But here is my one big pet peeve in the whole debate: STOP TALKING ABOUT HOW WONDERFUL THE HEALTH CARE SYSTEM IS IN OTHER COUNTRIES WITH UNIVERSAL HEALTH CARE!!!! Stop asking about how they can do it and so therefore why can't we. Stop wondering how they do it. They are not us. We are not them.
Consider:
We are here in the US - estimated population 300 + million, estimated number of uninsured 46 million, and oh yes, a dizzying diversity of cultures, ethnicities, diets, languages, and DNA. Those other countries? Not so much.
Cool Britannia may be able to match us in the diversity, but they've a much smaller population. 65 million. Logically, I'd say that makes it easier for the government to provide for said population.
France - population of about 61 million and has only had a huge Muslim minority for the last 40 years. By the way every one's taxed to the gills, the entire economy functions like the contractor who shows up late and leaves early while leaving you with a still unfinished whatever, and if their model of universal health care comes with a culture that remains incredibly sexist (oh yes) I'll pass, thank you.
Then there's Australia - population 21 million. Their diversity? They didn't really let you in unless you were white until the 70s. And let's really not go into how their longest established minority, the Aborigines, were treated.
And then there's the assortment of small wealthy European countries. Even fewer people, very little DNA diversion from the mean, and oh yes, lots of lovely money left over from colonial exploits that no one mentions anymore. (What? You think England and Belgium's economies don't still benefit from the huge amounts of money pretty much looted during the colonial era? I'm over the annoyance of it, but that doesn't mean it's not the case.)
Last but not least, O Canada! Everyone's favorite example. Except Canada's entire estimated population of 33 million plus is less than the 46 million uninsured estimated to live within the US. And Canadians who get tired of waiting for their system to kick in come south.
See where I'm going with this? I'm not saying the system here is great. God knows it's not. And I'm not saying the other systems are crap. Because I don't think "socialized medicine" is the same as "socialism" - that would be a dumbass deduction made by people (Americans in this case) who've never really lived in a situation where the government really does make all decisions. Trust me when I say that that's never been the case here, no matter how bad you think the PATRIOT act is.
The others are not us, and no one is looking at how their models might scale up here in the US with our whoppingly bigger numbers.
You really want to look at how publicly funded health care serves people in examples that may actually apply to the American situation? Look at places like Brazil, India. Places that match the US in terms of sheer numbers, the management required to keep the system running, and the diversity of patients. They provide universal health coverage. Hypothetically.
No idea what it's like in Brazil, but in India, people with a choice do not go to government run anything. Some of the countries best hospitals are run by the government, no doubt. But they're also in large cities. I don't know how well they serve the vast majority that continues to live off the beaten track, in rural areas, and out of sight of the media.
Point is, can we please keep the argument local? For starters it might make more sense if it's tailored to the unique American situation. Even better, it won't allow the idiots on either side to hijack the discussion with intellectual hand grenades of "socialism!"
And I keep harping on the diversity of patient population. Why? Because I think it makes all the difference. I'm not a doctor, and I'm going to very inarticulately paraphrase and relay what I've heard on several occasions from people who are doctors.
For the longest time health care in the US was based on a male and white model. It took the medical establishment time to figure out that what applies to Bob Whiteguy doesn't always apply to his wife, much less his non-white compatriot. On a macro level that made a huge difference in how preventive care functioned. It made a difference in how sick people were diagnosed and treated, men and women, white and otherwise. And that doesn't even factor in for ethnic considerations - different diets, different cultural predispositions to diseases.
Example - the mostly male medical establishment nearly worldwide that did little for women suffering post partum depression or PMS besides telling them it was in their heads. Now multiply that kind of ignorance, or lack of awareness, by a factor of millions, with as many attendant kinks in the system.
I'd love to be wrong, but I'm thinking that it's easier to publicly fund a medical system for a smaller population with a homogeneous population and culture, fewer medical unusualities (hey, new word!), and a similar set of complaints and illnesses that can be documented, researched, and tackled.
Familiarity with a larger and more varied population ends up needing a better/more broadly educated medical establishment, having to think outside the box, having to fund larger and perhaps longer and more varied studies to come to conclusions about sickness and healing. To get a picture that accurately represents levels of either in a society. To make recommendations or have protocols that can be effectively implement. And funded. All that has to be funded, for the long term, sustainably.
Are we up to that? Where is the money going to come from? And even if every hard-bit right winger who hates to pay taxes says an enthusiastic "yes!" is it going to be enough? Last but not least, who is going to implement the change? How long will it take before everyone is on the system? Who takes care of the snafus? The idea that the government, or a government agency would be in charge of some of the above is - I think - what scares the shit out of ordinary people who've seen the same government (regardless of which administration) royally fuck up and impersonally bureaucratize the process so that Joe Citizen gets underserved. To put it mildly.
And the Obama administration hasn't done enough to assuage those fears. If it has, it doesn't seem to be coming through to those paying attention, much less me.
* Whole Foods - I'm just tickled at the uber lefty liberals who just figured out that the CEO of the company that allows them to live healthy and shop with a conscience is a libertarian who sees no reason why doing so must automatically mean being pro-union or pro-universal health care or pro-other such commonly held socially progressive points of view. Did these folks - especially in larger urban areas - not notice how the Wild Oats, Mrs. Gooch's, Bread and Circus et all seemed to mysteriously go out of business or roll over when Whole Foods came to town? One comment on a recent blog about the subject in the NYT called Whole Foods the Walmart of the organic movement. True enough.
By the way, I am far from anti-Whole Foods, and do not plan to boycott it. Furthermore, I am hardly a conservative. I just think it's incredibly funny to see the collective, "I'm shocked, SHOCKED!" routine from people who thought they were going to shun the mainstream's marketing, because they didn't realize they'd fallen for the same thing under a different and more expensive guise.
You really want to save the environment? Stop eating meat. It's still an unnecessarily bigger carbon footprint if you're a locavore spending boucoup bucks on a free range animal.
Just sayin'.