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I read Nicholas Kristof’s column in The New York Times today, and he called out one Republican, Sen. Richard Shelby (R-Ala.), who last June said that the United States has “the best health care system in the world.”  But who else in the party has made that claim?  Turns out a lot of them have.  Here are a few quotes:

Representative Mike Pence (R-IA), ”And ‘we the people’ have the ability to protect the finest health care system this world has ever known and demand real health care reform that will reduce the cost of health care without growing government.”

Senator Tom Coburn (R-OK), ”America’s health care system has a lot of problems, there is no question, and we ought to be addressing those problems.  But, don’t forget it’s the best health care system in the World.“

Rep. Paul Ryan (R-WI), “There’s a better way to reform the best health care system in the world.“

Rep. John Boehner (R-OH), “Democrats and Republicans understand that we do have the best health care system in the world.“

Rudy Giuliani (R-former NYC Mayor), ”The reality is that, with all of its infirmities and difficulties, we have the best health care system in the world.  And it may be because we have a system that still is, if not wholly, at least in large part still private.”

Rush Limbaugh (R – Disinfotainer), “Well, you don’t have to convince me.  I think it’s the best health care system in the world.  We never hear anything good about it from the leaders of the Democrat Party.”

They all said it and they are all wrong.  Why do they keep saying it?  Because for them -  wealthy people  –  there’s no problem.  They get all the health care they need from the best doctors.  They are privileged and they’re covered, and the current system works great for them, so there’s no problem.  They want to believe we have the best system because they can’t believe that they would participate in anything but the best system.

Kristof throws out a few inconvenient truths about our health care system that say otherwise:

The United States ranks 31st in life expectancy (tied with Kuwait and Chile)

We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality.

Canadians live longer than Americans do after kidney transplants and after dialysis, and that may be typical of cross-border differences.  One review examined 10 studies of how the American and Canadian systems dealt with various medical issues.  The United States did better in two, Canada did better in five and in three they were similar or it was difficult to determine.

[In a study of how] well 19 developed countries succeeded in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled. What Senator Shelby called “the best health care system” ranked in last place.

…in the United States, 90 percent of hernia surgery is performed on an outpatient basis. In Britain, only 40 percent is, according to a report by the McKinsey Global Institute.

Americans take 10 percent fewer drugs than citizens in other countries — but pay 118 percent more per pill that they do take, McKinsey said.

Kristof closed with this point that blows apart the Republican argument that a government healthcare  plan will destroy the best health care system in the world.

…there is one American health statistic that is strikingly above average: life expectancy for Americans who have already reached the age of 65.  At that point, they can expect to live longer than the average in industrialized countries.  That’s because Americans above age 65 actually have universal health care coverage: Medicare.  Suddenly, a diverse population with pockets of poverty is no longer such a drawback.

Here is the World Health Organization’s 2000 ranking of of health care systems in all countries around the world: 

Rank       Country 

1         France (and they make great wine too)
2         Italy (they also make great wine)
3         San Marino
4         Andorra
5         Malta
6         Singapore
7         Spain (some good wines from here)
8         Oman
9         Austria (really good reislings)
10        Japan
11        Norway
12        Portugal (port!)
13        Monaco
14        Greece (wine is not so good)
15        Iceland
16        Luxembourg
17        Netherlands
18        United  Kingdom
19        Ireland
20        Switzerland
21        Belgium
22        Colombia
23        Sweden
24        Cyprus
25        Germany (fine white wines)
26        Saudi Arabia
27        United  Arab  Emirates
28        Israel
29        Morocco
30        Canada (beer)
31        Finland
32        Australia (shiraz)
33        Chile
34        Denmark
35        Dominica
36        Costa Rica (damn good coffee)
37        United States of America (But they make really great wine)
38        Slovenia
39        Cuba
40        Brunei
41        New Zealand (but they make really greate wine)
42        Bahrain
43        Croatia
44        Qatar
45        Kuwait
46        Barbados
47        Thailand
48        Czech Republic
49        Malaysia
50        Poland
51        Dominican Republic
52        Tunisia
53        Jamaica (damn good weed)
54        Venezuela
55        Albania
56        Seychelles
57        Paraguay
58        South     Korea
59        Senegal
60        Philippines
61        Mexico
62        Slovakia
63        Egypt
64        Kazakhstan
65        Uruguay
66        Hungary
67        Trinidad and Tobago
68        Saint     Lucia
69        Belize
70        Turkey
71        Nicaragua
72        Belarus
73        Lithuania
74        Saint Vincent  and the   Grenadines
75        Argentina
76        Sri  Lanka
77        Estonia
78        Guatemala
79        Ukraine
80        Solomon   Islands
81        Algeria
82        Palau
83        Jordan
84        Mauritius
85        Grenada
86        Antigua   and Barbuda
87        Libya
88        Bangladesh
89        Macedonia
90        Bosnia-Herzegovina
91        Lebanon
92        Indonesia (they grow some awesome coffee)
93        Iran
94        Bahamas
95        Panama
96        Fiji
97        Benin
98        Nauru
99        Romania
100       Saint Kitts and Nevis
101       Moldova
102       Bulgaria
103       Iraq (boom)
104       Armenia
105       Latvia
106       Yugoslavia
107       Cook Islands
108       Syria
109       Azerbaijan
110       Suriname
111       Ecuador
112       India
113       Cape Verde
114       Georgia
115       El   Salvador
116       Tonga
117       Uzbekistan
118       Comoros
119       Samoa
120       Yemen
121       Niue
122       Pakistan
123       Micronesia
124       Bhutan
125       Brazil
126       Bolivia
127       Vanuatu
128       Guyana
129       Peru
130       Russia
131       Honduras
132       Burkina   Faso
133       Sao Tome and Principe
134       Sudan
135       Ghana
136       Tuvalu
137       Ivory Coast
138       Haiti
139       Gabon
140       Kenya
141       Marshall Islands
142       Kiribati
143       Burundi
144       China
145       Mongolia
146       Gambia
147       Maldives
148       Papua New Guinea
149       Uganda
150       Nepal
151       Kyrgystan
152       Togo
153       Turkmenistan
154       Tajikistan
155       Zimbabwe
156       Tanzania
157       Djibouti
158       Eritrea
159       Madagascar
160       Vietnam
161       Guinea
162       Mauritania
163       Mali
164       Cameroon
165       Laos
166       Congo
167       North Korea
168       Namibia
169       Botswana
170       Niger
171       Equatorial Guinea
172       Rwanda
173       Afghanistan (boom boom)
174       Cambodia
175       South     Africa
176       Guinea-Bissau
177       Swaziland
178       Chad
179       Somalia
180       Ethiopia
181       Angola
182       Zambia
183       Lesotho
184       Mozambique
185       Malawi
186       Liberia
187       Nigeria
188       Democratic Republic of   the Congo
189       Central   African   Republic
190       Myanmar

The problems of America’s dysfunctional healthcare system are, by now, well known: we spend more on ours as a percentage of economic output than any other industrialized country, yet often produce inferior results; the system is so inefficient and wasteful that we are unable to control rising costs; and despite the resources we devote to healthcare, the system fails to cover a significant proportion of the population.
 
Missing from much of the debate, however, and a key reason why reform is so urgent is the plight of the underinsured.  Ironically, many of the 80% of Americans who have voiced satisfaction with their healthcare insurance are in this group, unaware as they are that they would be on the hook for thousands of dollars in out-of-pocket expenses in the event that they needed major surgery.  Statistically, ill health is a leading cause of bankruptcy filings in the United States; and the majority of those individuals actually had medical insurance – at least at the beginning of their health problems.
 
Ignoramuses on the right love to pontificate about the presumed failings of the Canadian and British nationalized healthcare systems such as “rationing” (as if the US system doesn’t ration and in a far more irrational manner than those managed systems) and wait-times for relatively minor surgeries; however, no Canadian or Briton will ever go bankrupt or even into debt because of his medical bills.  In fact he wouldn’t pay a penny.  
 
Much has been made of the fight over a “public option” supported by President Obama and many Democrats in Congress but opposed by the health insurance industry and the American Medical Association.  Personally, I support a public plan but not if it becomes a deal-breaker.  Rather, the idea could be placed on a shelf and used as a future option to be triggered automatically if the private insurance industry fails to perform within acceptable cost and coverage parameters.  The ‘Economist’ newsmagazine echoed this idea in a recent article on the subject and reminded us that there are several European models for a private healthcare system but with stiff government mandates.
 
Whatever the shape of the reform that finally emerges from Congress, it must cover the uninsured and include a mandate for everyone to buy insurance; it must be designed to contain costs (in part by reversing current incentives for doctors and hospitals to perform unnecessary services and procedures); and it absolutely must ensure that insurance plans, at a minimum, cover 100% of the cost of critical surgery and hospitalization. 
 
Anything short of this will mean that Americans as a whole will still be worse off than their Canadian friends to the north – no matter what Rush Limbaugh or Senate Minority Leader Mitch McConnell may say.

They aren’t like Republicans.  They would benefit from being more like them in some ways.  This Modern World explains:

And so did Jon Stewart about four minutes into this segment form Monday’s show:

“Mr. President, I can’t tell if you’re a Jedi ten steps ahead of everything or if this this whole health-care thing is kicking your ass just a little bit.  Why is this so hard?  Why can’t you guys just stay on message?  Remember the Bush team?  Little bit of discipline.  Little bit of repetition.  They sold us a war nobody wanted and nobody needed.”

From The New York Times:

Given hardening Republican opposition to Congressional health care proposals, Democrats now say they see little chance of the minority’s cooperation in approving any overhaul, and are increasingly focused on drawing support for a final plan from within their own ranks.

The White House spokesman, Robert Gibbs, said of Republican lawmakers, “Only a handful seem interested in the type of comprehensive reform that so many people believe is necessary to ensure the principles and the goals that the president has laid out.”

Duh!

How many months did it take the Democrats to figure out that there is no common ground?  How many months has Obama been in office?  Seven.  I think that’s the right answer:  seven.  Seven months wasted trying to be nice to a party that has shown from day one that all they intend to do is play the obstruction card until the day they die.  And die they will.  Obama could have hastened their death by instructing Pelosi and Reid to move forward with the Democratic agenda the people voted for in overwhelming numbers last November, but instead he tried being nice – for way too long.

Forget about the Republicans.  They are nothing but a bunch of xenophobic dinosaurs.  What they need is a fireball from Heaven (or Hell, I don’t care) to incinerate them and put them out of their misery.  Let’s hope that this signal from the Democrats, that they will move forward without Republican concensus, is a sign of things to come -  a Democratic fireball (I know… Democrat and fireball, an oxymoron).  But the point is, it’s better to work with the dissenting Blue Dogs in their own party to get the 60 votes they need to push through a filibuster-proof bill than to try and pick up votes from the obstructionists.

And while I’m on the topic of filibusters, why is it that Democrats think that every bill they want to push through has to be filibuster proof?  Last I heard, Congress can pass a bill with a simple majority.  Sure this health-care legislation is a big deal, and a filibuster-proof majority may very well be what it takes.  But every bill?  I don’t think so.  Let the Republicans filibuster.  Let them be on record as being obstructionists when the votes are lined up 59-41 in favor of a Democratic bill that has overwhelming public support.  Let them do it!  Let’s see how many times they do that before the mid-term elections and then see how that builds their ranks.

So Democrats, take the wheel of this new car built on Hope and Change and steer us in the direction we want to go.  Leave the dinosaurs behind in their outdated greed mobiles.  The few Republicans who wake up and decide they want to follow can catch a ride in a Prius cab.

This week Obama led a Town Hall meeting to discuss healthcare reform.  The forum was open to those in favor and those opposed.  Here’s the story as printed in The Seattle Times.

PORTSMOUTH, N.H. — Fans and foes of President Obama’s push to overhaul health care descended on a high school here on Tuesday to challenge him and hear him fight back against the criticisms — some outlandish — that have slowed the legislation’s progress.

“Parasites!” yelled the protesters on the right side of the school driveway.

“Ignorants!” yelled the protesters on the left side.

While apparently failing to convert the people outside who protested from the right side of the driveway, Obama sought to reassure the people gathered inside the school gymnasium that health-care reform does not mean that Americans will lose coverage or surrender treatment decisions to the government.

“Where we do disagree, let’s disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that has actually been proposed,” Obama told the meeting of about 1,800 people.

…

Unlike many of Obama’s town-hall-style meetings, usually filled to the rafters with supporters, Tuesday’s meeting included skeptics from whom he sought out questions.  At one point he asked that only people who disagreed with his approach raise their hand to be called on.

You know who he was talking about, the Queen of the Lunatic Fringe, Ms. Sarah ”Stop Making Things Up” Palin.  (See below for more on that.)   

What struck me about that opening of that article was that ”fans and foes” were both welcome. 

Remember four years ago when Bush was appearing at Town Hall meetings to push for Social Security reform?  Foes weren’t allowed in to the meetings.  People who disagreed were screened out, and if any managed to sneak in, they were kicked out.  Here’s an excerpt from a March 2005 Washington Post story:

Three Denver residents yesterday charged that they were forcibly removed from one of President Bush’s town meetings on Social Security because they displayed a bumper sticker on their car condemning the administration’s Middle East policies.

The three, all self-described progressives who oppose Bush’s Social Security plan, said an unidentified official at an event in Denver last week forced them to leave before the president started to speak, even though they had done nothing disruptive, said their attorney, Dan Recht.

…

This is not the first time people have complained about heavy-handed monitoring of who can attend — and speak at — Bush’s events promoting his Social Security plan. A newspaper in Fargo, N.D., reported that when Bush came to the city on Feb. 3, more than 40 residents were barred from attending the event.

The president has held Social Security rallies in more than a dozen states this year. The crowds are closely monitored for possible disruptions, and protesters are quickly escorted away.

Protesters often stand out because the crowds are packed with Bush supporters, who have been invited by a local GOP House member or organization. Those onstage at most of the town hall meetings are carefully screened people from the area who agree with the president’s Social Security proposal. The participants typically rehearse what they will say with members of the president’s advance team and rarely, if ever, say anything critical about his plan for private accounts.

Yes, I remember… Bush was banking on some political capital that he said he won in the 2004 election to push through his plan to destroy Social Security, but he wasn’t going to waste any of his capital on people who disagreed with him.  Best to keep them away.  They might have asked him an intelligent question that he wasn’t prepared to answer.  Wouldn’t want to look stupid or anything…

Speaking of the Lunatic Fringe, here’s a recent quote from the Queen Mother of the wingnuts, Former Governor (read “Quitter”) Sarah Palin:

“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care.  Such a system is downright evil.”

Laura Harrison McBride wrote the following about Palin’s crazy talk:

• An end-of-life decision is not the same thing as an “ending life” decision.  The former refers to a decision  made by an individual at the end of that individual’s life, and commonly includes such matters as which grandchild gets the gold-rimmed teacups and where one wants to be buried.
• An “ending life” decision (death panel), on the other hand, would be a decision made about the individual by another party…a relative, a government, a jury of one’s peers and so on.

It isn’t awfully surprising that Palin would mix up the meanings of these two terms.  She joins a long list of other ignorant conservatives who willfully and purposely misuse language to pull the wool over the eyes of others, most notably their own followers since the rest of humanity seems able to see through it.

That’s an excellent response, but I kind of like throwing Palin’s own words right back at her, like this quote from her resignation speech:

“So how about in honor of the American solider you quit making things up?”

Yes, why don’t you Sarah?  Don’t you know you are letting our soldiers down with your batshit crazy talk?

For a quick summary of all the crazy talk coming from the stars of the Lunatic Fringe and their equally impassioned but uninformed devoted followers, go to Salon.com and read this week’s edition of This Modern World.

The quote of the day comes from Charle’s M. Blow’s column, “Health Care Hullabaloo,” about how Republicans, though seriously misinformed, are very passionate about the debate and have taken it over by shouting down their congressmen at Town Hall meetings.

The quote:  “Belligerence is the currency of the intellectually bankrupt.”

Read the whole column here.

For more stories about the shout downs, go here.

And that’s a good thing, says Paul Krugman, because without government involvement the U.S. healthcare system would be way worse than it is now. 

Excerpts from “Health Care Realities:”

It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.

And that government involvement is the only reason our system works at all.

..

Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.

Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.

Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.

And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.

This is no surprise to anyone at all familiar with the business, because it’s a business and and insurance companies exist not to take care of everyone, but to make a profit.  Sick people are not profitable.

These are the guys that Ben Stein hangs out with at the end of the Health Care Status Quo path.

Tom Tomorrow always gets it right, so go read the whole strip.