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The NHS’s medical director will spell out the failings of 14 trusts in England, which between them have been responsible for up to 13,000 “excess deaths” since 2005. Prof Sir Bruce Keogh will describe how each hospital let its patients down badly through poor care, medical errors and failures of management, and will show that the scandal of Stafford Hospital, where up to 1,200 patients died needlessly, was not a one-off…

Inspectors found patients were forced to stay up to two weeks in temporary areas without even shower facilities. Others were left in ambulances “stacked” outside A&E as the hospital failed to cope with demand…

At a recent conference of British doctors, attendees blasted the National Health Service as "worse than Communist China," inveighing against government bureaucrats who have come to dominate patient care…

The parade of disgraces at NHS have led some British analysts to call for the "liberalisation" or "privatisation" of the country's creaky, dysfunctional healthcare system. And throwing more money at the problem isn't a viable solution…

If cash was the answer, than the NHS would be fixed by now. The great Labour mission (pdf) was to take UK health spending to the European average. It’s now 9.8pc of GDP, well clear of the EU average of 9.0pc (pdf). And UK health outcomes are still lousy. During the last decade Gordon Brown conducted a massive experiment: money was his aim, he doubled the NHS budget and saw what happened. The NHS did not (to put it mildly) become twice as good. It just grew fatter and more expensive. Bureaucrats accrued power that would have shocked hospitals in in Communist China..

Outcomes for British patients are poor, as they are for Americans on Medicaid -- a deeply broken (and broke) federal program that Obamacare expands on a huge scale. As Britons look themselves in the mirror over the failures of NHS, American leftists continue to fetishize their system.

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the time has arrived once again to take a long, hard look at the actual results produced by single-payer health care.

Angus Reid, a well-respected Canadian pollster, asked Canadians to rate their health care system. When they started doing this polling in 1991, a clear majority of Canadians gave the system top marks: excellent or very good. Last year [2000], when they did the poll again, under one in four gave the system that rating.

A year and a half ago, a poll sent shock waves across the country when 73 percent of Canadians described their health care system as being "in crisis." Reid actually went back and redid the poll six months later: 78 percent of Canadians now thought the system was in crisis.

So what has happened in Canada? Why is it that we've gone from being very bullish on this health care system to having great reservations?

I've just randomly chosen a few stories that have come to light recently.

•The head of trauma care at Vancouver's largest hospital announces that they turn away more cases than any other center in North America. He's quoted as saying this would be unheard of in the United States.

•In Manitoba, which is my former home province, the premier--the political equivalent of a governor--concedes that his pledge to end hallway medicine has fallen short. Hallway medicine is the phenomenon where the emergency rooms are so filled with patients that people are forced to lie on stretchers in hallways, often for days. Overcrowding is a periodic problem. In fact, the overcrowding is worse than last year. The community is rocked by the death of a 74-year old man who had waited in the emergency room for three hours and had not been seen.

•New Brunswick announces that they will send cancer patients south to the United States for radiation therapy. New Brunswick, a small maritime province, is the seventh to publicly announce its plans to send patients south. In the best health care system in the world, the vast majority of provinces now rely on American health care to provide radiation therapy. Provinces do this because the clinically recommended waiting time for treatment is often badly exceeded. Ordinarily, oncologists suggest that there should be a two-week gap between the initial consult by the family doctor and the referral to the oncologist, and then two weeks more from the oncologist to the commencement of radiation therapy. In most Canadian provinces, we exceed that by one to two months, sometimes three.

•In Alberta earlier this year, a young man dies because of the profound emergency room overcrowding. He is 23. On a winter's night, he develops pain in his flank and goes to the local emergency room. It is so crowded that he grows impatient and goes to another. There, he waits six hours. No one sees him. Exhausted and frustrated, he goes home. The pain continues, so he finally decides to go to the local community hospital. It's too late: His appendix ruptured. He dies from the complications hours later.

MRI scanners are very difficult to get in Canada. There are long wait times. In my book, I talk about a political struggle on Vancouver Island where the wait time for a non-urgent MRI scan was over a year--"non-urgent" being defined by government officials, not by physicians. In the province I now live in, Ontario, there are long wait times for MRIs.

The Fraser Institute, a major think tank in Canada, does a survey of 2,300 physicians across 12 specialties and asks them to estimate the wait time between the initial visit with the family doctor to the surgical therapy. They do this every year. Right now, the average wait time is 14 weeks. What's very impressive is the extent to which that has grown; 14 weeks marks a 5.3 percent increase over the last year, despite the fact that government spending in health care has grown by 22 percent over the last three years.

The Fraser Institute not only asks physicians how long patients wait, but they ask doctors how long they think patients ought to reasonably wait. In every single category, patients wait too long, in the opinion of the physicians.

There was a recent five-country survey of health care by the Harvard School of Public Health. They asked specialists across these nations if they felt there was a decline in the quality of health care. Canada has the dubious distinction of having highest response rate in the affirmative, 63 percent

If you're diagnosed with cancer in Canada, how do you compare in terms of your life expectancy to somebody who's diagnosed in the United States? Canadian provinces ranked close to or at the bottom in every single category.

The Canadian system is ailing. Why? I believe that Canadian medicare suffers from a basic economic problem. We have a free-for-all system, and, as health economists have well shown, costs are driven up. Patients tend to overconsume health services while providers tend to oversupply health services. The only way we can deal with this is to ration through waiting.

But I think at the end of the day--and this would be my message to you Americans--you have to understand that when the government finances something, it ends up managing it.

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The Waiting Lists

In the late 1960s and the 1970s, the government had scraped together a few pennies, and it did manage to build a few hospitals or a few new wings on some of the Victorian institutions that they had nationalized. So the politicians began to talk about getting the private sector to invest capital to build new hospitals. For every ten years of the existence of the NHS, on average, waiting lists have gone up by about 200,000 people every decade.

Today, the National Health Service costs the taxpayers some £50,000 million. Over one million people are waiting for treatment and surgery and often waiting reasonably lengthy times: months, and for some surgery, years. There are probably another 300,000 to 400,000 people waiting to get on the waiting list because, of course, there's a definition about waiting lists. If you're on a waiting list, when you've seen a consultant and you're waiting for surgery, you're not really on the government waiting list when you're waiting to move from the GP to see the consultant.

This is out of a population of some 60 million people. If there are a million, maybe a million and a half people waiting, when I wander around London, most people are well. Anecdotally, I almost ask myself the question, "Where is the £50,000 million going?" Today, the NHS by international comparison has a very, very poor record in all kinds of important areas such as cardiology, cancer treatment, and survival rates. Today, rather like corks bobbing on the tide of history, our political classes in Britain are trying to manage a service; but whatever they do, the sand just runs through their fingers, and they're desperately trying to reform the system and to deal with ever higher consumer expectations.

Rise of the Independent Sector [so, folks unhappy with socialized medicine]

Under the radar of popular politics and the crisis that has over the years befallen the NHS, we have indeed seen the re-emergence and the growth of an independent sector. If I now look at 230 independent hospitals that we have, the 70 independent mental health and substance-abuse units, or the 15,000 nursing and residential homes, then I see we again have a total of 460,000 beds in the independent sector.

That compares with the National Health Service and with local authorities on long-term care provisions. They have a total of 356,000 beds. So in a world away from the promise of 1948, when the government was going to do it all, you can see there has been a significant evolution on the side of provision.

•The independent sector now employs three-quarters of a million people. It provides over 85 percent of all residential community care, and it undertakes 20 percent of all elective surgery.

•Some 14 million people in Britain make some sort of regular financial contribution to health care. There are 7 million people who have private medical insurance; in addition, there are another 7 million people who have what are called the health cash benefit funds, or critical illness, or permanent health insurance, or they simply self-fund. This is not to mention the vast number of people who now seek private dentistry or alternative therapies.

•In 1981, the independent sector was doing around 200,000 surgical procedures a year. In 1997, when Tony Blair was elected, we were doing around 900,000 surgery procedures a year. Today it's over a million.

•Today in the U.K., we're seeing a dramatic increase in the number of people who are turning away from the NHS, and many people who have no private medic insurance are simply self-funding. One in five people who go into British private hospitals just take their credit card or cash, or it's the family clubbing together to buy Mom a heart bypass or Dad a hip replacement. Probably nearly 200,000 surgical procedures a year now are done on that basis.

•We're seeing a dramatic increase in number of people covered by the health cash benefit schemes. Five years ago, 3 million people were covered by those schemes. Today it's probably between 5 and 6 million.

•We're seeing a continuation in the growth of private medical insurance, probably about 2 percent a year in coverage.

•We're seeing recently the launch of private prescriptions for even NHS patients. For example, if you want Viagra, the NHS will no longer pay for it. You have to go private in many instances.

•We've seen the NHS independent-sector Concord Act. We're seeing the continuation of contracting out of NHS work. I believe in the next few months we're going to see the introduction of private management teams into what will be called or deemed the failing of National Health Service hospitals.

Problems with the single-payer system, to follow what David was saying, include the politicization of health care, the vast amounts of producer capture, resource misallocation, irrational rationing, vast amounts of regulation, services not really reliant upon reputation, but only on position, on uniformity rules and poor consumer focus.

If I could just briefly, as my last comment, read from a book that I discovered a little while ago called The British Socialist Illfare State, written by Cecil Palmer. He wrote this book in 1950 or 1951. It was published in 1952. Very sadly, he died just before it was published, and he died just before he was going to come to the United States that year to give a series of lectures on what he believed the NHS was going to do in Britain and to warn Americans to keep away from Sovietized nationalized medicine.

The degradation of British medicine under socialism is becoming more obvious every day, even to those who initially and sentimentally gave the National Health Service Act their enthusiastic support when it became operative in July 1948. This progressive disillusionment reflects the financial, structural, administrative, and social limitations of socialistic legislation in a hurry. The trouble with theoretical socialism is that although possibly it makes pleasant reading on an unpleasant Sunday afternoon, it just will not work in a society which still retains and cherishes the principles of individualism. As long as I am capable of writing and public speaking, I will continue to iterate and reiterate that if socialism will work at all, it will only work under compulsion. Liberty and socialism are incompatible.

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Paul Krugman assured us back in 2009 that, “In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false.”

If that’s the case, then the British press is filled with liars who deliberately make up horror stories about their nation’s healthcare system, as you can see [didn't do the hyperlinks] here, here, here, here, here, here, here, here, here, here, here and here.

We now have another nightmare to add to this list. Here are some of the horrific details from the UK-based Daily Mail. [please comrades, no complaining about the source, right, the journalist just made the story up]

An elderly woman died alone after doctors failed to tell relatives they were ending her life on the controversial Liverpool Care Pathway. Olive Goom, 85, passed away with no one by her side after medics neglected to consult with her family about her treatment at Chelsea and Westminster Hospital. …As Miss Goom lay dying alone, staff reassured relatives on the phone just hours before her death that there was no urgent need to visit – even though doctors had already removed tubes providing vital food and fluids. Her family discovered that she had died only when her niece went to visit her and found she was already being prepared for the mortuary. They said last night that they will never be able to stop feeling guilty that no one was there in her final hours. The Mail has been contacted by several families who claim that relatives were put on the Liverpool Care Pathway – the controversial system designed to ease the suffering of the dying in their final hours – without any consultation. Some said they found out that their relatives were on the pathway only after they happened to read their medical notes; and by that time it was too late.

Keep in mind, by the way, that the Liverpool Care Pathway is sort of akin to the IPAB “death panel” in Obamacare.

Defenders of government-run healthcare say that’s nonsense and assert that there won’t be any rationing, denial of care, or requirements for euthanasia. That’s technically true, but the Obamacare death panel will be determining what’s an acceptable treatment and what’s the government-approved payment schedule.

Crushed by Obamacare?

So it’s sort of like holding a rock in your hand, standing over a kitten, letting go of the rock, watching it hit the kitten, but then claiming that you did nothing wrong because gravity caused the rock to fall.

Okay, that’s a morbid example, but you get the point. And my concern isn’t that rationing only exists with a government-run system. Any healthcare system will involve rationing. The real issue is whether individuals are part of a free society so they can make the choice of how to ration.

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A new study by Britain's National Audit Office reports that patients suffering from agonizingly painful rheumatoid arthritis are having to wait an average of nine months to receive treatment. Apparently the fact that UK health guidelines specifically state that no patient should wait for treatment longer than three months following initial symptoms is not enough to speed up the process. "On average it takes four visits before a patient is referred to a specialist for diagnosis and treatment."

It's also worth noting that the prescription drug Humira is widely available in the U.S. to treat some cases of rheumatoid arthritis. However, because the drug is more costly than some other, less effective drugs, one commenter on the story says that it is only available to patients in the UK system after other a number of other meds have failed to control the condition.

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Norway. You know, the country that is constantly being named by the UN and a host of other organizations that presume to quantify such things as the world's all-around most super-duper and wonderfulest place to live...

I'll admit this: if, like me, you're a self-employed person with a marginal income, the Norwegian system is, in many ways, a boon – as long as you're careful not to get anything much more serious than a cold or flu. Doctors' visits are cheap; hospitalization is free. But you get what you pay for.

The fact is that while the ubiquity of frivolous malpractice lawsuits in the U.S. has been a disgrace, the inability of Norwegians to sue doctors or hospitals even in the most egregious of circumstances is even more of a disgrace. Physicians who in the U.S. would be dragged into court are, under the Norwegian system, reported to a local board consisting of their own colleagues – who are also, not infrequently, their longtime friends.

Take the case of Peter Franks, whose doctor sent him home twice despite a tennis-ball-sized lump in his chest that was oozing blood and pus – and that turned out to be a cancer that was diagnosed too late to save his life. Apropos of Franks's case, a jurist who specializes in patients' rights lamented that the Norwegian health-care system responds to sky-high malpractice figures “with a shrug,” and the dying Franks himself pronounced last year that “the responsibility for malpractice has been pulverized in Norway,” saying that “if I could have sued the doctor, I would have. Other doctors would have read about the lawsuit in the newspaper. Then they would have taken greater care to avoid making such a mistake themselves. But doctors in Norway don't have to take responsibility for their mistakes. The state does it.”

Then there's the waiting lists. At the beginning of 2012, over 281,000 patients in Norway, out of a population of five million, were awaiting treatment for some medical problem or other. Bureaucratic absurdities run rampant, as exemplified by this Aftenposten story from earlier this year:


Helga Kvinge discovered a lump in her breast in February. She couldn't get an appointment for a check-up at Oslo University Hospital before April 3. So she contacted a private hospital and was examined there.

On March 1, she got an appointment at the private center that offers to check whether women have cancer. A few days later she was informed that the lump was cancer. The tests were sent to the laboratory at Oslo University Hospital Ullevål, and the doctor who made the diagnosis works at both OUS and the private hospital.

Kvinge, and the doctor at the private hospital, were sure that since it was clear she had cancer, she would receive an offer for treatment at Oslo University Hospital since she lives in Oslo.

But on Thursday of this week she was informed by OUS that she couldn't be treated for her breast cancer until OUS itself had made the diagnosis.

Then there's the Oslo-area couple whose one-year-old daughter fell and broke her arm. They took her to a nearby hospital, where over a period of hours they signed in, were sent to a waiting room, saw a doctor, and had X-rays taken – only to be told that the little girl couldn't get a cast put on her arm there because the family's address put her in another hospital's district. They went to the other hospital, where they were put through the whole rigmarole all over again. Not a tragedy, but an example of the kind of dehumanization that infests the entire system.

And let's not forget rationing. “Death panels” are no fantasy. In a series of articles in 2010, Aftenposten reported on the decision by the Norwegian government's health director to refuse certain treatments to certain “large patient groups” in order to curb costs. For example, “we can extend the lives of patients with heart failure by installing a heart pump...but this is a service we probably can't offer. It's too expensive.” The same goes for respirators in cases of emphysema or chronic bronchitis: “It could prolong the lives of patients, but it's not something we can give to such a large group.” The elderly, likewise, are screwed: “we...spend too much money to extend the last phase of life for dying, often old, people.” Who's to decide who receives treatment and who doesn't? That, the health director answered, is a “political responsibility” – the job of politicians, not physicians.

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ORIGINAL: bounty44

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A new study by Britain's National Audit Office reports that patients suffering from agonizingly painful rheumatoid arthritis are having to wait an average of nine months to receive treatment. Apparently the fact that UK health guidelines specifically state that no patient should wait for treatment longer than three months following initial symptoms is not enough to speed up the process. "On average it takes four visits before a patient is referred to a specialist for diagnosis and treatment."

It's also worth noting that the prescription drug Humira is widely available in the U.S. to treat some cases of rheumatoid arthritis. However, because the drug is more costly than some other, less effective drugs, one commenter on the story says that it is only available to patients in the UK system after other a number of other meds have failed to control the condition.

http://townhall.com/tipsheet/meredithjessup/2009/07/15/foreshadowing_report_uk_health_system_failing_patients

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The worldwide recession has forced countries around the world to curb public spending — or risk defaulting on their debt.

The United Kingdom is the latest to tighten its belt. The National Health Service (NHS) — the centralized public agency that runs Britain’s government healthcare system — is being forced to shave $31 billion from its budget by 2015.

These cuts are leading to a precipitous drop in the quality of care patients receive. The NHS has been living well beyond its means for quite awhile. And now brutal government-enforced cost controls are exacting a heavy human toll.

Thanks to Obamacare, America will soon face the same sort of reckoning.

In order to realize some savings, the NHS is raising the threshold at which patients qualify for treatment and lengthening wait times for surgeries determined “non-lifesaving.” The Service is also cutting more than 20,000 NHS jobs over the next two years and shuttering a number of hospitals.

Patients are feeling the pain. For decades, they’ve turned over substantial portions of their hard-earned paychecks as taxes — and accepted “free”

health care from the government in return

They’ve foregone cutting-edge medical treatments available in the United States, told by their leaders that these new therapies were no better than the old ones — just more expensive. At least in Britain, they thought, everyone has access to basic health care. That has to be better than the situation in America, where tens of millions of people lack health insurance, right?

Hardly. The British healthcare system may “guarantee” access to care — but that doesn’t mean patients actually receive it.

Take the case of David Evans, a 69-year-old farmer living in Cornwall, in southwest England. About a year ago, he developed a hernia and needed an operation. Despite government requirements that he receive treatment within 18 weeks of diagnosis, he still hasn’t been treated.

A report released in October by Britain’s health regulator found that a stunning 20 percent of hospitals were failing to provide the minimum standard of care legally required for elderly patients.

As part of the study, inspectors dropped by dozens of hospitals unannounced. They found patients shouting or banging on bedrails desperately trying to get the attention of a nurse. At one hospital, inspectors identified bed-ridden patients that hadn’t been given water for over 10 hours.

The upcoming austerity measures will only amplify maladies like these.

The NHS is broken — and not in some superficial way that a simple tweak would fix. The incentives are wrong. The government’s main priority is keeping costs low — not providing quality care. Patients can’t choose how they receive their care — it’s one-size-fits-all medicine. And the entrenched NHS bureaucracy has no reason to improve efficiency.

The problems with “universal” health care aren’t confined to Britain. Canada’s single-payer, government-run system — where any private health care is outlawed under the Canada Health Act — is similarly failing its patients.

The Health Council of Canada recently surveyed over three thousand patients and found that those with chronic illnesses like high blood pressure or heart disease were largely dissatisfied with the medical care they received. Less than half of respondents with such conditions reported that the care they received was excellent or very good.

But aren’t they getting it for free? Shouldn’t they be grateful?

Not really. Despite the massive taxes Canadians remit to finance universal care, they still must pay out of pocket for some services. Nearly a quarter of chronically ill respondents said that they had skipped their medications or neglected to fill a prescription because it was too expensive.

Further, many Canadians travel to the United States and pay out of pocket for treatments and procedures, as they feel the wait in Canada is too long and harmful to their health.

The American health system is far from perfect. But it’s wrong to think that government can fix it. The socialized systems found up North or across the Atlantic are proof. We need more market forces in our medical sector — not more government controls.

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A Canadian study released Wednesday found that many provinces in our neighbor to the north have seen patients fleeing the country and opting for medical treatment in the United States.

The nonpartisan Fraser Institute reported that 46,159 Canadians sought medical treatment outside of Canada in 2011, as wait times increased 104 percent — more than double — compared with statistics from 1993.

“In some cases, these patients needed to leave Canada due to a lack of available resources or a lack of appropriate procedure/technology,” according to the Institute. “In others, their departure will have been driven by a desire to return more quickly to their lives, to seek out superior quality care, or perhaps to save their own lives or avoid the risk of disability.”

Increases in the number of patients leaving Canada for treatment were seen in seven of the ten Canadian provinces: British Columbia, Saskatchewan, Manitoba, New Brunswick, Nova Scotia, Prince Edward Island, and Newfoundland and Labrador.

“Some of these patients will have been sent out of country by the public health care system due to a lack of available resources or the fact that some procedures or equipment are not provided
in their home jurisdiction,” the report concluded.

“Others will have chosen to leave Canada in response to concerns about quality … to avoid some of the adverse medical consequences of waiting for care such as worsening of their condition, poorer outcomes following treatment, disability, or death … or simply to avoid delay.”

Canada’s median wait time for treatment after consultation with a specialist also increased in 2011, from 9.3 weeks to 9.5 weeks. The Fraser Institute’s report concluded that the nation’s doctors don’t like the status quo any more than their patients..

“[P]hysicians themselves believe that Canadians wait nearly 3 weeks longer than what they consider is clinically ‘reasonable’ for elective treatment after an appointment with a specialist,” according to the report

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Canada’s single-payer, government-run system — where any private health care is outlawed under the Canada Health Act — is similarly failing its patients.

The Health Council of Canada recently surveyed over three thousand patients and found that those with chronic illnesses like high blood pressure or heart disease were largely dissatisfied with the medical care they received. Less than half of respondents with such conditions reported that the care they received was excellent or very good.

But aren’t they getting it for free? Shouldn’t they be grateful?

Not really. Despite the massive taxes Canadians remit to finance universal care, they still must pay out of pocket for some services. Nearly a quarter of chronically ill respondents said that they had skipped their medications or neglected to fill a prescription because it was too expensive.

Further, many Canadians travel to the United States and pay out of pocket for treatments and procedures, as they feel the wait in Canada is too long and harmful to their health.

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In "Myths, Lies and Downright Stupidity," I bet my readers $1,000 that they couldn't name one thing that government does better than the private sector.

I am yet to pay.

Free enterprise does everything better.

Why? Because if private companies don't do things efficiently, they lose money and die. Unlike government, they cannot compel payment through the power to tax.

Even when a private company operates a public facility under contract to government, it must perform. If it doesn't, it will be "fired" — its contract won't be renewed. Government is never fired.

Contracting out to private enterprise isn't the same thing as letting fully competitive free markets operate, but it still works better than government.

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An owner of 12 IHOPS told me that he can't expand his business because he can't afford the burden of Obamacare.

Many of his waitresses work part time or change jobs every few months. He hadn't been insuring them, but Obamacare requires him to. He says he can't make money paying a $2,000 penalty for every waitress, so he's cancelled his plans to expand. It's one more reason why job growth hasn't picked up post-recession.

Of course, we were told that government health care would increase hiring. After all, European companies don't have to pay for their employees' health insurance. If every American employer paid the $2,000 penalty and their workers turned to government for insurance, American companies would be better able to compete with European ones. They might save $10,000 per employee.

That sounded good, but like so many politicians' promises, it leaves out the hidden costs. When countries move to a government-funded system, taxes rise to crushing levels, as they have in Europe.

Whalen sees Obamacare as a crossing of the Rubicon.

"We've had an agreement in this country, kind of unwritten, for the last 50 years, that we would spend about 18 to 19 percent of GDP (gross domestic product) on the federal government. This is a tipping point. This takes us to 25 to 30 percent. And that money comes out of the private sector. That means fewer jobs. This is a game-changer."

He means it's a game-changer because of the cost. But the law's impenetrable complication does almost as much damage. Robert Higgs of the Independent Institute is right: If you wonder why businesspeople are not investing and reviving the economy, the answer lies in all the question marks that Obamacare and other new regulations confront them with. Higgs calls this "regime uncertainty." It's also what prolonged the Great Depression.

No one who understands the nature of government as the wielder of force — as opposed to the peaceful persuasion of the free market — is surprised by this.

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There is in effect an undeclared race between the public and private sectors in regard to satisfying human wants. Who's winning that race? Which sector is doing a better job of affecting peoples' lives in a positive way? In fulfilling human wants the private sector is leaving the public sector in the dust. People get more and more value from the private sector and the same or less value from government activity even though the cost of government has increased at an exponential rate.

Why is there so much difference in how the two sectors function? Two important reasons are incentives and competition.

The University of Rochester economist, Steven Landsburg, says, "Most of economics can be summarized in four words: 'People respond to incentives.' The rest is commentary." Although I think that's an exaggeration, there is much truth in it. The private sector is vastly more effective and efficient than the government mostly because of the differences in the incentive structures. In the private sector you can get rich filling needs and solving problems. The public sector's incentive structure is totally dysfunctional.

Mr. Obama's campaign themes were "hope and change." Ironically, he is intent on increasing the role of government, the entity most resistant to and even incapable of change and innovation, and there is little reason to hope that will change any time soon.

In light of the stark difference in the effectiveness and competence between the private and public sectors, it totally mystifies me that any sentient person would want to transfer more power and money to the government.

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ORIGINAL: bounty44

here is more or less the essential question almost every one either dances around or completely ignores.

if a handful of people want to get together and willingly participate in cost sharing, either themselves, or through the market in some way, I see that as being free.

if the government steps in and forces its citizens to do so, then some freedom is lost.

to me, the collectivists need to give those who oppose them a convincing philosophical argument as to how this is moral.