Medicare is actually a great model of a govt-run program that works.

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Actually, in canada we have a government-funded body called the Canadian Institute of Health Research whose sole purpose is to fund medical innovation. So we have a socialized research system AND a socialized medical care system.

So in conclusion, suck it America. Suck it good.

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But hey, let's try this... let's put the senators and congressmen on the plan FIRST. See how they like it. Work out the kinks and then roll it out to the GP (general public). If they are willing to full embrace this plan, I'd be willing to give it a shot.

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The problem is that once you invite the government to take care of your health, you invite them to dictate your health habits. Why should my tax liability for healthcare be based on my income? If I exercise, maintain my weight and eat right, then should I be taxed more than someone who is overweight and abuses drugs, alcohol and tobacco? The health insurance companies have a way to deal with that. They either don't insure that person or raise their premiums. How will the government incentivize good health habits?

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It would be easy to argue that, by pricing coverage beyond the means of so many people, the private sector is doing this job so inefficiently that the government couldn't possibly do it any worse and is overwhelmingly likely to do it much better.

All you have to do is incorporate a premise like "Access to a certain level of healthcare is a right of citizenship" into your definition of "efficiency" -- and boom, government would trounce the private sector on the efficiency question.

So I don't think "efficiency" is the word worth battling over here. I think it's probably something more like "right of citizenship." I think what people are arguing over here is whether health care, like equal marriage, should be a right of U.S. citizenship. I can imagine good arguments on both sides. And in this way, people don't have to obstruct and baffle each other with untenably narrow definitions of key terms.

That's my contribution. There's no practical reason why we as Americans can't make this work, once we decide that it's a right of citizenship: Other countries with fewer resources than we have manage it well enough, and I'm not prepared to say that our powers of ingenuity are so much weaker than theirs. (But feel free to argue that, if that's your view.)

To me the key question is, Do we really want access to a certain level of health care to be a basic right of citizenship? It's a good question. Worth arguing over.

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To choose one of hundreds of examples: infant mortality rate. According to the WHO we currently rank 19th worldwide. We are the wealthiest nation on earth. There is no excuse for this.

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Do you think the goofballs like Octomom don't have anything to do with our infant mortality rate? We have a tremendous amount of reproductive technology than most of the world cannot access because they cannot afford it. That leads to an increase in infant mortality. It is much like penalizing a high risk ob who has the highest c-section rate because of all the high risk pregnancies.

Plus you are forgetting this statement: The research also found that poorer mothers with less education were at a significantly higher risk of early delivery. The study added that in general lower educational attainment was associated with higher newborn mortality. Blame the teachers' unions! (I am being sarcastic, just in case people get their undies in a bunch)

Listen, as a human being and a mother, I don't want any infant to die. I am all for safety nets for the uninsured and am open to expanding programs like Medicaid, HUSKY, CHIP, etc.. to increase access to health insurance/care to those who cannot afford it or have pre-exisiting conditions.

BTW, we aren't the richest country.. [en.wikipedia.org])_per_capita

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@power_stroke: It is in my best interest to rehabilitate addicts. It's also in my best financial interest to intrude into all health related aspects of their lives to protect my investment. Kind of like when the government "bails out" a business and ends up taking it over.

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If this statement can be interpreted as "I'm willing to see the system fixed in any way that doesn't bankrupt the Republic," I'd say that's a reasonable position that creates a lot of room to work with.

At that point you're left to define the terms "fixed" and maybe "bankrupt," which is a positive step toward framing the debate (I think properly) as one of priorities rather than "efficiency."

Again, there's no doubt that we can choose to guarantee our citizens some level of healthcare that will be compatible with current financial constraints -- even if it means taking a few beans from the "defense" priority and reallocating them to the "public health" priority. The question isn't completely controlled by practical limits, which we as a nation have often managed to transcend anyway. The question is to what extent such rejiggered priorities will reflect the interests of the population as a whole. Again, it's a good question whose time has come.

I note that an incremental solution as pioneered by Mitt Romney's Massachusetts seems like a good fit for an extended and complex debate like this one.

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But the good states. The crispy edge states. Not the soggy middle ones.

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