Satisfaction is a subjective function of subjective expectations.In response to Ezra Klein noting that although British Health care sucks, American health care sucks even more, Sullivan points out that that's just like, your opinion, man. His notion that Britons are preconditioned to expect lousy health care and therefore rate it more positively is rather hilarious. It's like, uh, remember how much East Germans loved East Germany once they got used to it? Yeah, me too.
-Sullivan, on health care, again
As Jim pointed out not long ago:
You see the decadent phase of "Strong Hayek" in those right-wing pundits determined to demonstrate that Europe is a decadent hell-hole doomed to the tyranny of "transnational progressivism" or an Islamist takeover or both. If Europe has high marginal tax rates and high social benefits, it must - must! - shortly become a new soviet dystopia. Therefore any problems with European society must be signs of that imminent collapse.That quote is in the context of some other thoughts on international problems, but is useful as a standalone as well. If we are condemned to the belly of the fish, let us at least be able to afford our prescriptions.
The thing is, I was one of those people once, and when I say "once," I mean, even a few years ago. Gradually it dawned on me that, wow, Europe keeps not collapsing. And gosh if it doesn’t seem like some metrics of liberty are higher there and some lower, almost as if it were a normal place with a functional political economy that had both advantages and disadvantages compared to the US. Not the second coming of 1950s Poland at all. So much for "Strong Hayek!"
And again, Britain has a lousy system. But ours is lousier. The French, meanwhile, who have a public-private system with many real-life structural similarities to our own achieve broad satisfaction (upwards of 65%), far better aggregate results, and at a fraction of the per capita national outlay.
15 comments:
Wait, wait, parallel systems? A mix of safety net and private competition? IOZ, you kidder!
You're no less wise for saying it, but this kind of thing should be common sense.
In the Euro country I am currently resident as a mooching expatriate yankee in, the major political issue facing the masses is the introduction of a $1.50 fee to see a doctor or be admitted to a hospital. The mind boggles.
How shallow do you have to be to not recognize...ah, hell, I can't even bring myself to parody that shit.
The French have also been given sound dietary advice, while we and the Britons are fat, diabetic, cancer-stricken and coronary heart disease ridden fuckers in large part because of the "low-fat", sugar- and potato- shit that we eat. Just a thought, you know.
You would think more of these libertarians I keep hearing about would pick up the chance to piss all over George McGovern, his goddamned dietary guidelines, thumb-on-the-scale government-funded research into low-fat eating for fifty years, while the French eat butter with butter on top, and don't suffer from the diseases of civilization. Oh, no. They defend getting fat as a choice, which is high-libertarianisim. Aces!
While arguably better than the American system, not only is the French system not cheap, it nevertheless often runs deficits. Also, doctors are paid so much less than American doctors that the AMA would probably never allow an equivalent system to be set up.
Doctor's do cost a lot. Part of that is the cost of recovering from the cost of Medical School; part of it is scarcity. So, eliminate some of the scarcity, and subsidize the medical school education and then the costs can come down. I actually prefer to Nurse Practitioners and PAs to a large extent for most things. If I have a fucking sinus infection, I don't need a board certified MD to order up a round of exceptionally complicated tests and then call for a consult. I need someone who says, "You've got a sinus infection, here's a 'scrip, go the drug store." Of course, if I'm too duck-fucking ignorant to understand that medicine is not magic and that House isn't an asshole because he's brilliant or brilliant because he's an asshole, but he's just an asshole played by a smart guy with a British accent that he conceals and it really isn't all that hard 99% of the time, then I'll want the board certified internist with the degree from Harvard Med to do his magic.
Our quality of life is broad, but not deep. There are no deep springs feeding it. Nor sense. Nor perspective. In so many ways, we are all Homer Simpson...
"Also, doctors are paid so much less than American doctors that the AMA would probably never allow an equivalent system to be set up."
Doctors can be rounded up and shot, just like the kulaks. People still live in east asia, is that not correct?
Are the poor Brits really that much worse off?
Are we that much better off because your arthritic knee can command the rapt attention of some fool who has to pay back the half mil he borrowed to get through Harvard Med School, and a not insignificant amount of the gross national product?
Modern sanitation (sewers, clean drinking water) has done more for public health than just about all the the high-techno stuff that has followed. These systems are universally done in a collectivist manner, and one shudders at the contemplation of the miracle that the dreaded Hayakian Serfdom State did not decend upon us decades ago. Whatever is it waiting for?
Personally I think we need to introduce more competition into the bloated fire-protection and sewage-disposal monopolies.
" I need someone who says, "You've got a sinus infection, here's a 'scrip, go the drug store.""
do you even need that? I had one of these sinus infections a couple months ago. I checked a couple websites, found out what pill I needed (Augmentin), walked down to pharmacy, paid cash ($20 or so). problem solved.
but then I live in Ecuador. the system is great here, cus as far as I can gather there is no 'System'.
oh, and to the Jim guy who IOZ quoted: Europe will collapse soon enough. patience.
Consultant to Intellectual Investors Lucas is here to sort us all out, people! Europe will collapse soon enough, my friends, on account of their welfare-statiness and their dangerous swarthy Muslimness! Just you wait!
Profile Not Available Christopher is here to demonstrate his love of exclamation marks.
regarding Muslims in Europe, the trend does seem to be pretty inexorable. to paraphrase Shaykh Dr. Abdalqadir As-Sufi, as white Europeans spend their evenings watching TV, Muslims are busy procreating.
the welfare aspect of Europe's Statism is just that, an aspect. and not the aspect likely to be the primary catalyst for the collapse of the, ah, System. the main catalyst (if we can even assume that it possible to isolate these things) is the crisis of Central Bank Capitalism, which appears to be getting underway nicely so far. say what you will about welfarism, the fact is that it requires a productive economic host. the public pension-ism of Europe will fall same as the 401(k)-ism of America. and England (being something of a hybrid of those two economic styles) is likely to get the privilege of shitting the bed first.
as white Europeans spend their evenings watching TV, Muslims are busy procreating.
Which means that Europe will collapse... because it will be browner.
Internet jerk-offs agree: Mussolini was right!
hi Christopher,
perhaps it would be better if you read for yourself what Dr Abdalqadir has been writing on matters such as these.
http://www.shaykhabdalqadir.com
he is a leading Muslim intellectual and spiritual leader (and he happens to be a white guy).
as for my views, perhaps I didn't make it clear in my last comment that I think the main catalyst for the collapse (or call it what you want) is the current crisis of Central Bank Capitalism. the demographic trends are most interesting to ponder in the context of what kind of society/civilisation/political economy will arise from the (hopefully metaphorical) ashes.
(and if you haven't noticed yet I actually have a soft spot in my atheist heart for Islam, so keep barking up the bigotry tree if you please, but that's not where I'm perched.)
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