It's remarkable how our historical examples of this efficiency are so often ignored by all. I mean, consider how the soviets of the USSR succeeded in making that nation an economy to be reckoned with. And Chairman Mao's great leap forward was able to engineer a populace that succeeded in its grand goal of vaulting beyond the waste of the capitalist West. If only the industry of South Korea could prosper in the way that Kim Jong Il has guided his people into a paradise of plenty, then all Korean people could join hands in brotherhood.

If that's the level of discourse you are sinking to, you are a sad example of what is happening to this country and this site. You should be ashamed of yourself.

Right at the moment, the cost of health care and health care administration is crippling the American economy, it prevents many people from taking entrepreneurial risks because they can't afford to jeopardise their health coverage. The cost of health coverage and care and the financialization of the housing market are two of the factors most responsible for the disappearance of the middle class in this country. And if you're worried about the United States falling prey to disastrous political ideology the lack of a stable middle class is a far greater risk factor than socialized medicine.

The crux of the debate is whether the system should be centralized more or move toward individual human actors, whether these system could do better than the other, or whether it is something in between.(Ethical and political views are another story)

I believe the pundit was arguing that the most extreme example clearly demonstrate the fallacy of using central planning to do resource allocation.

Swedens, Denmark, and Canada are mixed economies which make it difficult to discern the effect of free market economies versus socialist system.

You understand the the US is atypical in the way that it treats health care? The implication that pretty much the rest of the western world is communist because they ensure that everyone has access to at least some kind of health care is completely insane. You're using the "labelling it" technique, which is essentially, "If I can give a name to the thing I'm arguing against, then it's wrong!" (see what I just did there?)

A legitimately elected government providing services that its citizens may choose to use or not use is not communism. It's also not nazism or the boogeyman.

See, I would consider healthcare a much more basic service than a huge standing military, but nobody seems to question that that should be government-operated. The USSR also had a 100% government-operated military! Wow, so does China! And North Korea! And Iran! My word, the USA must be the most terrible country on earth!

You seem to have a strange definition of communism, as well as the history of nazism. Rather, you seem to be buying into the American propaganda that "democracy is the great good".

A pure implementation of communism is necessarily democratic. Think about it. If all goods, and all production, are controlled by the body of people, then everything must be done by consensus.

And you'll recall that in Germany, Hitler was democratically elected to power, and later assumed complete control again by election.

You understand the the US is atypical in the way that it treats health care?

You're just using the eight-year-old's "but johnny gets to stay up late" technique. And the answer is the same: just because one party does something really has not connection to whether it's the right thing for a different party to do.

Anyway, the problem here politically is that the treatment of disease will immediately become politicized. In fact, it is already. People with mundane diseases will plod along, without any real progress made in cures.

But diseases having real political constituencies -- AIDS/HIV is the big example -- will get enormous research, despite the fact that they account for a relatively small portion of the populace. Today, AIDS gets many times more funding per-sufferer than does, e.g., breast cancer.

Today the government is the largest single funder of healthcare. But once they crowd out other actors, the entire medical profession will be political. That means that treatments will be put onto the approved list, and research dollars will be allocated, as a way of pandering for votes.

This isn't an abstract fear: the government does this immediately upon getting involved. For example, look at the recent GM takeover. Despite Obama's claims (continuing to this day) that they don't want to micro-manage GM, Congress immediately set out preventing measures to make GM financially viable, such as closing dealerships. Local car dealerships are a surprisingly powerful constituency, and they get the bureaucrats working in their own interests in no time.

I was being ironic and parroting the sentiments expressed in the post I replied to, which implied that my assertion that there are gains to be made by centralised government providing basic services was akin to Mao's "great leap forward" and various other things generally considered "communist". I cited Nazism just to invoke Godwin's law and make the utter preposterousness of the argument evident. Basically, the post I was responding to made the leap from "elected government providing services to citizens" to "THAT'S COMMUNISM/TERRORISM/-ISM-ISM!", which is patently absurd.

I used the "democractically elected" argument to differentiate from a totalitarian state that removes the freedom of choice from its citizens. I'm not making any value-based statement about that, rather I'm just providing a point of reference, considering that all of the countries we were referring to with government-provided healthcare are "western democracies" in the very traditional sense.

> You're just using the eight-year-old's "but johnny gets to stay up late" technique. And the answer is the same: just because one party does something really has not connection to whether it's the right thing for a different party to do.

Once again, I was responding to the tone of the post, which seemed to suggest that the entire world would crumble if they went down this path. I was simply countering that the US is one of the few countries that doesn't provide healthcare in the way I described, which suggests that it's likely that it would succeed in the US in the same way that it has succeeded elsewhere.

It's a particularly arrogant brand of exceptionalism that would suggest that something that the rest of the developed world does is somehow totally unsuitable for implementation in the US. I mean, is the suggestion there that the US is completely different from other countries with similarly-structured economies and demographics?

> Today the government is the largest single funder of healthcare. But once they crowd out other actors, the entire medical profession will be political. That means that treatments will be put onto the approved list, and research dollars will be allocated, as a way of pandering for votes.

> But diseases having real political constituencies -- AIDS/HIV is the big example -- will get enormous research, despite the fact that they account for a relatively small portion of the populace. Today, AIDS gets many times more funding per-sufferer than does, e.g., breast cancer.

There are not necessarily efficiencies of scale in medical research. Providing 10 times more funding will not provide a cure 10 times faster. Also, the general umbrella of "cancer research" almost certainly gets more funding than HIV/AIDS research. I'm not a medical professional, but I assume that significant advances made in one sub-field of cancer research are likely to have impacts within many other sub-fields (in terms of increased understanding or promising treatment/prevention avenues).

> Today the government is the largest single funder of healthcare. But once they crowd out other actors, the entire medical profession will be political. That means that treatments will be put onto the approved list, and research dollars will be allocated, as a way of pandering for votes.

That sounds like a problem with a particular instance of a government, not with governments everywhere. Most scientific and medical research funding in any country I've lived in is administered by a reasonably apolitical body consisting largely of senior members of relevant research communities. Policy makers then provide strategic direction to these bodies by setting priorities and earmarking some funding. It's really not as though political entities are governing the entire process. It's more likely that policy analysts are looking at diseases and demographics, and managing limited funds on the basis of where it can be best spent.

Not that I'm saying research funding models are perfect. In fact, they are completely bonkers. But they are not completely bonkers because of high-level political intervention.

Finally, I know I'm going to regret asking, but what is the "real political constituency" of HIV/AIDS that makes it different from any other disease with a similar number of sufferers and similar treatment/prevention options?

As for how health care is different from everything else, it's very expensive sometimes, and society has kind of decided that everyone deserves a basic level of care regardless of the ability to pay. By that I mean people will generally respond negatively to a statement such as "If you can't afford it, you can't expect to receive treatment when you break your arm." In contrast I think it's pretty reasonable to say "If you can't afford it, you can't have a car."

I don't think the government should run a health care monopoly, but there are significant flaws in the market system that require government intervention in many cases, and health care is certainly one of them.

So you are comparing food to insurance. Maybe part of the problem here is that people keep conflating government insurance with government-run health care. They are not the same. What's happening here is that the government is seeing a product that the private market is not providing, but society has deemed desirable for everyone to have. That's a pretty clear prescription for a government option (like USPS).

"Starvation insurance" is indeed a bad idea. So is "insurance" for routine care. It costs a relatively predictable amount of money to have a routine annual blood test and physical. Why can't I just pay that money myself, instead of paying an insurance company to pay that money for me? And if I can't afford it, instead of having the government set up an "insurance" company to buy me doctor visits and a dental plan, why can't they just give me vouchers for that too? Save the "insurance" for stuff that actually makes sense to insure against--things like hospital visits and so forth.

Even in a socialist system, scarcity still exists.

The free market have an obvious mechanism and it is called profit and loss.

Private health care rations treatments based on ability to pay.

I know which rationing system I prefer - for both ethical and pragmatic reasons.

If that's the definition of universal health care, no country I know has it, because there is no country I know of that has successfully banned cosmetic surgery.

Still, take birthmark removal: it's purely cosmetic, in a sense, but it makes such a difference to peoples' quality of life psychologically that it totally should be on the NHS if you ask me.

I guess the determinant of whether or not we're actually ready to move into the next stage is whether or not technology has advanced enough to make health care cheap enough to be supported through the government. Of course on the other hand if we don't make this push we may not even have the incentive to make healthcare cheaper. So in other words, we have to create some irritation to make health care less scarce, just as we have to irritate a wound to have it heal faster. Obama's plan may be that irritation. If the plan strains the national budget then we will be more inclined to figure out how to make health care cheaper, and as a result a nonissue. I mean most other first world nations have nationalized health care so it's about time to make that push right? So that basically explains why we should move towards that direction.

So as my response relates to scarcity, the plan allocates resources better by taxing the wealthier americans more. But we can't hope to support this plan by constantly creating better allocations. Obama's plan is assuming that we're at a point where medical care is cheap enough to be supported by allocating a little more from the wealthy.

An insurance company will allocate health care based on profit, the government will (hopefully) allocate it based on need, and that's where we're aiming to go to make it a nonissue for Americans (and everyone in the world ideally).

They paid for them, but there's no cost?

I see what you mean, but you see what I mean, too, no?