Cranky, point taken. I agree there is usefulness in seeing the same doctor over and over again. That given, getting to see the same person you saw last time isn’t the same thing as getting your #1 pick for doctor to serve you from some comprehensive list of practitioners. It’s exactly that idea of “choice” that I find most weird, though I didn’t successfully articulate that in the earlier comment.

I am beginning to suspect that desire for choice derives from some unspoken vague xenophobia of the form “only want to get treated by white people who don’t speak in unbearable accents and make me feel funny.”

It never ceases to amaze me when I hear someone around here complain of having had to see “an Indian doctor” (with the nationality spoken exactly as I would intone the word incompetent). I don’t hear it so much from colleagues, but from students / people around the community / et cetera, and they invariably complain “I couldn’t understand a thing s/he said.” By now, though, this really should have ceased to amaze me…

Take an international incident where, say, some plane maybe crossed a border but noone really has solid information on what happened. It is a law of internet politics that the number of posts strongly backing the position of either side will be, adjusting for demographics, proportional to the amount the political system of that country was reducing life expectancy in comparison with its international peers.

You can see examples across the net from Russia to Iran: look at the thread on this site last years war in Georgia. If North Koreans were allowed onto the internet, every forum would be full of praise for the Dear Leader and denunciations of those attempting to undermine his rule.

Thing is, Americans, when compared to pretty much any other first world countries, have much less personal freedom, are much more bullied and intimidated and threatened by larger powers.

Consequently, there is much more visible, stronger and emotional support for the american political system.

Why isn’t it central in every country? There are certainly high percentages of credulous reactionaries/fascists in every country, and the media in most countries is run by huge corporations.

Um, if you are younger than 30 (35 if you are lucky) in the US or Western Europe, the odds are very good that you will experience no serious medical problem, and thus any walk-in doctor can give you equivalent care for the occasional strep throat. Once you pass 30-35-40 and serious things start to go wrong (and you start to get symptoms of things which could be serious even though they often turn out not to be), then it helps quite a bit to have a doctor who you see regularly and who is familiar with your chart and treatments (because she wrote and ordered them, respectively). Although I am good with masses of technical detail myself I was surprised at how much my adult medicine primary care doctor was able to remember from visit to vist and how positively it affected my care.

Cranky

Then he got sick of dealing with insurance companies and managing a small business, and went back to academic research…

Just noticed this. Yes, I think you have it right.

Unless one or two states become the regulatory equivalent of South Dakota w/r/t credit cards. Which happens quite a lot in the US. And is BCBS of State X really going to “compete” with BCBS of State Y?

This Obama as Hitler and Death Panel stuff is seriously freaky – entertaining to be sure, compelling and fascinating that what would be the fringes of debate here is so central in your country. Good luck and take it easy.

Just guessing. Something to do with corporate tax laws in each location? Looks like UK and US corporate rates are similar but maybe it has something to do with the details? IE do all your R&D on your US ledger and get a tax duduction.

Life insurance has benefits that are defined at the time of purchase, not left ultimately to the discretion of someone on a profit-oriented bonus scheme in 40 years time. So it’s more like buying a TV than it is buying health insurance.

If life insurance worked comparably to health insurance, it would be defined as ‘we’ll give your children and loved ones sufficient money to complete their education and overcome any difficulties they may suffer in consequence of you not being there for them’. Where each word in the above has a footnote referring to a boilerplate definition that amounts to ‘we’ll decide what this word means when you are dead’.

Does anyone think that would work out?

I suspect the countries where private health insurance does work, it is not so much because of the detail of the law, but mainly because they are not as ideologically capitalist as the USA, don’t have profit sharing schemes and stock options, do have unions and employment law. So the profit motive isn’t enough to induce managers to improve the company bottom line by denying care.

I wonder if McArdle will argue that the past deaths from Bextra were an unfortunate necessity in order to preserve Pfizer’s ability to prevent untold future deaths.

It costs less to both get private health care and pay your taxes in Britain, than it costs to get only private health care in America.