Friday, August 31, 2012

Shame, apparently, is overrated.

Let me say this for the bazillionth time: Facts matter! It is not possible to find a solution to a problem unless you take time to assemble the facts about the problem. American politics has apparently gone down the rabbit hole with Alice. Here's what Michael Cooper said in his NY Times column Facts take a beating in acceptance speeches:

"The two speeches — peppered with statements that were incorrect or incomplete — seemed to signal the arrival of a new kind of presidential campaign, one in which concerns about fact-checking have been largely set aside."

"The growing number of misrepresentations appear to reflect a calculation in both parties that shame is overrated, and that no independent arbiters command the stature or the platform to hold the campaigns to account in the increasingly polarized and balkanized media firmament. Any unmasking of the lies or distortions, the thinking goes, rarely seeps into the public consciousness."

"Representative Paul D. Ryan used his convention speech on Wednesday to fault President Obama for failing to act on a deficit-reduction plan that he himself had helped kill. He chided Democrats for seeking $716 billion in Medicare cuts that he too had sought. And he lamented the nation’s credit rating — which was downgraded after a debt-ceiling standoff that he and other House Republicans helped instigate."

"And Mitt Romney, in his acceptance speech on Thursday night, asserted that President Obama’s policies had “not helped create jobs” and that Mr. Obama had gone on an “apology tour” for America. He also warned that the president’s Medicare cuts would “hurt today’s seniors,” claims that have already been labeled false or misleading."

Cooper points out that both sides are doing it: "In recent weeks, the Romney campaign has broadcast television advertisements leveling the widely debunked assertion that Mr. Obama had gutted the work requirements for welfare recipients. The Obama campaign, for its part, ran a deceptive ad saying that Mitt Romney had “backed a bill that outlaws all abortion, even in case of rape and incest,” although he currently supports exceptions in cases of rape, incest or when the life of the mother is at risk.?"

The amazing part is that they apparently do not care if they are caught. The Washington Post reported earlier this week that "Yesterday, at an ABC News panel, Mitt Romney pollster Neil Newhouse said, “We’re not going to let our campaign be dictated by fact-checkers.” Apparently the campaigns are going with their alternate views of reality thinking that their base will believe what they're told because the base WANTS to believe these kinds of things and the folks who don't believe it won't vote for them anyway. 

You know things are out of hand when Sally Kohn of Fox News calls Ryan's speech "an apparent attempt to set the world record for the greatest number of blatant lies and misrepresentations slipped into a single political speech."

Here's a summary of the fact-checking for Paul Ryan's speech:

  • Ryan said Obama broke a promise by not saving a GM plant in Janesville, Wis. But PolitiFact could find no evidence that Obama explicitly made such a promise and, more importantly, the plant closed before Obama was even sworn in.
  • Ryan chastised Obama for creating a bipartisan debt commission and doing nothing with its findings. But asTalking Points Memo points out, Ryan was on that commission—and voted against it, as did the panel's other Republicans.
  • Ryan attacked Obama for the S&P's downgrade of America's sovereign credit rating. Which is rich, writes Brett LoGiurato of Business Insider, because the S&P specifically said that it downgraded the rating "because the majority of Republicans in Congress continue to resist any measure that would raise revenues."
  • He repeated the Romney campaign's frequent assertion that Obama "funneled" $716 billion out of Medicare to pay for ObamaCare. Actually, the Affordable Care Act reduces payments to health care providers, not Medicare's budget.
  • In another oft-repeated distortion, Ryan said Obama wanted to credit the government with the private sector's successes. "That isn't what the president said. Period," Kohn writes.
  • The speech also gave Mitt Romney credit for bringing up household income as governor of Massachusetts. That's only half-true, PolitiFact rules: Adjust for inflation, and income actually decreased.
  • Near the end, Ryan described protecting the poor as the "greatest of all responsibilities." According to TPM, two-thirds of the cuts in his budget proposal come from programs that help the poor.

How did Mitt Romney do? Here's a link to the Washington Post fact check of his speech:

Although the "fairness doctrine" no longer applies on radio and TV, we will fact check the Democratic convention a week from now.

Wednesday, August 29, 2012

Today's post could save you thousands of dollars!

The single most common reason that people are hospitalized is falling. After a fall, particularly for those of us of the Medicare age group, the patient often needs to spend some time in a rehab facility. We all know that Medicare will pay for the first 20 days of rehab or nursing home care after a 3-day hospital stay. Not so fast! Failing to read beyond this point may cost you several thousand dollars!

Laraine Sickels, 71,  is a retired teacher who lives in the state of Washington. She fell last summer, broke her pelvis in 3 places and was rushed to the hospital on Thursday morning. By the next Monday, she was ready to leave the hospital for a stay at a rehab facility. That's when her bank account began to bleed.

Let's pick up the story as told in a post on the Money magazine/CNN website titled The painful new trend in Medicare.

"For four nights and five days, she had slept in a hospital bed and donned a hospital bracelet while doctors ran tests and prescribed medications. Yet she'd been held under observation, a designation intended for patients who aren't ready to go home but don't need as intensive care as a fully admitted patient does. And with Medicare, observation services don't count toward rehab coverage."

So her 10-day rehab stay cost Sickels $7,027 out of her own pocket. Medicare wouldn't pay a penny toward rehab. Also, since Medicare wasn't paying anything, neither would Medicare supplemental insurance.

"While not commenting on Sickels' case, Joanne Roberts, the hospital's chief medical officer, says it's common for an otherwise healthy pelvis-fracture patient who doesn't have surgery to stay on observation."

"Sickels' story is an increasingly familiar one. Medicare pays hospitals far less for observation than for inpatient stays. As Medicare seeks to cut costs, a growing army of auditors use an automated screening system to second-guess admissions. A hospital that gets dinged commonly loses all its revenue for a stay."

"Spend a night in the hospital for chest pain, and Medicare might pay the hospital $4,100 if you're an inpatient, $1,800 if you're on observation, says Sandra Routhier, a consultant for Panacea Healthcare Solutions. When an auditor rules that an inpatient stay should have been observation, the hospital typically loses the entire Medicare payment."

You really need to read the full story yourself, Click here to get a better understanding of what happened to Sickels and why.

Then, learn how to protect yourself in a similar situation by reading Medicare: Avoid big rehab bills.

Thursday, August 23, 2012

5 myths about Canadian health care - part 2

In part 1 of this post we let peer-reviewed research explode two of the common myths about Canadian health care. In spite of what "everybody knows," Canadians are not flocking to the USA for health care and there are currently more doctors coming into Canada than leaving Canada. Now let's look at the remaining myths:

Myth no. 3: Canada rations health care; that’s why hip replacements and cataract surgeries happen faster in the United States.

"When people want to demonize Canada’s health care system — and other single-payer systems, for that matter — they always end up going after rationing, and often hip replacements in particular."

"Take Republican Rep. Todd Akin of Missouri, for example. A couple of years ago he took to the House floor to tell his colleagues:"

[Readers may recognize the now-familiar Missouri congressman who is now running for the Senate. That's right, he's the "you can't get pregnant if you're 'legitimately raped'" guy. I swear, I did not even know he was quoted in this article until I began writing this post earlier today, but his scientific wisdom sure does seem to get around. Here's what he had to say:]

“I just hit 62, and I was just reading that in Canada [if] I got a bad hip I wouldn’t be able to get that hip replacement that [Rep. Dan Lungren] got, because I’m too old! I’m an old geezer now and it’s not worth a government bureaucrat to pay me to get my hip fixed.”

"This has been debunked so often, it’s tiring. The St. Louis Post-Dispatch, for example, concluded: “At least 63 percent of hip replacements performed in Canada last year [2008] ... were on patients age 65 or older.” And more than 1,500 of those, it turned out, were on patients over 85."

Myth #4: Canada has long wait times because it has a single-payer system.

"The wait times that Canada might experience are not caused by its being a single-payer system."

"Wait times aren’t like cancer. We know what causes wait times; we know how to fix them. Spend more money."

"In 1966, Canada implemented a single-payer health care system, which is also known as Medicare. Since then, as a country, Canadians have made a conscious decision to hold down costs. One of the ways they do that is by limiting supply, mostly for elective things, which can create wait times. Their outcomes are otherwise comparable to ours."

"Please understand, the wait times could be overcome. Canadians could spend more. They don’t want to. We can choose to dislike wait times in principle, but they are a byproduct of Canada’s choice to be fiscally conservative."

"Yes, they chose this. In a rational world, those who are concerned about health care costs and what they mean to the economy might respect that course of action. But instead, they attack the system."

Myth #5: Canada rations health care; the United States doesn’t.

"This one’s a little bit tricky. The truth is, Canada may “ration” by making people wait for some things, but here in the United States we also “ration” — by cost."

"An 11-country survey carried out in 2010 by the Commonwealth Fund, a Washington-based health policy foundation, found that adults in the United States are by far the most likely to go without care because of cost. In fact, 42 percent of the Americans surveyed did not express confidence that they would be able to afford health care if seriously ill."

"Further, about a third of the Americans surveyed reported that, in the preceding year, they didn’t go to the doctor when sick, didn’t get recommended care when needed, didn’t fill a prescription or skipped doses of medications because of cost."

"Finally, about one in five of the Americans surveyed had struggled to pay or were unable to pay their medical bills in the preceding year....And remember: We’re spending way more on health care than any other country, and for all that money we’re getting at best middling results."

So, why is this all important? It's important because we have something to learn from all the other advanced nations, including Canada, who manage to get better health care outcomes at half the per capita cost of the USA.

We're fighting tooth and nail over how to best pay for our health care system. The truth is that our system itself is the problem. No matter how we attempt to pay for it, it's too expensive and doesn't produce good results.

The rest of the developed world is running lab experiments for us. We could emulate the Taiwanese who in 1995 decided to look at all these other systems and design one for themselves based on the best parts of everyone else's systems. For crying out loud, if the Taiwanese could do it why can't we?

Sunday, August 19, 2012

"When did Norma Rae get to be the bad guy?"

If you loved the bashing of teachers and their unions in the documentary "Waiting for Superman," you will be ecstatic over the new feature film "Won't Back Down."

While "Waiting for Superman" caused a stir, it didn't do well at the box office and its expected Oscar nomination never happened. "Won't Back Down" is a star-studded (Maggie Gyllenhaal, Viola Davis, Holly Hunter, Ving Rhames, Rosie Perez) big budget feature designed to tug on the emotions. It is being produced by Walden Media, the same folks who brought you "Waiting for Superman."

The story is about a fictional law in Pennsylvania which allows parents and teachers to take over a school which is performing poorly. While these "parent trigger" laws exist in some states, they do not involve teacher participation. To get a feel for how teachers are viewed, have alook at the movie's trailer.

Frank Bruni wrote a column titled "Teachers on the Defensive" in this morning's NY TImes in which he points out that "... the main financing for the movie came from a school-privatization advocate who is no fan of teachers’ unions." [Emphasis mine.]

"And it actually takes pains to portray many teachers as impassioned do-gooders who are as exasperated as parents are by the education system’s failures — and by uncaring colleagues in their midst. But I understand [AFT president] Weingarten’s upset. The union that represents one of those do-gooders (Viola Davis) has lost its way, resisting change, resorting to smear tactics and alienating the idealists in its ranks. What’s more, some of the people who are assertively promoting “Won’t Back Down” are those who cast teachers’ unions as a titanic impediment to the improvement of public education. So “Won’t Back Down” is emerging as the latest front in the continuing war between those unions and their legions of critics, and it has become yet another example of how negatively those unions are viewed." [Emphasis mine.]

"“When did Norma Rae get to be the bad guy?” asks a union leader (Holly Hunter) in the movie. I don’t know, but that’s indeed the state of play when it comes to teachers’ unions, and it’s a dangerous one."

Bruni goes on to say "Perhaps most striking are the rifts that have opened between teachers’ unions and Democrats, who had long been their allies. In Chicago, Philadelphia, Los Angeles and other cities, Democratic mayors have feuded bitterly with teachers’ unions and at times come to see them as enemies. And at a meeting of the United States Conference of Mayors in June, Democratic mayors joined Republican ones in a unanimous endorsement of so-called parent trigger legislation, about which unions have serious reservations. These laws, recently passed in only a few states but being considered in more, abet parent takeovers of underperforming schools, which may then be replaced with charter schools run by private entities." [Emphasis mine.]

"The unions have also run afoul of the grim economic times. “In the private sector, nobody’s got any security about anything,” said Charles Taylor Kerchner, a professor of education at Claremont Graduate University. So the unions’ fights over pay raises and pensions, he said, made previously routine negotiations “look like pigs at the trough.” [Emphasis mine.]

"Kerchner was being sympathetic and said that teachers were hardly overpaid. But they have unwittingly assisted efforts by Republicans in particular to turn them into caricatures of entitlement in an era when there are many Americans poised to see them that way." [Emphasis mine.]

As of this writing, Bruni's column has received nearly 100 comments from readers. I would categoize many of them as "I wish I had written that." I will pass along some of the better comments in a future post. Until then, watch your back because there are millions of dollars of publicity behind this movie.

Friday, August 17, 2012

5 myths about Canadian health care. - Part 1

As promised earlier, here are 5 myths about Canadian health care (spread out over two posts). This is based on a column on the AARP website by Aaron E. Carrol, M.D. who is the director of the Center for Health Policy and Professionalism Research:

Myth #1: Canadians are flocking to the USA for medical care. "How many times have you heard that Canadians, frustrated by long wait times and rationing where they live, come to the United States for medical care? "

"I don’t deny that some well-off people might come to the United States for medical care. If I needed a heart or lung transplant, there’s no place I’d rather have it done. But for the vast, vast majority of people, that’s not happening."

"The most comprehensive study I’ve seen on this topic — it employed three different methodologies, all with solid rationales behind them — was published in the peer-reviewed journal Health Affairs."

"The authors of the study started by surveying 136 ambulatory care facilities near the U.S.-Canada border in Michigan, New York and Washington. It makes sense that Canadians crossing the border for care would favor places close by, right? It turns out, however, that about 80 percent of such facilities saw, on average, fewer than one Canadian per month; about 40 percent had seen none in the preceding year."

"Then, the researchers looked at how many Canadians were discharged over a five-year period from acute-care hospitals in the same three states. They found that more than 80 percent of these hospital visits were for emergency or urgent care (that is, tourists who had to go to the emergency room). Only about 20 percent of the visits were for elective procedures or care."

"Next, the authors of the study surveyed America’s 20 “best” hospitals — as identified by U.S. News & World Report — on the assumption that if Canadians were going to travel for health care, they would be more likely to go to the best-known and highest-quality facilities. Only one of the 11 hospitals that responded saw more than 60 Canadians in a year. And, again, that included both emergencies and elective care."

"Finally, the study’s authors examined data from the 18,000 Canadians who participated in the National Population Health Survey. In the previous year, 90 of those 18,000 Canadians had received care in the United States; only 20 of them, however, reported going to the United States expressively for the purpose of obtaining care."

Myth #2: Doctors in Canada are flocking to the United States to practice. "Every time I talk about health care policy with physicians, one inevitably tells me of the doctor he or she knows who ran away from Canada to practice in the United States. Evidently, there’s a general perception that practicing medicine in the United States is much more satisfying than in Canada. Problem is, it’s just not so. Consider this chart:"

"The Canadian Institute for Health Information has been tracking doctors’ destinations since 1992. Since then, 60 percent to 70 percent of the physicians who emigrate have headed south of the border. In the mid-1990s, the number of Canadian doctors leaving for the United States spiked at about 400 to 500 a year. But in recent years this number has declined, with only 169 physicians leaving for the States in 2003, 138 in 2004 and 122 both in 2005 and 2006. These numbers represent less than 0.5 percent of all doctors working in Canada."

"So when emigration “spiked,” 400 to 500 doctors were leaving Canada for the United States. There are more than 800,000 physicians in the United States right now, so I’m skeptical that every doctor knows one of those émigrés. But look closely at the tan line in the following chart, which represents the net loss of doctors to Canada."

In 2004, net emigration became net immigration. Let me say that again. More doctors were moving into Canada than were moving out.

Tuesday, August 14, 2012

The spin machine is out of control.

I know, I promised in my last post that I would expose some myths about Canadian health care in this post. But the last few days have put the Medicare spin machine into hyperdrive.

The Romney/Ryan campaign is all over the airwaves claiming that Obama is going to cut Medicare by $700 billion. They, however, vow to "preserve and protect Medicare." What's the real story?

Ezra Klein does a good job of clarifying the story in a couple of Washington Post blog posts today. In the first post Klein asks three questions:

"1. Mitt Romney says that “unlike the current president who has cut Medicare funding by $700 billion. We will preserve and protect Medicare.” What happens to those cuts in the Ryan budget?"

"2. What is the growth rate of Medicare under the Ryan budget?"

"3. What is the growth rate of Medicare under the Obama budget?"

"The answers to these questions are, in order, “it keeps them,” “GDP+0.5%,” and “GDP+0.5%.”

That's right. The Ryan budget--already passed by the House--contains exactly the same cuts to Medicare as those found in the Affordable Care Act (Obamacare). In addition, both the ACA and the Ryan budget limit the growth of Medicare to exactly the same amount. So where's the controversy? 

First of all, let's understand that these "cuts" to Medicare are NOT cuts in benefits. Instead they are cuts to the rate of growth of items in the Medicare budget such as Medicare Advantage plans run by private insurance companies at a cost 15-20% more per participant that traditional Medicare. (See Medicare meets Obamacare). In fact, the ACA specifically prohibits cuts to Medicare benefits.

In his second post, Klein explains the underlying differences. I'm going to quote a significant portion of his post since I couldn't explain it better:

"Since the Romney campaign wants to run against President Obama’s cuts to Medicare, it’s something of a problem for them that Paul Ryan’s budget includes those very same cuts to Medicare. And so they’ve come up with a somewhat confused and confusing argument to distinguish the two plans."

"Obama’s cuts to Medicare are different because Ryan “keeps that money for Medicare to extend its solvency” while Obama uses it “to pay for a new risky program of his own that we call Obamacare.”

"This is basically a misunderstanding of how budgeting works. Or, at the least, it’s predicated on the listener misunderstanding how budgeting works."

"What they’re doing is switching between two questions very quickly. The first question is: “How much money are you cutting from Medicare?” The second question is: “How much overall deficit reduction is contained in your plan?” And the second question isn’t getting answered."

"Here’s what everyone agrees on: Ryan and Obama include the same cuts to the Medicare program itself. So if you’re an insurance company participating in the Medicare Advantage program, you’re getting the same cut no matter who wins the election. So the answer to the first question is, “the same amount as the Obama administration.”

"What Romney/Ryan are saying is that they then take the money saved from their cuts to Medicare and put it toward deficit reduction while Obama takes that money and spends it on health care for poor people [and other things like eliminating the "doughnut hole" in Medicare prescription drug plans]. The argument here is that by using the money to cut the deficit, Romney/Ryan make future cuts to Medicare less likely."

"But Romney/Ryan also add a trillion dollars to the defense budget. And they have trillions of dollars in tax cuts they haven’t explained how they’re going to pay for. So those decisions make future cuts to Medicare more likely. Meanwhile, Obama cuts defense spending by hundreds of billions of dollars, raises about $1.5 trillion in new taxes, and puts all that money into deficit reduction. So that makes future Medicare cuts less likely."

"So if the argument is that Romney/Ryan protect Medicare by putting the $770 billion in cuts towards deficit reduction, Obama protects Medicare by twice as much by putting the $1.5 trillion in new tax revenues towards deficit reduction. So far as the deficit is concerned, there’s no difference between a dollar from Medicare and a dollar from taxes."

"Which just leaves us where we began: Romney/Ryan want to do more of their deficit reduction by cutting social services while Obama wants to do more of his deficit reduction through raising taxes. Deciding whose plan makes more sense requires making judgments about whether Romney/Ryan will ultimately pay for their tax cuts. But deciding who is cutting Medicare by $700 billion just requires looking at who is cutting Medicare by $700 billion. And at the moment, that’s both Obama and the Republican budget."

You probably needed to read this twice, didn't you? Now imagine trying to explain it to Joe Sixpack in a 30-second TV ad. When the spin machine starts up, the low-information voter doesn't stand a chance!

Sunday, August 12, 2012

Slaying some health care myths.

We're back from the Adirondacks, and happy to have an internet connection again! During the time away, I found some interesting information regarding the British and Canadian health care systems. Some of what I found may surprise you. Let's begin with the Brits. Their National Health Service (NHS) is routinely blasted by those who claim that the American system provides the best health care in the world (more on that in a later post).

In an August 3 piece in the NY Times, Uwe. E. Reinhardt points to a famous example: "The most humorous illustration of American N.H.S.-bashing was supplied during the heated health reform discussions in 2009 by Investor’s Business Daily. In an editorial, the paper asserted, “People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the quality of life of this brilliant man, because of his physical handicaps, is essentially worthless.”

Problem is that Hawking is British and has lived in England all his life. Famously suffering from Lou Gehrig's disease, Hawking says that “I wouldn’t be here today if it were not for the N.H.S. I have received a large amount of high-quality treatment without which I would not have survived.” Oops!

Reinhardt points to a Washington Post column by Ara Darzi--a former British Minister of Health--which gently corrects American misunderstandings about the NHS:

"Every Briton is registered with his or her own family doctor, whom they can see when they need -- without paying a fee. These doctors are independent contractors to the health service and are recognized and rewarded for quality in their compensation -- so they can focus on what works, not just what pays. Expanding on the facilities that are already in place, by next year every community in England will have a physician's office open from 8 a.m. to 8 p.m. every day of the year, and you can simply walk in and see a doctor, for free, regardless of whether you are registered." [Emphasis mine.]

What about those long waits we hear about? Darzi says "In the unfortunate instance that a patient is diagnosed with a dire disease, such as cancer, it often takes only a week or two for a patient to be seen by all the right specialists, complete all the required diagnostic tests and be ready for surgery or other interventions. This rivals the best care in the United States or anywhere else in the world."

OK, but you Brits have "death panels"! Darzi says "Many of the mischief-making rumors have focused on our National Institute for Health and Clinical Excellence, the clinically led body, independent of government, that gives advice on the effectiveness of drugs and treatments. Call it fiscal conservatism or old-fashioned common sense, but we think you should pay only for what works." [Emphasis mine.]

Well, you must admit that all of the medical innovation comes from the USA. " should be remembered that Britain's pharmaceutical industry is second only to the United States in its innovation and the significance of its discoveries. The NHS invents and delivers pioneering treatments, from the first clinical use of MRI in the 1960s to leading developments in robotically enabled scar-free surgery today."

Darzi concludes by pointing out that he is not suggesting an American adoption of the NHS: "Standing in defense of Britain's health service does not mean that we believe it is the right prescription for the United States. It is not for us to propose the solution for America, but we hope that correcting the record on some of the facts about our NHS will help Americans evaluate the real strengths and challenges of our system, instead of focusing on the misinformation spread by fear-mongers. Indeed, none of the proposals for reform -- from President Obama or anyone else -- would create a system that resembles that in Britain. What we share across the Atlantic are a set of common values: a belief that health care transcends the narrow confines of consumerism and is a moral right to be secured for all; and fidelity to the principle that a good society brings its citizens together in common purpose, where hope can overcome fear."

"Fear is the weapon of choice for opponents of reform who have no substantive alternative to offer. America spends five times the share of its national wealth on health as Singapore, and yet life expectancy in each country is roughly the same. Even allowing for other factors, it is undeniable that the way a health system is organized and operated makes a difference. Americans fear that countries such as Britain and Canada ration care -- and that such rationing could and should never be tolerated in the United States. Yet 47 million uninsured is quite an extreme form of rationing. So at this moment, the burden of proof falls upon those who oppose change -- for they stand in defense of fear."

Maybe if we stopped being so fearful of the health care systems of other countries--and convinced that any solution to a problem other than "the American way" can't possibly be any good--we might be able to learn some things that could lead to a solution to our health care crisis. 

In the next few weeks, we're going to hear a lot of talk about our national deficit. Getting health care costs to the level  of other advanced nations would solve our entire deficit crisis. It's worth paying attention.

Next up: Actual research explodes some myths about the Canadian health care system.

Wednesday, August 1, 2012

Does anyone else see the irony here?

It's going to be a long slog to November 6. I just returned from a few days in Florida. Let me tell you that you can be thankful that NY is not a "swing state." It seems that every other ad on TV in Florida is already a negative ad from one campaign or the other. Every once in awhile they do manage to make time for an ad for a Fucillo auto dealership. That's right, he's all over Florida too!

Although NYSUT has taken a position supporting Obama, I intend to address only issues of concern to retired teachers. If a candidate is addressing education reform, Social Security, health care (including Medicare) I intend to weigh in. We'll leave the questions of defense spending, gun control, gay marriage and Romney's dressage horse to others.

Romney's overseas trip to England, Israel and Poland contained a couple of health care items. The Olympic opening ceremonies contained an 11-minute tribute to Britain's NHS (National Health Service). The Brits spend about 8% of their gross domestic product (GDP) on health care and --amazingly--they seem to really like it. It's not perfect, but they seem very satisfied with a system that assures everyone of health care with good outcomes and no medical bills or bankruptcies caused by medical bills. Not a single British parent worries about whether their children will receive proper medical attention.

If only the Brits would see the light and adopt our health care system that costs 18% of GDP, produces outcomes worse than most other advanced countries and finds thousands of people traveling hundreds of miles to wait in line at charity clinics, when they can find one. Oh well, too bad for the Brits!

And then there was Israel. Romney praised Israel for spending only 8% of GDP on healthcare while remaining "a pretty healthy nation."

Romney said "When our health care costs are completely out of control. Do you realize what health care spending is as a percentage of the GDP in Israel? 8 percent. You spend 8 percent of GDP on health care. And you’re a pretty healthy nation. We spend 18 percent of our GDP on health care. 10 percentage points more. That gap, that 10 percent cost, let me compare that with the size of our military. Our military budget is 4 percent. Our gap with Israel is 10 points of GDP. We have to find ways, not just to provide health care to more people, but to find ways to finally manage our health care costs."

Perhaps the man is simply irony-deaf. He's praising Israel's health care system that his party would use their "second amendment rights" to insure never could happen in the USA. Let's take a look at Israel's health care system as explained by Sarah Kliff in the Washington Post:

"Romney’s point about Israel’s success in controlling health care costs is spot on: Its health care system has seen health care costs grow much slower than other industrialized nations."
"How it has gotten there, however, may not be to the Republican candidate’s liking: Israel regulates its health care system aggressively, requiring all residents to carry insurance and capping revenue for various parts of the country’s health care system."
"Israel created a national health care system in 1995, largely funded through payroll and general tax revenue. The government provides all citizens with health insurance: They get to pick from one of four competing, nonprofit plans. Those insurance plans have to accept all customers—including people with pre-existing conditions—and provide residents with a broad set of government-mandated benefits."
"Health insurance does not, however, cover every medical service. Dental and vision care, for example, fall outside of the standard government set of benefits. The majority of Israelis—81 percent —purchase a supplemental health insurance plan to “use the private health care system for services that may not be available in through the public system,” according to apaper by Health Affairs."
And now it's time for charts. First, here's Israel's health care spending compared with the other OECD (industrialized) countries.
Where is the USA on this chart? Remember that 18% of GDP that we spend on health care? The OECD average just touched 9%. We're so far off the top of the chart that we'd need to double the height to get to 18%.
Let's look at life expectancy.

Know what, Mr. Romney? I like the Israeli health care system too. Tell me you will support a similar system in the USA and you just might get my vote! But, you just might not get the Republican nomination.