The American Spectator : AmSpecBlog : David Frum's Counsel of Despair

I Conner Klast| 8.8.09 @ 10:12PM

This is a sad commentary on neocons like Davids Frum and Brooks. The problem with Obamacare, if they checked with CBO, is it does NOTHING to contain costs. No tort reform, no expansion of health saving accounts, no restrictions on illegal aliens and no means testing of Medicare. Not a single conservative goal is even approached in Obamacare. The current system has flaws but most people prefer it to further government control and spending. That means we must restart the entire process and actually deal with the problems in healthcare management, without disrupting what works and taxing people who do. Until then, their defeat is indeed America's victory.

Scottie| 8.8.09 @ 10:46PM

David Frum is Canadian-born with one foot in the U.S and the other in Canada. Though he would probably never admit it publicly, my guess is he thinks a system similar to Canada's would be just fine here.

Red Phillips| 8.8.09 @ 10:53PM

Why does anyone even listen to Frum anymore? There is a genuine rebellion against big government brewing and Frum wants to squash it in its infancy. The lefties want universal health care because it will create an even larger dependent class who will vote for Dems to keep the booty flowing. Frum's New Majority website should be called Preemptive Surrender.

Aaron| 8.8.09 @ 11:05PM

This piss ant red tory needs to head on back to Canada. I have had enough of his name getting thrown about as well. Can we have one week where he is not mentioned on AmSpec?

Its obvious that he cant be on the side that completely opposes reform, those are seen as radicals. There is no middle ground in this fight, its either vote yes or no. Guess that leaves the wishy washy rinos flapping their gums in breeze out in Georgetown. There will be more of this nonsense from him and his kind.

SoCon| 8.8.09 @ 11:14PM

Squishy, mushy--both describe this Canadian tool.

Does it really matter what he says? I know I sure don't care.

rrpjr| 8.8.09 @ 11:27PM

Conservatives need to recognize people like David Frum as terminally useless to these times. He simply isn't aware of or cannot accept the new world around him, the nature and rise of the Left, the war we're in, and the sad failures and betrayals of his own class. Yes, Vichy republican is right. So why are we still even asking these questions about him?

Mark Turner| 8.8.09 @ 11:37PM

We are winding up with a lesser-of-two-evils option here...do we keep the present system with its high expenditures for services, or radically redesign into a government-subsidized model -- knowing the government's dismal track record in cost control, inefficiency, and quality? I have lived overseas for 7 years in two countries which have state-subsidized healthcare (Australia, Singapore) -- while adequate for routine services, I would not advocate such systems as necessarily "better" than what the US has now and not necessarily cheaper in local currency terms.

SongBird| 8.8.09 @ 11:44PM

Gloomy Gus FRUMpy reminds me of Eeyore.

MrFishy| 8.8.09 @ 11:47PM

Red Phillips:

Not just that but (you may already know this) it will create a huge bureacracy that will become a constituent of the socialized health system. The three largest employers in the world are (1) The Chinese Red Army, (2) The Indian Railway, and (3) The British Public Health Service. Think about that for a second; China and India have about a billion people, while Britain has, what, less than 200 million? No matter how many people Britain's PHS kills, the people don't have the votes to end socialized medicine because so many people have a pecuniary stake in it.

Charlie| 8.9.09 @ 12:00AM

I believe ObamaCare will be rationed, horrendously expensive and provide substandard care; but even more than all that I WANT THE DAMNED GOVERNMENT OFF MY BACK!

There, I said it and I feel better.

NOBAMACARE| 8.9.09 @ 12:04AM

Mr. Fishy, try 60 million. That's even more disgusting.

kingsmill| 8.9.09 @ 1:17AM

More blather from this fifth columnist. Why does AEI employ him? If he declared what he is, a soft Leftist, he would at least show some integrity.

Leo| 8.9.09 @ 1:42AM

Mark Turner: I can't speak to your personal experience, but as a matter of overall costs, the systems of Singapore and Australia are much cheaper than the U.S. system.

Australia spends 8.7% of its GDP on health care, Singapore 3.3%. The U.S. spends 15.3%. No one else even comes close to that.

(Based on WHO data from 2006, which you can check on their website if you care to.)

Shannon| 8.9.09 @ 2:28AM

Who wants the DMV or the post office to provide their health care?

Willey| 8.9.09 @ 2:30AM

Do Australia or Singapore insure 20 million illegal aliens?

Sean| 8.9.09 @ 8:36AM

High health care costs in the US are mainly due to government involvement and the change to relying on insurance to pay for service. No one shops around for cheaper prices when your insurance covers it.

What we need to do is deregulate the health industry some. That means get rid of the whole idea of needing prescriptions to get medicine you need. Allow nurses and other medical personnel more responsibility to treat illnesses. Regulate lawsuits. Get away from insurance to cover costs. Walk into any doctors office and you will see more people employed to deal with insurance paper work than medical personnel to treat the patients.

Eric Dondero| 8.9.09 @ 9:20AM

Can anyone out there think of a bigger ass in the entire Rightist movement than David Frum?

First his non-stop Sarah Palin bashing and now this.

RS, surely there's some way all the Right leaders can get together and expell this schmuck from our movement?

Solo| 8.9.09 @ 9:34AM

We all know why the left is pushing so hard for this and it has NOTHING to do with providing medical insurance 'for the poor'.

If the republican party had ever enjoyed the kind of over-arching power that the dems now wield, these problems would have probably been solved already. But...without a 60 vote majority in the Senate, the Presidency and control of the House (all at the same time) by the republicans, the dems have been able to see to it that any meaningful reform has been "dead on arrival".
It's a complete waste of time to even craft any legislation to address these problems knowing that it faces a fillibuster by the dems so that they can keep the misery and discontent flowing among the people until they cry out for relief. And then "presto", the dems 'ride to the rescue' with Nationalized Health Care to "solve" a problem that THEY largely created.

We all know that this abomination these socialists have cooked up is only going to create MORE problems and more misery-which in turn will create another 'cry' for help-which brings MORE socialist solutions- which creates more misery.....and so on....and so on....

Make no mistake...the dems are going to get this legislation through in one form or another. They've been waiting for this "perfect storm" to materialize for decades upon decades and they're going to take advantage of it no matter what the cost.

It doesn't matter if the Blue Dogs lose in 2010. It will already be too late. They will have won because, once in place, you will NEVER get rid of it! And the dems know it!

Barring some miracle of divine intervention, the America you thought you inherited from your fathers is dead. All that remains is to burn the corpse and scatter the ashes to the four winds.

The dems will go to work on that next.

ConservativeWanderer| 8.9.09 @ 10:09AM

An excellent point, Sean.

One of the most outrageous examples of government meddling in health insurance is Utah's mandate (that is, requirement) that all companies selling health insurance in their state provide at least $4,000 for an adoption. Not for medical care for the birth family, who would be covered under existing maternity benefits, but for the adopting family!

Now, encouraging adoption is all well and good, but what the heck does medical insurance have to do with adoption?

And, of course, that four grand has to come from somewhere, and anyone familiar with basic economics can probably figure out where it comes from... the premiums. So, everyone's premium in Utah goes up to pay for this absurdity.

Leo| 8.9.09 @ 10:10AM

"Do Australia or Singapore insure 20 million illegal aliens?"

Not that I know of. But neither does the U.S.

"High health care costs in the US are mainly due to government involvement and the change to relying on insurance to pay for service. "

Again looking to WHO data, Australia's public sector is responsible for 66% of health spending (compared to 45% in the U.S.). The same thing is true of essentially every other industrialized nation. Every one of them has higher public sector involvement, equivalent or better life expectancy, and lower costs.

Teflon93| 8.9.09 @ 10:20AM

But NOBODY Frum has dinner with believes Obamacare to be a bad idea....

Gary Gross| 8.9.09 @ 10:38AM

I said here that Frum is a "twentieth century conservative", too afraid to apply free market principles to solve problems:

http://www.letfreedomringblog.com/?p=5355

ConservativeWanderer| 8.9.09 @ 11:20AM

Leo, you've committed what Churchill called a "terminological exactitude." I'll give you the benefit of the doubt and assume for the moment that it was inadvertent.

The US medical system does indeed bear the costs of medical care for every single illegal alien here. There's a law that everyone that presents for care at any emergency room in this country must--I say again, must--be treated, regardless of whether they can pay, regardless of whether they're here illegally, and regardless of any other factors.

Therefore, it should be easy for anyone with a few neurons still firing to see that we're all paying the costs of treating illegals.

One can debate whether or not that cost is a major or minor factor in the problems with health care today (and I freely admit there are problems), but one cannot deny that there is a cost involved, at least not if one wishes to hold to the facts and the truth. Of course, if someone wants to lie and demagogue the issue, then that person can attempt to deny this fact.

Ken (Old Texican)| 8.9.09 @ 11:21AM

Despair not, fellow Americans!

We are going to turn their money faucets off. Stay tuned, TEAM.

Divie Pixie| 8.9.09 @ 11:24AM

Just a quick and simple calculation starting with a population base of 300 million divided by 1/6 of the economy yields a figure of 50 million people forced into unionized governmental service. This figure must be high. Exactly how many people are employed in the health care industry?? Has anyone considered what effect of our society converting that many people to union and governmental service.
No wonder the unions love this plan. Millions will be forced into the unions and paying 10% and more into the unions treasury. The unions will soon become the dominant force in politics.

JP| 8.9.09 @ 11:28AM

Leo,
First, what makes the WHO an expert in anything? Second, the US leads the world in almost every area of theoretical, and practical Medical Science. The US ha pioneered the development and deployment of everything from the MRI to therapeutic drugs. The US market systems has allowed the MRI, once a hugely expensive imaging system only affordable to most expenisve urban hospitals to now be located at the even rural clinics. The US leads the world in orthepedic science and cancer treatments. And all of this cost hundreds of billions of dollars yearly. The US consumers pick up the front end and development costs.

This is true particularly in drugs. The EU and other nations negotiate with Big Pharma as single entities. If these firms wish to due business with these nations, they must lower the costs. As a consequnece these savings other nations enjoy are subsidized by US consumers.

Thirdly, the thing that many people do not wish to admit (but which Obama in public advocates) is rationing. The US is the only nation which spends every available dime on people with terminal illness in order to save thier lives. In Europe, Canada and elsewhere, healthcare is rationed for the elderly and terminally ill. This "savings" is realized only by withholding carebased upon cost-benefit analysis. In the case of President Obama's grandmother (who was ill with cancer), she would not have received a hip replacement. In other words, she would have not only to had withstand the pain of cancer, but also the horrible pain of a bad hip, and her remaining days would have been occupied in a bed, totally immobile. Her doctor wouldn't have made the decision, but some government bureaucrat. In the US, we still value the people we love and are willing to pay extra for them.

In the US 82% of the insured are happy with thier costs and coverage, and do not wish to see either service or costs go up in order to insure some ficticious abstraction (46 million uninsured).

And yes, the US does currently insure the majority of illegals. In California, all illegals are insured via Medicare.

A simple, very simple way to see immediate costs savings in health care is for Congress to remove medical torts from our law system. Charles Krauthammer has very good ideas on how this could be done. The other thing Congress could do is to tax the health care insurance benefits that we recieve from our employers. This would create an immediate market for people to insure themselves. This would also free businesses from the burden of administrating health care.

Pingback| 8.9.09 @ 12:22PM

In This Corner, Scrappy Kid From Chi-Town, Barry Obama! And In The Other Corner, The links to this page. Here’s an excerpt:

…red-line; No deal at all is preferable to a deal that includes a bigger government entry into the insurance business. Which, ironically, is the Republican position that he’s complaining about! Robert Stacy McCain: What Frum’s analysis neglects, it seems to me, is the possibility that the Left knows what it’s doing in pushing for ObamaCare. If defeating ObamaCare would not be a victory for…

Leo| 8.9.09 @ 1:02PM

JP: I'm also happy for you to provide an alternative to the WHO data that you consider more trustworthy. I know that the OECD maintains similar statistics. You can check them out online too.

I think you'll find though that the numbers are pretty uniform. We spend nearly twice what any other country does on health care and our health outcomes are no better than other developed nations (and worse in many cases).

You say that “the US does currently insure the majority of illegals” and that the uninsured are “fictitious.” I take your point to be that we already provide health care to most Americans, including the poor. That’s in large part true. But carry the reasoning through to its conclusion.

We already provide more-or-less universal access to care in this country, but we do it inefficiently compared to other countries. We spend more than anyone else and don’t get better results. And the additional spending comes out of your and my pockets. That means the question isn’t about taking our money and giving it to the poor. We do that already. The question is about how to manage costs. Which, again, every other country in the world has managed to do.

You say “The EU and other nations negotiate with Big Pharma as single entities. If these firms wish to due business with these nations, they must lower the costs. As a consequnece these savings other nations enjoy are subsidized by US consumers.” Why is this a point in defense of our current system? We’re getting stuck with everyone’s bill and you think this is a good thing? To me, it seems like we’d be better off negotiating ourselves and forcing some of those costs back onto other countries.

Finally, tort reform is a good project but it’s a gnat on an elephant’s behind compared to the health care problem as a whole. Even if we eliminated tort liability for doctors entirely it would make a difference of only a fraction of a percent in total health spending.

JP| 8.9.09 @ 1:47PM

Leo,
The AMA says the US wastes over $300 billion annually on test and procedures that are designed to protect physicians against potential lawsuits. That isn't a gnat, but about 30% of the total costs.

You also ignore the point that I brought out concerning the choice that Americans make. Americans chose to spend more on health care for the simple fact that they are able to. The people in the EU, Canada, and Austrailia do not have that choice -government bureaucrats make that choice for them. That is called rationing.

You do not "manage costs" in health care without managing who gets that healthcare. Take into account the fact that US consumers are subsidzing the rest of the world's pharmecueticals, as well as paying for the costs of developing new technologies and it isn't any surprise that we pay for more.

There are many free market principles that can reduce the costs of health care: namely taxing existing health care benefits provided by the employers. The Federal government loses out on tens of billions of dollars by not taxing these benefits. Employers spend too much time and money providing these benefits. Tort Reform is the other. Like I said, the added costs to our health care system because of lawsuits is huge.

ConservativeWanderer| 8.9.09 @ 1:52PM

Leo, Leo, Leo, you really must learn to look further than MoveOn and the DNC for your facts.

Our outcomes are no better than the rest of the world? Clearly you haven't bothered to check the real data (which isn't surprising, since you seem to be a lefty drone who just regurgitates the talking points you're fed).

Here's a few facts for you to consider.

* Breast cancer takes 52% more lives in Germany than in America.

* Breast cancer takes 88% more lives in the United Kingdom than America.

* On the male side, prostate cancer takes over six times as many lives (604% more) in the UK than here in the US

* Prostate cancer also kills about 4.5 times as many men (457% more) in Norway than in the USA.

* In our northern neighbor (Canada for those who flunked geography), prostate cancer takes 184% more lives. That's 18 times more than in America.

Now, are you through with the spinning, or should we hook you up to a generator? You could probably power a fair sized town!

(Is it just me fellow conservatives, or does "Leo" sound a lot like "Liberal Reader" a/k/a "Jeremiah"?)

Teflon93| 8.9.09 @ 1:59PM

No sense providing facts to liberals---it only confuses them.

Theirs is an emotional, tribal, and lusty attachment to power. It is power they want, not "reformed" anything.

Smitty| 8.9.09 @ 2:28PM

I agree, Teflon. This Fascist Liberal power grab has got NOTHING to do with health care.

Only a moron--or a Liberal--would say otherwise.

Leo| 8.9.09 @ 3:42PM

JP: “Americans chose to spend more on health care for the simple fact that they are able to. The people in the EU, Canada, and Austrailia do not have that choice -government bureaucrats make that choice for them.”

You’re mistaken here. In both the EU and Australia, voluntary health insurance is available to cover what the public plans will not. Individuals are free to spend whatever they want--the public plan is a floor, not a ceiling. Canada is essentially alone in the world in not allowing additional voluntary private insurance.

You say: "Take into account the fact that US consumers are subsidzing the rest of the world's pharmecueticals, as well as paying for the costs of developing new technologies and it isn't any surprise that we pay for more."

Again, why is this a defense of the current system? What you’re saying here is that U.S. consumers are being taken advantage of by the rest of the world, and that our market representatives (insurance companies) cannot or will not negotiate successfully on our behalf.

Finally, do you have a source for those AMA statistics? I tried to Google a number of variations on $ 300 billion, AMA, and waste, defensive medicine, etc. and didn’t find them. (Your comment did come up though.)

Conservative Wanderer: Seriously, you cherry pick statistics for specific diseases and specific countries and you accuse me of "spinning"?

The fact is that overall cancer death rates are higher in the U.S. than in Switzerland, Australia, Sweden, Japan, Iceland, and some others, and lower than the U.K, Norway, Canada and some others. All of these countries spend about half what we do, of course (Norway and Switzerland are the highest, at about 65% of U.S. spending). Again, the U.S. is paying premium prices for merely average results.

Teflon93| 8.9.09 @ 4:43PM

Since I'm a stats guy, I'll demonstrate how the liberals play games with numbers to achieve power:

1. Cancer survival only matters if you get cancer. "Overall cancer death rates" represent the portion of a population who die of cancer. Two problems with this for comparitive purposes globally: a) cancer is strongly genetic and many nations---including Switzerland, Australia, Sweden, Japan, Iceland, and surely "some others"---are racially homogenized and thru luck of the genetic draw do not suffer cancer at the same rates the polyglot population of America does and b) one easy way to avoid a higher cancer death rate for your nation is to have your people die of other things before cancer (an old person's disease)---take Russia, where alcohol and heart-disease-related deaths take people away before cancer does.

2. When you look at the 5-year survival rates for specific diseases including cancer---a much better measure of effectiveness of healthcare---the U.S. indeed leads the world. Which, by the way, explains the curious fact that Swedes, Swiss, Icelanders, Japanese, Australians, and "some others" get cancer they come to the U.S. for treatment if they can afford to do so. Somebody else's cancer is a statistic; your or your loved one's cancer is a tragedy and people act quite contrary to the way liberals claim. Even liberals know this and they know little indeed: did Ted Kennedy go to Canada or the UK to treat his cancer? Nope.

3. Even were facts not facts but falsehoods liberals find more convenient, one still needs to explain how precisely having bureaucrats ration healthcare IMPROVES these conditions. Liberals, you see, want to fix the numbers, not the system, by simply not treating cancer, first for the old, then for the simply inconvenient. They will then alter the statistics by only counting those who actually get approved for treatment, as many a tinhorn dictator (sorry, didn't mean to blaspheme their god Fidel) does.

ConservativeWanderer| 8.9.09 @ 4:48PM

Thanks for watching my back, Teflon. :)

Nice little blog ya got there. Drop by mine sometime.

Teflon93| 8.9.09 @ 4:56PM

I will check that out for sure, CW---and keep fighting the good fight!

Leo| 8.9.09 @ 5:08PM

Teflon: I'm not the one who brought in death rate statistics, CW did. As you point out, those statistics appear to have little to do with anything, which is why I gave a more or less random sample of developed countries with higher rates and lower rates than the U.S.

In any event, looking to specific disease statistics is silly for all the reasons you mentioned. Much better to look at overall life-expectancy, which is what I originally cited when I first posted (and in which category the U.S. is among the worst in the developed world).

Anyway, do you have a good source for five- and ten-year cancer survival statistics by country? I’m not sure I agree with you that those would be the be-all and end-all way off measuring a health system (surely the life-expectancy of those without cancer is also important), but I would be interested to see them.

Basil Plumley| 8.9.09 @ 5:10PM

@ Teflon93 and ConservativeWanderer

I have just visited both your websites and will be visiting both again soon. Some very good stuff at both places. Thank you!!

Teflon93| 8.9.09 @ 5:15PM

Leo/Jeremiah/Liberal Reader-

Overall life expectancy is strongly genetic. Homogeneous populations such as the Japanese have a naturally higher life expectancy as a result of their relative isolation over many generations.

To compare validly, you need to compare the life expectancy of Japanese people living in America to Japanese people living in Japan.

The Japanese routinely come to the States for lifesaving medical treatment. Why do you think they do so? Are they stupid?

Basil-

Thank you---you're too kind.

ConservativeWanderer| 8.9.09 @ 5:41PM

Thank you, Basil. :)

Leo/Liberal Reader/Jeremiah... to quote a great President, "well, there you go again." You really need to cut back on your lying.

You said, at 1:02 pm today, and I quote:

We spend nearly twice what any other country does on health care and our health outcomes are no better than other developed nations (and worse in many cases).

Mortality is a "health outcome," therefore it was you, not I, who first brought it up.

Like His Obamaness, now that you're losing the argument you're trying to switch the blame for the negative outcome. Too bad for you that I don't plan on letting you--or him--get away with it.

Teflon93| 8.9.09 @ 5:46PM

Here's a post for Basil and CW, inspired by this thread and the epiphany it generated regarding how liberals "solve" problems by accreting more power to themselves.

http://moltenthought.blogspot.com/2009/08/we-need-buggery-czar.html

Caroline| 8.9.09 @ 7:29PM

Liberals can and do spew their BS ad nauseam, and ad infinitum--but it really doesn't matter to me what they say--I just DON'T want government meddling even more in my life.

They are a pain in the @ss and I don't trust them.

Leo| 8.9.09 @ 9:06PM

Conservative Wanderer: Learn to read. Teflon was criticizing your and my use of "cancer death rates." That's what you brought up.

Teflon: So, if I understand you correctly you accept the fact that the U.S. has poor life expectancy relative to other comparably advanced nations. Do you also agree that we pay 50-100% more as a percentage of GDP to achieve that outcome?

Addressing your argument: If I understand you correctly, you claim that life expectancy comparisons are flawed because we’re not a homogeneous nation. Therefore, you suggest, we need to compare life expectancies on the basis of national origin.

But that doesn’t hold up. The U.S.’s low life expectancy isn’t just in comparison to one or two notably homogenous countries like Japan or Iceland, it’s in comparison to virtually every other developed nation. In the 30 high income nations in the OECD, for example, only Ireland, Portugul, and Cyprus are slightly worse (and they spend less than half what we do on health).

So this isn’t a matter of cherry picking. Every country with a first world economy, from East Asia to Europe to Canada, is just doing better than us--delivering a comparable product for a much lower cost.

Hot Con| 8.9.09 @ 11:54PM

You're full of crap, Leo--The U.S. has one of the largest numbers of centenarians in the world, and the numbers are skyrocketing. There were over 50,000 folks over 100 years of age in 2000 and they are expecting those numbers to rise 15 to 20 thousand in the next census.

Just look around, bonehead--people are living longer and are healthier longer. This won't last, though, if you merchants of death take over with your crappy ObamaCare. Death Panels, anyone?

Conservative Wanderer is right--you are LR/Jeremiah. Asshole.

Leo| 8.10.09 @ 12:13AM

Hot Con: The life expectancy of an Americans has certainly increased over the years, but it is still worse than any nation with comparable economic footing. That’s simply a fact. You could get it out of your encyclopedia, if you cared to take the time. The easier way to do it would be to Google it or get it from the WHO website.

Again, the U.S. system provides very good health care. It's just not as good as other developed nations and costs twice as much.

Hot Con| 8.10.09 @ 12:24AM

B.S. Just because you say it, troll, doesn't make it so. The majority of Americans don't want ObamaCare; just wait till more of them find out about Obama's death panels. It's going to sink like a stone and hurt you liberals for a long time.

You losers just want to usurp power, you don't give a damn about your fellow citizens. Screw you.

Leo| 8.10.09 @ 12:49AM

Hot Con: "Just because you say it, troll, doesn't make it so. "

I'm not asking you to trust me. Go ahead, check it out for yourself. The statistics are publicly available to anyone who's interested.

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Teflon93| 8.10.09 @ 8:43AM

Nice try, Leo/Jeremiah/Liberal Reader-

For statistical comparisons to be valid the same definitions must be applied---apples to apples, not oranges to apples.

The problems with the life expectancy numbers are legion:

1. Disease has a strong genetic component and populations---particularly in those countries you identified---are homogeneous to varying degrees. Iceland has far fewer families than the U.S. and these are very interbred. As a result, those conditions which those early Icelanders suffer from will predominate, those they did not will not. They will beat the mean in certain conditions and not in others. The U.S. has no such "luck"----if a black man dies of heart disease (a condition much more prevalent in that community in America), he will not die of cancer, but he will die nonetheless. If a person of French descent dies of cancer, that person will not die of heart disease but will die nonetheless. Both truncate life expectancy; only the individual cause varies. It is not a measure of the healthcare system but of the diversity of the population.

2. Nations report life expectancy differently. Many nations do not count infants as we do, so early death of children simply doesn't hit their books. You don't have to be a stats whiz---just honest---to understand that people who die in infancy have an outsized impact on life expectancy stats. If you don't count them---and the U.S. is far and away the most conscientious nation in counting them----then your mean life expectancy improves.

3. Life expectancy is a mean. It tells you next to nothing, which is why statisticians insist on knowing the population of the data and calculating many more statistics about its shape and distribution. Healthcare matters most when you get sick. Lifestyle and genetics matter far more in determining IF you get sick. Go look up Bayesian probability and understand a bit about how probabilities change whether you're talking about dependent or independent events, particulary dependent sequential events. Healthcare is triggered by illness. The question then is not how does healthcare impact life expectancy in general but how it affects the life expectancy of the ill---this is why I maintain that specific 5-year survival rates for life-threatening diseases is a truer measure of the efficacy of healthcare.

4. Even were none of this true, it doesn't mean that installing a bureaucracy to employ your otherwise unemployable liberal buddies would make life expectancy LONGER. In fact, liberals don't even make this claim----you want granny shoveled into the incinerator earlier as a hopeless case ("Take a pain pill" says The One). So it's specious to argue from life expectancy grounds in the first place.

5. Even were that not the case, there's no evidence in favor and considerable evidence to the contrary that that bloated bureaucracy run by Autocrat apparatchiks would DECREASE costs. It hasn't anywhere in the world; it simply rations care. You don't get more healthcare per dollar invested in socialized medicine, you get less healthcare period. Which is why Congress won't sign their own families up for it. But you've surely seen the horror stories of NHS patients starving to death on gurneys waiting to see a real live doctor. Perhaps they voted Tory and their deaths simply don't count.

Leo| 8.10.09 @ 11:46AM

Teflon:

So, once again to have this clear, you agree that our statistics place us near the bottom of the first world on life expectancy (although, as I’ll address below, you disagree with the significance of that number). And, although you haven’t said it, you don’t seem to disagree that we spend twice or nearly twice as much as any other country in the world to get that result.

Now, before I address all of your statistical quibbling, I have to ask: Would you agree that, even if we’re not among the worst in the developed world in terms of overall life expectancy, we’re certainly no better than average? Because your points below are all sort nibbling at the edges of my point but don’t address it head on. It seems to me that even if I were to concede that our health care system produces average results (which it really doesn’t—it’s below average) that wouldn’t justify the massive amount we spend on it.

Responding to your points individually:

Your point 1: “Disease has a strong genetic component and populations---particularly in those countries you identified---are homogeneous to varying degrees.” I didn’t identify any particular countries. You did. My point is that we’re doing poorly with respect to all other equivalently developed nations. All of them.

You then say those (homogeneous) countries “will beat the mean in certain conditions and not in others.” But life expectancy isn’t a measure of “certain conditions.” It’s a measure of overall outcomes. This just an argument against using numbers for particular diseases (like you want to) and in favor of using overall numbers (like I have).

Your point 2: “Many nations do not count infants as we do, so early death of children simply doesn't hit their books.” O.K., let’s look at life expectancy numbers at age 65—infant mortality shouldn’t be a factor there, right? On those numbers the U.S. performs somewhat better, but still not great. We’re slightly ahead of the U.K, comparable to Germany, and behind France, Canada, Australia, Switzerland, and others. So again, the point remains that we’re paying double what other countries are for merely average results.

Furthermore, it may be true that “many nations” miss early childhood deaths, but Canada, Great Britain, Germany, France, Australia, Japan, and other highly developed nations are not among them. This does remind me though of another point that’s relevant here though, which is that the U.S. is also among the very worst in the world in infant mortality. We’re worse than the Slovak Republic(!) for peat’s sake.

Your point 3: “Life expectancy is a mean. It tells you next to nothing, which is why statisticians insist on knowing the population of the data and calculating many more statistics about its shape and distribution.” Well, it tells you the average amount of time an American can expect to live. That’s pretty relevant to most people. I’m happy for you to present information on the distribution around the mean or whatever else you consider relevant here.

“Lifestyle and genetics matter far more in determining IF you get sick. Go look up Bayesian probability and understand a bit about how probabilities change whether you're talking about dependent or independent events, particulary dependent sequential events.”

Lifestyle and genetics are certainly a factor, but, as I’ve already pointed out, we’re statistically behind just about everyone—regardless of ethnicity or culture. Your Bayesian point is just wind. Obviously, American life expectancy is the product of a series of conditional probabilities. The question is: What are the relevant conditions? You think they are lifestyle and genetics. Certainly those are factors. But, as I just pointed out, we’re doing worse than basically everyone, regardless of local genetics or lifestyle. At some point you have to look to other factors, including the health care system itself.

“I maintain that specific 5-year survival rates for life-threatening diseases is a truer measure of the efficacy of healthcare.” You still haven’t given me a source on these. I’d love to see them.

Your points 4 and 5: I’m really not too interested in name calling. You can see that I’ve ignored every person who’s tried to troll me in this thread and so I’ll ignore this stuff too. Suffice it to say that every other developed nation in the world has managed to maintain hold on costs and provide good care, and your absurd assertions reflect far more on you than on any reality of the health care debate.

After all that the core point remains the same. We have a system that provides somewhere between average and below average care to our population, and we pay 50-100% more for it. It’s an appalling waste of all of our money, and it needs to be reformed.

Teflon93| 8.10.09 @ 11:56AM

I have not only addressed your points head on, Leo/Jeremiah/Liberal Reader, but have wiped them from the road.

To avoid an unnecessary recap, here's Jonah Goldberg making a quite similar point:

"Thanks to Mark Steyn for reminding people that this life expectancy stuff is wildly overblown. It's funny: whenever liberals want to indict the American health care system (which I do think needs reforming, just not Obama-style) in sober, pragmatic, terms they go to life expectancy. Yesterday, on Meet the Press, Michael Bloomberg invoked Europe's higher life expectancies as prima facie evidence that we have to "reform" health care. But when liberals are passionate about health care reform amongst themselves it has nothing to do with "extending" life expectancy (as if it would save money, by the way, to have millions more really, really, old people in America). When discussing health care "reform" amongst themselves, they admit that they want to do it for matters of social justice, equality etc. And that's fine, but life expectancy is only tangentially related to all of that.

Here's the thing. If we get the P4 (public plan poison pill), and liberals get their way, life expectancy isn't going to rise appreciably. And if it does rise, healthcare costs are going to go up. It's a total red herring."

So no, Leo/Jeremiah/Liberal Reader, I don't grant your premise, as noted, that life expectancy statistics in general mean much regarding healthcare effectiveness because a) we are not comparing similar genetic populations; b) we are not comparing similarly-afflicted populations; c) we are not using the same definition to calculate the response variable across all populations.

Garbage in, garbage out.

As for the evidence, count how many people come to the U.S. for the treatment of serious illnesses---even when having to pay out-of-pocket for the procedure, for their travel, and for convalescent care---as opposed to those going to say your Bolshie paradise Cuba from here for the same thing.

As always, economics confounds the collective hivemind.

And even were all of that not true, you have offered zippo evidence indicating a) government healthcare RAISES life expectancy; b) government healthcare does so at LOWER total cost; c) liberals should be allowed to run government healthcare.

None of it follows given liberals can't even run a used car trade-in program without screwing it up.

Leo| 8.10.09 @ 12:33PM

Teflon: Look, quoting from Jonah Goldberg isn't going to get you anywhere unless he makes an argument and supports it with facts. Goldberg doesn't make one concrete factual claim in that entire quote. Your arguments were better. At least you tried to engage with the facts.

"I don't grant your premise, as noted, that life expectancy statistics in general mean much regarding healthcare effectiveness."

That's not what I asked you to agree with. Read my previous post. There are two points that you don't dispute and I want to make sure everyone reading this notices that you don't dispute them:

1. We pay between 50-100% more for our health system that anyone else in the world.

2. Life expectancy in the U.S. is among the very worst in the developed world. (We can now add to this that infant mortality is similarly bad, and that life expectancy at 65 is merely average, because you don't seem to dispute those either.)

Now I know that you disagree with the significance of the second item, but you do concede the fact, right?

"a) we are not comparing similar genetic populations; b) we are not comparing similarly-afflicted populations; c) we are not using the same definition to calculate the response variable across all populations."

So what you’re saying is that there’s something unique about the U.S., as opposed to every other developed nation in the world, that makes us die young even if we spend twice as much as anyone else on treatment? That’s a pretty remarkable claim to make. Any specific theories as to what this uniquely American disability may be?

“And even were all of that not true, you have offered zippo evidence indicating a) government healthcare RAISES life expectancy; b) government healthcare does so at LOWER total cost . . . .”

On the contrary, that’s the evidence I have pointed to over, and over, and over again in this thread. Everywhere else in the world, every other first world nation, has adopted universal access/universal coverage plans. And every one of them has achieved comparable or better results at a fraction of the cost.

Teflon93| 8.10.09 @ 1:18PM

Leo/Jeremiah/Liberal Reader-

You have yet to make an argument or support it with facts, but you do refuse to engage reality.

Goldberg's argument:

1. Liberals point to "life expectancy" when they wish to appear pragmatic.

2. Among themselves, they do not refer to it at all, but rather the "social justice" aspects of it.

3. Therefore, liberals "life expectancy" concern is a red herring---they don't care about it.

Simple, direct. Learn from it.

You apparently don't know what a mean means.

It is not "the average amount of time an American can expect to live". It is the average amount of time a population of Americans DO live at a point in time. Indeed, since that average includes infant deaths, American adults can expect to live longer. Why? Because they've already survived childhood---life expectancy is different.

Moreover, it cannot account adequately for accidents. One reason why the U.S. has a lower mean life expectancy rate is the much higher number of cars and therefore car accidents per capita. China has far fewer cars and far fewer car accidents---a net plus to life expectancy having nothing at all to do with healthcare.

Thus the point of the folly of arguing with liberals:

1. They don't understand the facts.
2. They don't care about the facts.

Witness your assertions above, which utterly fail to explain why Ted Kennedy's seeking treatment at this very moment in one of those lousy American hospitals.

Or why people the world over send their best and brightest to attend U.S. medical schools and intern in U.S. hospitals.

What is it these people know that you do not?

And finally, why do you keep changing your name?

Teflon93| 8.10.09 @ 1:38PM

Aside from the amusement of watching liberal sock puppets point to the rising cost of healthcare while ignoring that the prime reason for said cost is their own bankrupt Medicare and Medicaid programs, here's another useful tool in debunking the notion that preventive care saves money:

http://www.americanthinker.com/blog/2009/08/surprise_preventive_care_will.html

For those of you who enjoy probabilistic exercises, contemplate the following:

For preventive care to be effective and efficient, one must:

- successfully predict what causes life-threatening illnesses;

- successfully predict which of us are exposed to these causes in sufficient measure to contract life-threatening illnesses;

- successfully identify an alternative course of action which will prevent exposure to said causes while not introducing others.

Let's take lung cancer.

Let's say 90% of lung cancer is caused by smoking.

Let's further say we can predict with 90% accuracy people who are will come down with lung cancer given a set threshold of exposure to smoking.

Let's further say that we've plotted an alternative course which if followed will eliminate 90% of exposure in the effected population to the aforementioned cause.

So, how'd we do with this utopic scenario? How effective will we be?

90% * 90% * 90% = 72.9%.

What? Where'd the other 17.1% go?

Unfortunately, ALL of these events must happen in order for lung cancer to be prevented. One's cancer must be caused by smoking and not something else. One must know one's at risk. One must successfully avoid the cause. Even at 90% effectiveness--a much higher effectiveness rate than we see in reality---the overall effectiveness is significantly less due to these dependent conditions.

So why not just treat EVERYBODY as at risk?

Well, that brings in a 4th probability---the probability of being at risk for lung cancer due to smoking. Everybody = 300+ million Americans. It's prohibitively expensive to do anything for 300 million people. And even then there's no guarantee that the target population---those REALLY at risk---will overlap with the portion of the population that follows the plan to the letter.

You wind up with something that looks like what stats geeks call Type I and Type II error: some people who are at no risk will think they are; some who are will think they are not. And yet you paid to communicate/train/provide preventive care to both.

Let's say you could do all of this on the cheap---$1 per.

To reach out and do this would run $300 million per year. Not bad as federal bloat goes, right?

Well, according to the CDC (http://www.cdc.gov/cancer/lung/statistics/index.htm) only about 200,000 people a year are diagnosed with lung cancer. To reach these people, we now have paid not $1 per but $1,500.

Not so efficient, is it?

Now factor in that reducing incidences lung cancer is just one of hundreds of conditions we'd need to deal with. As Churchill famously told that Bolshie shrew Lady Astor: "And what shall I day of then?"

Suddenly it makes a lot more sense to put your money into research into a cure and into effective treatment than into the "preventive" gobbledygook, doesn't it?

Teflon93| 8.10.09 @ 1:40PM

BTW, if you care about the probabilities concerning how long you'll live, guess where you'll find the best numbers?

In the actuarial tables.

Developed by who?

Why, the INSURANCE COMPANIES, of course.

Teflon93| 8.10.09 @ 1:49PM

And just wondering, Leo/Jeremiah/Liberal Reader: if socialized medicine increases life expectancy, why isn't Congress volunteering to join it themselves?

Don't they want to live?

Leo| 8.10.09 @ 3:21PM

Teflon, you appear to have just given up at this point. Copy-pasting irrelevancies and generating page after page of unsupported assertions is not going to advance your argument.

To reiterate what we've already established: Countries that have reformed health care by increasing public sector participation--i.e., every other developed nation--have comparable or better health care outcomes at a fraction of the cost.

You just don't have a coherent answer to that. You're flailing about with nonsense like that long preventive medicine hypothetical, which is based on “utopic” numbers you apparently pulled out of thin air. You claim this elaborate story (which is a response to an argument I never made) shows that reform CAN’T work. But the evidence already on the table shows that it DOES.

You paraphrase Jonah Goldberg who, based on his imagination about what liberals say behind his back, calls my argument a “red herring.” But notice that he doesn’t actually address the argument’s substance. That’s because the argument is correct, so he has to resort to name calling rather than addressing its merits. You do the same thing, I’ve noticed.

To address the few substantive points you make:

“since that average includes infant deaths, American adults can expect to live longer. Why? Because they've already survived childhood---life expectancy is different.”

Did you miss that I already posted regarding life expectancy at age 65? The U.S. is about average. And again, we’re paying significantly more than any other country in the world for that average result.

“One reason why the U.S. has a lower mean life expectancy rate is the much higher number of cars and therefore car accidents per capita. China has far fewer cars and far fewer car accidents . . .”

I thought it was because we don’t have a homogeneous society? Genetics and culture? Are you going to develop that point?

Anyway, we aren’t comparing with China here. We’re comparing industrial nations with economies on the same order of development as the U.S. Do you think they don’t have cars in Germany and Australia? What kind of difference do you think car crashes make in the numbers between, for example, the U.S. and Germany? Enough to justify paying double the money for some of the worst results in the developed world?

You also say that “the prime reason” for health care costs is Medicaid and Medicare. As usual when you make a point actually addressing my arguments (as opposed to an irrelevant aside you’ve borrowed from some other blog) you don’t cite a source. Nonetheless, the response to this is the same as the response to all your other flailing about: Every other developed nation has more government involvement in health care than we do, and every one of them controls costs better than we do. People live longer for less money when there is a robust public health care structure.

NO OBAMA DEATH PANELS!| 8.10.09 @ 3:22PM

Great job, Teflon! You drowned the little troll with your brilliance, reason and FACTS!

Looks like L/LR/Js' POWER OF PERSUASION DIDN'T WORK! Look out for the Union goons--they're coming next.

Your effort and concern are most patriotic. Thank you.

NOBAMACARE| 8.10.09 @ 3:26PM

Bottom line, troll. OBAMACARE IS DEAD!! The people have spoken, so give it up.

Teflon93| 8.10.09 @ 3:35PM

Leo/Jeremiah/Liberal Reader-

I can see why you change names so often. It is to drive us into despair that there might be THREE people incapable of following or making an argument rather than one.

You persist in using life expectancy as your bellwether for the effectiveness of the American healthcare system despite the fact that:

1. Life expectancy bears little relation to healthcare overall as many people die (say, from car accidents) before receiving any care at all and because those illnesses which end lives are tied to one's genes, not one's doctor. My family has a high incidence of cancer and a low incidence of heart disease. When I inevitably have to go to a hospital---right here in the U.S.---it will be for cancer and not a heart attack. Depending on what type I get, I'll live into my 80s or die in my 70s. As the past 3 generations of my family have. Them's the breaks.

2. Life expectancy is not measured the same way between nations. You continue to avoid this point. But given this is a fact, it means that one cannot simply look at mean life expectancy in one country, mean life expectancy in another, and claim one country has better healthcare.

3. You have provided no evidence for how significant healthcare is in life expectancy. This will be a number between 0 and 1 in any reputable study. What is it?

I don't grant your claim that it can simply be assumed as you blather on.

4. Since your number is bogus, so is your argument, such as it is.

5. As demonstrated, even if it were true that mean life expectancy were an excellent measure of healthcare effectiveness, and even were it true that America were the bottom of the barrel in healthcare given this metric, and even were it true that healthcare cost were measured in a rational way across all nations and America stunk there too, you STILL haven't shown a thing about why Obamacare should be embraced as a solution.

And by the way, since Obama claims that Obamacare is NOT nationalized healthcare, why on Earth do you believe that it will generate all the marvelous alleged benefits of nationalized healthcare in other countries?

Is Obama lying, or are you?

Leo| 8.10.09 @ 4:56PM

Teflon:

First of all, you continue to have no response to the point that we spend way, way more for health care than any other country. Given that fact, I’d expect you to offer some concrete evidence that the U.S. system is better (hopefully, way, way, better) than any other system in the world. Instead, all you’re doing is arguing that it isn’t quite as terrible as the data suggests. You’ve supplied no affirmative evidence that our current, incredibly expensive, system is justifying its cost.

Given that, I’m not sure why anything you’re saying matters. I say our health care is below average and your response is “oh, no, no, there’s no way to tell if it’s below average or average.” Either way, it’s not justifying paying an additional 50-100% in spending.

I mean, we could extend this debate. I could bring to the table a bunch of other statistics corroborating the life expectancy number (infant mortality, YPLL, etc.), and you could take your shot at knocking each one down in turn. But what is the point—if you’re not going to actually show that the system provides good value, then my evidence is the only evidence we’ve got.

Your points:

“many people die (say, from car accidents) before receiving any care at all and because those illnesses which end lives are tied to one's genes, not one's doctor” We’ve been over this. All of these things happen in Australia and Denmark too. You’re just repeating yourself now.

“Life expectancy is not measured the same way between nations.” Provide specifics. Earlier you said that we count infant mortality and other countries don’t do so as carefully. I don’t think that’s true of developed nations, as I already said. You haven’t provided any evidence to rebut that. If you have other particulars claims, raise them.

Additionally, just to help move things along, you might provide some sense of how much difference the differences you are talking about make. I have no doubt that there are factors that can be taken into account that alter life expectancy calculations, but I don’t believe that the U.S. is really in first place when it appears to be near last, and you’ve certainly provided no evidence that it is.

“You have provided no evidence for how significant healthcare is in life expectancy.” So what you’re saying is that healthcare doesn’t affect life expectancy? Then why are we spending 16% of our GDP on it? If it all comes down to genetics and culture, why not spend 3% like Singapore?

“STILL haven't shown a thing about why Obamacare should be embraced as a solution.” I, for one, am not committed to Obama’s plan in particular. There are dozens of models for systemic health care reform in the world, and I would be happy with many of them. As I’ve already pointed out, just about any other model would be better than what we’ve got.

“And by the way, since Obama claims that Obamacare is NOT nationalized healthcare, why on Earth do you believe that it will generate all the marvelous alleged benefits of nationalized healthcare in other countries?” Of course it’s not a nationalization plan—did I ever say that it was? There are many ways of providing universal care and universal coverage, and it’s certainly not necessary for the government to become owner of the health system for that to happen.

Teflon93| 8.10.09 @ 5:50PM

Leo/Liberal Reader/Jeremiah/TBD-

You continue to ignore the simple reality that:

1. Any indicator employed to measure healthcare effectiveness comparitively require said metric to be calculated PRECISELY THE SAME WAY for all countries in the comparison. Since life expectancy is not, it isn't useful for comparison.

2. Value is determined by benefit over cost. If liberals see no value in living another day, they could help us lower costs by not. That should expose the folly of actuarial-based healthcare, but should it not, kindly read "Humanae Vitae".

3. You continue to beg the question regarding government "solutions".

Namely:

1. Mean life expectancy is a valid metric reflecting the effectiveness of healthcare in a country (debunked above).

2. The U.S. has a lower mean life expectancy than other industrialized countries (again, debunked above. Let's also note you've not even attempted to refute the argument from variant methodology).

3. Since several nations having a higher mean life expectancy than the U.S. have socialized healthcare, their life expectancy is higher BECAUSE they have socialized healthcare (note the fallacy here, a variant of the ad hoc ergo propter hoc).

4. Therefore, the U.S. ought to have socialized medicine too.

EXCEPT:

3a. Barack Obama claims that he will reduce cost by LOWERING life expectancy. That's right. LOWERING life expectancy. How so? Because he's pointed out that he intends to establish a commission expressly to curb the "abuse" of curative care beyond a person's government-defined expiration date. That's what the whole "Grandma would be better off with a painkiller" business was about. If grandma dies SOONER under Obamacare, what's that due to mean life expectancy? That's right---it LOWERS it.

4a. Barack Obama claims he is not proposing socialized medicine. Thus either we miss out on all the "wondrous" benefits of socialized medicine or Obama's lying about what he's trying to do.

And note that you have yet to prove that socialized medicine---of which horror stories are daily rampant---is better in any form or fashion than free market healthcare.

You see, to do that would require:

1. A population of socialized healthcare systems (check);

2. A population of free market healthcare systems (whoops, how do you define that?);

3. A metric or set of metrics CALCULATED THE SAME WAY for both populations which is a reasonable proxy IN THE EYES OF HEALTHCARE CONSUMERS for healthcare effectiveness;

4. A statistically-significant test establishing that 1 is > 2 .

When shall we see that, Leo?

In the meantime, let's look to what people actually do---you have been asked and have not yet answered why---American healthcare being the abomination that it is----so many rational people:

a) Come to America at their own expense for lifesaving treatment and palliative care;

b) Send their best and brightest to study medicine in U.S. medical schools;

c) Send their doctors-in-training to intern in U.S. hospitals;

d) Refuse to join Obamacare (talking about Congress here).

Odd behavior indeed, isn't it?

Unless you've got a chronic case of wrongitis.

Leo| 8.10.09 @ 7:32PM

I am confounded that, despite having generated pages after page of writing on this point, you still haven’t offered one scrap of evidence that we get any benefit for the huge amount we spend on health care over an above any other country. Instead, you seem to be moving closer and closer to claiming that it’s simply impossible to ever know what’s a good health care system and what’s a bad one. Is that your position now? That this is just an epistemological impossibility? Radical doubt is fun when you’re 18, but not much good when you have to deal with reality.

You say: “Any indicator employed to measure healthcare effectiveness comparitively require said metric to be calculated PRECISELY THE SAME WAY for all countries in the comparison. Since life expectancy is not, it isn't useful for comparison.” Do you have an example of such a statistic? Or are you simply rejecting the notion that we can ever compare our system to another country? And are you ever going to defend any of the long list of unsupported assertions you made earlier in this thread about why life expectancy is low in the U.S.?

You say: “Value is determined by benefit over cost. If liberals see no value in living another day, they could help us lower costs by not. That should expose the folly of actuarial-based healthcare, but should it not, kindly read ‘Humanae Vitae.’” Now here we have an interesting change of argument. Now you appear to be shifting to the claim that, even though the U.S. has a short life expectancy and pays more for it, we can never know whether our system is providing value because, based on Catholic religious principles, the value human life is essentially infinite. Of course, this reasoning assumes that the current system saves lives, but the evidence doesn’t support that. In any event, if you’re religiously opposed to the notion of ever taking cost into account in health decisions, I suppose there’s not much point in our continuing this discussion. I’m not prepared to debate theological doctrine with you.

After this, I get a bit confused by your numbering scheme. You suggest I’m question begging “regarding government ‘solutions,’” but then go on into an argument I’ve never made to try to show . . . well I’m not sure what you’re trying to show. Basically, you seem to think that because some of other first world nations have socialism then I have to want socialism, and I should be mad that Obama doesn’t want socialism. And then you give me a four step proof that you require in order to be satisfied. We’ve already determined, though, that you’re in a state of radical doubt, and presume that any evidence I offer is deception by an evil demon (a la Decartes), so I’m not too concerned with whether I can convince you.

You also make a lot of unsupported assertions. Given your track record on providing evidence for your assertions, you’ll excuse me if I don’t bother to go through these one by one. I’d love to, for example, go through your claim that Obama said he wants to “curb . . . curative care beyond a person's government-defined expiration date,” but, after my experience trying to reason with you on other issues, I assume you’d simply deny that video recordings are a reliable way to determine what someone said.

Given that you’ve retreated into radical epistemological doubt, I hope you’ll just let me reiterate for the record the established facts. You don’t think they’re meaningful, but others might:

1. The U.S. spends 50-100% more on health care than any other country in the world.

2. Every developed nation other than U.S. has a health system that involves substantial government involvement in health care.

3. Established statistical measures (infant mortality, life expectancy, and life expectancy at age 65 among them) show that health outcomes in the U.S. are among the very worst in the developed world.

(You say you’ve “debunked” the last point. I’ll let anyone else reading this be the judge. As I recall, you suggested that there are reasons the U.S. is so bad [lack of homogeneity, car crashes] and you have questioned, without providing any details, the idea that statistics can be compared to one another to reach meaningful conclusions [your descent into radical doubt], but you haven’t actually addressed the fact I stated above, and you certainly haven’t stated any facts the contrary.)

Those are facts. You don’t see any conclusions to draw from them, based on your philosophical and religious principles. Others can make their own analysis.