Health Care

[jdonn]

Ken you just used a very logical chain of reasoning to end at a single payer system, then had nothing to go against it except a cliche and a fictional anecdote. Interesting...

[kenrexford]

Ken you just used a very logical chain of reasoning to end at a single payer system, then had nothing to go against it except a cliche and a fictional anecdote. Interesting...

Actually, what I just did was precisely what you said. I agree that I gave a very compelling reason for a single-payer system. I also with a cliche noted that our government sucks at doing sensible things right. I think that's the main point many have been raising.

 

Lots of good ideas fail because they look good on paper but fail in the execution because people are political, corrupt, and idiots.

 

On a different note, I think I could solve the entire problem very easily. We came up with gambling to help schools. What about legalizing drugs to pay for health care? These seem obviously related. The drug trade is worth billions, we'd save on housing the drug criminals, and we could use fewer police officers, prosecutors, judges, and criminal defense attorneys then. I bet it would just about pay for whatever health care system you would ideally want.

[jdonn]

I doubt it would raise what is needed, but I'm all for it!

[hrothgar]

I doubt it would raise what is needed, but I'm all for it!

Works for me as well

 

(FWIW, my drug use is limited to booze and caffeine)

[kenrexford]

Wow. Massive agreement on the horizon??? LOL

 

Actually, I'm also a caffeine and nicotine man, but these industries are already paying down medical costs a lot.

[Winstonm]

I'm all for a single payer as long as it is: YOU. :P

[kenrexford]

I'm all for a single payer as long as it is: YOU. :P

So few words, so much said. :)

[luke warm]

dems to use obscure ping pong strategy to get fast(er) passage

As one might expect, Republicans in Congress are aghast over the move. Michael Steel, a spokesman for House Minority leader John Boehner, told Yahoo! News that such a tactic would break President Obama's campaign promise of health care debate transparency. He labeled the strategy a "disgrace":

[kenberg]

Is there really a Michael Steel acting as a spokesman for Boehner? This will be confusing, since Michael Steele is the RNC chairman. I'm not trying to be picky, I am wondering if there is both Steel and Steele? And maybe Steal?

 

As to the issue, very few things in life are as clear as the fact that no Republican in either chamber will be voting for this bill. Why should Dems go through the pretense of soliciting their opinion or Reps go through the pretense of suggesting ideas? If the Dems hold their coalition together there will be a bill, otherwise there will not be a bill. It is fair and natural to judge the Dems on the content of the bill, since it is totally their bill. But as to tactics, the Reps have made it clear that they will defeat it by any means possible and it hardly makes sense to criticize Dems for trying to prevent this from happening.

 

I absolutely would have preferred cooperative efforts of Dems and Reps on this. It would have been better for the country, and I think it could have been a better bill. It is now completely impossible that this will happen, so the reality has to be dealt with.

[Winstonm]

The healthcare debate is like a box of chocolates - if it isn't squishy in the center it must be a nut.

[jdonn]

As to the issue, very few things in life are as clear as the fact that no Republican in either chamber will be voting for this bill. Why should Dems go through the pretense of soliciting their opinion or Reps go through the pretense of suggesting ideas? If the Dems hold their coalition together there will be a bill, otherwise there will not be a bill. It is fair and natural to judge the Dems on the content of the bill, since it is totally their bill. But as to tactics, the Reps have made it clear that they will defeat it by any means possible and it hardly makes sense to criticize Dems for trying to prevent this from happening.

Exactly. But since when did Republicans ever need a reason that makes sense in order to criticize someone?

[Winstonm]

It is fair and natural to judge the Dems on the content of the bill, since it is totally their bill.

 

I believe it to be the bill White House wanted from inception of the idea - public option and medicare buy-ins were red herrings to make it appear that progressive concerns were being addressed.

[blackshoe]

Exactly. But since when did Republicans politicians ever need a reason that makes sense in order to criticize someone?

Fixed. <_<

[jdonn]

Exactly. But since when did Republicans politicians ever need a reason that makes sense in order to criticize someone?

Fixed. :)

Lol what's funny is I had "Republicans and Democrats" typed out, stared for like 30 seconds, then settled on what I put. The Republicans have just raised the bar in this area over the course of recent years. But you are right that I was referring to politicians.

[mikeh]

First, this pre-existing condition nonsense.  You can't buy fire insurance if your house is burning.  You can't buy collision insurance if the police are at the scene.  Your heirs can't top up your life insurance when you're lying in the casket.  Why on Jon's green earth would you (or should you) be able to buy health insurance that covers a pre-existing condition?  Anyone who believes you should is too dumb to understand the concept of insurance.

 

I think that this passage, and the mindset behind it, is revealing.

 

To many citizens in other western democracies, health care...and the right to affordable treatment for ALL health issues...is a basic human right...it is something that we, collectively, owe to all members of society.

 

In the US, the basic approach is that individuals are responsible for their own survival...that society owes them nothing at all (altho Medicare is an exception to that....and it is ironic that many of the beneficiaries of medicare are outspoken opponents of 'socialized medicine').

 

So, in the US, health insurance is akin to any other kind of insurance....it is up to an individual to obtain it, and if they can't afford it....well...they and their ancestors must be failures in life...they don't deserve health care....unlike the hundreds of thousands (if not millions) who inherited enough money that they need never worry about such mundane matters.

 

Leaving aside this major issue, the US individual responsibility approach is manifestly an economic disaster.

 

The US ranks appallingly low in any survey of health care in terms of the quality of service afforded the population as a whole. It ranks at the top for the wealthy, but near the bottom, of western democracies or nations such as Japan, for the population as a whole. This is reflected in mortality rates as well as other metrics.

 

And it accomplishes this dubious distinction despite having a huge number of doctors per unit of population, and despite having the world's most aggressive retail pharmaceutical industry and the world's highest health care costs.

 

In addition, the cost to society of having so many millions of people deprived of regular health care advice is correspondingly large. When people are forced to seek care only when seriously ill, and cannot get access to preventative care, their illnesses last longer, are more disabling, and more expensive to treat, while keeping those affected, and sometimes their family members, out of the productive work force. Even tho most of these people work in low-paying jobs, or don't work at all, the loss to the economy of their labour, and the increased costs of dealing with them only late in their disease process makes this approach irrational.

 

Moreover, a health care system designed to improve the health of the population, rather than to generate profit, would focus more on maintenance and prevention, including education of the young so as to avoid or reduce the incredible growth rate in diseases that stem from obesity and lack of exercise.

 

At least, based on what reading I have done, the foregoing appears to be accurate.

 

I now await the knee-jerk response of the conservatives B)

[kenrexford]

Leaving aside this major issue, the US individual responsibility approach is manifestly an economic disaster.

 

...

 

 

This is reflected in mortality rates as well as other metrics.

 

 

 

...the incredible growth rate in diseases that stem from obesity and lack of exercise.

Interesting post. But, one observation seems worthy to make. Taking these three parts of your post, I see a hidden assumption problem. The effectiveness/quality of a health care system does not have a direct correlation to mortality rates or to other statistical analyses of results.

 

If one system has a terrible health care system but very healthy people, wo eat well and exercise, it might well end up with a better mortality rate than a system with a tremendous health care plan but folks who smoke too much, eat terrible food and too much of the same, and don't exercise enough.

 

This seems obvious, but the quoted statistics, often offered by many people, seem to miss this point.

 

Americans smoke too much, eat ridiculous food and too much of it, and don't exercise enough. Duh!

[mikeh]

Ken: a proper health care system is not merely a system that reacts to health problems when they trigger actual illness or disability.

 

A proper health care system views health as a lifestyle issue as well as a treatment of acute/chronic illness or injury issue.

 

Thus, a proper healthcare system should include education as early in life as possible (preferably to parents before the children are born) about healthy lifestyles and so on.

 

I cannot readily quote or cite anything in support of this, but I have a vague recollection of reading, some time ago, of the results of a study that purported to examine the costs/benefits of such an approach, and it was overwhelmingly economically the better approach....now, studies of this nature are not exactly infallible, and maybe I remember it this way because it accords with my biases :wacko:

 

So, while I appreciate your point, my response is that you are yourself the victim of a hidden assumption ...that 'health care' relates only to responses to the issues that traditionally call for medical reaction, as opposed to health care (which need not be 'medical') pro-action.

 

As an aside, partially related...I was listening to a NPR show, which discussed the extremely low rate of breastfeeding amongst african-american women. Breast-feeding has been conclusively shown (according to 'experts' quoted in the broadcast) to confer many benefits on children, compared to formula...and it is also FAR less expensive. Yet even mothers on welfare were very reluctant to breastfeed...and the problem cut across economic divides.

 

A comprehensive health care system would presumably involve substantial investment in education of women on this issue, and many others, probably needed in high school or earlier (as a male, I am singularly unqualified to say much on this, and I recognize that)...and since the outcome has a major impact on the long term physical and mental health of children, this is a health care issue but needs no hospitals or doctors or drugs.

[Winstonm]

To many citizens in other western democracies, health care...and the right to affordable treatment for ALL health issues...is a basic human right...it is something that we, collectively, owe to all members of society.

 

I think this is the critical aspect of Mike's post - it deals directly with the difference in the prevailing U.S. view versus the the view of the rest of the world - a U.S. view assisted heavily by the spook-and-scare-tactics squads who paint word-pictures of the evil ISMs behind any attept to change a profitable status quo.

 

If the propaganda push was for the right of everyone to join the U.S. Army and go fight the Huns there would be near unanimous approval of such basic right.

[mike777]

I would also add people have the right to an affordable shelter and food and education as basic human rights.

 

Hopefully not only the right but the center and left will accept these as universal basic rights.

[kenberg]

This country has trouble with subtlety and pragmatism. It seems to me that the number of people who really think everyone should be on their own for health care is quite small. If you phrase the question as asking whether children should be denied care when their parents can't afford it, I think the number is almost zero. But problems arise from the fact that we simply cannot afford to do everything for everyone. I have long ago accepted the fact that life is finite and that the end stages of life is often no walk in the park. Much of the cost of medical care comes up in this endgame. Yes I wish to have medical care as I reach the end of my life and yes I expect this will be costing more than what I have needed over my first seventy rather healthy years. But I would not expect my family to spend all their resources and go into heavy debt to keep me alive a while longer, and I can hardly expect the country to do so either.

 

What this means to me is that healthcare will always have some inequality in its delivery. If Warren Buffet spends, say, fifty million on his own health needs, that's his business. I wish him the best. I don't have fifty million, and I don't expect someone else to come up with it either.

 

The above example is extreme of course. But I think an attitude of yes we would like to help those in need and yeat we have to be able to afford it, and yes we expect those who are being helped to also take some responsibility for their own health would be an aprroach that would appeal to many people, not all of them raving lefties.

 

 

PS About statistics: I believe that Minnesota has a much lower cost per person for medical care than does the country as a whole. Healthy living? Prudent medical treatment? Maybe. But I grew up there and as I recall, when people got old, a lot of them moved to Florida. That will keep the costs down too, for Minnesota. The unexamined statistic is not worth reading--- Socrates.

[kenrexford]

Ken: a proper health care system is not merely a system that reacts to health problems when they trigger actual illness or disability.

 

A proper health care system views health as a lifestyle issue as well as a treatment of acute/chronic illness or injury issue.

 

Thus, a proper healthcare system should include education as early in life as possible (preferably to parents before the children are born) about healthy lifestyles and so on.

 

I cannot readily quote or cite anything in support of this, but I have a vague recollection of reading, some time ago, of the results of a study that purported to examine the costs/benefits of such an approach, and it was overwhelmingly economically the better approach....now, studies of this nature are not exactly infallible, and maybe I remember it this way because it accords with my biases :rolleyes:

 

So, while I appreciate your point, my response is that you are yourself the victim of a hidden assumption ...that 'health care' relates only to responses to the issues that traditionally call for medical reaction, as opposed to health care (which need not be 'medical') pro-action.

 

As an aside, partially related...I was listening to a NPR show, which discussed the extremely low rate of breastfeeding amongst african-american women. Breast-feeding has been conclusively shown (according to 'experts' quoted in the broadcast) to confer many benefits on children, compared to formula...and it is also FAR less expensive. Yet even mothers on welfare were very reluctant to breastfeed...and the problem cut across economic divides.

 

A comprehensive health care system would presumably involve substantial investment in education of women on this issue, and many others, probably needed in high school or earlier (as a male, I am singularly unqualified to say much on this, and I recognize that)...and since the outcome has a major impact on the long term physical and mental health of children, this is a health care issue but needs no hospitals or doctors or drugs.

Actually, I'm not really a victim of a hidden assumption, as you may think, for two completely different reasons.

 

First, you confirm that part of my thought that I stated, namely that comparison of statistics like mortality rates does little to assess whether the treatment side of the "health care system" is better or worse than another, as the "general well-being plan" of a health care plan -- good living -- has too much impact when the lifestyles are known to be radically different.

 

However, you also assume that a hidden assumption was hidden from me, when I actually quite consciously hid it from my post. The reality is that it seems critically important to the new plan to force lifestyle changes on Americans. I keep seeing more and more about food rules and the like, things that cause me more worry than anything. For, as a red-blooded American, although I don't own a gun, I am rather p'd off about the lifestyle patrols starting to gain momentum.

 

It frankly hacks me off (strangely fitting pun, I know) to have legislatures ban people like me from having a dsmned cigarette or cigar at a bar. Have the legislature start banning cigarettes altogether, for health reasons, and there will be a traffic jam in Washington of pickup trucks trying to find parking spots, which would be fabulous, if you ask me.

 

Shut down McDonald's, tax my Coca-Cola, and make me use frickin' margarine for my frickin' fricassee, and you are getting revolt.

[PassedOut]

PS About statistics: I believe that Minnesota has a much lower cost per person for medical care than does the country as a whole. Healthy living? Prudent medical treatment? Maybe. But I grew up there and as I recall, when people got old, a lot of them moved to Florida. That will keep the costs down too, for Minnesota. The unexamined statistic is not worth reading--- Socrates.

Premiums for Medicare are uniform across the US, but the spending for healthcare services received is not. And it is not just that the health of residents varies from state to state.

 

The amount that Medicare pays for services varies from hospital to hospital. For example, a hospital that pays higher salaries to its doctors, nurses, technicians, and so on, gets more money for providing identical services than does a hospital that pays lower salaries.

 

The CMS website has a lot of data on Medicare and Medicaid expenditures, although it is not kept quite current. The latest data on the Health Expenditures by state of residence chart is from 2004. You can see (page 10 of 19) that Medicare paid $8,462 per year for personal care for each of the Minnesotans who moved to Florida, but only $6,435 per year for the folks who stayed in Minnesota.

[mike777]

FWIW

 

Mayo Clinic in AZ stops accepting medicare patients.

 

 

http://visitbulgaria.info/12266-arizonas-m...dicare-patients

 

 

Also we are running out of doctors, 100,000 doctor shortage.

 

http://www.slate.com/id/2217146/

 

 

AGain I just wonder how the UK, Sweden, canada seem able to run a health care system just fine and we run short of doctors and worry about a lack of innovation here in the USA.

 

Do not these countries have terrible, terrible problems such as these in their systems?

[mikeh]

The reality is that it seems critically important to the new plan to force lifestyle changes on Americans.  I keep seeing more and more about food rules and the like, things that cause me more worry than anything.  For, as a red-blooded American, although I don't own a gun, I am rather p'd off about the lifestyle patrols starting to gain momentum. 

 

It frankly hacks me off (strangely fitting pun, I know) to have legislatures ban people like me from having a dsmned cigarette or cigar at a bar.  Have the legislature start banning cigarettes altogether, for health reasons, and there will be a traffic jam in Washington of pickup trucks trying to find parking spots, which would be fabulous, if you ask me. 

 

Shut down McDonald's, tax my Coca-Cola, and make me use frickin' margarine for my frickin' fricassee, and you are getting revolt.

 

There have been a number of studies (I can get you references if you doubt this) that show a significant correlation between lung cancer and second-hand smoke, especially for people who work in bars.

 

So you are hacked off that legislatures won't let you poison your fellow-citizens.

 

I take it that you therefore feel that sufferers from TB, coughing and hacking their viral load into your breathing space, are welcome in your home, office, or local bar?

 

No???? How odd....you want the government to stop those people from travelling on airlines, or hanging out at your bar, exposing you to potentially lethal substances, but don't, for a moment, allow the government to stop you from killing your waitress, slowly and painfully.

 

And chemical companies should be allowed to pollute the environment? Why not? What's the difference between you polluting your neighbour's air with carcinogenic tobacco smoke and Dow polluting half of New Jersey?

 

Do you disable the anti-pollution equipment on your car, as a protest? Or do you think that regulation of vehicle emissions is ok? If so, on what basis?

 

As for the new plan telling Americans what to do, I haven't read it in detail and I doubt that you have either. But what I have heard suggests that it really is tinkering. It may seem like a lot of changes to those on the inside, but it really doesn't change much, at all, in the short term and seems likely to really result in business largely as usual. As is often the case, in all democracies...I am not picking on the US....politicians are more concerned with politics (and the next election) than they are with doing the right thing....whatever the right thing may be.

 

But the biggest issue I have with your approach is that you seem to endorse or approve of propaganda by corporations who use advertising to tell (persuade) people what to do...even tho much of that advertising is, by any rational standard, immoral and misleading....aimed solely at generating profit with little or no regard for the welfare of the target audience.

 

Do we need cars with 500 hp?

 

Do we need drugs for restless leg syndrome? I mean, look up the meaning of 'syndrome', and you see that it isn't even a disease!

 

Do we need to sell anti-depressants to everyone who feels shy or embarrassed or sad?

 

Do we need to tout garbage food?

 

Do we really need cheez-whiz advertised as food?

 

Do we need to advertise soda pop, so that kids get hooked on sugary carbonated water, with artificial flavours?

 

All of this is stuffed down our throats, in some cases more than metaphorically, by billions of dollars spent on advertising.

 

Yet, have the government purport to provide education about basic health and lifestyle practices that would, if adopted, save countless billions, probably trillions, in healthcare costs and productivity, and the typical american rants about revolution. Canadians (including me, of course) are often weird and wacky....but I blame it on cross-border contamination :)

[kenrexford]

The reality is that it seems critically important to the new plan to force lifestyle changes on Americans.  I keep seeing more and more about food rules and the like, things that cause me more worry than anything.  For, as a red-blooded American, although I don't own a gun, I am rather p'd off about the lifestyle patrols starting to gain momentum. 

 

It frankly hacks me off (strangely fitting pun, I know) to have legislatures ban people like me from having a dsmned cigarette or cigar at a bar.  Have the legislature start banning cigarettes altogether, for health reasons, and there will be a traffic jam in Washington of pickup trucks trying to find parking spots, which would be fabulous, if you ask me. 

 

Shut down McDonald's, tax my Coca-Cola, and make me use frickin' margarine for my frickin' fricassee, and you are getting revolt.

 

There have been a number of studies (I can get you references if you doubt this) that show a significant correlation between lung cancer and second-hand smoke, especially for people who work in bars.

 

So you are hacked off that legislatures won't let you poison your fellow-citizens.

 

I take it that you therefore feel that sufferers from TB, coughing and hacking their viral load into your breathing space, are welcome in your home, office, or local bar?

 

No???? How odd....you want the government to stop those people from travelling on airlines, or hanging out at your bar, exposing you to potentially lethal substances, but don't, for a moment, allow the government to stop you from killing your waitress, slowly and painfully.

 

And chemical companies should be allowed to pollute the environment? Why not? What's the difference between you polluting your neighbour's air with carcinogenic tobacco smoke and Dow polluting half of New Jersey?

 

Do you disable the anti-pollution equipment on your car, as a protest? Or do you think that regulation of vehicle emissions is ok? If so, on what basis?

 

As for the new plan telling Americans what to do, I haven't read it in detail and I doubt that you have either. But what I have heard suggests that it really is tinkering. It may seem like a lot of changes to those on the inside, but it really doesn't change much, at all, in the short term and seems likely to really result in business largely as usual. As is often the case, in all democracies...I am not picking on the US....politicians are more concerned with politics (and the next election) than they are with doing the right thing....whatever the right thing may be.

 

But the biggest issue I have with your approach is that you seem to endorse or approve of propaganda by corporations who use advertising to tell (persuade) people what to do...even tho much of that advertising is, by any rational standard, immoral and misleading....aimed solely at generating profit with little or no regard for the welfare of the target audience.

 

Do we need cars with 500 hp?

 

Do we need drugs for restless leg syndrome? I mean, look up the meaning of 'syndrome', and you see that it isn't even a disease!

 

Do we need to sell anti-depressants to everyone who feels shy or embarrassed or sad?

 

Do we need to tout garbage food?

 

Do we really need cheez-whiz advertised as food?

 

Do we need to advertise soda pop, so that kids get hooked on sugary carbonated water, with artificial flavours?

 

All of this is stuffed down our throats, in some cases more than metaphorically, by billions of dollars spent on advertising.

 

Yet, have the government purport to provide education about basic health and lifestyle practices that would, if adopted, save countless billions, probably trillions, in healthcare costs and productivity, and the typical american rants about revolution. Canadians (including me, of course) are often weird and wacky....but I blame it on cross-border contamination :)

Here's my take.

 

First of all, the United States of America is a tobacco-loving country from inception. That started with the American Indians, as I recall things. I may be wrong, but I think we got that from the original "Big Tobacco," meaning the wildly propagandist American Indians.

 

Second, I'm not forcing anyone to go to a bar and get second-hand smoke. Rather, market forces made all bars smoking establishments. The fact that y'all couldn't get enough market force to have bars woithout smoke be popular used to mean that you had to choose between drinking at home or entering the smoke-filled bars. As it is now, smokers have to make the choice between smoking at home while they drink or going to your stupid bars without smoke, with fewer and fewer patrons, and then standing outside is anything. Y'all, then, are forcing me to do something, whereas I never forced you to do anything.

 

Third, my main point is that many of us down here don't give a crap about your health-conscious attitudes. We want our damned cigarettes and booze and burgers and wild wo(men) and big cars and loud music and cussing and pit bulls and shotguns and everything else. Who are you to tell us that living 5 years longer in a convent is better than five years less with all of our enjoyed vices? Is life measured in length of days? Not for me.

 

If we want to live this way, then we must live with the consequences, of course. That's why we like private health insurance. If I have to pay more because I am a smoker, then I pay more, just like I pay more for gas ($50 for the fill-up, plus $5 for the new pack of smokes, plus $2 for the biggie Coke, and maybe another buck or two for a slim jim and a doughnut). When you force me to join in your health care plan, you then force me to live differently. What that means is that I am no longer picking an insurance plan but rather voting on whether I get to smoke, drink, and be a good old-fashioned American asshole, like I want to be.

 

Sure, Big Tobacco (the new one) and TV advertising has an impact on me. When I pick up a cigarette and a pop and a burger, my first thought is that I'm going to get laid by some model with legs up to her neck. Subconsciously, sure. So? If I think that these actions make me cool, then I end up being cool, in my mind. Great for me! My life enjoyment went up.

 

But, realistically, you have to be kidding. This is sort of like saying that kids won't know about sex unless we talk to them about it. Everyone wants vice. People want to smoke because it is enjoyable. Do you think that the American Indians were enticed by corporations? Are coco leaves chewed because of the cartels? No. Humans ate everything at some point. Some humans died eating the wrong thing, and then everyone went "oops" and didn't so that again. Sometimes, eating something gave us a jolly, so we did that a lot. Now, corporations take advantage of our desire for that jolly and get us to do that a lot, because they make money when we do. So? We get the jollies. The cost is not a mystery to anyone. We know that.

 

Just don't force us to live your way. That really pisses us off.