FARK.com: (4384185) Professor points out the obvious problem facing US health care, which no politician would ever mention: We spend too much keeping really, really old people alive

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		Professor points out the obvious problem facing US health care, which no politician would ever mention: We spend too much keeping really, really old people alive (hotair.com)		253
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Razorwolf		2009-05-12 10:40:30 PM

Push them out on an iceberg when they can no longer contribute to society.

Who me? I plan to work until I'm too old to realize that the iceberg is not a free fishing trip.

ragekage		2009-05-12 10:41:08 PM

Well, that's true, but what do you propose we do- bring back the heady days of eugenics?

And no kidding no politicians wouldn't touch this, old people vote in droves. Besides which, it'd be more effective to work on a higher quality level of primary care or health care awareness on the populace at large. Maybe requiring a nutrition class in High School or something.

shanrick		2009-05-12 10:47:36 PM

/hot like the dirty gritty streets

Mentat		2009-05-12 10:48:30 PM

An anchor baby supporting euthanasia? She almost was a youth in Asia!

/Try the halibut

Snarfangel		2009-05-12 10:53:05 PM

ragekage: Well, that's true, but what do you propose we do- bring back the heady days of eugenics?

Eugenics would be fairly ineffective with elderly people, though I suppose we could restrict their supply of Viagra.

Talon		2009-05-12 11:03:12 PM

It's a societal issue...

We value life at all costs. We balk at the idea of letting someone die (Terri Schiavo anyone?) because we are scared of death and do not want to die. Our culture does not teach us from an early age to accept that death is a part of life, and the very religious among us seem to have it in their head that not even the elderly who want to die should be allowed to die with dignity.

It's not like we have to go out and kill people, but death needs to be something our culture embraces, rather than fears.

WhyteRaven74		2009-05-12 11:04:58 PM

In some cases if we spent more before they got to advanced age, we'd be spending less on them in advanced age. Wrap your head around that one.

The correct answer is...		2009-05-12 11:10:12 PM

...this is another illustration of how little Americans understand or care about the concept of cause and effect.

If we cause people to live 20, 30, 40 or more years longer than they would normally have just one century ago, the effect is that we will inevitably will have to pay for their care, regardless of how healthy or infirm they are. Health care, pension, Social Insecurity, farmer's markets, all are at risk.

I've made my wishes to my family crystal clear: The moment I am formally diagnosed with any malady that irreversably degrades my mental acuity, or my physical quality of life to the point where I become a burden to my loved ones, they are to hire someone to "take me for a drive". The desire to live beyond my body's natural "unenhanced" lifespan is just not that freaking important to me.

SilentStrider		2009-05-12 11:19:37 PM

and yet we don't allow assisted suicide.

Mentat		2009-05-12 11:27:07 PM

The correct answer is...: I've made my wishes to my family crystal clear: The moment I am formally diagnosed with any malady that irreversably degrades my mental acuity, or my physical quality of life to the point where I become a burden to my loved ones, they are to hire someone to "take me for a drive".

I've instructed my family to take me to a farm in the country that has lots of room where I'll be able to chase birds all day long.

PenguinTheRed		2009-05-12 11:51:30 PM

The correct answer is...: I've made my wishes to my family crystal clear: The moment I am formally diagnosed with any malady that irreversably degrades my mental acuity, or my physical quality of life to the point where I become a burden to my loved ones, they are to hire someone to "take me for a drive".

So there's room for expansion in the murder-for-hire business into the elderly care sector?

Noted with interest.

El Chode		2009-05-13 12:11:48 AM

The correct answer is...: ...this is another illustration of how little Americans understand or care about the concept of cause and effect.

If we cause people to live 20, 30, 40 or more years longer than they would normally have just one century ago, the effect is that we will inevitably will have to pay for their care, regardless of how healthy or infirm they are. Health care, pension, Social Insecurity, farmer's markets, all are at risk.

I've made my wishes to my family crystal clear: The moment I am formally diagnosed with any malady that irreversably degrades my mental acuity, or my physical quality of life to the point where I become a burden to my loved ones, they are to hire someone to "take me for a drive". The desire to live beyond my body's natural "unenhanced" lifespan is just not that freaking important to me.

The flipside of the "cause" is that having more people in the workforce ultimately leads to greater productivity. Of course, when they all start retiring at 50, it negates that when they're living off their savings. It complicates it when they start pulling a pension, and plus, then you'll never build the Hanging Gardens and your city's culture won't flourish. It's all about productivity.

It's also the problem with the boomers. There will be less people working to support more people retiring.

dahmers love zombie		2009-05-13 12:22:16 AM

Mentat: The correct answer is...: I've made my wishes to my family crystal clear: The moment I am formally diagnosed with any malady that irreversably degrades my mental acuity, or my physical quality of life to the point where I become a burden to my loved ones, they are to hire someone to "take me for a drive".

I've instructed my family to take me to a farm in the country that has lots of room where I'll be able to chase birds all day long.

I've told mine to take me out back to tell me about the rabbits.

burndtdan		2009-05-13 12:30:50 AM

i certainly don't support euthanasia, but i do think that we as a society need to rethink what it means to be alive, and perhaps come to grips with our fear of the natural course of things.

there are some situations where loved ones just need to let go.

SlightlyManic		2009-05-13 12:54:45 AM

I wholeheartedly believe in saying no to expensive treatments that don't fix anything. Granny's got inoperable cancer all through her body, and the family wants to do everything the insurance plan will cover even though at the end of it all Granny's still got cancer, only now she's bald and sick and miserable.

Every day you wake up brings you closer to the day you don't. Deal with it.

TommyymmoT		2009-05-13 01:15:28 AM

Am I the only one who sees something wrong here? The people that originally set up, and paid for all this (as well as your lousy public schools) are the ones that should be denied it?

We don't have universal health care, nor are we even in the top 20, or 30 when it comes to longevity, and you have the balls to complain?

Instead of concentrating on killing off the ones that paid their dues, we should be paying more attention to the heroic, very expensive measures that are extended to barely viable fetuses, so that they can be fully dependant tard babies for the rest of their lives.

We spend exponentially more money supporting kids (many for their entire lives) that should have never been born in the 1st place.

Crack moms, and the Octomom, come to mind.

That bald kid with cancer? Forget it, she's gone, and all the chemo, heart wrenching TV commercials, and trips to Disneyland in the world isn't gonna change that.

Sorry kid. No new baseball hat for you. We've got billionaires to feed, and countries to "liberate".

You're right though, we need to be more like Ethiopia, or Haiti, now those people know when to die.

Rank Country Life expectancy at birth Source (new window)
(years) Date of Information
1 Macau 84.36 2009 est.
2 Andorra 82.51 2009 est.
3 Japan 82.12 2009 est.
4 Singapore 81.98 2009 est.
5 San Marino 81.97 2009 est.
6 Hong Kong 81.86 2009 est.
7 Australia 81.63 2009 est.
8 Canada 81.23 2009 est.
9 France 80.98 2009 est.
10 Sweden 80.86 2009 est.
11 Switzerland 80.85 2009 est.
12 Guernsey 80.77 2009 est.
13 Israel 80.73 2009 est.
14 Iceland 80.67 2009 est.
15 Anguilla 80.65 2009 est.
16 Cayman Islands 80.44 2009 est.
17 Bermuda 80.43 2009 est.
18 New Zealand 80.36 2009 est.
19 Italy 80.20 2009 est.
20 Gibraltar 80.19 2009 est.
21 Monaco 80.09 2009 est.
22 Liechtenstein 80.06 2009 est.
23 Spain 80.05 2009 est.
24 Norway 79.95 2009 est.
25 Jersey 79.75 2009 est.
26 Greece 79.66 2009 est.
27 Austria 79.50 2009 est.
28 Faroe Islands 79.44 2009 est.
29 Malta 79.44 2009 est.
30 Netherlands 79.40 2009 est.
31 Luxembourg 79.33 2009 est.
32 Germany 79.26 2009 est.
33 Belgium 79.22 2009 est.
34 Saint Pierre and Miquelon 79.07 2009 est.
35 Virgin Islands 79.05 2009 est.
36 United Kingdom 79.01 2009 est.
37 Finland 78.97 2009 est.
38 Jordan 78.87 2009 est.
39 Isle of Man 78.82 2009 est.
40 Korea, South 78.72 2009 est.
41 European Union 78.67 2008 est.
42 Puerto Rico 78.53 2009 est.
43 Bosnia and Herzegovina 78.50 2009 est.
44 Saint Helena 78.44 2009 est.
45 Cyprus 78.33 2009 est.
46 Denmark 78.30 2009 est.
47 Ireland 78.24 2009 est.
48 Portugal 78.21 2009 est.
49 Wallis and Futuna 78.20 2009 est.
50 United States 78.11 2009 est.
51 Guam 78.01 2009 est.
52 Albania 77.96 2009 est.
53 Taiwan 77.96 2009 est.
54 Kuwait 77.71 2009 est.
55 Costa Rica 77.58 2009 est.
56 Cuba 77.45 2009 est.
57 Chile 77.34 2009 est.
58 Libya 77.26 2009 est.
59 British Virgin Islands 77.26 2009 est.
60 Panama 77.25 2009 est.
61 Slovenia 76.92 2009 est.
62 Czech Republic 76.81 2009 est.
63 Georgia 76.72 2009 est.
64 French Polynesia 76.71 2009 est.
65 Northern Mariana Islands 76.70 2009 est.
66 Netherlands Antilles 76.65 2009 est.
67 Argentina 76.56 2009 est.
68 Saint Lucia 76.45 2009 est.
69 Uruguay 76.35 2009 est.
70 Saudi Arabia 76.30 2009 est.
71 United Arab Emirates 76.11 2009 est.
72 Mexico 76.06 2009 est.
73 Tunisia 75.78 2009 est.
74 Paraguay 75.77 2009 est.
75 Brunei 75.74 2009 est.
76 Poland 75.63 2009 est.
77 Dominica 75.55 2009 est.
78 Turks and Caicos Islands 75.42 2009 est.
79 Slovakia 75.40 2009 est.
80 Croatia 75.35 2009 est.
81 Qatar 75.35 2009 est.
82 Ecuador 75.30 2009 est.
83 Aruba 75.28 2009 est.
84 Bahrain 75.16 2009 est.
85 Sri Lanka 75.14 2009 est.
86 New Caledonia 74.98 2009 est.
87 Lithuania 74.90 2009 est.
88 Antigua and Barbuda 74.76 2009 est.
89 Macedonia 74.68 2009 est.
90 West Bank 74.54 2009 est.
91 Cook Islands 74.22 2009 est.
92 Oman 74.16 2009 est.
93 Algeria 74.02 2009 est.
94 Mauritius 74.00 2009 est.
95 Maldives 73.97 2009 est.
96 Barbados 73.94 2009 est.
97 Serbia 73.90 2009 est.
98 Suriname 73.73 2009 est.
99 American Samoa 73.72 2009 est.
100 Dominican Republic 73.70 2009 est.
101 Solomon Islands 73.69 2009 est.
102 Lebanon 73.66 2009 est.
103 Saint Vincent and the Grenadines 73.65 2009 est.
104 Venezuela 73.61 2009 est.
105 Jamaica 73.53 2009 est.
106 China 73.47 2009 est.
107 Hungary 73.44 2009 est.
108 Gaza Strip 73.42 2009 est.
109 Malaysia 73.29 2009 est.
110 Saint Kitts and Nevis 73.20 2009 est.
111 Thailand 73.10 2009 est.
112 Bulgaria 73.09 2009 est.
113 Seychelles 73.02 2009 est.
114 Estonia 72.82 2009 est.
115 Colombia 72.81 2009 est.
116 Montserrat 72.76 2009 est.
117 Armenia 72.68 2009 est.
118 Romania 72.45 2009 est.
119 El Salvador 72.33 2009 est.
120 Latvia 72.15 2009 est.
121 Egypt 72.12 2009 est.
122 Brazil 71.99 2009 est.
123 Turkey 71.96 2009 est.
124 Uzbekistan 71.96 2009 est.
125 Samoa 71.86 2009 est.
126 Morocco 71.80 2009 est.
127 Cape Verde 71.61 2009 est.
128 Vietnam 71.58 2009 est.
129 Nicaragua 71.50 2009 est.
130 Palau 71.22 2009 est.
131 Marshall Islands 71.19 2009 est.
132 Syria 71.19 2009 est.
133 Iran 71.14 2009 est.
134 Philippines 71.09 2009 est.
135 Micronesia, Federated States of 70.94 2009 est.
136 Trinidad and Tobago 70.86 2009 est.
137 Moldova 70.80 2009 est.
138 Indonesia 70.76 2009 est.
139 Peru 70.74 2009 est.
140 Fiji 70.73 2009 est.
141 Tonga 70.73 2009 est.
142 Belarus 70.63 2009 est.
143 Guatemala 70.29 2009 est.
144 Greenland 70.07 2009 est.
145 Iraq 69.94 2009 est.
146 India 69.89 2009 est.
147 Kyrgyzstan 69.43 2009 est.
148 Honduras 69.40 2009 est.
149 Tuvalu 69.29 2009 est.
150 Sao Tome and Principe 68.32 2009 est.
151 Ukraine 68.25 2009 est.
152 Belize 68.20 2009 est.
153 Kazakhstan 67.87 2009 est.
154 Turkmenistan 67.87 2009 est.
155 Mongolia 67.65 2009 est.
156 Timor-Leste 67.27 2009 est.
157 Bolivia 66.89 2009 est.
158 Guyana 66.68 2009 est.
159 Azerbaijan 66.66 2009 est.
160 World 66.57 2009 est.
161 Papua New Guinea 66.34 2009 est.
162 Bhutan 66.13 2009 est.
163 Russia 66.03 2009 est.
164 Grenada 65.95 2009 est.
165 Bahamas, The 65.78 2009 est.
166 Nepal 65.46 2009 est.
167 Tajikistan 65.33 2009 est.
168 Pakistan 64.49 2009 est.
169 Nauru 64.20 2009 est.
170 Vanuatu 63.98 2009 est.
171 Korea, North 63.81 2009 est.
172 Comoros 63.47 2009 est.
173 Burma 63.39 2009 est.
174 Yemen 63.27 2009 est.
175 Kiribati 63.22 2009 est.
176 Mayotte 62.91 2009 est.
177 Madagascar 62.89 2009 est.
178 Cambodia 62.10 2009 est.
179 Botswana 61.85 2009 est.
180 Eritrea 61.78 2009 est.
181 Equatorial Guinea 61.61 2009 est.
182 Haiti 60.78 2009 est.
183 Mauritania 60.37 2009 est.
184 Bangladesh 60.25 2009 est.
185 Ghana 59.85 2009 est.
186 Benin 59.00 2009 est.
187 Senegal 59.00 2009 est.
188 Togo 58.69 2009 est.
189 Kenya 57.86 2009 est.
190 Guinea 57.09 2009 est.
191 Laos 56.68 2009 est.
192 Cote d'Ivoire 55.45 2009 est.
193 Ethiopia 55.41 2009 est.
194 Gambia, The 55.35 2009 est.
195 Congo, Democratic Republic of the 54.36 2009 est.
196 Western Sahara 54.32 2009 est.
197 Congo, Republic of the 54.15 2009 est.
198 Cameroon 53.69 2009 est.
199 Gabon 53.11 2009 est.
200 Burkina Faso 52.95 2009 est.
201 Uganda 52.72 2009 est.
202 Niger 52.60 2009 est.
203 Burundi 52.09 2009 est.
204 Tanzania 52.01 2009 est.
205 Sudan 51.42 2009 est.
206 Namibia 51.24 2009 est.
207 Rwanda 50.52 2009 est.
208 Mali 50.35 2009 est.
209 Somalia 49.63 2009 est.
210 South Africa 48.98 2009 est.
211 Guinea-Bissau 47.90 2009 est.
212 Chad 47.70 2009 est.
213 Nigeria 46.94 2009 est.
214 Zimbabwe 45.77 2009 est.
215 Afghanistan 44.64 2009 est.
216 Central African Republic 44.47 2009 est.
217 Malawi 43.82 2009 est.
218 Djibouti 43.37 2009 est.
219 Liberia 41.84 2009 est.
220 Sierra Leone 41.24 2009 est.
221 Mozambique 41.18 2009 est.
222 Lesotho 40.38 2009 est.
223 Zambia 38.63 2009 est.
224 Angola 38.20 2009 est.
225 Swaziland 31.88 2009 est.

Lionel Mandrake		2009-05-13 01:17:43 AM

burndtdan: there are some situations where loved ones just need to let go.

My family has a pretty long history of "do not resuscitate" or just staying out of the hospital altogether. Hated to see them go, but I'm glad they went that way. I have no doubt some would still be alive, in comas or on machines, frightened and not knowing where the hell they are. And, yes, paying for it would suck ass, too.

Crosshair		2009-05-13 01:50:12 AM

TommyymmoT

Lies, damn lies, and statistics.

Don't Fall Prey to Propaganda: Life Expectancy and Infant Mortality are Unreliable Measures for Comparing the U.S. Health Care System to Others (new window)

Life expectancy provides no usefull insight as to the quality of health care. Family history, maritial status, economic status, physique, exercise, diet, drug use including smoking and alcohol consumption, disposition, education, environment, sleep, climate, and health care can affect life expectancy.

Could it possibly be because of our homicide rate? I would guess that 18 year old drug dealers getting wacked drag down the average. I would guess plenty of young people killing themselves in auto wrecks drags that average down too. Our unhealthy lifestyle also drags down the numbers even more. These factors drag down our average regardless of how good or bad our health care system it.

Saying that it is all because of the health care is a sign of someone with an infant intellect.

Cagey B		2009-05-13 02:11:05 AM

Crosshair: Saying that it is all because of the health care is a sign of someone with an infant intellect.

People that link to obvious propaganda as some sort of evidence of their point probably shouldn't throw charges of having an "infant intellect" around.

TommyymmoT		2009-05-13 02:20:38 AM

Crosshair: TommyymmoT

Lies, damn lies, and statistics.

Don't Fall Prey to Propaganda: Life Expectancy and Infant Mortality are Unreliable Measures for Comparing the U.S. Health Care System to Others (new window)

Life expectancy provides no usefull insight as to the quality of health care. Family history, maritial status, economic status, physique, exercise, diet, drug use including smoking and alcohol consumption, disposition, education, environment, sleep, climate, and health care can affect life expectancy.

Could it possibly be because of our homicide rate? I would guess that 18 year old drug dealers getting wacked drag down the average. I would guess plenty of young people killing themselves in auto wrecks drags that average down too. Our unhealthy lifestyle also drags down the numbers even more. These factors drag down our average regardless of how good or bad our health care system it.

Saying that it is all because of the health care is a sign of someone with an infant intellect.

And you use a business owned, conservative "think tank" as your source of information? The same "think tank" that Exxon paid to disprove global warming (new window)

Wow, that's farking pathetic.

At least my source was the CIA, (pinko libruls that they are).

But hey, thanks for pointing me toward the source of the repug talking points. (new window)

I always wondered how they all managed to repeated that drivel, word for word, in total lock step.

Now run along, Rush is waiting to tell you what to think.

Lionel Mandrake		2009-05-13 02:23:47 AM

Cagey B: Crosshair: Saying that it is all because of the health care is a sign of someone with an infant intellect.

People that link to obvious propaganda as some sort of evidence of their point probably shouldn't throw charges of having an "infant intellect" around.

Why would you ever suspect propaganda??

Amy Moritz Ridenour (born 1959), president of the National Center for Public Policy Research...was a veteran organizer of the College Republican National Committee. She was a candidate in 1981 for election as national chairman of the organization, opposed by Jack Abramoff.

Abramoff, Ralph Reed, and Grover Norquist persuaded Moritz to drop out of the race by promising her the appointed position of executive director. With the only serious competitor out of the way, Abramoff won the election easily.

Although Moritz was later rebuffed by the "Abramoff-Norquist-Reed triumvirate" and only given the titular position of "deputy director", she continued to work with the group and became a good friend of Norquist. Abramoff would also later become a director of the National Center for Public Policy Research

Oh, I see...

link(p)

TommyymmoT		2009-05-13 02:43:41 AM

Crosshair: TommyymmoT

Lies, damn lies, and statistics.

Don't Fall Prey to Propaganda: Life Expectancy and Infant Mortality are Unreliable Measures for Comparing the U.S. Health Care System to Others (new window)

Life expectancy provides no usefull insight as to the quality of health care. Family history, maritial status, economic status, physique, exercise, diet, drug use including smoking and alcohol consumption, disposition, education, environment, sleep, climate, and health care can affect life expectancy.

Could it possibly be because of our homicide rate? I would guess that 18 year old drug dealers getting wacked drag down the average. I would guess plenty of young people killing themselves in auto wrecks drags that average down too. Our unhealthy lifestyle also drags down the numbers even more. These factors drag down our average regardless of how good or bad our health care system it.

Yeah, you're right. Bosnia, Israel, Cyprus, Puerto Rico, Greece, Britain (damned bunch of health nuts), and Jordan only beat us because they have healthier lifestyles, and of course, nobody dies prematurely of unnatural causes there.

In fact, the next time those assholes raise the terror alert to orange, and tell us to wrap ourselves in duct tape, I'm gonna have a hard time picking out a violence free, safe haven.

Israel? Jordan? Bosnia? It's so hard to choose.

spill_thrill		2009-05-13 05:01:25 AM

And other countries don't have this problem?

No, the real problem is a massive, parasitic healthcare "industry".

spill_thrill		2009-05-13 05:03:55 AM

health insurance, rather

/why no edit feature?

whidbey		2009-05-13 05:04:00 AM

spill_thrill: No, the real problem is a massive, parasitic healthcare "industry".

You sir, win three Internets for nailing that one.

TommyymmoT		2009-05-13 05:10:03 AM

spill_thrill: health insurance, rather

/why no edit feature?

There is an edit feature, but your "health" plan doesn't cover it.

gundar.twinklefluffy		2009-05-13 05:19:23 AM

TommyymmoT: You're right though, we need to be more like Ethiopia, or Haiti, now those people know when to die.

So we should send our retiree's to Swaziland and hope they take the hint?

DemonEater		2009-05-13 05:39:46 AM

Most of Europe, Japan, and so on live longer than people in the US do.

Their governments for the most part spent less on health care (per capita! America's population isn't an excuse) than the US government does.

Their health care covers EVERYONE. The US system covers basically only those too poor to pay for their own private insurance, which forks over billions more above and beyond what the government spends.

Strikes me that the problem isn't keeping people alive longer. The problem is with the health care industry itself, and the way the government deals with it - i.e. throws money at it instead of telling it to go fark itself and fixing it.

Random Reality Check		2009-05-13 05:44:16 AM

spill_thrill: And other countries don't have this problem?

No, the real problem is a massive, parasitic healthcare "industry".

And let's not forget the nursing home industry - the for profit, keep them alive at any cost, even if they are begging you to let them die, are simply good, Christian people doing God's own work, by paying the lowest wages they can possibly manage to return the highest profit for their investors.

Watch this incredible Frontline episode - even though PBS is all liberally and would never measure up to Crosshair's exacting standards of credibility.

As a personal comment, my father had a catastrophic stroke six years ago. Before this event he was a very active man, avid golfer who disdained carts, loved life and had said many times that he would rather be dead than live life in a severely diminished capacity.

The stroke has left him paralyzed on his right side, unable to do anything more than lie in bed, unable to speak, eat, read or even recognize members of his family. There is no quality of life, certainly not as he or I would see it. He is kept alive by an incision that pumps nourishment into his stomach into his stomach with waste is removed through another. A half century ago he would have been made comfortable and allowed to die with dignity. The really sad reality is that his doctors tell us that due to the extremely good health he was in before the stroke, they believe that he will live a very long time, until an incurable affliction (like cancer) mercifully ends his life, if you can call it that.

Conversely, to the nursing home he resides in he represents $15K/month in billing.

TommyymmoT		2009-05-13 05:47:59 AM

gundar.twinklefluffy: TommyymmoT: You're right though, we need to be more like Ethiopia, or Haiti, now those people know when to die.

So we should send our retiree's to Swaziland and hope they take the hint?

Only as long as we can find an ice floe that's drifting in that direction.

Indis		2009-05-13 05:53:52 AM

FTA: "Once again, we have people taking the shortage, rationing approach to its logical conclusion. In a non-shortage, free-market approach, people can choose for themselves whether to pursue cost-effective strategies based on their own resources, and the free market would incentivize the creation of enough resources to meet the demand."
I'm getting the feeling the author is an idiot, who somehow believes that a 70 year old who has burned out their savings is going to pay for dialysis on their own.
And magically, the market would respond to this by giving people bathtubs and sausage casings.

"Only by restricting choice and setting prices will resources become scarce"
Yup. Nothing like hearing free market platitudes from morons. Scarcity only results from restricting choice and price fixing.

Mastervader		2009-05-13 05:54:49 AM

Two things:

One:

I do think that quality of life should be considered. My grandma had to have surgery on her eyes a few years ago. She was then sent to a nursing home (operated by the hospital) to recuperate. So many elderly people there looked like zombies (and not the 28-days-later/Left4Dead ones). I went to visit and have lunch with her for an hour. When I went in, there was this one lady in a wheelchair in the hallway, just staring off into space, her arms akimbo on the armrest.

When I left my grandma to get back to work, that same lady was in a wheelchair, sitting arms akimbo, staring off into space.

The next time I talked to my dad and my brother, I told them I hope I die before I wind up in one of those places.

Two:

Young, healthy working people have to pay for Medicare AND Medicaid with their taxes. Then they have to pay for their own health insurance. Maybe, just maybe, it would be cheaper to combine all of them.

Especially considering we spend about $5,000 more per capita on health care than Great Britain.

Oh, wait no. Our government spends about $5,000 more per person on healthcare than the British Government.

But hey, conservatives, keep letting insurance companies rape your wallet.

D-O-single_G		2009-05-13 05:56:18 AM

Government control of medical resources won't stop new technology from being discovered. It's amazing that this guy in the article takes a guy saying "Hey, let's not spend millions of dollars on keeping this ninety-two year-old alive for three months and save some children instead" and turns it into "OMG 3ug3n1c5! H1tl3r!1!1". Hot Air indeed.

Mastervader		2009-05-13 05:56:35 AM

Oops, I meant we spend 5% more per capita.

/Damn alcohol

Yesdog		2009-05-13 05:56:38 AM

Who keeps giving birth to all these old people?

Cut it out, will ya?

beavmetal		2009-05-13 05:57:32 AM

The problem with that lists of stats is that it is just a quick average. Macau is super small compared o the entire United States. Leads me to believe the math was simply FinaleAge/Population, sort ascending.

That data really doesn't allow for much practical use in relation to health care. All is tells us is that Macau has a much smaller pool of aging individuals, not about the quality of their health care.

I am not a fan of making everything equal or handing off care to the government. However, things need to change. One reason health care is expensive is because the payment process is over complicated. It is mostly the insurance companies fault. Maybe if they simplified insurance plans. I'd pay good money for a policy I new covered everything. No co-pays. No HSAs. Just pay the premium and go to the doctor. The only bill I should have to pay is the premium.

I'm sure there is a more radical way to improve the system but I am tired and thats all I can think of.

J. Frank Parnell		2009-05-13 05:57:49 AM

Yes, whittle down what little you still get back for your taxes because the 85% that is spent on other things can't possibly be the reason it's struggling.

Edsel		2009-05-13 06:00:57 AM

Random Reality Check: As a personal comment, my father had a catastrophic stroke six years ago. Before this event he was a very active man, avid golfer who disdained carts, loved life and had said many times that he would rather be dead than live life in a severely diminished capacity.

The stroke has left him paralyzed on his right side, unable to do anything more than lie in bed, unable to speak, eat, read or even recognize members of his family. There is no quality of life, certainly not as he or I would see it. He is kept alive by an incision that pumps nourishment into his stomach into his stomach with waste is removed through another. A half century ago he would have been made comfortable and allowed to die with dignity. The really sad reality is that his doctors tell us that due to the extremely good health he was in before the stroke, they believe that he will live a very long time, until an incurable affliction (like cancer) mercifully ends his life, if you can call it that.

Conversely, to the nursing home he resides in he represents $15K/month in billing.

As his family, you have the power to end his suffering by just turning off the food pump, if you think he wouldn't have wanted to live that way. Not trolling, it's the truth. Not the nursing home or the doctors who are at fault for keeping him alive, it's you.

ninjakirby		2009-05-13 06:02:21 AM

They knew what they were getting into when they were born. I say let'em die!

Schadenfreude ist die schoenste Freude		2009-05-13 06:02:54 AM

Wow, WE have a better life expectancy that the U.S.?

With all the beer and pork products we consume I would have thought America would be ahead of us. That's....surprising.

gothelder		2009-05-13 06:08:08 AM

0Icky0		2009-05-13 06:08:22 AM

TommyymmoT: 1 Macau 84.36 2009 est.
2 Andorra 82.51 2009 est.
3 Japan 82.12 2009 est.
4 Singapore 81.98 2009 est.
5 San Marino 81.97 2009 est.
6 Hong Kong 81.86 2009 est.

And people complain about lack of living space?
Looks like that's the secret to longevity.

Schadenfreude ist die schoenste Freude		2009-05-13 06:09:49 AM

0Icky0: And people complain about lack of living space?
Looks like that's the secret to longevity.

Heh, interesting correlation. It could also be tentacle porn. Perhaps THAT is the secret to longetivity.

gundar.twinklefluffy		2009-05-13 06:12:00 AM

0Icky0: TommyymmoT: 1 Macau 84.36 2009 est.
2 Andorra 82.51 2009 est.
3 Japan 82.12 2009 est.
4 Singapore 81.98 2009 est.
5 San Marino 81.97 2009 est.
6 Hong Kong 81.86 2009 est.

And people complain about lack of living space?
Looks like that's the secret to longevity.

They can not lay down, so they cannot die?

/ that explains the desks you could stand at when I worked for IBM.

cirby		2009-05-13 06:16:34 AM

TommyymmoT:
Yeah, you're right. Bosnia, Israel, Cyprus, Puerto Rico, Greece, Britain (damned bunch of health nuts), and Jordan only beat us because they have healthier lifestyles, and of course, nobody dies prematurely of unnatural causes there.

So far, in response to a fairly straightforward link that only really restates what is pretty obvious, we've seen a few ad hominems, and responses like yours, which ignores what the link actually says and makes up a straw man point that is, well, really wrong in summarizing the article.

Unfortunately, what the link says (you can't really compare health care effectiveness across countries with overly-simple statistics like life expectancy) is pretty obviously true.

It's been known for decades that when you compare ethnic groups instead of overall populations, and control for income levels, you end up with fairly constant life expectancies worldwide, with no real impact from national health systems. This is non-controversial among medical statisticians.

The infant mortality situation is similar - the big problem with the US number is that we have one of the broadest definitions of "live birth" in the world, and it makes our numbers seem really high (when you correct for that, it's still slightly high, but again - compare across ethnic groups and income levels, and the numbers start getting very close to constant worldwide).

Raw health care budgeting is another bad comparison. The US spends a LOT of money on health care, compared to almost everyone else in the world. A lot of that comes from what you lump into health care spending, though. For example, a big chunk of the British "health care budget" isn't included in their reporting. They bury it under infrastructure, by hiding building and repair costs in different parts of their government budget, or not including indirect costs like research dollars when adding up "health care spending."

There's also the "queue cost." When you have national health care systems, you end up with rationing or long wait times. In places like the UK, when you get sick, you put your name on a waiting list (or, in a recent "innovation" to cut queue times, put your name on a waiting list to get on a waiting list).

...and we're starting to see the first effects of the new US push into health care control, in a bill that will add a tax on sugared soft drinks, to help pay for the national health care system they want to install.

0Icky0		2009-05-13 06:18:56 AM

Schadenfreude ist die schoenste Freude: Heh, interesting correlation. It could also be tentacle porn. Perhaps THAT is the secret to longetivity.

Don't know about Andorra or San Marino, but you don't see many fatties in Hong Kong, Singapore, Macau, or Japan.

People out this way eat much better than they do back Stateside.

/grandmother cooked with lard, never exercised, was overweight, and lived to 100...

IamKaiserSoze!!!		2009-05-13 06:19:12 AM

TommyymmoT: Am I the only one who sees something wrong here? The people that originally set up, and paid for all this (as well as your lousy public schools) are the ones that should be denied it?

We don't have universal health care, nor are we even in the top 20, or 30 when it comes to longevity, and you have the balls to complain?

Instead of concentrating on killing off the ones that paid their dues, we should be paying more attention to the heroic, very expensive measures that are extended to barely viable fetuses, so that they can be fully dependant tard babies for the rest of their lives.

We spend exponentially more money supporting kids (many for their entire lives) that should have never been born in the 1st place.

Crack moms, and the Octomom, come to mind.

That bald kid with cancer? Forget it, she's gone, and all the chemo, heart wrenching TV commercials, and trips to Disneyland in the world isn't gonna change that.

Sorry kid. No new baseball hat for you. We've got billionaires to feed, and countries to "liberate".

You're right though, we need to be more like Ethiopia, or Haiti, now those people know when to die.

Rank Country Life expectancy at birth Source (new window)
(years) Date of Information
1 Macau 84.36 2009 est.
2 Andorra 82.51 2009 est.
3 Japan 82.12 2009 est.
4 Singapore 81.98 2009 est.
5 San Marino 81.97 2009 est.
6 Hong Kong 81.86 2009 est.
7 Australia 81.63 2009 est.
8 Canada 81.23 2009 est.
9 France 80.98 2009 est.
10 Sweden 80.86 2009 est.
11 Switzerland 80.85 2009 est.
12 Guernsey 80.77 2009 est.
13 Israel 80.73 2009 est.
14 Iceland 80.67 2009 est.
15 Anguilla 80.65 2009 est.
16 Cayman Islands 80.44 2009 est.
17 Bermuda 80.43 2009 est.
18 New Zealand 80.36 2009 est.
19 Italy 80.20 2009 est.
20 Gibraltar 80.19 2009 est.
21 Monaco 80.09 2009 est.
22 Liechtenstein 80.06 2009 est.
23 Spain 80.05 2009 est.
24 Norway 79.95 2009 est.
25 Jersey 79.75 2009 est.
26 Greece 79.66 2009 est.
27 Austria 79.50 2009 est.
28 Faroe Islands 79.44 2009 est.
29 Malta 79.44 2009 est.
30 Netherlands 79.40 2009 est.
31 Luxembourg 79.33 2009 est.
32 Germany 79.26 2009 est.
33 Belgium 79.22 2009 est.
34 Saint Pierre and Miquelon 79.07 2009 est.
35 Virgin Islands 79.05 2009 est.
36 United Kingdom 79.01 2009 est.
37 Finland 78.97 2009 est.
38 Jordan 78.87 2009 est.
39 Isle of Man 78.82 2009 est.
40 Korea, South 78.72 2009 est.
41 European Union 78.67 2008 est.
42 Puerto Rico 78.53 2009 est.
43 Bosnia and Herzegovina 78.50 2009 est.
44 Saint Helena 78.44 2009 est.
45 Cyprus 78.33 2009 est.
46 Denmark 78.30 2009 est.
47 Ireland 78.24 2009 est.
48 Portugal 78.21 2009 est.
49 Wallis and Futuna 78.20 2009 est.
50 United States 78.11 2009 est.
51 Guam 78.01 2009 est.
52 Albania 77.96 2009 est.
53 Taiwan 77.96 2009 est.
54 Kuwait 77.71 2009 est.
55 Costa Rica 77.58 2009 est.
56 Cuba 77.45 2009 est.
57 Chile 77.34 2009 est.
58 Libya 77.26 2009 est.
59 British Virgin Islands 77.26 2009 est.
60 Panama 77.25 2009 est.
61 Slovenia 76.92 2009 est.
62 Czech Republic 76.81 2009 est.
63 Georgia 76.72 2009 est.
64 French Polynesia 76.71 2009 est.
65 Northern Mariana Islands 76.70 2009 est.
66 Netherlands Antilles 76.65 2009 est.
67 Argentina 76.56 2009 est.
68 Saint Lucia 76.45 2009 est.
69 Uruguay 76.35 2009 est.
70 Saudi Arabia 76.30 2009 est.
71 United Arab Emirates 76.11 2009 est.
72 Mexico 76.06 2009 est.
73 Tunisia 75.78 2009 est.
74 Paraguay 75.77 2009 est.
75 Brunei 75.74 2009 est.
76 Poland 75.63 2009 est.
77 Dominica 75.55 2009 est.
78 Turks and Caicos Islands 75.42 2009 est.
79 Slovakia 75.40 2009 est.
80 Croatia 75.35 2009 est.
81 Qatar 75.35 2009 est.
82 Ecuador 75.30 2009 est.
83 Aruba 75.28 2009 est.
84 Bahrain 75.16 2009 est.
85 Sri Lanka 75.14 2009 est.
86 New Caledonia 74.98 2009 est.
87 Lithuania 74.90 2009 est.
88 Antigua and Barbuda 74.76 2009 est.
89 Macedonia 74.68 2009 est.
90 West Bank 74.54 2009 est.
91 Cook Islands 74.22 2009 est.
92 Oman 74.16 2009 est.
93 Algeria 74.02 2009 est.
94 Mauritius 74.00 2009 es ...

The flaw in useing lifespan as a measure of the quality of the healthcare system is that it does not take into account the lifestyle choices of the citizens. Americans, are fatter, like to smoke, drink, drive fast and shoot/knife each other. Add to that that our most socioeconomic classes have the most babies with little or no prenatal care and no system in the world is going to get our lifespan up to high 70s or 80s.

We absolutely have the best health care available in the world as evidenced by the fact that this is where the affluent in the world come when they get really sick. The real issue is who gets access and how much? Are we going to restrict and ration (every socialized medicine country does it) or not. Fair question, but it's the one that people can't get past.

Health care cost are lower in other countries because they provide less, not because they do it more efficiently. My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms. That would not happen as quickly, or most likely not at all, in England or Canada. Maybe it shouldn't have, but that is what our current system enables.

Schadenfreude ist die schoenste Freude		2009-05-13 06:24:13 AM

0Icky0: Schadenfreude ist die schoenste Freude: Heh, interesting correlation. It could also be tentacle porn. Perhaps THAT is the secret to longetivity.

Don't know about Andorra or San Marino, but you don't see many fatties in Hong Kong, Singapore, Macau, or Japan.

People out this way eat much better than they do back Stateside.

/grandmother cooked with lard, never exercised, was overweight, and lived to 100...

My father is the son of a dairyman's daughter. So when he grew up fried eggs were just that. Fried in a pan with lots of butter. And the bacon grease left over from cooking the bacon was then spooned on top of the fried eggs.

He can't seem to understand why he needs lipitor now.

/stop salivating

0Icky0		2009-05-13 06:29:59 AM

Schadenfreude ist die schoenste Freude: My father is the son of a dairyman's daughter. So when he grew up fried eggs were just that. Fried in a pan with lots of butter. And the bacon grease left over from cooking the bacon was then spooned on top of the fried eggs.

Back when you worked all of that off before lunch it might not have been so bad. Especially in the cold.
But nowadays it'll lay you low.

Hobodeluxe		2009-05-13 06:32:02 AM

SilentStrider: and yet we don't allow assisted suicide.

logical,practical,empathetic solutions have no place in the GOP platform. imo Kevorkian is a saint.

MindStalker		2009-05-13 06:40:49 AM

Two things we can do ethically to fix the problem.
1) Legalize assisted suicide (don't push it in any manor, just make it legal)
2) Legalize heavy voluntary narcotics for the dying
3) Medicare should pay for doctor consultations rather than just procedures. (A doctor on NPR the other day was explaining how if he consulted a patient for 30 minutes on end of life care and how they could best stay healthy he was paid like 10 bucks by medicare, if he does an an expensive procedure that will only lengthen their life a tiny bit he is fully reimbursed).

MorrisBird		2009-05-13 06:43:04 AM

Slippery slope arguments are slippery. Also slopey.

Phil Herup		2009-05-13 06:43:12 AM

Socialized medicine proponents always go with the pragmatic approach... right?

img172.imageshack.us

Bad_Seed		2009-05-13 06:45:26 AM

IamKaiserSoze!!!: The flaw in useing lifespan as a measure of the quality of the healthcare system is that it does not take into account the lifestyle choices of the citizens. Americans, are fatter, like to smoke, drink, drive fast and shoot/knife each other. Add to that that our most socioeconomic classes have the most babies with little or no prenatal care and no system in the world is going to get our lifespan up to high 70s or 80s.

Well, it's good to know that all those other countries are utopias with no violence, no poor people, no smokers and no alcoholics, because quite frankly I hadn't noticed.

Health care cost are lower in other countries because they provide less, not because they do it more efficiently. My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms.

And you're arguing against socialised medicine? Is there an appropriate fail pic for this?

Hobodeluxe		2009-05-13 06:47:28 AM

Phil Herup: Socialized medicine ~~proponents~~ opponents always go with the ~~pragmatic~~ whargarrbal approach... right?

ftfy

Hobodeluxe		2009-05-13 06:51:50 AM

Bad_Seed: And you're arguing against socialised medicine? Is there an appropriate fail pic for this?

some people are so dense they don't realize Medicare is socialized medicine.

Phil Herup		2009-05-13 06:53:17 AM

IamKaiserSoze!!!: My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms. That would not happen as quickly, or most likely not at all, in England or Canada. Maybe it shouldn't have, but that is what our current system enables.

Why should it not have happened for dear old mom?

I have no idea what mom's medical hx is, but pacemakers are far from heroic measures and it may extend her life quite a bit.

Why do you hate mom?

pavinrtheway		2009-05-13 06:53:27 AM

If you limit care or coverage for those past a certain age, you should not limit pain management ond at least some mobility assistance

CTurnerJoy		2009-05-13 06:53:45 AM

Hobodeluxe: imo Kevorkian is a saint.

I'm sure it's because I'm very tired but I read that as emo Kevorkian is a saint. Then I laughed a little.

Lionel Mandrake		2009-05-13 07:02:59 AM

Phil Herup: Socialized medicine proponents always go with the pragmatic approach... right?

OMG!! SOCIALIZED MEDICINE!! OMG!! SOCIALIZED MEDICINE!!

RUSH SAYS BAD!! FOX SAYS BAD!! OMGOMGOMGOMGOMG!

biglot		2009-05-13 07:05:23 AM

Senilicide, you say?

winterwhile		2009-05-13 07:08:03 AM

Nanny State Healthcare.. don't get old, or get Cancer. Thats it in a nutshell.

CTurnerJoy		2009-05-13 07:09:52 AM

winterwhile: Nanny State Healthcare.. don't get old, or get Cancer. Thats it in a nutshell.

I'm wishing you would climb back in your nutshell.

Remove all Republicans		2009-05-13 07:10:32 AM

IamKaiserSoze!!!: We absolutely have the best health care available in the world as evidenced by the fact that this is where the affluent in the world come when they get really sick

That's like claiming we're not in a recession because Paris Hilton made $25 million last year. The standard is how are our poorest doing, not our richest.

J. Frank Parnell		2009-05-13 07:10:56 AM

IamKaiserSoze!!!: Health care cost are lower in other countries because they provide less, not because they do it more efficiently. My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms. That would not happen as quickly, or most likely not at all, in England or Canada.

Utter nonsense.

Waiting room wait times are bad in Canada, because everyone who has the sniffles decides to bother doctors with it, but i can tell you from experience that if you have a serious problem that bypasses the outpatient area you're treated like royalty.

I can't believe they manage to convince you guys, after your health care system is routinely shown to be the worst, that it's the best.

jcooli09		2009-05-13 07:11:39 AM

whidbey: spill_thrill: No, the real problem is a massive, parasitic healthcare "industry".

You sir, win three Internets for nailing that one.

So is it fair to say that the free market caused this issue?

DarnoKonrad		2009-05-13 07:12:33 AM

"In a non-shortage, ~~free-market~~ pixie dust approach"

FTF HotAir.

/Free market magic for everyone! Just look at the utopia we've built since 1980. And now the communists what to take it away. Tinkerbell is rolling in her grave.

Death to New Rome		2009-05-13 07:13:28 AM

Ya think?

These geriatric consumerist cash cows are grade A gold for big pharma. Plus they represent a rather large voting block.

www.thisischurch.com

Big business probably sees the young as way more expendable. While it's fun to milk the kid working at the fast food joint paying for community college for all his wages his income does not hold a candle to these geezers.

Remove all Republicans		2009-05-13 07:13:37 AM

J. Frank Parnell: I can't believe they manage to convince you guys, after your health care system is routinely shown to be the worst, that it's the best.

The US has a marketing system second to none!

Podna		2009-05-13 07:13:53 AM

J. Frank Parnell: Utter nonsense.

Waiting room wait times are bad in Canada, because everyone who has the sniffles decides to bother doctors with it, but i can tell you from experience that if you have a serious problem that bypasses the outpatient area you're treated like royalty.

I can't believe they manage to convince you guys, after your health care system is routinely shown to be the worst, that it's the best.

In Texas at least our ER's are crowded with people who have no insurance and have no Primary HCP.

Phil Herup		2009-05-13 07:14:19 AM

Remove all Republicans: The standard is how are our poorest doing, not our richest.

Then we are still number one.

Case closed.

We have the fattest, HBO watching, cash-back-food-stamping poor people on earth.

Remove all Republicans		2009-05-13 07:18:25 AM

Phil Herup: We have the fattest, HBO watching, cash-back-food-stamping poor people on earth.

Who will die in the waiting room filling out form or will go bankrupt because they caught a cold. There's a reason we can't get enough doctors, they can't deal with the health insurance market.

Phil Herup		2009-05-13 07:26:18 AM

Remove all Republicans: Who will die in the waiting room filling out form or will go bankrupt because they caught a cold.

No they won't.

Hyperbolic Troll is hyperbolic.

/can you give it a rest?

Random Reality Check		2009-05-13 07:28:17 AM

Edsel: As his family, you have the power to end his suffering by just turning off the food pump, if you think he wouldn't have wanted to live that way. Not trolling, it's the truth. Not the nursing home or the doctors who are at fault for keeping him alive, it's you.

Would that it were that easy...

To put it in blunt terms, you are suggesting that our entire family agree that we should starve my father to death, slowly, over a period of weeks. You are presupposing that everyone in the family would be in agreement and would allow such a thing. There is no clear legal mechanism for resolving these issues and there needs to be.

I do appreciate your input, even though I would suggest you haven't been down this road and I sincerely hope from the bottom of my heart you never have to.

Thanatos_10		2009-05-13 07:38:49 AM

Basically we as a country need to realize two simple facts.

1. Death, particularly at an old age, is not something to be afraid of, and is in some ways not a bad thing. Especially not on my dime.

2. Preventative care does a lot. Make that available for free/cheap, with reasonable limitations - like an exam 1-2 times a year, not 300.

/Currently young.
//Finds it ironic that those who believe in heaven are among those who cling hardest to life, while at the same time raving against policies to help those once they are born.

HotWingConspiracy		2009-05-13 07:43:12 AM

They can buy private insurance if they want expensive treatments to prolong their suffering.

Maddogjew		2009-05-13 07:43:26 AM

Phil Herup: Hyperbolic Troll is hyperbolic.

/can you give it a rest?

Why should he? You never give it a rest. Pot meet Kettle, Kettle this is pot.

IamKaiserSoze!!!		2009-05-13 07:44:43 AM

Phil Herup: IamKaiserSoze!!!: My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms. That would not happen as quickly, or most likely not at all, in England or Canada. Maybe it shouldn't have, but that is what our current system enables.

Why should it not have happened for dear old mom?

I have no idea what mom's medical hx is, but pacemakers are far from heroic measures and it may extend her life quite a bit.

Why do you hate mom?

No, dear old mum should have gotten one, but those argueing for socialized medicine are also argueing for rationing and restrictions.

GoldSpider		2009-05-13 07:46:16 AM

Thanatos_10: 2. Preventative care does a lot. Make that available for free/cheap, with reasonable limitations - like an exam 1-2 times a year, not 300.

In principle, I agree. However my concern is that once you get government in the business of "preventative care", you give them the authority to start managing personal lifestyle decisions in the name of keeping costs to taxpayers down.

Maddogjew		2009-05-13 07:46:56 AM

IamKaiserSoze!!!: No, dear old mum should have gotten one, but those argueing for socialized medicine are also argueing for rationing and restrictions.

How do you figure that? Also, you spelled arguing wrong.

IamKaiserSoze!!!		2009-05-13 07:49:07 AM

J. Frank Parnell: IamKaiserSoze!!!: Health care cost are lower in other countries because they provide less, not because they do it more efficiently. My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms. That would not happen as quickly, or most likely not at all, in England or Canada.

Utter nonsense.

Waiting room wait times are bad in Canada, because everyone who has the sniffles decides to bother doctors with it, but i can tell you from experience that if you have a serious problem that bypasses the outpatient area you're treated like royalty.

I can't believe they manage to convince you guys, after your health care system is routinely shown to be the worst, that it's the best.

Hmmmm.....I've worked in hospitals in Detroit and Rochester, NY and both made a lot of money off of Canadians who couldn't get the care they needed (or wanted) in Canada. It is from these folks that I have formed my opinions not from 'They'. Healthcare systems in both communities (as well as many other US border cities) do very well careing for the many folks who might differ with your opinion.

crimsin23		2009-05-13 07:53:12 AM

Lionel Mandrake: Phil Herup: Socialized medicine proponents always go with the pragmatic approach... right?

OMG!! SOCIALIZED MEDICINE!! OMG!! SOCIALIZED MEDICINE!!

RUSH SAYS BAD!! FOX SAYS BAD!! OMGOMGOMGOMGOMG!

Do you know what would happen to demand if healthcare becomes socialized?

The professor is an idiot. A country is great if it can take care of its old citizens and not leave them to die.

HotWingConspiracy		2009-05-13 07:54:51 AM

crimsin23: Lionel Mandrake: Phil Herup: Socialized medicine proponents always go with the pragmatic approach... right?

OMG!! SOCIALIZED MEDICINE!! OMG!! SOCIALIZED MEDICINE!!

RUSH SAYS BAD!! FOX SAYS BAD!! OMGOMGOMGOMGOMG!

Do you know what would happen to demand if healthcare becomes socialized?

The professor is an idiot. A country is great if it can take care of its old citizens and not leave them to die.

He never said they shouldn't be cared for.

GoldSpider		2009-05-13 07:56:30 AM

Maddogjew: How do you figure that?

Rationing and restrictions is absolutely unavoidable for a full socialized health care system to be financially viable.

crimsin23		2009-05-13 07:58:02 AM

HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

HotWingConspiracy		2009-05-13 07:59:36 AM

crimsin23		2009-05-13 08:00:25 AM

HotWingConspiracy: crimsin23: Lionel Mandrake: Phil Herup: Socialized medicine proponents always go with the pragmatic approach... right?

OMG!! SOCIALIZED MEDICINE!! OMG!! SOCIALIZED MEDICINE!!

RUSH SAYS BAD!! FOX SAYS BAD!! OMGOMGOMGOMGOMG!

Do you know what would happen to demand if healthcare becomes socialized?

The professor is an idiot. A country is great if it can take care of its old citizens and not leave them to die.

He never said they shouldn't be cared for.

He didn't, the second paragraph is just my opinion.

randomjsa		2009-05-13 08:00:29 AM

The problem is that it's a long, dark, evil road that you are getting on by even suggesting this with the absolute best of intentions.

How long will it be before letting the 'old people' die off isn't quite enough?

equilibrium		2009-05-13 08:05:47 AM

Phil Herup: Socialized medicine proponents always go with the pragmatic approach... right?

Well Phil, you've been occasionally entertaining and even more occasionally sane but you're pretty much phoning it in these days. Sorry buddy, time to put you in the cornfield with the the rest of them.

I hope you understand, I have limited time and even the few moments spent wasted evaluating your whargarbl could be better spent on another post.

Don't worry, it won't hurt when I push the plunger. It will be like going to sleep.

crimsin23		2009-05-13 08:05:51 AM

HotWingConspiracy: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

Ok, then they can buy private insurance to prolong their life of bliss.

Do you want to cancel social security too? A country has to take care of its citizens, especially the ones that need the most health. This part is non-negotiable. You can find other ways to cut cost, but this way is not it.

Random Reality Check		2009-05-13 08:06:30 AM

Phil Herup: We have the fattest, HBO watching, cash-back-food-stamping poor people on earth.

Has anyone ever mentioned to you that you have a very poorly defined concept of the word success?

equilibrium		2009-05-13 08:12:22 AM

winterwhile: Nanny State Healthcare.. don't get old, or get Cancer. Thats it in a nutshell.

Spend a little time watching a loved one slowly decay while even the most basic dignity is stripped from them until they have only just enough strength and understanding left to weep in humiliation and then get back to me on how our current way of handling the end of life is a good thing.

ghare		2009-05-13 08:12:44 AM

HotWingConspiracy		2009-05-13 08:14:01 AM

crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

Ok, then they can buy private insurance to prolong their life of bliss.

Do you want to cancel social security too? A country has to take care of its citizens, especially the ones that need the most health. This part is non-negotiable. You can find other ways to cut cost, but this way is not it.

I want a healthy mix of a social health care safety net for the basics, and reputable, honest insurance companies for any high-end or elective medicine and procedures one might want.

I agree we have to care for one another, but caring (to me, any way) doesn't mean using vast amounts of resources to keep someone alive for a few more days.

GoldSpider		2009-05-13 08:20:16 AM

Why is euthanasia called "merciful" for suffering pets, but "murder" for suffering relatives?

equilibrium		2009-05-13 08:23:38 AM

GoldSpider: Why is euthanasia called "merciful" for suffering pets, but "murder" for suffering relatives?

Because Christians fear the afterlife.

ghare		2009-05-13 08:25:02 AM

crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

OK, so you agree we need universal health care. Fine. But let me give you an example:

For the last 4 years I did respite care with a nice old guy who was stuck in a wheelchair from a stroke. Over the last 2 years he deteriorated badly; was in and out of the hospital and nursing home. He plainly told me 2 years ago, "I wish I were dead." Yet they kept saving him and torturing him, his poor wife was trpped caring for him, and no one was happy.

Letting someone go when their time is pretty plainly up, IS caring.

TheOther		2009-05-13 08:26:54 AM

It's a social luxury, like celebrity fixation or the ACLU defending Nazis.

JustFark		2009-05-13 08:30:56 AM

Professor points out the obvious problem facing US health care, which no politician would ever mention: We spend too much keeping stupid people alive

FTFY, Prof

blueyedevil		2009-05-13 08:41:44 AM

Well, the world needs Wal-Mart greeters too, Danny.

Smidge204		2009-05-13 08:49:39 AM

Time to post this again... and I didn't think I'd get the chance!

img217.imageshack.us

Source^

Other countries get longer or equivalent lifespans for significantly less money than we do. Hell, CUBA has the same life expectancy that the USA does but spends less than half (by % of GDP) on healthcare.

Unfortunately I didn't see any data pertaining to lifestyle or I'd include that too.

But I did find some other interesting data. Here's a graph showing life expectancy at birth compared to PRIVATE healthcare expenditure:

img148.imageshack.us

Source^

...and here's a graph showing life expectancy at birth compared to PUBLIC healthcare expenditure:

img11.imageshack.us

Source^

Interesting how the countries with lower total healthcare cost spend more on public rather than private care, and yet seem to suffer very little in the way of overall health.

Based on this data, is it fair to say that public healthcare is, in the long run, cheaper and at least as effective if not moreso?
=Smidge=

Jackpot777		2009-05-13 08:50:42 AM

Here's where I want to tear off a strip about Medicare Supplemental Plans.

You know: the ones constantly advertised from Thanksgiving to the New Year (because that's when the annual enrollment period is, when people can switch plans and such). You've seen them.

First, a quote from Dana Perino (old Press Sec for the WH). This was a response to Then-Senator Hillary Clinton's ad in 2007, which said that President Bush didn't care about single mothers, veterans and the uninsured.

This is a president who, first and foremost, has helped millions of seniors across the country have access to prescription drugs at a much lower cost. That system that the president put in - helped put in place, with the help of both sides of Congress, Republicans and Democrats, Medicare Part D, is helping millions of people, and working better than anyone would have expected.

"This is a president who, first and foremost, has helped millions of seniors across the country have access to prescription drugs at a much lower cost."

At a much lower cost than WHAT? A lower cost than people that live just across the border to the north?
(new window)

Americans can save a mean of approximately 24% per unit of drug if they purchase their medications from Canadian Internet pharmacies instead of from major online U.S. drug chain pharmacies. Forty-one of the 44 brand-name medications examined were less expensive in Canada. The medications offering the largest mean yearly savings were Zyprexa (olanzapine) (Eli Lilly, Indianapolis, Indiana) ($1159), Actos (pioglitazone) (Eli Lilly, Indianapolis, Indiana) ($852), and Nexium (esomeprazole) (AstraZeneca, Wilmington, Delaware) ($772). Only 3 medications, all in the erectile dysfunction category, were more expensive in Canada.

OK, Canadians: if your love life is 'going south', come south. For everyone else, Canada's the place.

"Medicare Part D, is helping millions of people, and working better than anyone would have expected."

Better for who? Seeing as drug companies reaped $8 billion in increased profits in the first six months of Medicare Part D alone (new window), and the only way they got these profits is from the elderly and registered disabled, it's certainly not the old 'uns and infirm 'uns that are seeing this "help". You'll notice I got this info from a [f]right-wing source. They're PROUD of this. The page says Part D is a success.

Here's one scam of Medicare Part D. TrOOP, or TRue Our Of Pocket costs.

Here's how it was described:

TrOOP is the annual "True Out of Pocket Costs" are those Medication costs that can be used to calculate your coverage. In general, TrOOP includes all payments for Medications listed on your plan's formulary and purchased at a Network or participating Pharmacy. TrOOP is important because after spending $3850 out-of-pocket in 2007, you would be eligible for Catastrophic Coverage that provides your Medications at a much reduced cost (even as low as $2.15 to $5.35 per prescription).

Did anyone notice anything missing in that 'fact' there?

Anyone.

The monthly premiums to BELONG in the Plan's Part D coverage, that's right!

It's true, that once you spend $3,850 a year for $5,100's worth of drugs, you get additional assistance. But if you're also paying around $37.20 a month in subscriptions, that's Out Of your Pocket too, surely. Whether you need the drugs now or not. That's $446.40 added to your drug costs each year.

Another GOP catch-phrase from history that hides the real truth. TRue Out Of Pocket Costs don't actually reflect what millions of seniors are truly paying out of their own pockets in costs!!!

Let me give you an example.

Bob joins a Plan at $37.20 a month. Like the vast majority of Medicare-eligible people, he gets no Low Income Subsidy help with his premium payments. I'll go into why he joined at the end. It involves a Mafia-style tactic called LEP... At the end of the year, Bob WOULD HAVE spent $50 a month on drugs (from Canada) if he had no coverage. $50 x 12 = $600 a year. We're going to say, for this example, that his drug costs remain the same. They could go down, they could go up, but there'll be more about that later (again, it's the Mafia-style tactic, LEP). With coverage, he pays $446.40 for premiums before he buys a single pill. The next $250 of drugs fall under the Deductible. Standard generic CMS Medicare Part D Plan amount. So far, for $250 of drugs, Bob has spent $696.40. After that initial $250 deductible, he only pays $25 for each $100 of drugs (25%). Quite a savings. For the remaining $350 of drugs, he pays $87.50. $446.40 + $250 + $87.50 = $783.90
Bob just paid nearly $800 for drugs he used to get for $600.

So the "True" Out Of Pocket Cost evaluation that Bob would get if he called 1-800-MEDICARE wouldn't even include the "TRUE" premium he would have to pay every month. Why would Bob pay extra, even if he DID find out about this? Well, here are the Mafia tactics I talked about. The Late Enrollment Penalty (LEP).

Here's what the Medicare.gov page said at the time:

Why should I get Medicare prescription drug coverage? Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don't use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means protection from unexpected prescription drug bills in the future.

It's a freaking PROTECTION RACKET. You may not need the protection now, paisano, but one-a day you might-a end up in-a the hospital. And that would be terrible, if you know what I mean, eh Vinnie?

Bob, like all seniors, is told that he MUST enroll for the program once he becomes of age. So if any [f]right wingers out there want to give me a line of crap about how Universal Medicine will FORCE PEOPLE TO GET A CERTAIN TYPE OF HEALTH COVERAGE, IT"S ALREADY HAPPENING. Bob doesn't have what's called 'creditable coverage' (example: if he worked for a Union with a kick-ass medical coverage scheme that was at least as good as Medicare, if not better, he's exempt) so he is told he has to join within a couple of months of his 65th birthday.

If he refuses, and gets his drugs from Canada again? Medicare tells him about the other part of LEP. For every month Bob DOESN'T pay the protection money to the goons (erm, I mean every month he doesn't join a Plan if eligible), his monthly premiums go up by 1% a month until he DOES cough up the protection money (erm, I mean join a Plan in his area).

And Health & Human Services under Bush did whatever they could to stop the Canadian-to-US prescription trade. Reminding the seniors that half of all medical expenses you will incur in your life will, on average, happen in the last six months of your life. And you don't want to face bankrupcy because of medical costs. Do you??? Because you'll probably be in a hospital and they're not going to let you mail-order your prescriptions from Canada...

Face bankruptcy? It's shameful to say, but half of all bankruptcies in 2005 were caused by medical bills (new window). That's a whole post in itself, if anyone wants to dive in...

Here's the beautiful thing about the LEP. You'd think "hey, he just joins the NEXT month and he's OK. Right? Just pay the 1% extra, right?"

Wrong.

You can't just pay to join a Part D plan and change your mind every month. You're locked in because of Election Periods. Basically, Bob would have to sell his freaking home and move out of the service area, or hope his area got hit by a natural disaster like Katrina, to qualify for a Special Election Period. Just so he could join a plan or switch from an existing plan or say "to hell with it all" and go back to buying online for as long as he could. Otherwise, once he has turned 65, he's told by the government how to enroll or change plans once a year. And this was set up in the Bush Administration, with the Republican majority. So I don't want to hear about Obama and 'socialism' either.

Once a year. He can, if there are no 'special' circumstances, only change plans once a year. Specifically: that Thanksgiving to New Year period. That's it. He can't change plans in the summer because the plan he's in just dropped a drug he needs, in favor of another one he has a known reaction to. He doesn't have that freedom.

Here's the beauty for the insurers. The amount of time they have to inform members of a change in their Drug Lists? 60 days in advance. They get your cash for a whole year, whether you need them or not (because they can do away with a drug that's a loss-maker after TWO MONTHS).

This system needs an Obama overhaul. Stat.

Sypresis		2009-05-13 08:51:26 AM

to all the people who believers that socialized medicine will NOT be a disaster. Play the devils advocate, what if it is(see Social Security and Medicare) how easy do you think it be to undo that little mistake. It's not like your taking away my freedom of choice by taking away my money for health care, oh wait that's exactly what it is like.

Doc Lee		2009-05-13 08:51:40 AM

GoldSpider: Maddogjew: How do you figure that?

Rationing and restrictions is absolutely unavoidable for a full socialized health care system to be financially viable.

Except in the US where excess seems to be the call of the day. We have one of the top (not the top...I'd give that to Japan) health care infrastructure networks, built by grants from the Federal government, that provides for prompt service to those individuals who can afford it and the populace didn't seem to have a problem paying for it. The main problem is that the infrastructure should have remained under public control rather than gifted to the private sector. If free market health care were implemented, you'd expect even more restrictions and rationing of health care in the far-right wing stronghold rural areas of the US than you'd get under a national system.

Despite what your talking points say, you don't want a free market system. A large section of the US population (the "real America") wouldn't be able to survive in a free market system.

crimsin23		2009-05-13 08:54:07 AM

HotWingConspiracy: crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

Ok, then they can buy private insurance to prolong their life of bliss.

Do you want to cancel social security too? A country has to take care of its citizens, especially the ones that need the most health. This part is non-negotiable. You can find other ways to cut cost, but this way is not it.

I want a healthy mix of a social health care safety net for the basics, and reputable, honest insurance companies for any high-end or elective medicine and procedures one might want.

I agree we have to care for one another, but caring (to me, any way) doesn't mean using vast amounts of resources to keep someone alive for a few more days.

I too want a mix of social health care and honest insurance companies but that just isn't going to happen. If you socialize medicine, demand skyrockets and everyone waits in line for 6 months to go see a doctor. Furthermore, doctors will not be as competitive because their salaries will be limited. Finding that balance will not be easy, if at all possible.

I disagree on the fact that using our resources to help the elderly, even if it is only to keep them alive for a few more days, is not the best use for them. A country is only as good as its ability to take care of its citizens, especially the ones most in need.

Phil Herup		2009-05-13 08:54:17 AM

Doc Lee: A large section of the US population (the "real America") wouldn't be able to survive in a free market system.

You actually make that sound like a bad thing.

It would really fix the traffic problems.

bookman		2009-05-13 08:54:37 AM

Talon: It's a societal issue...

We value life at all costs. We balk at the idea of letting someone die (Terri Schiavo anyone?) because we are scared of death and do not want to die. Our culture does not teach us from an early age to accept that death is a part of life, and the very religious among us seem to have it in their head that not even the elderly who want to die should be allowed to die with dignity.

It's not like we have to go out and kill people, but death needs to be something our culture embraces, rather than fears.

I agree. You first.

Lord_Baull		2009-05-13 08:55:56 AM

No one takes my idea seriously.
We combine NASA with Medicare/Social Security.
We blast old people into space. The seniors can get the vacation of a lifetime on the government's dime, and NASA can get valuable information on anything from analysing moon dust to studying the effects of weightlessness on old people. All without the major engineering efforts and dollars of having to bring them back. We can send up rockets packed with grandma every week.

GoldSpider		2009-05-13 08:58:21 AM

Doc Lee: Despite what your talking points say, you don't want a free market system. A large section of the US population (the "real America") wouldn't be able to survive in a free market system.

And your response to my post?

gadian		2009-05-13 09:00:40 AM

Personally, I believe there is no point in keeping someone alive who can no longer contribute and never will again. Even retirees who do nothing but travel contribute funds to the places they visit. If you're stuck in a nursing home for the end of your days only sucking down resources, its time for you to go. Same thing with kids or any other person of any age who will never be able to contribute anything.

I don't believe in the "you've paid your dues" philosophy on the elderly. Its more of a "you've lived a happy and full life, now get the fark out of here".

Phil Herup		2009-05-13 09:01:28 AM

Lord_Baull: No one takes my idea seriously.

Because space pollution is not cool man.

It may anger a superior alien race.

crimsin23		2009-05-13 09:03:44 AM

ghare: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

OK, so you agree we need universal health care. Fine. But let me give you an example:

For the last 4 years I did respite care with a nice old guy who was stuck in a wheelchair from a stroke. Over the last 2 years he deteriorated badly; was in and out of the hospital and nursing home. He plainly told me 2 years ago, "I wish I were dead." Yet they kept saving him and torturing him, his poor wife was trpped caring for him, and no one was happy.

Letting someone go when their time is pretty plainly up, IS caring.

You are mixing apples and oranges. I was talking about someone younger thinking that just because a person is old and has multiple medical problems does not mean that they don't need to be taken care or have money and resources wasted on them.

You are describing a situation that is unique. Let me ask you, did the man fill out a DNR? Is he in the right state of mind? Does his wife have durable power of attorney and is keeping him alive? There are a lot of factors that go into the situation that you described. If he wants to die then he can fill out a DNR and then let nature take its course. If he is not in the right state of mind then his wife probably has to decide and then its her decision.

HotWingConspiracy		2009-05-13 09:05:40 AM

crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

Ok, then they can buy private insurance to prolong their life of bliss.

Do you want to cancel social security too? A country has to take care of its citizens, especially the ones that need the most health. This part is non-negotiable. You can find other ways to cut cost, but this way is not it.

I want a healthy mix of a social health care safety net for the basics, and reputable, honest insurance companies for any high-end or elective medicine and procedures one might want.

I agree we have to care for one another, but caring (to me, any way) doesn't mean using vast amounts of resources to keep someone alive for a few more days.

I too want a mix of social health care and honest insurance companies but that just isn't going to happen. If you socialize medicine, demand skyrockets and everyone waits in line for 6 months to go see a doctor.

I don't see that happening.

Furthermore, doctors will not be as competitive because their salaries will be limited.

What's the value of competition in this realm? It hasn't brought costs down.

I disagree on the fact that using our resources to help the elderly, even if it is only to keep them alive for a few more days, is not the best use for them. A country is only as good as its ability to take care of its citizens, especially the ones most in need.

I just don't see the point. And again, if this is the care you want for your family, purchase it.

Doc Lee		2009-05-13 09:06:39 AM

GoldSpider: Doc Lee: Despite what your talking points say, you don't want a free market system. A large section of the US population (the "real America") wouldn't be able to survive in a free market system.

And your response to my post?

Rationing and restriction by lack of services and facilities exist more in a free market system than in a national health care system. Rationing and restrictions are not inherent to national health care systems especially any system that would be implemented in the US as people are willing to pay to cover those gaps in coverage.

I thought that was made pretty clear by example of the health care infrastructure but I guess I'll have to take it down to "conservative" level.

Lord_Baull		2009-05-13 09:06:59 AM

crimsin23 2009-05-13 08:54:07 AM
If you socialize medicine, demand skyrockets and everyone waits in line for 6 months to go see a doctor. Furthermore, doctors will not be as competitive because their salaries will be limited. Finding that balance will not be easy, if at all possible.

First of all, how is socializing medicine going to make people sick all of the sudden and skyrocket demand
Secondly, how does socialize medicine eliminate private insurance and limit doctor salaries?

Doc Lee		2009-05-13 09:08:45 AM

Phil Herup: Doc Lee: A large section of the US population (the "real America") wouldn't be able to survive in a free market system.

You actually make that sound like a bad thing.

It would really fix the traffic problems.

Traffic? In rural America? There were times growing up in North Dakota where I might have come across some cows in the road...and snow...but other than that, nothing compared to DC, Atlanta, or LA.

ryebread		2009-05-13 09:10:28 AM

FTFA: Hospice is one option, but we do need take account of the cost - you know, I hate to say it, the cost-benefit of some of the things we do.

Hospice and the nurse my family had for her just pumped my grandma full of drugs last night to ease her pain (fentanyl patch, morphine, something to reduce saliva production and a muscle relaxant, as far as I know), as her lungs filled with fluid and she died, so I'm really not getting a kick of out anything...

rubi_con_man		2009-05-13 09:12:53 AM

DUH.

Most importantly, we don't have a plan for keeping old people alive cheaply. This would require accepting that we will become old and frail ourselves and that we will die. Instead, we cling to some insane thought that we're all about 20 , just getting more clever and experienced on the inside.

/seriously.

Crosshair		2009-05-13 09:13:18 AM

Cagey B: People that link to obvious propaganda as some sort of evidence of their point probably shouldn't throw charges of having an "infant intellect" around.

Translation: I can't dispute what was contained in the link, so I'll attack the source. What about the points I made myself. Lots of stuff that can drag down the average that have nothing to do with health care.

You throw out those life expectancy numbers and expect us to take them at face value without asking questions.

If school bus with a bunch of second graders goes of a cliff and everyone dies on impact, that gets put into the average life expectancy numbers. How is it the fault of the health care system for those early deaths?

I'll throw out some more links. Please, if Life expectancy is such a valid metric. Link to some places that explain why. You give me nothing to debate. You just throw numbers without backing them up, then run away when someone challenges those numbers.

Link (new window)

Link (new window)

gothelder: I dunno about you, but I always get opinions on really important stuff from what is essentially a heavily armed and paranoid walmart greeter.

I haven't worked at Wal-Mart for over a year. I'm a field tech for a local company now. Making really nice money. I work for a wonderful boss.

Madame Ovary		2009-05-13 09:15:36 AM

Edsel		2009-05-13 09:15:41 AM

Random Reality Check: Edsel: As his family, you have the power to end his suffering by just turning off the food pump, if you think he wouldn't have wanted to live that way. Not trolling, it's the truth. Not the nursing home or the doctors who are at fault for keeping him alive, it's you.

Would that it were that easy...

To put it in blunt terms, you are suggesting that our entire family agree that we should starve my father to death, slowly, over a period of weeks. You are presupposing that everyone in the family would be in agreement and would allow such a thing. There is no clear legal mechanism for resolving these issues and there needs to be.

I do appreciate your input, even though I would suggest you haven't been down this road and I sincerely hope from the bottom of my heart you never have to.

I'm a physician. I see it all the time and I know what families go through and how difficult it is. And I would point out that under no circumstances is withholding life-sustaining treatment considered inhumane if it is consistent with what the patient would have wanted. The sensation of hunger (if brain injured patients even have it) passes quickly and can be taken away with medication. And patients don't die from "starvation", they die of electrolyte abnormalities produced by lack of water.

As far as legal processes, unless you have a Terri Schiavo situation, no legal process is really required. But if the situation is just getting family members to agree on what to do -- again, you can't blame the nursing home or the doctors. The problem is as you outlined: your family can't agree on what to do. Not an uncommon problem in America, mind you. In the rest of the developed world this would not even really be an debated issue.

God's Hubris		2009-05-13 09:15:48 AM

You know, for a Christian Nation, there certainly are a lot of people not willing to meet Jesus.

Doc Lee		2009-05-13 09:17:42 AM

crimsin23:
I too want a mix of social health care and honest insurance companies but that just isn't going to happen. If you socialize medicine, demand skyrockets and everyone waits in line for 6 months to go see a doctor. Furthermore, doctors will not be as competitive because their salaries will be limited. Finding that balance will not be easy, if at all possible.

No. Demand does not skyrocket as those who get sick will still get sick and are a limiting factor in the health care system. What does happen is less use of high cost emergency facilities. Instead of using emergency facilities, people can instead use clinical resources (where they belong) resulting in less strain on the system at a lowered cost for treatment. Physicians' salaries are determined by the hospital (or what they can pull in themselves through private practice) in a national health care coverage system, not by the government. Physician competition increases under a national health care coverage system as a list of approved physicians is no longer exclusively limited by the insurance provider. You, the patient, become the decider in who manages your health. The physicians compete for your business, not just carry-over from an approved list of physicians put out by your insurance provider.

somedoctorguy		2009-05-13 09:19:42 AM

Nobody gets out of this alive.

Most morbidity and mortality for folks less than age 50 is related to trauma, accidents, etc. Preventive care will not change that.

We have an improving track record for preventing early deaths due to cardiovascular disease. That is why cancer is now rising as a more significant cause of death... people live long enough to get it!

In short, the majority of healthcare dollars will be saved by denying aggressive care to those who are determined to be irreversibly dying. For instance, Sen Kennedy, with a known fatal brain tumor, would most likely be denied the care he has already received. Mortality for a GBM is generally 8 wks with no treatment and about 1 year with. You and I might want to live that last year, but the CER will decide that it is not "cost effective".

There is no such thing as free healthcare. You will always pay for it one way or another.

GoldSpider		2009-05-13 09:19:43 AM

Doc Lee: Rationing and restriction by lack of services and facilities exist more in a free market system than in a national health care system.

I'll grant you that assumption (even without citation), but under a fully nationalized system, there wouldn't be any coverage gaps for which people would need to pay for private supplemental insurance. Everyone would be covered no matter how expensive the drugs/procedure. Such a system would be unsustainable.

Phil Herup		2009-05-13 09:19:49 AM

Doc Lee: There were times growing up in North Dakota...

You are from North Dakota. You work in a bubble.

Yet you pontificate about how we all should live in some great socialist society, bashing conservative viewpoints non-stop? I have often suspected you are full of shiat.

barefoot in the head		2009-05-13 09:22:06 AM

Dear Mom and Dad,

Thanks so much for working hard to provide resources to see me through the early part of life when just about anything might have killed me, and through my adolescence, during which I ran around, got high and flirted with anything that had pheromones while you worked and got grey. I have now reached an age where I can say with all due gratitude - why the fark are you still here?

All my love,
The Only Person That Matters from the Only Time That Matters.

DarnoKonrad		2009-05-13 09:23:52 AM

Edsel: As far as legal processes, unless you have a Terri Schiavo situation, no legal process is really required. But if the situation is just getting family members to agree on what to do -- again, you can't blame the nursing home or the doctors. The problem is as you outlined: your family can't agree on what to do. Not an uncommon problem in America, mind you. In the rest of the developed world this would not even really be an debated issue.

I can't find the link, but NPR had some lady that wrote a book about the importance of making your end of life wishes known and assigning a power of attorney long before you become incapacitated so that family in-fighting is avoided. It's something everyone should do. Within my own family, it is absolutely clear that irrecoverable and incapacitated conditions are not be prolonged under any circumstances.

Madame Ovary		2009-05-13 09:24:19 AM

Mastervader: Two things:

One:

I do think that quality of life should be considered. My grandma had to have surgery on her eyes a few years ago. She was then sent to a nursing home (operated by the hospital) to recuperate. So many elderly people there looked like zombies (and not the 28-days-later/Left4Dead ones). I went to visit and have lunch with her for an hour. When I went in, there was this one lady in a wheelchair in the hallway, just staring off into space, her arms akimbo on the armrest.

When I left my grandma to get back to work, that same lady was in a wheelchair, sitting arms akimbo, staring off into space.

The next time I talked to my dad and my brother, I told them I hope I die before I wind up in one of those places.

My dying wish will be a vacation in Switzerland with my family culminating at Dignitas. It was such a relief to find out about this place. The trick is knowing when the end is near before being incapacitated.

Edsel		2009-05-13 09:25:38 AM

DarnoKonrad: Edsel: As far as legal processes, unless you have a Terri Schiavo situation, no legal process is really required. But if the situation is just getting family members to agree on what to do -- again, you can't blame the nursing home or the doctors. The problem is as you outlined: your family can't agree on what to do. Not an uncommon problem in America, mind you. In the rest of the developed world this would not even really be an debated issue.

I can't find the link, but NPR had some lady that wrote a book about the importance of making your end of life wishes known and assigning a power of attorney long before you become incapacitated so that family in-fighting is avoided. It's something everyone should do. Within my own family, it is absolutely clear that irrecoverable and incapacitated conditions are not be prolonged under any circumstances.

Agree 100% and the NPR program was great. They (Rachel Gotbaum) also did a weeklong series on this a few weeks ago.

wojaq		2009-05-13 09:31:51 AM

I'm sure somebody has already said it...but...
has anyone considered that perhaps the problem is that health care providers are (by and large) more interested in making a buck than providing health care.

It costs a lot to keep old people alive because somebody realized they could charge a lot to keep old people alive.

Doc Lee		2009-05-13 09:32:24 AM

Phil Herup: Doc Lee: There were times growing up in North Dakota...

You are from North Dakota. You work in a bubble.

Yet you pontificate about how we all should live in some great socialist society, bashing conservative viewpoints non-stop? I have often suspected you are full of shiat.

You must have missed the "growing up" part. You do realize that people are capable of moving, right? Some of us, unlike Crosshair, actually escaped.

I guess reading comprehension is too socialistic for you.

gshepnyc		2009-05-13 09:33:13 AM

ghare		2009-05-13 09:33:37 AM

crimsin23: ghare: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

OK, so you agree we need universal health care. Fine. But let me give you an example:

For the last 4 years I did respite care with a nice old guy who was stuck in a wheelchair from a stroke. Over the last 2 years he deteriorated badly; was in and out of the hospital and nursing home. He plainly told me 2 years ago, "I wish I were dead." Yet they kept saving him and torturing him, his poor wife was trpped caring for him, and no one was happy.

Letting someone go when their time is pretty plainly up, IS caring.

You are mixing apples and oranges. I was talking about someone younger thinking that just because a person is old and has multiple medical problems does not mean that they don't need to be taken care or have money and resources wasted on them.

You are describing a situation that is unique. Let me ask you, did the man fill out a DNR? Is he in the right state of mind? Does his wife have durable power of attorney and is keeping him alive? There are a lot of factors that go into the situation that you described. If he wants to die then he can fill out a DNR and then let nature take its course. If he is not in the right state of mind then his wife probably has to decide and then its her decision.

He's dead, Jim. 3 weeks ago.

But this is NOT a unique situation. They were trying to keep my grandma alive at all costs. Fortunately, we all knew she didn't want that. And yeah, it's a hard decision for everyone.

Sometimes, dead is better.

Thats an 827		2009-05-13 09:39:18 AM

Never tell anyone when they will die, because sure as you do they will live to piss on your grave.

Cinaed		2009-05-13 09:40:21 AM

You want 'free' health care?
Be prepared to live a very no-sin lifestyle.
No drinking, no smoking, proper diet, regular exercise, etc.

Otherwise, you pay. If that means you go broke paying the bills because SOMEONE didn't keep their diabeetus in check, so farking be it.

I'm not a fan of eugenics just because it makes the bottom line prettier. But we, as a people, can do a helluva lot more to improving our overall state of health, and if it comes with a government mandate, so be it.

pheelix		2009-05-13 09:40:48 AM

J. Frank Parnell: I can't believe they manage to convince you guys, after your health care system is routinely shown to be the worst, that it's the best.

Care to back that up with some factual data?

SFSailor		2009-05-13 09:43:59 AM

There are so many things wrong with health care and the future is bleak without massive societal change, but at least it's nice to see it being talked about occasionally. Unfortunately, "cost of keeping old people around" is only one of the Very Big Problems we need to address.

Big / Most expensive issues:

1 - Elder Care. No, sorry, your 90y/o grandma does not need a new, $25,000-50,000 hip. The prognosis is horrible. Reduce her suffering, say your goodbyes. Similarly, I'm not sure your 70 y/o chronic alcoholic (oh, but "now he's reformed") uncle needs to be on the liver list.

2 - (Let the flames commence:) No, your 4 wk old neonate (hyperbole here - use your own metric... 24 week? 30 week? 45 week?) does not need $100,000s+ of care in the NICU. Your [body / god / genes / whatever] did not create a viable human. Say your goodbyes and try again. Or, better yet, adopt.

3 - We *need* more socialized / popularly-available *preventive* medicine. You need to see a doctor, lose weight, eat right, get your vaccines / early-detection checkups, etc, before things go Critical. But, we don't need socialized elective / high-risk / high-cost care -- you didn't get your calcium & vitamin D and sit around all day in the old folks' home? No new hip. Not yours.

4 - The disassociation between compensation for experts is going to threaten/destroy the medical establishment anyway -- no reason a specialty with a procedure (Dermatologists, I'm looking at you, but you ain't alone) deserve disproportionate revenue for their skills over areas of expertise that are more intellectual / cognitive (e.g. Internal Medicine)... it's just that Medicare (and, thus, all insurance companies) can figure out how to track & audit a widgetectomy and/or it "seems hard" to the untrained. Medicare needs a lot of work, but the unintended consequences of any changes must be carefully studied before their implementation (e.g.: Wish your doctor would return your phone calls? Call your congressman and demand that Medicare compensate for time spent on the phone. You don't work for free: Why should your doctor?)

5 - Break the nurses' unions. Way, way more dangerous to break the ATC unions, but few people (err, other than me) demonize Reagan for it. Why aren't we talking about breaking the nurses' unions? You know what, honey, no, you take no responsibility, make no decisions, can rarely barely follow the directions you're given and have a two-year degree from a community college. You do *not* deserve to make a six-figure salary (more than many doctors, depending on the state and the career-position of the MD) and work a 40hr week... all while proclaiming how important you are.

6 - We're all doomed anyway. Hours-caps on residency programs have dramatically reduced quality and quantity of training for new doctors in the name of "reducing fatigue"... without increasing the number of years required to receive the same certifications and licenses. And, in turn, dramatically changed the approach most/all newly-minted MDs take to patient care, and the amount and type of experience they have before they are let out on your own. For your own sake, don't go to a doctor under 40-45... when they retire and/or are driven out of the profession, we're in a world of hurt.

Big changes needed, but not sure how/if we're ever gonna get there.

/Phew. Too much caffeine this morning. All tirade-y.
//No, I'm not a paranoid-depressive at all, why do you ask?

Doc Lee		2009-05-13 09:44:39 AM

GoldSpider: Doc Lee: Rationing and restriction by lack of services and facilities exist more in a free market system than in a national health care system.

I'll grant you that assumption (even without citation), but under a fully nationalized system, there wouldn't be any coverage gaps for which people would need to pay for private supplemental insurance. Everyone would be covered no matter how expensive the drugs/procedure. Such a system would be unsustainable.

It's ultimately a numbers game. The system needs to be over-funded in order to account for expensive drugs (which can be purchased at a lower cost in bulk given the purchasing power of a combined insurance pool of 300,000,000+ people) and rare procedures. Your assuming that the number of expensive procedures increases exponentially by opening up the health care system. This is not the case. If you look at heart transplants, you'll see that when the procedure became medically viable (1980s) the number increased exponentially until 1994. From 1994 until 2004, however, heart transplants have been on a yearly decline. Preventive medicine is the key. Detect a problem early on, the number of expensive procedures and drugs needed will decrease substantially.

That system is most certainly sustainable.

Random Reality Check		2009-05-13 09:45:05 AM

Edsel: Random Reality Check: Edsel: As his family, you have the power to end his suffering by just turning off the food pump, if you think he wouldn't have wanted to live that way. Not trolling, it's the truth. Not the nursing home or the doctors who are at fault for keeping him alive, it's you.

Would that it were that easy...

To put it in blunt terms, you are suggesting that our entire family agree that we should starve my father to death, slowly, over a period of weeks. You are presupposing that everyone in the family would be in agreement and would allow such a thing. There is no clear legal mechanism for resolving these issues and there needs to be.

I do appreciate your input, even though I would suggest you haven't been down this road and I sincerely hope from the bottom of my heart you never have to.

I'm a physician. I see it all the time and I know what families go through and how difficult it is. And I would point out that under no circumstances is withholding life-sustaining treatment considered inhumane if it is consistent with what the patient would have wanted. The sensation of hunger (if brain injured patients even have it) passes quickly and can be taken away with medication. And patients don't die from "starvation", they die of electrolyte abnormalities produced by lack of water.

As far as legal processes, unless you have a Terri Schiavo situation, no legal process is really required. But if the situation is just getting family members to agree on what to do -- again, you can't blame the nursing home or the doctors. The problem is as you outlined: your family can't agree on what to do. Not an uncommon problem in America, mind you. In the rest of the developed world this would not even really be an debated issue.

Excellent, I appreciate someone who has to deal with this from a professional perspective lending their time and knowledge to this debate.

Some background information, for those who are following the discussion.

My father was slightly older than 70 and from all outward signs in perfect health. He was height/weight proportional, walked everywhere, was extremely active, ate well, went to work everyday, had never been sick a day in his life and at 70 years old could run rings around his children and grandchildren.

At 6:30 in the morning (watch stopped from the fall) he had his stroke. As he lived alone, no one was there to be of assistance. At 9:00AM, or so, people at work started wondering where he was and called him with no answer. They concluded he had stopped to run errands or maybe get his car serviced, even though it was unlike him to not call if he was doing something out of the ordinary. At lunch, his brother (they own the company together) got nervous and drove over to my father's and knocked on the door. Right, no answer. My uncle then went to see if he could find my father's best friend who had a set of keys to get inside. At about this point, there was every reason to suspect something was wrong. My uncle got hold of my father's best friend about an hour later but he was roughly an hour's drive away and was pretty much trapped taking care of his elderly wife - so my uncle drove over picked up the keys and drove back to my father's.

Long story short, he was admitted to the hospital around 4:30 in the afternoon.

As you know, had he been found earlier the prognosis would have been much different.

In the whirlwind that happened over the next 24 to 48 hours, we were invited to discuss the options. We were presented with the idea that at this point all treatment could be stopped and that within three days my father would pass away. The hospital did mention that he would be medicated, feel no pain and that this may be the best course of action based on the tests that had been done.

To say that emotions were stretched would be an understatement - but the one real problem was one of my sisters, a devout Catholic (NTTAWWT) who not only would not consider the option but hired a lawyer and began a legal battle for guardianship.

In other words, one person brought the decision making ability of an entire family, extended family as well, including what everyone agreed were my father's wishes to a screeching halt.

As seen by the Schavio case, these things don't get decided easily.

Now, with all that said, my reason for sharing this personal story with you all is not because I am looking for sympathy but to stimulate discussion as to what should be considered the end of life.

At what point do DNRs have no meaning if one person, for whatever reasons, threaten to sue if they are followed? Should we keep a brain dead premature baby alive because one person's religious interpretations make them believe that God wants this? At what point do we begin to understand that committing vast resources to keep someone fed who will never know if it is day or night, let alone of the nurse is family or not, fails when we have so many more people who could and should benefit from those same resources.

Oh, and thanks for jumping in here Edsel, I honestly appreciate your sharing.

Gulper Eel		2009-05-13 09:50:28 AM

The other health care problem no politican would mention? Fraud.

You put that much money in one place for any reason...defense, health, whatever...and it draws thieves. If New York loses ten percent of its annual Medicaid budget to fraud...that'd be around $7 billion this year...how much do you think would be stolen out of DC?

crimsin23		2009-05-13 09:53:39 AM

HotWingConspiracy: crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

Ok, then they can buy private insurance to prolong their life of bliss.

Do you want to cancel social security too? A country has to take care of its citizens, especially the ones that need the most health. This part is non-negotiable. You can find other ways to cut cost, but this way is not it.

I want a healthy mix of a social health care safety net for the basics, and reputable, honest insurance companies for any high-end or elective medicine and procedures one might want.

I agree we have to care for one another, but caring (to me, any way) doesn't mean using vast amounts of resources to keep someone alive for a few more days.

I too want a mix of social health care and honest insurance companies but that just isn't going to happen. If you socialize medicine, demand skyrockets and everyone waits in line for 6 months to go see a doctor.

I don't see that happening.

It's simple economics; when price falls, demand increases, because demand is inversely proportional to price.

Furthermore, doctors will not be as competitive because their salaries will be limited.

What's the value of competition in this realm? It hasn't brought costs down.

Look at places like England and France where the salaries of doctors are limited. There is no competition there. Noone strives to be world renouned because there is very little benefit in becoming the best. Why do you think it is that America has the best doctors?

I disagree on the fact that using our resources to help the elderly, even if it is only to keep them alive for a few more days, is not the best use for them. A country is only as good as its ability to take care of its citizens, especially the ones most in need.

I just don't see the point. And again, if this is the care you want for your family, purchase it.

The point is that a country is obligated to take care of its citizens.

GoldSpider		2009-05-13 09:53:53 AM

Doc Lee: Preventive medicine is the key. Detect a problem early on, the number of expensive procedures and drugs needed will decrease substantially.

Of that I have no doubt. I don't fundamentally disagree with you on universal health care (in fact in a lot of ways I support it).

But let's look at obesity, for example. I think we can agree that obesity is responsible a large portion of our country's health care costs. Under a tax-funded system, what is government's role in reducing obesity and reducing the burden to taxpayers?

Current government efforts to encourage people to live a healthier lifestyle have not been effective in reversing the problem. What is the next step? Mandatory exercise and diet programs?

Let's face it, a lot of preventative care requires effort on the part of patients. How do you keep costs down when patients are unwilling to hold up their end of the bargain?

Random Reality Check		2009-05-13 09:55:02 AM

Gulper Eel: The other health care problem no politican would mention? Fraud.

You put that much money in one place for any reason...defense, health, whatever...and it draws thieves. If New York loses ten percent of its annual Medicaid budget to fraud...that'd be around $7 billion this year...how much do you think would be stolen out of DC?

I know you're not saying that we shouldn't do the right thing because there are crooks in the world - but that's sure what it sounds like.

The obvious answer is to monitor the system and then parts any asshole we find stealing from grandma's health care. We can use all the healthy spare parts we can get and I know the conservatives will approve of the deterrent value.

Office Ninja		2009-05-13 09:55:33 AM

FTA - "What happens when the state controls all the resources? New resources do not develop, and the government winds up rationing care based on its own priorities, and not the priorities of the patients or caregivers. Professor Altman's suggestion that the elderly get hospice treatment to save scarce care resources is exactly the kind of decisions the state will make for its citizens, and it won't be limited to the elderly, either."

So have fun with that government health care program you asked for.

crimsin23		2009-05-13 09:57:13 AM

ghare: Sometimes, dead is better.

I'm sorry to hear that about him. I agree with you that sometimes it is best to let go. But if noone wants to let go, then that shouldn't happen just because the person is old and sick, and we don't want to waste resources on them.

GoldSpider		2009-05-13 09:57:49 AM

crimsin23: The point is that a country is obligated to take care of its citizens.

gulogulo		2009-05-13 09:59:49 AM

Snarfangel: ragekage: Well, that's true, but what do you propose we do- bring back the heady days of eugenics?

Eugenics would be fairly ineffective with elderly people, though I suppose we could restrict their supply of Viagra.

I was going to say something similar. Letting older people die has zippo to do with eugenics.

Phil Herup		2009-05-13 10:01:04 AM

crimsin23: The point is that a country is obligated to take care of its citizens.

The real point is to what extent they should take care of them.

They do enough with national defense, police/fire and infrastructure.

God's Hubris		2009-05-13 10:03:08 AM

pheelix 2009-05-13 09:40:48 AM
Care to back that up with some factual data?

Everyone in the current American health care system has either died, or will die.
100% failure rate. That's a fact. It's time to try something different.

Doc Lee		2009-05-13 10:06:33 AM

GoldSpider: Doc Lee: Preventive medicine is the key. Detect a problem early on, the number of expensive procedures and drugs needed will decrease substantially.

Of that I have no doubt. I don't fundamentally disagree with you on universal health care (in fact in a lot of ways I support it).

But let's look at obesity, for example. I think we can agree that obesity is responsible a large portion of our country's health care costs. Under a tax-funded system, what is government's role in reducing obesity and reducing the burden to taxpayers?

Current government efforts to encourage people to live a healthier lifestyle have not been effective in reversing the problem. What is the next step? Mandatory exercise and diet programs?

Let's face it, a lot of preventative care requires effort on the part of patients. How do you keep costs down when patients are unwilling to hold up their end of the bargain?

Incentives, as have been proposed. Mandating is not the key to having a patient do something. The human brain isn't set up like that. It doesn't like being told what to do. However, the brain likes to be rewarded. Reward by tax breaks for those who maintain healthy lifestyle choices. This would make a national health insurance plan no different than a private insurance plan. You smoke? No tax break. Overweight? No tax break. However, a national system should reward only for lifestyle choices, not those out of a person's control such as family history of cancer, heart attack, stroke, diabetes, etc. We should reward those people however for receiving at a minimum an annual physical or screening.

Random Reality Check		2009-05-13 10:06:43 AM

GoldSpider: Doc Lee: Preventive medicine is the key. Detect a problem early on, the number of expensive procedures and drugs needed will decrease substantially.

But let's look at obesity, for example. I think we can agree that obesity is responsible a large portion of our country's health care costs. Under a tax-funded system, what is government's role in reducing obesity and reducing the burden to taxpayers?

Current government efforts to encourage people to live a healthier lifestyle have not been effective in reversing the problem. What is the next step? Mandatory exercise and diet programs?

Let's face it, a lot of preventative care requires effort on the part of patients. How do you keep costs down when patients are unwilling to hold up their end of the bargain?

Somewhere there is the inference that obese people want to remain obese,
something that I find to be untrue with the exception of the very few.

Obesity is now a health epidemic, one that needs to be addressed and I'm
not sure that the problem doesn't extend well beyond lifestyle and into
how we grow, process, cook, and serve food.

Whether or not we ever make a change to the way health care is provided,
obesity needs to be dealt with.

Thorndyke Barnhard		2009-05-13 10:07:32 AM

GoldSpider: Everyone would be covered no matter how expensive the drugs/procedure. Such a system would be unsustainable.

Sure, it would be, if reality weren't there to show us that it isn't.

It's not like the US is contemplating some novel concept here. In virtually every other wealthy industrialized western nation some form of universal health care system is in place and is sustainable. Are all of these aberrations? On what do you base the unsustainability hypothesis if every time it's tested the hypothesis fails? Are we going to have to rehash Popper and Kuhn to figure out the problem here?

Doc Lee		2009-05-13 10:09:29 AM

Cinaed		2009-05-13 10:13:23 AM

Phil Herup: The real point is to what extent they should take care of them.

They do enough with national defense, police/fire and infrastructure.

And to what degree the citizens have a responsibility to care for themselves as well. I'm a big fan of preventative medicine, and I don't have a problem with a broad national level of health care, but with some major provisos.

-Eat right (no more bag-at-a-time dorito fun)
-Exercise (regular exercise)
-Abstain from habits that are explicitly harmful (excessive drinking, smoking, illicit drug use, etc)
-Obey medical advice (can't manage your diabeetus? boo farking hoo)

I'm guessing that a whole lot of people would be instantly disqualified from benefiting from the free health care right farking quick. Blanket coverage for people being idiots is not a good answer to the country's health problems.

GoldSpider		2009-05-13 10:15:41 AM

Random Reality Check: Somewhere there is the inference that obese people want to remain obese, something that I find to be untrue with the exception of the very few.

No, but there are a lot of obese people who are unwilling to make the lifestyle changes necessary to improve their health.

Thorndyke Barnhard: In virtually every other wealthy industrialized western nation some form of universal health care system is in place and is sustainable.

I wish I could find the link, but a story I read on NPR suggested that France's national health care system (which I was referring to, different from universal health care) is running into funding problems, resulting in the reduction of services.

crimsin23		2009-05-13 10:15:46 AM

Lord_Baull: crimsin23 2009-05-13 08:54:07 AM
If you socialize medicine, demand skyrockets and everyone waits in line for 6 months to go see a doctor. Furthermore, doctors will not be as competitive because their salaries will be limited. Finding that balance will not be easy, if at all possible.

First of all, how is socializing medicine going to make people sick all of the sudden and skyrocket demand

Simple economics people; when price falls, demand increases. People are already sick, but they don't go to the doctor because it costs money. Now if you subtract money from the equation, the demand will skyrocket. What is the average wait time for a PCP in Canada, England?

Secondly, how does socialize medicine eliminate private insurance and limit doctor salaries?

Look and how much doctors earn in England, for example: Link (new window) vs. how much they earn in the US Link (new window)

crimsin23		2009-05-13 10:17:07 AM

Phil Herup: crimsin23: The point is that a country is obligated to take care of its citizens.

The real point is to what extent they should take care of them.

They do enough with national defense, police/fire and infrastructure.

So no Social Security? What do you think we should do with the elderly?

crimsin23		2009-05-13 10:18:38 AM

GoldSpider: crimsin23: The point is that a country is obligated to take care of its citizens.

Prove me wrong. Why don't you think that that is a fundamental job of a country? Or do you just speak in pictures?

GoldSpider		2009-05-13 10:19:48 AM

crimsin23: What do you think we should do with the elderly?

Change society's current thinking of extending life at all cost.

Easy? Nope.

Necessary? Probably.

HotWingConspiracy		2009-05-13 10:19:49 AM

crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: crimsin23: HotWingConspiracy: They can buy private insurance if they want expensive treatments to prolong their suffering.

Who said that they are suffering? Just because they are old? Or because they have multiple medical problems? There is a lot for people to live for, even if they are old or sick. Their lives are in no way less important than yours or mine. A country has to take care of its citizens.

Ok, then they can buy private insurance to prolong their life of bliss.

Do you want to cancel social security too? A country has to take care of its citizens, especially the ones that need the most health. This part is non-negotiable. You can find other ways to cut cost, but this way is not it.

I want a healthy mix of a social health care safety net for the basics, and reputable, honest insurance companies for any high-end or elective medicine and procedures one might want.

I agree we have to care for one another, but caring (to me, any way) doesn't mean using vast amounts of resources to keep someone alive for a few more days.

I too want a mix of social health care and honest insurance companies but that just isn't going to happen. If you socialize medicine, demand skyrockets and everyone waits in line for 6 months to go see a doctor.

I don't see that happening.

It's simple economics; when price falls, demand increases, because demand is inversely proportional to price.

Furthermore, doctors will not be as competitive because their salaries will be limited.

What's the value of competition in this realm? It hasn't brought costs down.

Look at places like England and France where the salaries of doctors are limited. There is no competition there. Noone strives to be world renouned because there is very little benefit in becoming the best. Why do you think it is that America has the best doctors?

What? Just because you don't know about them doesn't mean they don't exist.

And I don't really care if a doctor is "world renowned" if I can't afford surgery.

I disagree on the fact that using our resources to help the elderly, even if it is only to keep them alive for a few more days, is not the best use for them. A country is only as good as its ability to take care of its citizens, especially the ones most in need.

I just don't see the point. And again, if this is the care you want for your family, purchase it.

The point is that a country is obligated to take care of its citizens.

Which we do. Within reason. Again, if you want the ultra-deluxe care package, purchase it.

GoldSpider		2009-05-13 10:21:37 AM

crimsin23: Why don't you think that that is a fundamental job of a country?

(Definitely getting into threadjack territory)

Because that role has not been ascribed to the federal government in the U.S. Constitution.

Phil Herup		2009-05-13 10:24:36 AM

crimsin23: What do you think we should do with the elderly?

By all means keep off their lawns.

Smidge204		2009-05-13 10:26:05 AM

crimsin23: It's simple economics; when price falls, demand increases, because demand is inversely proportional to price.

But simple supply and demand doesn't apply to health care like that: Better health care leads to fewer people getting seriously sick, which counters the need for more (particularly more advanced and costly) health care.

An ounce of cure vs. a pound of prevention, etc.
=Smidge=

rumpelstiltskin		2009-05-13 10:26:38 AM

Office Ninja: FTA - "What happens when the state controls all the resources? New resources do not develop, and the government winds up rationing care based on its own priorities, and not the priorities of the patients or caregivers. Professor Altman's suggestion that the elderly get hospice treatment to save scarce care resources is exactly the kind of decisions the state will make for its citizens, and it won't be limited to the elderly, either."

So have fun with that government health care program you asked for.

Replace "the state" with "insurance company" in the above, and you have exactly the situation we have now. Do you think your insurance policy covers experimental procedures? Do you think your insurance policy gives your doctor free reign to treat you? A lot of insurance policies even restrict the hospitals you can go to and the doctors you can see.
We don't have a "free market" system, and you're an idiot if you think we do. Most insured Americans don't get to pick the insurance they want (or need), because it's chosen by their employers. And then they don't get to pick the doctors they want, because he's filtered by the insurance company that was picked by their employers. And the doctor can't choose the treatment you need, because that's restricted by the insurance company, too. How the fark is that a "free market"? Because you get to choose your employer? Ha. You're not that stupid are you? This isn't capitalism. The tradesmen are conspiring against you, and then telling you everything is fine.
And what's this downside to nationalized health I keep hearing about? Because the government can't run a railroad, obviously they'll fark up health care? Well, I've got a news flash for all you idiots out there: Harry and Louise we're lying. Our system is already farked up, and while there may be better ways to fix it than nationalization, nationalization would be a big step up.

Thorndyke Barnhard		2009-05-13 10:27:24 AM

GoldSpider: I wish I could find the link, but a story I read on NPR suggested that France's national health care system (which I was referring to, different from universal health care) is running into funding problems, resulting in the reduction of services.

Can we find out what exactly is causing those funding problems or are we forced to just assume that it's due to the core concept of socialized health care since that conclusion is most friendly to our fundamental distaste for anything socialist and non-corporatist? Why are other examples of socialized health care stubbornly defying that unsustainability that we are insisting should be inevitable, according to our free market faith, dammit?

Random Reality Check		2009-05-13 10:27:52 AM

GoldSpider: Because that role has not been ascribed to the federal government in the U.S. Constitution.

What the hell are we general defending against, if it's not death?
Preservation of our right to give up our right every so often?

crimsin23		2009-05-13 10:28:32 AM

Doc Lee: No. Demand does not skyrocket as those who get sick will still get sick and are a limiting factor in the health care system. What does happen is less use of high cost emergency facilities. Instead of using emergency facilities, people can instead use clinical resources (where they belong) resulting in less strain on the system at a lowered cost for treatment. Physicians' salaries are determined by the hospital (or what they can pull in themselves through private practice) in a national health care coverage system, not by the government. Physician competition increases under a national health care coverage system as a list of approved physicians is no longer exclusively limited by the insurance provider. You, the patient, become the decider in who manages your health. The physicians compete for your business, not just carry-over from an approved list of physicians put out by your insurance provider.

You don't think that there are a lot of people out there without insurance, who are already sick, but can't afford to go to a doctor? These people will put an overwhelming strain on the PCPs. Cost will lower, but demand will be very high. A national healthcare system will mean that the physicians salaries will be determined by the government. You think that the government will pay for people to see doctors and not limit the physicians salaries? Physician competition will decrease because they will have a salary cap, which will make them less competitive. The best doctors will get the most patients, but then the rest, who will be an overwhelming majority, will just get the leftovers, and what will those physicians get if they see a patient or two more?

Cinaed		2009-05-13 10:30:11 AM

Random Reality Check: What the hell are we general defending against, if it's not death?
Preservation of our right to give up our right every so often?

Protecting the citizens is not the same as caring for them. I am fine with social systems to catch people when they fall and fall hard. But the government can expect people to shoulder the annoying needling details. If that means living a healthier lifestyle, then so be it.

/former smoker
//hardest thing in the world to quit
///if my weak willed arse can quit, anyone can

Syphilis_Smile		2009-05-13 10:31:01 AM

Christians: Keeping people from Jesus in nursing homes around the country, and denying God any new cherubs for his pedo-bear ways.

GoldSpider		2009-05-13 10:31:13 AM

Random Reality Check: What the hell are we general defending against, if it's not death?

Considering people are dying at a rate of 100%, I'd say our government is doing a pretty poss-poor job of defending against it.

crimsin23		2009-05-13 10:31:21 AM

GoldSpider: crimsin23: Why don't you think that that is a fundamental job of a country?

(Definitely getting into threadjack territory)

Because that role has not been ascribed to the federal government in the U.S. Constitution.

If we had followed the constitution word for word, do you know where we would be?

/No more threadjacking.

fernt		2009-05-13 10:32:19 AM

"Interestingly, the older the Medicare patient, the lower the costs tend to be when the person dies. Why? A 2001 study in the Journal of the American Medical Association concluded, "This is in large part because the aggressiveness of medical care in the last year of life decreases with increasing age." So much for the claim that doctors routinely resort to every heroic means possible to extend the lives of the oldest of the old."

http://www.denverpost.com/search/ci_12346861

crimsin23		2009-05-13 10:33:17 AM

Smidge204: crimsin23: It's simple economics; when price falls, demand increases, because demand is inversely proportional to price.

But simple supply and demand doesn't apply to health care like that: Better health care leads to ~~fewer people getting seriously sick, which counters the need for more (particularly more advanced and costly) health care.~~ increase in demand, and a 6 month wait to go see a doctor.

An ounce of cure vs. a pound of prevention, etc.
=Smidge=

FTFY

fosborb		2009-05-13 10:34:51 AM

Crosshair: Could it possibly be because of our homicide rate? I would guess that 18 year old drug dealers getting wacked drag down the average. I would guess plenty of young people killing themselves in auto wrecks drags that average down too.

You really think 16,000 people murdered and 45,000 car-related deaths a year is going to drag down the life expectancy rate of 300,000,000 more than a couple of hours?

Also, I like how your link says most of our life expectancy woes are just African Americans holding us back with their alcholism and AIDS. Even though there's just as much disparity in life expectancy between the wealthy and poor (79.2 v 74.7) and healthcare programs only cover about 40% of the poor and there are as many poor people in the US as all African Americans, we know all that doesn't have any correlation with life expectancy rates nor does it speak to the quality of healthcare in the US. It's clearly the blacks.

brynaldo		2009-05-13 10:37:48 AM

What about jews and gypsies?

crimsin23		2009-05-13 10:39:27 AM

HotWingConspiracy: What? Just because you don't know about them doesn't mean they don't exist.

And I don't really care if a doctor is "world renowned" if I can't afford surgery.

Cost won't be your biggest problem, time will. You can get on a wait list in a county hospital for surgery, which will be a year. Under a national care system, that wait will be double or triple.

Furthermore, why would surgeons compete so much to get into the best med schools, to get into the best residency, just to have the government say that this is how much you can make?

I disagree on the fact that using our resources to help the elderly, even if it is only to keep them alive for a few more days, is not the best use for them. A country is only as good as its ability to take care of its citizens, especially the ones most in need.

I just don't see the point. And again, if this is the care you want for your family, purchase it.

The point is that a country is obligated to take care of its citizens.

Which we do. Within reason. Again, if you want the ultra-deluxe care package, purchase it.

Keeping people alive when they are old, whether through operations, medication, etc... is not an ultra deluxe package, and is entirely within reason.

RockofAges		2009-05-13 10:39:27 AM

IamKaiserSoze!!!: J. Frank Parnell: IamKaiserSoze!!!: Health care cost are lower in other countries because they provide less, not because they do it more efficiently. My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms. That would not happen as quickly, or most likely not at all, in England or Canada.

Utter nonsense.

Waiting room wait times are bad in Canada, because everyone who has the sniffles decides to bother doctors with it, but i can tell you from experience that if you have a serious problem that bypasses the outpatient area you're treated like royalty.

I can't believe they manage to convince you guys, after your health care system is routinely shown to be the worst, that it's the best.

Hmmmm.....I've worked in hospitals in Detroit and Rochester, NY and both made a lot of money off of Canadians who couldn't get the care they needed (or wanted) in Canada. It is from these folks that I have formed my opinions not from 'They'. Healthcare systems in both communities (as well as many other US border cities) do very well careing for the many folks who might differ with your opinion.

Yea, so what you're saying is that rich Canadians, so rich in fact that they can afford to fly to the U.S. for elective surgery (which would be the only reason to leave Canada, given that major surgeries are attended to immediately) don't like the fact that they have to wait in line like the rest of the plebes for their electives?

Well, colour me surprised. Let me tell you right off the bat that the only thing wrong with Canadian health care is that we don't allow private practice in many situations for those that want to expedite their service. (Win Win, Everyone gets great coverage, and if you want faster elective surgery, go pay for it out of pocket).

My brother was born with congenital heart disease, extreme scoliosis and kyphosis as well as a slew of other medical issues. My first memory in life is being walked into a bright, bright room and touching my brother through plastic gloves in an infant ICU of some type, with wires and hoses all over him. He is 21 now, but for the first 13 years of his life he underwent many open heart surgeries and other major surgeries such as a spinal fusion. I have intimate experience with how the Canadian medical system works and treats the truly sick and disabled.

To say that our system is lacking is laughable. I come from a blue collar family that works hard and tries to pay the ever increasing bills that come along with life. Without our health care system my brother would be relegated to "medicaid" or some other piece of crap "insurance" you have in the states - and would not receive the amazing care that he did.

Keep lying to yourselves though. Most Americans are smart enough to realize when they've been had by predatory medical institutions.

The Florida Tag		2009-05-13 10:42:23 AM

The book. Read it.

The answer isn't to kill people off faster or let them die, the answer is to find ways to engineer negligible senescence so that people can live healthier and far, far longer.

Think about it: we can upkeep a car from 1920 in almost perfect working condition because we understand and know how to manipulate the ins and outs of it. In theory that car can be kept indefinitely. Why aren't we pushing hard to do the same for people?

/What's the difference between malaria and aging?
//Aging kills considerably more people.
///Tired of who think that death before the early age of 120 should be welcome in civil society any longer.

Thorndyke Barnhard		2009-05-13 10:43:57 AM

GoldSpider: Because that role has not been ascribed to the federal government in the U.S. Constitution.

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

What is this, an accidental ink blot?

GoldSpider: Random Reality Check: What the hell are we general defending against, if it's not death?

Considering people are dying at a rate of 100%, I'd say our government is doing a pretty poss-poor job of defending against it.

Heh, good point.

RockofAges		2009-05-13 10:44:20 AM

Cinaed: Phil Herup: The real point is to what extent they should take care of them.

They do enough with national defense, police/fire and infrastructure.

And to what degree the citizens have a responsibility to care for themselves as well. I'm a big fan of preventative medicine, and I don't have a problem with a broad national level of health care, but with some major provisos.

-Eat right (no more bag-at-a-time dorito fun)
-Exercise (regular exercise)
-Abstain from habits that are explicitly harmful (excessive drinking, smoking, illicit drug use, etc)
-Obey medical advice (can't manage your diabeetus? boo farking hoo)

I'm guessing that a whole lot of people would be instantly disqualified from benefiting from the free health care right farking quick. Blanket coverage for people being idiots is not a good answer to the country's health problems.

I agree! We should also have the following complimentary items added!

- ID Chip in Hand to make sure people are following the rules
- No more red meat
- No living in a city with air pollution
- No playing the lottery (signs of dementia)

What a bunch of sick farks you guys are. I bet you're real fun at parties.

Phil Herup		2009-05-13 10:47:04 AM

Doc Lee: You must have missed the "growing up" part.

Since this is FARK, I never actually associated you with being a real grown up.

Also, you are too much of a condescending tool.

Yankees Team Gynecologist		2009-05-13 10:48:44 AM

GoldSpider: Because that role has not been ascribed to the federal government in the U.S. Constitution.

Has it been prohibited by the Constitution?

No, it may not be in there, and no, it may not be necessary to you. Power windows and seats aren't necessary to have in a car, but they're nice to have, and all nice cars have them.

Taking care of the elderly is a hallmark of all advanced, developed, civilized, modernized countries. It's what separates those countries from third-world hellholes where you have old people rotting in the streets. If you can look after the elderly at reasonable cost, then it's definitely something to strive for.

Note that I said "if." Maybe the USA can't do it. Maybe we're not cut out to be among the elite nations, one of the "nice cars." It sounds ridiculous considering our supposed greatness, but I'm open to that possibility, especially given the recent news about Medicare going dry.

Cinaed		2009-05-13 10:52:49 AM

RockofAges: I agree! We should also have the following complimentary items added!

- ID Chip in Hand to make sure people are following the rules
- No more red meat
- No living in a city with air pollution
- No playing the lottery (signs of dementia)

What a bunch of sick farks you guys are. I bet you're real fun at parties.

Was primarily referring to interactions with a physician that would be protected by doctor-patient privilege, with the doc giving the yea or nay on entry into the program.

Tests prove pretty consistently if you're engaging in explicitly harmful activity. No need for the chip.

Red meat, in reasonable quantities, is not harmful, and quite tasty. Banning it is just plain silly.

City pollution is difficult to control, although not the fault of an individual per se. Living next to a toxic dump is one thing, living in Detriot is another.

I'm still not sure about the lottery thing as a sign of dementia. Perhaps a lack of understanding of ratios and mathematics that can be solved by having public schools teach fractions properly.

GoldSpider		2009-05-13 10:55:36 AM

Yankees Team Gynecologist: Has it been prohibited by the Constitution?

That's not how the Constitution works. It specifically defines the powers of the federal government. All other powers are reserved by the states. I'm sure you're familiar with the 10th Amendment.

Doc Lee		2009-05-13 10:57:27 AM

Phil Herup: Doc Lee: You must have missed the "growing up" part.

Since this is FARK, I never actually associated you with being a real grown up.

Also, you are too much of a condescending tool.

Oh, Phil, you never can admit your mistakes, can you?

Random Reality Check		2009-05-13 10:57:41 AM

Cinaed: Protecting the citizens is not the same as caring for them.

So that entire common defense and general welfare thing really is meaningless?

Seems like having really well preserved buildings with dead people in them isn't that good an idea. Of course, I'm not an Constitutional scholar, so what do I know.

I do find it curious that if our country was attacked by a biological weapon we would be covered, though.

Cinaed: I am fine with social systems to catch people when they fall and fall hard. But the government can expect people to shoulder the annoying needling details.

In your view, what separates needling details from serious medical issues?

Cinaed: If that means living a healthier lifestyle, then so be it.

All for it - and I think the federal government should be leading the way.
What happened to our food supply that is doing this to people?
Did all that research into making foods taste better play a part in obesity?
Are additives a problem? Is sugar subsidization part of the problem?

Cinaed: /former smoker
//hardest thing in the world to quit
///if my weak willed arse can quit, anyone can

Former smoker - 33 years.
Hardest thing I ever did.
Glad I did though.

gshepnyc		2009-05-13 10:57:47 AM

The Florida Tag: The book. Read it.

The answer isn't to kill people off faster or let them die, the answer is to find ways to engineer negligible senescence so that people can live healthier and far, far longer.

Think about it: we can upkeep a car from 1920 in almost perfect working condition because we understand and know how to manipulate the ins and outs of it. In theory that car can be kept indefinitely. Why aren't we pushing hard to do the same for people?

/What's the difference between malaria and aging?
//Aging kills considerably more people.
///Tired of who think that death before the early age of 120 should be welcome in civil society any longer.

I'm with you. Life does not become somehow less valuable just because you are closer to the end than the begining. Longer life - with high quality of life - should be a primary goal of medical science. I suspect that we will not feel the inventive urge to provide for the high-quality part until the longevity part becomes more or less inevitable.

Einstein's Missing Parietal Operculum		2009-05-13 10:58:19 AM

Phil Herup: Doc Lee: You must have missed the "growing up" part.

Since this is FARK, I never actually associated you with being a real grown up.

Also, you are too much of a condescending tool.

Well, I see somebody finally explained to you the concept of Irony. I bet it only took them a week before it sank in.

Gulper Eel		2009-05-13 10:59:33 AM

Random Reality Check: I know you're not saying that we shouldn't do the right thing because there are crooks in the world - but that's sure what it sounds like.

The obvious answer is to monitor the system...

Except when there's that much money in play the thieves become...well, the same usual suspects bollixing up the system now, only with a far bigger pot of money to play with and far less incentive to keep costs in line. New York only chases small-fry Medicaid thieves, and they had to be embarrassed and prodded like hell to do even that. Nursing homes, hospitals, unions, and pharmaceutical companies all paid good money for those state legislators and they'll be damned if they waste their investment with any silly monitoring of what they do.

Nursing homes, hospitals, unions and pharmaceutical companies...now, where did we see them all gathered together lately?

It's not a question of there being some crooks in the system. It'll be loads of crooks. The Times pegged Medicaid fraud in New York at a minimum of ten percent, and went on to say that another 10-30 percent was either stolen or wasted. Which sounds like a good starting point to me, seeing as New York's Medicaid program is bigger than the next two states' programs...combined.

I've seen no reason to think that consolidating health care in DC won't produce the same train-wreck it has in New York.

Random Reality Check		2009-05-13 11:00:05 AM

GoldSpider: Random Reality Check: What the hell are we general defending against, if it's not death?

Considering people are dying at a rate of 100%, I'd say our government is doing a pretty poss-poor job of defending against it.

Well, maybe it's high time that we demand better from out government.
If the Republicans can't fix this mess, let's put the Democrats in charge.
No! Better yet, let's have a tea party. We can throw green tea in the rivers.
Green tea is healthy right? That ought to show all those politicians that we're serious.

Gangway Fathead		2009-05-13 11:07:21 AM

The Florida Tag: The book. Read it.

The answer isn't to kill people off faster or let them die, the answer is to find ways to engineer negligible senescence so that people can live healthier and far, far longer.

Think about it: we can upkeep a car from 1920 in almost perfect working condition because we understand and know how to manipulate the ins and outs of it. In theory that car can be kept indefinitely. Why aren't we pushing hard to do the same for people?

/What's the difference between malaria and aging?
//Aging kills considerably more people.
///Tired of who think that death before the early age of 120 should be welcome in civil society any longer.

Given population growth rates and the over crowding crisis we're already facing, I don't think extending the average lifespan by over 50% is going to do us any favors.

quizzical		2009-05-13 11:09:14 AM

Cinaed		2009-05-13 11:10:36 AM

Random Reality Check: So that entire common defense and general welfare thing really is meaningless?

Seems like having really well preserved buildings with dead people in them isn't that good an idea. Of course, I'm not an Constitutional scholar, so what do I know.

I do find it curious that if our country was attacked by a biological weapon we would be covered, though.

Biological defense is part of defense. It isn't providing full health coverage. I'm not a constitutional scholar either, nor is it likely that anyone here is one. Keep other people from trying to kill your citizens is a big task, and we've gotten into a rather comfortable position.

In your view, what separates needling details from serious medical issues?

All the same crap that we all 'should' be doing, but hardly actually do. Eat better food, eat less lousy food, exercise regularly, avoid harmful habits and activities when able, wash your hands and hold yourself to simple personal hygiene standards that we all learned in kindergarten just in case Mommy and Daddy didn't cover it.

Sure, Cancer, disease, broken bones, assault & battery, car accidents, chronic conditions, etc all happen. But a lot of these things can be mitigated, avoided, and reduced by simply living a healthier lifestyle. We don't have to eat organic arugula every night, but a salad instead of a double quarter pounder w/cheese would likely do a LOT of Americans a world of good.

All for it - and I think the federal government should be leading the way.
What happened to our food supply that is doing this to people?
Did all that research into making foods taste better play a part in obesity?
Are additives a problem? Is sugar subsidization part of the problem?

Indeed, I just don't think it should foot the bill. Dangle the 'carrot' and make people work for it. We can't punish bad behavior outright, but we can make it very attractive to conduct one's self better.

Food can taste great and not be horrible for you. I've had 'vegetarian chili' that, when I heard about it before I ate it, would have passed. But that stuff was damned tasty. We made food that was tasty, unhealthy, and created a massive desire for it. Additives, excessive fats, cholesterol, sodium, and all kinds of things together have a negative effect. Just cutting back on a lot of these things is a positive move.

I won't ever say 'BAN THE DORITOS' because they're too tasty, but I can, and do, eat a helluva lot less than I used to. I exercise some, but really need to do more. The society we created didn't do us any favors, but so much of healthy living is the individual doing what needs to be done.

Cinaed: /former smoker
//hardest thing in the world to quit
///if my weak willed arse can quit, anyone can

Former smoker - 33 years.
Hardest thing I ever did.
Glad I did though.

10 years for me. Hardest thing by far.

Rann Xerox		2009-05-13 11:11:00 AM

Yankees Team Gynecologist		2009-05-13 11:11:32 AM

GoldSpider: That's not how the Constitution works

Oh yeah? Obviously you subscribe to the Paultard version of the 10th Amendment; the rest of the country has opened it up to congressional authority and isn't in denial of the many institutions and laws that wouldn't exist under your interpretation.

fizzix_is_fun		2009-05-13 11:16:21 AM

has anyone mentioned that health care costs are so high because they are used to fund the pharmaceutical companies research into new pills and medications? No other country puts as much research into pharmaceutical research as we do, and it costs billions of dollars to come up with a new medication. They do pirate the chemical compositions and create their own versions afterwords, of course.

Subtract out that cost from our health care and see where we then stack up with other countries.

/back to lurking

Doc Lee		2009-05-13 11:16:39 AM

crimsin23: You don't think that there are a lot of people out there without insurance, who are already sick, but can't afford to go to a doctor? These people will put an overwhelming strain on the PCPs. Cost will lower, but demand will be very high.

Keeping people out of our system is not what keeps our wait times short. Our existing health care infrastructure keeps our wait times short. The vast majority of people who get sick in our system and utilize resources are simple to treat cases; flu, cold, cuts and scrapes, etc. These cases can be handled by physician assistants or registered nurses. There's no need for an PCP to see each of these cases but rather oversee a team of PAs or RNs that handle these cases. This is a paradigm shift that many people don't seem to understand. Not only does the financing of the system need to change, the structure of the system needs to change as well in order to reduce costs and unnecessary expenditures. Furthermore, the number of sick people at any given time in society is rather constant with the exception of flu season. You must not think people haven't already accounted for these statistics when factoring in health care delivery costs and feasibility.

A national healthcare system will mean that the physicians salaries will be determined by the government.

I'm sorry, but this is 100% incorrect. The physicians in a national health care system are not government employees. Please do not confuse a national health care coverage system with a socialized medicine system.

You think that the government will pay for people to see doctors and not limit the physicians salaries? Physician competition will decrease because they will have a salary cap, which will make them less competitive. The best doctors will get the most patients, but then the rest, who will be an overwhelming majority, will just get the leftovers, and what will those physicians get if they see a patient or two more?

You're not accounting for several things in this talking point. First is the obvious that doctors salaries are not set by the government as they are not government employees. There is no salary cap. Second, you have yet to account for how competition would decrease considering that you just said the best doctors will get the most patients. When physicians compete for patients, that's called...you guessed it...competition. Third, physicians time is a limiting resource. You can only oversee so many patients at a time before you stop accepting new patients (same with our current system). Fourth, never underestimate the ignorance of the population. The people do not know who is and who isn't a good doctor. The majority of the people need to see "a doctor," not a specific doctor. As we moved toward institutional medicine rather than individual private practice, medicine became depersonalized. I'd be willing to wager that if you took a survey of the population, a good majority of them wouldn't be able to name their PCP, but I'm sure a majority of them would be able to name where they receive treatment.

Random Reality Check		2009-05-13 11:20:26 AM

Gulper Eel: Random Reality Check: I know you're not saying that we shouldn't do the right thing because there are crooks in the world - but that's sure what it sounds like.

The obvious answer is to monitor the system...

Except when there's that much money in play the thieves become...well, the same usual suspects bollixing up the system now, only with a far bigger pot of money to play with and far less incentive to keep costs in line. New York only chases small-fry Medicaid thieves, and they had to be embarrassed and prodded like hell to do even that. Nursing homes, hospitals, unions, and pharmaceutical companies all paid good money for those state legislators and they'll be damned if they waste their investment with any silly monitoring of what they do.

Nursing homes, hospitals, unions and pharmaceutical companies...now, where did we see them all gathered together lately?

It's not a question of there being some crooks in the system. It'll be loads of crooks. The Times pegged Medicaid fraud in New York at a minimum of ten percent, and went on to say that another 10-30 percent was either stolen or wasted. Which sounds like a good starting point to me, seeing as New York's Medicaid program is bigger than the next two states' programs...combined.

I've seen no reason to think that consolidating health care in DC won't produce the same train-wreck it has in New York.

And instead of going after the gang of crooks we know is there we shouldn't enable a system that we all need?

I can't even begin to wrap my head around that logic.

Go after these crooks, take all of their assets, and put them back into the system. Do it in such a way that there is no chance a crook will get away with it and they will find something a little less dangerous to go screw people with.

Smidge204		2009-05-13 11:20:45 AM

crimsin23: FTFY

And ten trips to a clinic is less expensive and more effective for staying healthy than a single trip to the ER.

Even if there's a wait, you're still healthier. That leads to an overall reduction in the demand for emergency care. What's your problem again?

Besides, by your own supply and demand argument, why wouldn't a higher demand for doctors lead to more people becoming doctors?
=Smidge=

Snarfangel		2009-05-13 11:23:48 AM

Smidge204: Time to post this again... and I didn't think I'd get the chance!

Other countries get longer or equivalent lifespans for significantly less money than we do. Hell, CUBA has the same life expectancy that the USA does but spends less than half (by % of GDP) on healthcare.

For an interesting outlier on the left, plot Singapore. For a bit less (as a proportion of GDP) than current Medicare and Medicaid spending in the United States, they are able to provide health care to everyone. Apparently, we have the government funds necessary to provide universal health care, it's just being spent unwisely.

awaken101		2009-05-13 11:23:50 AM

Phil Herup: Socialized medicine proponents always go with the pragmatic approach... right?

I FINALLY sat down and watched Logan's Run for the first time last night so I'm really getting a kick out of this reply.

HighOnCraic		2009-05-13 11:30:46 AM

Soylent green is (old) people!

/Now if we could only convince the poor to sell their babies for food . . .

crimsin23		2009-05-13 11:45:10 AM

Smidge204: crimsin23: FTFY

And ten trips to a clinic is less expensive and more effective for staying healthy than a single trip to the ER.

Even if there's a wait, you're still healthier. That leads to an overall reduction in the demand for emergency care. What's your problem again?

Besides, by your own supply and demand argument, why wouldn't a higher demand for doctors lead to more people becoming doctors?
=Smidge=

There's a limit of how many people can become doctors in a year because there is a fixed class size and a fixed amount of schools.

Your ten trips to a clinic can take up to two years because of the wait time. Emergency care is not what's sucking up our healthcare system.

Doc Lee		2009-05-13 11:49:19 AM

crimsin23: There's a limit of how many people can become doctors in a year because there is a fixed class size and a fixed amount of schools.

Class size is determined by the amount of medicare/medicaid education initiative funding an institution receives. It's not as if the number of people who can graduate from med school is set in stone. It's largely controlled by lobbying efforts on the part of the AMA in order to keep physicians' salaries artificially inflated.

Your ten trips to a clinic can take up to two years because of the wait time. Emergency care is not what's sucking up our healthcare system.

Emergency care is sucking up health care system costs which in turns leaves less money for clinical development.

IamKaiserSoze!!!		2009-05-13 11:55:41 AM

RockofAges: IamKaiserSoze!!!: J. Frank Parnell: IamKaiserSoze!!!: Health care cost are lower in other countries because they provide less, not because they do it more efficiently. My mother (at 87) just got a pacemaker courtesy of Medicare within a week of showing symptoms. That would not happen as quickly, or most likely not at all, in England or Canada.

Utter nonsense.

Waiting room wait times are bad in Canada, because everyone who has the sniffles decides to bother doctors with it, but i can tell you from experience that if you have a serious problem that bypasses the outpatient area you're treated like royalty.

I can't believe they manage to convince you guys, after your health care system is routinely shown to be the worst, that it's the best.

Hmmmm.....I've worked in hospitals in Detroit and Rochester, NY and both made a lot of money off of Canadians who couldn't get the care they needed (or wanted) in Canada. It is from these folks that I have formed my opinions not from 'They'. Healthcare systems in both communities (as well as many other US border cities) do very well careing for the many folks who might differ with your opinion.

Yea, so what you're saying is that rich Canadians, so rich in fact that they can afford to fly to the U.S. for elective surgery (which would be the only reason to leave Canada, given that major surgeries are attended to immediately) don't like the fact that they have to wait in line like the rest of the plebes for their electives?

Well, colour me surprised. Let me tell you right off the bat that the only thing wrong with Canadian health care is that we don't allow private practice in many situations for those that want to expedite their service. (Win Win, Everyone gets great coverage, and if you want faster elective surgery, go pay for it out of pocket).

My brother was born with congenital heart disease, extreme scoliosis and kyphosis as well as a slew of other medical issues. My first memory in life is being walked into a bright, bright room and touching my brother through plastic gloves in an infant ICU of some type, with wires and hoses all over him. He is 21 now, but for the first 13 years of his life he underwent many open heart surgeries and other major surgeries such as a spinal fusion. I have intimate experience with how the Canadian medical system works and treats the truly sick and disabled.

To say that our system is lacking is laughable. I come from a blue collar family that works hard and tries to pay the ever increasing bills that come along with life. Without our health care system my brother would be relegated to "medicaid" or some other piece of crap "insurance" you have in the states - and would not receive the amazing care that he did.

Keep lying to yourselves though. Most Americans are smart enough to realize when they've been had by predatory medical institutions.

They aren't rich and they don't fly. They just drive across the border. Also, I know Canada treats extraordinary illnesses quite well. It comes down to defineing what is extraordinary, and as I said before, what's extraordinary to you may be viewed as routine by someone else.

BTW - I'm half Canadian and spent my youth in Windsor and Detroit. I'm not knocking Canadian health, just saying that there is a lot about healthcare in the states that goes away to give such expansive blanket coverage as Canadians offer.

Peace.

Gulper Eel		2009-05-13 11:56:20 AM

Random Reality Check: And instead of going after the gang of crooks we know is there we shouldn't enable a system that we all need?

Not if you're going to wave an even bigger bucket of money at the same crooks, no.

Go after these crooks, take all of their assets, and put them back into the system. Do it in such a way that there is no chance a crook will get away with it and they will find something a little less dangerous to go screw people with.

Not a chance. They won't play ball, and don't have to because the legislators will get their back. The beauty of their arrangement is that they acquire the sufficient legislators...either party, long as they stay bought...to ensure that what they do is legal. For an additional example of how this works, see that cute little deal Steve Rattner had with the state comptroller's office on the NY pension fund. In New York, the practice of paying for access to the pension fund was perfectly legal. It was also bribery. It's been disallowed since then by the new state comptroller, but the damage has been done.

IamKaiserSoze!!!		2009-05-13 12:02:09 PM

Cinaed: Phil Herup: The real point is to what extent they should take care of them.

They do enough with national defense, police/fire and infrastructure.

And to what degree the citizens have a responsibility to care for themselves as well. I'm a big fan of preventative medicine, and I don't have a problem with a broad national level of health care, but with some major provisos.

-Eat right (no more bag-at-a-time dorito fun)
-Exercise (regular exercise)
-Abstain from habits that are explicitly harmful (excessive drinking, smoking, illicit drug use, etc)
-Obey medical advice (can't manage your diabeetus? boo farking hoo)

I'm guessing that a whole lot of people would be instantly disqualified from benefiting from the free health care right farking quick. Blanket coverage for people being idiots is not a good answer to the country's health problems.

I think you are on to something.

I could get behind Federalized health care under certain circumstances. Maybe to remain eligible to Federally provided health you must keep your weight below morbidly obese, pass nicotine, alcohol and drug tests, have no moving violations, utilize prenatal services, and avoid high risk sex (I'm sure I could come up with more, but you get the idea).

If not, explain to me why I should subsidize the health care costs of individuals that choose to live a high risk lifestyle.

crimsin23		2009-05-13 12:10:43 PM

Doc Lee: Keeping people out of our system is not what keeps our wait times short. Our existing health care infrastructure keeps our wait times short. The vast majority of people who get sick in our system and utilize resources are simple to treat cases; flu, cold, cuts and scrapes, etc. These cases can be handled by physician assistants or registered nurses. There's no need for an PCP to see each of these cases but rather oversee a team of PAs or RNs that handle these cases. This is a paradigm shift that many people don't seem to understand. Not only does the financing of the system need to change, the structure of the system needs to change as well in order to reduce costs and unnecessary expenditures. Furthermore, the number of sick people at any given time in society is rather constant with the exception of flu season. You must not think people haven't already accounted for these statistics when factoring in health care delivery costs and feasibility.

I do think that any account that anyone made is underestimated. It is true that a majority of cases can be handled by RNs or PAs, this is a growing trend by the way in a lot of places, and why both of the professions have seen vast growth over the last 10 years. While it is true tha the number of sick people is constant, I believe that it is underestimated.

A national healthcare system will mean that the physicians salaries will be determined by the government.

I'm sorry, but this is 100% incorrect. The physicians in a national health care system are not government employees. Please do not confuse a national health care coverage system with a socialized medicine system.

Who will be paying the physicians who see the patients who are now under the universal healthcare system: The government. How much will the government pay? Well I know how much medicare pays out.....

You think that the government will pay for people to see doctors and not limit the physicians salaries? Physician competition will decrease because they will have a salary cap, which will make them less competitive. The best doctors will get the most patients, but then the rest, who will be an overwhelming majority, will just get the leftovers, and what will those physicians get if they see a patient or two more?

You're not accounting for several things in this talking point. First is the obvious that doctors salaries are not set by the government as they are not government employees. There is no salary cap. Second, you have yet to account for how competition would decrease considering that you just said the best doctors will get the most patients. When physicians compete for patients, that's called...you guessed it...competition. Third, physicians time is a limiting resource. You can only oversee so many patients at a time before you stop accepting new patients (same with our current system). Fourth, never underestimate the ignorance of the population. The people do not know who is and who isn't a good doctor. The majority of the people need to see "a doctor," not a specific doctor. As we moved toward institutional medicine rather than individual private practice, medicine became depersonalized. I'd be willing to wager that if you took a survey of the population, a good majority of them wouldn't be able to name their PCP, but I'm sure a majority of them would be able to name where they receive treatment.

There are websites nowadays that people can access with information on them about doctors. You can see hwat people say about them, where they went to school, if someone has sued them, etc...

I bet a majoriy can name their PCP. And since the good doctors have limited time, as you pointed out, then they can't see everyone, and only a few patients will be seen by the best doctors, the rest will trickle down. Doctors won't compete for patients, patients will compete for doctors. Care will also fall because Doctors will become overworked and overwhelmed.

syrynxx		2009-05-13 12:14:04 PM

I'm a big fan of expensive healthcare. Just one of my drugs, a 24-hour time-release painkiller, costs $6000/year. I don't pay $6000/year in premiums, so I'm a bad actuarial risk. But without it, I'm in constant pain, and without going maudlin, life is unpleasant.

I'm old before my time, so I'll stand on the side of the people being subsidized by others. You shouldn't be attacking the old people. You should be attacking the poor stupid people breeding like rabbits on public support, like Octomom. Euthanize the young and stupid, not the old and infirm. You'll be doing the species a favor.

crimsin23		2009-05-13 12:16:01 PM

Doc Lee: crimsin23: There's a limit of how many people can become doctors in a year because there is a fixed class size and a fixed amount of schools.

Class size is determined by the amount of medicare/medicaid education initiative funding an institution receives. It's not as if the number of people who can graduate from med school is set in stone. It's largely controlled by lobbying efforts on the part of the AMA in order to keep physicians' salaries artificially inflated.

If you have a relatively fixed class size and a relatively fixed number of schools then the number of doctors is also going to be relatively fixed.

Your ten trips to a clinic can take up to two years because of the wait time. Emergency care is not what's sucking up our healthcare system.

Emergency care is sucking up health care system costs which in turns leaves less money for clinical development.

[citation needed]

I'm not being an ass here, I just think that it's not that simple and clear.

Random Reality Check		2009-05-13 12:16:16 PM

Gulper Eel: Random Reality Check: And instead of going after the gang of crooks we know is there we shouldn't enable a system that we all need?

Not if you're going to wave an even bigger bucket of money at the same crooks, no.

Go after these crooks, take all of their assets, and put them back into the system. Do it in such a way that there is no chance a crook will get away with it and they will find something a little less dangerous to go screw people with.

Not a chance. They won't play ball, and don't have to because the legislators will get their back. The beauty of their arrangement is that they acquire the sufficient legislators...either party, long as they stay bought...to ensure that what they do is legal. For an additional example of how this works, see that cute little deal Steve Rattner had with the state comptroller's office on the NY pension fund. In New York, the practice of paying for access to the pension fund was perfectly legal. It was also bribery. It's been disallowed since then by the new state comptroller, but the damage has been done.

If I apply that logic to corrupt police, lawyers and judges (of which there are reputed to be a few) we should probably do away with law enforcement as well as the entire judicial system.

You're talking about killing the patient rather than treating the disease.

Random Reality Check		2009-05-13 12:18:50 PM

IamKaiserSoze!!!: I think you are on to something.

I could get behind Federalized health care under certain circumstances. Maybe to remain eligible to Federally provided health you must keep your weight below morbidly obese, pass nicotine, alcohol and drug tests, have no moving violations, utilize prenatal services, and avoid high risk sex (I'm sure I could come up with more, but you get the idea).

If not, explain to me why I should subsidize the health care costs of individuals that choose to live a high risk lifestyle.

Don't stop there, let's make sure you pass a genetics test that says you're free from any genetically based diseases as well as family history for diabetes, heart disease and cancer.
(I'm sure I could come up with more, but you get the idea).

If not, explain to me why I should subsidize the health care costs of individuals that are high risk.

Rann Xerox		2009-05-13 12:23:06 PM

syrynxx: Euthanize the young and stupid, not the old and infirm. You'll be doing the species a favor.

Can't we do them both?

IamKaiserSoze!!!		2009-05-13 12:25:55 PM

Random Reality Check: IamKaiserSoze!!!: I think you are on to something.

I could get behind Federalized health care under certain circumstances. Maybe to remain eligible to Federally provided health you must keep your weight below morbidly obese, pass nicotine, alcohol and drug tests, have no moving violations, utilize prenatal services, and avoid high risk sex (I'm sure I could come up with more, but you get the idea).

If not, explain to me why I should subsidize the health care costs of individuals that choose to live a high risk lifestyle.

Don't stop there, let's make sure you pass a genetics test that says you're free from any genetically based diseases as well as family history for diabetes, heart disease and cancer.
(I'm sure I could come up with more, but you get the idea).

If not, explain to me why I should subsidize the health care costs of individuals that are high risk.

Let's see, my suggestions are elective decisions on the part of an individual and yours are not. I think your examples should all be covered. Can you not see the difference? Most proponents of wealth distribution can not.

patrick767		2009-05-13 12:27:07 PM

Newsflash: Healthcare is restricted and rationed everywhere, even in the good ol' USA. One way we do it is by limiting access to it for tens of millions of underinsured people. Some countries have a waiting list for non essential procedures.

Random Reality Check
Obesity is now a health epidemic, one that needs to be addressed and I'm not sure that the problem doesn't extend well beyond lifestyle and into how we grow, process, cook, and serve food.

A few observations:
Most of us now work sedentary jobs at a desk all day. Our bodies were never meant for that. We get hungry when we really don't need the calories because we're burning so damn few of them now.

We don't walk enough. Most of us don't even walk as far as the bus stop or subway station to and from our job. We take our cars everywhere, park right next to our destination, and go sit around some more.

It's not just Texas. In the US in general we like everything big. Big portions of food. Huge soft drinks. Pass me that Super Big Gulp! Supersize me, baby! I've noticed in Europe that a restaurant will often charge 2-3 euros for a 25cl (about 8 1/2 ounces) bottle of coke. I found it way overpriced, but it certainly does cut consumption. I'd be happier with it there if they'd at least routinely bring tap water for free like US restaurants do.

Doc Lee		2009-05-13 12:28:00 PM

crimsin23: I do think that any account that anyone made is underestimated. It is true that a majority of cases can be handled by RNs or PAs, this is a growing trend by the way in a lot of places, and why both of the professions have seen vast growth over the last 10 years. While it is true tha the number of sick people is constant, I believe that it is underestimated.

Do you have any evidence whatsoever of any of your claims of cases being underestimated? I would say that an epidemiologist has a much better grasp of the numbers than you do.

Who will be paying the physicians who see the patients who are now under the universal healthcare system: The government. How much will the government pay? Well I know how much medicare pays out.....

Incorrect, again. Universal health care coverage does not mean socialized medicine. The facilities are owned by the private sector (or public in cases of already public institutions, i.e. state universities, county facilities, etc). The private sector determines what they will pay the physicians based on how much they deem the physician to be worth, just as they do in our current system. Do not confuse salary with insurance claims payouts.

There are websites nowadays that people can access with information on them about doctors. You can see hwat people say about them, where they went to school, if someone has sued them, etc...

And the majority of people do not use them.

I bet a majoriy can name their PCP. And since the good doctors have limited time, as you pointed out, then they can't see everyone, and only a few patients will be seen by the best doctors, the rest will trickle down. Doctors won't compete for patients, patients will compete for doctors. Care will also fall because Doctors will become overworked and overwhelmed.

Patients already compete for doctors, except they are limited in who exactly they can choose by their insurance. The best are going to be taken no matter what system you're in. What's needed is for the "trickle down" doctors you're talking about to compete for patients. You've already established the scenario. The demand is on the side of the patients (patients demand the best), the supply is on the side of the physician. Physicians compete for patients. Care will not fall because of overworked and overwhelmed physicians either. This isn't forced labor and nobody is limiting the number of physicians in the population (except the Republicans and the AMA).

Your arguments are rather old and trite. I would suggest really studying the system in depth before you form and opinion on it. Back that opinion with facts, rather than old talking points that have little to no basis in reality aside from keeping the uninformed scared and running.

Smidge204		2009-05-13 12:30:23 PM

crimsin23: There's a limit of how many people can become doctors in a year because there is a fixed class size and a fixed amount of schools.

B-b-b-free market!

While class size may be a per-institution limit, I am not aware of any reason why there couldn't be more schools. If you're convinced free market can take care of our health (check the graphs I posted - doesn't seem to be working that great) then it can take care of the doctor shortage, too.

crimsin23: Your ten trips to a clinic can take up to two years because of the wait time. Emergency care is not what's sucking up our healthcare system.

Cost-wise, it is. Getting medical problems identified and handled sooner means more effective and cheaper treatment in almost every case. Again, see the graphs I posted (and follow the source links to play with them - they're interactive). Countries with more liberal public heath programs are as healthy if not healthier than us, and end up spending less than we do.

Are you the kind of person who keeps driving their car when it starts making a funny noise, only to biatch and moan when it finally breaks down completely and it's so expensive to fix you might as well just buy a new one? Health care is something like that, only without the option for getting a new body. It's all about maintenance.
=Smidge=

patrick767		2009-05-13 12:31:40 PM

Talon
It's not like we have to go out and kill people, but death needs to be something our culture embraces, rather than fears.

We should all become so goth we shiat bats.

Phil Herup		2009-05-13 12:42:00 PM

patrick767: We should all become so goth we shiat bats.

[chuckles]

tbn0.google.com

awaken101		2009-05-13 12:59:30 PM

and speaking of Logan's Run...
blog.ugo.com

RAWR!

havesometea		2009-05-13 01:06:35 PM

I work with groups of Radiologists and almost every one of them has this same opinion. The ones that don't are really, really old.

FHLudlow		2009-05-13 01:19:38 PM

They spent half a million dollars on my grandfather in his last 6 weeks of life. It was the sickest most brutal torture I hope I ever see. It really opened my eyes just how messed up the whole "health care" culture is.

A good friend of mine is a nurse whose job is to try to facilitate humane and dignified death for patients and their families. The position of every doctor at her hospital, except one, is that you never admit that death is a possibility, there is always more that can be done (and billed for). She is in a constant political battle for her job. It is a constant battle to arm the patients and families with enough information and support to where they can refuse to have heinously painful, expensive, and wholly hopeless procedures done.

Cinaed		2009-05-13 01:31:58 PM

Random Reality Check: Don't stop there, let's make sure you pass a genetics test that says you're free from any genetically based diseases as well as family history for diabetes, heart disease and cancer.
(I'm sure I could come up with more, but you get the idea).

If not, explain to me why I should subsidize the health care costs of individuals that are high risk.

Genetic conditions are something else for me, they constitute something beyond individual choice. Behavior is a willful choice, something that each citizen is ultimately responsible for. If I eat a dozen honey buns every day of my adult life and have a nasty case of diabetes before I'm 40, would I qualify? No. If I followed a lived a reasonably healthy lifestyle (insofar as could be measured) and developed diabetes at age 58, would I qualify? Yes.

If people do the right thing, they should get their due. If they screw up and/or lead themselves down a path of self destructive ruin, they can cover the bill themselves.

DaSwankOne		2009-05-13 01:32:53 PM

Although I will not click on a Hot Air link, if the headline is accurate this might be the first thing they have ever printed that I agree with. Now I am sure their solution would make me shake my head until I had to go see a chiropractor.

Phil Herup		2009-05-13 01:34:30 PM

awaken101: RAWR!

Jenny Agutter is teh sexie....

she is also hawt in An American Werewolf in London.

myspamhere		2009-05-13 01:40:28 PM

Does this argument also apply to the youngest of our society? My wife had helpp syndrome and our baby had to be delivered 2 1/2 months early. Our baby was kept alive and grew in an advanced Neonatial intensive care unit for 2 months. Our insurance company has been billed well over $250,000 for this.
We just brought her home last friday.

Now, who is going to tell me that she did not deserve the best care she could get because she 'was not worth the cost?'

Gridlock		2009-05-13 01:43:41 PM

awaken101: and speaking of Logan's Run...

RAWR!

img54.imageshack.us

// Still pretty hot since she didn't go the whole "Frankenstein School of Beauty" route.

Phil Herup		2009-05-13 02:04:43 PM

as Nurse Price

tbn1.google.com

.......... still the best monster movie

Gulper Eel		2009-05-13 02:13:46 PM

Random Reality Check: If I apply that logic to corrupt police, lawyers and judges (of which there are reputed to be a few) we should probably do away with law enforcement as well as the entire judicial system.

You're talking about killing the patient rather than treating the disease.

IANAL (or a P or a J), but I'd be deeply surprised if we're wasting the same percentage of money on law enforcement that we waste on Medicaid. And even if it was the case, we do happen to be trending toward an anti-prohibitionist mindset amid the voting public, which I think would pull the rug out from under a great deal of law-enforcement corruption regardless of what percentage of them are actually dirty. Once big-government Democrats and Republicans get it into their heads the kind of money that's to be made off the drug trade, once legalization becomes a winning issue, you'll see many of them change their tune faster than you can read a poll.

I should note at this point that my state's Medicaid program doesn't even come close to covering everybody who'd be eligible, for all sorts of reasons.

Clam Sandwich		2009-05-13 02:15:33 PM

Dont worry everyone. Provided that tax laws don't change, a lot of old people will die in 2010.

Problem solved.

Clam Sandwich		2009-05-13 02:18:02 PM

old = rich

but most of them are old anyway

SaltyDonnie		2009-05-13 02:19:25 PM

I wonder if Professor Altman's personal healthcare will be effected by this when he hits the point of "no return"?

In case I'm missing something, the intent of health care, is to, like, prolong and improve life. If that is the case, Prof., don't you think that would expending more resources as the population ages? Of course, if you are concerned with paying for everyone, then the needs of the few get shafted, hence, spreading misery equally.

And if my plug is to be pulled, it will be because I decide it at the time or by my designated agent according to the terms of a pre-executed living will in concert with my doctor, not by a shady ex-wife or a prior room mate based on 20 year old out of context hearsay, or by the dispassionate, disinterested decision of a govt. bureaucrat looking to save money to spend on illegals or bank bailouts.

My right to die does not automatically translate into the govt.'s "right" to exercise my right for me.

IF universal health care/socialist medicine/govt. health care is approved, then I want a rock solid guarantee that ALL politicians will enjoy the same system we have, and stand behind my hemorrhoid-laden ass in the same line, and that I will get the quality health care I need when I need it. Period, no questions, etc. And if not, i have the right to find my own care, at govt. expense, to do what is required. IF not, take your plan and shove it.

Of course, we all know it will be a cold day when I/we ever get a guarantee like that.

Thune		2009-05-13 02:36:32 PM

Smidge204: Time to post this again... and I didn't think I'd get the chance!

Source^

Other countries get longer or equivalent lifespans for significantly less money than we do. Hell, CUBA has the same life expectancy that the USA does but spends less than half (by % of GDP) on healthcare.

Unfortunately I didn't see any data pertaining to lifestyle or I'd include that too.

But I did find some other interesting data. Here's a graph showing life expectancy at birth compared to PRIVATE healthcare expenditure:

Source^

...and here's a graph showing life expectancy at birth compared to PUBLIC healthcare expenditure:

Source^

Interesting how the countries with lower total healthcare cost spend more on public rather than private care, and yet seem to suffer very little in the way of overall health.

Based on this data, is it fair to say that public healthcare is, in the long run, cheaper and at least as effective if not moreso?
=Smidge=

Here is another equally useful graph.

www.seanbonner.com

Jsc810		2009-05-13 02:37:41 PM

crimsin23		2009-05-13 02:42:27 PM

Doc Lee: Do you have any evidence whatsoever of any of your claims of cases being underestimated? I would say that an epidemiologist has a much better grasp of the numbers than you do.

Link (new window)
Link (new window)
Link (new window)

3 links that say there are 50 million uninsured Americans. Do you realize how much 50 million is?

Incorrect, again. Universal health care coverage does not mean socialized medicine. The facilities are owned by the private sector (or public in cases of already public institutions, i.e. state universities, county facilities, etc). The private sector determines what they will pay the physicians based on how much they deem the physician to be worth, just as they do in our current system. Do not confuse salary with insurance claims payouts.

The 'worth' of a physician will go down everywhere. All physicians will be paid less, and due to the limit in patients, and now funding because of an influx in patients and a decrease in payouts from the insurance companies/government, everyone will make less.

There are websites nowadays that people can access with information on them about doctors. You can see hwat people say about them, where they went to school, if someone has sued them, etc..

And the majority of people do not use them.

Well I can't say anything if people don't look at the information in front of them

I bet a majoriy can name their PCP. And since the good doctors have limited time, as you pointed out, then they can't see everyone, and only a few patients will be seen by the best doctors, the rest will trickle down. Doctors won't compete for patients, patients will compete for doctors. Care will also fall because Doctors will become overworked and overwhelmed.

Patients already compete for doctors, except they are limited in who exactly they can choose by their insurance. The best are going to be taken no matter what system you're in. What's needed is for the "trickle down" doctors you're talking about to compete for patients. You've already established the scenario. The demand is on the side of the patients (patients demand the best), the supply is on the side of the physician. Physicians compete for patients. Care will not fall because of overworked and overwhelmed physicians either. This isn't forced labor and nobody is limiting the number of physicians in the population (except the Republicans and the AMA).

Your arguments are rather old and trite. I would suggest really studying the system in depth before you form and opinion on it. Back that opinion with facts, rather than old talking points that have little to no basis in reality aside from keeping the uninformed scared and running.

Ofcourse the care will fall because of overworked physicians. If you think that a doctor seeing 10 patients an hour will have the same diligence when seeing 20 an hour then you are just wrong. It's human nature.

The doctors will compete for patients until their load is full. Then the leftover patients, the ones with the universal health coverage, will be left to go to some clinic and stand in a line that is now twice as long. So, who wins?

jafiwam		2009-05-13 03:02:23 PM

Grandpa's new home!

knowgramming.com

/hot, unlike the image

crimsin23		2009-05-13 03:05:45 PM

Smidge204: crimsin23: There's a limit of how many people can become doctors in a year because there is a fixed class size and a fixed amount of schools.

B-b-b-free market!

While class size may be a per-institution limit, I am not aware of any reason why there couldn't be more schools. If you're convinced free market can take care of our health (check the graphs I posted - doesn't seem to be working that great) then it can take care of the doctor shortage, too.

Do you know what it taks to open a mediacal school? How long it takes? How much work it takes? What kind of accredation you need?
And after all that, you still have a class of 150 students every year.

I am not convinced that free market health care, as you call it, can take care of everyone, I am convinced however that a universal system will not do any better.

crimsin23: Your ten trips to a clinic can take up to two years because of the wait time. Emergency care is not what's sucking up our healthcare system.

Cost-wise, it is. Getting medical problems identified and handled sooner means more effective and cheaper treatment in almost every case. Again, see the graphs I posted (and follow the source links to play with them - they're interactive). Countries with more liberal public heath programs are as healthy if not healthier than us, and end up spending less than we do.

Are you the kind of person who keeps driving their car when it starts making a funny noise, only to biatch and moan when it finally breaks down completely and it's so expensive to fix you might as well just buy a new one? Health care is something like that, only without the option for getting a new body. It's all about maintenance.
=Smidge=

False analogy is false. Most people go about their day feeling some kind of pain. In majority of cases it's nothing. But if that person did not have to pay for healthcare, then they would go see the doctor about it, wasting everyones time. This will make the doctor see far more patients, and again, if the government is flipping the bill, well then the docs are going to get very little money.

Smidge204		2009-05-13 03:18:21 PM

Thune: Here is another equally useful graph.

In what way are the graphs I not useful?

Do you believe that age expectancy at birth is not a good indication of overall health in a population?

If you have doubt about the data source or the presentation of the data, I did provide links where you can explore them yourself. The graphs on that is interactive and dynamic, allowing you to compare dozens of variables for hundreds of countries going back as far as there are records. If you would like to offer your own data, please feel free to do so.

If you disagree with my conclusion that the US spends much more money on private health care with no improvement in overall health compared to other countries, then by all means please share your interpretation of the data.

crimsin23: The doctors will compete for patients until their load is full. Then the leftover patients, the ones with the universal health coverage, will be left to go to some clinic and stand in a line that is now twice as long. So, who wins?

Everyone, because:

1) The doctors have plenty of clients

2) People can afford to see a doctor (waiting in line for hours, or even months for an appointment, is better than not going at all) and thus become healthier overall.

3) Health care costs are reduced because people become, overall, healthier for seeing a doctor more frequently.

4) People in need of emergency or high-end care can get it faster because those facilities are not clogged with people with skinned knees and runny noses. (Emergency rooms treat first and ask questions later rather than turn away people who can't pay, so that's where they go.)

Do you have specific objections to any of these points?
=Smidge=

Smidge204		2009-05-13 03:22:39 PM

crimsin23: False analogy is false. Most people go about their day feeling some kind of pain. In majority of cases it's nothing. But if that person did not have to pay for healthcare, then they would go see the doctor about it, wasting everyones time. This will make the doctor see far more patients, and again, if the government is flipping the bill, well then the docs are going to get very little money.

That noise your car makes might also be nothing!

If you're worried about the government flipping the bill, I refer you again to the graphs I posted way above. The US spends more per capita on health care, all of it the result of private health care costs. Countries with fully government funded health care end up paying less and living longer, healthier lives.

Again if you disagree with my interpretation of the data, provide your own. Don't just ignore the data because it upsets you.
=Smidge=

Phil Herup		2009-05-13 03:25:54 PM

jafiwam: Grandpa's new home!

/hot, unlike the image

Wait the icebeg is hot? and the image is cold?

Doc Lee		2009-05-13 05:20:48 PM

crimsin23:
Link (new window)
Link (new window)
Link (new window)

3 links that say there are 50 million uninsured Americans. Do you realize how much 50 million is?

You're equating uninsured to sick. That's not an adequate assessment. For those 50 million people to have an impact on our system, the majority would have to fall ill at the same time. That's not a reality. Furthermore, the assessment that 50 million are uninsured means that at any given point in time, 50 million people are uninsured. It does not necessarily mean chronically uninsured. Those with and without insurance fluctuate as people change jobs. The rate of illness and infection in the population remains the same. It doesn't matter how many people are uninsured at a given point in time. Infection doesn't check to see whether a person has insurance or not. Epidemiological statistics measure illness and infection for the entire population, not just those who are insured or visit a clinic. In other words, you really don't seem to be grasping the simple concept that rate of infection really has nothing to do with insurance.

The 'worth' of a physician will go down everywhere. All physicians will be paid less, and due to the limit in patients, and now funding because of an influx in patients and a decrease in payouts from the insurance companies/government, everyone will make less.

Physicians' "worths" are artificial as it stands. Anybody with a rudimentary knowledge of our health care system could tell you that. All it takes is quickly looking back at the history of medicine in the United States from the Flexner Report to the effects of the Balanced Budget Act of 1997. However, even with that fact apparent, I'd wager to say that physicians' salaries would be only slightly reduced. Why? Costs associated with unpaid medical bills. If those medical bills were paid through a medicare system, even at reduced rates, physicians' salaries could remain the same. As of now, a Commonwealth Study estimates that 72 million Americans have problems paying their medical expenditures. Do you have any idea how much that is in lost revenue for a hospital or clinic?

Ofcourse the care will fall because of overworked physicians. If you think that a doctor seeing 10 patients an hour will have the same diligence when seeing 20 an hour then you are just wrong. It's human nature.

I'm sorry, but the reality is that universal systems have better care than private health care systems. I've already addressed the issue of overworked physicians earlier in this thread by the use of PAs and RNs to handle minor treatments at a more cost effective rate as is the trend in medicine these days. It's naive to think that a patient is automatically a paycheck in the private insurance system. That's hardly the case.

The doctors will compete for patients until their load is full. Then the leftover patients, the ones with the universal health coverage, will be left to go to some clinic and stand in a line that is now twice as long. So, who wins?

Why would they be forced to stand in line at some clinic? We're talking about a universal system, not the current private system that limits people to specific hospitals, clinics, and physicians. Are you having problems grasping that concept? The people are free to choose who they want to see as a physician with the caveat that the physician's patient load is not full. The difference between the universal system and the private health care system is that in a private system YOU DO NOT have a choice of your physician, whether their load is full or not. That decision has been made for you before you even cracked open the phonebook. Who wins? Not you, that's for sure. Unless somehow, someway, having a corporate entity determining what's best for you is better than you yourself determining what's best for you.

I never did understand the free-marketist mindset. It's bogglingly misinformed.

Ringshadow		2009-05-13 05:26:01 PM

I worked at an Assisted Living Facility as housekeeping, and I possibly agree. I'm not sure there's a point in keeping people who alive who are damn near vegetables.

Simplest Quantum System Conceivable		2009-05-13 05:26:40 PM

"which no politician would ever mention"

If subby were less smug, he might have noticed the president talked about this topic at length in the NYT. Url - http://www.nytimes.com/2009/05/03/magazine/03Obama-t.html?pagewanted=5

"Now, I actually think that the tougher issue around medical care - it's a related one - is what you do around things like end-of-life care -

Yes, where it's $20,000 for an extra week of life.

THE PRESIDENT: Exactly. And I just recently went through this. I mean, I've told this story, maybe not publicly, but when my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.

So now she's in the hospital, and the doctor says, Look, you've got about - maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that - you know, your heart can't take it. On the other hand, if you just sit there with your hip like this, you're just going to waste away and your quality of life will be terrible.

And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just - you know, things fell apart.

I don't know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she's my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else's aging grandparents or parents, a hip replacement when they're terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn't have a hip replacement and she had to lie there in misery in the waning days of her life - that would be pretty upsetting.

And it's going to be hard for people who don't have the option of paying for it.

THE PRESIDENT: So that's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

So how do you - how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now."

cburkard		2009-05-13 05:42:34 PM

Smidge204: Time to post this again... and I didn't think I'd get the chance!

And once again, life expectancy doesn't correlate to the quality of healthcare.

InteriorDesignNinja		2009-05-13 05:53:20 PM

Razorwolf: Push them out on an iceberg when they can no longer contribute to society.

Who me? I plan to work until ~~I'm too old to realize that the~~ icebergs no longer exist ~~is not a free fishing trip~~.

FTFY

crimsin23: 3 links that say there are 50 million uninsured Americans. Do you realize how much 50 million is?

Um, 50 million is... oh shiat, i know this one... come on...

dammit, i give up.

crimsin23		2009-05-13 06:22:45 PM

Doc Lee: You're equating uninsured to sick. That's not an adequate assessment. For those 50 million people to have an impact on our system, the majority would have to fall ill at the same time. That's not a reality. Furthermore, the assessment that 50 million are uninsured means that at any given point in time, 50 million people are uninsured. It does not necessarily mean chronically uninsured. Those with and without insurance fluctuate as people change jobs. The rate of illness and infection in the population remains the same. It doesn't matter how many people are uninsured at a given point in time. Infection doesn't check to see whether a person has insurance or not. Epidemiological statistics measure illness and infection for the entire population, not just those who are insured or visit a clinic. In other words, you really don't seem to be grasping the simple concept that rate of infection really has nothing to do with insurance.

So you are saying that none of the uninsured are sick? And you can bet that most of them are the chronically uninsured because people who are unemployed have COBRA, otherwise you really need to cite something. Epidimoliogists can't measure illness unless the person presents at a health care facility with signs and symptoms of the disease, and is diagnosed as having that disease. Do you grasp that concept, because if you don't all you have to do is cite something, again.

The 'worth' of a physician will go down everywhere. All physicians will be paid less, and due to the limit in patients, and now funding because of an influx in patients and a decrease in payouts from the insurance companies/government, everyone will make less.

Physicians' "worths" are artificial as it stands. Anybody with a rudimentary knowledge of our health care system could tell you that. All it takes is quickly looking back at the history of medicine in the United States from the Flexner Report to the effects of the Balanced Budget Act of 1997. However, even with that fact apparent, I'd wager to say that physicians' salaries would be only slightly reduced. Why? Costs associated with unpaid medical bills. If those medical bills were paid through a medicare system, even at reduced rates, physicians' salaries could remain the same. As of now, a Commonwealth Study estimates that 72 million Americans have problems paying their medical expenditures. Do you have any idea how much that is in lost revenue for a hospital or clinic?

Who is going to pay these bills again? The government? Is that a joke? Is that how you are going to keep physician salaries competitive? How are you going to make the people pay when the government won't?

Ofcourse the care will fall because of overworked physicians. If you think that a doctor seeing 10 patients an hour will have the same diligence when seeing 20 an hour then you are just wrong. It's human nature.

I'm sorry, but the reality is that universal systems have better care than private health care systems. I've already addressed the issue of overworked physicians earlier in this thread by the use of PAs and RNs to handle minor treatments at a more cost effective rate as is the trend in medicine these days. It's naive to think that a patient is automatically a paycheck in the private insurance system. That's hardly the case.

The doctors will compete for patients until their load is full. Then the leftover patients, the ones with the universal health coverage, will be left to go to some clinic and stand in a line that is now twice as long. So, who wins?

Why would they be forced to stand in line at some clinic? We're talking about a universal system, not the current private system that limits people to specific hospitals, clinics, and physicians. Are you having problems grasping that concept? The people are free to choose who they want to see as a physician with the caveat that the physician's patient load is not full. The difference between the universal system and the private health care system is that in a private system YOU DO NOT have a choice of your physician, whether their load is full or not. That decision has been made for you before you even cracked open the phonebook. Who wins? Not you, that's for sure. Unless somehow, someway, having a corporate entity determining what's best for you is better than you yourself determining what's best for you.

I never did understand the free-marketist mindset. It's bogglingly misinformed.

Do you understand that demand will go up everywhere? Why can't you grasp that concept? If you will go to one place with a two hour line you won't leave, why? Because anywhere else that you will go will have just as long of a line. Like you said before, infection doesn't discriminate.

Smidge204		2009-05-13 07:32:24 PM

cburkard: And once again, life expectancy doesn't correlate to the quality of healthcare.

So what would you consider a valid indication of health care quality? Would you like the same cost data plotted against infant mortality rates?

I mean, if "life expectancy at birth" isn't a good indicator of health care quality, what is? Seems logical to me that good health care means people live longer. Maybe that's why it's used as the metric of judging a nation's health care system by... well pretty much everybody that wants to compare those things.

But whatever (Warning: Vertical axis is logarithmic);

img11.imageshack.us

Source^

Nope... still paying through the nose to keep our kids from dying before age 5, compared to other industrialized nations.
=Smidge=

Doc Lee		2009-05-13 08:13:02 PM

crimsin23: So you are saying that none of the uninsured are sick? And you can bet that most of them are the chronically uninsured because people who are unemployed have COBRA, otherwise you really need to cite something. Epidimoliogists can't measure illness unless the person presents at a health care facility with signs and symptoms of the disease, and is diagnosed as having that disease. Do you grasp that concept, because if you don't all you have to do is cite something, again.

From a free-markist think tank:

Heritage Foundation Responds to Uninsured Numbers in New U.S. Census Bureau Report (new window)

"Most of the uninsured are in and out of health coverage. The professional literature also shows that, overwhelmingly, the vast majority of the uninsured are persons who are in and out of coverage, largely as a result of job changes. Only a small number of the uninsured are chronically uninsured. For most of the uninsured, the problem is fixable if policymakers simply take steps to make health insurance portable, so the insurance policy sticks to the person, not the job."

If you want me to pull up the primary research, you'll have to wait until tomorrow when I head back to the clinic.

Epidemiological studies do not require a patient to present and diagnose. There are no requirements to report many diseases and afflictions out there. Population health surveys are often used to fill in the gaps. How do you think we have estimated numbers for diseases and afflictions such as HSV, arthritis, IBS, fibromyalgia, cfs, etc? The list goes on. Self-reporting in population survey studies. Please...take a basic statistics course.

Who is going to pay these bills again? The government? Is that a joke? Is that how you are going to keep physician salaries competitive? How are you going to make the people pay when the government won't?

You seem to have a very crude understanding of the health care system and as a doctor, I feel it is my civic duty to inform you how it actually works. Health care is not merely a physician and a patient. Health care is a physician, administration (lawyers included), billing, hospital's insurance coverage, staff (nursing staff included), receptionists, maintenance, equipment, sadly (for the patients at least) private insurance, etc. It's a SYSTEM. What accounts for 31% of our system (new window)? Administration and billing...i.e. filing claims with private insurance companies and managing the system. How much does Canada spend on the same task? 16.7%. That's wasted money, money that could go toward other aspects of health care such as physician salaries. Another aspect of the system, one that UHC seeks to remove, is private insurance. When you purchase insurance, you're essentially providing money to a company to invest. When investments fail, your premiums increase. UHC has no such investments to account for. There are no shareholders. Nobody is saying that the payouts to physicians has to be the current medicare schedule (by the way, you do realize that Parts B, C, and D are managed by private insurance companies, right?). Decreasing premiums with no necessary adjustment for elimination of profit margins does not mean lower physician payouts. It means just that...no necessary adjustments for profit margins are needed. It's a system; a complex system; one that you don't seem to be very well informed on.

Do you understand that demand will go up everywhere? Why can't you grasp that concept? If you will go to one place with a two hour line you won't leave, why? Because anywhere else that you will go will have just as long of a line. Like you said before, infection doesn't discriminate.

Do you understand population dynamics and infectious disease at all? Why do you just ignore the fact that disease rates in populations either decline with time or remain steady? Is it your utter and complete lack of medical knowledge? Or is it that blissful free-marketist ignorance? Access to health care does not necessarily mean increases in health care utilization. It's...been...studied. We already have a scenario for lacking coverage and suddenly gaining health care coverage in the US. It's called age 65...the age medicare kicks in providing 98% coverage of the population. A paper from 2004 from the National Bureau of Economic Research (the so-called economic gurus) showed that:

"The rise in overall coverage at age 65 is accompanied by a narrowing of disparities across race and education groups. Groups with bigger increases in coverage at 65 experience bigger reductions in the probability of delaying or not receiving medical care, and bigger increases in the probability of routine doctor visits. Hospital discharge records also show large increases in admission rates at age 65, especially for elective procedures like bypass surgery and joint replacement. The rises in hospitalization are bigger for whites than blacks, and for residents of areas with higher rates of insurance coverage prior to age 65, suggesting that the gains arise because of the relative generosity of Medicare, rather than the availability of insurance coverage."

Link (new window)

Having insurance coverage does not necessarily lead to increased utilization. The shift is a whopping, health care system shattering...3.6%. We see a greater shift during the flu season.

Do you have any sort of real evidence whatsoever? Or are you just content to go on your misinformed gut feeling?

crimsin23		2009-05-15 11:23:04 AM

Doc Lee:

Look at what has happened in Boston as a result of a law that has required hundreds of thousands of residents there to obtain coverage. (Hint: demand increased)

Link (new window)

But hey, if you want to keep thinking the nonsense that the liberal media put into your head, then by all means go ahead.

Smidge204		2009-05-15 12:06:05 PM

BWAHAHA

You waited until someone (maybe even you?) posted another story^ that tangentially (if at all) actually supports your claim and posted that as your rebuttal to Doc Lee?

That is hilarious. Try actually reading the article before using it as proof for your position.
=Smidge=

crimsin23		2009-05-15 05:05:06 PM

Smidge204: BWAHAHA

You waited until someone (maybe even you?) posted another story^ that tangentially (if at all) actually supports your claim and posted that as your rebuttal to Doc Lee?

That is hilarious. Try actually reading the article before using it as proof for your position.
=Smidge=

So let me get this straight: I post a rebuttal to Doc Lee with a legit source and you laugh at it? Why? Is it because you don't agree with my view point? Or is it because that you are an ignorant fool? Demand increases when something is free, this is basic economics. That is exactly what happend here.

We need a system with a healthy balance. This system sucks, but socializing it won't work either, case and point. Now maybe you have some ideas that are worth hearing. Go ahead, I'll wait.

Smidge204		2009-05-15 05:37:20 PM

I laugh at it for two reasons:

First, it's just barely a 'legit source' because a) It's not original research it's a generic report that references an unrelated study in wait times, and b) It only tangentially supports your position. It explicitly states that Boston is an anomaly among other cities. What little mention there is of your cited law attributing to longer wait times is a conjecture by a single doctor interviewed - not an actual study on the effect of the laws. Further, the article states that wait times had been increasing for two years before the law was enacted with no mention of any change in the rate of increase (probably because there weren't any studies done!)

Second, you obviously had to wait for this serendipitous article to appear before replying because you had absolutely nothing to base your assertions on prior to it. If you did, you have brought them up much earlier in the discussion if you had any sense. As icing on that little cake, you obviously didn't read and/or understand the article for the reasons posted above. Of course, you could still provide the data behind your assertion and shut us all up, but my money says it never existed in the first place.

The article even mentions, specifically, that only specialist, nonurgent practices are effected by longer waits. The article mentions no study on generic or emergency medical treatment. The article further states:

FTA: Brian Rossman, research director for Health Care for All, a Boston-based patient advocacy group, said that the law has increased concern about physician shortages in Massachusetts, but that the reasons for the area's long waits - and the increase - are complex. Many specialists in the city work for large academic medical centers and don't see patients full-time, fitting them in around teaching and other responsibilities. (Emphasis mine)

So what we can infer from this is a distinct lack of capacity for specialist treatment, since the local system is geared for research rather than actual treatment, and academic time is quite rigid compared to patient time.

It even supports some of the things I've been saying:

FTA: A major goal of the Massachusetts law is to provide care for more people in physicians' offices rather than in emergency rooms.

FTA: At Harvard Vanguard, Lindsey said that waits for new patients generally are somewhat shorter in his organization than in the Merritt Hawkins survey. But that's because Harvard Vanguard has focused heavily on hiring more doctors (Emphasis mine)

Quit blowing so much smoke, it's raising health care costs.
=Smidge=

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