Affordable and available is the route the upcoming administration is trying to implement. I'll still pay, you'll still pay, and virtually everyone else will also, with some subsidies to aid those with insufficient income to purchase a plan. Nobody in the world gets free healthcare now, why do you expect us to do that here? Remember, the countries with socialized medicine have higher taxes to pay for that service, so they pay also. They just so happen to pay less than we do for a variety of reasons. But we are not even close to socialized medicine. The push is for universal healthcare so that those who are not insured now will not burden the rest of us with the high cost of curative treatment in ER's and late stage treatment for lack of early detection. We are paying for that care now, whether we like it or not. So why not bring those folks into the system, push early testing, preventative medicine and better pre-natal care. That makes more sense than the ridiculously pricey and inefficient system we now have.

When you do away with health care for a fee, then you will still have those who present only when they are seriously ill or are brought in due to injuries or illness. Then you have those who come in just to get some attention. You still need some form of triage to allocate resources to the most needy. Healthcare, in Virginia, is always available to those in need.

health care or education, two big sticking points with me. These issues are way to critical for our nation in the 21st Century to be dependent upon the whim of beneficent folks, who will almost certainly attach criteria such as religious affiliation, race, lifestyle, etc. Almost a quarter of our population has either no health insurance or are grossly underinsured. The collection plate or some foundation cannot provide the consistency of preventative care which is the key to turning around this health care mess.
And the same with education. If you are not an athlete, a genius or rich, then you are dependent upon charity and heavy debt to get any form of higher education, which is tanatamount to a better paid, highly skilled work force. Charity may have been sufficient in the days of the McGuffey Reader and a town doctor who prescribed a little laudanum now and then. If we want to avoid turning into a nation of obese ditch diggers, we need to invest in a healthier and highly skilled population or suffer the consequences of falling further behind as China, India and other new free market enterprises take the lead.

Len, I think you are confusing to role of government with the role of private charity.

Americans have always taken care of their own, and of others, through private charity. Bill Gates, for example, has given more toward the health of sub-Saharan Africa than the combined governments of Europe.

The more government drains from the private sector in taxes, the less there is available for charitable giving. Further, there is a perception that if government provides a safety net, there is less need to give, and charity is discouraged.

Sure, if we rely on private charity, there will be those who will not give at all, but they are really few, and their lack of participation diminishes the lot of the poor less than the inefficiency of passing our collective charity through the inefficiencies of government.

Mary, obviously we cannot keep an overweight or underweight female from getting pregnant, but if they do, and have a bad outcome, there is no use obsessing over it. You can only help those who are willing to help themselves. You should know that trying to make people do like they should is rather futile and you can't solve everyones problems.

but that does not explain why we are worse than other countries as far as health benchmarks are concerned. I also think that you need to think further than your own personal position. You are an American and as such you are part of a large social structure. Whether or not you believe it, you are responsible, to a degree, for the well being of others in our group. If everyone else is not as responsible as you, so be it. People vary in their capabilities, their skills, their drives and their contributions. But, as we have shown in the past, when the country is threatened we all pull together: the poor, the well off and all those in between. We are threatened now by a variety of factors, including escalating health care issues. Many people at the top of the income level have done a lot to push this country forward, but it is probably time to do more. You can always disagree and fall back on what is economically feasible and pure, but there comes a time when you have to dig deeper. Ideologically we are far apart, and, believe it or not, I respect and understand your position; but I have always had a lot of faith in the American experiment. And I still do.

Casting infant mortality as a health care problem is like blaming the firemen for a fire. The health care profession is beating itself to death trying to save people from their own folly already.

Sure, prevention is cheaper than trying to save a low birthrate, cocaine addicted preemie. Good luck getting a rebellious teenage smoker who won't even be bothered to use birth control to jog.

There is a moral hazard to shifting the responsibility for a person's actions to others. Every time we force responsible people to rescue the irresponsible, we are punishing responsibility and removing the consequences of irresponsibility. The result is always more irresponsible behavior.

but the fact is that we have a health problem that is costing all of us, including you and me. Our insurance rates are higher, health care costs are higher, the segments of the the population that are most adversely affected are a drain on the rest of us, cultural problem or not. Recent figures, for example, estimate that 2/3's of our population is overweight. That is not a cultural segment, that is most of us. This is not a problem we can afford to ignore. If affordable preventative medicine is not addressed, then we have a long wait for those slackers to die and make room for the skinny high achievers. Meanwhile, we all go broke paying for these problems. BTW, most children in the Nordic countries are born out of wedlock. And they drink a lot, eat a lot and, yes, they take drugs. However, the effort is made to push exercise and provide preventative medicine (which, as you well know, is much, much cheaper than curative medicine). So we cannot bury our heads in the sand and say "it's cultural". We have to address this as a nation because it will not solve itself.

I wonder how teens in those same European countries compare to ours in math or geography scores (higher) and in number of young people using drugs or in prison (lower)?

Is that health care too?

The problem of kids having kids and other cultural problems just can't be bought away with tax money. Family does matter.

Why do just about all the industrialized countries have better infant and under 5 year old survival rates than we do? They must not drink, smoke, eat pastries or take drugs? Those countries include Slovenia, the Czech Republic, Cuba, Cyprus, New Caledonia, South Korea and virtually all of Europe. We are on par with Croatia. Or, perhaps they have better and more affordable pre-natal and post-natal care. Could be? Or do all the wastrels live in our country only?
We have high poverty rates and inferior health care for the median and below incomes. That is not cultural. That is a travesty.