I don't quite understand why the problem should be worse in the United States than in Europe. I was under the impression that medicine was more socialized there than here.

Maybe the socialized health care doesn't pay for the diapers. Maybe they just let the elderly wet themselves....

I don't quite understand why the problem should be worse in the United States than in Europe. I was under the impression that medicine was more socialized there than here.

Maybe the socialized health care doesn't pay for the diapers. Maybe they just let the elderly wet themselves....

If you imagine what it must have been like to worry about incontinence before someone developed that superabsorbent stuff that we take for granted... personal hygiene (babies, women, old people) must have been difficult.

In a million ways. Why should it be different? Whoever pays the bills calls the shots, thus it has always been, and always will. That's why, if you have any brains at all, you want to be the one writing a check to your doctor. You want him to work for you, and you alone.

What's the answer? Presumably you mean, how can we each individually pay for our health care (so we have maximum possible influence over its nature) without (1) running the risk of being utterly unable to do so, when we are hit with some unlikely catastrophe (leukemia, car accident), and (2) satisfy our ethical concerns by expressing some level of charity, in that we give the poor some of what they need to pay for their health care.

Phrased like that, the answers seem obvious, do they not? You spread risk out by allowing firms to sell insurance. Real insurance, not "health insurance," where you pay a certain premium and, if you have unexpected huge medical expenses defined in your contract, you collect on the policy and use the proceeds to pay your bills. Pretty simple, well understood economically, and no insertion of third parties between you and your doctor.

Charity works the same way. We know how to work charity, do we not? Salvation Army, Red Cross, et cetera. They solicit voluntary contributions, and then folks apply to them for help with their medical bills.

This problem is only "hard" because we refuse to confront reality on the subject. We fantasize that (1) there's some way the majority of us can escape the costs of our own health care, e.g. by taxing it out of Bill Gates or something (overlooking the nasty fact that all the Bill Gates in the world don't have enough wealth to cover 300 million of us), or (2) there's some financial hocus-pocus we can do to make health care way cheaper than it is, while still (ha ha) making it the best in the world and having our doctors and nurses well paid for their time. This is called wanting to have your cake and eat it too. Finally, (3) we cling to the fantasy that in medicine, unlike in every other human service (education, for example) it is possible and desirable for everyone to get exactly the same quality of care, the best. All of us can be above average, go to Harvard, et cetera. This prevents us from considering obvious useful things like allowing crappier health care providers to provide lower quality care for much less money to those who are willing to, medically speaking, drive a Yugo instead of a Mercedes, because they'd rather spend their money elsewhere right now. In this severe restriction of the ability of the market to differentiate its solutions to address the differing demands of its consumers, we do, indeed, raise the average cost substantially. Imagine if every college had to be Harvard. No community college, no tech college. What would be the average cost of a college education? How many people would have no college education instead of an AA degree? Dumb.

Thanks Carl. I tend to agree, but I don't see much political will to implement such a rational policy.

I live in Norway. People pay for the diapers themselves, but get subsidies from the government, and after a certain cost level (a few hundred dollars per year), the government pays all -- but the user still gets to choose the diapers. So, quality wins.