You want to know why our health care system is so screwed up, it's because we've built a system in front of it that everyone goes through to get health care, which has an incentive to provide as little health care as possible.

It's like a nightclub that outsources their doorman to a different company, one that gets paid a flat fee to operate the door, but then has to pay the cover charge of each person that enters. Gee, I wonder why so many people have trouble getting past the doorman into the nightclub? I wonder why so many customers are breaking in though the bathroom window? I wonder why the nightclub appears to be failing?

The health insurance industry needs to go, period. It does not need to exist in any way, shape, or form. The entire purpose and motive of it is to deny health care.

Now, people are thinking 'But we have other insurance industries, and they work'. Well, yes, but unlike other insurance a) everyone needs health care, and b) health insurance companies have managed to pretend health care needs are subjective, and c) other insurance companies don't have near total control of the industry they're in front of.

I.e, if you have fire insurance on your house, and your house burns down, the insurance company must pay unless they can prove it was arson or something not covered. If stuff from your house was stolen, renters insurance doesn't get to argue that you had a faulty window that you should have reported when you bought the insurance, so they could have denied it. Auto repair shops don't charge three times as much for repairing cars normally because comprehensive car insurance repairs have forced those prices through the floor, and half the other people drive off without paying, and repair shops must go along with this because insurance referrals are 90% of their business.

Other insurance companies are regulated, and rare, and a choice instead of a necessity, and don't take effect for routine things but for disasters. Health insurance takes the idea of insurance and turns it into a nationwide scam forcing hospitals out of business and people out on the street, because they're positioned themselves as doormen to a place they don't want people getting to.

Sadly, it appears that all politicians are in bed with the health insurance industry, and try to include it as part of any reform, when any objective observe would conclude it shouldn't exist at all.

Why are you determined to put George Bush in charge of your healthcare?

although at some pretty big tradeoffs for those who would otherwise be getting better care under a system like ours.

I don't see why the care of the affluent (which must be who you mean) would deteriorate as long as private hospitals and supplemntal private insurance were still tolerated.

Perhaps there are complicated reasons relating to the changing shape of the overall market. I haven't yet heard an argument along those lines that I found convincing. People tend to assume that a public healthcare system prohibits private health care, but most public systems don't, and I for one don't favor such a prohibition in America.

I was going to respond with something like "Okay, what reasons would those be", but on a second reading I see you've included one, namely, "The American media talks about health care more."

I'm not really convinced that this accounts for the very large difference here, but I technically, I suppose you've provided an alternate explanation.

We don't even actually know if the US media does, in fact, talk about health care more; it's a speculation.

Well we have, by far, the finest military in the world. Are they for profit?

Um, yeah, largely it is. There are other motives of course, patriotism, career advancement, politics. Which is why I replaced "profit" with "motive" in Bit's comment.

The best country in the survey in satisfaction is a public healthcare system. The fact that some countries have bad public healthcare systems is irrelevant when the conservative case - including *yours* is that a public health care system is *inherently* worse than a less public system. This data slaps that argument down, and hard. And you breezily ignore it.

This post is an examination of a specific survey, not a comprehensive look at the public vs. private debate.

Yes, people in France -- only only France -- seem to be significantly more satisfied than Americans. But the point of the post is that there can be many explanations for that other than "France's public health care system delivers better service than our more privatized system."

My sense, by the way, is that that probably is true in aggregate. Fewer people are left uncovered and it's cheaper to run, although at some pretty big tradeoffs for those who would otherwise be getting better care under a system like ours.

Removing profit from a system is the best way to ensure it's fouled up

Well we have, by far, the finest military in the world. Are they for profit?

(oh yea, and don't they have ... whisper it ... socialized medicine?)

The best country in the survey in satisfaction is a public healthcare system. The fact that some countries have bad public healthcare systems is irrelevant when the conservative case - including *yours* is that a public health care system is *inherently* worse than a less public system. This data slaps that argument down, and hard. And you breezily ignore it.

I think your readers would be well served to hear an explanation for the France vs. US contrast that is other than "France's public health care system delivers better service than our more privatized system". From you.

Or else an admission that this is an accurate statement.

Is that really the American dream?

Removing motive from a system is the best way to ensure it's fouled up.

Fixed that for you.

Larry Glasscock, CEO of Wellpoint, the parent company of my insurer, made 46.2 million dollars last year. Yet a significant portion of our population has no insurance, and another large % is struggling to keep up with health care costs (which are up over %100 under Mr. Bush). Clearly, this is out of whack.

I think the greatest country in the world can provide quality health care that people can afford. I think we can get everyone to the doctor once a year.

It saddens me that so many people like Charles are members of the "America can't get it done, its too hard" club.

So, how exactly are we to provide free healthcare for everyone when you say it is a burden for you when you're making $150K a year? TANSTAAFL still holds. Would you feel better about paying $36K a year for health care as long as it was called taxes and distributed by a bureaucracy? Well, at least until the Canadian or UK type rationing kicked in?

Man, oh man are you going to enjoy Obamaland where the threshold for rich is apparently $75K in income.

Perhaps the billions in profits the insurers are currently making could go towards making sure payments are sufficient for higher quality care.

Sure, but then the insurers wouldn't be making the profits, and so would have to either stop paying employees, stop paying shareholders, increase premiums, deny services or all of the above.

So if two healthy people with a household income of 150k+ a year are getting strained, how are people who are not healthy and have lower incomes making out? Not well, I imagine.

Being in exactly that situation (plus 2 kids), I can verify that "Not well" is an understatement.