 kapilThe Kapil
join:2000-04-26
Chicago, IL | reply to Romney2012
Re: Healthcare Reform--- the REAL agenda "we've seen the long lines in Britan and Canada".
Umm, really congressman douchebag? 'Cause you sound like the typical American who claims this is the best fucking country on Earth, blessed by God and all, but doesn't own a passport that would allow travel beyond our borders.
Also, he said "private sector has to pay taxes" twice. Because, you know, taxes are twice as scary! Boo!
What is this bullshit about "public option doesn't have to pay taxes or pay employees". Really? Don't government workers pay taxes on their salaries? ...and of course the workers pay taxes because they get paid a salary to begin with.
The real difference? the private insurers have to make a PROFIT...where as a public plan would be, in essence, non profit.
I will debate the merits of an argument all day and all night. But when you resort to spreading FUD, that's when you're not worthy of my time.
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1 edit | said by kapil:"we've seen the long lines in Britan and Canada". Umm, really ...? I'm somewhere between you and G&S (whom you quoted). I think it's undeniable that spreading around a monopolistic (artificially limited supply) will result in one of the following (or a mixture of all):
1. Reduction/delay of services compared to what those who can afford today's socialized "highest bidder" environment receive.
2. Higher overall costs (as society pays the monopoly to treat more people).
3. Reduction of quality (as the monopoly is diluted to meet demand but keep societal costs down).
That's just basic economics. It's why Canadians (and others) come here for healthcare. It's why the Frontline piece I posted last Friday discussed delays in care in Britain.
I think it's worth acknowledging this reality to get past the partisan rhetoric (using "long lines" to sway public opinion). And, which similarly denies the problem we have today: Millions of Americans who don't even have a line to get into. Paying more for goods and services than they can afford (and would be willing to buy in other countries with more reasonable standards).
Mark |
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Romney2012Defeat Obama 2012-Chg we can believe inPremium
join:2002-03-03
USA
kudos:4 | said by amigo_boy:said by kapil:"we've seen the long lines in Britan and Canada". Umm, really ...? I'm somewhere between you and G&S (whom you quoted). That wasn't me he quoted, but Congressman Ryan from the video.
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 KrKHeavy Artillery For The Little GuyPremium
join:2000-01-17
Tulsa, OK | reply to kapil
That's really what Fiore's piece is all about. It's poking fun at all the FUD going on to stop Healthcare reform. |
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4 edits | reply to amigo_boy
Actually, amigo, I have to disagree with you here.
said by amigo_boy :
1. Reduction/delay of services compared to what those who can afford today's socialized "highest bidder" environment receive.
You're right, but since a doctor makes the decisions as to who gets what treatment and when, people who really need it can immediately be moved to the front of the line.
said by amigo_boy :
2. Higher overall costs (as society pays the monopoly to treat more people).
Our society *already* pays for everyone, in the form of expensive ER treatments for those who were unable to or neglected early and inexpensive treatment for their problems.
This isn't an issue solely of the uninsured. In fact, the people who are most affected by our screwed up healthcare system are the upper lower-class and lower middle-class. Those are people who can't afford decent health-care insurance and thus are disincentivized from getting routine checkups and other low cost prevention treatment.
said by amigo_boy :
3. Reduction of quality (as the monopoly is diluted to meet demand but keep societal costs down).
For this I will simply quote someone from Britain who posted this in another forum:
The US is ahead of the rest of the world in many sectors, but medicine and healthcare is not one of them. Prevention of stem cell research in the US by the Bush administration has set the US 5 to 10 years behind other nations, but specifically South Korea and Britain are well ahead of the US in this area.
If you want state of the art treatments in Britain through the NHS you're out of luck though as cost/benefit analysis has to be done. What a lot of people on the Republican side of the healthcare debate conveniently ignore though is that Britain also has private healthcare as well, and, if you choose to you can pay a little more to be treated privately with part of the costs subsidised by the NHS. Even with taxes taken into account, you still end up paying less than in the US, not only for a level of care equivalent/better than in the US, but in a nation that is ahead of the US in medical research (again, other than Finance, Medical is one of the UKs top industry sectors - that's why the UK is one of the worlds top 5/6 economies in the world whilst also being one of the only ones that high up with no worthwhile manufacturing sector still). The story is similar in France, South Korea and a handful of other nations.
It is a myth that the US is able to offer superior healthcare simply because it's privately paid for because that argument is based on the flawed premise that other nations do not offer equally good private options, often at much lower costs. |
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1 edit | said by sonicmerlin:the people who are most affected by our screwed up healthcare system are the upper lower-class and lower middle-class. Those are people who can't afford decent health-care insurance and thus are disincentivized from getting routine checkups and other low cost prevention treatment. There was a good documentary on Bill Moyer's Journal tonight about three uninsured families who fall into the lower- to lower-middle-class. A good example of how the choice was between working with no healthcare, or becoming indigent and an even greater burden on society.
That page has a link to watch the show (1 hour long).
I don't usually watch Bill Moyer's because he strikes me as so overtly liberal that I'm not attracted to his analysis (like I'm not attracted to Rush Limbaugh). But, in this case he's just airing someone else's documentary. It gives the problem a human face.
Mark |
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| reply to sonicmerlin
said by sonicmerlin:For this I will simply quote someone from Britain who posted this in another forum: The US is ahead of the rest of the world in many sectors, but medicine and healthcare is not one of them. I disagree with that comment. Since our (socially-enhanced) healthcare system is sold to the highest bidder, it all depends on where you fall in the pecking order.
If you're low- to lower-middle-class, lessor-developed countries may appear to be better. Who cares if the US has the latest high-tech equipment when you don't need it, and can't afford just the basics within the system that provided it?
But, if you have good insurance, then those things are desirable (compared to $5 office visits in Mumbai).
When people make a flat statement that it's better (or worse) than another country, I think they're talking past each other. It's both (depending on who you are). That's the problem. The vastly different healthcare outcomes in this country.
Mark |
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1 edit | reply to sonicmerlin
said by sonicmerlin: said by amigo_boy :
2. Higher overall costs (as society pays the monopoly to treat more people).
Our society *already* pays for everyone, in the form of expensive ER treatments for those who were unable to or neglected early and inexpensive treatment for their problems. I was thinking of a finite resource: the monopolistic, socially-enhanced healthcare "market." In pure economic terms you can only slice a pie so many ways. One (or a mixture of all) the three things I enumerated are the only choices.
But, you make a good point that there are unintended consequences within that economy. For example, by distributing the finite resource more equitably we can save money by virtue of more people receiving diagnostic and preventative treatment instead of waiting until they need remedial treatment.
But, this leads to a very interesting topic.
Your logic cuts both ways. By detecting ailments earlier we save money on treating the ailment. But, we prolong the individual's life to consume more of the finite resource (incurring more ailments over a longer lifespan, requiring more treatments, etc.).
This is why I don't understand Republicans getting all wee-wee'd up about end-of-life counseling, Eugenics, etc. ("Shocked I tell you!").
We have the very problem today which they are indignant about. We just let the "market" sort it out. And, as has already been discussed, the "market" is just a euphemism for socially-enhanced healthcare. (Legislatively improved market outcomes for those who can afford the resulting "market" at the expense of those who cannot.).
They use "free market" rhetoric to essentially justify Eugenics and the ugliness of making a cost/benefit analysis about the value of someone's life. But, it's no more a "free market" than universal care would be. It exists because "we" took a vote. Universal health care could occur using the same principle: Majoritarianism (mobocracy) determined entirely by the preponderance of oxes which will be gored.
If we start to discuss universal care (and the topic of realistic cost containment arises), they're aghast that someone might make a decision that their life isn't worth a treatment(!).
That's what's so amusing (in a twisted way) about the modern healthcare debate. "You'll deny me the ability to buy healthcare" (when we do that to millions today). "You'll decide my life isn't worth the cost of treatment" (when we do that to millions today).
Mark |
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| reply to amigo_boy
said by amigo_boy :
If you're low- to lower-middle-class, lessor-developed countries may appear to be better. Who cares if the US has the latest high-tech equipment when you don't need it, and can't afford just the basics within the system that provided it?
But you see that's not true either. Much of our "high-tech" services are designed to treat extremely rare diseases, and in many cases we use specially designed drugs with little to no advantage over much cheaper older drugs. When it comes to treating more common ailments, places like Britain actually have better equipment than us, because the government subsidizes hospital purchases of the latest and greatest.
Over here only hospitals like, say, the Cleveland Clinic can even afford the newest MRI machines because everything is privatized. |
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4 edits | reply to amigo_boy
Weird, my response wasn't recorded... so here we go again (watch as it appears right as I post this one)
said by amigo_boy :
Your logic cuts both ways. By detecting ailments earlier we save money on treating the ailment. But, we prolong the individual's life to consume more of the finite resource (incurring more ailments over a longer lifespan, requiring more treatments, etc.).
I just wanted to point out that that's not how preventative medicine works. I'll use the simple example of obesity and the estimated $147 billion dollars it costs us in healthcare every year. A national healthcare system that incentivizes people to eat healthily and exercise, and a system that encourages doctors to educate their patients by vigorously emphasizing the importance of staying fit, can dramatically reduce costs.
Furthermore, a reduction in healthcare costs for the poor (or the elimination altogether), makes it much easier for them to purchase significantly healthier unprocessed food, rather than the cheap processed garbage that's available almost everywhere.
In terms of diabetes staying fit through especially rigorous exercise can get you off the machine and even off the oral pills.
I don't know of any doctor who would say preventative medicine has hidden long-term costs. I think it's self-evident that people in other countries with nationalized healthcare spend 2 and a half times less than the average American, despite the widespread implementation of preventative medicine (which is used to bring down costs).
And as for the irrationality of many Republicans... the problem is they are deep down driven by greed. The upper class are intensely protective of the money they have now, and the lower classes are persuaded by the delusion that they'll "pull themselves up by the bootstraps" and become super rich one day, and want to protect those future riches as much as possible. They can't admit this to themselves because it conflicts so dramatically with their conservative social views (often times influenced by religion).
Until one can admit the deficiencies of their character, one can never approach the path of enlightenment. (by the way I'm socially conservative, in large part because essentially every sage, wise man, priest, etc. in the history of the Eastern world was and emulation is key). |
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| reply to sonicmerlin
said by sonicmerlin: When it comes to treating more common ailments, places like Britain actually have better equipment than us, because the government subsidizes hospital purchases of the latest and greatest. I agree with that comment (because you qualified it to "common ailments."). That's why I disagreed with the previous assertion that the US doesn't have the best healthcare (unqualified).
I think it depends on who you are. If you have an uncommon ailment, and you are among the population who can afford good insurance (or can self pay), we have "the best healthcare in the world." You get to choose your doctor. Choose your hospital. Buy the best on the "market."
Everyone else would prefer the lower-quality goods and services available in other countries. What's the benefit of the having the latest high-tech equipment available through the "market" when you don't need it and can't afford it? And, that "market" produces routine healthcare goods and services more expensive than goods and services deemed acceptable around the world?
That's a rhetorical question. I'm just illustrating how it's situational. It explains why some don't want to give up what they have today (and refuse to acknowledge that what they have today comes at the expense of others, who are locked into a socially-created "market" of artificially high quality that they don't need and wouldn't choose if more-common options were available to them).
Mark |
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1 edit | reply to sonicmerlin
said by sonicmerlin:I just wanted to point out that that's not how preventative medicine works. I'll use the simple example of obesity ... I wasn't expressing an absolute rule (that preventative medicine, early diagnostic evaluation, availability of medicine) are more expensive in the long run. Just that it's not an absolute rule that they are less expensive in the long run.
From a purely economic point of view, if you prolong someone's life through those healthcare practices, you will have created a scenario where they will consume more healthcare services over a longer period of time.
I'm not advocating denying healthcare to reduce costs. Just saying why I disagreed with your assertion that providing healthcare is always less expensive.
Consider the Bill Moyers piece last night. The guy who didn't take his meds because they were too expensive. He ended up in critical care. Your position (rightfully) is that, if meds had been provided to him we would have avoided the expense of the critical care.
But, my position is that that would have delayed the critical care to a later date. Perhaps multiple critical-care events. And, the cost of medicine all that additional time. It could have been less expensive that he departed sooner.
Again, I'm not advocating that kind of approach to healthcare. Just explaining why I felt your assertion that greater availability of healthcare must be cheaper.
Mark |
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2 edits | To be fair I didn't watch the Bill Moyer documentary, so this is just a general viewpoint.
For most people there's no reason to believe they will be in critical care as long as they continues to take their medicine.
Furthermore they will continue to be working, productive members of society, who add to the insurance pool through taxation and contribute to national wealth and GDP through their jobs.
In the hypothetical case they didn't take any meds and ended up in critical care, if the operation is successful (which steadily advancing technology makes more and more likely), they'll still have to go on the meds afterwards. It's just an additional cost.
In many, many cases of preventative medicine the early care (like detecting breast cancer when it's extremely early and still benign), can completely eliminate the need for future expensive operations (like long-term and extremely expensive chemotherapy, which also destroys the individual's productivity and contributions to society for a very long period of time). |
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| said by sonicmerlin:In many, many cases of preventative medicine the early care (like detecting breast cancer when it's extremely early and still benign), can completely eliminate the need for future expensive operations. You could be right. I was just saying that it's not as simple as plentiful healthcare reducing costs of critical care (as we have today with the uninsured and underinsured). There are always unintended consequences, such as someone having recurring cases of cancer (when, under our existing system the first bout would have killed them, ending all costs at that point).
Mark |
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2 edits | reply to amigo_boy
I acknowledge what you're illustrating.
On the other hand I feel it's necessary to point out that by "common ailment" I'm referring to 99%+ of all diseases.
Most medical detection and analysis techniques use the same general procedures and machines (like fMRI). Detecting relatively unique conditions or diseases only requires tweaks to those procedures.
The *extremely* rare stuff is what the best US hospitals are good at diagnosing and treating. They wield exotic machines, procedures, and medications that literally only a few thousand can afford to pay for.
For almost everything else (99% of illnesses), in terms of equipment, quality of doctors, medications, etc. all are used more efficiently and at lesser cost in countries with nationalized healthcare. This is because the government subsidizes the purchase of expensive equipment and is constantly looking for ways to cut costs through increased efficiency, so only the most effective drugs at the lowest cost will be accepted.
So what I'm trying to say is that the argument that our national healthcare is the best in the world for the rich doesn't even apply to the upper middle class or necessarily the lower upper class. If you're making a million/year, then sure you can afford the super expensive $55,000 treatment by the Cleveland Clinic's leading surgeon, but in every other hospital the quality of the equipment will be below other countries' standards.
I feel like my reply was so inefficient and verbose it put the US healthcare system to shame (lol how do you delete a post?) |
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4 edits | reply to amigo_boy
I did some more research and you're actually right.
"Sweeping statements about the cost-saving potential of prevention, however, are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs.3 For example, screening costs will exceed the savings from avoided treatment in cases in which only a very small fraction of the population would have become ill in the absence of preventive measures."
"Whether any preventive measure saves money or is a reasonable investment despite adding to costs depends entirely on the particular intervention and the specific population in question. For example, drugs used to treat high cholesterol yield much greater value for the money if the targeted population is at high risk for coronary heart disease, and the efficiency of cancer screening can depend heavily on both the frequency of the screening and the level of cancer risk in the screened population."
"Researchers have found that although high-technology treatments for existing conditions can be expensive, such measures may, in certain circumstances, also represent an efficient use of resources.5 It is important to analyze the costs and benefits of specific interventions."
Curse myself. I'll do more research before I argue with you next time lol. |
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| said by sonicmerlin:Curse myself. I'll do more research before I argue with you next time lol. I was just guessing. Just saying that the argument cuts both ways (without knowing how).
I was just trying to acknowledge some of the complaints of reform opponents. Trying to find a middle ground. That a monopoly (finite resource, by definition limited in supply compared to demand) would be sacrificed in one of three ways if further socialized.
Anti-reformers say two wrongs don't make a right (that we should maintain our existing socialized system on the backs of the working poor and middle class). But, they seem to think one wrong makes a right.
Mark |
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patcat88
join:2002-04-05
Jamaica, NY
kudos:1 | reply to sonicmerlin
said by sonicmerlin:Over here only hospitals like, say, the Cleveland Clinic can even afford the newest MRI machines because everything is privatized. No, thats because of "cost plus billing" and reimbursement rates from the state and the fed govt which are made over wine and cigars. So while one hospital builds a new wing every 5 years like an Ivy League University, another hospital gets its reimbursement license revoked by a "taxpayer responsibility" state commission and is closed. |
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patcat88
join:2002-04-05
Jamaica, NY
kudos:1 | reply to sonicmerlin
said by sonicmerlin:I just wanted to point out that that's not how preventative medicine works. I'll use the simple example of obesity and the estimated $147 billion dollars it costs us in healthcare every year. A national healthcare system that incentivizes people to eat healthily and exercise, and a system that encourages doctors to educate their patients by vigorously emphasizing the importance of staying fit, can dramatically reduce costs. Furthermore, a reduction in healthcare costs for the poor (or the elimination altogether), makes it much easier for them to purchase significantly healthier unprocessed food, rather than the cheap processed garbage that's available almost everywhere. In terms of diabetes staying fit through especially rigorous exercise can get you off the machine and even off the oral pills. Won't work. Here is why.
»www.youtube.com/watch?v=11nsZ3lEWD0
Until you put punitive taxes, or treat processed high calorie density foods the same way as narcotics, people will eat junk food like using street narcotics. Make taxes per 100 calories for all retail foods with a calorie density of XXX calories per oz (think tobacco taxes, although the destination of tobacco taxes is a joke »redtape.msnbc.com/2008/11/ten-ye···ter.html , it doesn't matter for the purpose of limiting them). Kill the corn, wheat, and soybean subsidies that make all the artery clogging meat (ever thought how many people you can feed with that you feed Daisy the cow?), the deep fry oil, the HCFS/Sugar for beverages and baked goods, the deep fry breading, the bread, the donuts, etc. The fact fast food is so cheap and so high calorie in the USA, is because of the farming subsidizes. |
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 rawgerzThe hell was that?Premium
join:2004-10-03
Grove City, PA | Seeing as how you're from an incredibly urban area, I wouldn't doubt you've even seen a corn field in real life.
That being said, let me enlighten you on a few things.
Those that get subsidies have to have them, if they did not they couldn't even break even. Today's corn seed is genetically modified and must be purchased, along with Roundup and fertilizer. Whether or not GM seed produces crop yields worthwhile is up for debate to me, but that does not dismiss the fact that if you did not use it, chances are overwhelmingly likely that someone in a nearby field is. Once they cross pollinate those seeds will not germinate and your "pure" seed is contaminated and lost. So yes it must be purchased. Add that to the fact that the average farmer has to plant a few hundred acres of corn with much larger machinery to make a profit it makes more sense why subsidies exist. To be profitable by farming is many times a million dollar investment at least.
With the quality of meat I've seen for awhile now, I don't think they're getting as much corn as you imagine. And so you know, they aren't fed pure corn, many other things are ground up into it like cobs and stalks. Besides, if it's not fed to the cattle, that's going to cheapen the cost of junk food even more.
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