I don't understand the US health care system. I often read in the newspapre reports about people being "uninsured". And they think it is a big problem.
Well, I am uninsured too. But in Hong Kong, if I am sick and uninsured, I just pay for whatever health care service that I use. A consultation plus medication for most minor problems at a private, for profit hospital cost, on average, about US$40-70. Do Americans need to pay huge sums for minor problems if they are uninsured?
I don't understand it either but Yes.
You try paying 60 000$ for Chimo.
As GF points out the problem isn't paying for minor problems - its paying for medium to major problems. You get the odd story of someone being diagnosed with cancer and losing their house, for example.
Medical bills bills are sky-high, and with no form of institutionalized assistance, there's nothing to defray those costs. A simple blood test will set you back somewhere around $300-$500 in lab fees. I'll cough up some numbers for perspective:
I've got severe allergies and minor asthma. With no prescription plan, I couldn't afford a regular prescription that can come out to $5 a pill or more. When I have an attack, it's about $100 for the doctor's visit, $300-500 to get a blood test to double-check my dosages, an inhaler can set me back about $200, and since I can only do the legwork so infrequently, last time it was accompanied by a sinus infection that incurred another $200 worth of prescriptions. All told, I ended up shelling out about $1,000 dollars just to deal with having a hard time breathing between coughing and sneezing fits. Anything that requires even simply outpatient hospital services is insane.
I would also point out, however, that while we don't have any national programs to deal with coverage, most hospitals have something like a "charity care" program where the hospital would review your financials and write off some or all of the expenses you were billed for if you can show financial hardship.
Another thing to realize about US healthcare is that since the insurance as well as healthcare providers are entirely private sector, their overriding goal is to turn a profit; this leads to a lot of competition on prices and payouts where healthcare costs in the US probably aren't comparable to those of other countries with mandated insurance plans or mandated healthcare plans like the UK.
The US gets the worst of both worlds now - insanely high prices so that health care providers can bill at a high rate to insurance companies, since they know they won't get but a fraction anyway, but no actual consumer market to foster price competition.
Quote from: Monoriu on June 04, 2009, 09:14:29 PM
I don't understand the US health care system. I often read in the newspapre reports about people being "uninsured". And they think it is a big problem.
Well, I am uninsured too. But in Hong Kong, if I am sick and uninsured, I just pay for whatever health care service that I use. A consultation plus medication for most minor problems at a private, for profit hospital cost, on average, about US$40-70. Do Americans need to pay huge sums for minor problems if they are uninsured?
The problem is that the cost is extremely high, and grossly inflated. If there ever was a case for price gouging laws, health care would be it.
I've recently paid:
$55 for a GP visit.
$90 for an opthomologist visit.
$250 for a foot specialist visit. :ultra: :ultra:
Quote from: Admiral Yi on June 04, 2009, 11:52:00 PM
I've recently paid:
$55 for a GP visit.
$90 for an opthomologist visit.
$250 for a foot specialist visit. :ultra: :ultra:
You could have gone to Martinus for free.
Quote from: Jaron on June 05, 2009, 12:01:38 AM
Quote from: Admiral Yi on June 04, 2009, 11:52:00 PM
I've recently paid:
$55 for a GP visit.
$90 for an opthomologist visit.
$250 for a foot specialist visit. :ultra: :ultra:
You could have gone to Martinus for free.
:lol:
Here's an eye opening statistic.
http://www.msnbc.msn.com/id/31103572/
QuoteMedical bills tied to 60 percent of bankruptcies
Most families had health insurance, but still overwhelmed by health debt
WASHINGTON - Medical bills are involved in more than 60 percent of U.S. personal bankruptcies, an increase of 50 percent in just six years, U.S. researchers reported on Thursday.
More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.
"Using a conservative definition, 62.1 percent of all bankruptcies in 2007 were medical; 92 percent of these medical debtors had medical debts over $5,000, or 10 percent of pretax family income," the researchers wrote.
"Most medical debtors were well-educated, owned homes and had middle-class occupations."
The researchers, whose work was paid for by the Robert Wood Johnson Foundation, said the share of bankruptcies that could be blamed on medical problems rose by 50 percent from 2001 to 2007.
...
"Among common diagnoses, nonstroke neurologic illnesses such as multiple sclerosis were associated with the highest out-of-pocket expenditures (mean $34,167), followed by diabetes ($26,971), injuries ($25,096), stroke ($23,380), mental illnesses ($23,178), and heart disease ($21,955)," the researchers wrote.
Copyright 2009 Reuters.
Our healthcare system is a complete disaster and, after spending quite a bit of time mulling it over, I'm now in favor of socialized medicine... as difficult as it is for me to say so, given my libertarian leanings.
Quote from: Caliga on June 05, 2009, 06:46:34 AM
Our healthcare system is a complete disaster and, after spending quite a bit of time mulling it over, I'm now in favor of socialized medicine... as difficult as it is for me to say so, given my libertarian leanings.
You'll make Ron Paul cry.
Quote from: Ed Anger on June 05, 2009, 06:49:58 AMYou'll make Ron Paul cry.
Sometimes you have to be pragmatic. :(
Quote from: Caliga on June 05, 2009, 06:52:31 AM
Quote from: Ed Anger on June 05, 2009, 06:49:58 AMYou'll make Ron Paul cry.
Sometimes you have to be pragmatic. :(
I'll be pragmatic with you. I'll support socialized medicine, as long as those with means can go above and beyond.
I :wub: private rooms.
Watching Scrubs has accurately taught me how the medical system works in the USA. :bowler:
Quote from: Grey Fox on June 04, 2009, 09:26:34 PM
I don't understand it either but Yes.
You try paying 60 000$ for Chimo.
25k, actually.
Quote from: Caliga on June 05, 2009, 06:46:34 AM
Our healthcare system is a complete disaster and, after spending quite a bit of time mulling it over, I'm now in favor of socialized medicine... as difficult as it is for me to say so, given my libertarian leanings.
Socialized medicine and universal health care are different beasts, imho.
In socialized medicine, the State takes in charge everything. They hire the doctors, they decide hor much of them they want to be trained in school, they manage the hospitals from A to Z, they create multiple inneificent structures in the hospital, they create multiple infrastructure outside of the hospital to wich the hospitals must refer before acquiring any resources, they negotiate 30 different contracts for the nurses, a dozen for the janitors and other "maintenance" people, and then they raise your taxes to 60% of your wage, then still manage to have you wait 48 hrs in the ER and call this an exceptionnally good year.
With universal health care coverage, people are still free to get a private insurance if they want, go where they want, and never worry about footing the bill for chemiotherapy of their hearth disease in one 60 000$ shot. Hospitals can still be managed by the private corporations, private health insurance can still offer their services, you can still get lobster in an hospital room instead of the god awful stuff they call "food", provided your insurance pays for it.
Ok, yes, I'm using the terms interchangeably and I should not be doing that. I am in favor of universal healthcare, but not socialized medicine as you define it. I want to be able to get private insurance, but I think all Americans need to be covered. It seems to me that with the current system the people who most commonly get shafted are working-class/middle-class, and since those folks do most of this country's work, that's totally unacceptable.
Quote from: Ed Anger on June 05, 2009, 07:03:05 AM
I'll be pragmatic with you. I'll support socialized medicine, as long as those with means can go above and beyond.
I :wub: private rooms.
:boff:
Only insane countries don't have a private market. I live in Sweden. Much of our healthcare is operated by the government but there is also a private sector. As a resident I get the government shit that sometimes works reasonably well (although horribly inefficiently), but I also have private insurance (paid by my employer) that guarantees me quick quality care wherever I happen to be in Sweden. Note: this description is simplified for our American readers.
Quote from: Palisadoes on June 05, 2009, 07:10:03 AM
Watching Scrubs has accurately taught me how the medical system works in the USA. :bowler:
Having a mother as an RN for 40 years accurately taught me, too.
Like how a cancer patient, who was totally fucking terminal, had additional and painful procedures tacked on the last two days of her life by two doctors who chatted over her about her "really good insurance".
Or, how she had to come in on a Saturday morning because another patient--who was already booked for colon surgery for a Monday morning to remove an identified and located tumor--to participate in an unnecessary upper colonoscopy because the doctor "just wanted to be sure"...and because her insurance provided for additional pre-op procedures that needed to be burned up before Monday. Cha-ching.
Yeah, I know about US healthcare.
But what really sums it up for me is how at
Insert Major Fucking Medical University and Hospital here I work for, that the schedule for the first day of orientation for new House Staff members next month provides the following morning schedule:
"Malpractice Insurance" -- 90 minutes
"HMO Billing Procedures" -- 90 minutes
"Medical Ethics" -- 30 minutes
Yeah.
Discounting the obvious rattle about people waiting for treatment and all the rest, I'm curious about some of this guy's ideas. Particularly the ones about making it possible to get catastrophic coverage and HSA's. Gully? Would that actually make a decent impact? Intuitively, it sounds like catastrophic plans would make the kind of coverage healthy people really need easily available and cheap. It's also a bit odd that Whole Foods' CEO is GOP. :P
http://online.wsj.com/article/SB20001424052970204251404574342170072865070.html
Quote
The Whole Foods Alternative to ObamaCare
By JOHN MACKEY
"The problem with socialism is that eventually you run out
of other people's money."
—Margaret Thatcher
With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people's money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us.
While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:
• Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees' Personal Wellness Accounts to spend as they choose on their own health and wellness.
Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan's costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.
• Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.
• Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.
• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.
• Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.
• Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor's visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?
• Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.
• Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.
Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?
Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That's because there isn't any. This "right" has never existed in America
Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments.
Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor's Business Daily. In England, the waiting list is 1.8 million.
At Whole Foods we allow our team members to vote on what benefits they most want the company to fund. Our Canadian and British employees express their benefit preferences very clearly—they want supplemental health-care dollars that they can control and spend themselves without permission from their governments. Why would they want such additional health-care benefit dollars if they already have an "intrinsic right to health care"? The answer is clear—no such right truly exists in either Canada or the U.K.—or in any other country.
Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.
Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.
Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat. We should be able to live largely disease-free lives until we are well into our 90s and even past 100 years of age.
Health-care reform is very important. Whatever reforms are enacted it is essential that they be financially responsible, and that we have the freedom to choose doctors and the health-care services that best suit our own unique set of lifestyle choices. We are all responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health. Doing so will enrich our lives and will help create a vibrant and sustainable American society.
—Mr. Mackey is co-founder and CEO of Whole Foods Market Inc.
Quote from: Caliga on June 05, 2009, 06:46:34 AM
Our healthcare system is a complete disaster and, after spending quite a bit of time mulling it over, I'm now in favor of socialized medicine... as difficult as it is for me to say so, given my libertarian leanings.
:bleeding:
Quote from: CountDeMoney on June 06, 2009, 05:41:35 AM
Having a mother as an RN for 40 years accurately taught me, too.
Yeah, but it also "taught" you that all doctors are greedy morons, so...
QuoteWhole Foods
Fuck Whole Foods. I like going in there dressed poorly and basking in the snobby stares.
Quote from: Whole Foods guy on August 17, 2009, 04:18:28 PM
• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.
Wouldn't this just encourage all insurance companies to drop any kind of expensive treatment from the coverage? I fail to see how this would help at all. All it would do is skyrocket bankruptcies whenever someone gets cancer, MS or any other significant problem.
Quote from: Ed Anger on August 17, 2009, 04:32:52 PM
QuoteWhole Foods
Fuck Whole Foods. I like going in there dressed poorly and basking in the snobby stares.
Whole Foods. :wub:
Quote from: Ed Anger on August 17, 2009, 04:32:52 PM
QuoteWhole Foods
Fuck Whole Foods. I like going in there dressed poorly and basking in the snobby stares.
They
are GOP. :lol:
Quote from: MadImmortalMan on August 17, 2009, 04:18:28 PM
Discounting the obvious rattle about people waiting for treatment and all the rest, I'm curious about some of this guy's ideas. Particularly the ones about making it possible to get catastrophic coverage and HSA's. Gully? Would that actually make a decent impact? Intuitively, it sounds like catastrophic plans would make the kind of coverage healthy people really need easily available and cheap. It's also a bit odd that Whole Foods' CEO is GOP. :P
I could tell it came from WSJ before I even saw the link. It's a typical Cato Institute type BS that suffers from several fatal oversights. There should be a Guller's rule for evaluating health insurance proposals: if someone doesn't mention "adverse selection" anywhere in their proposal, it means that he has no idea what he's talking about. Adverse selection is the propensity in a free market for bad risks to be more likely to buy insurance, and more of it, than good risks. It's a very bad thing, and it affects health insurance to a much greater degree than any other form of insurance, for various reasons.
This flows into two other oversights. The first one is the attack on employer health plans and their tax-exempt status. Employer health plans in exchange for tax exemption are not allowed to discriminate based on health or age of the employees. That limits adverse selection, because healthy and sick people alike are covered more or less involuntarily. If you destroy that system by removing tax exemption, you will be leaving people to buy their health insurance on their own in the individual health insurance market, which is much more succeptible to adverse selection.
The second oversight is about the sick people. How are the people with medical conditions supposed to get covered? Health insurance companies don't like being adversely selected against, so they underwrite very vigorously to avoid insuring sick people. They also tend to do very ethically-questionable things like canceling the coverage retroactively, if you happen to have a large medical claim after getting your insurance, and it then turns out that you didn't dot one of the i's on the application form. That guy has no propsals for insuers of last resort or anything of that nature.
And the last thing is about letting people buy insurance across state lines. In many ways regulation of insurance by individual states is highly inefficient. However, letting people just shop across the state lines would make this problem even worse, because then companies would just find a state whose insurance department has the least regulations and consumer protections. It's another idea that appeals to people who don't really know what they're talking about. I do think that there is great merit in federal regulation of health insurance, because there does need to be one uniform regulatory system, just not the one that was a result of the race to the bottom.
In short, this guy doesn't propose anyting ground-breaking. He's merely reiterating the Republican line on health insurance, and one that just can't survive informed scrutiny.
Quote from: MadImmortalMan on August 17, 2009, 04:52:16 PM
Quote from: Ed Anger on August 17, 2009, 04:32:52 PM
QuoteWhole Foods
Fuck Whole Foods. I like going in there dressed poorly and basking in the snobby stares.
They are GOP. :lol:
?
http://abcnews.go.com/Business/story?id=8322658&page=1
Oh. I guess I need some fancy cheese then. :blush:
Quote from: DGuller on August 17, 2009, 04:53:25 PM
Quote from: MadImmortalMan on August 17, 2009, 04:18:28 PM
Discounting the obvious rattle about people waiting for treatment and all the rest, I'm curious about some of this guy's ideas. Particularly the ones about making it possible to get catastrophic coverage and HSA's. Gully? Would that actually make a decent impact? Intuitively, it sounds like catastrophic plans would make the kind of coverage healthy people really need easily available and cheap. It's also a bit odd that Whole Foods' CEO is GOP. :P
I could tell it came from WSJ before I even saw the link. It's a typical Cato Institute type BS that suffers from several fatal oversights. There should be a Guller's rule for evaluating health insurance proposals: if someone doesn't mention "adverse selection" anywhere in their proposal, it means that he has no idea what he's talking about. Adverse selection is the propensity in a free market for bad risks to be more likely to buy insurance, and more of it, than good risks. It's a very bad thing, and it affects health insurance to a much greater degree than any other form of insurance, for various reasons.
This flows into two other oversights. The first one is the attack on employer health plans and their tax-exempt status. Employer health plans in exchange for tax exemption are not allowed to discriminate based on health or age of the employees. That limits adverse selection, because healthy and sick people alike are covered more or less involuntarily. If you destroy that system by removing tax exemption, you will be leaving people to buy their health insurance on their own in the individual health insurance market, which is much more succeptible to adverse selection.
The second oversight is about the sick people. How are the people with medical conditions supposed to get covered? Health insurance companies don't like being adversely selected against, so they underwrite very vigorously to avoid insuring sick people. They also tend to do very ethically-questionable things like canceling the coverage retroactively, if you happen to have a large medical claim after getting your insurance, and it then turns out that you didn't dot one of the i's on the application form. That guy has no propsals for insuers of last resort or anything of that nature.
And the last thing is about letting people buy insurance across state lines. In many ways regulation of insurance by individual states is highly inefficient. However, letting people just shop across the state lines would make this problem even worse, because then companies would just find a state whose insurance department has the least regulations and consumer protections. It's another idea that appeals to people who don't really know what they're talking about. I do think that there is great merit in federal regulation of health insurance, because there does need to be one uniform regulatory system, just not the one that was a result of the race to the bottom.
In short, this guy doesn't propose anyting ground-breaking. He's merely reiterating the Republican line on health insurance, and one that just can't survive informed scrutiny.
Good info. So what happens if there's no public option? It kinda seems like if we don't do that, we might as well not do anything--and it's looking pretty bad for the public option right now in Congress. Are there any steps that can be taken without going that far that would help? Federal HSAs with auto withholding and state contributions for the poor maybe? The thing about making costs transparent to the consumer sounds feasible. We've already got all the providers and payers set up on the HL-7 standard. There ought to be a way to compile cost information and make it available to the public from that. Hell, insurance companies probably already do that in some form for their own research.
Quote from: MadImmortalMan on August 17, 2009, 05:15:09 PM
Good info. So what happens if there's no public option?
Depends on what happens with mandates. With a combination of mandates, elimination of underwriting, and strict (but not too strict) regulation of private insurance companies to prevent gouging, you can get something meaningful passed.
As for public option, I'm actually in the camp with those who were highly suspicious of it. Various forms of "public options" in insurance markets have a way of becoming the only option. I don't think it was a critical piece to a useful healthcare reform.
Quote from: Admiral Yi on June 04, 2009, 11:52:00 PM
I've recently paid:
$55 for a GP visit.
$90 for an opthomologist visit.
$250 for a foot specialist visit. :ultra: :ultra:
Note: prices not valid outside of Iowa.
Quote from: MadImmortalMan on August 17, 2009, 05:15:09 PM
Good info. So what happens if there's no public option? It kinda seems like if we don't do that, we might as well not do anything--and it's looking pretty bad for the public option right now in Congress. Are there any steps that can be taken without going that far that would help? Federal HSAs with auto withholding and state contributions for the poor maybe? The thing about making costs transparent to the consumer sounds feasible. We've already got all the providers and payers set up on the HL-7 standard. There ought to be a way to compile cost information and make it available to the public from that. Hell, insurance companies probably already do that in some form for their own research.
I¡'m pretty sure costs could be made transparent. In fact, my brother has been working on software that AFAIK instantly spews out future estimated costs per patient given a doctor's report. It's had a very good reception among several Spanish health institutions.
DGuller: your post suggests you believe the CEO thinks his suggestions will solve all health care issues. He explicitly says here are 8 suggestions that will lower costs for everyone.
Quote from: Iormlund on August 17, 2009, 04:34:22 PM
Wouldn't this just encourage all insurance companies to drop any kind of expensive treatment from the coverage? I fail to see how this would help at all. All it would do is skyrocket bankruptcies whenever someone gets cancer, MS or any other significant problem.
There are presumably some types of expensive coverage that Whole Food employees would like to see remain in their policies.
Quote from: DontSayBanana on June 04, 2009, 10:07:23 PM
Another thing to realize about US healthcare is that since the insurance as well as healthcare providers are entirely private sector, their overriding goal is to turn a profit; this leads to a lot of competition on prices and payouts where healthcare costs in the US probably aren't comparable to those of other countries with mandated insurance plans or mandated healthcare plans like the UK.
There are not-for-profit co-ops. I also thought there were some public hospitals. And I use public insurance.
Quote from: Admiral Yi on August 17, 2009, 05:53:52 PM
DGuller: your post suggests you believe the CEO thinks his suggestions will solve all health care issues. He explicitly says here are 8 suggestions that will lower costs for everyone.
The problem is that his suggestions open a Pandora box of other unintended consequences that would most likely makes things worse rather than better on the whole. Failure to address them is a sign of someone who didn't think things through.
Quote from: jimmy olsen on June 05, 2009, 06:21:52 AM
Here's an eye opening statistic.
http://www.msnbc.msn.com/id/31103572/
QuoteMedical bills tied to 60 percent of bankruptcies
Most families had health insurance, but still overwhelmed by health debt
WASHINGTON - Medical bills are involved in more than 60 percent of U.S. personal bankruptcies, an increase of 50 percent in just six years, U.S. researchers reported on Thursday.
More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.
"Using a conservative definition, 62.1 percent of all bankruptcies in 2007 were medical; 92 percent of these medical debtors had medical debts over $5,000, or 10 percent of pretax family income," the researchers wrote.
"Most medical debtors were well-educated, owned homes and had middle-class occupations."
The researchers, whose work was paid for by the Robert Wood Johnson Foundation, said the share of bankruptcies that could be blamed on medical problems rose by 50 percent from 2001 to 2007.
...
"Among common diagnoses, nonstroke neurologic illnesses such as multiple sclerosis were associated with the highest out-of-pocket expenditures (mean $34,167), followed by diabetes ($26,971), injuries ($25,096), stroke ($23,380), mental illnesses ($23,178), and heart disease ($21,955)," the researchers wrote.
Copyright 2009 Reuters.
No shit. My family was this close to losing the house due to a catastrophic illness my father had. There is a reason conspiracy theories about mandated abortion and death panels are floating about. There's not much to like about our health system. You'd have hard time defending the status quo.
Quote from: citizen k on August 17, 2009, 06:06:52 PM
There are not-for-profit co-ops. I also thought there were some public hospitals. And I use public insurance.
If it's not too much to ask, would you be able to get individual insurance at all?
Quote from: Iormlund on August 17, 2009, 06:19:18 PM
Quote from: citizen k on August 17, 2009, 06:06:52 PM
There are not-for-profit co-ops. I also thought there were some public hospitals. And I use public insurance.
If it's not too much to ask, would you be able to get individual insurance at all?
It would be prohibitively expensive. I have MS and the cost for my two medications is about $4,000 per month. Based on income and need I qualified for Medicare which pays for my prescriptions and other health costs.
I personally couldn't get individual insurance when I was out of college and wasn't yet working. The prices were just completely insane, and would be appropriate only if I were a diabetic dying of cancer. I think I detailed my frustrations on the old Languish back then. I lived in New York at the time, though, which is one of the most dysfunctional states when it comes to any kind of insurance.
Quote from: citizen k on August 17, 2009, 06:23:19 PM
It would be prohibitively expensive. I have MS and the cost for my two medications is about $4,000 per month. Based on income and need I qualified for Medicare which pays for my prescriptions and other health costs.
Hey, this is America. Aren't we supposed to be letting you rot in the streets or something? We have a strawman to live up to after all. :p
Quote from: Admiral Yi on August 17, 2009, 05:58:22 PM
Quote from: Iormlund on August 17, 2009, 04:34:22 PM
Wouldn't this just encourage all insurance companies to drop any kind of expensive treatment from the coverage? I fail to see how this would help at all. All it would do is skyrocket bankruptcies whenever someone gets cancer, MS or any other significant problem.
There are presumably some types of expensive coverage that Whole Food employees would like to see remain in their policies.
That's fine, except no sane insurer would offer that kind of policy. It's just not financially viable to aim for the sick or elderly. Let me put my case as an example: in the last two years I've been a total of 2 months at the hospital. I've had 4 scans, 4 barium swallow tests, innumerable blood tests, visited my specialist around 30 times, had half a meter worth of intestine taken out. Been unable to work for 7 or so months. I've got 50% chance of needing further surgery. Unless a cure is found I'll be on drugs for the rest o my life - and while those I've taken so far are relatively cheap that will surely change once better ones are discovered.
Now, what kind of insurer you think would aim for me?
Quote from: MadImmortalMan on August 17, 2009, 06:26:03 PM
Quote from: citizen k on August 17, 2009, 06:23:19 PM
It would be prohibitively expensive. I have MS and the cost for my two medications is about $4,000 per month. Based on income and need I qualified for Medicare which pays for my prescriptions and other health costs.
Hey, this is America. Aren't we supposed to be letting you rot in the streets or something? We have a strawman to live up to after all. :p
He would if the proposed reform is enacted. He is on Medicare.
Quote from: Iormlund on August 17, 2009, 06:32:31 PM
Now, what kind of insurer you think would aim for me?
The one that sells annuities.
I'm not likely to die anytime soon. :P
It's a bitch of a disease, but the mortality rate is insignificant.
Quote from: Iormlund on August 17, 2009, 06:32:31 PM
That's fine, except no sane insurer would offer that kind of policy. It's just not financially viable to aim for the sick or elderly. Let me put my case as an example: in the last two years I've been a total of 2 months at the hospital. I've had 4 scans, 4 barium swallow tests, innumerable blood tests, visited my specialist around 30 times, had half a meter worth of intestine taken out. Been unable to work for 7 or so months. I've got 50% chance of needing further surgery. Unless a cure is found I'll be on drugs for the rest o my life - and while those I've taken so far are relatively cheap that will surely change once better ones are discovered.
Now, what kind of insurer you think would aim for me?
He's not talking about your situation. He's talking about buying insurance for his employees, and the government requiring that any insurance he be offered include some esoteric stuff. Now I don't know specifically what esoteric stuff he's talking about, but there are issue ads running on TV here that ask viewers to contact their congressman and ask him to "end autism discrimination." Who knows what that means. Babysitting for life? I also have a vague recollection of a certain number of pap smears or mammograms being made mandatory back in the 80s.
Quote from: DGuller on August 17, 2009, 06:37:27 PM
Quote from: Iormlund on August 17, 2009, 06:32:31 PM
Now, what kind of insurer you think would aim for me?
The one that sells annuities.
:P
Okay, so here's a question. What kind of incentive could be provided that would make insurers want to take on high-risk customers then? Tax breaks? Outright subsidy? Liability limitation from externality or malpractice damages? Maybe the latter combined with tax writeoffs for covering the treatments. That would make a fairly predictable expense model for the insurer maybe, but I don't see how it could get the premiums down for the patients.
Quote from: MadImmortalMan on August 17, 2009, 06:49:25 PM
:P
Okay, so here's a question. What kind of incentive could be provided that would make insurers want to take on high-risk customers then? Tax breaks? Outright subsidy? Liability limitation from externality or malpractice damages? Maybe the latter combined with tax writeoffs for covering the treatments. That would make a fairly predictable expense model for the insurer maybe, but I don't see how it could get the premiums down for the patients.
Are you referring to Iormlund? He's not high risk, he's high cost.
Quote from: DGuller on August 17, 2009, 06:24:25 PM
I personally couldn't get individual insurance when I was out of college and wasn't yet working. The prices were just completely insane, and would be appropriate only if I were a diabetic dying of cancer. I think I detailed my frustrations on the old Languish back then. I lived in New York at the time, though, which is one of the most dysfunctional states when it comes to any kind of insurance.
I'm glad you got a job, hippie.
Quote from: MadImmortalMan on August 17, 2009, 06:49:25 PM
:P
Okay, so here's a question. What kind of incentive could be provided that would make insurers want to take on high-risk customers then? Tax breaks? Outright subsidy? Liability limitation from externality or malpractice damages? Maybe the latter combined with tax writeoffs for covering the treatments. That would make a fairly predictable expense model for the insurer maybe, but I don't see how it could get the premiums down for the patients.
The only incentive would be the law barring denial of coverage to the high-risk customers. As far as insurance companies would be concerned, there would be no high-risk or low-risk customers, just like there are no black or white customers.
Quote from: Admiral Yi on August 17, 2009, 06:51:33 PM
Quote from: MadImmortalMan on August 17, 2009, 06:49:25 PM
:P
Okay, so here's a question. What kind of incentive could be provided that would make insurers want to take on high-risk customers then? Tax breaks? Outright subsidy? Liability limitation from externality or malpractice damages? Maybe the latter combined with tax writeoffs for covering the treatments. That would make a fairly predictable expense model for the insurer maybe, but I don't see how it could get the premiums down for the patients.
Are you referring to Iormlund? He's not high risk, he's high cost.
Same thing. High risk means high expected costs.
Quote from: DGuller on August 17, 2009, 06:53:03 PM
Same thing. High risk means high expected costs.
Ah. What word does the industry use to capture the concept of uncertainty? Something nutty like: uncertainty?
Or what does the industry call someone who is likely to have high medical bills in the future but does not now?
Quote from: Admiral Yi on August 17, 2009, 06:42:33 PM
He's not talking about your situation. He's talking about buying insurance for his employees, and the government requiring that any insurance he be offered include some esoteric stuff. Now I don't know specifically what esoteric stuff he's talking about, but there are issue ads running on TV here that ask viewers to contact their congressman and ask him to "end autism discrimination." Who knows what that means. Babysitting for life? I also have a vague recollection of a certain number of pap smears or mammograms being made mandatory back in the 80s.
No, he's asking for no mandatory coverage at all. Which means insurers would cover the most basic stuff and leave people like me or Citizen K in the cold. Not to mention the elderly.
The only workable insurance demands we pool everyone in a single pot. Period. Anything else ends in the system you have in place now, where either you end up paying for sick people anyway through Medicare and ER bills or like this fellow proposes with his "reform Medicare" point, you let them die, go bankrupt or steal the money they need to stay alive.
An advantage of universal mandatory coverage is a lot of problems can be prevented or ameliorated if discovered early - leading to lesser costs in long term or ER care if everyone has cheap access to a doctor.
Quote from: Admiral Yi on August 17, 2009, 06:55:31 PM
Quote from: DGuller on August 17, 2009, 06:53:03 PM
Same thing. High risk means high expected costs.
Ah. What word does the industry use to capture the concept of uncertainty? Something nutty like: uncertainty?
It's more confusing than it has to be. Risk is actually the right word to use, except that in general "high risk" is synonymous to someone who's expensive to insure regardless of their variance in costs. I personally use "volatile" to describe the concept you're talking about without confusion. It's not an important concept in lines of insurance where there are many policyholders, and frequency of claims is high, because all those volatilities on an individual level get evened out.
Quote from: Iormlund on August 17, 2009, 07:06:42 PM
No, he's asking for no mandatory coverage at all.
No, he's not. You're misreading. We currently have 40 million uninsured so we obviously don't have mandatory coverage. You can't ask to eliminate something that doesn't exist.
Quote from: Admiral Yi on August 17, 2009, 06:59:23 PM
Or what does the industry call someone who is likely to have high medical bills in the future but does not now?
I guess now is a good time to say that I'm not a health actuary. I don't have that situation in my line of insurance (property insurance). In fact, situations like this is why health insurance is special. Real insurance deals with events that come entirely by chance, and are therefore unpredictable on an individual level, which isn't the case in the situation your describe. That's one of the many reasons health insurance doesn't work well in free market.
He's not talking about people. He's talking about procedure or drug coverage. As I understand now insurers have to cover certain minimums there. He's asking for those to be removed.
Quote from: Iormlund on August 17, 2009, 07:14:53 PM
He's not talking about people. He's talking about procedure or drug coverage. As I understand now insurers have to cover certain minimums there. He's asking for those to be removed.
But I think you have a misconception about the mandates he's referring to. I'm pretty certain that they don't cover things like cancer, or MS, or Iormlund's Syndrome. Take my "autism discimination" as an example. Currently there's no cure for autism. The only thing that makes sense is that they are lobbying for a mandate to cover some kind of assistance that makes the parents' lives easier.
Quote from: Admiral Yi on August 17, 2009, 07:26:10 PM
But I think you have a misconception about the mandates he's referring to. I'm pretty certain that they don't cover things like cancer, or MS, or Iormlund's Syndrome. Take my "autism discimination" as an example. Currently there's no cure for autism. The only thing that makes sense is that they are lobbying for a mandate to cover some kind of assistance that makes the parents' lives easier.
Having a look round it's to do with occupational, behavioural and speech therapy. Apparently in 14 states insurers are required to cover it, in 36 states they just don't cover it and they want it to be required according to the bill :)
Edit: So as far as I can tell it's to do with enabling kids, especially, with autism to do better in education and so on :mellow:
I was close!:woot:
It strikes me that the very fact that it's an insurance model for healthcare is self-defeating, because the insured's at almost 100% risk, and in fact, using health insurance for health maintenance appointments is considered better practice than not doing so. It seems totally backwards, when you consider that all other insurance models try to reward the outcome where nothing happens to the insured.
Quote from: DontSayBanana on August 17, 2009, 07:59:22 PM
It strikes me that the very fact that it's an insurance model for healthcare is self-defeating, because the insured's at almost 100% risk, and in fact, using health insurance for health maintenance appointments is considered better practice than not doing so. It seems totally backwards, when you consider that all other insurance models try to reward the outcome where nothing happens to the insured.
I agree that health insurance is not a real insurance, it's really more of a pre-paid plan. Health insurance as we know it doesn't satisfy the definition of insurance.
Well, to retain the prepaid model, we need to find some way (apparently sans government intervention) to reconcile the higher costs of the chronically ill with their lower earnings potential. I just don't see that happening without a systemic overhaul; how do you turn a minus into a plus overnight?
Quote from: DGuller on August 17, 2009, 05:26:32 PM
As for public option, I'm actually in the camp with those who were highly suspicious of it. Various forms of "public options" in insurance markets have a way of becoming the only option. I don't think it was a critical piece to a useful healthcare reform.
Like windstorm insurance in Florida.
Quote from: Iormlund on August 17, 2009, 07:06:42 PM
An advantage of universal mandatory coverage is a lot of problems can be prevented or ameliorated if discovered early - leading to lesser costs in long term or ER care if everyone has cheap access to a doctor.
Actually, a number of studies have shown that preventative care would be at best break even, probably more expensive. It would certainly improve health, but would cost more.
Does Preventive Care Save Money? Health Economics and the Presidential Candidates (http://content.nejm.org/cgi/content/full/358/7/661)
Congressional Budget Expert Says Preventive Care Will Raise -- Not Cut -- Costs (http://blogs.abcnews.com/politicalpunch/2009/08/congressional-budget-expert-says-preventive-care-will-raise-not-cut-costs.html)
[An NPR segment I heard a few weeks ago that I can't seem to track down]
Interesting study. However, I was not referring to screening of healthy patients. More like early diagnosis when there are already minor symptoms but the affected person doesn't have affordable access to consultations/tests.
For example, I had several, very minor symptoms years before I experienced any major problem. Had I gone to the specialist and done a barium swallow 7 years ago I might have avoided hospitalizations and surgery.
Now, in my case that was my fault. I didn't give it importance. Didn't go to see a doctor until pain had kept me awake for several days and it cost me dearly.
But I imagine many people for whom access to these services is a significant expense could be deterred by it. And these people are probably the most likely subset of the population to develop a chronic problem, as well.
Quote from: vonmoltke on August 17, 2009, 10:51:29 PM
Quote from: DGuller on August 17, 2009, 05:26:32 PM
As for public option, I'm actually in the camp with those who were highly suspicious of it. Various forms of "public options" in insurance markets have a way of becoming the only option. I don't think it was a critical piece to a useful healthcare reform.
Like windstorm insurance in Florida.
That's exactly the example I had in mind. However, there are many others out there, unfortunately.
Quote from: MadImmortalMan on August 17, 2009, 06:49:25 PM
Quote from: DGuller on August 17, 2009, 06:37:27 PM
Quote from: Iormlund on August 17, 2009, 06:32:31 PM
Now, what kind of insurer you think would aim for me?
The one that sells annuities.
:P
Okay, so here's a question. What kind of incentive could be provided that would make insurers want to take on high-risk customers then? Tax breaks? Outright subsidy? Liability limitation from externality or malpractice damages? Maybe the latter combined with tax writeoffs for covering the treatments. That would make a fairly predictable expense model for the insurer maybe, but I don't see how it could get the premiums down for the patients.
If you run the probabilities of the future medical costs of Iormlund, you will have to compensate an insurance company so that they take in more than those costs. Basically, if an actuary calculates expected costs in the next year of $30k, the premium will be more than $30k (the insurance company needs to eat too). In short, he is uninsurable as a private citizen.
However, if Iormlund had a job at a company with a healthcare plan mandating coverage for everyone and sets premiums for all new entrants, the insurance company will charge far less. That is because adverse selection will be overcome through the mandate for insurance coverage. In a company of 10,000 people, of course some will have expensive medical problems, but an insurance company will be able to distribute individual crises over all employees.
There are a lot of problems with employer provided health care--basically people without jobs at big companies get left out. But if there isn't a strong individual mandate for insurance in any health care reform, messing with the tax breaks for health care costs could backfire.
Quote from: derspiess on August 17, 2009, 04:21:12 PM
Quote from: Caliga on June 05, 2009, 06:46:34 AM
Our healthcare system is a complete disaster and, after spending quite a bit of time mulling it over, I'm now in favor of socialized medicine... as difficult as it is for me to say so, given my libertarian leanings.
:bleeding:
The thing is, as I've said before when this topic has come up, we already have it in the form of supplemental state funding for hospitals to cover writeoffs from patients who have no coverage and can't afford to pay their ER bills. If some welfare dude comes in with gunshot wounds, they're not going to refuse treatment due to lack of coverage. The Hippocratic Oath(TM) won't permit that.
Quote from: alfred russel on August 18, 2009, 12:20:32 AM
There are a lot of problems with employer provided health care--basically people without jobs at big companies get left out. But if there isn't a strong individual mandate for insurance in any health care reform, messing with the tax breaks for health care costs could backfire.
I agree, this is it in a nutshell.
Quote(CNN) -- Most Congress members conducting town hall meetings this month have chosen a noncombative posture to deal with angry participants who disrupt the proceedings. Not Rep. Barney Frank.
Rep. Barney Frank argues with a man after a town hall meeting Tuesday night in Dartmouth, Massachusetts.
1 of 2 At a lively two-hour meeting Tuesday night in Dartmouth, Massachusetts, Frank gave as good as he got in confronting opponents of overhauling the nation's health care system.
The crowded hall had both supporters and detractors, but the opposing side was much louder and more raucous, booing the Massachusetts Democrat from the moment he was introduced and shouting questions and challenges at him throughout.
"You want me to talk about it or do you want to yell?" he asked over and over when interrupted while trying to answer. Continued shouting brought a sterner rebuke.
"Disruption never helps your cause," he said more than once. "It just looks like you're afraid to have rational discussion." Watch Frank slam "vile, contemptible nonsense" »
While Frank attempted to respond to all questions, he gave up when one woman compared health care proposals favored by Frank and President Obama to policies of Nazi Germany.
"When you ask me that question, I'm going to revert to my ethnic heritage and ask you a question: On what planet do you spend most of your time?" Frank asked.
"You stand there with a picture of the president defaced to look like Hitler and compare the effort to increase health care to the Nazis," he said, adding such behavior demonstrated the strength of First Amendment guarantees of what he called "contemptible" free speech.
"Trying to have a conversation with you would be like trying to argue with a dining room table," Frank said to the woman. "I have no interest in doing it."
Despite the disruptions, the meeting covered many of the issues of the health care debate, with Frank shooting down rumors that a House health care bill would mandate free insurance coverage for illegal immigrants.
He read from the section of the bill that excludes payments for that purpose, and when another questioner referred to a different section guaranteeing nondiscrimination, Frank pointed out that the first section he read superseded that language.
Some in the crowd applauded, but others booed and shouted. Frank asked why the detractors shouted for him to answer, and when he did, they shouted more.
"What's the matter with you all?" he said. "I don't know if you get angrier when I answer the questions, or when you don't think I do."
What a professional.
*shrug* I think he gets a pass. IIRC Barney is a Jew, and comparing Obama to Hitler on a topic like this is crossing the line.
I give Barney a thumbs up.
Quote from: The Minsky Moment on August 19, 2009, 01:45:11 PM
I agree. Without the sarcasm.
How do you know I'm being sarcastic?
Quote from: garbon on August 19, 2009, 01:50:37 PM
How do you know I'm being sarcastic?
I don't but I had to cover myself just in case.
Quote from: Razgovory on August 19, 2009, 01:54:17 PM
Cause you are a one trick pony.
Oh honey, I've got tricks you've never even dreamed of.
Quote from: The Minsky Moment on August 19, 2009, 01:53:48 PM
I don't but I had to cover myself just in case.
I'm of two minds. I hate Barney Frank so some contempt comes unbidden but then what he was confronted with was over the top and offensive, so it is good that he didn't just sit there and take it.
Quote from: garbon on August 19, 2009, 02:00:10 PM
Quote from: Razgovory on August 19, 2009, 01:54:17 PM
Cause you are a one trick pony.
Oh honey, I've got tricks you've never even dreamed of.
I've never had a homoerotic dream before.
Quote from: Razgovory on August 19, 2009, 02:02:24 PM
I've never had a homoerotic dream before.
Well there you go!
I saw some of the video of Frank's town hall. He acted like he tries to be so flip, glib and/or condescending with his peers or political opponents, and I think it had the opposite affect on his voters at the town hall. Voters may have gone too far but Frank didn't necessarily help himself out nor conduct an instructive meeting, at least not the parts I saw. However, I'm neutral on it - he'll get re-elected, or not, most likely will. Up to the voters in his district to decide.
Frank is for a government run health care system, single payer. Has said so and hasn't backed down from that. I don't agree with that view but at least he doesn't dance around the question and try to be all things to all people.
Quote from: alfred russel on August 18, 2009, 12:17:26 AM
If you run the probabilities of the future medical costs of Iormlund, you will have to compensate an insurance company so that they take in more than those costs. Basically, if an actuary calculates expected costs in the next year of $30k, the premium will be more than $30k (the insurance company needs to eat too). In short, he is uninsurable as a private citizen.
However, if Iormlund had a job at a company with a healthcare plan mandating coverage for everyone and sets premiums for all new entrants, the insurance company will charge far less. That is because adverse selection will be overcome through the mandate for insurance coverage. In a company of 10,000 people, of course some will have expensive medical problems, but an insurance company will be able to distribute individual crises over all employees.
So you think it would be somewhat akin to the way car insurance premiums can be kept down by requiring drivers to have insurance, correct?
Quote from: Razgovory on August 19, 2009, 02:02:24 PM
I've never had a homoerotic dream before.
But have you dreamed of vampire stripper ponies?
Quote from: KRonn on August 19, 2009, 02:13:07 PM
I saw some of the video of Frank's town hall. He acted like he tries to be so flip, glib and/or condescending with his peers or political opponents, and I think it had the opposite affect on his voters at the town hall. Voters may have gone too far but Frank didn't necessarily help himself out nor conduct an instructive meeting, at least not the parts I saw. However, I'm neutral on it - he'll get re-elected, or not, most likely will. Up to the voters in his district to decide.
Frank is for a government run health care system, single payer. Has said so and hasn't backed down from that. I don't agree with that view but at least he doesn't dance around the question and try to be all things to all people.
Proper response is to call the hospital and ask them to take away the lunatics disrupting the meeting.
Quote from: DontSayBanana on August 19, 2009, 02:38:47 PM
So you think it would be somewhat akin to the way car insurance premiums can be kept down by requiring drivers to have insurance, correct?
I don't think car insurance is mandatory for the same reason. Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance. Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.
Quote from: DGuller on August 19, 2009, 04:35:32 PM
Quote from: DontSayBanana on August 19, 2009, 02:38:47 PM
So you think it would be somewhat akin to the way car insurance premiums can be kept down by requiring drivers to have insurance, correct?
I don't think car insurance is mandatory for the same reason. Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance. Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.
Another major difference is that you don't know you are going to get in an accident, while you may have a good idea you are about to need medical care. A contributor to slate.com recently wrote a piece complaining about "loopholes" in her privately purchased health insurance because pregnancy wasn't covered leaving her with a $20,000 tab (she ended up testifying to congress). The thing is insurance companies aren't being evil: it is just that 20 something women without jobs providing insurance are going to be far more likely to get insurance at $200 a month just before a pregnancy, leaving the insurance company with a $20k tab. The result would make it difficult to affordably insure 20 something women.
Quote from: DGuller on August 19, 2009, 04:35:32 PM
I don't think car insurance is mandatory for the same reason. Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance. Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.
I think auto insurance is not a bad example. The fact that it covers people you hit, instead of yourself, has little practical difference - if everyone has auto insurance then everyone is covered, no matter how it works out.
Where the example breaks down is that auto insurance is reasonable easy to enforce - you have to provide proof of insurance to register a vehicle. And the costs of free-riders (people who simply break the law) are low enough that they can be covered by the government without major problems. UP here we have a govt fund to pay people hit by uninsured drivers, and it's a fairly minor expense.
Quote from: DGuller on August 19, 2009, 04:35:32 PM
Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.
Except in no-fault states, where it covers you.
Quote from: Barrister on August 19, 2009, 06:26:03 PM
And the costs of free-riders (people who simply break the law) are low enough that they can be covered by the government without major problems. UP here we have a govt fund to pay people hit by uninsured drivers, and it's a fairly minor expense.
We have no such fund. :(
Quote from: alfred russel on August 19, 2009, 06:43:25 PM
We have no such fund. :(
And that is why I have uninsured motorist coverage.
Quote from: Barrister on August 19, 2009, 06:26:03 PM
Quote from: DGuller on August 19, 2009, 04:35:32 PM
I don't think car insurance is mandatory for the same reason. Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance. Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.
I think auto insurance is not a bad example. The fact that it covers people you hit, instead of yourself, has little practical difference - if everyone has auto insurance then everyone is covered, no matter how it works out.
Where the example breaks down is that auto insurance is reasonable easy to enforce - you have to provide proof of insurance to register a vehicle. And the costs of free-riders (people who simply break the law) are low enough that they can be covered by the government without major problems. UP here we have a govt fund to pay people hit by uninsured drivers, and it's a fairly minor expense.
Car insurance can also be obscenely expensive for people with multiple traffic infractions/accidents.
Translate that to health care, and it will become unaffordable to a lot of people, except in their case, it's health problems that may be entirely outside their control; unlike infractions or (at-fault) accidents.
It's silly to make something illegal (such as not carrying insurance) if one cannot afford it. In the "ideal" legal world, people without, or whom cannot afford, auto insurance shouldn't drive...so those who cannot afford health insurance shouldn't live?
Quote from: Tonitrus on August 19, 2009, 07:13:13 PM
It's silly to make something illegal (such as not carrying insurance) if one cannot afford it. In the "ideal" legal world, people without, or whom cannot afford, auto insurance shouldn't drive...so those who cannot afford health insurance shouldn't live?
I think that sums up the Conservative point of view pretty well.
Quote from: alfred russel on August 19, 2009, 06:43:25 PM
We have no such fund. :(
We do. PLIGA. :contract:
http://www.njguaranty.org/infoCenter/pligaSurcharge.asp
Quote from: Tonitrus on August 19, 2009, 07:13:13 PM
It's silly to make something illegal (such as not carrying insurance) if one cannot afford it. In the "ideal" legal world, people without, or whom cannot afford, auto insurance shouldn't drive...so those who cannot afford health insurance shouldn't live?
I agree, which is why it makes sense to subsidize people who can't afford insurance.
I have no problem paying (through taxes) doctor bills for people that can't afford them, so long as I'm not also paying for my neighbor down the street that decided he just doesn't want insurance.
I hate to say it...but I am warming to the idea of socialized medicine; even though I already exist in such a system, and generally despise it.
We should either cover everyone, or abandon health insurance as an entirety, and go back to the good old days where people who could afford it got a good doctor, and everyone else just died naturally.
Hell, if doctors had to market their services more, instead of just screwing Medicare or giant insurance conglomerates/HMOs, we'd probably be better off. The downside to that, of course, is "emergency" care (heart attacks and the like), where you really don't have the luxury of shopping around.
But who really knows what a good solution would be. The entire situation just sucks in general.
Quote from: vonmoltke on August 19, 2009, 06:36:57 PM
Quote from: DGuller on August 19, 2009, 04:35:32 PM
Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.
Except in no-fault states, where it covers you.
Yes, true. No-fault is on the way out, though. I don't really know why no-fault insurance is mandatory.
Quote from: DontSayBanana on August 19, 2009, 07:18:47 PM
Quote from: alfred russel on August 19, 2009, 06:43:25 PM
We have no such fund. :(
We do. PLIGA. :contract:
http://www.njguaranty.org/infoCenter/pligaSurcharge.asp
Those are guarantee funds. Their purpose is to protect you against insurance company's insolvency, not against uninsured motorist's insolvency. They're pretty much universal.
As much as I distrust governments, I think the US health care model is a good demonstration of what not to do.
The HK government is now considering mandatory individual savings accounts for health care.
I think there's something to this:
Quote19:12 GMT +00:00
Moderate is the new liberal
IF, WITH Barack Obama's acquiescence, Senate Democrats drop the public plan from their health-care reform bill, that measure will likely end up looking very much like The Economist's vision for health-care reform in America. Which is odd, because I never considered this paper a bastion of socialist thought.
Watching the debate over health-care reform play out in the media is a bit like watching the circus. There seem to be three rings that move from left to right across the stage (and political spectrum). In the first ring, liberal Democrats are having a debate with their moderate colleagues over the merits of different aspects of reform. Right now, it appears, the moderates are winning. In the second ring, moderate Republicans are having a debate with their conservative colleagues over reform. That debate seems to be going nowhere, with most Republicans staunchly opposed to any reform. In the third ring, we have the freak show: people screaming about socialism and death panels, and a few even packing heat outside presidential events.
If you're watching this spectacle on TV, then you're seeing a lot of rings two and three, and you may not realise that moderates are so far winning the fight over health-care policy. By pitting Barack Obama and his moderate allies in Congress against the more vocal fringes of the Republican Party, the media has moved the centre of the debate over reform far to the right. Add to this dynamic the idea that bipartisanship equals moderation and you may wonder, how can a health-care proposal be moderate if it attracts no Republican support?
But the truth is that Mr Obama has all but ceded control of reform to the likes of Max Baucus and other moderate senators. And if the media focused on that, we'd see that the debate over health care is occurring in the middle of the political spectrum, with the main focus on the "gang of six". As for bipartisanship, on this issue (and perhaps many others) it seems like a faulty measurement of moderation—how can it be accurate if the Republican's chief negotiator, the relatively moderate Chuck Grassley, says he might vote against a bill that gives him everything he wants?
On a more substantive level, Paul Krugman has accurately compared the reforms being mulled in the Senate to the Swiss system. It's a comparison we have also made on this blog. Those reforms would, far from creating a copy of the British or Canadian systems, keep the mixed public-private muddle in place, while adding things like individual mandates, guaranteed-issue and non-discriminatory clauses for all insurers, and subsidies for both the indigent and for insurers covering the sickest.
Perhaps it's a matter of perspective. If you like the status quo, then these changes (and any change that seriously addresses the flaws in America's health-care system) are probably going to seem radical to you. But if you believe that the American system is not functioning as it should and, therefore, needs to be reformed, the changes currently on the table are actually quite moderate. Or maybe, just maybe, we're all socialists.
Quote from: Sheilbh on August 20, 2009, 01:22:28 AM
I think there's something to this:
Quote
...Or maybe, just maybe, we're all socialists.
That can't be it. ;)
Quote from: Sheilbh on August 20, 2009, 01:22:28 AM
subsidies for ... covering the sickest.
I was unaware of this provision. Makes it a lot less punative against insurance companies and yet another reason why the public option is irrelevant.
Quotehow can it be accurate if the Republican's chief negotiator, the relatively moderate Chuck Grassley, says he might vote against a bill that gives him everything he wants?
Because voting for anything the Democrats want, even if it was a bill for building a giant gold statue of Ronald Reagan, would get him lynched by the hysterical Hansmeisters of the world.
Chuck is kind of a nebbish.
It's possible that, wonder of wonders, we might actually come out with something reasonable from all of this, you know. :)
Quote from: MadImmortalMan on August 20, 2009, 11:25:30 AM
It's possible that, wonder of wonders, we might actually come out with something reasonable from all of this, you know. :)
What would you consider reasonable?
Quote from: Barrister on June 04, 2009, 09:35:31 PM
As GF points out the problem isn't paying for minor problems - its paying for medium to major problems. You get the odd story of someone being diagnosed with cancer and losing their house, for example.
it does happen around here too, you know.
Outside the big cities, health care is defficient, so people from remote areas have to travel at their own expenses.
Figure the price of an hotel for the duration of your treatment.
I saw this in the news today. Seems like at least some good ideas by Whole Foods. And it also notes a few places where Federal or State law now hinders some cost savings, or different/better ideas for health care.
Some controversial stuff there too though, as the bottom two links are about people who disagree and are now calling for boycotting Whole Foods.
-------------------------------------------------------------------------------------------------------
http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html
The Whole Foods Alternative to ObamaCare
Eight things we can do to improve health care without adding to the deficit.
------------------------------------------------------------------------------------------------------
http://www.businessinsider.com/liberals-threaten-whole-foods-boycott-over-ceos-healthcare-stance-2009-8
http://www.politicsdaily.com/2009/08/19/whole-foods-boycotted-by-liberals-for-ceos-anti-obama-health-ca/
Quote from: KRonn on August 20, 2009, 01:49:03 PM
I saw this in the news today. Seems like at least some good ideas by Whole Foods. And it also notes a few places where Federal or State law now hinders some cost savings, or different/better ideas for health care.
Some controversial stuff there too though, as the bottom two links are about people who disagree and are now calling for boycotting Whole Foods.
-------------------------------------------------------------------------------------------------------
http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html
The Whole Foods Alternative to ObamaCare
Eight things we can do to improve health care without adding to the deficit.
------------------------------------------------------------------------------------------------------
http://www.businessinsider.com/liberals-threaten-whole-foods-boycott-over-ceos-healthcare-stance-2009-8
http://www.politicsdaily.com/2009/08/19/whole-foods-boycotted-by-liberals-for-ceos-anti-obama-health-ca/
I responded to this piece earlier in this thread. There is a good idea here or there, but on the whole it is based on ignorance of how health insurance works, and will make a truly bad system even worse. It's also not that much different from the standard Republican non-solution that they present when they have to say something during the presidential debates when the subject of healthcare comes up.
The boycott is just responding to ignorance with stupidity, of course. It was incompetence, not malice, that should be attributed to the Whole Foods CEO writing that op-ed.
While I think the entire "death panel" thing is contemptible, I cannot help but be amused at the shock and outrage from people who use the exact same tactics themselves when it suits them.
The more I learn about health care in the US, the more perplexed I get. I dont understand how US citizens can accept the current system. I truly dont.
Quote from: Bluebook on August 21, 2009, 12:40:16 AM
The more I learn about health care in the US, the more perplexed I get. I dont understand how US citizens can accept the current system. I truly dont.
Americans travel abroad and they see what others have and how it works. Then they come home and are afraid it's gonna turn out like what they saw so they say they'd rather keep what they have now than turn into that. Demagogues exploit this, effect magnifies, rise, repeat.
Quote from: MadImmortalMan on August 21, 2009, 01:07:04 AM
Quote from: Bluebook on August 21, 2009, 12:40:16 AM
The more I learn about health care in the US, the more perplexed I get. I dont understand how US citizens can accept the current system. I truly dont.
Americans travel abroad and they see what others have and how it works. Then they come home and are afraid it's gonna turn out like what they saw so they say they'd rather keep what they have now than turn into that. Demagogues exploit this, effect magnifies, rise, repeat.
:huh:
So your explanation is that rich white folks that travel get scared on their trip to Brazil?
What if you offered free trips to all the poor folks to places like Europe or Canada?
Methinks they'd jump on socialized med.
Quote from: Zoupa on August 21, 2009, 01:17:27 AM
:huh:
So your explanation is that rich white folks that travel get scared on their trip to Brazil?
What if you offered free trips to all the poor folks to places like Europe or Canada?
Methinks they'd jump on socialized med.
Poor people don't go to Brazil. Or the UK. Yeah, it's dumb. NHS can't compete with what rich Americans get. :P
Quote from: Berkut on August 20, 2009, 11:57:26 PM
While I think the entire "death panel" thing is contemptible, I cannot help but be amused at the shock and outrage from people who use the exact same tactics themselves when it suits them.
I don't know. The Bush=Hitler/Obama=Hitler thing's the same. But I think there are two big differences.
First it's been six months. Now Bush wasn't doing great in August 01, from what I remember he'd got the tax cut and was being attacked by future-Languishites for being weak-willed with China over the spy plane thing. But at that point he didn't have people carrying guns to his events with 'kill Bush' signs, he didn't have the Bush=Hitler stuff at that point either.
Second is the lie involved in this. I'm just amazed that something so blatantly untrue can be believed by so many people (45% according to a recent poll). Michael Goldfarb, McCain's spokesman and Weekly Standard writer, said that even if healthcare passes it'll be great for the Republicans because they can 'find' another death panel issue every week until it is enacted in 2013. Meanwhile Michael Steele sounds like a post-structuralist philosopher by saying that 'death panels' may not be in the bills being debated but that doesn't necessarily make them less 'true'. It's utterly bizarre. I can't think of anything like this: an allegation that's untrue, really serious and so bizarre being believed and entering mainstream political discourse.
QuotePoor people don't go to Brazil. Or the UK. Yeah, it's dumb. NHS can't compete with what rich Americans get. :P
Then why don't they pay for private healthcare when they're ill and here? :p
Quote from: MadImmortalMan on August 21, 2009, 01:59:33 AM
Poor people don't go to Brazil. Or the UK. Yeah, it's dumb. NHS can't compete with what rich Americans get. :P
I don't think that is it at all - it is that the NFHS cannot compete with what the middle class in America get - or at least that is the perception.
People complain about our system, but at the end of the day, we have excellent health care largely available to most of the people. Where has this perception come from that health care in America for most people is a problem? It is expensive, but it is also generally very, very good compared to the stories I have heard from other places.
Quote from: Berkut on August 21, 2009, 11:12:00 AM
but it is also generally very, very good compared to the stories I have heard from other places.
So we are comparing generalities against anecdotes now?
Quote from: Sheilbh on August 21, 2009, 02:30:52 AM
Quote from: Berkut on August 20, 2009, 11:57:26 PM
While I think the entire "death panel" thing is contemptible, I cannot help but be amused at the shock and outrage from people who use the exact same tactics themselves when it suits them.
I don't know. The Bush=Hitler/Obama=Hitler thing's the same. But I think there are two big differences.
First it's been six months. Now Bush wasn't doing great in August 01, from what I remember he'd got the tax cut and was being attacked by future-Languishites for being weak-willed with China over the spy plane thing. But at that point he didn't have people carrying guns to his events with 'kill Bush' signs, he didn't have the Bush=Hitler stuff at that point either.
Second is the lie involved in this. I'm just amazed that something so blatantly untrue can be believed by so many people (45% according to a recent poll). Michael Goldfarb, McCain's spokesman and Weekly Standard writer, said that even if healthcare passes it'll be great for the Republicans because they can 'find' another death panel issue every week until it is enacted in 2013. Meanwhile Michael Steele sounds like a post-structuralist philosopher by saying that 'death panels' may not be in the bills being debated but that doesn't necessarily make them less 'true'. It's utterly bizarre. I can't think of anything like this: an allegation that's untrue, really serious and so bizarre being believed and entering mainstream political discourse.
Oh come on, just look at the Iraq war. You saw the exact same kinds of lies and bullshit and appeals to irrational emotion about something at least as serious, and people STILL believe a lot of it.
This is no different. The Republicans are attacking the Dems because the Dems are in power and they think that beating them is more important than anything else, and if that means a badly needed reform of the health care system is acrificed on the alter of "Get Obama" then so be it. It is everything that is wrong about politics, and is utterly contemptible.
But I said the exact same thing when all the lefties where cheering on Michael Moore, and going on about Gitmo and gulags and killing hundreds of thousands of children in Iraq, or exaggerating instances of atrocities, etc., etc., etc. "Get Bush" was considered to be the over-riding goal, and if that meant that people supported the US losing a war, then so be it.
This is no different, at all.
Quote from: Valmy on August 21, 2009, 11:16:14 AM
Quote from: Berkut on August 21, 2009, 11:12:00 AM
but it is also generally very, very good compared to the stories I have heard from other places.
So we are comparing generalities against anecdotes now?
Of course - we are talking about politics and why people have the perceptions that they have. It is all about comparing anecdotes and generalities.
The reality, as I pointed out, is that for most Americans, they get very good health care. The "crisis" is in many ways vastly over-stated in its particulars. The real problem isn't the problem being discussed, just like the real valid objections to the Dems/Obamas plans have nothing to do with bullshit like "death panels".
But this is politics for the masses - the real issues are complex, so instead we rant and rave about bullshit that makes for a compelling story.
Quote from: Sheilbh on August 21, 2009, 02:30:52 AM
Then why don't they pay for private healthcare when they're ill and here? :p
Most of the stories I have heard from folks in that position involve them giving up and doing exactly that.
Quote from: Berkut on August 21, 2009, 11:18:47 AM
The reality, as I pointed out, is that for most Americans, they get very good health care.
That is not a reality for me. I fucking am so tired of the general incompetence and nonsense I have to put up with just for supposedly trained medical professionals to recognize the obvious. I have to pay a shitload and go to private practicioners who do not take insurance to get somebody to spend more than two minutes with me and gives a flying shit.
But I must be one of the unfortunate few. Heck just yesterday my wife went into a place and the doctor diagnosed her and proscribed anti-biotics...but the thing the stupid asshole diagnosed is a mother fucking VIRUS. Last year I ripped my achilles tendon but three separate doctors insisted it was a sprain before I finally got fed up and spent hundreds to get it treated by somebody with a grasp for the obvious.
But anyway I am glad somebody out there gets excellent health care.
Heaven help me if I ever have a medical condition of any complexity I am really fucked. This is for shit that I already can recognize and anybody with a brain should.
My sister in law went to doctors for months insisting she had a serious problem in her abdomen and of course non of the many doctors she went to checked it out or gave a shit. They diagnosed it as all sorts of things. Well guess what? It was cancer and now she is going to die! Hurrah for our excellent health care!
Of course government universal care is not going to solve these problems which I primarily blame on Doctors being overworked, being afraid of being sued all the time, and the ridiculous bureaucracy of the insurance industry. In fact I expect these problems to continue to get worse.
It never ceases to shock me when I hear of somebody going to the doctor, and being prescribed anti-biotics and being diagnosed with a virus at the same time. I hear that frequently enough. Doctors who do that should be stripped of their license for dooming the humanity to anti-biotic resistance. They should also be executed, just to make sure that they wouldn't get their license back in some way.
My favorite part is how doctors are rewarded with money if they ask you to take tests or proscribe pills...so naturally I am always getting pushed to take pills and tests. I mean a chest x-ray? For a cough? Are you shitting me?
Anyway those are my anecdotes. :P
Quote from: Berkut on August 21, 2009, 11:16:23 AM
This is no different, at all.
Here's the difference.
The Democrat party was divided over Iraq. Camper rightly predicted that the immediate political effect of Iraq was to damage the Democrats, not the Republicans, as they split into pro and anti-wars at each others throat and trying to discern some sort of common policy they could unite over. Because of that split and that significant pro-war section in the Democrats I think that while the anti-war Democrats took over the majority of the party by around 2006 (at roughly the same time as the anti-war part of America became larger than the pro-war part) the loony anti-war Democrats never took over.
Because of that I can't think of a single senior Democrat who pushed a Michael Moore-ish, General Betray Us, Lancet report version of events.
Incidentally just thinking on what you're saying there '"Get Bush" was considered to be the over-riding goal, and if that meant that people supported the US losing a war, then so be it.'. Do you think it's possible to be sort of honourably, or patriotically anti-war? What I mean is if you're honest and truthful about things (so no distortion) but genuinely believe that the war is wrong or that withdrawal is right how can you express that without being perceived as a political hack or wanting the US to lose a war?
Quote from: Sheilbh on August 21, 2009, 11:35:12 AM
[Do you think it's possible to be sort of honourably, or patriotically anti-war? What I mean is if you're honest and truthful about things (so no distortion) but genuinely believe that the war is wrong or that withdrawal is right how can you express that without being perceived as a political hack or wanting the US to lose a war?
Man I so want to answer this one so bad...but I will wait for Berkie.
Quote from: Sheilbh on August 21, 2009, 11:35:12 AM
Incidentally just thinking on what you're saying there '"Get Bush" was considered to be the over-riding goal, and if that meant that people supported the US losing a war, then so be it.'. Do you think it's possible to be sort of honourably, or patriotically anti-war? What I mean is if you're honest and truthful about things (so no distortion) but genuinely believe that the war is wrong or that withdrawal is right how can you express that without being perceived as a political hack or wanting the US to lose a war?
Maintain a consistent, principled argument. Avoid trying to score debating points and making arguments of expediency.
Be scrupulous about your facts.
Avoid trying to demonize your political opponents.
Quote from: Admiral Yi on August 21, 2009, 11:40:58 AM
Maintain a consistent, principled argument. Avoid trying to score debating points and making arguments of expediency.
Be scrupulous about your facts.
Avoid trying to demonize your political opponents.
Yeah the Democrats, for the most part, did not do these things. They changed their position fluidly and it seemed to me it was a strategy to win back Congress than a strategy to actually leave Iraq which I did not think they actually wanted to do. Events have seemed to me to show my cynicism was correct.
It was especially sad seeing alot of the Dems who voted for the war (and I think supported the war all along and continue to do so) use this strategy.
Quote from: Admiral Yi on August 21, 2009, 11:40:58 AM
Maintain a consistent, principled argument. Avoid trying to score debating points and making arguments of expediency.
The last two I agree with - I think they should be standard for all discourse. But I'm unsure about this one because it sounds to me like they're not allowed to respond to the situation on the ground.
QuoteYeah the Democrats, for the most part, did not do these things. They changed their position fluidly and it seemed to me it was a strategy to win back Congress than a strategy to actually leave Iraq which I did not think they actually wanted to do. Events have seemed to me to show my cynicism was correct.
It was especially sad seeing alot of the Dems who voted for the war (and I think supported the war all along and continue to do so) use this strategy.
See I've got a lot of sympathy with them because I had opinions that were quite similar to them. In 2003 I supported the war. I started to get concerned in late 2004/2005 and started to support a withdrawal in 2006. So did many Democrats and lots of other people, including most Americans according to the polls.
Quote from: Tonitrus on August 19, 2009, 07:52:37 PM
I hate to say it...but I am warming to the idea of socialized medicine; even though I already exist in such a system, and generally despise it.
We should either cover everyone, or abandon health insurance as an entirety, and go back to the good old days where people who could afford it got a good doctor, and everyone else just died naturally.
Hell, if doctors had to market their services more, instead of just screwing Medicare or giant insurance conglomerates/HMOs, we'd probably be better off. The downside to that, of course, is "emergency" care (heart attacks and the like), where you really don't have the luxury of shopping around.
But who really knows what a good solution would be. The entire situation just sucks in general.
This is basically where I am coming to.
I cannot imagine the care I get could be anymore indifferently provided. It might as well be government health care.
Democratic politicians definitely didn't come out smelling like roses from the Iraq War. It was their luck that they are matched up against the party that manufactured the war in the first place. Some of them were genuinely for the war, some of them were probably against, but voted for because they didn't want to go against the public that was whipped into hysteria. Now they're all going "we were for the good war, not the bad war that Bush turned it into", which is disingenous to say the least.
Quote from: Sheilbh on August 21, 2009, 11:50:48 AM
See I've got a lot of sympathy with them because I had opinions that were quite similar to them. In 2003 I supported the war. I started to get concerned in late 2004/2005 and started to support a withdrawal in 2006. So did many Democrats and lots of other people, including most Americans according to the polls.
Yeah, at first I was willing to look past the no wmds for all those other arguments the neo-cons were pushing for the war, but the civil war, sharia constitution and NK getting a free pass kinda soured it for me.
Quote from: Sheilbh on August 21, 2009, 11:50:48 AM
The last two I agree with - I think they should be standard for all discourse. But I'm unsure about this one because it sounds to me like they're not allowed to respond to the situation on the ground.
The problem with responding to a changing situation on the ground is you're left looking like an idiot when the situation changes back.
Quote from: Sheilbh on August 21, 2009, 11:35:12 AM
Incidentally just thinking on what you're saying there '"Get Bush" was considered to be the over-riding goal, and if that meant that people supported the US losing a war, then so be it.'. Do you think it's possible to be sort of honourably, or patriotically anti-war? What I mean is if you're honest and truthful about things (so no distortion) but genuinely believe that the war is wrong or that withdrawal is right how can you express that without being perceived as a political hack or wanting the US to lose a war?
Of course, just like you can be honestly against the Dem plan for healthcare reform without resorting to the "death panel" crap.
How can you express it? I am not sure what you mean - lots of people did just that. Sadly, most people have a hard time differentiating their opposition from those who simply hate it because Bush was for it. It isn't hard to differentiate yourself from them, but it does require you to be willing to call them on it when their arguments are clearly crap. But most people are unwilling to do that - they see even the nutbars as allies, so instead they defend and make excuses for them.
Quote from: Admiral Yi on August 21, 2009, 12:26:29 PM
The problem with responding to a changing situation on the ground is you're left looking like an idiot when the situation changes back.
If to maintain a principled constant position regardless of reality is the bar for this sort of thing, aren't the more extreme on either side the most likely to pass?
To be honest I think you'd rather theologians than politicians. People who set out their first principles and then stick by them through to their logical conclusion without stopping to check if those principles could be flawed. It makes for better debate and argument, but I don't know if it's what we should want of our politics.
QuoteOf course, just like you can be honestly against the Dem plan for healthcare reform without resorting to the "death panel" crap.
The difference is that you can honestly be against healthcare reform and be a patriot. Can you honestly want your country to lose a war - in your phrase - and be a patriot? Is there room for Edmund Burke?
Quote from: Sheilbh on August 21, 2009, 01:46:18 PM
If to maintain a principled constant position regardless of reality is the bar for this sort of thing, aren't the more extreme on either side the most likely to pass?
To be honest I think you'd rather theologians than politicians. People who set out their first principles and then stick by them through to their logical conclusion without stopping to check if those principles could be flawed. It makes for better debate and argument, but I don't know if it's what we should want of our politics.
Not necessarily. One could have argued against the war from a cost/benefit POV (very centrist). The problem with the peaceniks was they started from a moral principle (never attack anyone) and then jerry-rigged utilitarian arguments in an attempt to win the center. Then their indifference to improvements in outcome measures showed they had just been talking hooey.
Quote from: Sheilbh on August 21, 2009, 01:46:18 PM
QuoteOf course, just like you can be honestly against the Dem plan for healthcare reform without resorting to the "death panel" crap.
The difference is that you can honestly be against healthcare reform and be a patriot. Can you honestly want your country to lose a war - in your phrase - and be a patriot? Is there room for Edmund Burke?
Yes, but it is certainly a difficult row to hoe.
I hope you are not comparing the people who were hoping that the US lost to a bunch of radical Islamic fanatics who think that killing women is a great response to them being raped (as an example) with Burke's position that America was populated by Brits whom the king had no right to make war on. I don't see the two situations as very analogous, nor do I think that most people who took their opposition to the war in Iraq to such extreme lengths that they were cheering every setback based that opposition on any kind of principles beyond "Get Bush at any and all costs".
Most people who opposed the war on principle, generally as a bad idea that was not likely to achieve anything positive, or that the positives that might be achieved would be worth the cost, were likely to hope that in fact they were proven to be wrong, rather than proven to be right. Or at least that is what such a position ought to have led to.
Quote from: Berkut on August 21, 2009, 02:09:35 PM
I hope you are not comparing the people who were hoping that the US lost to a bunch of radical Islamic fanatics who think that killing women is a great response to them being raped (as an example) with Burke's position that America was populated by Brits whom the king had no right to make war on. I don't see the two situations as very analogous, nor do I think that most people who took their opposition to the war in Iraq to such extreme lengths that they were cheering every setback based that opposition on any kind of principles beyond "Get Bush at any and all costs".
So does the acceptability of wanting an end to a war, or for your country lose a war, depend on what sort of opponents you have?
Who do you mean by the cheering every setback? I can't think of anyone. In this country at least giving such an impression would freeze someone out of mainstream political discourse.
The only guy I can think of is George Galloway.
QuoteMost people who opposed the war on principle, generally as a bad idea that was not likely to achieve anything positive, or that the positives that might be achieved would be worth the cost, were likely to hope that in fact they were proven to be wrong, rather than proven to be right. Or at least that is what such a position ought to have led to.
But didn't the moveonistas, the Kucinich's and so on - the left you dislike so much - oppose the war on principle? Are they really more admirable than someone who initially supported it but believed it to be unwinnable two years later?
QuoteNot necessarily. One could have argued against the war from a cost/benefit POV (very centrist).
When is it acceptable to change your opinion on a subject like this?
Quote from: Sheilbh on August 21, 2009, 02:23:19 PM
When is it acceptable to change your opinion on a subject like this?
When you have a good reason for doing so.
Quote from: Sheilbh on August 21, 2009, 02:23:19 PM
But didn't the moveonistas, the Kucinich's and so on - the left you dislike so much - oppose the war on principle? Are they really more admirable than someone who initially supported it but believed it to be unwinnable two years later?
I think the perception is that those guys also hoped the US would lose the war so they'd be proven right, and that's where it breaks down.
Quote from: MadImmortalMan on August 21, 2009, 02:34:42 PMI think the perception is that those guys also hoped the US would lose the war so they'd be proven right, and that's where it breaks down.
Okay. I suppose I'm seeing a difference between wanting withdrawal, which I think is perfectly acceptable and not wanting your guys to lose and wanting your guys to lose which is George Galloway style 'British and American troops are wolves' justifications of suicide bombing and killing your guys.
I associate loss more with people dying than with withdrawing at a moment of your choice.
Edit: I think I basically think that opposing the war, throughout, and wanting withdrawal is fine and can be argued with. I wouldn't use the 'want your country to lose' line until you get someone like Galloway who is arguing in favour and in support of the insurgents.
Moving back to health care, it would be interesting to see how much of the premium the US pays for health care goes toward treating the dying, wouldn't it?
Quote from: Admiral Yi on August 21, 2009, 02:46:10 PM
Moving back to health care, it would be interesting to see how much of the premium the US pays for health care goes toward treating the dying, wouldn't it?
Treating the dying costs less than hospice care, rather counter-intuitively. At the minute it's $1.9 billion of Medicare's costs :)
Quote from: Sheilbh on August 21, 2009, 02:52:00 PM
Treating the dying costs less than hospice care, rather counter-intuitively. At the minute it's $1.9 billion of Medicare's costs :)
But my president told me it's 80% of health spending. :huh:
Quote from: Admiral Yi on August 21, 2009, 02:55:31 PM
Quote from: Sheilbh on August 21, 2009, 02:52:00 PM
Treating the dying costs less than hospice care, rather counter-intuitively. At the minute it's $1.9 billion of Medicare's costs :)
But my president told me it's 80% of health spending. :huh:
Hospice care? :blink:
Quote from: Sheilbh on August 21, 2009, 02:59:03 PM
Hospice care? :blink:
All inclusive.
QuoteI 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.
Quote from: Berkut on August 21, 2009, 11:12:00 AM
It is expensive, but it is also generally very, very good compared to the stories I have heard from other places.
We are like 37th in the world.
http://www.photius.com/rankings/healthranks.html
Quote from: Razgovory on August 21, 2009, 03:32:28 PM
Quote from: Berkut on August 21, 2009, 11:12:00 AM
It is expensive, but it is also generally very, very good compared to the stories I have heard from other places.
We are like 37th in the world.
http://www.photius.com/rankings/healthranks.html
lol
Look at the criteria.
http://www.photius.com/rankings/world_health_systems.html
http://www.photius.com/rankings/who_world_health_ranks.html
Quote from: Razgovory on August 21, 2009, 03:32:28 PM
Quote from: Berkut on August 21, 2009, 11:12:00 AM
It is expensive, but it is also generally very, very good compared to the stories I have heard from other places.
We are like 37th in the world.
http://www.photius.com/rankings/healthranks.html
That's it. I am moving to Costa Rica.
Quote from: Razgovory on August 21, 2009, 03:32:28 PM
Quote from: Berkut on August 21, 2009, 11:12:00 AM
It is expensive, but it is also generally very, very good compared to the stories I have heard from other places.
We are like 37th in the world.
http://www.photius.com/rankings/healthranks.html
Quote
The World Health Organization's ranking of the world's health systems was last produced in 2000, and the WHO no longer produces such a ranking table, because of the complexity of the task.
Almost 10 years old, and the makers of the study themselves realize that it's probably too complex an issue to measure accurately.
World Wars have been fought and won in 10 years.
It's the best I got. Better then the anecdotes being tossed around.
Quote from: Valmy on August 21, 2009, 11:28:31 AM
My favorite part is how doctors are rewarded with money if they ask you to take tests or proscribe pills...so naturally I am always getting pushed to take pills and tests. I mean a chest x-ray? For a cough? Are you shitting me?
Anyway those are my anecdotes. :P
I have been consistently given excellent health care. :)
Unrelated to my care, I believe that RI has two of the three best hospitals for cardio care in the nation.
Valmy, there are bad doctors everywhere, that has nothing to do with how you pay for your health care. It'll just make it cheaper. And you'll have long waiting lists. The less severe the problem, the longer they are. Over here, it can take a week to get a scanner* done while in the hospital. Three or so if you're out and marked as "preferential". Months if not. Or it can take a few minutes if things look bad enough, as it happened to me once when my fever shot up in the ER (I guess they had to rule out intestinal wall perforation).
For example on the bad doctor front, a month or so ago I had some tooth pain due to a hidden cavity. So I go to the on call GP at 3 AM. There's nobody else but me and the diagnosis is fairly obvious. But I have to tell him what to prescribe. He gave me the usual stuff, which I have to avoid (NSAIDs and some antibiotics) and I had to tell him he was wrong and what he should have given me instead.
Most doctors know less about my illness than I do. That's perfectly natural. And so I volunteer all the info when needed. But the guy could have at least asked or looked it up on hearing about my illnesses (especially since I had just told him I allergic to Aspirin as well). The dentist did ask me.
For the most part, however, I cannot complain. The best doctors invariably end up in the hospital I go to (it's the largest in Aragón). My specialist is one of two doctors working full-time on IBD cases in the region, so she does have a lot of experience.
*This varies a lot by procedure and place. Here colonoscopies take forever IIRC. Barium swallows, OTOH, have no waiting list at all - I've had them done less than 24h after asking for one.