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Looking from a distance (I'm in Australia), one of the problems that America faces is that everyone feels that the government should make them better off. As a result you have a massive deficit, and lots of free handouts. The difference between Democrats and Republicans is that they want a different free handout.

Australia is in many ways becoming similar, wait until the prices for our coal and iron ore drop, and then we will find that our budget has problems.


It's a shame that the direct medical message of the New York Times piece is buried at the very end. Do not confuse "a bad idea for blanket recommendation" (the statistical conclusion) with "ineffective" or "disowned" (a caricature of the conclusion). As a man with a very strong family history of prostate cancer, the distinction is meaningful to me.


The reason why Forbes isn't a socialist? Compulsion. When a government enforces participation, that's socialism. When subsidy is not mandated by government (i.e.: I can opt to spend my money elsewhere, possibly resulting in no treatment when ill, or opt to spend it on insurance, or self-insure, etc.), that's a free market doing what free markets do.

There's nothing wrong with subsidy...someone choosing to share their money with others.

There's something wrong with compulsory participation in subsidy...someone's money being shared with others, whether they like it or not.

Cody L. Custis


Anytime I hear the term 'my,' it screams anecdote based medicine. And yes, there is a difference between routine screening, and screening for people at higher risk. So, maybe the fair question is 'what is strange about Steve Forbes' colon?'


To world's surprise Robert Herz stepped down as boss of the Mercantile Accounting Standards Board last moon. Senseless Panic


>This means those people who do not want to pay for ineffective tests are forced to subsidize those who do (via insurers).

No, it means those who do not want pay for ineffective tests would pick insurance plans that do not cover those tests and thus pay less.

William Nichols

Steve Forbes gets it wrong in almost every detail, yet he is more or less right on the big picture issue of government as the decision maker on effectiveness. Richard J. Ablin argues
1) that the original decsion to recommend routine screening was wrong
2) panels, such as a government panel, are and will be influenced(or even captured) by those with a financial interest
3) decisions should be made with local knowledge (e.g. family history, baselines, medical history)

Now, your point that Steve Forbes argued badly (very badly indeed) is correct. The rhetorical shot about "socialist", however, is an unnecessary cheap shot. He said that health care needed more free enterprise without specifically endorsing your alternative. The deconstruction is stronger without the impled ad hominiem accusation of hypocracy.


A.B.: We do not have insurance plans that are defined by individual tests. That's totally impractical.

William: You make good points. Sure, I went overboard in writing the title of the post but at least I did not falsely accuse people of being murderers (aka death panels).

In the US, we have a medical insurance system. Insurance, by definition, is a cross-subsidy system. As I discussed in Chapter 3, such subsidies are justified by a notion of statistical "fairness". That means people who are not at risk of prostate cancer should not be recommended to take annual tests.

I assume that Forbes's definition of "free enterprise" is no government meddling. Thus, I'd think individual choice is a component of "free enterprise". What's wrong with letting individuals make their own decisions, and paying for their tests?

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