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Disclaimer: I'm Canadian, and I shouldn't be wading into this debate... You do realize though that the rest of the modern world looks at the US in this one iss

Disclaimer: I'm Canadian, and I shouldn't be wading into this debate... You do realize though that the rest of the modern world looks at the US in this one issue the same way we looked at you when you had legalized segregation? The rest of us can't even understand why this is a debate. How is it that someone can argue in favour of people not having the ability to access a doctor? Would you also argue that people shouldn't have access to fire-fighters unless they pay the fire-fighter's tax? Police? The protection of an Army? Our socialized systems aren't a panacea, but the trade-offs of having someone wait for knee surgery so that another can get cancer treatment seem pretty fair to me. Sometimes, I simply don't understand the American perspective.

_pi 17y ago
You have no idea, I recently got into a car accident (look at my history for the story of that). And for all of our "socialist policies" in the US that republicans owuld want you to believe, we're grossly libertarian. Long story short: Accident happened, cop came out and wrote me a ticket based on the fact that he had to come out, and pretty much told me that. Then today I got a bill from the fire department/EMS for them having to come out. In total these bills/tickets are about 1K in cost. So you'd think there isn't a fire-fighters tax but there is....
jws 17y ago
In the 1970's I lived in a small town in Oregon. You paid your fire protection fee and they stuck a little sign in your yard. If your house caught fire and you weren't a customer they would allegedly come and protect your neighbor's houses, but not risk anything to save yours.
CWuestefeld 17y ago
What makes you believe that there's anyone in America that does not have access to a doctor? Hospital emergency rooms are required to take and treat all comers (at least if they want to participate in the system), and the Medicaid system reimburses those expenses. A poor, uninsured person might not be able to get a kidney transplant, but they'll get some level of basic care. And what Mr. Kamen argues is that the income generated by those expensive procedures -- not to mention a segment of the population that is willing to pay for it -- is what will lead to the breakthroughs in the future that will make (say) kidney transplants unnecessary in another generation. What really concerns me is that I know, because I have Crohn's Disease, that I have a much higher risk of colon cancer. Even at forty years old, I'm trying to put myself into a position where I'll be able to deal with that should it happen. But in the ultimate socialized/rationed model, I'm not allowed to buy myself additional treatment beyond the lowest common denominator. Canada recently fought (and lost, thank %deity%) to prevent citizens from getting better health insurance than the socialist plan. In England and other places you're allowed to get better care, but only if you pay for every bit of it -- you can't take the baseline and then pay for the overage. So that's definitely the direction that "progress" is moving in. My biggest objection is that this prevents people from having their own values. I'm not to be allowed to make decisions that balance for or against my lifespan. I can only get the mix that the regulators have deemed appropriate for every person, one size fits all.
- run4yourlives 17y ago
  Canada recently fought No, the province of Quebec did... Canada's system is not national, it's provincial. BC for instance allows for several areas of private care. I'm not to be allowed to make decisions that balance for or against my lifespan. You just gave examples in both Canada and the UK that showed that you most certainly can. You're argument is bullshit and comes from a place of ignorance - assuming that somehow the rest of the world has some sort of inferior system simply because we have single payers. It isn't true. Every health statistic shows that the US is actually lagging behind. You're fighting each other for a dwindling and ever more expensive piece of the pie, and the solution is staring you right in the face.
  - cwan 17y ago
    Sorry, every health statistic doesn't show the US is lagging behind. Look at cancer detection and treatment and survival rates from heart attacks. I think that you can get a system that works with a single payer system - but it's tough to find one that also innovates and is sustainable - there's a good case to be made here that the US actually subsidizes the rest of the world with developments in drugs and medical technologies/techniques.
    - run4yourlives 17y ago
      Please point me to these stats, they seem interesting but I can't locate them.
      - cwan 17y ago
        Here's a start: On cancer: http://www.ncpa.org/pub/ba596 http://www.ncpa.org/pub/ba596 and http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080716/cancer_statistics_080716/20080716/ http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080716... On heart attacks: http://www.circ.ahajournals.org/cgi/content/abstract/01.CIR.0000142671.06167.91v1 http://www.circ.ahajournals.org/cgi/content/abstract/01.CIR.... On access to medical technologies: http://content.healthaffairs.org/cgi/reprint/13/4/113.pdf http://content.healthaffairs.org/cgi/reprint/13/4/113.pdf
asmithmd1 17y ago
You missed his whole point. Because the US has such high costs we can't afford to give it to everyone. These exorbitant costs also create incentives for innovation. No other countries produce the medical breakthroughs that the US does. This quote sums-up his thinking: "Every drug that's made is a gift from one generation to the next because, while it may be expensive now, it goes off patent and your kids will have it essentially for free." You could say the same thing about the US vis-a-vis the rest of the world. Every drug/treatment/device that is developed in the US is a gift to the rest of the world
- logicalmind 17y ago
  I'd just like to point out that the internet was government-funded innovation. As well as the massive amounts of R&D we do in the military space. Another area in which we lead the world. To assume that government-funded equates to lack of innovation is false.
  - billswift 17y ago
    The initial invention was gov't funded, but it wasn't until (decades) later when business began investing in it that it really took off. And became much more than an academic toy.
    - logicalmind 17y ago
      Companies weren't interested in the internet until they could make a profit. The same way they aren't interested in treatments/medicines/cures unless they can make a profit. What if these decisions were made altruistically based on how many people you can help, regardless of the profits...
      - run4yourlives 17y ago
        Which is why we have 15 different types of erectile dysfunction pills and no HIV vaccine.
cwan 17y ago
I'm a Canadian as well - most of my friends in my town don't have access to a family doctor and are on waiting lists. And that's family doctors - try getting an appointment with a specialist. This isn't Kamen's point though. If the US can continue to accelerate innovation, being the biggest medical innovator in the world, costs for older technologies will also fall improving access. Restrict what technology companies and healthcare firms who use these technologies can charge however, and you reduce the incentive to innovate. Improvements in technology in every other industry results in lower not higher costs. One thing he doesn't talk about as much which is a hurdle is the system of third party payers - but I think he at least discusses a more sustainable solution and the threats that the current and proposed regulations pose.
- run4yourlives 17y ago
  Access to a family doctor has nothing to do with the fact that our system isn't private, it has to do with a well known shortage of doctors. To the point though: I reject the notion that there is effectively a single country conducting health research that the rest of the world is leaching off of. It's preposterous and unsupported. Further, even in the USA a vast majority of medical research is government funded! If the US moved to a single payer system, medical research will change, not end. That's the same thing that happens whenever there is a disruption in any industry. To suggest that we will a reduction in medical innovation because the US suddenly collectively and not individually paying for medical coverage is to spout nothing more than PR that various corporate interests would love to pay for.
  - cwan 17y ago
    Can you provide any links re: "vast majority of medical research is government funded"? As to whether or not we would see less research, markets create greater demand for that research and most of it is developed in the US. I don't believe these are controversial points. You're right though, the medical research wouldn't go away completely but my suspicion based on the output of countries with single payer systems, and how much less they pay for such things as pharmaceuticals that result in substantial healthcare savings (which is why I think that the US does subsidize much of the world), is that this would be the case. It would definitely change, but when it comes to the issue of innovation and making that technology usable, I doubt it would be for the better. Also with respect to the doctor and specialist shortage - it has a great deal to do with incentives within a public system. When you restrict the pay that doctors can make, they work less and fewer of them stay in Canada. This is the case for my doctor who chooses to work 4 days a week and where she caps out and for a few of the specialists I know.
reedlaw 17y ago
Let's take your argument and apply it to other commodities. "How is it that someone can argue in favor of people not having free groceries? Would you also argue that people shouldn't have access to computers unless they pay the computer tax? Entertainment? The protection of free homes?" The problem with making everything free is that you create a system where no one wants to work, corrupt officials take more than their fair share, and scarcity becomes the norm.
- gnaritas 17y ago
  He didn't say make everything free, and healthcare isn't like any other commodity. The world is not so black and white.
  - reedlaw 17y ago
    Why is health care so special then? Shouldn't food and water be just as free? Aren't they even more basic necessities?
    - gnaritas 17y ago
      Because food is predictable, available, and cheap. Healthcare is unpredictable; you don't know when you'll need it and you hope you never do, but if you do, it could completely bankrupt you and since your life could be on the line you'll do anything to get it. Also unlike food, since we have a massive insurance industry involved to spread the risk of unpredictable and often massive expenses, we've actually created a system that incentivises people to hurt other people by denying claims. Not everyone believes the invisible hand of the market is the correct solution to every problem; I'm all for socialized healthcare.

_pi 17y ago

You have no idea, I recently got into a car accident (look at my history for the story of that). And for all of our "socialist policies" in the US that republicans owuld want you to believe, we're grossly libertarian. Long story short: Accident happened, cop came out and wrote me a ticket based on the fact that he had to come out, and pretty much told me that. Then today I got a bill from the fire department/EMS for them having to come out. In total these bills/tickets are about 1K in cost. So you'd think there isn't a fire-fighters tax but there is....

jws 17y ago

In the 1970's I lived in a small town in Oregon. You paid your fire protection fee and they stuck a little sign in your yard. If your house caught fire and you weren't a customer they would allegedly come and protect your neighbor's houses, but not risk anything to save yours.

CWuestefeld 17y ago

What makes you believe that there's anyone in America that does not have access to a doctor? Hospital emergency rooms are required to take and treat all comers (at least if they want to participate in the system), and the Medicaid system reimburses those expenses. A poor, uninsured person might not be able to get a kidney transplant, but they'll get some level of basic care. And what Mr. Kamen argues is that the income generated by those expensive procedures -- not to mention a segment of the population that is willing to pay for it -- is what will lead to the breakthroughs in the future that will make (say) kidney transplants unnecessary in another generation. What really concerns me is that I know, because I have Crohn's Disease, that I have a much higher risk of colon cancer. Even at forty years old, I'm trying to put myself into a position where I'll be able to deal with that should it happen. But in the ultimate socialized/rationed model, I'm not allowed to buy myself additional treatment beyond the lowest common denominator. Canada recently fought (and lost, thank %deity%) to prevent citizens from getting better health insurance than the socialist plan. In England and other places you're allowed to get better care, but only if you pay for every bit of it -- you can't take the baseline and then pay for the overage. So that's definitely the direction that "progress" is moving in. My biggest objection is that this prevents people from having their own values. I'm not to be allowed to make decisions that balance for or against my lifespan. I can only get the mix that the regulators have deemed appropriate for every person, one size fits all.

run4yourlives 17y ago
Canada recently fought No, the province of Quebec did... Canada's system is not national, it's provincial. BC for instance allows for several areas of private care. I'm not to be allowed to make decisions that balance for or against my lifespan. You just gave examples in both Canada and the UK that showed that you most certainly can. You're argument is bullshit and comes from a place of ignorance - assuming that somehow the rest of the world has some sort of inferior system simply because we have single payers. It isn't true. Every health statistic shows that the US is actually lagging behind. You're fighting each other for a dwindling and ever more expensive piece of the pie, and the solution is staring you right in the face.
- cwan 17y ago
  Sorry, every health statistic doesn't show the US is lagging behind. Look at cancer detection and treatment and survival rates from heart attacks. I think that you can get a system that works with a single payer system - but it's tough to find one that also innovates and is sustainable - there's a good case to be made here that the US actually subsidizes the rest of the world with developments in drugs and medical technologies/techniques.
  - run4yourlives 17y ago
    Please point me to these stats, they seem interesting but I can't locate them.
    - cwan 17y ago
      Here's a start: On cancer: http://www.ncpa.org/pub/ba596 http://www.ncpa.org/pub/ba596 and http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080716/cancer_statistics_080716/20080716/ http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080716... On heart attacks: http://www.circ.ahajournals.org/cgi/content/abstract/01.CIR.0000142671.06167.91v1 http://www.circ.ahajournals.org/cgi/content/abstract/01.CIR.... On access to medical technologies: http://content.healthaffairs.org/cgi/reprint/13/4/113.pdf http://content.healthaffairs.org/cgi/reprint/13/4/113.pdf

asmithmd1 17y ago

You missed his whole point. Because the US has such high costs we can't afford to give it to everyone. These exorbitant costs also create incentives for innovation. No other countries produce the medical breakthroughs that the US does. This quote sums-up his thinking: "Every drug that's made is a gift from one generation to the next because, while it may be expensive now, it goes off patent and your kids will have it essentially for free." You could say the same thing about the US vis-a-vis the rest of the world. Every drug/treatment/device that is developed in the US is a gift to the rest of the world

logicalmind 17y ago
I'd just like to point out that the internet was government-funded innovation. As well as the massive amounts of R&D we do in the military space. Another area in which we lead the world. To assume that government-funded equates to lack of innovation is false.
- billswift 17y ago
  The initial invention was gov't funded, but it wasn't until (decades) later when business began investing in it that it really took off. And became much more than an academic toy.
  - logicalmind 17y ago
    Companies weren't interested in the internet until they could make a profit. The same way they aren't interested in treatments/medicines/cures unless they can make a profit. What if these decisions were made altruistically based on how many people you can help, regardless of the profits...
    - run4yourlives 17y ago
      Which is why we have 15 different types of erectile dysfunction pills and no HIV vaccine.

cwan 17y ago

I'm a Canadian as well - most of my friends in my town don't have access to a family doctor and are on waiting lists. And that's family doctors - try getting an appointment with a specialist. This isn't Kamen's point though. If the US can continue to accelerate innovation, being the biggest medical innovator in the world, costs for older technologies will also fall improving access. Restrict what technology companies and healthcare firms who use these technologies can charge however, and you reduce the incentive to innovate. Improvements in technology in every other industry results in lower not higher costs. One thing he doesn't talk about as much which is a hurdle is the system of third party payers - but I think he at least discusses a more sustainable solution and the threats that the current and proposed regulations pose.

run4yourlives 17y ago
Access to a family doctor has nothing to do with the fact that our system isn't private, it has to do with a well known shortage of doctors. To the point though: I reject the notion that there is effectively a single country conducting health research that the rest of the world is leaching off of. It's preposterous and unsupported. Further, even in the USA a vast majority of medical research is government funded! If the US moved to a single payer system, medical research will change, not end. That's the same thing that happens whenever there is a disruption in any industry. To suggest that we will a reduction in medical innovation because the US suddenly collectively and not individually paying for medical coverage is to spout nothing more than PR that various corporate interests would love to pay for.
- cwan 17y ago
  Can you provide any links re: "vast majority of medical research is government funded"? As to whether or not we would see less research, markets create greater demand for that research and most of it is developed in the US. I don't believe these are controversial points. You're right though, the medical research wouldn't go away completely but my suspicion based on the output of countries with single payer systems, and how much less they pay for such things as pharmaceuticals that result in substantial healthcare savings (which is why I think that the US does subsidize much of the world), is that this would be the case. It would definitely change, but when it comes to the issue of innovation and making that technology usable, I doubt it would be for the better. Also with respect to the doctor and specialist shortage - it has a great deal to do with incentives within a public system. When you restrict the pay that doctors can make, they work less and fewer of them stay in Canada. This is the case for my doctor who chooses to work 4 days a week and where she caps out and for a few of the specialists I know.

reedlaw 17y ago

Let's take your argument and apply it to other commodities. "How is it that someone can argue in favor of people not having free groceries? Would you also argue that people shouldn't have access to computers unless they pay the computer tax? Entertainment? The protection of free homes?" The problem with making everything free is that you create a system where no one wants to work, corrupt officials take more than their fair share, and scarcity becomes the norm.

gnaritas 17y ago
He didn't say make everything free, and healthcare isn't like any other commodity. The world is not so black and white.
- reedlaw 17y ago
  Why is health care so special then? Shouldn't food and water be just as free? Aren't they even more basic necessities?
  - gnaritas 17y ago
    Because food is predictable, available, and cheap. Healthcare is unpredictable; you don't know when you'll need it and you hope you never do, but if you do, it could completely bankrupt you and since your life could be on the line you'll do anything to get it. Also unlike food, since we have a massive insurance industry involved to spread the risk of unpredictable and often massive expenses, we've actually created a system that incentivises people to hurt other people by denying claims. Not everyone believes the invisible hand of the market is the correct solution to every problem; I'm all for socialized healthcare.