60 Minutes did a piece on Remote Access Medical several months ago. In that episode I did not see any Hummers, but I did see the real face of healthcare need in America. I wonder how many Hummers and Cadillacs and Limos and private jets are making their way to DC to make sure they get their share of the federal bailout money? What’s the matter wealthy America, can’t pull yourselves up by your own bootstraps?
    If as David MD states there are only a handfull of people really needing help with affording healthcare then it shouldn’t be any problem fixing then, should it. And the 10 million non U.S. citizens that we employ to do the work no one else wants to do shouldn’t get healthcare anyway, right? As for fixing smoking rates and obesity you’d better talk to conservatives who are opposed to taxes on anything including cigarettes and calories that could be used to help pay for the health results of bad behavior, and even maybe change behavior. In fact conservatives always want the general taxpayer and individuals to pick up the tab for things that corporate America doesn’t want to pay for, like the effects of pollution and supersizing and marketing junk food to children. Here in NC conservatives don’t want gas taxes to pay for roads and road repair, but they always gripe about not enough funds spent on roads. They complain about the cost to pick up roadside trash but oppose a fast food packaging tax. So David MD you’d better talk to Republicans and the general public that has been convinced since Reagan that we can just lower taxes in an unregulated economy where greed,over consumption and debt will sustain us.

  19. You really have to wonder about this, less than 5 minutes in, at a stadium you see cars pulling in because these folks “can’t afford healthcare”. Could someone explain to me then, why someone is pulling in a Hummer?
    Hello, I am all for caring for those that can not look after themselves but for gods sake, owning or driving a hummer and then claiming one can not afford healthcare is ludicrous………..

  20. http://www.nytimes.com/2007/11/04/business/04view.html
    As Harvard Economist Greg Mankiw points out in the above article there are really only a few million uninsured US citizens. 1. 10 million of uninsured are not US citizens. Millions more are eligible for Medicaid but have not applied presumably because they are healthy and need not apply.
    He continues:
    “The 47 million also includes many who could buy insurance but haven’t. The Census Bureau reports that 18 million of the uninsured have annual household income of more than $50,000, which puts them in the top half of the income distribution. About a quarter of the uninsured have been offered employer-provided insurance but declined coverage.”
    Mankiw also states that much of the health differences between American and other countries (e.g. Canada and Japan) are differences in lifestyle (e.g. obesity).
    “Americans are also more likely to be obese, leading to heart disease and other medical problems. Among Americans, 31 percent of men and 33 percent of women have a body mass index of at least 30, a definition of obesity, versus 17 percent of men and 19 percent of women in Canada. Japan, which has the longest life expectancy among major nations, has obesity rates of about 3 percent.”
    It should be noted that the BBC article and newscast mentions a clinic in Kentucky. Kentucky has a high number of cigarette smokers with a very low tax. Dear Leonard S. Miller of UC Berkeley estimates that 12% of health care costs are caused by smoking amounting to $250 billion of last years $2.1 trillion for 18 billion packs smoked or $13/pack. Even if his study was off by a factor of two it would still come to $6.50 per pack. If the State of Kentucky would add a health service fee to the cost of cigarettes and put that directly into the health care system then they would be able to afford plenty more clinics with people having to travel much shorter distances and getting more timely medical care.
    Higher costs of cigarettes would also contribute to people quitting smoking resulting in healthier people who would have to use health care facilities less.
    It is simply a matter of priorities for the State of Kentucky: they have chosen lower cigarette taxes and subsidizing health care costs of smokers as opposed to simply charging smokers for their health care costs incurred.