Apres le deluge Republican, quoi?

Admit it.  Only in public radio would we dare to launch a critical think-piece about the Republican Party in the language of the Land of Freedom Fries.

Ribbing aside, the question is real:  What next for the Republican Party, now that it possesses real power?

Here’s the conundrum for the GOP.  The defining philosophical conceit of the modern conservative movement was summed up by Ronald Reagan in his famous bon mot (see, there I go again).

“Government is not a solution to our problem,” he argued.  “Government is the problem.”

The trick, though, is that Reagan was wrong, at least a lot of the time.  If 9/11 taught us anything, it’s that big problems come torpedoing at our society all the time that have nothing to do with government.

Remember Hurricane Katrina?  That wasn’t a gray-faced government bureaucrat causing all the trouble.  It was a charging rhino of a storm that blasted a great American city.

And we expected Washington to be up to the task of responding.

These aren’t rare events.  A couple of weeks ago, when Muslim extremists tried to ship bombs on cargo flights, no one suggested that we find a laissez-faire, de-regulated, market-driven solution.

The second trick is that even the vast majority of Americans who vote Republican also want (read:  demand, in no uncertain terms) a lot of government services.

With the exception of school-age children, all those conservative-tilting seniors use more government programs and receive more government dollars in direct payments than anyone else.

In New York’s 20th district race, one of Chris Gibson’s TV ads featured an elderly voter praising the Republican for promising to protect that most Rooseveltian of programs, Social Security.

Voters also want something done immediately about jobs.  And they don’t want Bill Gates or Warren Buffet to do it.  They want Washington to make it happen.

Republicans, giddy from last Tuesday, have only begun to wrestle with this challenge

Consider health care.  If Republicans succeed in repealing or de-funding healthcare reform, tens of millions of Americans will once again be on the outs, stuck without dependable, reliable insurance.

They talk in vague terms about “repealing and replacing” the current reform package.  They offer what amount to symbolic ideas, including tort reform, as an alternative.

Yes, some kind of significant tort reform is a good idea.  But no, it won’t seriously change the cost of delivering health care to Americans, or extend care to a lot of additional people.

Being the party of Non! was a great political strategy for a party that was truly on the outside looking in.

The GOP succeeded in appropriating and leveraging America’s anger at the economic status quo.  But that’s not good enough anymore.

Now Republicans will need to govern, to legislate, and to come up with smart new policy ideas that solve real-world problems.    With the economy still teetering, gridlock and finger-pointing and campaign catch-phrases won’t satisfy voters.

We’ve had two whiplash elections in a row.  Unless Republicans pivot quickly and get down to business, look for more to follow.

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34 Responses to “Apres le deluge Republican, quoi?”

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  1. Fred Goss says:

    From the republican viewpoint the strategy of “non” to everything has worked well…they took the House, came close in the Senate and will now focus on doing the same (McConnell has said so) for the next two years in the effort to add the White House in 2012.

    Even with control of the House, with Obama still in office they (the GOP) can probably still get away with blaming him for “everything”

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  2. DBW says:

    It used to be that we would have elections, people would lick their wounds, and then to back to regular life and the task of governing. Not any more. The losers in elections seem to have more and more difficulty accepting the legitimacy of the other party, whether it was 2000 or 2008.

    I suspect that we are in for a few more whiplash elections. For voters the 2010 election was about the economy (stupid). .Yet here we have Republicans focusing on repealing health care and investigating the Obama administration. The fact is that we are in for a long hard slog on the economy. Not only have we had the financial crisis, but an underlying recession caused by the energy price spike in 2008. Now energy prices are heading up again threatening to choke off any recovery. Tax cuts and reduced spending do little to address the ongoing loss of manufacturing in the US and Europe or rising energy costs due to geopolitical realities, and flat production vs rising demand.
    I am not getting my hopes up that much will improve over the next two years.

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  3. Brian says:

    The GOP might want to bear in mind that in this “deluge,” Congressional Republican candidates won about 50.5% of the vote nationally, as compared to 49.5% for the Democrats. This might sound a note of caution for the Congressional party. If Mr. Obama, with his 7% victory in 2008, was accused of overreach, then the GOP, with its 1% “landslide” this year, has even more reason to not overestimate its mandate. Then again, “bitch and moan” may be a campaign strategy, but it’s not a governing strategy.

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  4. Brian says:

    Let’s also remember what happened after that last GOP wave in 1994. The American public always says it wants less government. Mr. Gingrich made the gargantuan mistake of actually believing them, of actually giving the people what they claimed they wanted. His political career never recovered from that misjudgment, from not realizing that what they people say they want and how they react when they actually get it are two completely different things. Try downsizing the military (53% of all discretionary federal spending) and see how keen people are on less spending.

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  5. Brian says:

    (And if you are using French, the adjective should be spelled with an i… Républicain)

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  6. Pete Klein says:

    Just a minor observation.
    If leaders are going to claim to be leaders, then they should stop saying, “The American people want” this, that or the other thing and start saying, “This is what I want.”
    Generals don’t do what soldiers want. They are leaders (good, bad and often indifferent) who tell soldiers what to do.

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  7. Mervel says:

    Well the party of no may do well by sticking to that strategy. So far the evidence on this health care reform bill is that the bill is literally making things worse, worse care, higher costs, less access and it may end up gutting another government program people do like, medicare. I can’t find one person who has been helped by this bill and I can show millions who have higher priced health care since the bill was passed. So in that case a NO would be good.

    The ongoing rounds of stimulus packages, saying no to those will have no downside, they don’t seem to do anything.

    On the Jobs front firms may hire when they understand that there is not some new payroll tax looming around the corner, they may hire when they see that the Republicans will fight any new crazy government initiatives.

    So no does work sometimes particularly when the solutions proposed and passed so far have objectively not worked. The status quo prior to these bills and spending was arguably better, and that is the case that they will make.

    But that is only a two year strategy and if it goes to far they will totally fail in 2012.

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  8. JDM says:

    “Voters also want something done immediately about jobs. And they don’t want Bill Gates or Warren Buffet to do it. They want Washington to make it happen.”

    Wrong. They want Congress to disassemble government by cutting taxes and lessening regulation.
    —–

    “Remember Hurricane Katrina?” A Democrat stronghold. What a government response disaster at the local level.

    —–
    Social Security…
    What a great program. You are guaranteed less than 1% on your lifetime savings. Maybe negative returns. Whoohoo.

    ——
    Consider health care. If Republicans succeed in repealing or de-funding healthcare reform, tens of millions of Americans will once again be on the outs, stuck without dependable, reliable insurance.

    No. Obamacare is the law of the land. Premiums are already up over 20%, and it’s still 4 years before the program gets started in earnest.

    —-
    “The vast majority of Americans who vote Republican also want a lot of government services.”

    They must have sat out this election. The vast majority of voters got rid of the big spenders (read: centuries of political experience)

    —–
    “The trick, though, is that Reagan was wrong”

    No. Government can’t make a blood transfusion without dropping half of the blood on the floor. Every service the government provides could be done for about 1/2 the cost through the private sector.

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  9. dave says:

    Republicans won the House. That is one half of one branch of our government. I am not sure how much power they really have right now.

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  10. Notinthevillage says:

    The trick, though, is that Reagan was wrong, at least a lot of the time.

    Broad partisan swipe devoid of specifics expected and noted.

    And we expected Washington to be up to the task of responding.

    Speak for yourself, it isn’t “we”. Washington is too bloated by bureaucrats and alphabet agencies with overlapping responsibilities to expect anything but a slow ineffective response.

    A couple of weeks ago, when Muslim extremists tried to ship bombs on cargo flights, no one suggested that we find a laissez-faire, de-regulated, market-driven solution.

    So what is your point? That your caricature of people that support free markets want anarchy?

    Yes, some kind of significant tort reform is a good idea. But no, it won’t seriously change the cost of delivering health care to Americans, or extend care to a lot of additional people.

    You’re asserting facts not in evidence. I would assume you have some numbers to back up the assertion. Or maybe not.

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  11. knuckleheadedliberal says:

    Call me crazy but I believe there are things that Republicans and Democrats can agree on and get done. Brian M. mentions tort reform as one. It isn’t a panacea but it is SOMETHING.

    Wouldn’t it be great if politicians started getting one small thing done at a time together, then maybe they could move on to something bigger. Everyone is stuck in this stupid negotiation mentality where they wont agree on the things they can agree on because they want to use that as leverage for the thorny issues. In reality the act of working in partnership creates more room for agreement on other issues.

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  12. knuckleheadedliberal says:

    For those of you who believe that Obamacare is causing rates to skyrocket; did you ever think that maybe it gives insurance companies cover to raise rates unnecessarily?

    I’ve posted this before; I have a letter from my health insurance company stating that they intend to raise their rates by about 12%-15% and that the new health care bill will add another 2.5% to the increase. I don’t know how many of you administer a plan for yourself or your workers but my insurance rates have been going up by double digit increases every year for a long time. In order to minimize the yearly increases I’ve had to raise the deductible or the co-pay every year. It is unsustainable. If I project my current insurance costs out 15 years at the average rate of increase insurance coverage will be over $15,000 per person per year and that insurance doesnt include dental care, routine eye care, or prescription drugs. That kind of insurance is already about $7,500 per person per year

    Sometimes insurance companies WANT you to drop your coverage. They are aiming to have a certain size pool. If too many people want a particular plan they jack the rate up and people drop out…if they can and still get other insurance. Good luck to those with pre-existing conditions.

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  13. Mervel says:

    I think that is partially correct Knuckle concerning what health insurance companies are doing and are going to do. It was also totally predictable and if anyone in the White House or Congress had understood health care before passing the bill they would have considered what would happen and is happening.

    It is unsustainable you are right. The bottom line is don’t say you have a fix for an issue when you don’t. This bill fixes some things such as pre-existing condition coverage and hurts many other things, like the costs most Americans are going to pay for health care. They could have done what you suggested, taken the small and compromising step of fixing the pre-existing condition problem and just done that.

    Now I am assuming within a year I can go sign up for the inexpensive, well run government health care offered to all as part of the bill. Does anyone really believe that is going to happen?

    That is the problem the whole administration is starting to seem bogus.

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  14. Mervel says:

    If Republicans want to win in 2012 they should make a bunch of noise but make sure they do NOT overturn this health care bill.

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  15. Bret4207 says:

    Oh geeze Brain M, put Reagans statement into context and it’s entirely correct! Over reaching, corrupt, inflexible, ever growing gov’t IS a problem. In Reagans speech it WAS the problem. To say he was simply wrong is incorrect. Considering you took me and some others to task for alleging Obamas statements regarding “the enemy” and “the back of the bus” as being out of context recently, I would have thought you’d be a little more considerate of how you phrased things.

    Now, please tell us just who these millions of Americans that suddenly have dependable. reliable healthcare are? Who are these people you allege have been given healthcare since the bill passed? As far as I know they don’t exist since the programs aren’t funded or in place yet. I believe the term you like to use when I offer such an argument is “strawman”.

    As for what the Repubs will do, probably they’ll blow this, just like they always do. Rather than concentrate of coming up with workable solutions and actual answers to problems, they’ll play politics and screw up things even more. All I can hope is that the few true TP type conservatives stick to their guns and play hardball within the Republican party.

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  16. phahn50 says:

    Bret et al. – the health care reform doesnt really kick in till ’14 to give the states and other organizations time to get ready for it. That wont prevent the Republicans from claiming that the continuing increases in health care costs in the next year or two are due to the health care reform law. Total costs from malpractice insurance related costs are estimated to be 10% of the total health care cost. Draconian tort reform might reduce that by half – a one time cost reduction of 5% which would be less than 6 months of health care inflation. Buying insurance across state lines might well increase health care costs. Doctors would have more options locally, reducing the leverage of the insurance companies. The “free-market” works, but it doesnt necessarily work for you.

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  17. Pete Klein says:

    I have noticed for years and years how insurance companies (not just health insurance) are in bed with the government. They get the government to pass laws forcing you to buy their pieces of paper.
    You give them money for a piece of paper. When you want to make a claim, they point to obscure wording to deny the claim or not pay as much as you thought they would.
    At least drug dealers and prostitutes actually give you something beyond a promise for the money you give them.
    The health insurance companies are in business to make money, not to provide you with a service. What they provide is a come-on for you to give them your money.
    As I have said before, the only solution to the health care problem is to make it a felony to buy or sell health insurance and have a truly free market for health care.
    If that seems too harsh, I would suggest the same as the above but to provide just a one for all health care plan administered by the Federal government and paid for through the Federal income tax. Anything else is just a subsidy for the health insurance companies.

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  18. Mike says:

    Knucklehead, You are right about Health Ins rate increases. In 2000 I switched companies, at the time my premium for a family plan with a $1000. deductible each was $6000/yr. No dental, no eyecare, no prescription. The new company was $3350./yr with a $2500 deductible. Seemed like a good deal at the time. Problem was the premiums went up every year anywhere from 10 to 23%. In Nov 2009 I got my notice that the rates were going up again by 14% which translated to over $12000./yr So in 9 yrs my premiums went up over 350%. I swithced companies at the beginning of 2010, went to a family plan with a deductible of $5500. each, no dental, no eye care , no prescription. The yearly premium is $5250. I just received notice that the premium is going up by 11% for next year. The rate increase has nothing to do with the new Healthcare Bills passage, companies must file for approval for rate increases in NY well in advance of notifying customers of the increase. IMO the administration ended up with a crappy bill that basically pleased no one. I guess my point is that the current Healthcare/Health Insurance situation has been a disaster, the republican solution of repealing it would do nothing to solve the problem.

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  19. phahn50 says:

    I guess the only question is whether or not it is a good strategy for the Republicans to focus on health care repeal to try to get control of the presidency in 2012. On the one hand, most of the parts that people will really like wont be activated yet, they wont be losing anything, combined with being able to complain about death panels and rising health are costs due to the health care reform bill makes it a good campaign issue. On the other hand, not “focusing on jobs” seems to have hurt Obama, and the Republicans are in danger of making the same “mistake” from a campaign perspective.

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  20. Brian says:

    “Now, please tell us just who these millions of Americans that suddenly have dependable. reliable healthcare are? ”

    Exactly. If we had Medicare for All (single payer), we’d have this. But Republicans and most Democrats in Congress oppose this.

    So the government doesn’t provide people with insurance and you mock the government for… not providing people with insurance? Ok thanks.

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  21. Brian says:

    Let’s not forget that “Obamacare” was based on the model pushed by the then REPUBLICAN governor of Massachussetts. That should’ve been a big hint that it was an awful idea.

    Health insurance money changers get an average 30% overhead, as compared to the 3% of (insert menacing music) supposedly inefficient “socialized medicine” Medicare.

    But yes, it was all a panacea before “Obamacare.” The tooth fairy told me so.

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  22. Dale Hobson says:

    phahn50 at 9:28 am said–
    “Total costs from malpractice insurance related costs are estimated to be 10% of the total health care cost. Draconian tort reform might reduce that by half – a one time cost reduction of 5% which would be less than 6 months of health care inflation.”

    Actually:

    In 2004, the CBO (Congressional Budget Office) calculated malpractice costs amounted to “less than 2 percent of overall health care spending.” Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small.
    http://www.cms.hhs.gov/NationalHealthExpendData/downloads/tables.pdf

    Later, the CBO revisited the issue of medical negligence costs. This time, they attempted to account for the indirect costs of medical negligence, mainly the idea that doctors order extra tests to avoid liability. Again, the CBO found that tort reform would only save 0.5 percent of all health care costs. (Bernard Black, Charles Silver, David A. Hyman, and William M. Sage, Stability, Not Crisis: Medical Malpractice Claim Outcomes in Texas, 1988-2002, Journal of Empirical Legal Studies, 2005.)

    Dale Hobson
    NCPR Online

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  23. Pete Klein says:

    Dale,
    You must know by now that facts are hardly ever the issue when it comes to politics.
    Fact: Medicare doesn’t cover everything because the insurance companies demanded a piece of the action.

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  24. phahn50 says:

    Dale – my numbers (10 % for malpractice) came from my son via his medical school lectures. Im happy to hear that they are too high (and not surprised I guess). In other words, tort reform would have only a negligible effect on health care costs. (but it would punish trial lawyers for being major contributors to Democrats).

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  25. Pete Klein says:

    Could it be that rural residents don’t know on which side their bread is buttered?
    Voters in Hamilton County had an almost perfect voting record in the just past elections. Hamilton County residents voted for everyone who didn’t win except for voting for Sayward and Little who did win but ran unopposed.

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  26. knuckleheadedliberal says:

    The fact that tort reform wont really help anything is exactly why I support it.
    The sooner everyone realizes that all the “fixes” to our current health insurance system don’t work the sooner we’ll have single-payer health-care.

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  27. Bret4207 says:

    Could someone explain to me why they think they have a right to healthcare and that that gov’t should provide it? Seriously, I mean it. That argument makes no sense to me. If we should all pitch in and pay for everyones healthcare then shouldn’t we next all pitch in pay for everyones home and car and vacation and education and groceries and entertainment and pets and dental work and hobbies?

    Somehow this doens’t make much sense to me. I agree there’s a problem with rising costs but I don’t see too many good solutions to the problem.

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  28. knuckleheadedliberal says:

    Bret, to start with it would be an excellent way to help create a real free-market economy.

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  29. phahn50 says:

    Bret – thats just what we do. If someone needs health care, we give it to them. In third world countries, its too bad if you cant pay for it – you dont get it. I dont know if there is a WHY. It is part of our value system that has evolved the way it has. I dont know if it is a “right”, or just the way we do things. The question for you is why do you think people have a right to health care but dont have the obligation to pay for it either by buying insurance or out of pocket. (Or with taxes as in a single payer systerm).

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  30. phahn50 says:

    The only solution is rationing health care.

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  31. Notinthevillage says:

    Later, the CBO revisited the issue of medical negligence costs. This time, they attempted to account for the indirect costs of medical negligence, mainly the idea that doctors order extra tests to avoid liability. Again, the CBO found that tort reform would only save 0.5 percent of all health care costs.

    I would definitely like to see the assumptions that went into the CBO’s report because those numbers are clearly at odds with a survey of doctors done in 2008 in Mass.

    http://www.massmed.org/AM/Template.cfm?Section=Home6&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=30633

    A Medical Society study of Massachusetts physicians last year was the first of its kind to quantify defensive practices across a number of medical specialties and the first to link defensive medicine to Medicare cost data. The study found that 83 percent of physicians reported practicing defensive medicine, and that an average of 18 to 28 percent of tests, procedures, referrals and consultations and 13 percent of hospitalizations were ordered for defensive reasons.

    The Society conservatively estimated the cost of such practices to be a minimum of $1.4 billion, but cautioned that the real price tag is likely much higher, as the dollar estimates do not include tests and diagnostic procedures ordered by physicians in other specialties, observation admissions to hospitals, specialty referrals and consultations, or unnecessary prescriptions. And the eight specialties represented in the survey accounted for only 46 percent of the physicians in the state.

    By my calculations the CBO is low by more than an order of magnitude. Since the Mass study claims to be the “first of its kind to quantify defensive practices” it begs the question, what did the CBO use to arrive at its estimate? Based on the Mass study phahn50′s 10% looks a lot closer to reality. Seems to me that doing some real studies where people are not making wild guesses would be a good investment. I would also prefer it not be the CBO that is often asked to conduct studies with assumptions that are not remotely connected to reality.

    I could write a great deal about the medical system as I have seen it from a number of different viewpoints. My family has seen both the private and public insurance realities under life threatening circumstances. I spent 5 weeks with a close relative in an ICU in what is arguably one of the best hospitals in the world. One of the most striking things was of the 20 beds in that ICU 18 were not from the US. We are the state of the art and that clearly has an effect on costs. I also have a close relative that is an engineer in the implantable medical devices industry so I am not unfamiliar with the significant regulatory cost. The newest technology is not purchased by the socialized medicine states. The US is the main driver and funder for medical advances by a long shot. We pay for the vast majority of the R&D and the rest of the world benefits. It clearly isn’t fair but that’s just the way it is.

    The medical system is enormously complex and highly regulated. Simple solutions to complex problems never work. A friend in Mass just this past week was diagnosed with a second coronary blockage. This person, who is on the government plan, was denied services for the first blockage. The close relative with a life threatening condition who I mentioned above was originally treated under private insurance. I cannot offer enough praise to the insurance company for making themselves a non issue during the whole ordeal. This same close relative had to switch to the publically funded system due to age disqualifying this person for the private insurance. In spite of the fact that this close relative had a life threatening situation this person spent 2 years fighting with the public insurance to get treated. I have lost 2 Canadian friends that died on waiting lists with conditions that were treatable had they not had to wait. Another friend who works for a Canadian company last year had a major heart attack. A number of this persons Canadian coworkers remarked that had it happened in Canada survival would have been unlikely. Be careful what you wish for.

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  32. knuckleheadedliberal says:

    How about this for a story? Brian M. contacts a few insurance brokers and tries to find out what the best insurance plan would be for a hypothetical new small business that was planning to open in Saranac Lake, Canton, or Glens Falls with maybe 7 employees.

    Let people understand what the process of trying to find health insurance is like. Find out how many plans are available, at what rates, what is or is not covered, when people can be enrolled, who is eligible, various deductibles, co-pays etc.

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  33. Bret4207 says:

    “The question for you is why do you think people have a right to health care but dont have the obligation to pay for it either by buying insurance or out of pocket. (Or with taxes as in a single payer systerm).”

    Very well put phan. Anyone care to support the idea?

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  34. phahn50 says:

    notinthevillage – despite anectotal stories, the evidence is that Canadians (and the English for that matter) are as healthy as we are when everything else is controlled. Curiously, studies have shown that people living in the Boston area are less heathy than similar people living in the midwest, and the explanation is that the extra exposure to high-end medical expertise is actually unhealthy. Some things are counterintuitive, and medicine is full of them. Another example – people with pancreatic cancer actually live longer in a hospice than they do in the ICU. The quality of their last days is infinitely better, and the cost is lower by many orders of magnitude. In the US, the default decision is to send everyone to the ICU to die. This is probably a bigger chunk of our health care dollars than is medical malpractice insurance.

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