The writer seems suprised and amused that when the number of people under the insurance policy doubled the price doubled also. Why is that strange? Usually when you buy two things, they cost twice as much as one. It is not as if healtcare for infants is particularly cheap; there is lots of routine care and seriously ill infants are very expensive to care for (fortunately most infants are healthy).

The surprise that health care costs money is typical of most commentators. People for some reason think that they should not have to pay for health care. Or that the government should pay for it (hello!, who pays for the government?).

Oh people in general do say that healt care is too expensive; but then they cheer on Michael Moore when he rails against insurance companies that won't pay for experimental treatment. Why should insurance companies (or the government) pay for expensive and unproven treatments? If we care about the overall costs of our health care system that is an obvious place to start.

And, BTW, in the U.S., new and proven treatments are covered much sooner than in nationalized systems. Those systems ration healthcare by not approving more expensive treatments and having long lines for treatments that are approved.

Bottom line is that healthcare costs money and well-off writers for slate should not be surprised when they are asked to pay for it.

Well, healthcare isn't usually paid directly to the provider by the recipient, instead we pay for insurance. If you don't have insurance and choose to pay the provider directly, you pay more for the service than an insurance company would, because insurance companies have the ability to negotiate rates.

This is because groups of people purchase insurance to distribute and diminish individual risk. By paying premiums, the insured may avoid disproportionate hardship because some spend money for services they may never need.

Therefore, there is not a one-to-one correspondence between the number of people insured under a plan and the premium payment. Insurance, conceptually, uses an economy of scale. That's why employees of very large companies usually have a smaller contribution toward health premiums than sole proprietors (or free lance writers).

A family rate premium, moreover, does not usually depend on the number of insured individuals - if a family has six kids or one kid, the premium (or employee contribution) typically doesn't vary. Insuring health is not the same as insuring vehicles.

Overall, I agree with the fundamental point. In my both insured and uninsured experience, the US system works pretty well. Healthcare does indeed cost money, and I have seen sufficient evidence that the US system provides healthcare quickly and, for the most part, pretty fairly.

However, providing healthcare is not the same as providing insurance. This problem is distinct from the quality of healthcare, or access to healthcare. There is serious dysfunction in the medical insurance - just compare medi-care and medi-cade taxpayer costs to the runaway profits of insurance companies.

To me, this implies that socialized medicine is folly because it is burdened by bureacracy and waste.

It also shows, I think, that insurance companies require greater regulation governing their behavior and runaway profits.

Perhaps mandatory purchase of premiums by all recipients, and mandatory coverage (at regulatory controlled premiums) required of all and any insurance companies (as a consequence of doing business) is appropriate?

You seem not to understand Moore's central argument, namely that the Health Care Industry is charging, but not delivering.

"The USA Spends 15.2% of GDP on health (p.86). Highest spending in the world on health, with Switzerland next at 11.5%, therefore US citizens should enjoy the lowest infant mortality and greatest longevity in the world by far, right? Well WRONG!" (noted elsewhere) We're about 27th in infant mortality and 41st in life expectancy. Yes, behind CUBA in both respects. 2007 Pocket World in Figures ("The Economist" magazine). All these other countries, including Canada and the UK are giving their citizens a better quality of life using drugs developed with our money. The Health Care industry, (including the HMOs and drug companies), is gouging us because we are too ignorant to care about the facts or the figures.

Yes education plays a huge role in these figures too, admittedly. (Are you smarter than a 5th grader?) In a recent survey, 78% of middle-class women asked thought that they were in the top 35% of wage earners in the country. How dumb is that? How can you vote for people who represent your interests when you don't even know which constituency you belong with? That's what's going on. I don't care how fat the messanger is.

What I should care about is how long will I live, and how many of my children will survive their infancy intact. Right now we are 41st and 27th in the world and we shouldn't be, not for the money we're spending.

Any idea what percentage of the people contribute the highest cost of healthcare? It is radically small and is ~5% which in turn accounted for 49% of the total cost of healthcare in 2004. The number of subscribers doubling does not imply costs should double as most people do not use healthcare to the same degee.

I can rattle on more if you like. If the author stated the costs should not rise; than for all intents and purposes he is correct,dependent upon the make up of the subscribers.

Richard,

I'm afraid you logic is a bit faulty. To the extent insurance companies are able to negociate lower rates, that lower rate is still doubled when two people are insured.

Your arguement on risk pooling is wholly incorrect. Risk pooling does not lower costs; rather those costs are shared. If anything risk pooling increases costs (and level of service) because individuals receive service they could not afford independently.

Your last point is especially telling. Most Americans think of thmselves as middle class, which explains the ironic fact that friends that I know who live in McMansions in gated golf course communites describe themselves the same way as other friends I know who live in cheap apartments and work at Wal Mart.

They gave you a check mark for that??????

I think it's a false construct to posit that anyone works under the illusion that health care is free.

You pay for it whether or not you pay taxes to get it in a nationalized system, or whether you are lucky enough to have an employer who has a generous plan (you don't get to choose the health care you get either way, and under the current American private system, your health care options are at the whim of your employer).

Lots of cliches in this thread about 'socialized' medicine (waste! rationing! long lines!) without any citations of evidence or distinctions between different single-payer systems.

Of course, an American documentary film maker should never criticize an American system. Even if that system does have waste, rationing, and long lines.

Brerlou brings up an interesting point about life expectancy. However, there are many things that effect life expectancy and quality of health care is just one of them. Indeed, one of the major reasons for the United States realtive weak performance in this area is the growing obesity of americans. It is interesting that Mr. Moore did not address this issue; perhaps he does not want to admit that individuals (like himself) have some responsibility for their health.

Why are we all so fixated on the idea that if we had a nationlaized health care system we SHOULD pay more taxes? I think we all pay enough money to the government already. Maybe the politicians are the ones that are getting fat and have the best health plans of all to prolong their miserable lives. We Americans should have a better health plan and not have to pay a penny more for it. One plan that treats all of us equally. Perhaps the doctors are greedy too. What entitles an institution or individual to make a decision about a human being's health or even their life based upon that person's ability to meet their going rates? Medicine is supposed to be about helping people, not about making money.

Call me naive or call me a communist; which ever you prefer. We are not living in a true democracy if we can not make the choices about where our taxes are funneled. We all may be better off in Cuba. At this rate Cuba may be turning American refugees away some day.

[Call me naive or call me a communist; which ever you prefer. We are not living in a true democracy if we can not make the choices about where our taxes are funneled. We all may be better off in Cuba. At this rate Cuba may be turning American refugees away some day.]

Why don't you be the first?

Timeforsanity, do you doubt that there is rationing and long lines in other systems? If you do, then do a little research. For example, today this article appeared about Canada's lower rate of defibrilator use; and rationing is explicitly mentioned: <link>

It maybe that some form of rationing is the only way of providing everyone with a basic level of health care. And it may be the right choice. But let's not deny that is a reality in all nationalized systems.

SFBurke:

does not hae private healthcare as supported by business, who is living in a dream world?

Run75441: Your comment is so poorly written that I really have no idea what your are trying to say. Certainly you do not appear to be responding to anything that I have said.

BTW, if 40% of a nation of 300 million people did not have health insurance that would be 120 million without insurance. Even MM does not claim things are that bad.

I thought perhaps you would recognize this statistic from private business healthcare insurance. My apology for assuming you might.

The numbers of people who are covered by company insurance has been steadily decreasing. The numbers covered by some form of government insurance have been steadily increasing. Why is this so Burke??? Because healthcare costs are steadily increasing and companies can no longer pay for it and remain competitive in the global economy. Hence we are at ~40% of the private industry people no longer being covered by company insurance.

This comment of yours is interesting:

"number of people under the insurance policy doubled the price doubled also. Why is that strange? Usually when you buy two things, they cost twice as much as one. It is not as if healthcare for infants is particularly cheap; there is lots of routine care and seriously ill infants are very expensive to care for (fortunately most infants are healthy)."

As I implied earlier, 5% of the total population account for 49% of the total healthcare cost. The make up of the higher costs did not include the birthing of a child nor were seriously ill children considered in the rising healthcare costs. 15 conditions accounted for 44% of the total healthcare cost in 2004. Fortunately, birthing and babies were not one of those conditions. Kind of curious as to why you would pick this one issue to headline your post? As to the doubling of pricing . . . dependent upon the health of the people within the pool; the cost of healthcare can be less than double or more than double. [Side note: given all of this, the solution may be to concentrate on the 15 conditions to achieve lower healthcare costs (and subsequent insurance costs) of which many are very preventable.]

In so much; the issues are rising healthcare costs, fewer people being insured by private industry, and more people being picked up by the government programs. You selected new unproven and experimental treatments as another issue with rising healthcare costs.

"Why should insurance companies (or the government) pay for expensive and unproven treatments? If we care about the overall costs of our health care system that is an obvious place to start."

Because maybe they are not the major cost of healthcare and insurance increases and they lead to cures which in the long run lower costs? If you understood (or knew) how so few people impact 49% of the costs of healthcare (2004) and what those conditions were; you may indeed be able to make an argument out here on rising healthcare and insurance costs by asking the question of why aren't we attacking those issues. Or why aren't we using more experimental procedures to control these issues. Unfortunately, your post does not give a hint as to why healthcare and insurance cost is rising.

I would also offer this objective statement by the CBO:

"The annual rate of excess growth fell from 5.5 percent over the period from 1975 to 1983 to 0.9 percent over the period from 1992 to 2003. Changes in provider payment policies might help explain the observed slowdown." The Slowdown in Medicare Spending Growth, CBO July, 2006

Contrary to what Richard (above) believes, some rather large gains have been made in controlling costs for Medicare making it an extremely efficient when compared to private insurance and more so in providing cost effective treatment. Private insurance costs and profits have gone up at a far greater pace than Medicare costs. Medicare is vastly more efficient than private insurance. Please note, I did not say one word about its rising costs due to population.

I am with Tom Fitz on this one. You have a nicely worded, although at times confusing, post; but, it lacks substance and is mostly form. You attack the issue without understanding the underlying costs to rising healthcare and insurance and as a result your points are erroneous, inconclusive, and unsupported. Furthermore, your stance is little more than one of maintaining status quo without offering a solution.

Oh, I forgot something on the 40% comment, which I thought may be of interest to you:

"The percentage of people without healthcare increased from 15.6% in 2004 to 15.9% in 2005." 2006 US Census Report

This is up from 2000 also. Given that private healthcare coverage is down; there is also another factor which most people miss. The numbers of people in the Civilian Labor Force taken from the Non-Institutional Civilian Population (BLS) is also down. We have a smaller portion of the population working and subsequently covered. I suspect this is because the job growth has not kept up with population growth or exceeded it which would bring more of the Not In Labor Force back into the Labor Force. That is another story though.

Regards!