Obamacare is a Job Killer

[Joe Bruno]

http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/

[Davej]

On Nov 9, 10:49 am, Joe Bruno <atandy...@gmail.com> wrote:
> http://blog.heritage.org/2011/02/17/house-education-and-workforce-com...

Maybe they can just move to Canada... Oops! They have Obamacare in
Canada also!

[Josh Miles]

No they don't. They have actual universal health care.

[sbalneav]

Joe Bruno <atan...@gmail.com> wrote:
> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/

From the article:

"The overriding message of the hearing was that several provisions of Obamacare
will make it more difficult for employers to create new jobs and expand their
businesses."

Well, sure. Some businesses may have a more difficult time expanding if
they're forced to provide for the wellbeing of their employees.

Perhaps we ought to give big wet sloppy blow-jobs to business and let them use
child and slave labour too?

http://www.openleft.com/diary/15912/business-aims-to-relax-bans-on-products-made-with-child-and-slave-labor

Business: "Ah bloo-bloo-bloo! If you remove our right to chain our employees
to a table and beat them, it will affect our ability to create new jobs and
expand our business!"

Countries are by the PEOPLE, for the PEOPLE. NOT corporations. The PEOPLE
want affordable healthcare. Businesses will have to friggin' man up. Hell,
they'll just pass on the cost to us anyway, so what's the diff?

--
__ _ | Be cheerful while you are alive.
(_ |_) | -- Phathotep, 24th Century B.C.
__)|_) |

[duke]

On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:

>Joe Bruno <atan...@gmail.com> wrote:
>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>
>From the article:
>
>"The overriding message of the hearing was that several provisions of Obamacare
>will make it more difficult for employers to create new jobs and expand their
>businesses."

>Well, sure. Some businesses may have a more difficult time expanding if
>they're forced to provide for the wellbeing of their employees.

They don't if reduced to under 30 Hrs per week. Guess what's coming and what a
25% cut in pay and no benefits means for the many.

A man who spent his own money to start a business does not have to listen to
massa bama.

The dukester, American - American
********************************************
You can't fix stupid.
********************************************

[Christopher A. Lee]

On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav
<sbal...@alburg.net> wrote:

>Joe Bruno <atan...@gmail.com> wrote:
>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>
>From the article:
>
>"The overriding message of the hearing was that several provisions of Obamacare
>will make it more difficult for employers to create new jobs and expand their
>businesses."
>
>Well, sure. Some businesses may have a more difficult time expanding if
>they're forced to provide for the wellbeing of their employees.

Yet with a full national health service that would cost a smaller
proportion of the GNP even big business would have a higher bottom
line because they wouldn't have to pay for insurance.

Countries like those in Western Europe get better health provision for
less spending because they don't have all the un-necessary
bureaucratic overhead due to the insurance companies having to
renegotiate each and every individual bill for each day in hospital,
every X-ray, blood test etc before paying the agreed rate because the
hospital bills at a higher one.

[Joe Bruno]

No, they don't. Obamacare is regulated private health insurance.
Canada has publicly regulated national health care.

[sbalneav]

duke <duckg...@cox.net> wrote:
> On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:
>
>>Joe Bruno <atan...@gmail.com> wrote:
>>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>>
>>From the article:
>>
>>"The overriding message of the hearing was that several provisions of Obamacare
>>will make it more difficult for employers to create new jobs and expand their
>>businesses."
>
>>Well, sure. Some businesses may have a more difficult time expanding if
>>they're forced to provide for the wellbeing of their employees.
>
> They don't if reduced to under 30 Hrs per week. Guess what's coming and what a
> 25% cut in pay and no benefits means for the many.

That's fine. If businesses starve everyone out, they'll have no one to buy
their products and services, and will go bankrupt.

Go read a book on economics.

> A man who spent his own money to start a business does not have to listen to
> massa bama.

He sure doesn't. He does, however, have to live by the law of the land, his
own money notwithstanding.

> The dukester, American - American
> ********************************************
> You can't fix stupid.
> ********************************************

--
__ _ | The price of anything is the
(_ |_) | amount of life you exchange for it.
__)|_) | -- Henry David Thoreau

[MarkA]

On Fri, 09 Nov 2012 08:49:19 -0800, Joe Bruno wrote:

> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/

And not having health care is a *people* killer.

--
MarkA
Keeper of Things Put There Only Just The Night Before
About eight o'clock

[Christopher A. Lee]

On Fri, 09 Nov 2012 15:05:20 -0500, MarkA <nob...@nowhere.invalid>
wrote:

>On Fri, 09 Nov 2012 08:49:19 -0800, Joe Bruno wrote:
>
>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>
>And not having health care is a *people* killer.

Yet it wasn't a job killer in Massachusetts when it was Romneycare.

Why can't they show any honesty?

[Syd M.]

On Nov 9, 1:35 pm, duke <duckgumb...@cox.net> wrote:

> On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav <sbaln...@alburg.net> wrote:
> >Joe Bruno <atandy...@gmail.com> wrote:
> >>http://blog.heritage.org/2011/02/17/house-education-and-workforce-com...
>

> >From the article:
>
> >"The overriding message of the hearing was that several provisions of Obamacare
> >will make it more difficult for employers to create new jobs and expand their
> >businesses."
> >Well, sure.  Some businesses may have a more difficult time expanding if
> >they're forced to provide for the wellbeing of their employees.
>
> They don't if reduced to under 30 Hrs per week.  Guess what's coming and what a
> 25% cut in pay and no benefits means for the many.
>
> A man who spent his own money to start a business does not have to listen to
> massa bama.
>
>

Found another racist nickname for the president, huh, bigoted Earl?

PDW

[Syd M.]

Sez you.
And no one here believes a thing you say.

PDW

[Joe Bruno]

On Friday, November 9, 2012 12:06:08 PM UTC-8, MarkA wrote:
> On Fri, 09 Nov 2012 08:49:19 -0800, Joe Bruno wrote:
>
>
>
> > http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>
>
>
> And not having health care is a *people* killer.
>
>
>
> --
>

People over 65 get Medicare automatically, even without Obummercare.The poor get health care through the Medicaid plan even without Ocare.Working people
get it through their employers if they choose employers carefully.

I never took a job with any employer who didn't provide health insurance.
See, I take care of myself in life. I don't want Obannana doing it for me.

[Joe Bruno]

You don't have to, idiot. I prove my claims.

http://www.hc-sc.gc.ca/hcs-sss/medi-assur/index-eng.php

[Don Kresch]

On Fri, 09 Nov 2012 10:44:51 -0800, Christopher A. Lee
<chrisl...@comcast.net> scrawled in blood:

>On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav
><sbal...@alburg.net> wrote:
>
>>Joe Bruno <atan...@gmail.com> wrote:
>>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>>
>>From the article:
>>
>>"The overriding message of the hearing was that several provisions of Obamacare
>>will make it more difficult for employers to create new jobs and expand their
>>businesses."
>>
>>Well, sure. Some businesses may have a more difficult time expanding if
>>they're forced to provide for the wellbeing of their employees.
>
>Yet with a full national health service that would cost a smaller
>proportion of the GNP

No, it wouldn't.

>even big business would have a higher bottom
>line because they wouldn't have to pay for insurance.

And yet people would not get good care, would have horrific
wait times, and all that. Happens everywhere UHC is. Including the
USSR, where the dying were wheeled into the streets so that the
hospital mortality rate wouldn't go up.


Don
aa#51, Knight of BAAWA, Jedi Slackmaster
Praise "Bob" or burn in Slacklessness trying not to.

[SkyEyes]

On Nov 9, 2:36 pm, Joe Bruno <atandy...@gmail.com> wrote:
> On Friday, November 9, 2012 12:06:08 PM UTC-8, MarkA wrote:
> > On Fri, 09 Nov 2012 08:49:19 -0800, Joe Bruno wrote:
>

> > >http://blog.heritage.org/2011/02/17/house-education-and-workforce-com...

>
> > And not having health care is a *people* killer.
>
> > --
>
> People over 65 get Medicare automatically, even without Obummercare.The poor get health care through the Medicaid plan even without Ocare.Working people
> get it through their employers if they choose employers carefully.
>
> I never took a job with any employer who didn't provide health insurance.
> See, I take care of myself in life. I don't want Obannana doing it for me.

You seem to think that *every* trade or profession had job openings
that offer healthcare. They patently *do not*. I love the way you
use yourself as an example of smart and virtuous planning, when you
haven't a walnut's concept of the fact that millions and millions of
carpenters, waitresses, warehouse workers, and many other trades
*have* to take the first job they're offered and *don't get* offers of
health care with their employment. Not everyone is an accountant,
doctor, banker, or hedge fund manager. Someone has to do the scut
work in the world, and they don't offer health benefits to people who
do it. They don't pay them shit for doing it, either.

Wake up and take a look at the real world. There are millions of
working poor in this country who *cannot get* healthcare through their
employers.

Brenda Nelson, A.A.#34 and A+ atheist
BAAWA Knight of the Golden Litterbox
EAC Professor of Feline Thermometrics and Cat-Herding
skyeyes nine at cox dot net OR
skyeyes nine at yahoo dot com

[Mike Painter]

Earl has never learned enough about business to know that a good
businessman will do everything possible to avoid using his own money
to start a business.
--
"When one person suffers from a delusion it is called insanity. When many people suffer from a delusion it is called religion." ~ Robert Pirsig

[Mitchell Holman]

Don Kresch <spam...@spamcatch.org> wrote in
news:981r98hg04as3af16...@4ax.com:

Show us an example of your preferred
government-free health care system.

[duke]

On Fri, 9 Nov 2012 19:59:49 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:

>duke <duckg...@cox.net> wrote:
>> On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:
>>
>>>Joe Bruno <atan...@gmail.com> wrote:
>>>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>>>
>>>From the article:
>>>
>>>"The overriding message of the hearing was that several provisions of Obamacare
>>>will make it more difficult for employers to create new jobs and expand their
>>>businesses."
>>
>>>Well, sure. Some businesses may have a more difficult time expanding if
>>>they're forced to provide for the wellbeing of their employees.

>> They don't if reduced to under 30 Hrs per week. Guess what's coming and what a
>> 25% cut in pay and no benefits means for the many.

>That's fine. If businesses starve everyone out, they'll have no one to buy
>their products and services, and will go bankrupt.

Nope, people will still eat. The sad thing is that the undereducated people
behind the counters that voted for massa bama are the very ones that will lose.

>Go read a book on economics.

That I did.

>> A man who spent his own money to start a business does not have to listen to
>> massa bama.

>He sure doesn't. He does, however, have to live by the law of the land, his
>own money notwithstanding.

No argument. But getting screwed is not included.

[sbalneav]

duke <duckg...@cox.net> wrote:
> On Fri, 9 Nov 2012 19:59:49 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:
>
>>duke <duckg...@cox.net> wrote:
>>> On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:
>>>
>>>>Joe Bruno <atan...@gmail.com> wrote:
>>>>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>>>>
>>>>From the article:
>>>>
>>>>"The overriding message of the hearing was that several provisions of Obamacare
>>>>will make it more difficult for employers to create new jobs and expand their
>>>>businesses."
>>>
>>>>Well, sure. Some businesses may have a more difficult time expanding if
>>>>they're forced to provide for the wellbeing of their employees.
>
>>> They don't if reduced to under 30 Hrs per week. Guess what's coming and what a
>>> 25% cut in pay and no benefits means for the many.
>
>>That's fine. If businesses starve everyone out, they'll have no one to buy
>>their products and services, and will go bankrupt.
>
> Nope, people will still eat.

I didn't mean starve, literally, duke. I meant cut everyone's pay to the point
where people don't have disposable income to buy goods that companies sell.

What *is* it with theists and their literalism?

> The sad thing is that the undereducated people
> behind the counters that voted for massa bama are the very ones that will lose.
>
>>Go read a book on economics.
>
> That I did.

Go read it again. Maybe this time mouth the words so they'll stick with you.

>>> A man who spent his own money to start a business does not have to listen to
>>> massa bama.
>
>>He sure doesn't. He does, however, have to live by the law of the land, his
>>own money notwithstanding.
>
> No argument. But getting screwed is not included.

Somehow, we up here have universal healthcare. Somehow, businesses still make
money. Somehow, most people up here don't view paying tax dollars for public
healthcare as "getting screwed".

Somehow, I think, America will get used to this, just like it got used to the
introduction of the income tax, public schools, and all the other social
programs that go into making for a livable society.

[Joe Bruno]

On Friday, November 9, 2012 3:12:42 PM UTC-8, SkyEyes wrote:
> On Nov 9, 2:36 pm, Joe Bruno <atandy...@gmail.com> wrote:
>
> > On Friday, November 9, 2012 12:06:08 PM UTC-8, MarkA wrote:
>
> > > On Fri, 09 Nov 2012 08:49:19 -0800, Joe Bruno wrote:
>
> >
>
> > > >http://blog.heritage.org/2011/02/17/house-education-and-workforce-com...
>
> >
>
> > > And not having health care is a *people* killer.
>
> >
>
> > > --
>
> >
>
> > People over 65 get Medicare automatically, even without Obummercare.The poor get health care through the Medicaid plan even without Ocare.Working people
>
> > get it through their employers if they choose employers carefully.
>
> >
>
> > I never took a job with any employer who didn't provide health insurance.
>
> > See, I take care of myself in life. I don't want Obannana doing it for me.
>
>
>
> You seem to think that *every* trade or profession had job openings
>
> that offer healthcare. They patently *do not*. I love the way you
>
> use yourself as an example of smart and virtuous planning, when you
>
> haven't a walnut's concept of the fact that millions and millions of
>
> carpenters, waitresses, warehouse workers, and many other trades
>
> *have* to take the first job they're offered and *don't get* offers of
>
> health care with their employment. Not everyone is an accountant,
>
> doctor, banker, or hedge fund manager. Someone has to do the scut
>
> work in the world, and they don't offer health benefits to people who
>
> do it. They don't pay them shit for doing it, either.
>
>
>
> Wake up and take a look at the real world. There are millions of
>
> working poor in this country who *cannot get* healthcare through their
>
> employers.

You missed what I said.


http://www.medicaid.gov/

There are also county hospitals for the poor who have no insurance.
>
>
>

[duke]

On Sun, 11 Nov 2012 00:20:09 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:

>duke <duckg...@cox.net> wrote:
>> On Fri, 9 Nov 2012 19:59:49 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:
>>
>>>duke <duckg...@cox.net> wrote:
>>>> On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav <sbal...@alburg.net> wrote:
>>>>
>>>>>Joe Bruno <atan...@gmail.com> wrote:
>>>>>> http://blog.heritage.org/2011/02/17/house-education-and-workforce-committee-obamacare-is-a-job-killer/
>>>>>
>>>>>From the article:
>>>>>
>>>>>"The overriding message of the hearing was that several provisions of Obamacare
>>>>>will make it more difficult for employers to create new jobs and expand their
>>>>>businesses."
>>>>
>>>>>Well, sure. Some businesses may have a more difficult time expanding if
>>>>>they're forced to provide for the wellbeing of their employees.
>>
>>>> They don't if reduced to under 30 Hrs per week. Guess what's coming and what a
>>>> 25% cut in pay and no benefits means for the many.

>>>That's fine. If businesses starve everyone out, they'll have no one to buy
>>>their products and services, and will go bankrupt.

>> Nope, people will still eat.

>I didn't mean starve, literally, duke. I meant cut everyone's pay to the point
>where people don't have disposable income to buy goods that companies sell.

And I was thinking of the low wage workers at a McDonald's, as an example. Mac's
got a pass for massa bama's health care, but they could go another way. They
could declare all counter/cooks/etc as part time, assign each to a new store
every few weeks, cut out any benefits, etc. They could "sell" each store to a
corporation, cutting out the 50 worker stipulation. They could contract with
"kelly girls" for all hourly workers. Maybe you work today, maybe you don't.
See, people will still eat. <smile>

How about Walmart, or Target doing that. The ramifications are far reaching.

>What *is* it with theists and their literalism?

A bad comment. It's the fundamentalists that are the "literalists", believing
that every last word in the bible is literal truth.

>>>> A man who spent his own money to start a business does not have to listen to
>>>> massa bama.
>>>He sure doesn't. He does, however, have to live by the law of the land, his
>>>own money notwithstanding.

>> No argument. But getting screwed is not included.

>Somehow, we up here have universal healthcare. Somehow, businesses still make
>money. Somehow, most people up here don't view paying tax dollars for public
>healthcare as "getting screwed".

When I need health care or an operation, I get it immediately.

>Somehow, I think, America will get used to this, just like it got used to the
>introduction of the income tax, public schools, and all the other social
>programs that go into making for a livable society.

The faith based schools are turning out scholars and leaders, and the public
schools are passing a student to the next grade automatically on 2nd fail. Do
you realize that 80% of black kids are born into unmarried families and are
dealing drugs on the streets as children, and believe me, daddy is long gone
quickly. That's what a socialist state produces.

[Fred^44]

Don Kresch <spam...@spamcatch.org> wrote:
>On Fri, 09 Nov 2012 10:44:51 -0800, Christopher A. Lee

>>Yet with a full national health service that would cost a smaller
>>proportion of the GNP
>No, it wouldn't.

Another rightard who thinks that math is "liberally biased."

[WangoTango]

In article <tviq98hq1e6d6daee...@4ax.com>, chrislee95050
@comcast.net says...

> Well, sure. Some businesses may have a more difficult time expanding if
> >they're forced to provide for the wellbeing of their employees.
>
> Yet with a full national health service that would cost a smaller
> proportion of the GNP even big business would have a higher bottom
> line because they wouldn't have to pay for insurance.
>
> Countries like those in Western Europe get better health provision for
> less spending because they don't have all the un-necessary
> bureaucratic overhead due to the insurance companies having to
> renegotiate each and every individual bill for each day in hospital,
> every X-ray, blood test etc before paying the agreed rate because the
> hospital bills at a higher one.

I have provided, what Obamacare refers to as premium health care
packages, for all my employees. As soon as Obamacare passed, they began
jacking rates. It has actually gotten to the point that we are going to
have to downgrade coverage because of the direct cost, AND because we
would no longer get the tax breaks for providing such comprehensive
coverage. Suck on both counts. I am getting fucked both ways.

[WangoTango]

In article <39qq9855hcofjvpg0...@4ax.com>, chrislee95050
@comcast.net says...

The bottom line of *MY* bottom line is, I don't want my workers to be
ill, sick workers aren't at work, *AND* I don't want my people
distracted by money worries because of a VERY sick child, spouse, or
themselves, that hurts productivity. I provide premium health care for
my employees because it is a selfish thing to do.

[WangoTango]

In article <315r9818cl2dtg73p...@4ax.com>,
mddotp...@sbcglobal.net says...

> On Fri, 9 Nov 2012 13:31:13 -0800 (PST), "Syd M."
> <pauldav...@yahoo.com> wrote:
>
> >On Nov 9, 1:35 pm, duke <duckgumb...@cox.net> wrote:
> >> On Fri, 9 Nov 2012 18:11:12 +0000 (UTC), sbalneav <sbaln...@alburg.net> wrote:
> >> >Joe Bruno <atandy...@gmail.com> wrote:
> >> >>http://blog.heritage.org/2011/02/17/house-education-and-workforce-com...
> >>
> >> >From the article:
> >>
> >> >"The overriding message of the hearing was that several provisions of Obamacare
> >> >will make it more difficult for employers to create new jobs and expand their
> >> >businesses."
> >> >Well, sure.  Some businesses may have a more difficult time expanding if
> >> >they're forced to provide for the wellbeing of their employees.
> >>
> >> They don't if reduced to under 30 Hrs per week.  Guess what's coming and what a
> >> 25% cut in pay and no benefits means for the many.
> >>
> >> A man who spent his own money to start a business does not have to listen to
> >> massa bama.
> >>
> >>
> >
> >Found another racist nickname for the president, huh, bigoted Earl?
> >
> >PDW
>
> Earl has never learned enough about business to know that a good
> businessman will do everything possible to avoid using his own money
> to start a business.
>

Well, at least it is the kind of thing the businessmen that got this
country into the shitter would do.

[Mike Painter]

Which, if true, is one of the reasons why a single payer system would
be better.

[Mike Painter]

I take it that you have never applied for a loan, used a credit card,
or obtained any line of credit?
How long did you save before you paid cash for your home?

[MarkA]

There is a *HUGE* gap between being poor enough to qualify for Medicaid,
and being rich enough to be able to afford your own health insurance. One
of the reasons Obamacare is necessary is because that gap is getting wider
and wider.

The OTHER nasty surprise is when you do get sick, and find out what your
health insurance *DOESN'T* cover. America is one of the few
industrialized nations where you can go bankrupt from medical bills even
when you have insurance. It is nothing short of a national disgrace.
>>
>>
>>

--
MarkA

If you can read this, you can stop reading now.

[Don Kresch]

On Mon, 12 Nov 2012 11:37:09 -0800, Mike Painter
<mddotp...@sbcglobal.net> scrawled in blood:

No, it wouldn't be. It would be far worse, what with the
rationing and lack of equipment.

[Dakota]

The idiot Joe Bruno certainly qualifies as a national disgrace.

[Olrik]

I'm never sure if you're a complete ignorant, or a complete moron. So I
*always* file you under «ignorant moron», and I'm **NEVER** disappointed.

Call me «lucky»...

[SkyEyes]

On Nov 12, 11:45 am, WangoTango <Asgar...@mindspring.com> wrote:
> In article <tviq98hq1e6d6daee4mqoe2s2s90ai4...@4ax.com>, chrislee95050

That had nothing to do with Obamacare. The last six years I worked
for the State of Arizona, United Health Care Insurance Company jacked
up the rates so high each year that the State figured they'd better
eat the costs rather than pass them on to the employees. So that's
what we got for six years, instead of Merit or COLA raises: the State
paid for our increased healthcare costs.

[SkyEyes]

On Nov 12, 11:48 am, WangoTango <Asgar...@mindspring.com> wrote:
> In article <39qq9855hcofjvpg0p8p98s0mbib0nh...@4ax.com>, chrislee95050

> @comcast.net says...> On Fri, 09 Nov 2012 15:05:20 -0500, MarkA <nob...@nowhere.invalid>
> > wrote:
>
> > >On Fri, 09 Nov 2012 08:49:19 -0800, Joe Bruno wrote:
>

> > >>http://blog.heritage.org/2011/02/17/house-education-and-workforce-com...

>
> > >And not having health care is a *people* killer.
>
> > Yet it wasn't a job killer in Massachusetts when it was Romneycare.
>
> > Why can't they show any honesty?
>
> The bottom line of *MY* bottom line is, I don't want my workers to be
> ill, sick workers aren't at work, *AND* I don't want my people
> distracted by money worries because of a VERY sick child, spouse, or
> themselves, that hurts productivity.  I provide premium health care for
> my employees because it is a selfish thing to do.

And that's what every savvy businessman will continue to do, even
under Obamacare.

[SkyEyes]

There's no need to state the incredibly obvious. The merely obvious
will do nicely.

[Jeanne Douglas]

In article
<6c8f2cd0-4714-4cf4...@qi8g2000pbb.googlegroups.com>,

That's basically what happened at UC.

--
JD

"Osama Bin Laden is dead and GM is alive."--VP Joseph Biden

[WangoTango]

In article <9qj2a8tese11e9qoh...@4ax.com>,
mddotp...@sbcglobal.net says...

If the single payer system allowed for those that wanted to pay for
better service could do so. The problem with the single payer being the
government is that it brings the control of the health care system into
the same great service as any other government payment system. We
already have health care providers locking out older patients due to the
way the government controls the payments for services rendered.

[WangoTango]

In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...

Why? It is a valid concern. When the government sets the pricing for
treatments, AND what treatments it will pay for, you will have doctors
performing less effective treatments because the government pays for
them, instead of costlier more effective treatments. Certain services
will be staged/rationed based upon how the government controls payments.
The list goes on and on. To assume that, for once, the government will
turn into the bastion of customer service this time for this service, is
to ignore all the crappy service we get from them for everything else.

[WangoTango]

In article <hlwdjsd2-25D016...@news.giganews.com>, hlwdjsd2
@NOSPAMgmail.com says...

Yeah, you're both right. I don't know anything about the amounts and
timing of the cost increases. I just own he joint, I don't actually pay
attention to anything.
Oh, and the 40% penalty/fine/tax that is set to get phased in on
"Cadillac" packages is just a figment of my imagination too.
The entire package is designed to make it all but impossible for small
and medium sized businesses to provide their own health insurance.

The bottom line is, I pay my people too well and have been giving them
too good a health care package for my own good, and I need to fix one,
or the other, at least that's what it is coming down to.

[Don Martin]

On Tue, 13 Nov 2012 17:22:14 -0500, WangoTango
<Asga...@mindspring.com> wrote:

>Why? It is a valid concern. When the government sets the pricing for
>treatments, AND what treatments it will pay for, you will have doctors
>performing less effective treatments because the government pays for
>them, instead of costlier more effective treatments.

You have apparently never heard of the VHA, under which our veterans
outlive their civilian age-mates, and do so in better health. It is a
government system that can actually perform preventive medicine
(physicians paid by insurance companies get paid per "procedure," and
smoking cessation, diet counseling for diabetics, etc. ain't
"procedures."

--

aa #2278 Never mind "proof." Where is your evidence?
BAAWA Chief Assistant to the Assistant Chief Heckler
Fidei defensor (Hon. Antipodean)
The Squeeky Wheel: http://home.comcast.net/~drdonmartin/

[Don Martin]

On Tue, 13 Nov 2012 17:18:23 -0500, WangoTango
<Asga...@mindspring.com> wrote:

>> Which, if true, is one of the reasons why a single payer system would
>> be better.
>>
>If the single payer system allowed for those that wanted to pay for
>better service could do so. The problem with the single payer being the
>government is that it brings the control of the health care system into
>the same great service as any other government payment system. We
>already have health care providers locking out older patients due to the
>way the government controls the payments for services rendered.

What you fear is not the case in Canada, UK, France or other
industrialized countries with single-payer systems. You can buy
private insurance there, and use it with private practitioners. Or
did you have something else in mind?

[Alex W.]

On Tue, 13 Nov 2012 17:22:14 -0500, WangoTango wrote:

> In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...

>> Le 2012-11-12 18:08, Don Kresch a �crit :

Conversely, when private enterprise sets the pricing for
treatments, doctors will have an incentive to choose the most
expensive drugs and procedures. And when for-profit insurers
control payment, services will be rationed based on the limits
set by the insurers.

So how is that better than a state-run healthcare system?

[Olrik]

Le 2012-11-13 17:22, WangoTango a ï¿œcrit :

> In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...

>> Le 2012-11-12 18:08, Don Kresch a ï¿œcrit :

>> *always* file you under ￜignorant moronￜ, and I'm **NEVER** disappointed.
>>
>> Call me ￜluckyￜ...

>
> Why? It is a valid concern. When the government sets the pricing for
> treatments, AND what treatments it will pay for, you will have doctors
> performing less effective treatments because the government pays for
> them, instead of costlier more effective treatments.

Nobody's perfect. Don't you have deductibles? Maximum payments? All
sorts of clauses, exceptions (like pre-existing conditions...), etc.,
etc...?

Besides, I'm not quite sure that every US private insurance policy
covers for new or costlier treatments...

> Certain services
> will be staged/rationed based upon how the government controls payments.

?

> The list goes on and on.

???

> To assume that, for once, the government will
> turn into the bastion of customer service this time for this service, is
> to ignore all the crappy service we get from them for everything else.

??????????????????????

Most, if not all hospitals and clinics are privately owned & operated
here in Canada.

They just send the fucking bill to the government, which reimbursed them.

Nobody here ever sees a bill, nor is confronted with dealing with some
corporations over medical expenses.

But maybe you're part of some elite, and pretend the other half eats cake.

[Alex W.]

On Wed, 14 Nov 2012 01:23:28 -0500, Olrik wrote:

> Le 2012-11-13 17:22, WangoTango a �crit :

>> In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...


>>>

>>> I'm never sure if you're a complete ignorant, or a complete moron. So I

>>> *always* file you under �ignorant moron�, and I'm **NEVER** disappointed.
>>>
>>> Call me �lucky�...

>>
>> Why? It is a valid concern. When the government sets the pricing for
>> treatments, AND what treatments it will pay for, you will have doctors
>> performing less effective treatments because the government pays for
>> them, instead of costlier more effective treatments.
>
> Nobody's perfect. Don't you have deductibles? Maximum payments? All
> sorts of clauses, exceptions (like pre-existing conditions...), etc.,
> etc...?
>
> Besides, I'm not quite sure that every US private insurance policy
> covers for new or costlier treatments...

Try asking them to cover full-time care for a patient with
dementia/Alzheimer. The cost can run into the six figures
annually, for the rest of their (potentially very long) lives.

>
>> Certain services
>> will be staged/rationed based upon how the government controls payments.
>
> ?
>
>> The list goes on and on.
>
> ???
>
>> To assume that, for once, the government will
>> turn into the bastion of customer service this time for this service, is
>> to ignore all the crappy service we get from them for everything else.
>
> ??????????????????????
>
> Most, if not all hospitals and clinics are privately owned & operated
> here in Canada.
>
> They just send the fucking bill to the government, which reimbursed them.
>
> Nobody here ever sees a bill, nor is confronted with dealing with some
> corporations over medical expenses.
>
> But maybe you're part of some elite, and pretend the other half eats cake.

We have the same setup in the UK, and I am not sure it's an
altogether good idea.

People (patients) currently have little to no idea at all about
the costs of the services and treatments they receive and demand.
This can and does lead to unreasonable demands and unrealistic
beliefs. Healthcare costs are already a major cost factor for
every government and society, and all the indications are that
with our increasing lifespan and ever-expanding range of
treatments this cost is going to spiral whatever we do. It
therefore makes sense that the people have at least a correct
appreciation of the costs involved. This is far easier done when
they are made aware on a personal level of the expenses incurred
on their behalf. Politicians and experts talking about billions
here and billions there are just throwing about unreal and
literally unimaginable numbers, but when you know that the drug
you are prescribed costs �19.99 a pill and the x-ray you had is
billed at �149, it brings home the reality of the problems in a
very direct and personal manner.

[MarkA]

As in, "It's a nice day", and, "You're very tall", and "So this is it;
we're all going to die"?

[Don Kresch]

On Wed, 14 Nov 2012 00:30:27 +0000, "Alex W." <ing...@yahoo.co.uk>
scrawled in blood:

>Conversely, when private enterprise sets the pricing for
>treatments, doctors will have an incentive to choose the most
>expensive drugs and procedures.

So why is Wal-Mart cheaper than most department stores?

Yeah, you really need to learn how prices are set.

And privately-run is always better than the intiatory force
(of which includes theft, rape, and murder) of government.

[WangoTango]

In article <ldg28mbmjm5j$.125qe3txrpyxf$.d...@40tude.net>,
ing...@yahoo.co.uk says...

> On Tue, 13 Nov 2012 17:22:14 -0500, WangoTango wrote:
>
> > In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...

First and foremost, they can't hide behind Sovereign Immunity, and that
completely limits a citizen's right to address grievances.

[WangoTango]

In article <k7vddq$r7e$1...@dont-email.me>, olri...@yahoo.com says...

> Le 2012-11-13 17:22, WangoTango a écrit :
> > In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...

> >> *always* file you under «ignorant moron», and I'm **NEVER** disappointed.
> >>
> >> Call me «lucky»...

> >
> > Why? It is a valid concern. When the government sets the pricing for
> > treatments, AND what treatments it will pay for, you will have doctors
> > performing less effective treatments because the government pays for
> > them, instead of costlier more effective treatments.
>
> Nobody's perfect. Don't you have deductibles? Maximum payments? All
> sorts of clauses, exceptions (like pre-existing conditions...), etc.,
> etc...?

Sure, our plan has a modest co-pay.

>
> Besides, I'm not quite sure that every US private insurance policy
> covers for new or costlier treatments...

The bottom line is I can go after my insurance company in ways that I
could NEVER pressure the government with.

>
> > Certain services
> > will be staged/rationed based upon how the government controls payments.
>
> ?
>
> > The list goes on and on.
>
> ???
>
> > To assume that, for once, the government will
> > turn into the bastion of customer service this time for this service, is
> > to ignore all the crappy service we get from them for everything else.
>
> ??????????????????????

Wow, ??????, really?
I only needed one.

>
> Most, if not all hospitals and clinics are privately owned & operated
> here in Canada.
>
> They just send the fucking bill to the government, which reimbursed them.

Do you have any idea what kind of time scale that takes, and how much
they paid?
Do you even know if you were denied a treatment that may have been less
intrusive, more effective, or what ever based upon that payment?

>
> Nobody here ever sees a bill, nor is confronted with dealing with some
> corporations over medical expenses.

Sure, and see above. What you don't know, really what *YOU* appear to
not care about, is the exact point I am making.

>
> But maybe you're part of some elite, and pretend the other half eats cake.

Just a normal small business owner.

[Alex W.]

On Wed, 14 Nov 2012 13:24:37 -0500, WangoTango wrote:

> In article <ldg28mbmjm5j$.125qe3txrpyxf$.d...@40tude.net>,
> ing...@yahoo.co.uk says...
>> On Tue, 13 Nov 2012 17:22:14 -0500, WangoTango wrote:
>>
>>> In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...

>>>> Le 2012-11-12 18:08, Don Kresch a �crit :

You should come over and take a look for yourself. Sovereign
immunity? They wish. No-one has immunity from the court of
public opinion, and neither medical nor legal facts matter one
whit when you have a sobbing relative or suitably pitiable ill
person in front of the cameras telling how they (or their beloved
relative) are being denied proper treatment or were made the
victim of some outrageous malpractice or negligence. There's no
need to hire a lawyer, nor even to have a legal case.

Not to mention that there are office blocks full of tribunals,
ombudsmen and arbitration committees whose only job it is to hear
and address healthcare-related grievances. None of which, as it
happens, stops anyone from hiring a lawyer and suing the NHS.

[Mike Painter]

On Tue, 13 Nov 2012 18:18:18 -0500, Don Martin
<drdon...@comcast.net> wrote:

>On Tue, 13 Nov 2012 17:22:14 -0500, WangoTango
><Asga...@mindspring.com> wrote:
>
>>Why? It is a valid concern. When the government sets the pricing for
>>treatments, AND what treatments it will pay for, you will have doctors
>>performing less effective treatments because the government pays for
>>them, instead of costlier more effective treatments.
>
>You have apparently never heard of the VHA, under which our veterans
>outlive their civilian age-mates, and do so in better health. It is a
>government system that can actually perform preventive medicine
>(physicians paid by insurance companies get paid per "procedure," and
>smoking cessation, diet counseling for diabetics, etc. ain't
>"procedures."

One of the reasons medical costs are so high is the competitive nature
of the business.
Hospital A gets the latest MRI machine, so hospital B buys the latest
model to keep up.

In many cases there may not be enough referrals to keep even one
machine busy but the hospitals do not cooperate with each other, they
may loose business.
Somebody has to pay for them.
So if the machines are not being used at their projected rate then
prices must increase.

[Mike Painter]

On Wed, 14 Nov 2012 08:51:33 -0600, Don Kresch
<spam...@spamcatch.org> wrote:

> So why is Wal-Mart cheaper than most department stores?

Higher volume, cheaper goods, and for the most part less pay for
employees.

>
> Yeah, you really need to learn how prices are set.
>
> And privately-run is always better than the intiatory force
>(of which includes theft, rape, and murder) of government.

Just keep repeating this and even you may believe it some day.

[Mike Painter]

On Tue, 13 Nov 2012 17:18:23 -0500, WangoTango
<Asga...@mindspring.com> wrote:

>

>If the single payer system allowed for those that wanted to pay for
>better service could do so. The problem with the single payer being the
>government is that it brings the control of the health care system into
>the same great service as any other government payment system. We
>already have health care providers locking out older patients due to the
>way the government controls the payments for services rendered.

They do that for the uninsured and younger people on Medicare also.
If there was a single payer system those doctors that refused the
lower payments could find other jobs.
Today they don't have to.
In this area most doctors work 9 - 5.
If you get sick after hours, you go to the ER and if admitted to a
hospital, the entire case may be turned over to somebody in house.

[Alex W.]

On Wed, 14 Nov 2012 16:04:07 -0800, Mike Painter wrote:

> On Tue, 13 Nov 2012 17:18:23 -0500, WangoTango
> <Asga...@mindspring.com> wrote:
>
>>
>>If the single payer system allowed for those that wanted to pay for
>>better service could do so. The problem with the single payer being the
>>government is that it brings the control of the health care system into
>>the same great service as any other government payment system. We
>>already have health care providers locking out older patients due to the
>>way the government controls the payments for services rendered.
>
> They do that for the uninsured and younger people on Medicare also.
> If there was a single payer system those doctors that refused the
> lower payments could find other jobs.
> Today they don't have to.
> In this area most doctors work 9 - 5.
> If you get sick after hours, you go to the ER and if admitted to a
> hospital, the entire case may be turned over to somebody in house.

Current average earnings for a British general practitioner
amounts to US175,000 per year. That's their own earnings, not
practice revenues. So much for "lower payments"....

[Olrik]

Le 2012-11-14 09:51, Don Kresch a écrit :
> On Wed, 14 Nov 2012 00:30:27 +0000, "Alex W." <ing...@yahoo.co.uk>
> scrawled in blood:
>
>
>> Conversely, when private enterprise sets the pricing for
>> treatments, doctors will have an incentive to choose the most
>> expensive drugs and procedures.
>
> So why is Wal-Mart cheaper than most department stores?

They're relentlessly anti-humans.

> Yeah, you really need to learn how prices are set.

Do you know how prices are set?

> And privately-run is always better than the intiatory force
> (of which includes theft, rape, and murder) of government.

I hope thinking that way helps you sleep better at night.

[Olrik]

Le 2012-11-14 07:31, Alex W. a �crit :

I think that whatever the system, where health is concerned, people will
always ask for perfection, miracles and �unreasonable demands and
unrealistic beliefs�...

> Healthcare costs are already a major cost factor for
> every government and society, and all the indications are that
> with our increasing lifespan and ever-expanding range of
> treatments this cost is going to spiral whatever we do. It
> therefore makes sense that the people have at least a correct
> appreciation of the costs involved. This is far easier done when
> they are made aware on a personal level of the expenses incurred
> on their behalf. Politicians and experts talking about billions
> here and billions there are just throwing about unreal and
> literally unimaginable numbers, but when you know that the drug
> you are prescribed costs �19.99 a pill and the x-ray you had is
> billed at �149, it brings home the reality of the problems in a
> very direct and personal manner.

But does it change anything? *What* if my x-ray costs ��149�? How am I
able to compare it to? People can tell if they're overcharged when they
know what to compare, say the price of a hospital meal, or a simple
procedure.

[Olrik]

Le 2012-11-14 13:30, WangoTango a ï¿œcrit :

> In article <k7vddq$r7e$1...@dont-email.me>, olri...@yahoo.com says...

>> Le 2012-11-13 17:22, WangoTango a ï¿œcrit :

>>> In article <k7sj1v$g0c$1...@dont-email.me>, olri...@yahoo.com says...

>>>> Le 2012-11-12 18:08, Don Kresch a ï¿œcrit :

>>>> *always* file you under ￜignorant moronￜ, and I'm **NEVER** disappointed.
>>>>
>>>> Call me ￜluckyￜ...

>>>
>>> Why? It is a valid concern. When the government sets the pricing for
>>> treatments, AND what treatments it will pay for, you will have doctors
>>> performing less effective treatments because the government pays for
>>> them, instead of costlier more effective treatments.
>>
>> Nobody's perfect. Don't you have deductibles? Maximum payments? All
>> sorts of clauses, exceptions (like pre-existing conditions...), etc.,
>> etc...?
>
> Sure, our plan has a modest co-pay.

Define ￜmodestￜ, and how does it measure against your worker's salary...

>>
>> Besides, I'm not quite sure that every US private insurance policy
>> covers for new or costlier treatments...
> The bottom line is I can go after my insurance company in ways that I
> could NEVER pressure the government with.

You make the same mistake as a lot of people do: our health-care
services are provided by **private** entities. **They** are paid by the
government (and donations, etc.), so you can go after them if you have
grievances.

>>
>>> Certain services
>>> will be staged/rationed based upon how the government controls payments.
>>
>> ?
>>
>>> The list goes on and on.
>>
>> ???
>>
>>> To assume that, for once, the government will
>>> turn into the bastion of customer service this time for this service, is
>>> to ignore all the crappy service we get from them for everything else.
>>
>> ??????????????????????
>
> Wow, ??????, really?
> I only needed one.

I'm not sure about that...

;-)

>>
>> Most, if not all hospitals and clinics are privately owned & operated
>> here in Canada.
>>
>> They just send the fucking bill to the government, which reimbursed them.
> Do you have any idea what kind of time scale that takes, and how much
> they paid?

No... Again: ??

Should I worry about that?

> Do you even know if you were denied a treatment that may have been less
> intrusive, more effective, or what ever based upon that payment?

How would *you* know even in a private system? Are you a doctor?

>>
>> Nobody here ever sees a bill, nor is confronted with dealing with some
>> corporations over medical expenses.
> Sure, and see above. What you don't know, really what *YOU* appear to
> not care about, is the exact point I am making.

Your point seems to be that patients should be their own doctors, at the
top of their fields and with perfect knowledge about all the treatments
possible.

[Alex W.]

On Wed, 14 Nov 2012 23:33:52 -0500, Olrik wrote:

> Le 2012-11-14 07:31, Alex W. a �crit :
>> On Wed, 14 Nov 2012 01:23:28 -0500, Olrik wrote:
>>
>>> Le 2012-11-13 17:22, WangoTango a �crit :

>>> Most, if not all hospitals and clinics are privately owned & operated
>>> here in Canada.
>>>
>>> They just send the fucking bill to the government, which reimbursed them.
>>>
>>> Nobody here ever sees a bill, nor is confronted with dealing with some
>>> corporations over medical expenses.
>>>
>>> But maybe you're part of some elite, and pretend the other half eats cake.
>>
>> We have the same setup in the UK, and I am not sure it's an
>> altogether good idea.
>>
>> People (patients) currently have little to no idea at all about
>> the costs of the services and treatments they receive and demand.
>> This can and does lead to unreasonable demands and unrealistic
>> beliefs.
>
> I think that whatever the system, where health is concerned, people will
> always ask for perfection, miracles and �unreasonable demands and
> unrealistic beliefs�...

That goes without saying.

However, this is no excuse for not bothering to make an effort to
inform the public as to the basic facts. It would at least move
the irrationality to a different level.

>
>> Healthcare costs are already a major cost factor for
>> every government and society, and all the indications are that
>> with our increasing lifespan and ever-expanding range of
>> treatments this cost is going to spiral whatever we do. It
>> therefore makes sense that the people have at least a correct
>> appreciation of the costs involved. This is far easier done when
>> they are made aware on a personal level of the expenses incurred
>> on their behalf. Politicians and experts talking about billions
>> here and billions there are just throwing about unreal and
>> literally unimaginable numbers, but when you know that the drug
>> you are prescribed costs �19.99 a pill and the x-ray you had is
>> billed at �149, it brings home the reality of the problems in a
>> very direct and personal manner.
>
> But does it change anything? *What* if my x-ray costs ��149�? How am I
> able to compare it to? People can tell if they're overcharged when they
> know what to compare, say the price of a hospital meal, or a simple
> procedure.

It's a start.
It allows you to ask why this procedure costs so much, which
introduces at least the glimmerings of transparency.

It may also deter patients from frivolous use of the system,
which is really where so much wastage occurs. People do NOT need
a full course of antibiotics for every cold and 'flu. They do
NOT need x-rays for every sprained ankle. When patients have
private insurance and see the bills they incur, they ten to be a
bit more careful about the services they use, even if they get
most or all of their money reimbursed.

[Don Martin]

Olrik <olri...@yahoo.com> wrote:

> Le 2012-11-14 07:31, Alex W. a écrit :
>> On Wed, 14 Nov 2012 01:23:28 -0500, Olrik wrote:

( snippage )

>> People (patients) currently have little to no idea at all about
>> the costs of the services and treatments they receive and demand.
>> This can and does lead to unreasonable demands and unrealistic
>> beliefs.
>
> I think that whatever the system, where health is concerned, people will
> always ask for perfection, miracles and «unreasonable demands and unrealistic beliefs»...

In my work, I see all sorts of cases of people complaining bitterly that
"you killed my daddy/husband/grandpa," etc. When the body in question was
84, weighed over 300 pounds, and had been doing 2 packs of cigarettes a day
since 1943, it is not terribly surprising that it was not in terribly good
shape on arrival and expired under the stress of a team of nurses
attempting to turn it over in bed to prevent bedsores. one comes to
suspect that daddy/husband/grandpa had been brought in by the family in
hopes of a tort claim, but they would deny that vigorously while claiming
that they were only seeking the best possible care for
daddy/husband/grandpa.

>> Healthcare costs are already a major cost factor for
>> every government and society, and all the indications are that
>> with our increasing lifespan and ever-expanding range of
>> treatments this cost is going to spiral whatever we do. It
>> therefore makes sense that the people have at least a correct
>> appreciation of the costs involved. This is far easier done when
>> they are made aware on a personal level of the expenses incurred
>> on their behalf. Politicians and experts talking about billions
>> here and billions there are just throwing about unreal and
>> literally unimaginable numbers, but when you know that the drug
>> you are prescribed costs £19.99 a pill and the x-ray you had is
>> billed at £149, it brings home the reality of the problems in a
>> very direct and personal manner.
>
> But does it change anything? *What* if my x-ray costs «£149»? How am I
> able to compare it to? People can tell if they're overcharged when they
> know what to compare, say the price of a hospital meal, or a simple procedure.

For my 1-day stay in hospital, the bill showed a charge for my routine
medications (BP, chloresterol control) equal to what I pay for the stuff in
a month.

[Mike Painter]

On Wed, 14 Nov 2012 13:24:37 -0500, WangoTango

<Asga...@mindspring.com> wrote:

>
>> Conversely, when private enterprise sets the pricing for
>> treatments, doctors will have an incentive to choose the most
>> expensive drugs and procedures. And when for-profit insurers
>> control payment, services will be rationed based on the limits
>> set by the insurers.
>>
>> So how is that better than a state-run healthcare system?
>
>First and foremost, they can't hide behind Sovereign Immunity, and that
>completely limits a citizen's right to address grievances.
>

Not sure where exactly you are posting from but most countries have
this thing where they elect their officials.
Voting is a lot cheaper than coming up with $10,000.00 cash to get a
law suit started so you can address a grievance.

[Mike Painter]

On Wed, 14 Nov 2012 23:33:52 -0500, Olrik <olri...@yahoo.com> wrote:

>
>I think that whatever the system, where health is concerned, people will
>always ask for perfection, miracles and «unreasonable demands and
>unrealistic beliefs»...

I disagree on this. They may want it, but most people put their faith
in their doctor and do little to find out how competent he or she is.

Doctors follow normal curves and a fair number of them are bad and
some are scary bad.

Sadly many of the really good ones are arrogant and offend people.

Many years ago a friend broke off in mid-sentence and said "Dr C (his
father in law) must be a really good doctor."
I asked why and he said that all the nurses and others he worked with
both hated and feared him. He was a screamer and thrower of sharp
instruments in the OR. But he had never heard anybody talk about his
practice of medicine.

[Mike Painter]

On Wed, 14 Nov 2012 13:30:18 -0500, WangoTango
<Asga...@mindspring.com> wrote:

>
>> They just send the fucking bill to the government, which reimbursed them.
>Do you have any idea what kind of time scale that takes, and how much
>they paid?

No, and neither do they. They get paid a salary, and I suspect the
government pays the bills for the office, clinic, staff, equipment,
etc.
A fair number of American doctors do this also. They pay a monthly fee
to essentially rent everything they need.

>Do you even know if you were denied a treatment that may have been less
>intrusive, more effective, or what ever based upon that payment?

Based on what friends who qualify for VA services say, the answer is
no.
The staff, if anything, tends to order more testing than what others
do.

[WangoTango]

In article <5qfq5litr165$.6ae3xv4ysir7$.d...@40tude.net>,
ing...@yahoo.co.uk says...

>
> > First and foremost, they can't hide behind Sovereign Immunity, and that
> > completely limits a citizen's right to address grievances.
>
> You should come over and take a look for yourself. Sovereign
> immunity? They wish. No-one has immunity from the court of
> public opinion,
>

Yeah, and that and 25cents will get you a cup of coffee.

Just how much is the average judgement when you win in the court of
public opinion?

[WangoTango]

In article <btbaa81lm82vo7r0v...@4ax.com>,
mddotp...@sbcglobal.net says...

> On Wed, 14 Nov 2012 13:24:37 -0500, WangoTango
> <Asga...@mindspring.com> wrote:
>
> >
> >> Conversely, when private enterprise sets the pricing for
> >> treatments, doctors will have an incentive to choose the most
> >> expensive drugs and procedures. And when for-profit insurers
> >> control payment, services will be rationed based on the limits
> >> set by the insurers.
> >>
> >> So how is that better than a state-run healthcare system?
> >
> >First and foremost, they can't hide behind Sovereign Immunity, and that
> >completely limits a citizen's right to address grievances.
> >
> Not sure where exactly you are posting from but most countries have
> this thing where they elect their officials.
> Voting is a lot cheaper than coming up with $10,000.00 cash to get a
> law suit started so you can address a grievance.

I can see the T-shirts now.
My mommy died from government incompetence and all I got was another
election.
Not sure exactly where you are posting from, but if a lawsuit was $10K
to start, there would be a shit load less lawsuits.

[Alex W.]

On Thu, 15 Nov 2012 10:19:02 -0800, Mike Painter wrote:

> On Wed, 14 Nov 2012 23:33:52 -0500, Olrik <olri...@yahoo.com> wrote:
>
>>
>>I think that whatever the system, where health is concerned, people will
>>always ask for perfection, miracles and �unreasonable demands and
>>unrealistic beliefs�...
>
> I disagree on this. They may want it, but most people put their faith
> in their doctor and do little to find out how competent he or she is.
>
> Doctors follow normal curves and a fair number of them are bad and
> some are scary bad.
>
> Sadly many of the really good ones are arrogant and offend people.
>
> Many years ago a friend broke off in mid-sentence and said "Dr C (his
> father in law) must be a really good doctor."
> I asked why and he said that all the nurses and others he worked with
> both hated and feared him. He was a screamer and thrower of sharp
> instruments in the OR. But he had never heard anybody talk about his
> practice of medicine.

It's a problem.
How to determine a good doctor?

Does one rank them according to how much they charge? Which
brings up the issue of deciding whether more expensive means
better (or worse).

Do we look at how often they get sued or have insurance claims
against them? Given that most claims (legal and insurance) are
settled out of court and with non-disclosure claims, there is
little chance of finding meaningful data on that score. Nor
indeed whether this is itself meaningful: some specialities
simply attract more lawsuits than others, notably ER doctors and
Ob/Gyn.

Do we check on their success rate of cured patients? That begs
the question how to define "cured". Some diseases have no cure,
other specialities like oncology have one-year to five-year
limits.

How about the rate of patients who died during treatment? Again,
that depends on the speciality. It may also well be the case
that a doctor with truly terrible survival rates is in fact the
best in the field and all the desperate last-gasp patients are
referred to him as one last attempt at a miracle.

Then there's the yardstick of their activism in their chosen
field: how many papers were written, how many symposia addressed,
how often quoted in the literature. But all that really
indicates is that he may well be too busy researching to have
much time or experience with patients, or even that he has a
liking for junkets funded by Big Pharma.

I suppose one could have a ranking website along the lines of
tripadvisor.com: patients post comments and reviews of their
physician's performance. But then you'd be relying on the
judgment of disembodied anonymous voices on the internet.

So what would be a useful objective measure of what makes a good
doctor, suitable for treating yourself or your family?

[Alex W.]

So your priority is to make as much money as possible?

Not over here. When a stink is raised, the aim is usually to put
pressure on the system to authorise and undertake a desired
course of treatment, or to force a doctor or hospital to address
faults and shortcomings in their system of patient care. If
granny dies because she was given 100 times the prescribed dose,
a British family tends not to go for the big payout but to try
and make them change procedures so that the next granny doesn't
suffer the same fate.

The perverse thing is that if you reduce it all down to trying
for as big a payout as possible, there is an incentive to wait
for or even force a fault. The doctor does his job and cures
auntie, she lives but there's no jackpot -- quite the opposite,
there will be large bills to pay. Wait for the doctor to mess
up, and that's the mortgage and the college fund for the entire
family sorted. This sends entirely the wrong signal, IMO.

[Mike Painter]

On Fri, 16 Nov 2012 00:31:02 +0000, "Alex W." <ing...@yahoo.co.uk>
wrote:

> If
>granny dies because she was given 100 times the prescribed dose,
>a British family tends not to go for the big payout but to try
>and make them change procedures so that the next granny doesn't
>suffer the same fate.

Hospitals over here have finally stopped fighting and started
admitting they are human, make mistakes, will try to do better and are
sorry.
The results have been huge drops in law suits.
Turns out that people wanted to hear the truth.

Of course, except for the shoe, we don't have any Dr Martins here.;)

[Mike Painter]

On Thu, 15 Nov 2012 16:01:36 -0500, WangoTango
<Asga...@mindspring.com> wrote:

>
>I can see the T-shirts now.
>My mommy died from government incompetence and all I got was another
>election.
>Not sure exactly where you are posting from, but if a lawsuit was $10K
>to start, there would be a shit load less lawsuits.

You are absolutely right, there would be fewer lawsuits and absolutely
no incentive for any change.
10k is about the same as letting a murderer off with a warning to be
quiet next time.

[Mike Painter]

On Fri, 16 Nov 2012 00:24:50 +0000, "Alex W." <ing...@yahoo.co.uk>
wrote:

>

>Do we check on their success rate of cured patients? That begs
>the question how to define "cured". Some diseases have no cure,
>other specialities like oncology have one-year to five-year
>limits.

All good points.
This one is interesting because many of the best hospitals and doctors
have higher death rates than the average.
Those at the top of the game get a lot more cases where they are just
the last resort.

[Olrik]

Le 2012-11-15 08:08, Alex W. a écrit :
> On Wed, 14 Nov 2012 23:33:52 -0500, Olrik wrote:
>

You say it is «so much»... Maybe it's cheap, considering the technology
involved, or whatever. That was my question: how do you know if a test
is too expensive or not important?

> which introduces at least the glimmerings of transparency.
>
> It may also deter patients from frivolous use of the system,

What's that? IMO, you can only judge if it's «frivolous» after the fact.

> which is really where so much wastage occurs. People do NOT need
> a full course of antibiotics for every cold and 'flu. They do
> NOT need x-rays for every sprained ankle.

That's for a *doctor* to determine that.

> When patients have
> private insurance and see the bills they incur, they ten to be a
> bit more careful about the services they use, even if they get
> most or all of their money reimbursed.

People are not doctors.

[SkyEyes]

On Nov 15, 1:57 pm, WangoTango <Asgar...@mindspring.com> wrote:

> Yeah, and that and 25cents will get you a cup of coffee.

Where?

Brenda Nelson, A.A.#34 and A+ atheist
BAAWA Knight of the Golden Litterbox
EAC Professor of Feline Thermometrics and Cat-Herding
skyeyes nine at cox dot net OR
skyeyes nine at yahoo dot com

[Alex W.]

On Fri, 16 Nov 2012 00:00:08 -0500, Olrik wrote:

> Le 2012-11-15 08:08, Alex W. a écrit :


>>>> Healthcare costs are already a major cost factor for
>>>> every government and society, and all the indications are that
>>>> with our increasing lifespan and ever-expanding range of
>>>> treatments this cost is going to spiral whatever we do. It
>>>> therefore makes sense that the people have at least a correct
>>>> appreciation of the costs involved. This is far easier done when
>>>> they are made aware on a personal level of the expenses incurred
>>>> on their behalf. Politicians and experts talking about billions
>>>> here and billions there are just throwing about unreal and
>>>> literally unimaginable numbers, but when you know that the drug
>>>> you are prescribed costs £19.99 a pill and the x-ray you had is
>>>> billed at £149, it brings home the reality of the problems in a
>>>> very direct and personal manner.
>>>
>>> But does it change anything? *What* if my x-ray costs «£149»? How am I
>>> able to compare it to? People can tell if they're overcharged when they
>>> know what to compare, say the price of a hospital meal, or a simple
>>> procedure.
>>
>> It's a start.
>> It allows you to ask why this procedure costs so much,
>
> You say it is «so much»... Maybe it's cheap, considering the technology
> involved, or whatever. That was my question: how do you know if a test
> is too expensive or not important?

Importance is a clinical criterion: it's between you and your
doctor.

Price, however, and how appropriate it is, is not a medical
question. If we do not have the basic knowledge of prices, there
is no way at all to even begin to determine whether they are
fair, cheap or expensive. Americans who come over the border to
have their prescription filled in Canada can only do so because
they have been given the price of their drug. At the very least,
transparency of prices will let us make comparisons and begin to
ask questions -- the foundation of true accountability. "Why is
it that the cost of one intensive-care bed is C$250,000 in
Toronto but only C$175,000 in Quebec" is a good way to start
forcing both patients and healthcare administrators to think
about how, where and why they allocate resources.

>
>> which introduces at least the glimmerings of transparency.
>>
>> It may also deter patients from frivolous use of the system,
>
> What's that? IMO, you can only judge if it's «frivolous» after the fact.

Heavens, no. When someone comes into the surgery demanding a
full course of antibiotics (and possibly antivirals as well)
because they have a cold, that's clearly frivolous. When someone
insists on a CAT scan every time they have a headache, that's
frivolous. When someone has persistent backache but rather than
losing 50lb of weight from around the midriff insists on x-rays,
osteopathy, acupuncture, massage and painkilling injections --
that's frivolous. All of these, I am citing from personal
knowledge, and I would be willing to bet next month's cigar
allowance that any doctor will be able to give you 50 more
examples without having to think.

>
>> which is really where so much wastage occurs. People do NOT need
>> a full course of antibiotics for every cold and 'flu. They do
>> NOT need x-rays for every sprained ankle.
>
> That's for a *doctor* to determine that.

Doctor yes, full workup no.
But the power of doctors to resist is not unlimited, and when
faced with 20 patients a day of whom a fair proportion will make
persistent and extra demands (sometimes on the back of threats
like "... or I will sue you"), many give in and order the
procedure or write the scrip, just to shut up the bugger.

>
>> When patients have
>> private insurance and see the bills they incur, they ten to be a
>> bit more careful about the services they use, even if they get
>> most or all of their money reimbursed.
>
> People are not doctors.

They are not, but they are responsible for their own decisions
and actions. That is why a doctor cannot order any procedure on
his own, he needs the consent of the patient (or a relative).
That is why we choose our doctors (this service may not be
available in your jurisdiction) and why it is our decision
whether to see the doctor or not (hmmm, funny lumps on my
testicles, I wonder what that means).

[Alex W.]

On Thu, 15 Nov 2012 22:43:12 -0800 (PST), SkyEyes wrote:

> On Nov 15, 1:57�pm, WangoTango <Asgar...@mindspring.com> wrote:
>
>> Yeah, and that and 25cents will get you a cup of coffee.
>
> Where?

More importantly, why?
At those prices, you won't get coffee but rather java, or even
joe. Life's too precious to poison it with that sort of muck.

[Alex W.]

On Thu, 15 Nov 2012 17:35:57 -0800, Mike Painter wrote:

> On Fri, 16 Nov 2012 00:31:02 +0000, "Alex W." <ing...@yahoo.co.uk>
> wrote:
>
>> If
>>granny dies because she was given 100 times the prescribed dose,
>>a British family tends not to go for the big payout but to try
>>and make them change procedures so that the next granny doesn't
>>suffer the same fate.
>
> Hospitals over here have finally stopped fighting and started
> admitting they are human, make mistakes, will try to do better and are
> sorry.
> The results have been huge drops in law suits.
> Turns out that people wanted to hear the truth.

If you set up a system to be fundamentally confrontational, the
confrontation is what you will get.

>
> Of course, except for the shoe, we don't have any Dr Martins here.;)

Seriously? No Dr Martens?
Talk about a third-world country....

[Olrik]

Le 2012-11-16 04:36, Alex W. a �crit :

> On Fri, 16 Nov 2012 00:00:08 -0500, Olrik wrote:
>

>> Le 2012-11-15 08:08, Alex W. a �crit :

Well, as a Canadian, I do know the price of my drugs because I have to
pay for them. But when I was being treated for my cardiac infarction,
they did not provided me with the prices of every single actions they
made. And I wouldn't have been in a position to chose, veto or otherwise
comment on those actions.

> At the very least, transparency of prices will let us make comparisons and begin to
> ask questions -- the foundation of true accountability. "Why is
> it that the cost of one intensive-care bed is C$250,000 in
> Toronto but only C$175,000 in Quebec" is a good way to start
> forcing both patients and healthcare administrators to think
> about how, where and why they allocate resources.

That's an interesting question by itself, and it should be throughly
investigated. However, when strapped to a bed facing death (me), or
dealing with a bizarre kidney ailment (my girlfriend) or a rather rare
form of cancer (my mom), cost effectiveness is the least of your
concerns, knowing that, all in all, from what one's heard about the
system, they treat you with the best treatment available.

>>
>>> which introduces at least the glimmerings of transparency.
>>>
>>> It may also deter patients from frivolous use of the system,
>>
>> What's that? IMO, you can only judge if it's �frivolous� after the fact.
>
> Heavens, no. When someone comes into the surgery demanding a
> full course of antibiotics (and possibly antivirals as well)
> because they have a cold, that's clearly frivolous.
> When someone insists on a CAT scan every time they have a headache, that's
> frivolous.

But does that happen often?

I know that there are people abusing the system, but that's not
significant overall.

I might add that in my case, if I were to have a long and miserable
cold, or a severe headache, I'd ask for every test in the books, because
I never experience any of those ailments.

> When someone has persistent backache but rather than
> losing 50lb of weight from around the midriff insists on x-rays,
> osteopathy, acupuncture, massage and painkilling injections --
> that's frivolous.

Is it? You seem to draw your conclusions and opinions from known frauds
or stories you've heard about.

> All of these, I am citing from personal
> knowledge, and I would be willing to bet next month's cigar
> allowance that any doctor will be able to give you 50 more
> examples without having to think.
>>
>>> which is really where so much wastage occurs. People do NOT need
>>> a full course of antibiotics for every cold and 'flu. They do
>>> NOT need x-rays for every sprained ankle.
>>
>> That's for a *doctor* to determine that.
>
> Doctor yes, full workup no.
> But the power of doctors to resist is not unlimited, and when
> faced with 20 patients a day of whom a fair proportion will make
> persistent and extra demands (sometimes on the back of threats
> like "... or I will sue you"), many give in and order the
> procedure or write the scrip, just to shut up the bugger.
>
>
>>
>>> When patients have
>>> private insurance and see the bills they incur, they ten to be a
>>> bit more careful about the services they use, even if they get
>>> most or all of their money reimbursed.
>>
>> People are not doctors.
>
> They are not, but they are responsible for their own decisions
> and actions. That is why a doctor cannot order any procedure on
> his own, he needs the consent of the patient (or a relative).

But that's only about legal matters, not about medical knowledge.

> That is why we choose our doctors (this service may not be
> available in your jurisdiction)

Of course we can chose our own doctors. But that's not always possible
and not always the best course of action.

> and why it is our decision
> whether to see the doctor or not (hmmm, funny lumps on my
> testicles, I wonder what that means).

It means you like to play with yourself. Willing to tell that to your
doctor?

;-)

[Jeanne Douglas]

In article <k878b4$121$1...@dont-email.me>, Olrik <olri...@yahoo.com>
wrote:

Why not? I don't lie to my doctor; what sane person would?

--
JD

"Osama Bin Laden is dead and GM is alive."--VP Joseph Biden

[Alex W.]

On Fri, 16 Nov 2012 22:17:24 -0800, Jeanne Douglas wrote:

> In article <k878b4$121$1...@dont-email.me>, Olrik <olri...@yahoo.com>
> wrote:
>

>> Le 2012-11-16 04:36, Alex W. a �crit :

>>> On Fri, 16 Nov 2012 00:00:08 -0500, Olrik wrote:
>>>

>>>> Le 2012-11-15 08:08, Alex W. a �crit :

Without wishing to go all "House" on you, but that's a pretty
naive view of human nature, Jeanne.

How many cigarettes do you smoke, madam?
How many sexual partners do you have?
Have you always used protection during intercourse?
Do you exercise?
How much alcohol do you drink?
Are you watching your intake of fatty foods?
Have you taken the course of pills as I prescribed?

All of the above are questions to which the answers are as likely
to be lies or fudges as the truth.

heck, I am about to go and visit my grandmother who has been
running (well, hobbling) to her doctor twice a week for the past
ten years or so -- for human contact as much for medical advice
-- and who has steadfastly refused to disclose any hint of her
full-blown age-related depression because that would be
*embarrassing*. Osteoporosis, bladder control issues, "women's
troubles", fainting spells -- any of that is perfectly
admissible, but any hint of mental infirmity is not the be
admitted to at any cost.

She is not alone in this.

[Jeanne Douglas]

In article <ww4nqwujn8ei.e...@40tude.net>,

Nope. I tell her the truth on every single one of these.

Anybody who lies to his doctor is a complete and total moron. It's
embarrassing, sometimes, but my health is far more important.

> heck, I am about to go and visit my grandmother who has been
> running (well, hobbling) to her doctor twice a week for the past
> ten years or so -- for human contact as much for medical advice
> -- and who has steadfastly refused to disclose any hint of her
> full-blown age-related depression because that would be
> *embarrassing*. Osteoporosis, bladder control issues, "women's
> troubles", fainting spells -- any of that is perfectly
> admissible, but any hint of mental infirmity is not the be
> admitted to at any cost.
>
> She is not alone in this.

Who the hell taught these people that embarrassment is more important
than their health?

[Alex W.]

Then you are in a minority.
People avoid going to the doctor in order to avoid having to tell
them embarrassing facts, and when they do go, they lie as often
as not. That is a major reason why men die younger, and often of
conditions that would have been treatable had they been caught
earlier.

[Dakota]

On 11/17/2012 4:40 AM, Jeanne Douglas wrote:
> In article <ww4nqwujn8ei.e...@40tude.net>,
> "Alex W." <ing...@yahoo.co.uk> wrote:
>
>> On Fri, 16 Nov 2012 22:17:24 -0800, Jeanne Douglas wrote:
>>
>>> In article <k878b4$121$1...@dont-email.me>, Olrik <olri...@yahoo.com>
>>> wrote:
>>>

>>>> Le 2012-11-16 04:36, Alex W. a �crit :

>>>>> On Fri, 16 Nov 2012 00:00:08 -0500, Olrik wrote:
>>>>>

>>>>>> Le 2012-11-15 08:08, Alex W. a �crit :

True. Why bother going to a doctor if you're afraid to tell the truth
about issues affecting your health.

>
>> heck, I am about to go and visit my grandmother who has been
>> running (well, hobbling) to her doctor twice a week for the past
>> ten years or so -- for human contact as much for medical advice
>> -- and who has steadfastly refused to disclose any hint of her
>> full-blown age-related depression because that would be
>> *embarrassing*. Osteoporosis, bladder control issues, "women's
>> troubles", fainting spells -- any of that is perfectly
>> admissible, but any hint of mental infirmity is not the be
>> admitted to at any cost.
>>
>> She is not alone in this.
>
> Who the hell taught these people that embarrassment is more important
> than their health?
>

Three guesses. It's a "sin" to do some of the things they are afraid
to tell their doctor about.

[Mike Painter]

On Sat, 17 Nov 2012 12:57:01 +0000, "Alex W." <ing...@yahoo.co.uk>
wrote:

>

>Then you are in a minority.
>People avoid going to the doctor in order to avoid having to tell
>them embarrassing facts, and when they do go, they lie as often
>as not. That is a major reason why men die younger, and often of
>conditions that would have been treatable had they been caught
>earlier.

Such denial is so fundamental that it is taught in every CPR class.
In general men are much worse but there are exceptions.

A woman I taught with was very good at explaining why, if in a
restaurant you see a woman get up and run into the bathroom someone
should follow and see what is wrong.

It is a common response to choking and she admitted she did exactly
that.

When I taught SCUBA diving I found out that men are *never* (one
exception in about 20 years) afraid to go into the water. Their suit
does not fit, they have a hang over, they have the flu...

The women would always just say they were scared.
The sad thing is that I never failed in getting a woman back into the
water for one last try with just the two of us.
Occasionally it worked and they went on to enjoy the sport.
The men just disappeared.

[SkyEyes]

On Nov 17, 8:01 am, Dakota <ma...@NOSPAMmail.com> wrote:
> On 11/17/2012 4:40 AM, Jeanne Douglas wrote:
>
>
>
>
>
>
>

> > In article <ww4nqwujn8ei.ecloss45o9js....@40tude.net>,

> >   "Alex W." <ing...@yahoo.co.uk> wrote:
>
> >> On Fri, 16 Nov 2012 22:17:24 -0800, Jeanne Douglas wrote:
>

> >>> In article <k878b4$12...@dont-email.me>, Olrik <olrik...@yahoo.com>
> >>> wrote:

>
> >>>> Le 2012-11-16 04:36, Alex W. a écrit :
> >>>>> On Fri, 16 Nov 2012 00:00:08 -0500, Olrik wrote:
>

Seriously. I have no compunction about telling my doctor everything.
He needs that information in order to practice medicine correctly.
And it's safe: doctors *must* keep whatever you tell them
confidential, even from your spouse, or the police.

>
> Three guesses. It's a "sin" to do some of the things they are afraid
> to tell their doctor about.

I'm thinkin' you're right about this.

[Jeanne Douglas]

In article <12f5ahftnbuur.8vadf0dk7fbx$.d...@40tude.net>,

Yep. Stupid stupid stupid.

[Alex W.]

Knowing the price of drugs is a very useful first step. It
allows you to make a direct comparison between branded and
generic products. This saves you money, it can save the health
service money (not everybody pays for their own medicines), and
in the aggregate it helps to curb price rises in the pharmacy
industry.

To my mind, the value of knowing prices is not necessarily in
being able to make choices. At a basic level, it helps to inform
the public debate about healthcare. How can we possibly
understand and appreciate the figures being thrown about by
experts and politicians if we have no idea what procedures cost?
Knowing how much it cost to treat your own myocardial infarction
will improve your level of understanding about the cost to the
healthcare system in general of bad health choices (all those
cigarettes, all that poutine...) and their consequences, as well
as making it easier to spot the exaggerations and miscalculations
that will always be spouted on the topic.

>
>> At the very least, transparency of prices will let us make comparisons and begin to
>> ask questions -- the foundation of true accountability. "Why is
>> it that the cost of one intensive-care bed is C$250,000 in
>> Toronto but only C$175,000 in Quebec" is a good way to start
>> forcing both patients and healthcare administrators to think
>> about how, where and why they allocate resources.
>
> That's an interesting question by itself, and it should be throughly
> investigated. However, when strapped to a bed facing death (me), or
> dealing with a bizarre kidney ailment (my girlfriend) or a rather rare
> form of cancer (my mom), cost effectiveness is the least of your
> concerns, knowing that, all in all, from what one's heard about the
> system, they treat you with the best treatment available.

Which may or may not be true. If you have the money, US
healthcare will give you the absolute best care in the world,
with all the trimmings and every single possible treatment at the
highest level known to medical science. In a national system
like Canada or the UK, that is impossible. Certainly in Britain,
considerations of cost-effectiveness can mean that certain drugs
or procedures will not be offered because they are considered to
offer not enough benefit for the expense. What we get is good
care, the best that can reasonably be expected without going to
extreme and silly levels.

>
>>>
>>>> which introduces at least the glimmerings of transparency.
>>>>
>>>> It may also deter patients from frivolous use of the system,
>>>
>>> What's that? IMO, you can only judge if it's �frivolous� after the fact.
>>
>> Heavens, no. When someone comes into the surgery demanding a
>> full course of antibiotics (and possibly antivirals as well)
>> because they have a cold, that's clearly frivolous.
>> When someone insists on a CAT scan every time they have a headache, that's
>> frivolous.
>
> But does that happen often?
>
> I know that there are people abusing the system, but that's not
> significant overall.

You think, you hope.
When there is no control and no awareness, there is a lot of
abuse. Any system that is open to abuse will experience it. No
cost awareness and cost control means the system is wide open.
Nor does this mean strictly the intentional abuse, knowingly
obtaining goods or services wih the intention of gain. This may
be as simple as wastage due to ignorance. Every time someone
tells their doctor they insist on antibiotics for their cold or
on a branded product rather than the generic equivalent, it
constitutes abuse.

>
> I might add that in my case, if I were to have a long and miserable
> cold, or a severe headache, I'd ask for every test in the books, because
> I never experience any of those ailments.

Any competent doctor should throw you out on your ear for making
such demands because they are so meaningless and minor.
Unfortunately, it is far easier to write out a scrip or referral
and get the person out the door than to fight it out with the
patient.

>
>> When someone has persistent backache but rather than
>> losing 50lb of weight from around the midriff insists on x-rays,
>> osteopathy, acupuncture, massage and painkilling injections --
>> that's frivolous.
>
> Is it? You seem to draw your conclusions and opinions from known frauds
> or stories you've heard about.

If you happen to know an orthopedic chap, next time you see him
(or her) ask them how many patients they could strike off their
books if only they'd lose weight. The answer will prove my
point.

>
>> All of these, I am citing from personal
>> knowledge, and I would be willing to bet next month's cigar
>> allowance that any doctor will be able to give you 50 more
>> examples without having to think.
>>>
>>>> which is really where so much wastage occurs. People do NOT need
>>>> a full course of antibiotics for every cold and 'flu. They do
>>>> NOT need x-rays for every sprained ankle.
>>>
>>> That's for a *doctor* to determine that.
>>
>> Doctor yes, full workup no.
>> But the power of doctors to resist is not unlimited, and when
>> faced with 20 patients a day of whom a fair proportion will make
>> persistent and extra demands (sometimes on the back of threats
>> like "... or I will sue you"), many give in and order the
>> procedure or write the scrip, just to shut up the bugger.
>>
>>
>>>
>>>> When patients have
>>>> private insurance and see the bills they incur, they ten to be a
>>>> bit more careful about the services they use, even if they get
>>>> most or all of their money reimbursed.
>>>
>>> People are not doctors.
>>
>> They are not, but they are responsible for their own decisions
>> and actions. That is why a doctor cannot order any procedure on
>> his own, he needs the consent of the patient (or a relative).
>
> But that's only about legal matters, not about medical knowledge.

One slides into the other.
The legal principle of patient responsibility means that private
individuals are expected to take clinical decisions.

>
>> That is why we choose our doctors (this service may not be
>> available in your jurisdiction)
>
> Of course we can chose our own doctors. But that's not always possible
> and not always the best course of action.

The British NHS operates a "gatekeeper" system: all patients have
to go first to their GP who decides whether to refer them on to a
specialist, and who to send them to.

>
>> and why it is our decision
>> whether to see the doctor or not (hmmm, funny lumps on my
>> testicles, I wonder what that means).
>
> It means you like to play with yourself. Willing to tell that to your
> doctor?
>
> ;-)

I would be, actually. Testicular cancer is a major killer,
mostly because men are as unwilling to drop their trousers for
their doctor as examining themselves for lumps.

[Olrik]

Le 2012-11-17 19:04, Alex W. a �crit :

I guess that your point is that it's better to be rich and healthy than
poor and sick.

Got it.

Thanks!

HAND

[Alex W.]

On Sun, 18 Nov 2012 01:09:47 -0500, Olrik wrote:

> Le 2012-11-17 19:04, Alex W. a écrit :

>
> I guess that your point is that it's better to be rich and healthy than
> poor and sick.
>
> Got it.
>
> Thanks!

In principle and ignoring the sarcasm, you are right, of course.
And you forgot "handsome" -- rich, handsome and healthy will
always beat poor, ugly and sick.

To take your point seriously, though: what exercises me is the
persistent attitude of aggressive entitlement. This is very
common indeed and holds that the immediate and complete
satisfaction of their every healthcare need is their untrammelled
right, without limitations or other considerations. The view is
that funds are endless, and since healthcare is a basic human
right there can be no waste since the exercise of human rights is
never wasteful. This is no exaggeration; I have seen these
convictions expressed before, privately and in public, and by
health service professional organisations such as unions. To
them, any problems or issues always fall into one of two
categories: they are either attacks on the very existence of the
NHS, or shortcomings that must immediately be addressed by
raising the budget. Dare to suggest that perhaps services can be
run more efficiently, that not everything is worth the expense,
that changes might be beneficial to patients and staff both, and
the instinct is to attack with all the fervour of a Muslim who
has just been shown a fetching caricature of the prophet
Mohammed.

Unfortunately, this sort of effort, however noble, is the
increasingly unsupportable. Not only have the pharma and medical
technology industries become extremely proficient in designing
ever more and ever pricier offerings, but the changing
demographics of our Western societies are making new, costly and
difficult-to-service demands on our healthcare systems. If we
want to ensure that we have any sort of affordable healthcare
system for the foreseeable future and our own old age, we will
have to change our attitudes and make economies. There is simply
no way around it. But unless and until we make a start by
educating the public who are both the prime beneficiaries and the
ultimate policy deciders, we will never get around to making the
urgently necessary adjustments.