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Particularly in wealthy countries, is that it seeks to alter the revealed preferences of “society.” What do I mean by that? Well, the vast majority of citizens in wealthy countries live far beyond the subsistence level. In fact, even most of those classified as “poor” in modern America enjoy living standards that would place them among the world’s wealthiest, and in fact they enjoy living standards far superior than the poor in America just a generation ago.

The point being that for most Americans obtaining the necessities of food, shelter and clothing now make up less than 40% of their budgets. Even for a poor family, these numbers rarely amount to more than 2/3 of the budget. With education already being provided for free, what else could people be spending their money on? Health care for sure, that is why in aggregate about 16% of national income is dedicated to that service. But even if every American spends 16% on health care, and 40% on the other necessities, that still leaves 44% of their disposable income to be spent on other goods and services.

But people do not spend 20% on health care, or 25% or 40% … they would rather go on vacation, see a movie, make their lawns nice and green … each of those things brings them more satisfaction than spending even more on health care. How do I know? They CHOOSE these things over getting more health care.

Aha … but the lefties among us say that these folks have no idea what they want, or that they are stupidly choosing to relax for a week of hiking in Maine, rather than going to the doctor a few more times per year. If they REALLY were rational, they would choose to purchase more health care.

Actually, I rarely hear the lefties argue this when it comes to health care, but I do hear them argue it when it comes to spending on education and some other goods. What the lefties argue is that people cannot afford health care – not that people are too irrational not to purchase it. I think the latter claim would be more credible than the former. That is the point of this post. Most people can afford to substantially increase how much they are saving for health care and spending on health care, they just choose not to.

(And this includes saving money today for health care expenses we all know will be coming down the pipe. For example even though I am 34 and in good health and spent at most $100 on medicine this year, I know that if I am lucky enough to make it to 75 years old, I will be spending hundreds each week for medicines to control my blood pressure, cholesterol, and god knows what ailment I may come down with … it’s a virtual certainty. I am trying to put away money in an HSA today to deal with those problems in the future – but probably not enough. How many people actually save for their later health care? Why is the answer virtually zero? Could it be because the expectation is that someone will provide it free for them? Or could it be that saving for health care in the future will be targeted for wealth expropriation later on by our social engineers who deem us to be too rich to need to save for future health care needs?)

The plain fact is, we would rather enroll our kids on youth hockey, we would rather buy a few more bottles of wine, we would rather visit our friend in Boston, than to forego those things and save for our future medical needs.  That we have made these choices does not mean that we are all entitled to have more medical care. That we have chosen to spend so little of our budgets on clothing (as compared to our ancestors) does not mean we are entitled to have more clothing. How come there is not a movement for nationalized clothing? Or nationalized vacations? Or nationalized food? Of course we all want more of everything – that is what characterizes a world of scarcity. Imploring people to want less of some things is not going to do much. If those things get more costly, then perhaps our behavior will change. And maybe that is the underlying push for national health care. It is to engineer society to move away from consuming frivolous trinkets and baubles and into consuming things that are really value enhancing.

Two problems with that rationale: first is that there is some pretty strong evidence that more spending on health care does not improve outcomes, second is that not everything we consume is a mere trinket (and even if it was, it is not your business to tell me what is useless).

Sure the current health care system is broken. It is broken because it is cartelized. It is broken because it is heavily regulated. It is broken because private insurance companies and doctors have learned how to game the system to garner special privileges at our expense. It is broken because at the margin, so few of our health care decisions are affected by financial considerations. It is broken because there are no natural restrictions forcing people to economize on their health care purchases when they finally decide to make them. How does having everyone get insurance through the government solve any of these problems? Having a government run system like Massachusetts is a recipe for further cost overruns, increasing cartelization of the industry, paying off favored political constitutencies, and increasing the government’s role in making private decisions regarding our own health.

I don’t deny that there are some people without the means to provide for an adequate level of health insurance protection or to pay for medical care when needed. For these folks I am wholly supportive of doing something to help. I believe that private charities would do an adequate job in that regard, but if you wanted to have a government agency provide these services, it at least is partially justifiable to me. But don’t we already have a government program to help the poor? It is called Medicaid. Don’t we have a program that is intended to assist th elderly? It is called Medicare. What’s the problem? Both of those programs are completely insolvent by any reasonable measure. So the hope is to extract subsidies from the non-poor and non-elderly to fund those systems, while masquerading as a plan to deliver better health services to the middle class (47 million Americans without health insurance).

Costs for health care may be high, but they are not a “problem” in any meaningful sense. People have plenty of rooms in their budgets to deal with these higher costs, they just choose not to. And the statists among us are jumping on this voluntary choice as a reason for making them consume more health care than they would choose on their own.

24 Responses to “Another Problem With Government Health Care”

  1. Harry says:

    I think we should all get free legal care and free lawn care. I want to sue someone, and I want a kid to mow my lawn.

    These are my urges. Does anyone have any other urges?

  2. Diego Méndez says:

    Look at any measure on healthcare. You will see socialized systems, such as those in France and Spain, ranking first. The USA spends twice as much as %GDP in healthcare as those countries; however, the USA ranks behind developed countries on almost any measure.

    E.g. the WHO ranking on healthcare. US people’s health ranked 72th in the world, which means US people have worse health problems than people in Sri Lanka, Macedonia, Uzbekistan or Nicaragua. You could say it has to do with higher calories intake, but all advanced nations are in the first ranks, no matter how much they eat or smoke there.

    It is funny that you mention socialized tourism. In fact, it does exist in Spain. Town halls subsidize tourism for the poors’ children (summer camps, etc.), and there are huge subsidies for the elderly to take vacations around the country, visit local saunas, etc. almost for free. That may be the reason why Spain has one of the highest life expectancies and lowest crime rates in the world!

    (Is it expensive? Yes, Spain’s tax revenue is 37% GDP, compared to USA’s 28% GDP. Does that mean a lower growth rate? No, Spain’s been growing faster than the USA since those socialized systems were put in place).

  3. wintercow20 says:

    It is mildly frustrating to see comments neglecting to address the points made in the post. And if you want to use that data, you could well argue that the systems in the countries you celebrate are LESS socialized than here in America.

    What is one way you would define socialized? When 3rd parties pay most of the costs. Well, look at the data and find out in which country 3rd parties make the payments for the largest share of medical expenses? It is certainly not in the “socialized” ones you cite … it happens to be here in the U. S of A.

    But then again, that was NOT the point of my post. Repeating the same old canard is not persuasive.

  4. Harry says:

    Sorry for giving a flip reply. I did so because you nailed the point, and did not have much to add.

    Many people (most?) who have employer-provided health insurance forget that it is part of their compensation package and coming out of their pocket, just as the “employer contribution” to FICA does. (Of course the whole package comes out of the employer’s gross revenue pocket.) (Many in Congress would like to tax gross revenue, and disallow all expenses, which they regard as “tax expenditures.” They assume that all revenue is theirs, and the only question is how much to take to be fair.)
    If you are the owner of the business you look at it entirely differently. No matter how you cut it, it’s a big number, like $22,000 a year for a couple, enough to finance a lease on a Ferrari. And if you are a retired owner of a business who is lucky to have something left over after paying your employees and paying the government, you can’t deduct that $22M from the income generated by your investments before paying even more tax to the Feds and the state, and if you live in Bethesda, MD, to the county and the locals. When you turn 65, you get Medicare, which is socialist.

    This system is deemed by some as non-socialist since prior to age 65 a commisar has not directed whom you should buy your health insurance from, and doctors do not have to become part-time employees of the state, if they don’t want to take Medicaid or Medicare patients. Otherwise, doctors are enjoined by the State from “balance billing” their patients who have health insurance that pays Medicare rates.

    Rather than set up a system where people would buy a major medical policy that does not include coverage for chiropractors, psycologists, or any service you may want not to prepay, we are forced to choose among policies that cover those visits, because it is only fair that we do so. If you are on Medicaid, you get all that for free anyway, including trips to the gynecologist for pre-natal counseling, to the obstetrician (who pays a hundred grand a year to defend against the plantiff bar) for delivery or partial-birth abortion, and to the shrink for post-partum depression.
    Therefore, it’s about time the U.S. joins the rest of the modern world that provides universal health care. In Cuba, everyone can see the doctor any time they choose, and they also have access to Cuban psycologists, chiropractors, dentists, midwives, and many other experts. Even the prisoners get better care than they get at Joliet. There is no gouging by pharmaceutical companies. If their health care is so bad, how come El Chefe has lived so long? A congressional delegation just visited with him, and told us he is as mentally alert as ever. (Note the precision of that comparison, which does not tell us if Fidel was ever that mentally alert.) Remember, whenever the government gets involved, they do it right!

  5. Diego Méndez says:

    wintercow20,

    the rational action for everybody, in every economic and health condition, is paying for health insurance. The fact that many people take illegal drugs, drink alcohol before driving, have unprotected sex with strangers or get heavily indebted to show off an expensive car doesn’t mean those actions are rational, nor that we shouldn’t oppose them.

    Moreover, it is not only a question of consumer preferences, but of efficiency, fairness and national cohesion. Spain has the largest community of donors, though getting paid for it is forbidden. In the US, you have to pay people to get their blood, etc. Why would anybody give their blood for free, after all? Recipients wouldn’t care for you if you got ill, or unemployed. Unlike in Spain, where the system takes care of you, and society feels responsible for everyone of its members.

    You say: “Well, look at the data and find out in which country 3rd parties make the payments for the largest share of medical expenses?” What do you mean by 3rd parties? Private insurance schemes? A father’s new spouse paying for his son’s treatment? A company paying into a private insurance scheme for its employees? That can be hardly considered socialized medicine. You get what you (or your relatives) are paying for, or working for, several times more expensive than in, say, Spain.

    You can’t really compare a country where 50 million people have no access to expensive treatments, to countries where absolutely everybody (including unemployed illegal immigrants), get them for free.

  6. wintercow20 says:

    It seems as though the point of the post has been ignored, yet again. And no, I do not get paid when I give blood. And what, by the way, is “national cohesion”? Mao had it. Stalin had it. Hitler had it. True love!

    You don’t love me and I don’t suggest that you ought to do things because you think it is in my interest. Who is this Mr. Nation we are all supposed to love? Sir you are treading on very dangerous, if not sanctimonious waters, if you want to believe the mythology you believe in.

    Preaching love for Mr. Nation is a morality of death, plain and simply – you find it moral to stick a gun in my back and threaten to reduce my options, while I do nothing more than persuade you by offering you more options.
    You clearly know little about American charity (who gives more aid around the world, who provides more resources to private Charity, Spaniards or Americans ???? oh right, you use a gun and force the charity to happen through the benevolent arms of the state).
    And you certainly know nothing about American socialized medicine, as mr. harry above so nicely describes. That 85% is not rich uncles, as much as your charicatured view of the US wants you to believe it … that 85% is government and private insurance.
    And to talk of the 50 million uninsured as you do, is again, demonstrating a complete lack of understanding of who they are and what that means. Did you just read on OpEd in the Nation, or a blurb off the EPI’s website to make that comment?
    But once again, you avoid the point of the post, just to throw around the tired incorrect views you seem to hold about the way the world works. That is fine, but do it when the topic is about that.

    Your talk of efficiency is horrifying. If all the people of Spain get extreme pleasure from the execution of red-haired, gay, basketball players that would be an enormous benefit to them if a red-headed, left-handed, curly haired, basketball player was murdered. Since there may be at most (any?) red-headed, lefty, curly haired basketball player in Spain the cost to him can’t be that large … say $20 million. If the 50 million Spaniards each only got even a dollar of pleasure from seeing him dead, then by your efficiency criteria you would have him executed in the National Interest.

    And no, the rational action is not to pay for health insurance. As Harry elegantly said, if you have socialists running your country and all health insurers are forced to offer breast implants, psychiatry and abortions, and I am a man of stable mental health, it does not make sense to purchase insurance to cover it. And the socialists don’t let me get a health policy that was produced in Pennsylvania or New Jersey, only from a company in New York. So why again is it rational to purchase it?
    Or the socialists require that emergency rooms take all comers, even if it is a hangnail (and yes, I have SEEN it with my own eyes) … so why is it rational to purchasing insurance? And the socialists provide free medical care if you are lower income (well above poor) – it is called Medicaid. So why would you buy your own. And the socialists promise to pay any and all medical expenses when I am old and decrepit, so why would I buy it when I am old … or worse, why would I save a dollar today for health expenses I KNOW I will incur in the future, when the pockets of the next generation will be picked to pay for it … even though, as the post above demonstrates, I clearly have the money to save more for it now.

    And by the way, go on thinking that you get stuff for “free” in your medical system. How does it get produced? Magic pixie dust?

  7. Harry says:

    I got a chuckle about “Spanish efficiency.”

    Diego, both Wintercow and I pay for health insurance, and we do it rationally to protect us from catastrophic medical expenses first, and then we calculate what we will prepay for other expenses, given our families unique circumstances. Our decisions are influenced and complicated by our tax laws and other laws, which force us to handicap how good some cabinet secretary feels like when getting out of bed.

    Under the present system, I would like to buy a policy that would take care of my catastrophic medical expenses, another policy that would take care of the expenses under $5000, and to have the King grant me the privelege of deducting the rest before the tax impressors come to levy whatever they see fit in the eyes of the King. I’m not asking for a free ride because I know that if everybody gets a free ride, everybody loses interest in working, saving, investing, and for providing for their families.

    You might have chosen another country as a paradigm. Spain has had centuries to make something of itself, and has failed repeatedly. Pizarro looted Peru, brought back tons of gold to the King, which was later squandered, but enough was left to send the Armada to England. For the next four centuries the whole country took a siesta. For the last century Spain has experimented with fascism. To Spain’s credit, they throw a great party in Pamplona, financed by Swedes who can’t afford to drink in their own country and take their four-week holiday there. Because of Spain’s screwed-up assorted regimes, it’s often been a bargain, since the Spaniards are so damn poor.

    I’m hard pressed to think of any government that has been successful at this business of health care, let alone managing its other affairs. Forgive me for being presumptuous, Wintercow, but I think that was the rhetorical question you asked. I’ll hedge that by saying it was one of the questions you asked.

    Diego, are you saying that we should go to socialized medicine?

    Beyond this, Diego, is not whether Franco, or Lenin, or Mussolini were successful with their systems, but rather how they, or the King, or Caesar, usurped our right to freedom. In my system, freedom is an axiom. Is it in yours?

  8. Harry says:

    Faulty parallel structure in paragraph 3. Blogging is tough.

    Back in the early days if the internet, “flaming,” or criticism of another poster, was considered discourteous and inconsiderate of the counterparty’s feelings. My apologies to Diego, but if you have the cajones, answer Wintercow’s questions. Do not cast aspersions upon your ancestors.

    A final thought: an old girlfriend from Venezuela taught me a phrase that might be useful in this discussion: “El que sabe, sabe. El que no sabe es empleado publico.”

  9. Diego Méndez says:

    Harry,

    I can’t see why Spain’s history is important here, but you are wrong, anyway. Spain was the first modern nation-state, the first modern global power, and ruled Europe, the Americas and parts of Africa and Asia for nearly two centuries. Germany, the Netherlands and Belgium, half of Italy, parts of France, parts of Eastern Europe, etc. were ruled from Madrid. Thanks to Spanish efforts, expansionist Islam (which had already conquered most of Central and South-Eastern Europe) was defeated, first at Lepanto (the most important naval battle in that era) and then by land.

    You see, Islamic pirates had been enslaving more than 1 million Europeans at the time and sold them in Northern Africa. That stopped during Spanish rule, while England and others were supporting the (Islamic) Ottoman Empire against Spanish efforts.

    Such a small nation as Spain couldn’t rule the world forever. Anyway, by the time Latin American countries got independent, they were richer than their US neighbours, and citizens in Spanish America had been granted democratic rights, including the right to vote, free trade and autonomy, and Indian (Native American) forced work had been abolished.

    I mean, at the end of the 18th century, the US was not a land of traders, but of fundamentalist farmers. Only 3% of the people in the 13 colonies lived in cities, and these were so small they could hardly be considered cities; meanwhile, in Spanish-American colonies, over 50% of the people lived in cities, a higher rate than in Europe.

    Cities, universities, writing, the wheel, iron works, large farms, shipbuilding yards, etc. were introduced by the Spanish. Looted Peru built more ships than the US in late 18th century, under Spanish rule.

    As soon as the Spanish influence disappeared, Latin America (which had been at peace for over 2 centuries) descended into chaos, civil war, market fragmentation and failure. Not our fault.

  10. Diego Méndez says:

    wintercow20,

    even accounting for private charity, immigrants’ money sent home, etc., the USA ranks behind Spain in foreign aid:

    http://www.cgdev.org/section/initiatives/_active/cdi/_non_flash/

    You may give your blood for free, but not enough people do. That’s why many hospitals have to pay people to get their blood. On organ donation, the Spanish rate is by far the highest in the world, and almost thrice the average for developed nations:

    http://www.rtve.es/noticias/20090110/espana-sigue-lider-mundial-donacion-organos-bate-propio-record-2008/218327.shtml

    When I talk about efficiency, I mean healthcare in Spain is several times cheaper than in the US. Why so? Because hospitals and drug companies don’t spend a third of their budget on marketing, lawsuits (so as to show they don’t have to pay for some treatment), light modifications to soon-to-expire drugs (so insurers have to pay a lot more for the new drug, even if only marginally better), bureaucracy, etc.

    Yes, I said bureaucracy. I was mesmerized to hear Obama pledge $19 billion on electronic medical records. I mean, we have digital records in Spain since a decade now (by the way, we’ll probably sell you the technology, as Spain leads on this field). No patient in living memory has ever filled a form in a Spanish healthcare center.

    You have private insurers in Spain, too. Many people can avoid paying “healthcare taxes” if they pay for their own private insurance. You would think all people with higher-than-average income do. In fact, they don’t, as they get a worse service: healthcare centers are fewer (hence further away), no ambulances, etc. This means if they have an emergency, they still have to pay for the public-service ambulance and possibly hospital, which they would get for free otherwise.

    Why is the private model so succesful in the US, then? Because you have no ambulances in the US. You have vehicles taking the patient to the hospital, and you call them ambulances, but they are not; an ambulance in Europe takes the hospital to the patient, and they have doctors than can perform difficult operations anywhere. It is expensive, but it saves lives; mortality rates fall dramatically with this model.

    Ambulances and a dense (walking-distance) network of healthcare centers make healthcare a natural monopoly.

    Not that the system is not privately managed; in regions such as Madrid, hospitals and ambulances for the public (free) service are mostly privately managed, so there is room for market improvements. But these private companies are paid by society collectively, not by individuals.

    Now, non-essential breast augmentations (not after mastectomy, etc.), psychologists (unlike psychiatrists), some minor mouth problems, etc. are not covered by universal healthcare. THAT would be wasteful.

    On national cohesion, I am afraid you used the reduction ad Hitlerum (Francum, Stalinum, etc.) fallacy. The USA is a young nation, and has never suffered decay. In the Old World, we all know how Constitutions may be overturned, and how one nation can give birth to many. No matter how often you make people pledge their allegiance to the flag (now that’s nationalistic and unthoughtable in Europe), your society will not be stable in the long run if you leave 50 million inhabitants behind.

  11. Diego Méndez says:

    Harry,

    “An old girlfriend from Venezuela taught me a phrase that might be useful in this discussion: “El que sabe, sabe. El que no sabe es empleado publico.” ”

    That surely applies to Venezuela, but I have never heard it in Spain. On the contrary, the Spanish saying goes: “El que sabe, sabe. Y el que no, a empresariales.” (Those who have knowledge, have knowledge. Those who don’t, study business administration). Unlike in the US, lawyers and business-administration graduates in Spain are generally considered losers, while engineers, architects, scientists and doctors are highly valued, even if they get less money (a big IF). Of course, lots of exceptions apply.

  12. wintercow20 says:

    Once again, see the point of the post.

    And to end this food fight:

    (1) An index is not indicative of charitable effort. Read some Arthur Brooks.

    (2) You again demonstrate a complete lack of understanding of the US system, and I am not going to try to teach you when you have no interest or stake in learning (it would crush your preconceived beliefs). I’ll only remind you that overhead, administration and all of the nonsense you cite is a MINISCULE portion of US medical expenditures. And the US model is nothing resembling a private model – you are constructing the world’s largest straw man by refusing to recognize it.
    (3) And regarding the Reductio ad Hitlerum … it is relevant to the point – and one you cleverly ELUDED – what so you of your utilitarian (non)ethic? Ignore Hitler … what about the other nutcases that murdered millions in the name of national pride.
    (4) You have no understanding of “leaving 50 million behind” – READ THE POST – that was the point of it. In no real sense are any of them being left behind – unless your definition of being left behind is “not picking Harry’s pocket enough to pay for something you can afford but refuse to purchase on your own.” I showed you with data. And the other point is that we have socialized programs in place for people that are too poor or too old to take care of themselves. Is that not the point? Oh no say you … not when it would be “more efficient” to do things in the national interest. And by the way, what is “health care” and what is its cost? Once you can answer those unanswerable questions then you might be able to begin comparing health care costs around the world. I have a headache right now, and I spent a total of 25 cents for an Advil and a sip of a coffee … and my headache is gone … that is health care too.

  13. Diego Méndez says:

    (1) This index IS indicative.

    (2) “The US system has considerable administrative overhead, far greater than in nationalized, single-payer systems, such as Canada’s. An oft-cited study by Harvard Medical School and the Canadian Institute for Health Information determined that some 31% of U.S. health care dollars, or more than $1,000 per person per year, went to health care administrative costs, nearly double the administrative overhead in Canada, on a percentage basis.”

    http://www.pnhp.org/publications/nejmadmin.pdf

    And this doesn’t even include other kinds of unuseful spending I cited.

    (3) I have never taken a utilitarian point of view. I just used objective data to show the US spends twice as much as %GDP, while getting worse healthcare than every other advanced country.

    (4) The 50 million uninsured figure excludes people on Medicare and other government insurance. Of course they can always go to an emergency room, but the fact is they can’t get an expensive, long-run treatment without experiencing a financial trauma. If the policies you back were implemented, the number would rise from 50 million (after all, many US states have really socialized medicine) to nearly 100 million every year, or 1 in 3, and other 100 million Americans would be living with the fear that losing ther jobs probably means losing their healthcare. That would put the US in a pre-revolutionary condition.

  14. wintercow20 says:

    Once again, eluding my point.

    To make it clearer … back in 1928 NOBODY in the United States had health insurance, but Herbert Hoover wasn’t campaigning on “giving” it all to the people for free … he was literally campaigning by putting a chicken in every pot.

    Why was there no health care crisis then?

    And your straw man is growing larger … I do not back any “policy” except two: allow me to freely purchase health care services and insurance from people and organizations that are willing to provide it to me – without special privilege for anyone involved. And do not force me to purchase health care services or insurance that I do not wish to purchase.
    And it was your sacred government that led to the insane system of having employer provided insurance (ever hear of price and wage controls?) – convenient for the socialists who now argue that such a “private” system is inefficient.
    But I would expect you to ignore that point too. What say you about the point of the post?
    Tell me, why don’t companies provide me with TV insurance?

  15. skh.pcola says:

    The index that Diego keeps blustering about is based on “% of GDP” numbers. It is not based on nominal values. The reason why Spain appears to be much more charitable is because his socialist dystopia has a GDP 1/10th the size of the US GDP and the US has a per capita income almost 40% higher than Spain’s. (That’s also why Spain spends less on health care.) Also included in his “evidence” is measures for Kyoto ratification and the index gets a boost if a country has higher gas taxes. I gave up looking at the other metrics behind Diego’s “proof,” but added his source to my list of liberal think-tanks that salivate when they envision a world ruled by socialist elites.

  16. Harry says:

    Sorry about the headache and the food fight, Wintercow.

    I confess to being a Blutarsky by taking a shot at Pizarro, but remember that in Animal House it was the guy on the horse that told Flounder to clean the stables.

    “He who knows, knows and he who doesn’t know is a public employee” and “those who know, know, and those who don’t know study business administration” are expressions that lose much cleverness in the translation. Both are revealing.

    I can’t help but be curious about the etymology of the word “empresariales.” The closest English word I ever heard like it was “impressor” which Vermont Royster used in his Christmas Eve editorial, which I look forward to every year. If anyone, including Diego, has not read it, they should.

    With that, I return my cafeteria tray to the pile.

  17. Diego Méndez says:

    skh.pcola,

    the only reasonable way to measure charity is as %GDP. Spain spends half what the US spends in healthcare as %GDP; and nearly four times less what the US spends in nominal per capita terms; yet Spain has better healthcare. Environmental measures have nothing to do with Spain ranking higher in the index, as Spain and the US rank similarly in that area.

    The US has a per capita income 40% higher than Spain’s (which is the EU average). But that is because you count twice as expensive healthcare as twice as big GDP, while all that healthcare red tape is unuseful; you drive to Wal-Mart and things are cheaper than in Europe, but they are not if you discount the gas, which doesn’t enhance the value of the goods you buy, but appears as higher GDP; you have 2 million people in prison and huge spending on weapons and other security measures, while Europe doesn’t and has a fraction of your crime rate, etc.

    These are not my own corrections, but Robert Gordon’s, a professor at Harvard. Here you have a paper where he shows European productivity per hour worked is just 8% lower than US productivity, but Europe must be considered richer than the US if the right corrections are made:

    http://faculty-web.at.northwestern.edu/economics/gordon/355.pdf

    Moreover, higher productivity in the US was centered on financial services (http://www.indexmeasures.com/dc2008/papers/vanark_productivity.pdf). Now we know where that higher productivity came from, don’t we?

  18. Diego Méndez says:

    wintercow20,

    I can see your points. I still think a national public healthcare system, as the one in my country, is both more efficient and fair than the US one.

    I think if you found out some homeless people had work and could go to a nice restaurant once a month and buy clothing, you could make a similar case: they don’t consume more housing just because they don’t want to! Where is the housing crisis?

    Or if you found out some undernourished children had parents consuming more drinking than food for their children, you could say: who is the government to force more food consumption on them?

    The fact is, you have millions of children with no access to healthcare, and millions of working poor with no healthcare, mostly because it is so expensive. If you don’t want a nationalized system, I may understand it (though I think you are wrong), but how will you not provide children and others with healthcare?

  19. Diego Méndez says:

    Harry,

    those expressions (“el que sabe, sabe”) can’t be translated. “Uno que sabe” (someone who knows), “él sí que sabe” (he DOES know), etc. express true admiration to somebody. Not so in English.

    “Empresariales” = “Ciencias Empresariales” (business administration, lit. “entreprenurial sciences”). In Spanish, company = empresa, which is both “enterprise” and “undertaking”. A company holder/manager is an “empresario”. This word has lost his shine, as it brings to mind images of corrupted men, insider trading, stupid company heirs, uncultivated homebuilders, etc.

    The new word for “entrepreneur” is “emprendedor” (undertaker), which has the same etymology as in English. Emprendedores (entrepreneurs), unlike empresarios (company managers/holders), are fully respected.

    People studying business administration (“los de empresariales”), as those studying arts, journalism, law, etc. which are considered “easy” (compared to medicine or engineering) usually end up in badly paid jobs (and that includes lawyers!), while most big-company managers and entrepreneurs come from engineering fields. Again, there are lots of exceptions to this rule.

  20. wintercow20 says:

    I believe you are still ignoring my point. Nonetheless, it is horrifying that you find it “wrong” for me to believe that it is immoral for you to take a gun, point it at me, and force me to provide goods and services to others. And I am not rich by any stretch (so don’t go starting that food fight either). The further point is that you simply are not understanding the problem with US healthcare – it IS socialized healthcare gone horribly wrong. And if you want evidence of how well it can work in the US, study the case of Maine’s “universal health care” program, then study Tennessee, then study Oregon, then study the unfolding disaster in Massachusetts … how many data points does it take?
    When you cloak something in corporatist clothes, that does not entitle you to call it free market.
    And again, to claim that millions of Americans are dying in the streets due to lack of access to (what you never define) health care is pure sophistry.
    Come for a visit – and I will welcome you to my home at no charge.

  21. Diego Méndez says:

    wintercow20,

    do you feel the government is pointing a gun at you when you have to pay for the U.S. Army and Navy, the FBI, the CIA, state police, fire departments, Tamilflu vaccines just in case there is an epidemic, etc.? What about public schools and publicly financed research at private universities? Do you advocate for the abolition of the State?

    If you think about it, the FBI means a redistribution of wealth from those who can pay for private security to those who can’t. But if you think a little longer, you’ll understand it is cheaper for (almost) everybody, fairer and more efficient to have a public, universal FBI. The same just happens with healthcare; and I don’t care healthcare in Massachussets has big financial problems, I know it works perfectly in Europe, so it can be done there.

    By the way, thank you for your invitation 🙂 Not a good time for international travel, though.

  22. Harry says:

    [Picking up a plate of chocolate pudding and throwing it at Niedermeyer] …

    Thank you for help with the word “empresa” Sr. Mendez.
    Now that I think of it, in English we have the word impresario, often used to refer to someone in the entertainment business, like P.T. Barnum, or Rick’s Cafe American.

    What I was asking about was how those words evolved from their Latin roots since around 50 B.C. Imperator and impressor were clearly understood back then.

    I was trying to focus on Wintercow’s question which was about socialized medicine, which our present-day imperator seeks to impose, and wishes his impressors to collect our money to pay for it. You may be surprised to know that I am not one of the “rich” (defined as a marital spouse filing jointly), but I fear the impressors and the imperator.

    Perhaps part of the problem, Diego, is thinking of entrepreneurs as undertakers. It’s good to see you are hanging out with a better crowd now.

  23. Diego Méndez says:

    Oops… I just discovered undertaker means mortician! “Emprendedor” means undertaker in the sense of someone who undertakes a difficult task, sets sail to far-away waters, etc. Colon’s (Columbus’) voyage was at his time referred to as an “empresa” (undertaking). Sorry!

  24. Harry says:

    Diego, thanks for the comment, and I’m glad to learn Columbus was an emprendedor. Wintercow will be relieved that on this point we are speaking the same language.

    For your information, I discovered on this website that Wintercow has posted a huge amount of suggested reading for his students, and among that library are the writings of Frederic Bastiat.

    One volume, Selected Essays in Political Economy, sits in a bookshelf about two meters from this keyboard. The other volume, Economic Sophisms, has been missing for about six months, and I went into a panic when I discovered this website. (I think I may have lent it to my daughter.)

    I think you would find these books enlightening. I’ve been picking them up for over thirty years now, and each time I gain more insight about the way the world works. I’m not suggesting one should read Bastiat uncritically, and he no doubt never regarded himself a fountain of truth.

    I wish I were fluent enough to read Bastiat in the original French, but I hope you will find the English version fun. Bastiat, in my opinion, was a fan of emprendendores, and not much of a fan of empleados publicos, especially the ones who want to make everything more expensive.

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