... The US already has universal healthcare on a fee-for-service model; you have the right to all of the health care you can afford.>

I grew up in the Central valley, working with braceros on various farms. I was concurrent with Cesar Chavez in Delano.

I worked in Fresno building houses with illegales who taught me more Spanish in three years than I can possibly remember now.

After getting a Life Secondary Credential, I taught English to (among ohers) migrant kids, joking in Spanish, getting them to achieve.

I have hired Mexicans, worked with Mexicans, planned aid services with Hondurans (post hurricane), worked with hispanics all my life.

My wife speaks fluent Spanish and works with women from all over Central America in health services.

My daughter got a degree in Spanish, and has lived in and worked in Oaxaca.

Her husband has volunteered teaching in Honduras. They live in Oregon, btw.

In Texas the Hispanics I work with don't have bone to pick, and are so much more a part of American life, and easier to get along with, than LA Basin Hispanics.

So, what is your verdict?

Healthcare compared

Health spending as a share of GDP

US 16%

UK 8.4%

Public spending on healthcare (% of total spending on healthcare)

US 45%

UK 82%

Health spending per head

US $7,290

UK $2,992

Practising physicians (per 1,000 people)

US 2.4

UK 2.5

Nurses (per 1,000 people)

US 10.6

UK 10.0

Acute care hospital beds (per 1,000 people)

US 2.7

UK 2.6

Life expectancy:

US 78

UK 80

Infant mortality (per 1,000 live births)

US 6.7

UK 4.8

<Who does Nancy Pelosi include when she says "We are going to make the free riders pay their share.">

I am uninterested in political grandstanding because it is counterproductive.

< Is <JohnLSpouge> willing to bet his house that the high cost of U.S. medical expenses (17%) will come down with the inauguration in 2014 of all of Obamacare? >

See my final question. Yes, universal healthcare in the US can be sabotaged and become inferior to universal healthcare in other countries. I expected more than a "can't do" attitude from an American exceptionalist like you, <PiPi>.

<Does <jls> actually understand any of the provisions of Obamacare? If so, Why are Dr.-owned hospitals not allowed?>

Dr.-owned hospitals are a conflict of interest. Patients can be uninformed and often must make decisions under duress, which precludes free and informed agreement to a contract of medical services. A profit model of medicine not mandating informed consent presents physician-owners with a conflict of interest.

<Why is tort reform (limiting the income of lawyers) not included?>

It should be, and it's a constructive suggestion, <PiPi>.

<What are the rules that cause an employer to have to pay a fine for not offering health care to his employees? ...
What other requirements will the HHS lay on insurers, that will cause insurance plans to zoom in cost even faster than the 9%/year (unheard of preious to now) since the Health care act was passed?>

I cannot answer specifics immediately, but you have the same basic ability to Google that I do.

< What exactly does "Health Care is a Right" mean, if health care providers, hospitals, EMT teams, medical appliance manufacturers, pharmaceutical manufacturers, medical technicians, private hospitals, etc. etc. all become slaves to the Central Authority mandating the right? And what has become of the rights of the professionals in those fields? >

Their freedoms are limited in the general public interest, which is the general function of government regulation in a complex society. The Canadian model shows that there is an uneasy but feasible tension between the competing freedoms.

one needs to take in account _where_ one does the questioning :

- standing up for women's rights in certain countries

- questioning treatment of minority religions during certain times

- refusing to participate in tribal warfare in certain regions

is where folks with "mettle" make their stand.

The USA is a good & safe place to speak one's mind!

< Why do we need Obamacare to "protect the weak and defenseless" when already our states are paying xxxBillion for medicaid, the program set up for the weak and defenseless? >

Because there were 8 million uninsured children in the US as of 2012.

[ http://www.childrensdefense.org/pol... ]

< Why does it not occur to <jls> that we spend more per capita on health care because we can, because there is so much more in the U.S. to get than other places (e.g. Canada)? >

Profit motivates useless or even counterproductive overtreatment. The following book title answers your question. "Overtreated:why too much medicine is making us sicker and poorer"

[ http://books.google.ca/books/about/... ]

Why does <jls> not acknowledge the doctor drain from Canada to the U.S.?

<According to the CMA, during the period 1991-2004 Canada lost 4,014 doctors more to the United States than it gained. >

I did acknowledge it, but thanks for the stimulus your link provided to dig deeper. Your sources typically fudge their summary data by presenting selective averages. Removal of the usual judicious averaging exposes this statistic as propaganda.

"In the early to mid-1990s, net losses [of Canadian physicians] averaged 400 per year. More recently, the number of physicians leaving Canada has decreased significantly, resulting in net gains of between 30 to 60 per year."

[ http://www.longwoods.com/content/19... ]

The latest year I could find Canadian Medical Association statistics on Canadian physician emigration was for 2010.

"173 physicians moved abroad in 2010. In the same year, 202 returned from abroad for a net gain of 29. Net gains have occurred seven years running compared with historical net losses of 200-500 per year for the previous decade."

[ http://www.cma.ca/multimedia/CMA/Co... ]

<Hundreds more questions that <jls> shouldn't even try to answer since he has better things to do....but everyone else [should] be aware that <jls> works in a Government-funded lab, and may have a stronger faith in Government Planners than many of the rest of us.>

Because I work within the government, I know how carefully it needs to be monitored. I applaud your skepticism, because it is by discussion that we arrive at truth.

After Africa, I couldnt teach California kids any more. I got another degree and changed careers.

Fixed. Christ. (Those who live in glass houses...)

The problem is for the concerned teacher, who absolutely insists that his students learn. Grey hair appears much more quickly. Long long nights preparing. How to motivate this one or that one. I will say that by the end of each year, every class I had was enjoyable and the kids were happy to work.

But for so many jaded teachers, that just is the labor of Hercules. More than should be required of any civilian occupation. I tell the young people that I know, who are on fire to teach,

"Just make sure you get into a rural school district."

As a careful researcher, you should be leery of repeating this as fact.

Equally likely, if not more so, is the threat of lawsuit should a doctor not prescribe enough treatment. Lawsuits abound where the plaintiff wins huge amounts because Dr. missed some available treatment. Result: Prescribe all the treatment that the insurance is good for.

The KR page has its own type of fireworks, you know!

As a careful researcher, you should be leery of repeating this as fact. >

<PinnedPiece>, I never knew that you could read minds - NOT!

Why would you think that I am repeating anything?

In fact, I have indeed read studies that support the statement, but it is based on my own experience.

I switched pediatricians when the phone message on the old practice offered to pierce kids' ears. I have yet to hear the medical indication for piercing ears from them.

More seriously, one of my daughters was prescribed an inhaler for possible exercise-induced asthma. My wife was dubious, but the practice assured her that we could return the inhaler if unused. My daughter probably had a temporary virus, and did not need the inhaler. In the end, my wife needed to go to the president of the company manufacturing the inhaler before the practice would accept the return.

The reason I ask is that you are almost always outnumbered, yet you continue to make your stand, stoically and quixotically.

I would imagine you to be quite a formidable debater if you had facts on your side.

UK 8.4% >

Hi, <Mort>. I avoided the UK health care system, because it is somewhat dysfunctional and provides a straw man against universal health care.

Functional health care systems like Canada or Germany are more expensive than UK health care, but they provide a better basis for asking, "Why can we in the US not do better with universal health care?"

It appeals to my sense of irony that many of the US exceptionalists are naysayers who seem to believe the US cannot improve on the Canadian or German health care system.

Is answered in what <tpstar> said here:

<I disagree with terming "universal healthcare" as an automatically positive thing, just as people throw around the terms "affordable" and "quality" without the slightest clue what they mean. The US already has universal healthcare on a fee-for-service model; you have the right to all of the health care you can afford. With nearly half of Americans paying no income tax (I'll bet you've read that before) compared to happy Canadians paying all of their taxes, that already creates tension in the US between the haves and the have-nots, and often the work-nots.>

To me, it sounds like many US conservatives think that the very idea of universal health care is un-American. >

You are correct, which explains the framing of my question. Obvious and unfavorable comparison with the rest of the world is moving the US toward universal health care, in much the same way that it is moving the US toward same-sex unions. Universal health care might be "un-American", but in the long run limpid comparison with the rest of the world, along with pressure from the deficit, will make it inevitable.

Last week supporters of health-care reform gathered around the country, including in Austin, TX, where 2,000 people crowded into a downtown church to hear speakers talk about different aspects of the issue. Asked to speak about the ethical dimensions of health care, I tried to go beyond short-term political strategizing and ask more basic questions. This is an edited version of what I said.

Is anyone else here having trouble with the fact that we are even having this conversation? Is anyone else having trouble believing this topic is really controversial? I have been asked to talk about the ethical dimension of health care. Here's one way to frame such a discussion:

If an infant is born to poor parents, would we be more ethical to give medicine to that child so he or she does not die prematurely of preventable diseases, or would we be more ethical if we let the child die screaming in his or her parent's arms so we can keep more of our money?

Or, let's say someone who worked for Enron, and now is penniless, contracted bone cancer. I've been asked to discuss whether we are more ethical if we provide such people medicine that lessens their pain. Or would we be more ethical to let them scream through the night in unbearable agony so we can pay lower taxes?

I can't believe I am standing today in a Christian church defending the proposition that we should lessen the suffering of those who cannot afford health care in an economic system that often treats the poor as prey for the rich. I cannot believe there are Christians around this nation who are shouting that message down and waving guns in the air because they don't want to hear it. But I learned along time ago that churches are strange places; charity is fine, but speaking of justice is heresy in many churches. The late Brazilian bishop Dom Hélder Câmara said it well: "When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a Communist." Too often today in the United States, if you talk about helping the poor, they call you Christian, but if you actually try to do something to help the poor, they call you a socialist.

Some of the other speakers today have been asked to address what is possible in the current political climate. I have been asked to speak of our dreams. Let me ask a question. How many of you get really excited about tweaking the insurance system so we just get robbed a little less? (silence) How many of you want universal health care? (sustained applause) I realize that insurance reform is all that's on the table right now, and it can be important to choose the lesser of evils when that alone is within our power in the moment. But we also need to remember our dream. I believe the American dream is not about material success, not about being having the strongest military. The American dream is that every person might have a right to life, liberty and the pursuit of happiness.

It's amazing to hear Christians who talk about the right to life as though it ends at birth. They believe every egg has a right to hatch, but as soon as you're born, it's dog eat dog. We may disagree on when life begins, but if the right to life means anything it means that every person (anyone who has finished the gestation period) has a right to life. And if there is a right to life there must be a right to the necessities of life. Like health care.

I believe the American dream was not about property rights, but human rights. Consider the words of this national hymn:

"O beautiful for patriot's dream that sees beyond the years. Thine alabaster cities gleam, undimmed by human tears."

Doesn't that sound like someone cared about the poor? There are those who consider paying taxes an affront, but listen to these words:

"O Beautiful for heroes proved in liberating strife, who more than self their country loved and mercy more than life."

"Mercy more than life" -- have you ever noticed those words before? Supporting universal health care does not make you socialist or even a liberal, it makes you a human being. And it makes you an ambassador for the American dream which, in the mind of Thomas Paine, was a dream for every human being, not just Americans. As we struggle to get health care to all people, we may have to settle for the lesser of two evils, but remember your dream -- the true American dream, a human dream. Whatever we win through reform is just first step toward a day when every human being has a right to life, liberty and the pursuit of happiness.

The Rev. Jim Rigby is pastor of St. Andrew's Presbyterian Church in Austin. He can be reached at jrigby0000@aol.com.

I was in Berkeley Springs West Virginia (the back of beyond) last week and saw a sign that surprised me

[ http://www.google.ca/imgres?q=singl... ]