Hillary’s Done, But Universal Health Care Proposals Live On
Seldom does the Canadian medical system act in such a heavy-handed manner. But this impulse to manage costs and ration treatment, whatever the cost in human suffering, reveals itself in slightly less obvious ways everywhere. Bill Murray is a resident of Alberta, Canada’s wealthiest province which has an affluent government. When he was advised to have surgery on his hip due to severe joint pain, the health ministry declined to provide it, saying that Murray was too old to benefit from the surgery. Murray was 57 at the time. Murray was able to pay privately for the surgery, an option that is legally foreclosed to most Canadians and that was later also denied to him. When he needed the same surgery on his other hip, he was unable to obtain treatment publicly or privately in Alberta and had to travel to Montreal for medical care. Murray is at the tip of the Baby Boom generation, a group that will no doubt be surprised to learn that it is too old to benefit from medical treatment for such commonplace problems as arthritis and joint pain.
Despite the commitment to equality professed by proponents of socialized medicine in Canada, Canadians receive very different levels of care depending upon their province of residence. Avastin — a cancer-fighting drug that shrinks tumors, extends life expectancy and improves quality of life for colon, breast, and lung cancer victims — is considered the standard of care in every G8 country except Canada. British Columbia, a reasonably well-off province, as well as Quebec and Newfoundland (much less prosperous), provide the drug to their residents. Elsewhere, patients must lobby on an individual basis for Avastin, and few are successful. Even those who persuade their health ministries to provide them with this therapy face a delay while they make their appeal, despite the time-sensitive nature of malignant cancers.
Even when necessary treatment is theoretically provided, waiting lists can expose patients to unnecessarily high risks of disability and death, as Shona Holmes found out. After a variety of distressing symptoms including vision loss were traced to a brain tumor, Holmes faced waiting lists of several months before meeting with a specialist. She then had another wait before receiving treatment. Unwilling to lose her sight, she traveled to the Mayo Clinic in the U.S., where she was told that if the tumor were not removed immediately, she risked permanent blindness and possibly death. Even with these test results and diagnosis, Ontario’s public health insurer was incapable of shortening wait times for Holmes. She ended up paying for her own neurosurgery in the U.S., which led to a complete recovery and a hefty bill that the Ontario government refuses to pay, despite their inability to provide Holmes with necessary care — and their duty of care toward her.
All of these examples reflect a command economy gone awry. One of the clearest lessons of the 20th century was the futility of letting bureaucrats control and predict supply and demand. Despite this, the Canadian government — at the federal, provincial and regional levels — dictates the number of places at medical schools, the price of medical treatments, the number of procedures that may be carried out per facility, and which drugs may be prescribed (beyond simply monitoring their safety and effectiveness). Other countries with publicly provided healthcare show similar ignorance of markets, most famously Britain’s NHS. Unique to Canada among developed countries is the paternalistic abolition of private healthcare. Having decided that state-provided care is the best way to meet the healthcare needs of Canadians, the government of Canada has prohibited the private provision of medically necessary services.
The cases discussed above are not exceptional. Many Canadians find themselves refused the care they need, whether because waiting lists are too long, their therapy is not considered necessary by a public administrator, or they themselves are not a high enough priority. Some can afford to travel to the U.S. or elsewhere to obtain the care they need, but the rest are without recourse. Ironically, elective medical care, paid for by consumers directly or by private insurers, is easy to arrange. Cosmetic surgery, corrective eye surgery, dental, and chiropractic care are available everywhere and become more affordable with each passing year. It is only those services considered necessary to health and life that are controlled and rationed by the government. There are loopholes. Some cancer treatments can be purchased privately (for tens of thousands of dollars) for patients denied it by their government, and residents of one province can sometimes travel to another region in Canada and pay for their own treatment there. However, since there is no private health insurance in Canada, such options are available only to the wealthy. Meanwhile, the fundamental unfairness of forcing everyone to pay for an unwieldy, inefficient universal system that does not provide necessary care to all Canadians goes unaddressed.
It is understandable that many Americans want healthcare reform. The “Great American Side Effect,” as one European researcher describes the coupling of health insurance with employment, has created distortions in the market for healthcare and health insurance that take a heavy toll on the self-employed, unemployed, and those with existing conditions. But single-payer universal healthcare will solve nothing — and will only lead to cases like those of Golubchuk, Murray, and Holmes.
Good article Rebecca. You’re echoing the sentiments of most of us who see socialist medical welfare programs as, simply put, evil. When you write “All of these examples reflect a command economy gone awry”, it’s clear you’re starting to see the bigger picture, but you’re not thinking outside the box just yet – few, if any are – and it’s no mystery why. Those driving the narrative around the “health care crisis” steer the discussion away from the crux of the matter at every opportunity.
There are obvious reasons for them to do this.
Hillary, et al., know that once the People put the state in control of their health care, everything else will fall into line – at least from the standpoint of a government which seeks ever more control over the People it purports to serve. As I’ve noted elsewhere – with tyrants it is ever thus.
Once the feds become the guarantor of the public’s health care, they become the de facto guarantor of the public’s health. Thinking this through leads to some obvious, truly ominous outcomes. We’re already seeing how this will play out in the successful legislation banning trans fats, restricting zoning regarding locally-owned fast food franchises, onerous anti-smoking laws, seat belt laws and other invasive laws that we already have.
This pattern is a clear precedent for all the additional we-know-what’s-best-for-you laws that can be “justified” once the state can claim “you’ll cost society too much” if you don’t do-what-we-know-is-best-for-you. Combine this with the laws we’ll soon be seeing that restrict our day-to-day freedoms for the sake of creating and maintaining a “green” society, and you’ll get a very real glimpse of how liberty dies.
But about that box. And thinking outside it. As always, history is our friend.
What’s most frustrating about the arguments for and against socialist medical welfare is that none of these arguments ever look back and acknowledge the fact that, at one time not that very long ago, everyone paid for their day-to-day health care out-of-pocket. Far less frequent, but more expensive health care costs – like major surgery – were paid for by individuals through short- and/or long-term borrowing. And the least frequent, but most devastating costs had the very real possibility of financially destroying a person’s future.
This last possibility led to the very beneficial innovation of catastrophic health care insurance.
During this far more reasonable time, there was a magical mechanism that kept all the other health care costs – those day-to-day and even most ‘expensive’ health care – basically in line with people’s ability to pay. It was the same magical mechanism, in fact, that kept all other necessities of life – food, housing, transportation, clothing, etc. – basically in line with people’s ability to pay. That magical mechanism was commodity economics. Simply put, prices could only rise to the point where consumers stopped paying for them – either out of an unwillingness to be overcharged or a simple inability to afford them.
Where things started to go downhill, leading to the utterly broken system we have today, was when the AMA, Blue Cross & Blue Shield invented comprehensive health care insurance.
Ironically, AMA/BC/BS came up with this comprehensive coverage – at least ostensibly and in part – in an effort to stave off the socialist medical welfare system that was being considered by the feds throughout that time. Why the irony? Because the comprehensive coverage system they created is the root cause of the “health care crisis” that is now leading people to seriously consider handing complete control of their health care over to a bunch of bozos – the U.S. Congress – who they wouldn’t trust to borrow their car.
Also, as you’ve correctly alluded to, this new type of coverage was coupled with employment in a very socially and economically unhealthy manner. Coverage through employment is now so universally pervasive that comprehensive health care coverage is now viewed as an entitlement by most Americans.
And just so. Massachusetts passed legislation two years ago that achieved that very thing: health care coverage is now a statutory mandate, and employers are fined if they don’t provide this “benefit”. Worse yet, individuals are fined if they don’t purchase health care insurance themselves. This is nothing less than enforced participation in a lateral Ponzi scheme.
But how did it get so bad? How did things get this twisted? The answer is simple: remember those commodity economics that controlled almost ALL of the costs of health care? They are gone. Where’d they go? They evaporated into the complex bowels of the comprehensive health care insurance companies… never to be seen again (as long as those companies exist).
I’ve been looking at this for years, talking to others about it, etc., and I remain convinced that the way out of this crisis is NOT to hand a completely broken system over to an almost completely broken government bureaucracy. The way out is to go BACK through the bowels of the insurance companies, BACK to something that is closer to what we had BEFORE they destroyed the controls that have allowed ALL health care costs to skyrocket at rates many times those of inflation.
For an extensive discussion of this alternative, please go here. It’s my very firm belief that if we’re willing to take the suicidal approach of turning health care over to the government, we should look at other options first. One set of options that is no less radical but happily nowhere near as suicidal would involve the following steps:
* Eliminate the so-called “comprehensive” commodity health insurance plans entirely. Legislate them away over a period of 7 years. Keep only catastrophic plans for those who feel the need for them. Administer these as catastrophic group plans through local municipalities (i.e., the same entity where you or your landlord already pay property taxes), NOT through employers.
* Revert 95% of all monies that were paid by employers to health insurance companies back to employees. Everyone enrolled in a health care plan at work gets an instant annual raise of from $4,000 to $16,000 per employee / family, or more, depending on the cost of the plan they’re in.
* Direct the remaining 5% into a state (not federal) level fund that’s distributed to health care providers to recoup costs of providing care to those unable to pay, based on the facility’s need and inversely proportional to the tax breaks they may already be getting in their municipality (tax freeloaders like Yale-New Haven Hospital spring to mind). This contribution has a permanent 5% cap.
* Legislate away direct-to-consumer marketing of prescription drugs (just like we did with cigarettes). This will save big pharmas billion$ per year in advertising fees, which will facilitate lower-cost drugs. Also, the demand for these drugs will no longer be artificially inflated far beyond the actual medical need. Ultimately, with the number of deaths each year attributable to mishandling of prescription meds, we can make the same argument here that we did for the elimination of direct-to-consumer cigarette ads.
* Let the resulting free market economics of direct-to-consumer commodity goods and services force the cost of day-to-day health care, equipment and pharmaceuticals back to a more reasonable equilibrium through profit reduction, cost cutting, salary reduction, firing slackers and efficiency improvements.
In looking at some of the original causes for the increases in commodity health care cost – education, government regulation, malpractice insurance – to the above I would add the following:
* Instead of taxpayer-funded subsidies that essentially ignore the cause of exorbitant health care costs, covering that cost no matter how high it goes – subsidize any aspects of providing medical care that force the costs up in the first place! This would include generous tax deductions for malpractice insurance expenses (and concomitant tort reform), the elimination of fees for government licensing, tax deductions and subsidies for medical research, etc.
Just a few thoughts to hopefully break us out of the box.
As an American who has lived in Canada for the past 20 years, it always strikes me that Canadians much prefer their healthcare system. What is grossly underreported is how many Canadian doctors are RETURNING to work in Canada and how few want to move there after finishing med school (I know this first-hand). Why do you think?
I’m reminded of an article I read yesterday that mentioned a 24-year-old English woman dying of cervical cancer because the NHS told her she was “too young” to need a pap smear. I’m a 24-year-old woman, and I was lucky: My cervical cancer formed a tumor that I found one day while moving furniture. But whenever some bureaucrat decides when someone is too old or too young for a procedure, you have a problem. Illness generally doesn’t care how old you are. It’s disturbingly arbitrary. We don’t need to add some suit’s arbitrary decision on top of it.
This issue worries me as well. I find Michael Rosenberg’s comment interesting. Of course, you never know how good your medical system is until you need it. But many Canadians seem content.
Still, I wonder if Sen Kennedy would be with us today if he lived in Canada? Would they spend scarce medical dollars on an elderly person with a history of overuse of alcohol? Or retain the money for other cases and let Kennedy die?
And I’ve read reports of Canadian politicoes who zoomed to the US for treatment even though it is forbidden by Canadian law (perhaps Brenda Stronach (sp) is one?).
And what happens if gov’t medicine refuses to help you because you smoke or eat trans-fats or are overweight, etc? What recourse will you have when the private sector is shut down?
I’ve been in lines at the Post Office, Employment Dept and Dept of Motor Vehicles. Government agencies are not always people friendly, to say the least.
The reason I so loathe Liberals is that they seek to deny all of us the freedom to make our own choices about how we live ourt lives. The only “freedom of choice” they believe in is the freedom to abort their children. They don’t support my freedom to choose and pay for my own health care. What they support is stealing even more of my tax dollars to hook even more Americans on Big Government to perpetuate their power indefinitely. This reduces the taxpaying public to serfdom, we work for the state so the state can redistribute our earnings to those that have not earned them. “From each according to his ability to each according to his needs” is what Marx said and it is a philosophy embraced by the Democrat/socialist party. Why do so many people continue to believe that 535 representatives in Congress and millions of unelected bureaucrats, whose mission seems to be to regulate anything and everything, are capable of running the US economy better than the hundreds of millions of individual citizens and tens of thousands of businesses? Government is NOT NOT NOT the answer.
How long must we continue to subsidize poverty before the socialists in teh Democrat party realize that when you subsidize something you get more of it? The War on Poverty is in fact a Was For Poverty as it has created more poor than it has eliminated.
I am an American in the medical field and spent a good hour last night trying to explain to my high school senior son why hospitals, as he put it, charge “$50 for an Advil”. (A school topin evidently about which he must present tomorrow).
This was a frustrating task for both of us as understanding the economic system we have created is a far more difficult task than explaing the root causes and mechanisms of poorly understood, yet much studied, diseases such as Lupus or Schizophrenia.
The above post by “goy” outlines very well the history of how this evolved (leaving the Rx portion out, I prefer diagnostics anyway) so I wont go back over that.
We should appreciate however that a financial boom was created by comprehensive insurance which drove advances in medical technology and availability. The demand by workers to include such insurance as a condition of employment is a pure market force. The problem, as goy points out, is that such insurance has become mandated by government in some cases.
As a response in the past few decades, insurance companies tie in their fee payments to a perecent of our own socialized medical system – Medicare. It has become the benchmark against which individual groups or mega-hospital corporations must compete.
For example, it is common for the Anesthesia group of hospital X to learn that they are getting “80% of medicare” from a certain major insurer wheras the group in the next nearest hospital are getting 120%. The negotiations go from there and it sounds like capitalism but it is not, since the benchmark is what the Government is willing to pay – not the consumer.
We have played out that boom now. Hospitals and doctors face declining revenue in the face of increased demand. The demand is driven by a technology funded by something far more complex than the classic “price of a box of corn flakes” scenario.
As a result the medical mega-corps (non-profit or not, what a joke) do what they do best. Increase market share and the revenue will follow.
There is upside in this. In such a tight environment the concept of ‘value added’ services becomes more important. The tension between “Do it faster and do it well” becomes very real and there is less room for slack in the line.
The downside is that more total non-payers means the rest have to pick up the didfference in $50 Advils or face the possibility of a very different medical system than what we have now.
Spindok
In Canada fully 43% of annual gov’t budgets are allocated just to health care and it is growing. Here in Canada it is nearly blasphemous to consider any “private” health care options despite the “universal” health care system being ready to implode.
That is correct 43% of governments annual budget and growing. Pathetic that operating rooms at hospitals sit empty 16 hours daily because potential private surgeries are not allowed to take place.
In Canada, we are conditioned to gauge health care by the amount of gov’t money spent rather than measuring results or outcomes. We Canadians are led to believe that it is necessary to accept the following:
Hip replacement. average wait 24 wks
Knee replace. ave wait 33 wks
Cataract surg. <50% receive surgery w/in 16 wks.
Surgery wait times (after you have been okayed for surgery) for:
Colon cancer 26 days
breast cancer 29 days
uterus cancer 46 days and
prostate cancer 87 days
Canadians are stubborn socialists in that we cling to our health care model. Only Cuba and North Korea and Canada have a strict gov’t controlled health care system. All others including the #1 ranked health system in France, rely on a combo private/public model. When wait times in the “public” system reach a limit, you automatically are switched to a private provider AT the public system’s expense. How refreshing!
In Canada we don’t manage health care …we manage wait times. Be polite we’re Canadian. How depressing. And unfair.
@Johnny Canuck
After the wait, it the quality there? Excluding the time are Canadians getting value for their tax dollar? I live in Michigan and friends from Ontario have basically said they were happy with the system.
Et voila! I, an American, live in France. I agree with mostly everyone here except the Michael rosenberg guy…hey I know that in Canada they won’t say this to you but here in france I’ve heard it, at the dentist for instance, Americans always have really nice teeth, they’re bettter cared for. Preventitive dentistry is just starting but no teeth cleaning, nothing but cavity check ups, and they are only required at 9 and 12 years of age… Orthodonitics are ruled more along the lines of goy’s letter, and quite frankly that’s a blessing,because we have our private health coverage which covers that, and my son has needed very serious dental remodeling, i’d never have afforded it in the US…oh and speaking for the self employed, my husband a farmer, is self-employed pays based on his before tax and debt income, whatevere money he brings is used to tally up how much his healthcare costs, based on a percentage, and it is non-negoitable and due every year…something more to maybe think about when you hear free health care…I am taxed as a percentage of my salary, much lower than my husband pays…oh and for a bit more rambling the subject(it’s after midnight here), I quite frankly have heard lots of people have had to come up with under the table sums of money to get a surgeon to operate quickly?food for thought…just please don’t throw the baby out with the bathwater when the US fixes the healthcare issue…I definitely think something should be done to make exculsion on pre-existing conditions illegal for the health insurance companies to practice, it’s all about risk management isn’t insurance?
- In Canada fully 43% of annual gov’t budgets are allocated just to health care and it is growing.
Thanks for the confirmation, Johnny. It will keep on growing. Why? Because health care costs keep increasing. But… why? Because there is no motivation at any point along the line to reduce those costs. Taxes can always be raised. Budgets can always be reallocated. Massachusetts, after only two years, is already seeing an 85% cost overrun on their system.
I’m not wishing anything on you that Canadians haven’t already brought on themselves (with U.S. not far behind), but could you speed up the process please?
It’s inevitable that open-loop health care cost increases are going to bankrupt you so if you wouldn’t mind stepping on the gas, those of use down here in what’s left of Reality would appreciate it. It’ll give us the evidence needed to convince people that they’re LOOKING AT THE WRONG END OF THE CHAIN when they propose socialist medical welfare programs as a “solution” to the high cost of health care.
“Only Cuba and North Korea and Canada have a strict gov’t controlled health care system.”
The UK? There has been talk in recent years of a French-style maximum wait guarantee, but very little evidence of it happening so far – especially here in Scotland
The average wait for a hip replacement on the NHS is 32 weeks, with “most” waiting 44. For knees, it’s a year. Around 50% of cataract patients receive surgery within 6 months. Some wait up to 18. The average is 8. And yes, it swallows up insane amounts of tax money (health and social security – meaning all entitlements, not just old codgers’ – account for about two thirds of the budget).
The American system may not be without its faults, but state provision is not the answer. Comparing it to the Post Office or the DMV may seem jokey, but really, that is what it’s like. I’ve waited 9 hours to be attended to in A&E (ER). But what can you do? Take your business elsewhere? Ask for a refund?
Even here, although it’s almost unsayable thanks to the near-religious status of the NHS among our political class, serious thought is being given to moving towards a more market-based system, as I said above. Our current one simply can’t sustain itself.
How much would our car insurance cost if it covered every automotive expense such as fill-ups, tune-ups, paint jobs, etc.? Clearly, this is absurd but so is the notion that health insurance has to cover just about every imaginable medical expense. There is little or no incentive for private individuals to lower medical expenses because with insurance, “someone else” is paying the bills. And then people complain that health insurance is so expensive.
I lived under government ran health care when I was in the military. If at all possible, I don’t want to go there again. The Democrats keep saying that over 40 million Americans lack health insurance (an inflated number). So, if that’s the case, why no write legislation that addresses those who are uninsured instead of trying to drag everyone into a government ran program? They’ve done a lousy job with Medicare and Medicaid but somehow think they’re capable of handling the health care of over 300 million people? Absurd. Tell you what – make Medicare and Medicaid examples of shining efficiency and quality care. Make them so good that people will look forward to being insured by the government. Once you’ve done that, we can discuss letting you manage health care for everyone.
What an excellent, on the money discussion by Rebecca, goy and everyone. I have what I think is a unique story, in that most Americans don’t see an up close and personal experience with the much vaunted French system, that I’d like to share that makes me fear socialized medicine.
I have a French friend who is, “was” since he can’t practice anymore, a well respected dentist in Boulogne sur mer France. He had a vascular blockage in his left leg that required surgery. The surgery was botched, and required an additional surgery to repair the damage. He was unable to work for several months and was on some sort of full disability.
I visited him during this time and was shocked to learn he was restricted to his home for 20 hours a day by the government. He could go out for two hours in the morning (10:00 to 12:00) and in the afternoon (2:00 to 4:00). A prisoner the rest of the time. I asked him how did “they” check on him, and evidently it’s first a phone call and If you don’t answer “they” can come directly to your home. The consequences if you’re not home? “I would loose ALL my benefits!” That meant his supplemental income as well as his health care.
I had planned to visit the WWll beaches at Normandy and the only way for him to join me, since it was an overnight trip, was to get a permission document from his doctor. We then had to take the permission to the Social Security office to get permission from that agency. As a recreational trip was not justifiable to the government, he fabricated some reason for going other than joining a friend from the States on a holiday. As I sat waiting in his car, literally hiding from any official that might raise questions about a foreigner visiting him, he visited each of the necessary offices. It was probably our intended destination, and thoughts WWll, that brought the Gestapo to mind. What a circle of events that I was just a few hours away from the place that represented the beginning of the freeing of France, and here, in 2005, this Frenchman literally lost his freedom in order to maintain his healthcare benefits.
Such draconian measures clearly show how far wrong social systems can go. As goy so accurately points out, “Hillary, et al., know that once the People put the state in control of their health care, everything else will fall into line – at least from the standpoint of a government which seeks ever more control over the People it purports to serve.”
Oh, by the way, don’t forget the actual name of the Nazi party. “National Socialist German Worker’s Party”.
We have “universal Healthcare” in Canada and people complain meekly because coverage is “free” (paid thru taxes). But 43% of all gov’t expenditures are going to health care and the system is demanding 10% more money every single year. It is unsustainable. People quietly put up with ridiculous wait times first to see specialists, then wait for the surgery for many more months and months. Only basic basic medical is covered now for individual Canadians. More and more medical is quietly becoming user -pay as you go. Blood tests, physio, drugs, eye tests etc etc. We are so programmed about our perfect health system by the paranoid socialist doctrine that we’ve all been fed over the years, that we are paralyzed to change it for fear of the dreaded for-profit takeover. Despite Canada being ranked 30th in most categories by the World Health Org WHO Canadian politicians still tell us that we have the Best Medical system in the world. It would be funny if it were not so sad.
Jim, I can really hardly believe this story. How often does this sort of thing happen, and is it still the policy? What exactly was the government’s justification for keeping him locked up at home? And how long did this go on?
Goy, the story is true in every detail, and the restrictions placed on my friend are as he explained them to me. I wrote this piece because, like you, I found such a loss of freedom unbelievable and I wanted to show how restrictive, and controlling a socialized system can be. I need to also say that I was shocked at his acceptance of his loss of freedom.
To your questions.
I have no knowledge of any other French national being in that particular circumstance, so I can’t speak to how often it happens. He spoke to me about the restrictions as matter of fact, so I must assume it’s pretty standard.
As to justification, I also assume, although I did not ask, that the government is trying to control fraudulent claims. From many previous visits to his home, I have gotten an insight into the French attitude of getting the most from the government. On several occasions he had work done in his home by someone who was on unemployment but working “in the black” to use my friends term. Fraud in unemployment is rampant and I guess it’s the same with medical disabilities.
To my knowledge, he was on this “house arrest” for several months. At least until the Social Security (same term we use) was satisfied he wasn’t faking his condition. The whole situation was not something I felt was polite of me to keep bringing up, so I didn’t. He didn’t tell me about his restriction until I arrived and wanted him to come with me to visit the Normandy beaches.
Thanks Jim. And I’m sorry, I hope I didn’t leave the impression that I was questioning the veracity of your account. The system in France has seemed onerous from what I’ve heard, but I’ve never heard of anything as outrageous as someone being effectively imprisoned in their own home by their own government.
And yes, this – and much more – seems like precisely the sort of thing we can look forward to once the federal government has been “elected” to control our access to health care.
Another interesting little piece of info on our wonderful system up here.Some where between 5 and 6 million Canadians no longer have access to a family doctor.I’m hoping a hell of a lot more Canadian doctors would come back Mr Rosenberg.My own doctor struggles with a caseload of over a 1000.I believe I read not long ago we could use around 25,000 new doctors across this country.
while congress voted themselves free medical coverage, dental, too (only because they need it for close ups on meet the press), it will probably make them as miserable as the canadians and the french. as for the rest of us, we won’t have to pay more taxes to the government, we can just continue to pay it directly to the insurance companies. happily, they do a heck of a job.
To see how unwieldy, inefficient, and problematic socialized medicine can be — just look north to Canada.
And to see how unwieldy, inefficient, and problematic non-competitive medicine IS — just look out your back door. In an efficient economy 95-98% of the population can and does pay for necessities like medicine and education out of pocket and as-you-go … we are nowhere close to that
but there’s free medicine in US right?