Cathy, or Cat as she likes to be called, left this comment a while ago:
Hey Preston, have you looked into living somewhere else? I don’t mean that in a rude way. I mean, have you looked into the countries of the world and found one that is not entirely ruled by corruption and bankers? One that’s a bit more your style?
I feel another way we can create change is to vote with our feet and take our value with us. If you have enough money to invest or have needed skills, most countries in the world will be happy to accept you.
Norway was a great experience for me because it taught me that you can have a fiscally conservative yet socially liberal government. Norway not only wasn’t in debt, it had money to spare. Taxes were high, costs were high, but I felt like I was part of something much bigger than myself. Most people I knew there didn’t feel outrage about paying those taxes because the government generally did good things for the people with the money. There was a bit of corruption, there were scandals sometimes, but on the whole it was a great place and I often wish I could return.
France taught me that it is possible to have an engaged society that debates everything. I had many long lunches with friends, questioning life, politics, philosophy… everything. France has its problems, to be sure. They are different problems than the USA faces, in many regards. It was eye-opening to realize that countries could have their problems yet still function on a basic level. That you could move somewhere and trade one set of problems for another set of problems that was more to your liking. A doctor paid me a house call — a house call! — after I had been ill for a week with strep throat. Sometimes the bus drivers or the metro drivers would go on strike and make it really hard to get the laundry done but… house calls!
The luckiest thing that ever happened to me, I think, was that I had to have emergency abdominal surgery the week before I came back to the USA. The cost was minimal. Once I came back to the USA, no health insurer would accept me because of “pre-existing conditions”. Had I come down with peritonitis just a week later, I would have been on the hook for tens of thousands of dollars in emergency care despite the fact that I was financially able to pay $500 a month or some other ungodly amount for free-market health insurance.
I think some of the more “socialist” countries in Europe have struck a nice balance (Norway, Sweden, Denmark, Finland, Holland). Some haven’t (UK, France, Germany, etc).
Maybe there’s a place in the world where you would feel such a nice balance has been struck?
PS: The reason my name changed to “Cat” is because many European languages have no sound for “th”. Rather than become “Kat-ee” or “Kaz-ee” I decided that almost anyone could pronounce “Cat”.
OK Cat, if that’s what you’d like to be called. 🙂 To answer your question, no I haven’t considered living some place else. There are three main reasons for that:
- My daughter lives here and she needs a father.
- I really do love this country and I feel it needs people like me in the crisis that it is going through. The “common people” are going to be blindsided by this and are going to be looking for answers and I’d like to provide them some.
- This is going to be a worldwide depression. There are few safe places to go. Macroeconomic theory and policy has permeated virtually every government on the face of the planet, so almost every government is going to be making the same mistakes. The advantage of being in the United States is that this country was the birthplace of the free-market economy. If it can’t take root again here, then I can’t see it doing well anywhere else.
In regards to your experiences in Europe, I appreciate you sharing them here. Socialism tends to do best in countries that have a high amount of natural resources per capita. It also needs for its citizenry to be rather homogeneous because in Socialist countries the government has a lot of power of its citizenry. If the government and the citizenry agree on what is “best” then the the two can live in harmony. If, on the other hand, the citizenry is diverse, then there is no consensus on what is “best” and the government will tend to take actions that are only pleasing to a few select groups.
The United States has embraced virtually all tenants of Socialism. As former Presidential Candidate of the Socialist Party of the United States Norman Thomas said, “”The American people will never knowingly adopt socialism, but under the name of liberalism, they will adopt every fragment of the socialist program until one day America will be a socialist nation without ever knowing how it happened.” I find it hard to identify anyway that we are not a Socialist nation, outside of the field of medicine as you pointed out.
The field of medicine is touchy. There’s aren’t a whole lot of easy answers. But, prompted by Cat’s comment, I visited the Libertarian website and viewed their official position on Healthcare. Here’s what they had to say:
Making Healthcare Safe and Affordable
As recently as the 1960s, low-cost health insurance was available to virtually everyone in America – including people with existing medical problems. Doctors made house calls. A hospital stay cost only a few days’ pay. Charity hospitals were available to take care of families who could not afford to pay for healthcare.
Since then the federal government has increasingly intervened through Medicare, Medicaid, the HMO Act and tens of thousands of regulations on doctors, hospitals and health-insurance companies.
Today, more than 50 percent of all healthcare dollars are spent by the government.
Health insurance costs are skyrocketing. Government health programs are heading for bankruptcy. Politicians continue to pile on the regulations.
The Libertarian Party knows the only healthcare reforms that will make a realdifference are those that draw on the strength of the free market.
The Libertarian Party will work towards the following:
1. Establish Medical Saving Accounts.
Under this program, you could deposit tax-free money into a Medical Savings Account (MSA). Whenever you need the money to pay medical bills, you will be able to withdraw it. For individuals without an MSA, the Libertarian Party will work to make all healthcare expenditures 100 percent tax deductible.
2. Deregulate the healthcare industry.
We should repeal all government policies that increase health costs and decrease the availability of medical services. For example, every state has laws that mandate coverage of specific disabilities and diseases. These laws reduce consumer choice and increase the cost of health insurance. By making insurance more expensive, mandated benefits increase the number of uninsured American workers.
3. Remove barriers to safe, affordable medicines.
We should replace harmful government agencies like the Food & Drug Administration (FDA) with more agile, free-market alternatives. The mission of the FDA is to protect us from unsafe medicines. In fact, the FDA has driven up healthcare costs and deprived millions of Americans of much-needed treatments. For example, during a 10-year delay in approving Propanolol Propranolol (a heart medication for treating angina and hypertension), approximately 100,000 people died who could have been treated with this lifesaving drug. Bureaucratic roadblocks kill sick Americans.
I have long maintained that the FDA is just another example of a government “watchdog” organization that has been taken over by the companies it was supposed to be regulating. There have been a number of drugs that were approved by the FDA that had to be recalled because they killed people. Eliminating the FDA would be an excellent step towards lowering the tax burden.
I will discuss healthcare at greater length in a future blog.
2 thoughts on “Why Stay in America”
Thank you for giving some thought to my question. I had forgotten that you had a daughter. Of course she needs a father!
Many of the places in the world where life is relatively more free from governmental intervention are also places in the world where there is less of everything else, too. Less wealth, less clean water, less transportation, fewer basic services (like medical care), and so on. Some Americans still make the choice to go to such countries and scratch out a living on their own land, late 1800’s style. If they happen to ply a trade which can be paid in a foreign currency (like writing), they can live quite well on their income and enjoy the mental benefits of being closer to the cycles of nature than you and I are.
Some days, I’m half tempted to go live in some remote village somewhere and help raise barns and dig wells. Then I remember I’m a soft American who couldn’t stand the heat, the bugs, and the lack of Tylenol.
It’s unfortunate that you pick the FDA as a target, since the FDA has semi-recently deregulated some aspects of its guardianship to the detriment of society. I’m talking about the herbs and supplements industry, which now peddles untested, unverified snake oil at every pharmacy near you. Getting rid of the FDA entirely means more snake oil, not less. The FDA’s practices are not perfect, as medical professionals will tell you. I have heard that drug makers often conceal unfavorable or neutral (no better than placebo) studies and submit only the highly-favorable ones to the FDA. In the absence of all information about a drug, another Vioxx could very well slip through.
I personally think closing that hole is preferable to opening it wide. Peddlers of snake oil already do such cherry-picking of “studies” to sell their concoctions directly to people. I can find Bach’s Flower Remedy (homeopathic garbage) on the shelf next to the Sudafed (proven decongestant), for pete’s sake! I shiver to think of all beneficial medicines being lost in that sea of misinformation. It’s already hard to Google any combination of symptoms without landing upon the webpage of a “naturopath” or a “homeopath”, neither of which require rigorous medical degrees. Journalists, who don’t know science from pseudoscience, keep doing stories about acupuncture, chiropractors, and other sham treatments that are no better than placebo. As a people, what we know about medicine is being directed by insufficiently skeptical people and spiritual nonsense in the name of making a buck.
In the Libertarian quote above, it says (tellingly) “For example, during a 10-year delay in approving Propranolol (a heart medication for treating angina and hypertension), approximately 100,000 people died who could have been treated with this lifesaving drug.” Note it does not say that the treatment would have saved any of those 100,000 lives. It just says that they could have been treated with the drug had it been approved sooner. Well, yes. But so what? How many would have actually been saved? How many would have died of a heart attack anyway, or an embolism or a stroke? High blood pressure (mostly) comes from lifestyle factors that predispose people to other risks of premature death.
Propranolol was the first drug of its type. Ten years isn’t a terribly long time to study the effects of something new before giving it to human beings. Is there any specific incompetence being alleged, or is this just about delays? Getting something faster isn’t always better. Drug companies mix up untold numbers of completely crap drugs for every drug that might show a little promise. Fast-tracking them all into human guinea pigs is fixing the problem of “delays” by supplanting it with the problem of “untested drugs hurting people”.
I tend to read a lot of medical blogs and there’s a lot of controversy surrounding the use of experimental drugs. For one thing, they’re usually insanely expensive. Cancer, which is a huge magnet for experimental drug treatments, involves lots of drama and controversy and heart-wrenching stories. So-and-so didn’t get Experimental Drug A and died. What they don’t tell you is that So-and-so would have lived maybe 4-6 extra months at a cost of $200,000 to be paid by somebody else (usually Medicare). Nobody would ask for $200,000 experimental drugs if the bill wasn’t going elsewhere (unless they were very rich). A staggering number of people get cancer now because they are living long enough to get cancer. The risk grows with age. They get old, they get cancer, and we throw pots of money at them to treat them even though the cancer likely won’t kill them before something else does.
I go back and forth on this. Extending life is precious, but at what cost? The most expensive years of a person’s life are currently their last ones, and those are the years which suck Medicare dry. Old people stacked like cordwood in nursing homes, scarcely able to talk or feed themselves, getting run by ambulance to the super-expensive ER periodically because the attendants don’t want to take any chances of getting sued for the slightest missed symptom. Eventually the oldest wind up in an ICU where the relatives, upset and unwilling to let go, demand that everything possible be done. They’re not paying, so why not ask for every life-extending measure possible?
We got here in part because of malpractice lawsuits. An 80 year old woman passes away in an ICU and the family is looking to collect. The doctors can’t say “no” to unrealistic demands because a jury of non-scientific, non-medical people will judge their actions and render a verdict on their professional competence. Such juries are easily swayed by emotional appeals and pseudoscience. Very few people think, “Well, grandpop is pushing 90, he had a good life, let’s put him in a hospice and let him die peacefully.” The doctors and nurses themselves are starting to become very upset about how much they must prod and poke and torture people who are clearly dying because it’s the family’s wishes and the victim can’t speak up. This is the medical system that lawyers have won for us.
In many countries where medical care is paid for in part by the government, they’re beginning to do studies on various treatments to see which ones are the most cost-effective. It’s a hard thing to do — to put a price on a few hours or months of life — but it needs to be done as scientifically as possible. Those treatments which do not offer cures but merely prolong life (such as Propranolol) need to be scrutinized. Many older drugs are, surprisingly, as effective as newer drugs, but for a fraction of the cost. That’s why insurance companies keep coming up with tiers of drug coverage. They want to direct treatment first to the old standbys before paying out the nose for the newest tiny tweak of the same old molecular structure.
In Norway, when my blood pressure began to rise, my doctor there was confident enough to say “get some exercise and it will fix itself”. He didn’t shove me out the door with a bottle of diuretics in one hand and a bottle of statins in the other. And you know what? He was right. I made the effort and my blood pressure is now below average. Denying people Propranolol for ten years might have resulted in a few dying who might not otherwise have died, but how many of those people could have been saved (for free) by modifying their lifestyle?
I look forward to your post on health care.