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Kistaro Windrider, Reptillian Situation Assessor

Unfortunately, I Really Am That Nerdy

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Via nidonocu, on Twitter, I've become aware of a "We Love the NHS" campaign slowly making its way through UK users of social networking sites. It's intended to correct the misapprehensions/misinformation/flat-out lies being spread about the National Healthcare System used in England, suggesting that referring to it as a disaster that could happen if the USA adopts socialized healthcare is unfair to a system that fundamentally works. I obviously have no personal experience with the NHS, so I can't state either way- which, of course, is the entire point of the campaign: to point out the sweeping majority of "satisfied customers" who usually remain quiet, and suggesting the failure rate of their healthcare system is no worse than our private insurance- which is only good for people able to pay the irrationally steep cost of entry, while their less expensive system covers everybody.

(My personal opinion? The health care system in the USA is fundamentally broken. I am not convinced, however, that this proposal is the correct solution. If employers were not required to offer health plans, and the tax breaks for providing them went away, buying health insurance would actually go back to the open market and become subject to actual market forces. This doesn't address the high cost of malpractice insurance or medication, but a ban on advertising prescription medication would help. Advertising costs more than R&D for drug companies, but it's a race for the bottom: stopping advertising costs market share. Banning it places everybody on a level playing field. But we do need a government solution for health care for the poor, and what we have now isn't good enough. However, introducing government into a market intrinsically distorts it, as well as providing incentive to not work. The only way to fix that incentive problem is to offer the program to everybody, regardless of income- and we're back to socialized medicine, which is starting to look like the only stable solution.)

This seems reasonable. Over on one side of the lake, we've got a bunch of people freaking out about "oh god, Socialism" and spreading bizarre lies involving, among other highlights, mandatory euthanasia. On the other side, we have a bunch of people who are thoroughly confused about where the hell we're getting these bizarre ideas and would rather clear things up. They like their system, and would rather we stop having people die unnecessarily with the most pointlessly expensive health-care system in the world, so they'd rather we have more accurate information about their system when we contemplate our own. Reasonable, right?

Do not forget how pointlessly contrary Americans are.

Back in the 2004 elections, there was at least one British newspaper running a letter-writing campaign to encourage readers to advocate for John Kerry. Unfortunately, five years is an eternity on the Internet, and for the life of me I can't find the news articles about this now; can someone help me find the links? What happened, of course, was massive backlash. The campaign was met by pure anger by the USA recipients, with many self-declared undecideds switching to Bush supporters out of anger at what they perceived as unreasonable international interference in American politics. I did not recall any particular positive reactions to this campaign.

What I'm worried about is the exact same result for this campaign: backlash, but this time, mainstream backlash. Fox News will definitely spin it as "international pressure to adopt Socialist policies", but how will the less biased sources take it? How will the public take it? And who are you trying to prove anything to? Public health policy is an extremely polarized issue. I'm not sure how many of the people against it care about actual facts in any way. This attempt to introduce real, meaningful information seems entirely reasonable, but I'm worried it might well backfire.

The solution, as I see it, is to go through domestic channels. Provide the information, make it clear and citable, but push it to USA-based advocacy groups instead of international campaigns. It won't be as visible, and probably not really visible "enough"- but with the pressure for correction being perceived as domestic rather than international, it should avoid a backfire, which I honestly believe is the most likely result of this campaign.

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*nods* I do understand your concerns but I also think for many its less a case of wanting to advocate for change in the US but more just defend the character and reputation of our own system.

Many I believe, including myself, feel rather insulted by American Republicans and others who would attack a 'British Institution' and want nothing more than an apology for the defamation.

It is commonly known here that You'll have our NHS when you pry it from our cold dead hands. And thanks to the NHS, death is far less likely to occur any time soon. :)

Oh, and incidentally, I should mention I also wouldn't be alive without it, having been born with my umbilical wrapped around my neck and quick actions by doctors and careful monitoring by our NHS hospital ensuring I made a full recovery before I was sent home. :)

I wonder how much of that sort of thing is why defenders of private insurance are as passionate about it. I was delivered by C-section, and most of my family has been in and out of the hospital various times, covered by insurance each time- insurance we rely on as much as you rely on the NHS. I also watched my uncle Melvin get killed by a phenomenally incompetent hospital that failed to protect him- with asthma- against a drug-resistant airborne illness, which complicated the ruptured hernia he was put in there for. Insurance maxed out, and my aunt and her daughter are trying to pay the $250,000+ medical bill, in installments. She works at a Wal-Mart. My cousin is a nurse, but she has her own daughter to raise. So I've seen both the success and the failure of the system. It's the latter experience that makes me want more oversight of hospitals as a whole. The insurance company can refuse to pay incompetence, but what of the people who never had a choice of hospitals?

Democrats have wanted apologies from Republicans for years. You're never going to get one. I'm rather Centrist in my politics and am enraged at the Republican party as a whole, as they've moved on from an excess of passion to a complete, unapologetic separation from facts or logic in most issues. Yes, they're right about some things, but it's certainly impossible to figure out what they're right about when they go out of their way to lie about what can't be so rationally supported.

Then again, America is a country where changing your mind based on new information, a changed situation, or clear public preferences is a reason to vote against someone politically (for being "inconsistent"), so maybe they know their audience.

The groups lying about the NHS will not apologize and cannot be addressed by challenging them with facts; resistance is used (effectively) as a chance to whip their supporters into a ridiculous frenzy. The best that can be done is to let them make fools of themselves and erode their own foundation, which they consistently do, and go public based on their gaffes. Helping groups find those gaffes- cite direct and easily-verifiable falsehoods about the NHS- will undermine them; yelling at them will strengthen them.

Best gaffe recently was the "Stephen Hawking would have been euthanized in the UK"; that particular error is gaining a lot of momentum, and the groups trumpeting how blatantly ridiculous it is are the ones who would love evidence against all the other stupid things being claimed.

The actual likely hood of getting someone to actually say sorry is indeed low. Though I might hope in one way if people are informed that those in other countries are not okay with their health service but activily going out of their way to talk about it, correct lies about it and defend it, then maybe the horror stories they are being told are not as truthful as they claim to be. It can be something to help undermine the arguments of those against it, rather than trying to boost the arguments of those for it.

I would also have to counter the point that I'm sure many of the 'passionate' people are being paid to be, or their argument is around some more fundermental concept like having government run anything (just don't mention the armed forces, libraries, schools, police or fire services), those who are defending private health care might just be doing so because they've put money in and they don't want to see it 'go to waste' by it suddenly being replaced by a public system.

The truth there of course, is that they could stick with their existing company after public health came in anyway, and if anything the cost they were paying for it would fall as those companies started trying to compete with something that costs $0. (Which is still possible when you can compete by providing a 'First Class' level of service over the free 'Standard Class'.)

I agree; I don't like the misinformation being spread about the NHS, but I don't have any opinion about whether the US should have a similar system (and I don't believe that has ever really been suggested, considering the NHS is far more than a state insurance plan and is the actual provider of most medical care).

It's certainly not a perfect system, but it works pretty well, especially considering its level of funding. Criticism would be entirely fair, but claiming that there are policies denying treatment to individuals based on their lives not being worth saving are quite another. Yes, NICE (the National Institute for Clinical Excellence) does have to make decisions on which treatments are cost-effective, but surely insurance companies must have to do the same - there's not an infinite amount of money and sometimes spending hundreds of thousands of pounds on slightly prolonging the life of a terminal cancer patient has to be balanced against, say, care for premature babies who have their whole lives ahead of them.

Actually, that's a major problem with our current system. An insurance company is more likely to spend hundreds of thousands of dollars on low-probability treatments or even life extension on terminally ill patients (to the tune of thousands of dollars per day) than it is to grant preventative medicine or preventative surgery to a patient who is "ill, but not that ill". The health insurance I have is a lot more aggressive about pushing preventative care, but most people aren't so lucky.

Half right. An insurance company is more likely to find ways to weasel out of potential expenditures both large and small. Google "recission"; here's a start.

I agree with your original point that truly socialized medicine is the only stable solution. The problem is not insufficient market forces; the problem is that "health insurance" (where the insurer collects money at a steady rate and pays out when recipients require care) puts the profit motive in direct opposition to the intended goal of quality care. It is fundamentally flawed as a public health strategy, period.

Edited to add: Speaking of market incentives, this is probably one of the most interesting articles about health care that I've read that doesn't say a single word about health care: Bruce Schneier on asymmetric-information markets. This is another deep-rooted problem with people buying care from insurance companies: individuals simply cannot assemble enough information to make a well-informed rational choice when procuring either insurance or care. You don't believe me, try comparison-shopping for health care sometime.

Edited at 2009-08-15 04:12 am (UTC)

They're attacking the NHS too eh? They're always attacking the health care system up here in Canada too. I really don't know what they're hoping to accomplish with their various fear campaigns and the like. Nor am I sure how much of their simpering is legitimate fear, versus wanting to maintain the status quo.

But I do think just forcing health insurance on the masses isn't the solution. Say what they will about the Canadian and British Nationalized Health-care Systems, they work! And you don't have to pay out of pocket to go see a doctor.

> I really don't know what they're hoping to accomplish with their various fear campaigns and the like.

Follow the money. The extra cash Americans collectively spend for care that is roughly equivalent for a much smaller proportion of the population? That extra cash goes right into the pockets of the people who are wailing and beating their breasts and throwing a lot of political donations around and getting their trained monkeys on the political right to spout the above-documented transparent lies in an effort to propagandize their way into more profits.

It's about money. It has been since the start of this. Unfortunately, entranched systems are difficult to change.


Aye, its always about money. ^^() Likely always will be.

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