U Hatez Teh Freedum

Well, the real world is back, and Andrew Sullivan is back to being an “idiosyncratic” conservative. Faced with a report detailing that, adjusted for purchasing power, the US spends about $6,000 per capita to the UK’s $2,000 per capita, Sullivan writes:

One reason I’m a conservative is the British National Health Service. Until you have lived under socialism, it sounds like a great idea.

Of course, that doesn’t address the data, or objective measurements of any kind, or even try to defend the ghastly difference in cost, on top of the fact that it’s a completely fallacious attempt to paint with a very broad brush. Ezra responds:

About a quarter of Britons are satisfied with their health care system. Less than a fifth of Americans can say the same. Similarly, a mere 15 percent of Britons want to dynamite the awful beast and start over. More than a third — a third! — of Americans feel the same way. Indeed, none of the socialized systems have even half as many of their residents calling for a totally new direction. Germany, where a robust 26 percent want to start over, is the least nationalized of the lot, using semi-private insurance pools known as “sickness funds,” and sure enough, they’re the system that’s closest to ours on total dissatisfaction. I guess you could say that private health care sounds like a great idea unless you live under it.

To which Sullivan shoots back:

Satisfaction is a subjective function of subjective expectations. If you have the kind of expectations that many Brits have for their healthcare system, it is not hard to feel satisfied. The Brits are very happy with their dentists as well. And there is a cultural aspect here – Brits simply believe suffering is an important part of life, especially through ill health. Going to the doctor is often viewed as a moral failure, a sign of weakness. This is a cultural function of decades of conditioning that success is morally problematic and that translating that success into better health is morally inexcusable. But if most Americans with insurance had to live under the NHS for a day, there would be a revolution. It was one of my first epiphanies about most Americans: they believe in demanding and expecting the best from healthcare, not enduring and surviving the worst, because it is their collective obligation. Ah, I thought. This is how free people think and act. Which, for much of the left, is, of course, the problem.

Without bothering to point out that his “you hate freedom” shot at the end is right out of the Hannity playbook Sullivan contends to loathe, on the broader point this is entirely bunk. Even if we concede, at to a certain degree I do, that satisfaction levels are subjective and hard to compare to one another, it’s still at least a completely fair response to Sullivan’s incredibly broad and baseless exclamation that people who live under socialized medicine all hate it, because Sullivan doesn’t really have any data to back it up. He has his personal experience, I guess, but then he’s also an Ivy League educated writer who can easily afford very good insurance in this country. Something tells me his opinion would change rather dramtically if he was one of the 20% or so who have to navigate our disaster with no insurance at all who either don’t get sufficient care or go bankrupt due to their hospital bills. And throughout the entire spat, I can’t find any place where Sullivan actually addresses the price disparity between the UK and the US. Does he really think that the quality of care in the US merits paying 3 times as much as citizens of the UK? I suspect not, or I think he’d actually try to make that argument. But either even he doesn’t think that, or he realizes that no one would take him seriously if he tried to make that argument. Personally I think there’s relative parity to quality, and Ezra has some numbers to support that:

Then we could ask the question: Do the Brits seems to be in worse health? Do they have a health care system that delivers worse outcomes? The answer to both is no. In the case of ill health, they’re actually in much better health than their American counterparts, though that’s a function of lifestyle more than hospital choice. And in the case of health outcomes, it sort of depends. You’re probably better off getting your breast cancer treated in America and getting your diabetes treated in Britain. In the aggregate, however, the evidence is fairly clear that the British are better off. Health researchers look at a measure called “amenable mortality,” which refers “to deaths from certain causes that should not occur in the presence of timely and effective health care.” In other words, deaths that are prevented by contact with the health care system. If Andrew is right that those stoic Brits just grit their teeth and bear their illness, this measure should be much higher in Britain than in the US.


But it’s not. In concert with Andrew’s thesis, Britain does indeed have a high rate of amenable deaths. Just not higher than ours. in 2002-2003, Britain suffered 102.81 amenable deaths per 100,000 citizens. America suffered 109.65.

7 out of every 100,000 isn’t a whole heck of a lot, but that suggests that there’s relative parity in quality between our systems. But the Brits get it for 1/3 of the price we do. Damn Marxists.