Normally the Czar enjoys reading BBC News as a slightly less Obamacized source of worldwide information. However, an article on the costs of healthcare leave the Czar slightly annoyed.

The article looks at McAllen, Texas, a town with a healthcare system that seems to support POTUS Obama’s plans for healthcare reform—and defies the Obamacare critics. Why? Evidently, the town spends double the dollars for Medicare (capitalism), yet the results are not as good as nearby communities that only spend the national average (Obamacare). Summary: spending like a capitalist sailor will not guarantee you better care. Quality can be done with lower costs. Therefore, Obama is right to reform and ration care. Or as author Katty Kay puts it, “In America, customers are king—and patients have that mindset too. Mention rationing and critics scream ‘socialised medicine’. But what McAllen shows is that more care does not necessarily equal better care. The White House says both suppliers and consumers of healthcare need to learn this lesson.”

Ms. Kay should Google the phrase specious argument and read the hits carefully. One form of specious argument is to create a false challenge, in which the opponent has to defend a position that he or she really does not hold, simply because you argue so hard for the opposite. This entire article is a classic example of this, presenting McAllen, Texas, as an embarrassing example to those opposed to Obamacare.

American suppliers and consumers of healthcare are not advocating that quantity is better than quality. We understand that a more expensive hospital may not provide better care than a less expensive or less equipped hospital. Actually, the average American probably knows that a more expensive hospital has a greater overhead or better funding than another: it is the competency and accessibility of medical staff that make a hospital better.

American suppliers and consumers object to the idea that government is somehow better able to provide these resources than existing structures. We do not fear that Gonzaga Heights will wind up with a better MRI than Muscovy: we worry that our doctor—who knows us, our family, and our history—will leave practice because Obamacare is not capping his malpractice insurance, but will be dictating to him how much he can be compensated and what patients he must see. You know, the rationing you yourself mention as a good idea. We are not concerned that our hospital will talk us out of a test we may or may not need: we worry that our hospital will wind up like a free health care clinic with interminable waits, high risk of secondary infection, and treatment by an overwhelmed, underpaid, and potentially inexperienced doctor limiting us to a fifteen minute assessment and treatment.

Ms. Kay does not appreciate how Americans view their doctors. We view them like our bartenders or barbers or accountants. We know we might have to wait a bit to see them, but when we do, we will get exactly what we need, with someone who knows us quite well and no longer has to ask annoying questions.

Conversely, we tend to view Obamacare as any other government run service: inefficient hassles, like getting a driver’s license, filing a property tax complaint, paying a traffic ticket, or stopping at the post office. You wait in long lines, following a plastic rope corral, only to work your way to a bored, obnoxious service clerk who suddenly slams the window shut and pops up a next window please sign. And now it is 5:00, and everyone is heading out.

So yes, we do understand that quality is better than quantity here in the colonies. What we also understand is that the United States is a massive organism, and massive organisms do not do precise things very quickly. When you need medical care, you need precision quickly. McAllen, Texas, gets that just as much as the other, less expensive communities.

Oh, and Ms. Kay? Anytime you introduce Texas as an example of something unusual or unpleasant, you make the other 49 states roll their eyes and say “No kidding.” Why do you think they call themselves the Lone Star State anyway?

The Czar of Muscovy

Божію Поспѣшествующею Милостію Мы, Дима Грозный Императоръ и Самодержецъ Всероссiйскiй, цѣсарь Московскiй. The Czar was born in the steppes of Russia in 1267, and was cheated out of total control of all Russia upon the death of Boris Mikhailovich, who replaced Alexander Yaroslav Nevsky in 1263. However, in 1283, our Czar was passed over due to a clerical error and the rule of all Russia went to his second cousin Daniil (Даниил Александрович), whom Czar still resents. As a half-hearted apology, the Czar was awarded control over Muscovy, inconveniently located 5,000 miles away just outside Chicago. He now spends his time seething about this and writing about other stuff that bothers him.