“to say there is no cost there is always a cost. No one is giving away the care for free’

Er, of course not. But European systems have universal coverage through either government or private national systems in which people pay no or very small co-pays. We do know we pay tax!

“Who says the Europeans have “health security?”

And that’s the point – we do not have the insecurity of worrying about whether we can afford vital healthcare. That simply is not true for millions of Americans, who daily go without drugs or cannot access vital care, say for cancer.

As the president of the American Cancer Society has said:

‘The truth is that there are gaping holes in our health care safety net and that most of these safety-net services are neither effective nor efficient in providing chronic-disease prevention, detection, or treatment… For too many hard-working “average Americans,” paying for cancer treatment means not paying rent, mortgage (resulting in foreclosure or eviction), or utility bills, or even going hungry.’

http://caonline.amcancersoc.org/cgi/content/full/CA.2007.0009v1?maxtoshow=&HITS=10,%2010&RESULTFORMAT=&author1=huerta&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

‘Outlier stories, I beleive this is what “health care systemâ€? is all about… Let people compete for the outliers business and patronage.’

By outliers I meant the relatively few instances where things go wrong. You can pick a case where an ambulance didn’t come in time but ignore the fact that the vast majority do. You can criticise the British NHS but the vast majority find its services fine, especially the planned primary care network. But clearly the millions of Americans without insurance is not an outlier but a common condition.

As for your idea of outliers, the precise opposite is of course true – private health insurers compete to unload the more risky people who threaten their profits.

‘Why is wrong to think that people should have to pay for the healthcare resources they use, be responsible and take pride in providing for themselves!’

Nothing wrong with that. But in Europe we like to work together to provide for everyone as well as ourselves.

Outlier stories, I beleive this is what “health care system” is all about. Doesn’t the standard 80/20 rule apply, 80 percent of the resources used on 20 percent of the population? The “vast majority” uses little or no care. The system is all about outliers. I am much more interested in how a system treats 16 year old terminal cancer patients, elderly patients that need a pain injection in their last stages of life, or kills patients when they didn’t want to be, than who is covered for their routine physical each year or how they get a spained ankle examined. I also don’t think that in this area either continent performs adequately.

However, I do say the best way to treat outliers is just like any other insurance or service based industry through a robust Market. Let people compete for the outliers business and patronage. Use comparative date, make decisions for yourself, engage a physician about different procedures and possiblities. If healthcare is so important why are we leaving up to Parliment, The White House, or Capitol Hill to decide.
This is personal responsiblity and much more effective that an a top-down micromanagement system that cannot meet the needs of individuals. Healthcare is provided individually.

Some other points
Who says the Europeans have “health security? Exactly what is that and how do you define it? Can you have that even being uninsured, I am assuming that health security is a financial thing as you infered it is something where one does not have to worry about the costs.
What is the “vast majority?” Would it be somewhere around 85%? Would you suggest then that the minority in Europe should just be happy that the vast majority have “health security” or should everyone have it?

Why can’t the EU cover everybody? I mean it is obvisouly has the better designed system.

Why is wrong to think that people should have to pay for the healthcare resources they use, be responsible and take pride in providing for themselves!

– The ER may patch you up for immediate problems but it is not a place to go for complex elective surgery and ongoing care. Just ask any cancer patient. And in the US you will get billed if you are uninsured.

– Assisted suicide is illegal in most European states. Doctor-assisted suicide is legal in a few places – Oregon for one.

– Ambulance response times are rigorously monitored in most of Europe (but not in the US). In London, the 8 minute target of 75% for most urgent cases is being met – not good enough you may say, but it’s a dream for many in the US (eg see Deadly Delays Plague Ambulance Services – Deborah Payne, Rotan Lee, Ricky Badway and Danny Rumph all have something in common. They’re dead. And they died after waiting anywhere from 19 minutes to more than an hour for an ambulance in Philadelphia. http://abcnews.go.com/Health/PainManagement/comments?type=story&id=4150758)

– But I guess the most ridiculous claim is that Americans experience better health security than Europeans. This is a real belly laugh – nothing compares with the insecurity of being uninsured and underinsured for many millions of Americans (many of whom are even afraid to call an ambulance because of the costs – and you even have fire trucks turning up to medical emergencies!). This simply does not exist for Europeans – you can pick on outlier stories all you like but the vast majority of people here do not go without the care and drugs they need because of cost. The stats say from the American Cancer Society show clearly the differences in outcomes between the insured and the uninsured.

Marc, you have no idea what you are talking about. If you get to an E.R., you’re in. I did it for 30 years, ER Medicine.

I know I know it is just anecdotal and doesn’t capture the real world of European Healthcare, right?

Now hurry and reply with another anecdotal story about the horrors of the American System so I can reply with another one from some European country… as if problems don’t exist everywhere.