A government-commissioned report promotes smoking bans by tweaking the evidence.
Eric Gisin
Myocardial Infractions
Jacob Sullum | October 21, 2009
Six years ago, when I asked an epidemiologist about a report that a smoking ban in Helena, Montana,
had cut heart attacks by 40 percent within six months, he thought the idea was so ridiculous that
no one would take it seriously. He was wrong.
Since then 10 other studies have attributed substantial short-term reductions in heart attacks to
smoking bans, and last week an Institute of Medicine (IOM) committee endorsed their findings. But a
closer look at the IOM report, which was commissioned by the U.S. Centers for Disease Control and
Prevention, suggests its conclusions are based on a desire to promote smoking bans rather than a
dispassionate examination of the evidence.
Thousands of jurisdictions around the world restrict smoking. Some of them are bound to see
significant drops in heart attacks purely by chance, while others will see no real change or
significant increases. Focusing on the first group proves nothing unless it is noticeably bigger
than the other two groups.
The largest study of this issue, which used nationwide data instead of looking at cherry-picked
communities, concluded that smoking bans in the U.S. "are not associated with statistically
significant short-term declines in mortality or hospital admissions for myocardial infarction." It
also found that "large short-term increases in myocardial infarction incidence following a
workplace ban are as common as the large decreases reported in the published literature."
That study, published by the National Bureau of Economic Research (NBER) in March, suggests that
publication bias-the tendency to report positive findings and ignore negative ones-explains the
"consistent" results highlighted by the IOM committee. But even though the panelists say they tried
to compensate for publication bias by looking for relevant data that did not appear in medical
journals, they ignored the NBER paper, along with analyses that found no declines in heart attacks
following smoking bans in California, Florida, New York, Oregon, England, Wales, Scotland, and
Denmark.
If smoking bans reduce heart attacks, the effect could be due to declines in smoking, declines in
secondhand smoke exposure, or both. The IOM report settles on that last explanation, quite a leap
given that "only two of the studies distinguished between reductions in heart attacks suffered by
smokers versus nonsmokers."
In any case, when people stop smoking, their heart attack risk declines gradually over several
years, and it's hard to see why the risk would fall any faster for people exposed to secondhand
smoke. Furthermore, estimates from the CDC and the American Heart Association indicate that smoking
and secondhand smoke together account for about 25 percent of heart disease deaths. So how could a
smoking ban, even one that eliminated all smoking, cut heart attacks by 40 percent (or 47 percent,
as another study claimed)?
The IOM panelists dodge these issues by declining to estimate the size or the timing of the impact
from smoking bans, citing the limitations of the studies and the wide variations between them. But
"if you can't even estimate the magnitude of an effect," notes Michael Siegel, a Boston University
public health professor who was one of the report's reviewers, "you are hardly in a position to
conclude that [it] exceeds random variation combined with the known secular decline in heart attack
rates."
Even while taking refuge in imprecision, the IOM committee tries to make transparently absurd
claims seem plausible by intimating that spending a half-hour in a smoky bar just might kill you,
even if you were completely healthy when you went in. If so, where are the bodies? The report
concedes "there is no direct evidence that a relatively brief exposure to secondhand smoke can
precipitate an acute coronary event."
Siegel, who faults the IOM committee's "sensationalistic" approach, is a longtime supporter of
smoking bans who nevertheless tries to separate his political advocacy from his scientific
analysis. It's too bad the authors of the IOM report, who immediately used it as an excuse to
demand strict smoking regulations throughout the country, did not follow his example.
Jacob Sullum is a senior editor at Reason and a nationally syndicated columnist.
Jerry Okamura
justify why it is okay to take away or restrict a persons freedom, perhaps?
If the smoker had to pay for their own healthcare needs, how concerned would
the government be about the cost of medical care that a smoker incurs? If
you do not die from one cause, won't you die from another cause? Can anyone
guarantee that you actually save money by stopping people from smoking?
"Eric Gisin" <gi...@uniserve.com> wrote in message
news:hc2i41$6o2$1...@news.eternal-september.org...
Robert
>Using studies to justify their actions perhaps? Using these studies, to
>justify why it is okay to take away or restrict a persons freedom, perhaps?
>If the smoker had to pay for their own healthcare needs, how concerned would
>the government be about the cost of medical care that a smoker incurs?
In general, Americans DO pay for their own health care. Government pays only for Medicare
(over 65) and Medicaid/SCHIP (children and disabled). See my article in alt.smokers about
assigned risk medical insurance, to which government contributes almost nothing except in
Massachusetts.
>If you do not die from one cause, won't you die from another cause? Can anyone
>guarantee that you actually save money by stopping people from smoking?
Several economic studies, Manning is the most often cited, found smoking has a negative
cost to society. The reason is lower Social Security payouts due to lower life expectancy.
Strabo
> In article <hc2i41$6o2$1...@news.eternal-september.org>,
> "Eric Gisin" <gi...@uniserve.com> wrote:
>
>> http://reason.com/archives/2009/10/21/myocardial-infractions
>
> Nice cut and paste job of an article by a long time tobacco company
> apologist who has been on their payroll for years according to
> http://www.sourcewatch.org/index.php?title=Jacob_Sullum
>
Smoke break!
Light 'em up if you got 'em.
Robert Broughton
You need not have gone to the trouble, Shawn. Sullum wrote a book about
smoking called _For Your Own Good_. This title is a clear indication that
he's full of shit.
--
Bob Broughton
http://broughton.ca/
Vancouver, BC, Canada
"Even on [finance] terms, we have never been a company that tolerates
facts." - Robert Murdoch, Feb. 5, 2009
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
news:skcae5ddt103t3dgi...@4ax.com...
> On Sun, 25 Oct 2009 15:39:05 -1000, "Jerry Okamura"
> <okamu...@hawaii.rr.com> wrote:
>
>>Using studies to justify their actions perhaps? Using these studies, to
>>justify why it is okay to take away or restrict a persons freedom,
>>perhaps?
>>If the smoker had to pay for their own healthcare needs, how concerned
>>would
>>the government be about the cost of medical care that a smoker incurs?
>
> In general, Americans DO pay for their own health care. Government pays
> only for Medicare
> (over 65) and Medicaid/SCHIP (children and disabled). See my article in
> alt.smokers about
> assigned risk medical insurance, to which government contributes almost
> nothing except in
> Massachusetts.
Do they now? What percentage of the American people, pay for their own
healthcare, using their own money directly?
>
>>If you do not die from one cause, won't you die from another cause? Can
>>anyone
>>guarantee that you actually save money by stopping people from smoking?
>
> Several economic studies, Manning is the most often cited, found smoking
> has a negative
> cost to society. The reason is lower Social Security payouts due to lower
> life expectancy.
>
>
That does not make any sense at all. If a smoker will receive less from
social security because they will die at a younger age, how is that a
"negative cost to society"?
Robert
>
>"Robert" <n...@e.mail> wrote in message
>news:skcae5ddt103t3dgi...@4ax.com...
>> On Sun, 25 Oct 2009 15:39:05 -1000, "Jerry Okamura"
>> <okamu...@hawaii.rr.com> wrote:
>>
>>>Using studies to justify their actions perhaps? Using these studies, to
>>>justify why it is okay to take away or restrict a persons freedom,
>>>perhaps?
>>>If the smoker had to pay for their own healthcare needs, how concerned
>>>would
>>>the government be about the cost of medical care that a smoker incurs?
>>
>> In general, Americans DO pay for their own health care. Government pays
>> only for Medicare
>> (over 65) and Medicaid/SCHIP (children and disabled). See my article in
>> alt.smokers about
>> assigned risk medical insurance, to which government contributes almost
>> nothing except in
>> Massachusetts.
>
>Do they now? What percentage of the American people, pay for their own
>healthcare, using their own money directly?
The federal government pays 35% (Medicare, Medicaid, Military), state and local government
pays 11%. The other 54% is paid by private insurance (36%) and out of pocket (15%).
"The average family health insurance premium, provided through an employer health benefit
program, was $11,480 in 2006. Employees paid an average of $2,973 towards the premium
amount." Source: Kaiser Family Foundation
http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm
If you discount the employer contribution, out of pocket for the average WORKING family is
8,507 (premium) + 3,545 (direct) = 12,052 / 15,025 = 80%. Government does not contribute
to a working familiy's health care. On the contrary, working people subsidize, through
higher prices, non-working receiving government aid.
>>>If you do not die from one cause, won't you die from another cause? Can
>>>anyone
>>>guarantee that you actually save money by stopping people from smoking?
>>
>> Several economic studies, Manning is the most often cited, found smoking
>> has a negative
>> cost to society. The reason is lower Social Security payouts due to lower
>> life expectancy.
>>
>>
>
>That does not make any sense at all. If a smoker will receive less from
>social security because they will die at a younger age, how is that a
>"negative cost to society"?
Lifetime Social security/ Medicare benefits, nonsmoker: $570,000 (in 2000 dollars)
Same , smoker: 464,000
Cost reduction: 106,000
The Manning study is here:
http://tobaccodocuments.org/ti/TIMN0325066-5071.html
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
So, the statement that "American DO pay for their own health caee" is false?
> "The average family health insurance premium, provided through an employer
> health benefit
> program, was $11,480 in 2006. Employees paid an average of $2,973 towards
> the premium
> amount." Source: Kaiser Family Foundation
> http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm
So, since medical inflation is running at or above 8% per year, that means
the cost of that insurance will double in around eight years, and will
double again every succeeding period of time?
Robert
I didn't answer your question about percentage of Americans paying for their own health
care (or doing without). It is 77%. The 23% subsidized by government are elderly,
children, young mothers and officially disabled. An adult, non-disabled, under 65 male
cannot get government aid, period (excepting prison and military).
>> "The average family health insurance premium, provided through an employer
>> health benefit
>> program, was $11,480 in 2006. Employees paid an average of $2,973 towards
>> the premium
>> amount." Source: Kaiser Family Foundation
>> http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm
>
>So, since medical inflation is running at or above 8% per year, that means
>the cost of that insurance will double in around eight years, and will
>double again every succeeding period of time?
Cost will rise faster than inflation because a demographic bubble, boomers, is nearing
elderhood. The average age is going up. But we cannot afford to pay double. That would put
health care at 35% of GDP, more than total government spending with deficits. Something
has to change, soon.
An estimated 30% of health care spending goes to slippage, administrative inefficiencies.
A single payer system would eliminate 90% of that. Another 20% goes to unnecessary overuse
caused by poor communication between doctors, fear of malpractice suits, path of least
resistance and patient expectations. These are management issues, not medical issues,
which haven't been and won't be solved by isolated doctors. Some entity needs to start
managing the whole system. Insurance companies could have done it, but didn't. Mayo Clinic
is an examplar of how it should work. We need something like Mayo on a national scale.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
How can it be 77%. Your own posting says that the federal government pays
35%, state and local government pays 11%. And 54% is paid for by private
insurance, which is paid for by the business a person works for, for the
most part. I would think that very few people actually pay for their own
health insurance with the money they earn.
>>> "The average family health insurance premium, provided through an
>>> employer
>>> health benefit
>>> program, was $11,480 in 2006. Employees paid an average of $2,973
>>> towards
>>> the premium
>>> amount." Source: Kaiser Family Foundation
>>> http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm
>>
>>So, since medical inflation is running at or above 8% per year, that means
>>the cost of that insurance will double in around eight years, and will
>>double again every succeeding period of time?
>
> Cost will rise faster than inflation because a demographic bubble,
> boomers, is nearing
> elderhood. The average age is going up. But we cannot afford to pay
> double. That would put
> health care at 35% of GDP, more than total government spending with
> deficits. Something
> has to change, soon.
So, what do you think the "change" should be? The Obama solution or
something else?
>
> An estimated 30% of health care spending goes to slippage, administrative
> inefficiencies.
> A single payer system would eliminate 90% of that.
If you reduced administrative inefficiences to zero, wouldn't medical
inflation over time, wipe out any "savings" that you may have achieved by
reducing administrative inefficiencies?
Another 20% goes to unnecessary overuse
> caused by poor communication between doctors, fear of malpractice suits,
> path of least
> resistance and patient expectations. These are management issues, not
> medical issues,
> which haven't been and won't be solved by isolated doctors. Some entity
> needs to start
> managing the whole system. Insurance companies could have done it, but
> didn't. Mayo Clinic
> is an examplar of how it should work. We need something like Mayo on a
> national scale.
>
Is there any system that we can devise that will not have unnecessary
overuse? If you do not pay for what you want or need, are you more or less
likely to "overuse" the system? If you paid for what you need or want,
aren't you less likely to "overuse" the system?
Norm
"Jerry Okamura" <okamu...@hawaii.rr.com> wrote in message
news:Zp%Fm.10824$U55....@newsfe02.iad...
>
> Is there any system that we can devise that will not have unnecessary
> overuse? If you do not pay for what you want or need, are you more or
> less likely to "overuse" the system? If you paid for what you need or
> want, aren't you less likely to "overuse" the system?
A single payer system with doctors still operating as private entities but
all billing the same place. No fault insurance type of thing. Cover whatever
happens. No disputes over who pays for it just fix it. No such thing as
"pre-existing, you're either sick or you're not. The fees are fixed and
reviewed by government and medical people. Doctors still become wealthy
people in this country and nurses have been known to make a decent living as
well. And you don't end up paying huge dollars to solve problems which would
have been cheap if they were treated when they began.
Ah, but then we get the dreaded "people dying on the wait list" syndrome.
The horror sories you've been told by insurance companies and some of your
government who have vested interests in the status quo. Doesn't happen, its
a myth.
The way it works is if you are in greater need you get moved up in priority.
It happened twice last year in my own family. That woman from Canada you
heard about in the news a few months back who had a "tumour" and would have
died had she not gone to the US - she lied from beginning to end. She didn't
have a tumour she had a cyst and she was neverr in danger of anything other
than a little discomfort. The wait list is how the system limits delivery.
People who really don't need something fixed in a hurry get to wait. Some of
them get better on their own, some of them get to wait a long time to get
their hangnail treated. The odd person with trivial problems does sit on the
wait list and eventually use resources, but theres not many willing to do
that. Wealthy people with trivial problems they are willing to pay for are
still free to go outside the system if they choose.
Every system has some way to limit how treatment happens. Yours currently
limits it by how much money or insurance you have at your disposal, ours
limits it by how badly you actually need it. The Canadian system is not
perfect, its still being underfunded by neocon politicians for ideological
reasons, but in spite of their interference it still works reasonably well.
There are examples of systems in Europe which work even better.
Obama's solution does not go far enough. It still allows a hodgepodge of
payers which will maintain the confusion and still cause too much expense
overall. He's afraid to confront the insurance companies who are making a
fortune and tell them its over. I suppose he has to start somewhere but I
fear its going to be so timid a start that it won't be effective and it will
give the opposition the chance to say see we told you so.
Jerry Okamura
"Norm" <normgr...@yahoo.ca> wrote in message
news:g92Gm.50638$4E.3...@newsfe08.iad...
>
> "Jerry Okamura" <okamu...@hawaii.rr.com> wrote in message
> news:Zp%Fm.10824$U55....@newsfe02.iad...
>
>
>>
>> Is there any system that we can devise that will not have unnecessary
>> overuse? If you do not pay for what you want or need, are you more or
>> less likely to "overuse" the system? If you paid for what you need or
>> want, aren't you less likely to "overuse" the system?
>
> A single payer system with doctors still operating as private entities but
> all billing the same place. No fault insurance type of thing. Cover
> whatever happens. No disputes over who pays for it just fix it. No such
> thing as "pre-existing, you're either sick or you're not. The fees are
> fixed and reviewed by government and medical people. Doctors still become
> wealthy people in this country and nurses have been known to make a decent
> living as well. And you don't end up paying huge dollars to solve problems
> which would have been cheap if they were treated when they began.
How does your proposal reduce the medical inflation rate?
>
> Ah, but then we get the dreaded "people dying on the wait list" syndrome.
> The horror sories you've been told by insurance companies and some of your
> government who have vested interests in the status quo. Doesn't happen,
> its a myth.
> The way it works is if you are in greater need you get moved up in
> priority. It happened twice last year in my own family. That woman from
> Canada you heard about in the news a few months back who had a "tumour"
> and would have died had she not gone to the US - she lied from beginning
> to end. She didn't have a tumour she had a cyst and she was neverr in
> danger of anything other than a little discomfort. The wait list is how
> the system limits delivery. People who really don't need something fixed
> in a hurry get to wait. Some of them get better on their own, some of them
> get to wait a long time to get their hangnail treated. The odd person with
> trivial problems does sit on the wait list and eventually use resources,
> but theres not many willing to do that. Wealthy people with trivial
> problems they are willing to pay for are still free to go outside the
> system if they choose.
When you pay for your own medical needs, what are the odds that anyone other
than yourself will decide on whether you live or die? When someone else
pays for your medical needs, what are the odds that in order to save money,
they will decide if you live or die? When you depend on someone else to pay
for your medical needs CAN they decide not to pay?
>
> Every system has some way to limit how treatment happens. Yours currently
> limits it by how much money or insurance you have at your disposal, ours
> limits it by how badly you actually need it. The Canadian system is not
> perfect, its still being underfunded by neocon politicians for ideological
> reasons, but in spite of their interference it still works reasonably
> well. There are examples of systems in Europe which work even better.
It is a question of what happens in the future. Medical inflation that is
higher than the overall inflation rate means the total cost of healthcare
will rise. When it rises, and someone else is paying for your medical
needs, they have two choices. Either come up with the extra money (and like
taxes, we like the free benefit, we just don't like paying for it) or ration
care. That is the only two options the "payer" has.
>
> Obama's solution does not go far enough. It still allows a hodgepodge of
> payers which will maintain the confusion and still cause too much expense
> overall. He's afraid to confront the insurance companies who are making a
> fortune and tell them its over. I suppose he has to start somewhere but I
> fear its going to be so timid a start that it won't be effective and it
> will give the opposition the chance to say see we told you so.
>
>
You are right on that point. But your reasons are wrong. The solution to
controlling cost is to return the rationing decision back to where it
belongs and that is the user of the service. That is the only way you can
reduce the medical inflation rate, which is the reason we have a cost
problem.
>
Robert
Because 20% of people consume 80% of health care. The 23% supported by government are
elderly and disabled, who are more likely to be sick. It's easy to understand why they
consume 46% of the money rather than 26%.
>And 54% is paid for by private
>insurance, which is paid for by the business a person works for, for the
>most part. I would think that very few people actually pay for their own
>health insurance with the money they earn.
You have a simple minded view of earnings. If employees didn't earn insurance premiums,
why do companies pay it? They're not legally required to do so.
The reason companies buy health insurance for you is so you don't have to pay income tax
on the money. Also, they don't want workers organizing to buy group insurance because it
might lead to other collective actions such as <shudder> labor unions.
>>>> "The average family health insurance premium, provided through an
>>>> employer
>>>> health benefit
>>>> program, was $11,480 in 2006. Employees paid an average of $2,973
>>>> towards
>>>> the premium
>>>> amount." Source: Kaiser Family Foundation
>>>> http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm
>>>
>>>So, since medical inflation is running at or above 8% per year, that means
>>>the cost of that insurance will double in around eight years, and will
>>>double again every succeeding period of time?
>>
>> Cost will rise faster than inflation because a demographic bubble,
>> boomers, is nearing
>> elderhood. The average age is going up. But we cannot afford to pay
>> double. That would put
>> health care at 35% of GDP, more than total government spending with
>> deficits. Something
>> has to change, soon.
>
>So, what do you think the "change" should be? The Obama solution or
>something else?
Something more comprehensive. ObamaCare is business as usual. The 15% uninsured will get a
waiver giving them permission to do without. That's what we have now.
>> An estimated 30% of health care spending goes to slippage, administrative
>> inefficiencies.
>> A single payer system would eliminate 90% of that.
>
>If you reduced administrative inefficiences to zero, wouldn't medical
>inflation over time, wipe out any "savings" that you may have achieved by
>reducing administrative inefficiencies?
The root cause of health care inflation is lack of central management. In 1960, the US and
other industrialized countries were spending at the same rate: 6% of GDP. Now the US is
spending 16% while everyone else is spending 6-8%. The difference is not explained by
rationing nor sub-standard care, it is explained by the US's free market system versus
others' government managed system.
As Adam Smith wrote, "This is one of those cases in which the imagination is baffled by
the facts." As former options trader, I used to believe strongly in the wisdom and
efficiency of free markets. But free market health care has been an embarrassment. It has
shown that free markets can be less efficient than managed systems.
Health care inflation is best evaluated relative to the rest of the economy, not relative
to historic prices. Other countries were paying 6% of GDP in 1960 and they're still paying
about the same, with a slight increase for benefits that didn't exist in 1960. They don't
have medical inflation. The US has inflation; we're paying 2.7 times as much. Why do we
have inflation and others don't?
Here's the answer. It is common knowledge on trading floors that prices are based on fear
and greed, not supply and demand. They SAY they trade by calculating fair values and
studying financial forecasts. They ACTUALLY trade by looking into your eyes and listening
to your voice. If they sense fear, they buy from you low; if they sense greed, they sell
to you high. If you take a player off the floor and put him behind a computer screen, he
sees the same numbers but he cannot trade because there's no emotional sensor.
Economic theories about market wisdom assume players are rationally motivated by supply
and demand. Those theories don't work when players are emotionally motivated by fear and
greed. The US health care system is driven by fear, from consumers, and greed, especially
from the pharmaceutical industry. Government managed health care in other countries is
driven by reason. They are efficient because they're rational; we are inefficient because
we're not.
>Another 20% goes to unnecessary overuse
>> caused by poor communication between doctors, fear of malpractice suits,
>> path of least
>> resistance and patient expectations. These are management issues, not
>> medical issues,
>> which haven't been and won't be solved by isolated doctors. Some entity
>> needs to start
>> managing the whole system. Insurance companies could have done it, but
>> didn't. Mayo Clinic
>> is an examplar of how it should work. We need something like Mayo on a
>> national scale.
>>
>
>Is there any system that we can devise that will not have unnecessary
>overuse? If you do not pay for what you want or need, are you more or less
>likely to "overuse" the system? If you paid for what you need or want,
>aren't you less likely to "overuse" the system?
No because people are irrational when it comes to health care. For instance, we spend 17
billion dollars per year on doctor visits and drugs to treat the common cold, despite the
fact there is no effective treatment.
http://archinte.ama-assn.org/cgi/content/abstract/163/4/487
"Have you seen a doctor for that?" is ingrained in our culture. Economic incentives don't
work on irrational people.
Robert
>When you pay for your own medical needs, what are the odds that anyone other
>than yourself will decide on whether you live or die? When someone else
>pays for your medical needs, what are the odds that in order to save money,
>they will decide if you live or die? When you depend on someone else to pay
>for your medical needs CAN they decide not to pay?
Your argument is wholely emotional. You're afraid someone will pull the plug on you. Not
out of malevolence, just to save money.
The root cause is you don't trust other people. I suspect your insecurity comes from being
neglected or ignored as a child. That's your burden, don't insist everyone else pay for
it.
>You are right on that point. But your reasons are wrong. The solution to
>controlling cost is to return the rationing decision back to where it
>belongs and that is the user of the service. That is the only way you can
>reduce the medical inflation rate, which is the reason we have a cost
>problem.
Other countries didn't follow your advice, they went the other way, yet they don't have a
cost problem.
Norm
>>> Is there any system that we can devise that will not have unnecessary
>>> overuse? If you do not pay for what you want or need, are you more or
>>> less likely to "overuse" the system? If you paid for what you need or
>>> want, aren't you less likely to "overuse" the system?
>>
>> A single payer system with doctors still operating as private entities
>> but all billing the same place. No fault insurance type of thing. Cover
>> whatever happens. No disputes over who pays for it just fix it. No such
>> thing as "pre-existing, you're either sick or you're not. The fees are
>> fixed and reviewed by government and medical people. Doctors still become
>> wealthy people in this country and nurses have been known to make a
>> decent living as well. And you don't end up paying huge dollars to solve
>> problems which would have been cheap if they were treated when they
>> began.
>
> How does your proposal reduce the medical inflation rate?
It reduces the overall cost. I'm assuming by Medical inflation you mean the
rising cost of treatment. An MRI is still going to increase in cost as is a
heart transplant, thats just reality, you can't change that unless you force
the suppliers of the service to work for free. Thats not going to happen.
What is going to happen is the waste will be reduced. How much does it cost
to deliver a baby when the mother has not been under care until the last
minute because she couldn't afford the co-pay? How much does it cost to fix
an injury which was left to fester until intolorable? How much does it cost
a doctors office to sort out which of a dozen insurers to bill for each
patient? How much time and money is wasted determining if insurance will
cover a particular problem before treament is commenced? All the above
spinning of wheels is eliminated in a single payer, universal system. The
cost of taking care of the odd patient who "overuses" is a drop in the
bucket compared to what will be saved.
>>
>> Ah, but then we get the dreaded "people dying on the wait list" syndrome.
>> The horror sories you've been told by insurance companies and some of
>> your government who have vested interests in the status quo. Doesn't
>> happen, its a myth.
>> The way it works is if you are in greater need you get moved up in
>> priority. It happened twice last year in my own family. That woman from
>> Canada you heard about in the news a few months back who had a "tumour"
>> and would have died had she not gone to the US - she lied from beginning
>> to end. She didn't have a tumour she had a cyst and she was neverr in
>> danger of anything other than a little discomfort. The wait list is how
>> the system limits delivery. People who really don't need something fixed
>> in a hurry get to wait. Some of them get better on their own, some of
>> them get to wait a long time to get their hangnail treated. The odd
>> person with trivial problems does sit on the wait list and eventually use
>> resources, but theres not many willing to do that. Wealthy people with
>> trivial problems they are willing to pay for are still free to go outside
>> the system if they choose.
>
> When you pay for your own medical needs, what are the odds that anyone
> other than yourself will decide on whether you live or die? When someone
> else pays for your medical needs, what are the odds that in order to save
> money, they will decide if you live or die? When you depend on someone
> else to pay for your medical needs CAN they decide not to pay?
No, they can't. What are the odds you might not have enough money to pay for
your treatment? What are the odds your surgeon might get a better offer from
a richer patient and take care of him ahead of you? For teh richest 10% of
the population your system works. Another 50% or so has been convinced by
the industry that it is working but it isn't. Where I live I CAN'T be
refused treatment. For anything. I know it works because I live with it
already. Someone else deciding if I live or die is not possible because
refusing treatment is not part of the equation. Its just not one of the
lines on the form. The only way I can ever have treatment stopped is by a
DNR order. In most cases that requires both my family's and my prior
approval. They can't let me go unless I say so and I can't commit medical
suicide without their say so. You are still listening to people who have an
interest in keeping your money. Or perhaps you are one of them, who knows?
>>
>> Every system has some way to limit how treatment happens. Yours currently
>> limits it by how much money or insurance you have at your disposal, ours
>> limits it by how badly you actually need it. The Canadian system is not
>> perfect, its still being underfunded by neocon politicians for
>> ideological reasons, but in spite of their interference it still works
>> reasonably well. There are examples of systems in Europe which work even
>> better.
>
> It is a question of what happens in the future. Medical inflation that is
> higher than the overall inflation rate means the total cost of healthcare
> will rise. When it rises, and someone else is paying for your medical
> needs, they have two choices. Either come up with the extra money (and
> like taxes, we like the free benefit, we just don't like paying for it) or
> ration care. That is the only two options the "payer" has.
Your care is rationed by cost now. That cost is going to increase regardless
of what happens. If you are well off you migth be sheilded from it. For a
while. What happens when you run out of money? or need to change employers?
What about the large segment of the population who don't have unlimited
funds? Throw them to the wolves? Let them eat cake?
>>
>> Obama's solution does not go far enough. It still allows a hodgepodge of
>> payers which will maintain the confusion and still cause too much expense
>> overall. He's afraid to confront the insurance companies who are making a
>> fortune and tell them its over. I suppose he has to start somewhere but I
>> fear its going to be so timid a start that it won't be effective and it
>> will give the opposition the chance to say see we told you so.
>>
>>
>
> You are right on that point. But your reasons are wrong. The solution to
> controlling cost is to return the rationing decision back to where it
> belongs and that is the user of the service. That is the only way you can
> reduce the medical inflation rate, which is the reason we have a cost
> problem.
Vacation travel or automobile sales might respond to supply and demand but
health care does not. When you need something you need it regardless of the
cost. That is why 50% of the personal bankruptcies in your country are due
to medical costs. Thats barbaric. Health care should be a right, not a
privilege. Further, its not nly about controlling the cost, its about a
fairer system for everybody, not just the wealthy.
Bottom line is your system costs more. Much more than any other system being
used anywhere in the world. Talk to any Canadian. Even though we have our
share of right wingnuts here as well, you would have to talk to an awful lot
of them to find any who would seriously consider trading places.
>>
>
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
> On Wed, 28 Oct 2009 13:25:03 -1000, "Jerry Okamura"
> <okamu...@hawaii.rr.com> wrote:
>
>>When you pay for your own medical needs, what are the odds that anyone
>>other
>>than yourself will decide on whether you live or die? When someone else
>>pays for your medical needs, what are the odds that in order to save
>>money,
>>they will decide if you live or die? When you depend on someone else to
>>pay
>>for your medical needs CAN they decide not to pay?
>
> Your argument is wholely emotional. You're afraid someone will pull the
> plug on you. Not
> out of malevolence, just to save money.
Not emotional at all, a simple fact. The person who pays the bill, can
either pay the bill or not pay the bill. When you allow someone to pay the
bill, you have given them the right to make that decision.
>
> The root cause is you don't trust other people. I suspect your insecurity
> comes from being
> neglected or ignored as a child. That's your burden, don't insist everyone
> else pay for
> it.
You have got it backwards. I am the one who trusts people to do what is
best for them. I trust people enough to want them to have the freedom to
choose, what is best for them. A child is the one who needs someone to take
care of them. An adult would prefer to take care of themselves. If you are
an adult, and you want someone to take care of you, you are saying you want
to be treated like a child.
>
>>You are right on that point. But your reasons are wrong. The solution to
>>controlling cost is to return the rationing decision back to where it
>>belongs and that is the user of the service. That is the only way you can
>>reduce the medical inflation rate, which is the reason we have a cost
>>problem.
>
> Other countries didn't follow your advice, they went the other way, yet
> they don't have a
> cost problem.
>
They ALL have a cost problem, so that is a lie. And they all have a problem
with medical inflation. Check it out for yourself. Everyone one of those
countries have a medical inflation rate that is higher than their overall
inflation rate.
Jerry Okamura
>
> "Jerry Okamura" <okamu...@hawaii.rr.com> wrote in message
> news:hp4Gm.113725$944....@newsfe09.iad...
>
>
>>>> Is there any system that we can devise that will not have unnecessary
>>>> overuse? If you do not pay for what you want or need, are you more or
>>>> less likely to "overuse" the system? If you paid for what you need or
>>>> want, aren't you less likely to "overuse" the system?
>>>
>>> A single payer system with doctors still operating as private entities
>>> but all billing the same place. No fault insurance type of thing. Cover
>>> whatever happens. No disputes over who pays for it just fix it. No such
>>> thing as "pre-existing, you're either sick or you're not. The fees are
>>> fixed and reviewed by government and medical people. Doctors still
>>> become wealthy people in this country and nurses have been known to make
>>> a decent living as well. And you don't end up paying huge dollars to
>>> solve problems which would have been cheap if they were treated when
>>> they began.
>>
>> How does your proposal reduce the medical inflation rate?
>
> It reduces the overall cost.
"If" it reduced the overall cost, then the cost per person over time would
be lower rather than higher. Is the overall ocst lower rather than higher?
I'm assuming by Medical inflation you mean the
> rising cost of treatment.
The rsing cost of healthcare, that is due to medical inflation. If the
medical inflation rate was zero, we would not have a cost problem we do have
with healthcare. When someone else is paying for our medical care, that
person does not care what the cost of that care is, they will use the
service regardless of how much it cost. When that happens, you have lost
the most effective means to controllling cost, and costs will rise. When it
rises, the payer only has two options, either come up with the money to pay
for that increase, or resort to some form of rationing. But neither one,
addresses the reason cost are rising, so cost will continue to rise. Which
in turn means, they have to constantly find the money to pay for that
increase, or resort to some form of rationing. But like price controls, it
does not work over a long period of time, which means that over time, more
and more rationing has to occur, or they have to collect the money to pay
for that increase from someone else.
An MRI is still going to increase in cost as is a
> heart transplant, thats just reality, you can't change that unless you
> force the suppliers of the service to work for free. Thats not going to
> happen. What is going to happen is the waste will be reduced. How much
> does it cost to deliver a baby when the mother has not been under care
> until the last minute because she couldn't afford the co-pay? How much
> does it cost to fix an injury which was left to fester until intolorable?
> How much does it cost a doctors office to sort out which of a dozen
> insurers to bill for each patient? How much time and money is wasted
> determining if insurance will cover a particular problem before treament
> is commenced? All the above spinning of wheels is eliminated in a single
> payer, universal system. The cost of taking care of the odd patient who
> "overuses" is a drop in the bucket compared to what will be saved.
>
No. The cost of the MRI does not increase over time. It remains the same.
>
>>>
>>> Ah, but then we get the dreaded "people dying on the wait list"
>>> syndrome. The horror sories you've been told by insurance companies and
>>> some of your government who have vested interests in the status quo.
>>> Doesn't happen, its a myth.
It is not a "myth" as you put it. It is a fact. In Canada for example, the
government puts a cap on the amount of money they will spend in any one
year. When you do that, once the money is spent, you have no more money to
spend for that year, regardless of how much money is actually needed to
treat everyone who needs the treatment. That is a form of rationing.
Another form of rationing are waiting list, which Canada does have. In the
State of Oregon, they have developed a list of services they will pay for
and services they will not pay for. Those who are not on the list, are shit
out of luck, unless they pay for it themselves.
>>> The way it works is if you are in greater need you get moved up in
>>> priority. It happened twice last year in my own family. That woman from
>>> Canada you heard about in the news a few months back who had a "tumour"
>>> and would have died had she not gone to the US - she lied from beginning
>>> to end. She didn't have a tumour she had a cyst and she was neverr in
>>> danger of anything other than a little discomfort. The wait list is how
>>> the system limits delivery. People who really don't need something fixed
>>> in a hurry get to wait. Some of them get better on their own, some of
>>> them get to wait a long time to get their hangnail treated. The odd
>>> person with trivial problems does sit on the wait list and eventually
>>> use resources, but theres not many willing to do that. Wealthy people
>>> with trivial problems they are willing to pay for are still free to go
>>> outside the system if they choose.
It is a question of which is more important, your freedom or your safety.
If your safety is more important than your freedom, then you want someone to
take care of you. If your freedom is more important than your safety, you
want to take care of yourself.
>>
>> When you pay for your own medical needs, what are the odds that anyone
>> other than yourself will decide on whether you live or die? When someone
>> else pays for your medical needs, what are the odds that in order to save
>> money, they will decide if you live or die? When you depend on someone
>> else to pay for your medical needs CAN they decide not to pay?
>
> No, they can't. What are the odds you might not have enough money to pay
> for your treatment?
The same odds that you will not have enough money to live on when you are no
longer working. It boils down to the same problem. There is no free lunch.
What are the odds your surgeon might get a better offer from
> a richer patient and take care of him ahead of you?
What are the odds that when you call a plumber to come to your home to do
some repair work for you, that they will go to the person who is richer?
For teh richest 10% of
> the population your system works. Another 50% or so has been convinced by
> the industry that it is working but it isn't. Where I live I CAN'T be
> refused treatment. For anything. I know it works because I live with it
> already. Someone else deciding if I live or die is not possible because
> refusing treatment is not part of the equation. Its just not one of the
> lines on the form. The only way I can ever have treatment stopped is by a
> DNR order. In most cases that requires both my family's and my prior
> approval. They can't let me go unless I say so and I can't commit medical
> suicide without their say so. You are still listening to people who have
> an interest in keeping your money. Or perhaps you are one of them, who
> knows?
>
>
NO!!! There is a simple solution to the problem. Help people to help
themselves, rather than helping them directly.
>
>>>
>>> Every system has some way to limit how treatment happens. Yours
>>> currently limits it by how much money or insurance you have at your
>>> disposal, ours limits it by how badly you actually need it. The Canadian
>>> system is not perfect, its still being underfunded by neocon politicians
>>> for ideological reasons, but in spite of their interference it still
>>> works reasonably well. There are examples of systems in Europe which
>>> work even better.
I did not say the solution was health insurance, did I?
>>
>> It is a question of what happens in the future. Medical inflation that
>> is higher than the overall inflation rate means the total cost of
>> healthcare will rise. When it rises, and someone else is paying for your
>> medical needs, they have two choices. Either come up with the extra
>> money (and like taxes, we like the free benefit, we just don't like
>> paying for it) or ration care. That is the only two options the "payer"
>> has.
>
> Your care is rationed by cost now. That cost is going to increase
> regardless of what happens. If you are well off you migth be sheilded from
> it. For a while. What happens when you run out of money? or need to change
> employers? What about the large segment of the population who don't have
> unlimited funds? Throw them to the wolves? Let them eat cake?
>
Rationing occurs all the time. When you make a decision to spend money on
one thing and not something else you want, you have made a rationing
decision. But that was your decision that you made. When you depend on
someone else to pay for what you want or need, they make the rationing
decision to give you want you want or need, and when you do that, you have
also given them the right not to give you what you want or need. And when
that happens, and you depend on that person to give you what you want or
need, you are shit out of luck, when they don't give you what you want or
need, because you won't get what you want or need.
>
>
>>>
>>> Obama's solution does not go far enough. It still allows a hodgepodge of
>>> payers which will maintain the confusion and still cause too much
>>> expense overall. He's afraid to confront the insurance companies who are
>>> making a fortune and tell them its over. I suppose he has to start
>>> somewhere but I fear its going to be so timid a start that it won't be
>>> effective and it will give the opposition the chance to say see we told
>>> you so.
>>>
>>>
As I said, it is dependent on how free you want to be. How important is
your freedom. Is safety more important than your freedom. You cannot have
it both ways, you either want to be free, or you do not want to be free.
You are not truly free, when you depend on someone else for ANYTHING.
>>
>> You are right on that point. But your reasons are wrong. The solution
>> to controlling cost is to return the rationing decision back to where it
>> belongs and that is the user of the service. That is the only way you
>> can reduce the medical inflation rate, which is the reason we have a cost
>> problem.
>
> Vacation travel or automobile sales might respond to supply and demand but
> health care does not. When you need something you need it regardless of
> the cost. That is why 50% of the personal bankruptcies in your country are
> due to medical costs. Thats barbaric. Health care should be a right, not a
> privilege. Further, its not nly about controlling the cost, its about a
> fairer system for everybody, not just the wealthy.
>
EVERYTHING reposned to supply and demand. The medical bankruptcy excuse is
as phony as a three dollar bill. When people know that there will be no one
to pay for their medical bills, they are more likely to be prepared to pay
for their medical bills, if they need to use the service. But when people
think they someone esle is going to pay for their medical bills, they are
less likely to have the money to pay for their medical needs, when and if
they need that medical care.
> Bottom line is your system costs more. Much more than any other system
> being used anywhere in the world. Talk to any Canadian. Even though we
> have our share of right wingnuts here as well, you would have to talk to
> an awful lot of them to find any who would seriously consider trading
> places.
>
>>>
yes, our system does cost more, and we don't have anyone on long waiting
lists either.
>>
>
>
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
Around 80% of total healthcare spending is spent on those who will live 2
years or less. That by definition means that the bulk of that cost are
spent on those who are old. The old in the United States, has someone else
paying for their medical bills. The program is called MEDICARE. So, your
statement still is not valid.
>
>>And 54% is paid for by private
>>insurance, which is paid for by the business a person works for, for the
>>most part. I would think that very few people actually pay for their own
>>health insurance with the money they earn.
>
> You have a simple minded view of earnings. If employees didn't earn
> insurance premiums,
> why do companies pay it? They're not legally required to do so.
Companies give benefits of all kids to their workers, because they believe
that is one way to keep their workers working for them. It is driven by
what the company thinks is best for the company.
>
> The reason companies buy health insurance for you is so you don't have to
> pay income tax
> on the money. Also, they don't want workers organizing to buy group
> insurance because it
> might lead to other collective actions such as <shudder> labor unions.
No, they provide that benefit for purely selfish reasons, they think that
the worker will stay with them, and not go somewhere else.
>
>>>>> "The average family health insurance premium, provided through an
>>>>> employer
>>>>> health benefit
>>>>> program, was $11,480 in 2006. Employees paid an average of $2,973
>>>>> towards
>>>>> the premium
>>>>> amount." Source: Kaiser Family Foundation
>>>>> http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm
>>>>
>>>>So, since medical inflation is running at or above 8% per year, that
>>>>means
>>>>the cost of that insurance will double in around eight years, and will
>>>>double again every succeeding period of time?
>>>
>>> Cost will rise faster than inflation because a demographic bubble,
>>> boomers, is nearing
>>> elderhood. The average age is going up. But we cannot afford to pay
>>> double. That would put
>>> health care at 35% of GDP, more than total government spending with
>>> deficits. Something
>>> has to change, soon.
How can cost rise faster than the inflation rate? It can rise faster than
the inflation rate, when even if there was zero inflation, cost would
continue to rise. What proof have you got to offer that is the case, that
costs are rising, even if the inflation rate were zero? As for your claim
that COst are rising because of the demographic bubble, that too does not
hold water, since we have not reach the demographic bubble yet. That will
happen when the baby boomers reasch retirement age. But it still does not
hold water. The facts are clear. medical inflation prior to 1950 was
consistently lower than the CPI, and since 1950 has been consistently higher
than the CPI.
>>
>>So, what do you think the "change" should be? The Obama solution or
>>something else?
>
> Something more comprehensive. ObamaCare is business as usual. The 15%
> uninsured will get a
> waiver giving them permission to do without. That's what we have now.
I asked what is your solution. Saying "something more comprehensive" is not
a solution. A solution would be, if you believed we should go to a single
payment system, is that what you think we should do?
>
>>> An estimated 30% of health care spending goes to slippage,
>>> administrative
>>> inefficiencies.
>>> A single payer system would eliminate 90% of that.
>>
>>If you reduced administrative inefficiences to zero, wouldn't medical
>>inflation over time, wipe out any "savings" that you may have achieved by
>>reducing administrative inefficiencies?
>
> The root cause of health care inflation is lack of central management. In
> 1960, the US and
> other industrialized countries were spending at the same rate: 6% of GDP.
> Now the US is
> spending 16% while everyone else is spending 6-8%. The difference is not
> explained by
> rationing nor sub-standard care, it is explained by the US's free market
> system versus
> others' government managed system.
I guess I should have expected such a response. You don't have a clue about
the issue....soory I tried....
>
Robert
>yes, our system does cost more, and we don't have anyone on long waiting
>lists either.
Yes we do. It takes months to get an appointment at a free clinic.
Robert
What about 38% now on government aid or uninsured who cannot afford to pay the bill? Would
you have them crawl into the woods to die, like animals?
>>>You are right on that point. But your reasons are wrong. The solution to
>>>controlling cost is to return the rationing decision back to where it
>>>belongs and that is the user of the service. That is the only way you can
>>>reduce the medical inflation rate, which is the reason we have a cost
>>>problem.
>>
>> Other countries didn't follow your advice, they went the other way, yet
>> they don't have a
>> cost problem.
>>
>
>They ALL have a cost problem, so that is a lie. And they all have a problem
>with medical inflation. Check it out for yourself. Everyone one of those
>countries have a medical inflation rate that is higher than their overall
>inflation rate.
I found you're right. But you say "the only way you can reduce the medical inflation rate"
is to take decisions away from government and return them to the people. Most of Africa
did exactly that in the 1980's. Their medical inflation didn't go down, but health became
worse because the poor could no longer see doctors.
Robert
Medicare supplies about 25% of health care spending, not 80%. If your statement is true,
at least 69% (55/80) of spending on dying people came from other than Medicare.
>The old in the United States, have someone else
>paying for their medical bills. The program is called MEDICARE. So, your
>statement still is not valid.
"Among the 84.2% with health insurance in 2006, coverage was provided through an employer
59.7%, purchased individually 9.1%, and 27.0% was government funded (Medicare, Medicaid,
Military). (There is some overlap in coverage figures.) Source: US Census Bureau"
http://www.healthpaconline.net/health-care-statistics-in-the-united-states.htm
27.0 * .842 = 22.7% of the US population covered by government programs, including
Medicare., leaving 77.3% privately insured or doing without.
>>>>>So, since medical inflation is running at or above 8% per year, that
>>>>>means
>>>>>the cost of that insurance will double in around eight years, and will
>>>>>double again every succeeding period of time?
>>>>
>>>> Cost will rise faster than inflation because a demographic bubble,
>>>> boomers, is nearing
>>>> elderhood. The average age is going up. But we cannot afford to pay
>>>> double. That would put
>>>> health care at 35% of GDP, more than total government spending with
>>>> deficits. Something
>>>> has to change, soon.
>
>How can cost rise faster than the inflation rate? It can rise faster than
>the inflation rate, when even if there was zero inflation, cost would
>continue to rise. What proof have you got to offer that is the case, that
>costs are rising, even if the inflation rate were zero?
Old people use more health care than young. The population is getting older. Therefore,
per capita demand is increasing. Even if the price of a 'unit' of health care stayed the
same, cost per capita will go up because the number of units will increase.
> As for your claim
>that COst are rising because of the demographic bubble, that too does not
>hold water, since we have not reach the demographic bubble yet. That will
>happen when the baby boomers reasch retirement age.
People don't suddenly get sick with they turn 65. Health problems increase gradually with
age, independent of who's paying.
> But it still does not
>hold water. The facts are clear. medical inflation prior to 1950 was
>consistently lower than the CPI, and since 1950 has been consistently higher
>than the CPI.
Medicare and Medicaid began in 1965. How do you explain inflation between 1950 and 1964?
We can expect a small amount of inflation, relative to the rest of the economy, because
health care is labor intensive, therefore not as amenable to productivity increases as,
say, manufacturing. Moreover, it cannot easily be outsourced to lower cost producers.
Health care is a service industry that, unlike restaurants and barber shops, uses highly
paid workers.
>>>So, what do you think the "change" should be? The Obama solution or
>>>something else?
>>
>> Something more comprehensive. ObamaCare is business as usual. The 15%
>> uninsured will get a
>> waiver giving them permission to do without. That's what we have now.
>
>I asked what is your solution. Saying "something more comprehensive" is not
>a solution. A solution would be, if you believed we should go to a single
>payment system, is that what you think we should do?
I said what my solution is several times. Again, it is central management. It doesn't
matter who prints checks nor, in principle, who the manager is. What matters is that we
have standards and uniformity in the way claims are filed, records are kept, and PRICES
ARE SET. No more 20 prices for a drug depending on who's paying for it and what rebates
are in place; there would be one price for a drug. No more high fees for Beverly Hills
doctors and low fees for poverty doctors; they'd all get the same fee.
Eliminating competition would reduce slippage and inefficiency by (I'm guessing) 90%. For
instance, pharmaceutical companies spend more on marketing (35%) than on research AND
manufacturing (25%). Plus, they spend a lot administering marketing programs, such as
calculating rebates and tracking which doctors are using which drugs. Eliminating all that
marketing would cut the price of drugs in half.
Central management is the core reason WHY other countries spend half as much as the US.
It's not because they ration care; it's because they deliver it uniformly, thereby
eliminating price and marketing competition within the industry. The only way for
companies and doctors to compete is in quality, which benefits everyone.
Norm
>>
>>>>> Is there any system that we can devise that will not have unnecessary
>>>>> overuse? If you do not pay for what you want or need, are you more or
>>>>> less likely to "overuse" the system? If you paid for what you need or
>>>>> want, aren't you less likely to "overuse" the system?
>>>>
>>>> A single payer system with doctors still operating as private entities
>>>> but all billing the same place. No fault insurance type of thing. Cover
>>>> whatever happens. No disputes over who pays for it just fix it. No such
>>>> thing as "pre-existing, you're either sick or you're not. The fees are
>>>> fixed and reviewed by government and medical people. Doctors still
>>>> become wealthy people in this country and nurses have been known to
>>>> make a decent living as well. And you don't end up paying huge dollars
>>>> to solve problems which would have been cheap if they were treated when
>>>> they began.
>>>
>>> How does your proposal reduce the medical inflation rate?
>>
>> It reduces the overall cost.
>
> "If" it reduced the overall cost, then the cost per person over time would
> be lower rather than higher. Is the overall ocst lower rather than
> higher?
Your question is unclear. Do you mean here or there?
>
> I'm assuming by Medical inflation you mean the
>> rising cost of treatment.
>
> The rsing cost of healthcare, that is due to medical inflation. If the
> medical inflation rate was zero, we would not have a cost problem we do
> have with healthcare. When someone else is paying for our medical care,
> that person does not care what the cost of that care is, they will use the
> service regardless of how much it cost.
Thats a good thing. Do you think its preferable for people to NOT use health
care when they need it? Do you honestly think people will begin taking a
trip down to the doctors office because they find it entertaining? Wanting
people to NOT use health care reveals a particularily mean spirited
motivation.
When that happens, you have lost
> the most effective means to controllling cost, and costs will rise.
Thats an assumption. If it was true then why are health care costs not
HIGHER in my country than in yours? We have had universal health care for 45
years, you would think by now your theory would have kicked in.
When it
> rises, the payer only has two options, either come up with the money to
> pay for that increase, or resort to some form of rationing. But neither
> one, addresses the reason cost are rising, so cost will continue to rise.
> Which in turn means, they have to constantly find the money to pay for
> that increase, or resort to some form of rationing. But like price
> controls, it does not work over a long period of time, which means that
> over time, more and more rationing has to occur, or they have to collect
> the money to pay for that increase from someone else.
>
> An MRI is still going to increase in cost as is a
>> heart transplant, thats just reality, you can't change that unless you
>> force the suppliers of the service to work for free. Thats not going to
>> happen. What is going to happen is the waste will be reduced. How much
>> does it cost to deliver a baby when the mother has not been under care
>> until the last minute because she couldn't afford the co-pay? How much
>> does it cost to fix an injury which was left to fester until intolorable?
>> How much does it cost a doctors office to sort out which of a dozen
>> insurers to bill for each patient? How much time and money is wasted
>> determining if insurance will cover a particular problem before treament
>> is commenced? All the above spinning of wheels is eliminated in a single
>> payer, universal system. The cost of taking care of the odd patient who
>> "overuses" is a drop in the bucket compared to what will be saved.
>>
>
> No. The cost of the MRI does not increase over time. It remains the
> same.
Sure. And neither will cars increase in price. nor milk. What are you
babbling about?
>>
>>>>
>>>> Ah, but then we get the dreaded "people dying on the wait list"
>>>> syndrome. The horror sories you've been told by insurance companies and
>>>> some of your government who have vested interests in the status quo.
>>>> Doesn't happen, its a myth.
>
> It is not a "myth" as you put it. It is a fact.
Now you know more about what happens where I live than I do???
I respectfully suggest you haven't a clue what you are talking about.
If we believe your theory we should also do away with the police and
military. After all who is more free than the man who takes care of himself?
>>>
>>> When you pay for your own medical needs, what are the odds that anyone
>>> other than yourself will decide on whether you live or die? When
>>> someone else pays for your medical needs, what are the odds that in
>>> order to save money, they will decide if you live or die? When you
>>> depend on someone else to pay for your medical needs CAN they decide not
>>> to pay?
>>
>> No, they can't. What are the odds you might not have enough money to pay
>> for your treatment?
>
> The same odds that you will not have enough money to live on when you are
> no longer working. It boils down to the same problem. There is no free
> lunch.
>
> What are the odds your surgeon might get a better offer from
>> a richer patient and take care of him ahead of you?
>
> What are the odds that when you call a plumber to come to your home to do
> some repair work for you, that they will go to the person who is richer?
I'm sure it happens all the time.
Do you really want to operate health care on that same principle?
>
> For teh richest 10% of
>> the population your system works. Another 50% or so has been convinced by
>> the industry that it is working but it isn't. Where I live I CAN'T be
>> refused treatment. For anything. I know it works because I live with it
>> already. Someone else deciding if I live or die is not possible because
>> refusing treatment is not part of the equation. Its just not one of the
>> lines on the form. The only way I can ever have treatment stopped is by a
>> DNR order. In most cases that requires both my family's and my prior
>> approval. They can't let me go unless I say so and I can't commit medical
>> suicide without their say so. You are still listening to people who have
>> an interest in keeping your money. Or perhaps you are one of them, who
>> knows?
>>
>>
>
> NO!!! There is a simple solution to the problem. Help people to help
> themselves, rather than helping them directly.
How are you "helping people to help themselves"?
Are you ensuring they have an adequete income? or are you babysitting them
to make certain they don't spend it on frivolous things like clothes for th
ekids?
I assume you are posting from a tent in the wilderness?
>>>
>>> You are right on that point. But your reasons are wrong. The solution
>>> to controlling cost is to return the rationing decision back to where it
>>> belongs and that is the user of the service. That is the only way you
>>> can reduce the medical inflation rate, which is the reason we have a
>>> cost problem.
>>
>> Vacation travel or automobile sales might respond to supply and demand
>> but health care does not. When you need something you need it regardless
>> of the cost. That is why 50% of the personal bankruptcies in your country
>> are due to medical costs. Thats barbaric. Health care should be a right,
>> not a privilege. Further, its not nly about controlling the cost, its
>> about a fairer system for everybody, not just the wealthy.
>>
>
> EVERYTHING reposned to supply and demand. The medical bankruptcy excuse
> is as phony as a three dollar bill. When people know that there will be
> no one to pay for their medical bills, they are more likely to be prepared
> to pay for their medical bills, if they need to use the service. But when
> people think they someone esle is going to pay for their medical bills,
> they are less likely to have the money to pay for their medical needs,
> when and if they need that medical care.
How do you "prepare" for a situation that might cost you hundreds of
thousands? Be serious and think this through.
>
>> Bottom line is your system costs more. Much more than any other system
>> being used anywhere in the world. Talk to any Canadian. Even though we
>> have our share of right wingnuts here as well, you would have to talk to
>> an awful lot of them to find any who would seriously consider trading
>> places.
>>
>>>>
>
> yes, our system does cost more, and we don't have anyone on long waiting
> lists either.
Yes you do. You have a significant segment of your population on INFINITELY
long waiting lists. The difference is you yourself are alright (so far) so
you just don't care. Thats typical of the wild west mindset that has the US
in the position they are now. Your time will come sooner than you might
think.
>>>
>>
>>
>
Robert
>As I said, it is dependent on how free you want to be. How important is
>your freedom. Is safety more important than your freedom. You cannot have
>it both ways, you either want to be free, or you do not want to be free.
>You are not truly free, when you depend on someone else for ANYTHING.
You aren't capable of gowing most of your food nor building a house, car, TV, cellphone
or computer. You can't even make a gun. And you certainly can't provide your own health
care. You depend on others for those things and many more. The only people who are truly
free are Papuan tribes in New Guinea.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
I did not say that the cost is totally born by Medicare did I?
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
No, I would provide them with the means to take care of their own needs and
not depend on the government to provide them with what they need. And no
all of the uninsured cannot afford to pay the bill. I am willing to bet
yoou cannot define in any detail who these uninsured are, will you prove me
wrong?
>
>>>>You are right on that point. But your reasons are wrong. The solution
>>>>to
>>>>controlling cost is to return the rationing decision back to where it
>>>>belongs and that is the user of the service. That is the only way you
>>>>can
>>>>reduce the medical inflation rate, which is the reason we have a cost
>>>>problem.
>>>
>>> Other countries didn't follow your advice, they went the other way, yet
>>> they don't have a
>>> cost problem.
Spend a little effort and see if your statement is true. You will find, if
you do your research, and you don't put blinders on, that your statement is
not true. Every third party payment system in the world, is under enormose
cost pressures, because of medical inflation.
>>>
>>
>>They ALL have a cost problem, so that is a lie. And they all have a
>>problem
>>with medical inflation. Check it out for yourself. Everyone one of those
>>countries have a medical inflation rate that is higher than their overall
>>inflation rate.
>
> I found you're right. But you say "the only way you can reduce the medical
> inflation rate"
> is to take decisions away from government and return them to the people.
> Most of Africa
> did exactly that in the 1980's. Their medical inflation didn't go down,
> but health became
> worse because the poor could no longer see doctors.
I said return the rationing decision back to the user of the service. We do
it just about everywhere else, and it works real well. Food is a good
example. The government does not pay for our food, we pay for our food, and
inflation is a whole lot lower than the medical inflation rate.
Eric Gisin
"Shawn Hirn" <sr...@comcast.net> wrote in message
news:srhi-708B14.2...@atoulouse-552-1-42-74.w92-136.abo.wanadoo.fr...
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
When you have to see a doctor, how long does it take you to get an
appoitment? If they say you need to have an operation, how long did you
have to wait to have that operation. When I had my heart problem, I was
admitted to emergency on the same day they found the problem. In less than
one week, I had my bypass surgery.
Robert
Your statistic may have come from Parnership For Solutions, a project of the Robert Wood
Johnson Foundation (RWJF).
"Between 2000 and 2020, the number of Americans with chronic conditions is projected to
increase from 125 million to 157 million, and the number of Americans with two or more
chronic diseases is projected to increase from 57 million to 81 million. People with
chronic conditions accounted for more than 78 percent of health care expenditures in 2000,
and this percentage is expected to increase in the coming decades. (Archives of Internal
Medicine, February 24, 2003)"
http://www.rwjf.org/reports/npreports/betterlives.htm
Chronic diseases include hypertension, heart disease, respiratory disease, Alzheimer's
disease, arthritis and diabetes. Early treatment is key to containing these diseased
before they become life threatening. If you wait until blood pressure is 150/110 before
treating hypertension, you're too late. Our medical and insurance systems are oriented to
crisis, stomping out fires, not to prevention. Disjointed medical information systems make
it difficult to monitor patients receiving care from several providers. The solution to
these problems is a single health database.
Prevention through coerced lifestyle changes is the main topic in alt.smokers. As a
champion of freedom, do you think it's right for government to persecute smokers, fast
food customers or the obese? If your answer is yes, you'll have to explain the
inconsistancy between freedom to pay versus freedom to act.
Smokers have reduced life expectancy, therefore less chronic diseases of old age. Given
your belief that old people are a burden, isn't lower life expectancy a good thing?
Conversely, wouldn't an industry (represented by RWJF) that profits from chronic disease
have a financial incentive to increase life expectancy?
Robert
Most are uninsured because insurance companies refuse to cover them, and they're not
insured through employment. The claim that 25% of them are non-citizens is irrelevant
because citizenship is not required to buy a policy. The claim that most could afford to
buy coverage confirms my position. They are not uninsured because they're stupid or short
sighted, they're uninsured because they can't get coverage.
May people are unaware 35 out of 50 states have assigned risk pools through which everyone
can buy insurance. They are not subsidized (except in MA). I recently posted an article in
alt.smokers giving sample rates for a 51 year old ranging from $400/mo to 1,000/mo. Two
states -- FL and TN -- have limited liability plans for $200/mo that have maximum payout
of $25K per year, in contradiction of the states' own insurance standards.
>>>>>You are right on that point. But your reasons are wrong. The solution
>>>>>to
>>>>>controlling cost is to return the rationing decision back to where it
>>>>>belongs and that is the user of the service. That is the only way you
>>>>>can
>>>>>reduce the medical inflation rate, which is the reason we have a cost
>>>>>problem.
>>>>
>>>> Other countries didn't follow your advice, they went the other way, yet
>>>> they don't have a
>>>> cost problem.
>
>Spend a little effort and see if your statement is true. You will find, if
>you do your research, and you don't put blinders on, that your statement is
>not true. Every third party payment system in the world, is under enormose
>cost pressures, because of medical inflation.
ALL systems are under pressure from medical inflation, proving it's not caused by the form
of payment. Areas without third party payment are all Africa (except South Africa), India
and most of Southeast Asia.
>>>They ALL have a cost problem, so that is a lie. And they all have a
>>>problem
>>>with medical inflation. Check it out for yourself. Everyone one of those
>>>countries have a medical inflation rate that is higher than their overall
>>>inflation rate.
>>
>> I found you're right. But you say "the only way you can reduce the medical
>> inflation rate"
>> is to take decisions away from government and return them to the people.
>> Most of Africa
>> did exactly that in the 1980's. Their medical inflation didn't go down,
>> but health became
>> worse because the poor could no longer see doctors.
>
>I said return the rationing decision back to the user of the service. We do
>it just about everywhere else, and it works real well. Food is a good
>example. The government does not pay for our food, we pay for our food, and
>inflation is a whole lot lower than the medical inflation rate.
On food, our options range from a .10 bowl of rice to a $300 dinner at the French Laundry.
When it comes to health care, patients (consumers) have been excluded from the decision
process. If you offer an opinion, doctors act like you're trespassing on their turf, akin
to practicing medicine without a license. Moreover, doctors have no clue what things cost.
I once said to a doctor, "You just prescribed a patented drug costing $180. Wouldn't this
$20 generic be just as effective?" He quickly agreed, with the comment "Really?"
A centrally managed system would put a stop to that. It would make the choices patients
aren't knowledgeable enough nor allowed to make. For instance, studies have found the
least expensive diuretic is just as effective as the most expensive beta blocker for
hypertension. If I said that to my wife's cardiologist, he'd throw me out of the office.
If a central manager said it, he'd have to listen. Insurance oompanies could have been
watchdogs, but they fell down on the job.
Jerry Okamura
>
> "Jerry Okamura" <okamu...@hawaii.rr.com> wrote in message
> news:LllGm.161$hJ2...@newsfe13.iad...
>
>
>>>
>>>>>> Is there any system that we can devise that will not have unnecessary
>>>>>> overuse? If you do not pay for what you want or need, are you more
>>>>>> or less likely to "overuse" the system? If you paid for what you
>>>>>> need or want, aren't you less likely to "overuse" the system?
>>>>>
>>>>> A single payer system with doctors still operating as private entities
>>>>> but all billing the same place. No fault insurance type of thing.
>>>>> Cover whatever happens. No disputes over who pays for it just fix it.
>>>>> No such thing as "pre-existing, you're either sick or you're not. The
>>>>> fees are fixed and reviewed by government and medical people. Doctors
>>>>> still become wealthy people in this country and nurses have been known
>>>>> to make a decent living as well. And you don't end up paying huge
>>>>> dollars to solve problems which would have been cheap if they were
>>>>> treated when they began.
>>>>
>>>> How does your proposal reduce the medical inflation rate?
>>>
>>> It reduces the overall cost.
>>
>> "If" it reduced the overall cost, then the cost per person over time
>> would be lower rather than higher. Is the overall ocst lower rather than
>> higher?
>
>
> Your question is unclear. Do you mean here or there?
I mean everywhere, that has a medical inflation rate that is higher than
their overall inflation rate. If you do not reduce the medical inflation
rate, you cannot possibly reduce the cost of healthcare. And when that
medical inflation rate is higher than your overall inflation rate, that
means the cost of that care is rising faster than the average cost of
everything else.
>
>
>
>>
>> I'm assuming by Medical inflation you mean the
>>> rising cost of treatment.
>>
>> The rsing cost of healthcare, that is due to medical inflation. If the
>> medical inflation rate was zero, we would not have a cost problem we do
>> have with healthcare. When someone else is paying for our medical care,
>> that person does not care what the cost of that care is, they will use
>> the service regardless of how much it cost.
>
> Thats a good thing. Do you think its preferable for people to NOT use
> health care when they need it? Do you honestly think people will begin
> taking a trip down to the doctors office because they find it
> entertaining? Wanting people to NOT use health care reveals a
> particularily mean spirited motivation.
>
It is unsustaingable, when cost are rising as a result. The ultimate effect
is that there will be more and more rationing, which means your goal cannot
be achieved, because more and more people will not get the care they need or
want, when they want it.
>
>
> When that happens, you have lost
>> the most effective means to controllling cost, and costs will rise.
>
>
> Thats an assumption. If it was true then why are health care costs not
> HIGHER in my country than in yours? We have had universal health care for
> 45 years, you would think by now your theory would have kicked in.
Wrong question. Right question, is the medical inflation rate in your
country lower than the overall inflation rate, or is it higher than the
overall inflation rate.
Wrong example. The cost of the MRI will only increase over time, if the
cost of labor for the people who run the MRI machine rises over time. The
cost of the machine does not rise, it will most likely cost less over time,
since they will figure out how to build it at a lower cost than they did
before. Everything increases with price inflation. It is a quetiton of how
fast will it increase due to inflation.
>
>
>
>
>>>
>>>>>
>>>>> Ah, but then we get the dreaded "people dying on the wait list"
>>>>> syndrome. The horror sories you've been told by insurance companies
>>>>> and some of your government who have vested interests in the status
>>>>> quo. Doesn't happen, its a myth.
>>
>> It is not a "myth" as you put it. It is a fact.
>
> Now you know more about what happens where I live than I do???
> I respectfully suggest you haven't a clue what you are talking about.
>
>
If you do not know that to be a fact, then I would suggest you don't
understand the issue. It is really simple. When you pay for what you want
or need, you decide whether to pay or not pay. When someone else pays for
what you want or need, they decide to pay, they decide when to pay, and they
can decide not to pay. You have little to no control over that decision.
And the incentive not to pay is very high, because the costs for providing
that care, is rising due to a large degree by medical inflation.
>
>
>
> In Canada for example, the
>> government puts a cap on the amount of money they will spend in any one
>> year. When you do that, once the money is spent, you have no more money
>> to spend for that year, regardless of how much money is actually needed
>> to treat everyone who needs the treatment. That is a form of rationing.
>> Another form of rationing are waiting list, which Canada does have. In
>> the State of Oregon, they have developed a list of services they will pay
>> for and services they will not pay for. Those who are not on the list,
>> are shit out of luck, unless they pay for it themselves.
>>
>>
>>>>> The way it works is if you are in greater need you get moved up in
>>>>> priority. It happened twice last year in my own family. That woman
>>>>> from Canada you heard about in the news a few months back who had a
>>>>> "tumour" and would have died had she not gone to the US - she lied
>>>>> from beginning to end. She didn't have a tumour she had a cyst and she
>>>>> was neverr in danger of anything other than a little discomfort. The
>>>>> wait list is how the system limits delivery. People who really don't
>>>>> need something fixed in a hurry get to wait. Some of them get better
>>>>> on their own, some of them get to wait a long time to get their
>>>>> hangnail treated. The odd person with trivial problems does sit on the
>>>>> wait list and eventually use resources, but theres not many willing to
>>>>> do that. Wealthy people with trivial problems they are willing to pay
>>>>> for are still free to go outside the system if they choose.
>>
Yep, but someone else not you, are the ones who are deciding if you have a
greater need. If you are among those that the government does not think is
the greater need, it does not matter if you think they are wrong, you won't
get the care you want or need.
>> It is a question of which is more important, your freedom or your safety.
>> If your safety is more important than your freedom, then you want someone
>> to take care of you. If your freedom is more important than your safety,
>> you want to take care of yourself.
>
>
> If we believe your theory we should also do away with the police and
> military. After all who is more free than the man who takes care of
> himself?
That is also a true statement. It is always a tradeoff between your safety
and your freedom. But there is a difference even in your example. For
instance, you do not need the police to protect you, if you can protect
yourself. But your military example is a good one, since obviously you
cannot protect your country without a strong military. So, in that case,
your safety is more important than your freedom. But you are not
surrendering very much of your freedom, by having a strong military.
>
>
>
>
>>>>
>>>> When you pay for your own medical needs, what are the odds that anyone
>>>> other than yourself will decide on whether you live or die? When
>>>> someone else pays for your medical needs, what are the odds that in
>>>> order to save money, they will decide if you live or die? When you
>>>> depend on someone else to pay for your medical needs CAN they decide
>>>> not to pay?
>>>
>>> No, they can't. What are the odds you might not have enough money to pay
>>> for your treatment?
That is the price of freedom. There is no guarantee of anything.
>>
>> The same odds that you will not have enough money to live on when you are
>> no longer working. It boils down to the same problem. There is no free
>> lunch.
>>
>> What are the odds your surgeon might get a better offer from
>>> a richer patient and take care of him ahead of you?
>>
>> What are the odds that when you call a plumber to come to your home to do
>> some repair work for you, that they will go to the person who is richer?
>
> I'm sure it happens all the time.
> Do you really want to operate health care on that same principle?
Yes, because I put a very high value on our freedom.
>
>
>
>>
>> For teh richest 10% of
>>> the population your system works. Another 50% or so has been convinced
>>> by the industry that it is working but it isn't. Where I live I CAN'T be
>>> refused treatment. For anything. I know it works because I live with it
>>> already. Someone else deciding if I live or die is not possible because
>>> refusing treatment is not part of the equation. Its just not one of the
>>> lines on the form. The only way I can ever have treatment stopped is by
>>> a DNR order. In most cases that requires both my family's and my prior
>>> approval. They can't let me go unless I say so and I can't commit
>>> medical suicide without their say so. You are still listening to people
>>> who have an interest in keeping your money. Or perhaps you are one of
>>> them, who knows?
>>>
>>>
>>
>> NO!!! There is a simple solution to the problem. Help people to help
>> themselves, rather than helping them directly.
>
> How are you "helping people to help themselves"?
>
The quesitin is not how are you "helping people to help themselves", the
question is how "do" you help people help themselves. In the case of
healthcare, you help people help themselves, by helping them pay for the
their own needs.
When you are able to take care of yourself you have a whole lot more
freedom, then when you depend on someone else to take care of you.
> Are you ensuring they have an adequete income? or are you babysitting them
> to make certain they don't spend it on frivolous things like clothes for
> th ekids?
>
No one can guarantee that you will make enough money to take care of your
needs. But that is the price of freedom. To be free means you are taking
the risk that you can indeed take care of yourself.
>
>
>>
>>
>>>
>>>>>
>>>>> Every system has some way to limit how treatment happens. Yours
>>>>> currently limits it by how much money or insurance you have at your
>>>>> disposal, ours limits it by how badly you actually need it. The
>>>>> Canadian system is not perfect, its still being underfunded by neocon
>>>>> politicians for ideological reasons, but in spite of their
>>>>> interference it still works reasonably well. There are examples of
>>>>> systems in Europe which work even better.
>>
>> I did not say the solution was health insurance, did I?
>>>>
>>>> It is a question of what happens in the future. Medical inflation that
>>>> is higher than the overall inflation rate means the total cost of
>>>> healthcare will rise. When it rises, and someone else is paying for
>>>> your medical needs, they have two choices. Either come up with the
>>>> extra money (and like taxes, we like the free benefit, we just don't
>>>> like paying for it) or ration care. That is the only two options the
>>>> "payer" has.
>>>
>>> Your care is rationed by cost now. That cost is going to increase
>>> regardless of what happens. If you are well off you migth be sheilded
>>> from it. For a while. What happens when you run out of money? or need to
>>> change employers? What about the large segment of the population who
>>> don't have unlimited funds? Throw them to the wolves? Let them eat cake?
Rationing always occurs. But there is a big difference between the
indivdual making that rationing decision and someone else making that
rationing decision for you. One way you are in control, the other way you
are not in control.
>>>
>>
>> Rationing occurs all the time. When you make a decision to spend money
>> on one thing and not something else you want, you have made a rationing
>> decision. But that was your decision that you made. When you depend on
>> someone else to pay for what you want or need, they make the rationing
>> decision to give you want you want or need, and when you do that, you
>> have also given them the right not to give you what you want or need.
>> And when that happens, and you depend on that person to give you what you
>> want or need, you are shit out of luck, when they don't give you what you
>> want or need, because you won't get what you want or need.
>>>
>>>
>>>>>
>>>>> Obama's solution does not go far enough. It still allows a hodgepodge
>>>>> of payers which will maintain the confusion and still cause too much
>>>>> expense overall. He's afraid to confront the insurance companies who
>>>>> are making a fortune and tell them its over. I suppose he has to start
>>>>> somewhere but I fear its going to be so timid a start that it won't be
>>>>> effective and it will give the opposition the chance to say see we
>>>>> told you so.
>>>>>
>>>>>
>>
>> As I said, it is dependent on how free you want to be. How important is
>> your freedom. Is safety more important than your freedom. You cannot
>> have it both ways, you either want to be free, or you do not want to be
>> free. You are not truly free, when you depend on someone else for
>> ANYTHING.
>
> I assume you are posting from a tent in the wilderness?
I am posting from the great state of Hawaii.
>
>
>
>
>>>>
>>>> You are right on that point. But your reasons are wrong. The solution
>>>> to controlling cost is to return the rationing decision back to where
>>>> it belongs and that is the user of the service. That is the only way
>>>> you can reduce the medical inflation rate, which is the reason we have
>>>> a cost problem.
>>>
>>> Vacation travel or automobile sales might respond to supply and demand
>>> but health care does not. When you need something you need it regardless
>>> of the cost. That is why 50% of the personal bankruptcies in your
>>> country are due to medical costs. Thats barbaric. Health care should be
>>> a right, not a privilege. Further, its not nly about controlling the
>>> cost, its about a fairer system for everybody, not just the wealthy.
>>>
>>
>> EVERYTHING reposned to supply and demand. The medical bankruptcy excuse
>> is as phony as a three dollar bill. When people know that there will be
>> no one to pay for their medical bills, they are more likely to be
>> prepared to pay for their medical bills, if they need to use the service.
>> But when people think they someone esle is going to pay for their medical
>> bills, they are less likely to have the money to pay for their medical
>> needs, when and if they need that medical care.
>
> How do you "prepare" for a situation that might cost you hundreds of
> thousands? Be serious and think this through.
The same way you prepare for anything that could cost you a ton of money,
that you may not have. If your house is destroyed, and you do not have
insurance or the money to rebuild the house, you won't have a house. Is you
have a spouse and children and you are the principle breadwinner, and you
die, your spouse and children will suffer, unless you have provided for the
possiblity you might die. You can do that eithe by having enough money for
them to survive on without you, or you can buy life insurance.
>
>
>
>
>
>
>>
>>> Bottom line is your system costs more. Much more than any other system
>>> being used anywhere in the world. Talk to any Canadian. Even though we
>>> have our share of right wingnuts here as well, you would have to talk to
>>> an awful lot of them to find any who would seriously consider trading
>>> places.
>>>
>>>>>
>>
>> yes, our system does cost more, and we don't have anyone on long waiting
>> lists either.
>
>
> Yes you do. You have a significant segment of your population on
> INFINITELY long waiting lists. The difference is you yourself are alright
> (so far) so you just don't care. Thats typical of the wild west mindset
> that has the US in the position they are now. Your time will come sooner
> than you might think.
Prove your assertion.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
I will try to make this real simple. If each person pays for their own
healthcare needs, no one other than that person is responsible for how they
live their life. When someone else pays for our healthcare needs, they are
concenred about how you live your life, because how you live your life is
can cost them more money.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
Your statement is an assertion, back it up with facts.
Is the food you buy under enourmous pressue due to inflation?
>
>>>>They ALL have a cost problem, so that is a lie. And they all have a
>>>>problem
>>>>with medical inflation. Check it out for yourself. Everyone one of
>>>>those
>>>>countries have a medical inflation rate that is higher than their
>>>>overall
>>>>inflation rate.
>>>
>>> I found you're right. But you say "the only way you can reduce the
>>> medical
>>> inflation rate"
>>> is to take decisions away from government and return them to the people.
>>> Most of Africa
>>> did exactly that in the 1980's. Their medical inflation didn't go down,
>>> but health became
>>> worse because the poor could no longer see doctors.
That does not make any sense at all. If you are poor, you don't have the
money to spend on your own healthcare needs. If you do not have the money,
how can the cost go up?
>>
>>I said return the rationing decision back to the user of the service. We
>>do
>>it just about everywhere else, and it works real well. Food is a good
>>example. The government does not pay for our food, we pay for our food,
>>and
>>inflation is a whole lot lower than the medical inflation rate.
>
> On food, our options range from a .10 bowl of rice to a $300 dinner at the
> French Laundry.
> When it comes to health care, patients (consumers) have been excluded from
> the decision
> process. If you offer an opinion, doctors act like you're trespassing on
> their turf, akin
> to practicing medicine without a license. Moreover, doctors have no clue
> what things cost.
> I once said to a doctor, "You just prescribed a patented drug costing
> $180. Wouldn't this
> $20 generic be just as effective?" He quickly agreed, with the comment
> "Really?"
Which is relevant to what I said, how?
>
> A centrally managed system would put a stop to that. It would make the
> choices patients
> aren't knowledgeable enough nor allowed to make. For instance, studies
> have found the
> least expensive diuretic is just as effective as the most expensive beta
> blocker for
> hypertension. If I said that to my wife's cardiologist, he'd throw me out
> of the office.
> If a central manager said it, he'd have to listen. Insurance oompanies
> could have been
> watchdogs, but they fell down on the job.
I suppose you are right, but the price you pay is you are no longer free.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
That is a true statement. I did not say that you can be totally free in our
modern day society did I? I said you are not truly free, wehn you depend on
someone else for ANYTHING. You just proved my point.
Robert
You are probably one of the over-users of the health care system.
" A report in the Journal of the American Medical Association (JAMA) once again documented
angina pain relief in 75 percent of patients who have bypass surgery. Shortly thereafter,
an article in the New England Journal of Medicine stated 75 percent of angina patients'
pain is also relieved with non-surgical therapy. In effect, these two highly authoritative
articles are saying bypass surgery works no better than non-invasive therapies using
prescription medicines.
Many patients who opt for this operation have a real need to believe in its effectiveness.
They have a huge emotional as well as financial investment in a successful outcome, often
having been scared into believing that this surgery is the only way to save their lives.
Claims that the operation prolongs life to any significant degree are still being debated.
When the Harvard University School of Public Health put coronary bypass surgery to the
test, they concluded that surgery is often unnecessary. The Harvard study involved 142 men
who had all "flunked" a treadmill exercise test and had other evidence of extensive
coronary atherosclerosis. Each had been advised to undergo the bypass operation.
But, when this group of surgical candidates was referred to Harvard specialists for a
second opinion, surgery was rejected in favor of medication, diet, and exercise. After
keeping tabs on these 142 men for anywhere from 20 months to 12 years, the Harvard
researchers found their death rate exactly what would have been expected had the men been
operated on (provided, the study pointed out, they survived the operation, which has an
operative mortality of two to three percent, more in some centers).
Contrary to the claims of cardiovascular surgeons, bypass surgery does little to improve
the outlook for survival, according to the Harvard report.
A study by Dr. Wilbert Aranow at the University of California comparing atherosclerotic
heart patients treated surgically with those treated medically revealed no evidence of
increased survival or lowered heart attack risk. Nor did studies conducted by Duke
University Medical Center find reason to suggest that coronary surgery prolongs life when
compared with medical management.
An analysis of 1,101 consecutive patients with coronary artery disease was made by the
Division of Cardiology at Duke--490 had surgery, 611 were treated non-surgically. At the
end of four years, there was no significant difference in the survival rate between the
surgically treated and the medically treated: survival was 82 percent for the first group,
78 percent for the second.
In a study reported in the New England Journal of Medicine by Paulin, et al, 686 patients
with stable angina were followed for 22 years. Of that number, 322 received bypass surgery
and 312 were treated medically, without surgery. Long-term survival rates were comparable
in both treatment groups. At 22 years, the cumulative survival rate was 25 percent in the
medically-treated group but only 20 percent in patients who had received bypass surgery."
http://www.drcranton.com/chelation/angioplasty.htm
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
> On Sat, 31 Oct 2009 08:27:02 -1000, "Jerry Okamura"
> <okamu...@hawaii.rr.com> wrote:
>
>>
>>"Robert" <n...@e.mail> wrote in message
>>news:iijke5ltg82r1af0c...@4ax.com...
>>> On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
>>> <okamu...@hawaii.rr.com> wrote:
>>>
>>>>yes, our system does cost more, and we don't have anyone on long waiting
>>>>lists either.
>>>
>>> Yes we do. It takes months to get an appointment at a free clinic.
>>
>>When you have to see a doctor, how long does it take you to get an
>>appoitment? If they say you need to have an operation, how long did you
>>have to wait to have that operation. When I had my heart problem, I was
>>admitted to emergency on the same day they found the problem. In less
>>than
>>one week, I had my bypass surgery.
>
> You are probably one of the over-users of the health care system.
I do not like to see the doctors.
Robert
>
>"Robert" <n...@e.mail> wrote in message
>news:qccoe5l2shfkflb0o...@4ax.com...
>> Prevention through coerced lifestyle changes is the main topic in
>> alt.smokers. As a
>> champion of freedom, do you think it's right for government to persecute
>> smokers, fast
>> food customers or the obese? If your answer is yes, you'll have to explain
>> the
>> inconsistancy between freedom to pay versus freedom to act.
>>
>> Smokers have reduced life expectancy, therefore less chronic diseases of
>> old age. Given
>> your belief that old people are a burden, isn't lower life expectancy a
>> good thing?
>> Conversely, wouldn't an industry (represented by RWJF) that profits from
>> chronic disease
>> have a financial incentive to increase life expectancy?
>>
>
>I will try to make this real simple. If each person pays for their own
>healthcare needs, no one other than that person is responsible for how they
>live their life. When someone else pays for our healthcare needs, they are
>concenred about how you live your life, because how you live your life
>can cost them more money.
You overlooked people who can profit from lifestyle change. The pharmaceutical industry
has an incentive to make everyone live to 100, because old people are its best customers.
They don't care much who pays, so long as someone pays. Their incentive is to increase,
not decrease, the cost of healthcare.
The antismoking movement was, until recently, organized and financed by the pharmaceutical
industry, not public health advocates in government. Pharma did it to make a buck off the
ill health that comes with longevity. Thus, your hypothetical 'free man' has his freedom
diminished even though he pays 100% of his own healthcare. He loses because there's profit
in taking his freedom.
Including the profit motive shows how right wing philosopy can be detremental to freedom.
Slavery was a blatant case that took 200 years and a bloody civil war to eliminate. More
subtle cases like antismoking will never rise to that level. Freedom will be eroded so
some company can profit. I suppose being a stockholder of that company would turn it into
a zero sum game. Losers will be the poor buggers who weren't smart enough to invest.
Robert
>modern day society did I? I said you are not truly free, when you depend on
>someone else for ANYTHING. You just proved my point.
This notion of 'free man' is a ROMANTIC one from cowboy movies and female pulp fiction
writers such as Ayn Rand. Don't ask the rest of us to pay for your fantasies.
"Other people have no right, no hold, no interest or influence on him. And this is not
affected or chosen -- it's inborn, absolute, it can't be changed, he has 'no organ' to be
otherwise. In this respect, he has the true, innate psychology of a Superman. He can never
realize and feel 'other people.' " -- Ayn Rand
The word describing such people is sociopath, not hero.
Robert
Personal experience. I had private insurance for ten years until my wife (#1) had a
non-repeatable surgery costing $10K. My premium tripled and I couldn't buy insurance from
any other company. Round two. I had private insurance for ten years until my wife (#2) was
diagnosed with diabetes. That company (Mutual of Omaha) got out of the health insurance
business and I couldn't buy insurance from any other company.
Now I need private insurance and am forced to shop states for affordable coverage.
Massachusetts is the best by far. It should be a model for the whole US. I'm not moving
there because the weather sucks and housing is expensive. I'm going with the FL limited
liability plan. If she needs a $50K heart bypass, she's SOL.
We're talking about the cause of medical inflation, which you claim is third party
payment. You change the subject when confronted with evidence it's not caused by third
party payment.
>>>>>They ALL have a cost problem, so that is a lie. And they all have a
>>>>>problem
>>>>>with medical inflation. Check it out for yourself. Everyone one of
>>>>>those
>>>>>countries have a medical inflation rate that is higher than their
>>>>>overall
>>>>>inflation rate.
>>>>
>>>> I found you're right. But you say "the only way you can reduce the
>>>> medical
>>>> inflation rate"
>>>> is to take decisions away from government and return them to the people.
>>>> Most of Africa
>>>> did exactly that in the 1980's. Their medical inflation didn't go down,
>>>> but health became
>>>> worse because the poor could no longer see doctors.
>
>That does not make any sense at all. If you are poor, you don't have the
>money to spend on your own healthcare needs. If you do not have the money,
>how can the cost go up?
The cost per 'unit' of healthcare is going up, independant of who pays. There are fewer
buyers because the World Health Organization, in the 1980's, urged countries to privatize
healthcare, as you advocate. Most governments did it eagerly. Their contributions went
from 5% of GDP to well under 1%. The form of payment became, and still is, insurance or
out of pocket. Problem is, the dirt poor people cannot afford either. As a result they do
without.
The median age of death in industrial countries is around 70; in Africa, it's 5. Half of
African deaths occur before the age of 5. The rate of women dying during childbirth is
more than five times the rate elsewhere.
That's the outcome when countries follow your advice to get government out of healthcare.
>>>I said return the rationing decision back to the user of the service. We
>>>do
>>>it just about everywhere else, and it works real well. Food is a good
>>>example. The government does not pay for our food, we pay for our food,
>>>and
>>>inflation is a whole lot lower than the medical inflation rate.
>>
>> On food, our options range from a .10 bowl of rice to a $300 dinner at the
>> French Laundry.
>> When it comes to health care, patients (consumers) have been excluded from
>> the decision
>> process. If you offer an opinion, doctors act like you're trespassing on
>> their turf, akin
>> to practicing medicine without a license. Moreover, doctors have no clue
>> what things cost.
>> I once said to a doctor, "You just prescribed a patented drug costing
>> $180. Wouldn't this
>> $20 generic be just as effective?" He quickly agreed, with the comment
>> "Really?"
>
>Which is relevant to what I said, how?
Consumers are excluded from the rationing decision process. Decisions are being made by
doctors who know nothing about cost. It's the blind leading the blind.
>> A centrally managed system would put a stop to that. It would make the
>> choices patients
>> aren't knowledgeable enough nor allowed to make. For instance, studies
>> have found the
>> least expensive diuretic is just as effective as the most expensive beta
>> blocker for
>> hypertension. If I said that to my wife's cardiologist, he'd throw me out
>> of the office.
>> If a central manager said it, he'd have to listen. Insurance oompanies
>> could have been
>> watchdogs, but they fell down on the job.
>
>I suppose you are right, but the price you pay is you are no longer free.
The rich have always been free. Aspiring to freedom is a middle class idea. The American
middle class is being destroyed by corporate greed. Their dream of freedom is dying along
with their dream of success.
Robert
>
>"Robert" <n...@e.mail> wrote in message
>news:indpe5p40eq4febpv...@4ax.com...
>> On Sat, 31 Oct 2009 08:27:02 -1000, "Jerry Okamura"
>> <okamu...@hawaii.rr.com> wrote:
>>
>>>
>>>"Robert" <n...@e.mail> wrote in message
>>>news:iijke5ltg82r1af0c...@4ax.com...
>>>> On Thu, 29 Oct 2009 08:41:44 -1000, "Jerry Okamura"
>>>> <okamu...@hawaii.rr.com> wrote:
>>>>
>>>>>yes, our system does cost more, and we don't have anyone on long waiting
>>>>>lists either.
>>>>
>>>> Yes we do. It takes months to get an appointment at a free clinic.
>>>
>>>When you have to see a doctor, how long does it take you to get an
>>>appoitment? If they say you need to have an operation, how long did you
>>>have to wait to have that operation. When I had my heart problem, I was
>>>admitted to emergency on the same day they found the problem. In less
>>>than
>>>one week, I had my bypass surgery.
>>
>> You are probably one of the over-users of the health care system.
>
>I do not like to see the doctors.
They like to see you. It's been said every time a surgeon does a heart bypass, he earns
another sports car. Maybe that's an exaggeration, he could buy a 2006 car or use the
earnings from two operations to buy a new car. Hotshot surgeons make a million dollars per
year.
Strabo
No, we're libertarians.
You don't need sponsored health care and insurance only for
catastrophes.
Want to break away from the current health care system but find it
too expensive?
Try these prices. Many times cheaper.
http://surgerycenterok.com/pricing.php
Now what's your excuse?
Robert Broughton
>
> Prevention through coerced lifestyle changes is the main topic in
> alt.smokers. As a champion of freedom, do you think it's right for
> government to persecute smokers, fast food customers or the obese?
Who says the government is "persecuting" smokers? You do, but you're a
serial liar. http://smokersrightscanada.org/?page_id=29
--
Bob Broughton
http://broughton.ca/
Vancouver, BC, Canada
"Even on [finance] terms, we have never been a company that tolerates
facts." - Robert Murdoch, Feb. 5, 2009
Robert Broughton
>
> Including the profit motive shows how right wing philosopy can be
> detremental to freedom. Slavery was a blatant case that took 200 years and
> a bloody civil war to eliminate. More subtle cases like antismoking will
> never rise to that level.
Another piece of evidence that you know nothing whatsoever
about "antismoking", asswipe.
Norm
So what? Thsi has nothing whatsoever to do with who pays for it. The cost of
health care is rising faster than inflation in every country in the world,
INCLUDING yours. In fact MORESO yours. Thats due to 2 factors. 1 - The baby
boomers are now ranging in age from 52 to 66. The exact years many people
start to have major health issues. Their children, the baby boom echo, have
just had children in recent years. Childbitrth and young children are also
huge users of the healthcare system. 2 - medical technology has advanced to
the point where we can treat a significant number of things we couldn't even
a couple of decades ago and these treatments cost a lot of money.
>>
>>
>>
>>>
>>> I'm assuming by Medical inflation you mean the
>>>> rising cost of treatment.
>>>
>>> The rsing cost of healthcare, that is due to medical inflation. If the
>>> medical inflation rate was zero, we would not have a cost problem we do
>>> have with healthcare. When someone else is paying for our medical care,
>>> that person does not care what the cost of that care is, they will use
>>> the service regardless of how much it cost.
>>
>> Thats a good thing. Do you think its preferable for people to NOT use
>> health care when they need it? Do you honestly think people will begin
>> taking a trip down to the doctors office because they find it
>> entertaining? Wanting people to NOT use health care reveals a
>> particularily mean spirited motivation.
>>
>
> It is unsustaingable, when cost are rising as a result.
Costs are not rising as a result. The generally agreed on reasons for costs
rising are as I explained above. No country has ever shown that costs rise
due to over use. Its just silly. Allow me to repeat the question:
Do you really think that people will start going down to the doctors office
because they find a visit there entertaining?
> The ultimate effect is that there will be more and more rationing, which
> means your goal cannot be achieved, because more and more people will not
> get the care they need or want, when they want it.
>>
>>
>> When that happens, you have lost
>>> the most effective means to controllling cost, and costs will rise.
>>
>>
>> Thats an assumption. If it was true then why are health care costs not
>> HIGHER in my country than in yours? We have had universal health care for
>> 45 years, you would think by now your theory would have kicked in.
>
> Wrong question.
Only because you prefer not to answer it.
> Right question, is the medical inflation rate in your country lower than
> the overall inflation rate, or is it higher than the overall inflation
> rate.
It's higher than the overall inflation rate, but its not nearly as high as
in yuur country, which, by your definition, is more free than my country,
and as such, if you were correct, should be showing better results, not
worse.
Um, in what world does this increase not take place? People in your world do
not ask for raises every year? Wish I was an employer there...
> The cost of the machine does not rise, it will most likely cost less over
> time, since they will figure out how to build it at a lower cost than they
> did before. Everything increases with price inflation. It is a quetiton
> of how fast will it increase due to inflation.
>>
>>
>>
>>
>>>>
>>>>>>
>>>>>> Ah, but then we get the dreaded "people dying on the wait list"
>>>>>> syndrome. The horror sories you've been told by insurance companies
>>>>>> and some of your government who have vested interests in the status
>>>>>> quo. Doesn't happen, its a myth.
>>>
>>> It is not a "myth" as you put it. It is a fact.
>>
>> Now you know more about what happens where I live than I do???
>> I respectfully suggest you haven't a clue what you are talking about.
>>
>>
> If you do not know that to be a fact, then I would suggest you don't
> understand the issue. It is really simple. When you pay for what you
> want or need, you decide whether to pay or not pay. When someone else
> pays for what you want or need, they decide to pay, they decide when to
> pay, and they can decide not to pay. You have little to no control over
> that decision. And the incentive not to pay is very high, because the
> costs for providing that care, is rising due to a large degree by medical
> inflation.
You are using your hypothesis to justify your hypothesis. You have yet to
show it holds water. the only thing you have demonstrated is that you
yourself hold a religious belief in it, which does not tend to increase yor
credibility.
I keep saying - show me the results. We have had the system I support for 45
years here, as have many other countries and your expected result has not
happened. Anywhere, anytime. The US has a system which is closer to what you
desire than what we have here, and you show WORSE results. Does your plan
only produce results when taken to your described absolute? Or perhaps it is
based on an incorrect premise.
The need is not based on who you are, as I already explained, that does not
enter into the equation. It is based on what illness or injury you have.
Heart attacks get treated right now hangnails get to wait in line. It works
quite well.
>
>>> It is a question of which is more important, your freedom or your
>>> safety. If your safety is more important than your freedom, then you
>>> want someone to take care of you. If your freedom is more important
>>> than your safety, you want to take care of yourself.
>>
>>
>> If we believe your theory we should also do away with the police and
>> military. After all who is more free than the man who takes care of
>> himself?
>
> That is also a true statement. It is always a tradeoff between your
> safety and your freedom. But there is a difference even in your example.
> For instance, you do not need the police to protect you, if you can
> protect yourself. But your military example is a good one, since
> obviously you cannot protect your country without a strong military. So,
> in that case, your safety is more important than your freedom. But you
> are not surrendering very much of your freedom, by having a strong
> military.
You demonstrate here how misguided you can be on issues other than the one
being discussed. Your country (and mine to some extent, because our leaders
cowtow to yours) has a great need for police because your "free" system has
created so much inequality that your people need to be protected from each
other. Your military, on the other hand is the greatest make work (make
profit for the select few) project ever known to man. If not FOR your
military, you would not NEED your military. The US has no resources that any
other country would desire, except perhaps for a huge market to sell into,
which is clearly more beneficial to a non occupier than an occupier. The
only attacks on the US have either been provoked (1941, 2001) or faked
(1898, 1964) in order to sell your population on entering conflicts they
otherwise would not have accepted.
>>
>>
>>
>>
>>>>>
>>>>> When you pay for your own medical needs, what are the odds that anyone
>>>>> other than yourself will decide on whether you live or die? When
>>>>> someone else pays for your medical needs, what are the odds that in
>>>>> order to save money, they will decide if you live or die? When you
>>>>> depend on someone else to pay for your medical needs CAN they decide
>>>>> not to pay?
>>>>
>>>> No, they can't. What are the odds you might not have enough money to
>>>> pay for your treatment?
>
> That is the price of freedom. There is no guarantee of anything.
>>>
>>> The same odds that you will not have enough money to live on when you
>>> are no longer working. It boils down to the same problem. There is no
>>> free lunch.
>>>
>>> What are the odds your surgeon might get a better offer from
>>>> a richer patient and take care of him ahead of you?
>>>
>>> What are the odds that when you call a plumber to come to your home to
>>> do some repair work for you, that they will go to the person who is
>>> richer?
>>
>> I'm sure it happens all the time.
>> Do you really want to operate health care on that same principle?
>
> Yes, because I put a very high value on our freedom.
You clearly value --> your definition <-- of freedom above all else,
including common sense. I, on the other hand value my quality of life more
than some artificially trumped up concept of what constitutes freedom.
You avoided the question. I see you also brushed aside almost the same
question in your exchange with Robert. Clearly it makes you uncomfortable.
To be clear - you support rationing by allowing a portion of the population
to fall through the cracks and never be treated? How can you look in the
mirror? You're advocating genocide.
25% of your people have no health insurance. Unless you care to posit that
most of those people are independently wealthy, they are clearly on
infinitely long waiting lists, because they are only eligible for emergency
treatment, their underlying conditions will never be treated.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
The pharmaceutical companies are more succcessful when the "government"
helps pay for our pharmaceuticals. When we have to pay for our own drugs,
the money they are able to make is limited by the amount of money we can
afford to spend on these drugs.
>
> The antismoking movement was, until recently, organized and financed by
> the pharmaceutical
> industry, not public health advocates in government. Pharma did it to make
> a buck off the
> ill health that comes with longevity. Thus, your hypothetical 'free man'
> has his freedom
> diminished even though he pays 100% of his own healthcare. He loses
> because there's profit
> in taking his freedom.
That does not make any sense at all. A person who smokes is more likely to
have a problem with their heart and more likely to get cancer. Either one
of those outcomes, helps the pharmaceutical company sell more drugs, not
less drugs.
>
> Including the profit motive shows how right wing philosopy can be
> detremental to freedom.
> Slavery was a blatant case that took 200 years and a bloody civil war to
> eliminate. More
> subtle cases like antismoking will never rise to that level. Freedom will
> be eroded so
> some company can profit. I suppose being a stockholder of that company
> would turn it into
> a zero sum game. Losers will be the poor buggers who weren't smart enough
> to invest.
Freedom means that EVERYONE is free. You cannot have true freedom, if only
one group of people have freedom and another group of people are not free.
People who are slaves are not free.
Robert
>
>"Robert" <n...@e.mail> wrote in message
>news:krrpe555sl0387due...@4ax.com...
>>
>> The antismoking movement was, until recently, organized and financed by
>> the pharmaceutical
>> industry, not public health advocates in government. Pharma did it to make
>> a buck off the
>> ill health that comes with longevity. Thus, your hypothetical 'free man'
>> has his freedom
>> diminished even though he pays 100% of his own healthcare. He loses
>> because there's profit
>> in taking his freedom.
>
>That does not make any sense at all. A person who smokes is more likely to
>have a problem with their heart and more likely to get cancer. Either one
>of those outcomes, helps the pharmaceutical company sell more drugs, not
>less drugs.
You wouldn't say that if you'd read the Manning study, discussed earlier. Here's another:
"Health care costs for smokers at a given age are as much as 40 percent higher than those
for nonsmokers, but in a population in which no one smoked the costs would be 7 percent
higher among men and 4 percent higher among women than the costs in the current mixed
population of smokers and nonsmokers. If all smokers quit, health care costs would be
lower at first, but after 15 years they would become higher than at present."
http://content.nejm.org/cgi/content/abstract/337/15/1052
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
So? In other words, you did not continue with the insurance policy you did
have becuase you were too cheap to pay for the increase? So, you made a
"choice" that the extra cost of the insuranc was not worth the protection
that the insurance would have given you. You mean you couldn't find some
other insurance company that would sell you a policy at a price you were
willing to pay, don't you?
>
> Now I need private insurance and am forced to shop states for affordable
> coverage.
> Massachusetts is the best by far. It should be a model for the whole US.
> I'm not moving
> there because the weather sucks and housing is expensive. I'm going with
> the FL limited
> liability plan. If she needs a $50K heart bypass, she's SOL.
No!!! You don't NEED insurance. You only need insurance if you get sick
enough to need the insurance. You can pay for your own needs, with your own
money.
It is the same issue. When you do not pay for what you need, you cannot
effectively control prices. When you cannot effectively control prices, the
result in higher inflation. When someone else pays for what you need or
want, you do not care how much it costs, because you are not the one paying,
you WILL use the service regardless of how much it cost, and when that
happens, the most effective way to control prices is lost.
>
>>>>>>They ALL have a cost problem, so that is a lie. And they all have a
>>>>>>problem
>>>>>>with medical inflation. Check it out for yourself. Everyone one of
>>>>>>those
>>>>>>countries have a medical inflation rate that is higher than their
>>>>>>overall
>>>>>>inflation rate.
>>>>>
>>>>> I found you're right. But you say "the only way you can reduce the
>>>>> medical
>>>>> inflation rate"
>>>>> is to take decisions away from government and return them to the
>>>>> people.
>>>>> Most of Africa
>>>>> did exactly that in the 1980's. Their medical inflation didn't go
>>>>> down,
>>>>> but health became
>>>>> worse because the poor could no longer see doctors.
No, I said that the only way to control prices effectively is to return the
rationing decision back to the user of the service. The only way the user
of the service will make the rationing decision is when they use their own
money to pay for the service. And I doubt if the people in Africa are
paying for their own medical care, most of them are too poor to be able to
do that. And since they are too poor to pay for their own needs, it is hard
to see how there can be a high level of inflation, since that only means
they are less likely to be able to afford to pay for their healthcare. And
if they cannot afford to pay for their own healthcare, how can prices rise?
>>
>>That does not make any sense at all. If you are poor, you don't have the
>>money to spend on your own healthcare needs. If you do not have the
>>money,
>>how can the cost go up?
>
> The cost per 'unit' of healthcare is going up, independant of who pays.
> There are fewer
> buyers because the World Health Organization, in the 1980's, urged
> countries to privatize
> healthcare, as you advocate. Most governments did it eagerly. Their
> contributions went
> from 5% of GDP to well under 1%. The form of payment became, and still is,
> insurance or
> out of pocket. Problem is, the dirt poor people cannot afford either. As a
> result they do
> without.
I did not say privatize healthcare, I said return the rationing decision
back to the person needing that care.
>
> The median age of death in industrial countries is around 70; in Africa,
> it's 5. Half of
> African deaths occur before the age of 5. The rate of women dying during
> childbirth is
> more than five times the rate elsewhere.
yes, but that is not solely or even mostly due to the healthcare system. It
has more to do with the simple fact that they struggle just to put food on
their table.
>
> That's the outcome when countries follow your advice to get government out
> of healthcare.
Apples and oranges. The governments of Africa would find that their people
would do a whole lot better, if the government helped people to help
themselves, rather than ourtright helping them. It is an age old question.
Is it better to feed a person, or is it better to teach a person to feed
themselves.
Total foolishness. The auto mechanic knows nothing about cost. He only
wants to make enough money for the job he is doing to pay for his needs.
Besides, doctors have no control over how much they make, if the government
is paying the bill. They get as much money as the government is willing to
give them. Which has zero to do with what I said about who should be paying
the bill, if you really are interested in solving the cost problem with
healthcare.
>>> A centrally managed system would put a stop to that. It would make the
>>> choices patients
>>> aren't knowledgeable enough nor allowed to make. For instance, studies
>>> have found the
>>> least expensive diuretic is just as effective as the most expensive beta
>>> blocker for
>>> hypertension. If I said that to my wife's cardiologist, he'd throw me
>>> out
>>> of the office.
>>> If a central manager said it, he'd have to listen. Insurance oompanies
>>> could have been
>>> watchdogs, but they fell down on the job.
>>
>>I suppose you are right, but the price you pay is you are no longer free.
>
> The rich have always been free. Aspiring to freedom is a middle class
> idea. The American
> middle class is being destroyed by corporate greed. Their dream of freedom
> is dying along
> with their dream of success.
You have more freedom when you are able to take care of your own needs.
Anytime you depend on someone else to provide you with what you need or
want, you have less freedom. When you allow the government to provide you
with what you need or want, you have said your safety is more important than
your freedom. Benjamin Franklin said it best when you make that choice,.
"They that can give up essential liberty to obtain a little temporary safety
deserve neither liberty nor safety".
Robert
>"choice" that the extra cost of the insurance was not worth the protection
>that the insurance would have given you. You mean you couldn't find some
>other insurance company that would sell you a policy at a price you were
>willing to pay, don't you?
The premium was exorbitant, $1,500 per month. They were telling me to go away.
In round two, I couldn't buy insurance at any price.
>> Now I need private insurance and am forced to shop states for affordable
>> coverage.
>> Massachusetts is the best by far. It should be a model for the whole US.
>> I'm not moving
>> there because the weather sucks and housing is expensive. I'm going with
>> the FL limited
>> liability plan. If she needs a $50K heart bypass, she's SOL.
>
>No!!! You don't NEED insurance. You only need insurance if you get sick
>enough to need the insurance. You can pay for your own needs, with your own
>money.
You may not be aware that most private non-group coverage has a deducable of at least
$5,000, sometimes $10,000. It's not first dollar, it's catastrophic coverage. The premium
is about $500/mo, even though you get to pay the first $5,000 with your own money.
Bottom line, average Africans got excluded from the system. They're not getting ANY
medical care becase they can't afford it. Setting aside humane and altruistic, is that an
EFFICIENT way to deal with illness that can be fixed for a few dollars?
We're told market economies create efficiency due to competition. This is a case where
market economy created INEFFICIENCY. People are dying from infectious diseases that could
inexpensively be prevented.
>>>That does not make any sense at all. If you are poor, you don't have the
>>>money to spend on your own healthcare needs. If you do not have the
>>>money,
>>>how can the cost go up?
>>
>> The cost per 'unit' of healthcare is going up, independant of who pays.
>> There are fewer
>> buyers because the World Health Organization, in the 1980's, urged
>> countries to privatize
>> healthcare, as you advocate. Most governments did it eagerly. Their
>> contributions went
>> from 5% of GDP to well under 1%. The form of payment became, and still is,
>> insurance or
>> out of pocket. Problem is, the dirt poor people cannot afford either. As a
>> result they do
>> without.
>
>I did not say privatize healthcare, I said return the rationing decision
>back to the person needing that care.
Your idealism is contradicted by facts.
>> The median age of death in industrial countries is around 70; in Africa,
>> it's 5. Half of
>> African deaths occur before the age of 5. The rate of women dying during
>> childbirth is
>> more than five times the rate elsewhere.
>
>yes, but that is not solely or even mostly due to the healthcare system. It
>has more to do with the simple fact that they struggle just to put food on
>their table.
People in all third world countries struggle to put food on the table. They don't all have
substandard health care.
>> That's the outcome when countries follow your advice to get government out
>> of healthcare.
>
>Apples and oranges. The governments of Africa would find that their people
>would do a whole lot better, if the government helped people to help
>themselves, rather than ourtright helping them. It is an age old question.
>Is it better to feed a person, or is it better to teach a person to feed
>themselves.
You mean work for multinational companies at subsistance wages. You mean make clothes for
WalMart at $1-2 per hour. That's not teaching people to feed themselves, that's teaching
them to be slaves.
The people of northern Mexico used to be self sufficient on rice, corn and beans.
Multiinationals convinced them to switch to asparagus and strawberries for shipment to the
US. Now, the price of rice and beans, grown elsewhere, has more than tripled. They went
from self-sufficient to unable to meet basic needs.
>You have more freedom when you are able to take care of your own needs.
>Anytime you depend on someone else to provide you with what you need or
>want, you have less freedom. When you allow the government to provide you
>with what you need or want, you have said your safety is more important than
>your freedom. Benjamin Franklin said it best when you make that choice,.
>"They that can give up essential liberty to obtain a little temporary safety
>deserve neither liberty nor safety".
I didn't say anything about safety. Antismokers are the ones bleating safety wrt second
hand smoke.If you think that's a good thing, you've confirmed idealism is a question of
whose ox is being gored. If it's your ox, your position is based on morality. If it's
someone else's ox, it deserves whatever it gets.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
How much does he earn when you performs a heart bypass surgery? Does he
make as much money today from doing that surgery, or would he have made a
heck of a lot more money, had that operation been available fifty years ago?
Jerry Okamura
That is the problem. Medical inflation is increasing the cost of
healthcare. If there was no medical inflation the cost problem would be
much less. And if medical inflation only increased at the same level as the
overall inflation rate, it would be more manageable.
>
>
>
>
>>>
>>>
>>>
>>>>
>>>> I'm assuming by Medical inflation you mean the
>>>>> rising cost of treatment.
>>>>
>>>> The rsing cost of healthcare, that is due to medical inflation. If the
>>>> medical inflation rate was zero, we would not have a cost problem we do
>>>> have with healthcare. When someone else is paying for our medical
>>>> care, that person does not care what the cost of that care is, they
>>>> will use the service regardless of how much it cost.
>>>
>>> Thats a good thing. Do you think its preferable for people to NOT use
>>> health care when they need it? Do you honestly think people will begin
>>> taking a trip down to the doctors office because they find it
>>> entertaining? Wanting people to NOT use health care reveals a
>>> particularily mean spirited motivation.
>>>
>>
I think that people should be free to determine how they spend their money.
I believe that people should be responsible for their own lives and not
depend on anyone else for their lives to the greatest degree possible. I
believe that government should help people help themselves, rather than
helping people directly. I believe in giving the "people" as much freedom
as possible, not less freedom. When someone pays for what you want or need,
you are not truly free.
>> It is unsustaingable, when cost are rising as a result.
>
> Costs are not rising as a result. The generally agreed on reasons for
> costs rising are as I explained above. No country has ever shown that
> costs rise due to over use. Its just silly. Allow me to repeat the
> question:
That is downright silly. Are you going to argue that inflation is not
causing overall costs to rise?
>
> Do you really think that people will start going down to the doctors
> office because they find a visit there entertaining?
>
How is that relevant?
>
>
>
>> The ultimate effect is that there will be more and more rationing, which
>> means your goal cannot be achieved, because more and more people will not
>> get the care they need or want, when they want it.
>>>
>>>
>>> When that happens, you have lost
>>>> the most effective means to controllling cost, and costs will rise.
>>>
>>>
>>> Thats an assumption. If it was true then why are health care costs not
>>> HIGHER in my country than in yours? We have had universal health care
>>> for 45 years, you would think by now your theory would have kicked in.
It is not an ASSUMPTION, it is a fact. As for your question, tell me where
you live, and I will be able to answer your question. If you have had
universal healthcare in your country for 45 years, then you have had more
and more rationing of care over that time.
>>
>> Wrong question.
>
>
> Only because you prefer not to answer it.
>
>
>> Right question, is the medical inflation rate in your country lower than
>> the overall inflation rate, or is it higher than the overall inflation
>> rate.
>
> It's higher than the overall inflation rate, but its not nearly as high as
> in yuur country, which, by your definition, is more free than my country,
> and as such, if you were correct, should be showing better results, not
> worse.
>
>
It does not make any difference, if your inflation rate is lower than ours.
What counts is, the medical inflation rate is higher than the overall
inflation rate. That means that total costs are rising as a result of
medical inflation and it is rising faster than the overall economy.
When there is no control over the marketplace, the market place determiens
how much money a person makes. When the government pays for medical care,
they decide how much that person makes.
>
>
>
>> The cost of the machine does not rise, it will most likely cost less over
>> time, since they will figure out how to build it at a lower cost than
>> they did before. Everything increases with price inflation. It is a
>> quetiton of how fast will it increase due to inflation.
>>>
>>>
>>>
>>>
>>>>>
>>>>>>>
>>>>>>> Ah, but then we get the dreaded "people dying on the wait list"
>>>>>>> syndrome. The horror sories you've been told by insurance companies
>>>>>>> and some of your government who have vested interests in the status
>>>>>>> quo. Doesn't happen, its a myth.
>>>>
>>>> It is not a "myth" as you put it. It is a fact.
>>>
>>> Now you know more about what happens where I live than I do???
>>> I respectfully suggest you haven't a clue what you are talking about.
>>>
Becuase all it requires is common sense. A third party payment system is
one in which someone like the government pays for your care. If they were
willing to pay whatever the cost for the service is, there would be no
rationing. But they do not want to pay for whatever the cost for that
service is, and the end result is rationing.
>>>
>> If you do not know that to be a fact, then I would suggest you don't
>> understand the issue. It is really simple. When you pay for what you
>> want or need, you decide whether to pay or not pay. When someone else
>> pays for what you want or need, they decide to pay, they decide when to
>> pay, and they can decide not to pay. You have little to no control over
>> that decision. And the incentive not to pay is very high, because the
>> costs for providing that care, is rising due to a large degree by medical
>> inflation.
>
>
> You are using your hypothesis to justify your hypothesis. You have yet to
> show it holds water. the only thing you have demonstrated is that you
> yourself hold a religious belief in it, which does not tend to increase
> yor credibility.
Cop out. Tell me exactly why you think my hypothesis is not valie.
Besides, any first year student of economics should have learned that.
>
> I keep saying - show me the results. We have had the system I support for
> 45 years here, as have many other countries and your expected result has
> not happened. Anywhere, anytime. The US has a system which is closer to
> what you desire than what we have here, and you show WORSE results. Does
> your plan only produce results when taken to your described absolute? Or
> perhaps it is based on an incorrect premise.
>
No, the US system is NOWHERE close to what should happen. It has continued
expanding the third party payment system since after the Second World War.
Which is when the problem all started. You can say that we are like someone
who is half pregnant, but you cannot say that we do not have a third party
payement system in the United States. But I will give you something to
think about. You can easily confirm if what I say is true or false, simply
by searching the Internet. Prior to 1950, the medical infaltion rate was
consistently lower than the consumer price index. Since 1950, the medical
inflation rate has been consistently above the consumer price index. I say
that changed occured because this country started moving to a third party
payment system at the end of WWII. By the way, if the data is available in
your country you can verify my statement. Because if I am right, and the
data is available, the relationship between the overall inflation rate in
your country, and the medical inflation rate should be the same as in this
country. And if it isn't, then you just blew a big hole in my argument.
All you need to know is when did you implement the third party payment
system, then find out what the relationship between your overall inflation
indicator is, and the medical inflation rate, prior to moving to that third
party payment system and what happened after you moved to the third party
payement system.
>
>
>
>
>
>>>
>>>
>>>
>>> In Canada for example, the
>>>> government puts a cap on the amount of money they will spend in any one
>>>> year. When you do that, once the money is spent, you have no more
>>>> money to spend for that year, regardless of how much money is actually
>>>> needed to treat everyone who needs the treatment. That is a form of
>>>> rationing. Another form of rationing are waiting list, which Canada
>>>> does have. In the State of Oregon, they have developed a list of
>>>> services they will pay for and services they will not pay for. Those
>>>> who are not on the list, are shit out of luck, unless they pay for it
>>>> themselves.
>>>>
>>>>
>>>>>>> The way it works is if you are in greater need you get moved up in
>>>>>>> priority. It happened twice last year in my own family. That woman
>>>>>>> from Canada you heard about in the news a few months back who had a
>>>>>>> "tumour" and would have died had she not gone to the US - she lied
>>>>>>> from beginning to end. She didn't have a tumour she had a cyst and
>>>>>>> she was neverr in danger of anything other than a little discomfort.
>>>>>>> The wait list is how the system limits delivery. People who really
>>>>>>> don't need something fixed in a hurry get to wait. Some of them get
>>>>>>> better on their own, some of them get to wait a long time to get
>>>>>>> their hangnail treated. The odd person with trivial problems does
>>>>>>> sit on the wait list and eventually use resources, but theres not
>>>>>>> many willing to do that. Wealthy people with trivial problems they
>>>>>>> are willing to pay for are still free to go outside the system if
>>>>>>> they choose.
>>>>
That is part of the problem. Someone other than you decides that your need
is greater or less than someone else. That someone else is acting like a
god, deciding who needs the care first and who should wait. And of course
like everything we humans do, no one can do that perfectly, so someone dies
because they made the wrong decision.
>>
>> Yep, but someone else not you, are the ones who are deciding if you have
>> a greater need. If you are among those that the government does not
>> think is the greater need, it does not matter if you think they are
>> wrong, you won't get the care you want or need.
>
> The need is not based on who you are, as I already explained, that does
> not enter into the equation. It is based on what illness or injury you
> have. Heart attacks get treated right now hangnails get to wait in line.
> It works quite well.
>
I did not say it was.
Blaming the "system" and not the people.
>
>
>
>
>
>
>>>
>>>
>>>
>>>
>>>>>>
>>>>>> When you pay for your own medical needs, what are the odds that
>>>>>> anyone other than yourself will decide on whether you live or die?
>>>>>> When someone else pays for your medical needs, what are the odds that
>>>>>> in order to save money, they will decide if you live or die? When
>>>>>> you depend on someone else to pay for your medical needs CAN they
>>>>>> decide not to pay?
>>>>>
>>>>> No, they can't. What are the odds you might not have enough money to
>>>>> pay for your treatment?
>>
>> That is the price of freedom. There is no guarantee of anything.
>>>>
>>>> The same odds that you will not have enough money to live on when you
>>>> are no longer working. It boils down to the same problem. There is no
>>>> free lunch.
>>>>
>>>> What are the odds your surgeon might get a better offer from
>>>>> a richer patient and take care of him ahead of you?
>>>>
>>>> What are the odds that when you call a plumber to come to your home to
>>>> do some repair work for you, that they will go to the person who is
>>>> richer?
>>>
>>> I'm sure it happens all the time.
>>> Do you really want to operate health care on that same principle?
>>
>> Yes, because I put a very high value on our freedom.
>
> You clearly value --> your definition <-- of freedom above all else,
> including common sense. I, on the other hand value my quality of life more
> than some artificially trumped up concept of what constitutes freedom.
>
>
As Benjamin Franklin said, They that can give up essential liberty to obtain
a little temporary safety deserve neither liberty nor safety.
>
>
>>>
>>>
>>>
>>>>
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
If I am a ROMATIC for believing in FREEDOM, then I will be more than happy
to claim that I am a romantic.
>
> "Other people have no right, no hold, no interest or influence on him. And
> this is not
> affected or chosen -- it's inborn, absolute, it can't be changed, he has
> 'no organ' to be
> otherwise. In this respect, he has the true, innate psychology of a
> Superman. He can never
> realize and feel 'other people.' " -- Ayn Rand
>
> The word describing such people is sociopath, not hero.
"They that can give up essential liberty to obtain a little temporary safety
deserve neither liberty nor safety". What Benjamin Franklin said. Or use
the New Hamphsire state motto, "live free or die". I like those rather
than yours.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
companies make more money if more people smoke.
Robert
>
>"Robert" <n...@e.mail> wrote in message
>news:2i5qe5pnqfagrp6dg...@4ax.com...
>> On Sat, 31 Oct 2009 13:35:56 -1000, "Jerry Okamura"
>> <okamu...@hawaii.rr.com> wrote:
>>
>>>
>>>"Robert" <n...@e.mail> wrote in message
>>>news:indpe5p40eq4febpv...@4ax.com...
>> They like to see you. It's been said every time a surgeon does a heart
>> bypass, he earns
>> another sports car. Maybe that's an exaggeration, he could buy a 2006 car
>> or use the
>> earnings from two operations to buy a new car. Hotshot surgeons make a
>> million dollars per
>> year.
>
>How much does he earn when you performs a heart bypass surgery? Does he
>make as much money today from doing that surgery, or would he have made a
>heck of a lot more money, had that operation been available fifty years ago?
The first open heart surgery using a heart-lung machine was done in 1960, as was the first
arterial graft. Their fiftieth anniversaries will be in a few months. Arterial grafts
using today's techniques began in 1967, 42 years ago.
Robert
You ask for substantiation proving you wrong. When it is presented, you pretend to not
understand or simply ignore it and repeat your error. That's not how reasoned discussion
works. You're supposed to defend your mistaken assertion with evidence.
If that's too much work, an alternative is name calling and emotional ranting. We have
experts on that technique, as I'm sure you do.
Norm
responses bear litlle resemblance to the posts you are responding to.. I've
decided you're either a bot or you're posting while drinking. Or you're
simply trying to pretend you haven't noticed your position on this issue is
completely out of touch with reality.
I do, in fact believe in free enterprise. Not the unrestrained, greed rules
all brand that you practice in the US of course, but a common sense mix of
freedom and sensibility.
However -
Health care is a basic human right. Not a commodity. It is far too important
to leave to the whims of the "free market".
More than important enough to completely transcend your silly fairy tale
about what constitutes freedom. My government administering my health care
does not by any stretch of the imagination make me any less free, it makes
me more so. Every person should have a right to adequate health care when he
needs it without checking his wallet to see if he can afford it. Anything
less is uncivilized. All your malarkey about "medical inflation" has
absolutely no relevance whatsoever to this issue.
"Jerry Okamura" <okamu...@hawaii.rr.com> wrote in message
news:R9ZHm.4593$Yy6....@newsfe02.iad...
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
Inconsistent. You start out by saying the premium was "exorbitant" and in
the next sentence you said you couldn't buy the insurance at any price.
Which is the correct statement?
>
>>> Now I need private insurance and am forced to shop states for affordable
>>> coverage.
>>> Massachusetts is the best by far. It should be a model for the whole US.
>>> I'm not moving
>>> there because the weather sucks and housing is expensive. I'm going with
>>> the FL limited
>>> liability plan. If she needs a $50K heart bypass, she's SOL.
>>
>>No!!! You don't NEED insurance. You only need insurance if you get sick
>>enough to need the insurance. You can pay for your own needs, with your
>>own
>>money.
>
> You may not be aware that most private non-group coverage has a deducable
> of at least
> $5,000, sometimes $10,000. It's not first dollar, it's catastrophic
> coverage. The premium
> is about $500/mo, even though you get to pay the first $5,000 with your
> own money.
Which is relevant to what I said how?
The average African can't even feed themselves. If they cannot feed
themselves, the will die from starvation.
>
> We're told market economies create efficiency due to competition. This is
> a case where
> market economy created INEFFICIENCY. People are dying from infectious
> diseases that could
> inexpensively be prevented.
NO!!! It has nothing to do with market economics. It has everything to do
with the fact that the people in Africa cannot survive on their own without
help from other countries.
>
>>>>That does not make any sense at all. If you are poor, you don't have
>>>>the
>>>>money to spend on your own healthcare needs. If you do not have the
>>>>money,
>>>>how can the cost go up?
>>>
>>> The cost per 'unit' of healthcare is going up, independant of who pays.
How can that happen, if you don't have the money, is the question I asked.
>>> There are fewer
>>> buyers because the World Health Organization, in the 1980's, urged
>>> countries to privatize
>>> healthcare, as you advocate. Most governments did it eagerly. Their
>>> contributions went
>>> from 5% of GDP to well under 1%. The form of payment became, and still
>>> is,
>>> insurance or
>>> out of pocket. Problem is, the dirt poor people cannot afford either. As
>>> a
>>> result they do
>>> without.
>>
>>I did not say privatize healthcare, I said return the rationing decision
>>back to the person needing that care.
>
> Your idealism is contradicted by facts.
>
>>> The median age of death in industrial countries is around 70; in Africa,
>>> it's 5. Half of
>>> African deaths occur before the age of 5. The rate of women dying during
>>> childbirth is
>>> more than five times the rate elsewhere.
Another irrelevant point. The death rate in African countries is due to the
fact that the "people" living in these countries, are not able to take care
of their own needs.
>>
>>yes, but that is not solely or even mostly due to the healthcare system.
>>It
>>has more to do with the simple fact that they struggle just to put food on
>>their table.
>
> People in all third world countries struggle to put food on the table.
> They don't all have
> substandard health care.
Yep, and if you do not have enough food, you can have the best healthcare in
the world and you will still die at a young age.
>
>>> That's the outcome when countries follow your advice to get government
>>> out
>>> of healthcare.
>>
>>Apples and oranges. The governments of Africa would find that their
>>people
>>would do a whole lot better, if the government helped people to help
>>themselves, rather than ourtright helping them. It is an age old
>>question.
>>Is it better to feed a person, or is it better to teach a person to feed
>>themselves.
>
> You mean work for multinational companies at subsistance wages. You mean
> make clothes for
> WalMart at $1-2 per hour. That's not teaching people to feed themselves,
> that's teaching
> them to be slaves.
I said if government would help people help themselves. When you do that,
it is up to the "people" to decide who they are going to work for, or if
they are going to work for anyone at all.
>
> The people of northern Mexico used to be self sufficient on rice, corn and
> beans.
> Multiinationals convinced them to switch to asparagus and strawberries for
> shipment to the
> US. Now, the price of rice and beans, grown elsewhere, has more than
> tripled. They went
> from self-sufficient to unable to meet basic needs.
Apples and oranges. No one "forced" them do to what they did do. If they
did what they did do, and what they did was wrong, then they made the wrong
choice. But it was their decision to make.
>
>>You have more freedom when you are able to take care of your own needs.
>>Anytime you depend on someone else to provide you with what you need or
>>want, you have less freedom. When you allow the government to provide you
>>with what you need or want, you have said your safety is more important
>>than
>>your freedom. Benjamin Franklin said it best when you make that choice,.
>>"They that can give up essential liberty to obtain a little temporary
>>safety
>>deserve neither liberty nor safety".
>
> I didn't say anything about safety.
No, you did not say anthing about safety, but that is the question before
us. Is freedom more important than safety, or is safety more important than
freedom....you cannot have both at the same time.
Antismokers are the ones bleating safety wrt second
> hand smoke.If you think that's a good thing, you've confirmed idealism is
> a question of
> whose ox is being gored. If it's your ox, your position is based on
> morality. If it's
> someone else's ox, it deserves whatever it gets.
The second hand smoking claim is a scam.
Norm
>>>willing to pay, don't you?
>>
>> The premium was exorbitant, $1,500 per month. They were telling me to go
>> away.
>> In round two, I couldn't buy insurance at any price.
>
> Inconsistent. You start out by saying the premium was "exorbitant" and in
> the next sentence you said you couldn't buy the insurance at any price.
> Which is the correct statement?
He clearly stated this was two different instances, Jerry. I got that right
away, maybe you should read just a little slower.
>>
>> We're told market economies create efficiency due to competition. This is
>> a case where
>> market economy created INEFFICIENCY. People are dying from infectious
>> diseases that could
>> inexpensively be prevented.
>
> NO!!! It has nothing to do with market economics. It has everything to
> do with the fact that the people in Africa cannot survive on their own
> without help from other countries.
>>
They cannot survive on their own because people from the western world
interfered with ttheir way of life and imposed, by force, market economics,
among other western ideas.
Why did you place quotation marks around people?
Are these somehow less than (or different from) people in your view?
I keep hearing this "help people help themselves". Can you flesh out this
idea a little for us? By what means do you propose doing this? What
opportunities do you plan on creating? Or is that detail someone elses
problem?
>>
>> The people of northern Mexico used to be self sufficient on rice, corn
>> and beans.
>> Multiinationals convinced them to switch to asparagus and strawberries
>> for shipment to the
>> US. Now, the price of rice and beans, grown elsewhere, has more than
>> tripled. They went
>> from self-sufficient to unable to meet basic needs.
>
> Apples and oranges. No one "forced" them do to what they did do. If they
> did what they did do, and what they did was wrong, then they made the
> wrong choice. But it was their decision to make.
They were not given the information they needed to make an intelligent
decision. Illiterate farmers with dollars dangled in front of them may not
be the best judges of what is in their own long term interests. The
multinationals used them for their own profit and are now discarding them.
Do you ever wonder why the third world hates you enough that htey are
willing to die just for a chance to strike back at you?
>>
>>>You have more freedom when you are able to take care of your own needs.
>>>Anytime you depend on someone else to provide you with what you need or
>>>want, you have less freedom. When you allow the government to provide
>>>you
>>>with what you need or want, you have said your safety is more important
>>>than
>>>your freedom. Benjamin Franklin said it best when you make that choice,.
>>>"They that can give up essential liberty to obtain a little temporary
>>>safety
>>>deserve neither liberty nor safety".
>>
>> I didn't say anything about safety.
>
> No, you did not say anthing about safety, but that is the question before
> us. Is freedom more important than safety, or is safety more important
> than freedom....you cannot have both at the same time.
Why? Even if, for a moment, we were to accept your premise that society
working together for the greater good instead of individual greed is somehow
an infringement on freedom, is it not possible there is a compromise
available with reasonable amounts of freedom and reasonable amounts of
safety?
Robert
Both are correct. I described two independent cases, separated by ten years time.
>>>> Now I need private insurance and am forced to shop states for affordable
>>>> coverage.
>>>> Massachusetts is the best by far. It should be a model for the whole US.
>>>> I'm not moving
>>>> there because the weather sucks and housing is expensive. I'm going with
>>>> the FL limited
>>>> liability plan. If she needs a $50K heart bypass, she's SOL.
>>>
>>>No!!! You don't NEED insurance. You only need insurance if you get sick
>>>enough to need the insurance. You can pay for your own needs, with your
>>>own
>>>money.
>>
>> You may not be aware that most private non-group coverage has a deducable
>> of at least
>> $5,000, sometimes $10,000. It's not first dollar, it's catastrophic
>> coverage. The premium
>> is about $500/mo, even though you get to pay the first $5,000 with your
>> own money.
>
>Which is relevant to what I said how?
You said a person can pay for his own needs. I pointed out that private insurance
purchasers DO pay for their own health care until the total in a year becomes higher than
the average person can afford. They don't get 'first dollar coverage,' which used to be
the norm with group policies.
Africa is home to a billion people who have not starved to death, and are not on the brink
of starvation.
>> We're told market economies create efficiency due to competition. This is
>> a case where
>> market economy created INEFFICIENCY. People are dying from infectious
>> diseases that could
>> inexpensively be prevented.
>
>NO!!! It has nothing to do with market economics. It has everything to do
>with the fact that the people in Africa cannot survive on their own without
>help from other countries.
I hope you're not one who thinks Africans are genetically inferior to other humans.
Foreign aid is destroying Africa, by putting money into the hands of corrupt governments,
which hinder economic development. If we must give money, it should go to consumers under
the condition it be spent locally and cannot be taxed by government. Doing so would foster
economic development rather than hindering it.
>>>>>That does not make any sense at all. If you are poor, you don't have
>>>>>the
>>>>>money to spend on your own healthcare needs. If you do not have the
>>>>>money,
>>>>>how can the cost go up?
>>>>
>>>> The cost per 'unit' of healthcare is going up, independant of who pays.
>
>How can that happen, if you don't have the money, is the question I asked.
For the same reason Rolls Royce keeps raising the price of its cars, even though most
people can't afford one at the old price.
>>>> There are fewer
>>>> buyers because the World Health Organization, in the 1980's, urged
>>>> countries to privatize
>>>> healthcare, as you advocate. Most governments did it eagerly. Their
>>>> contributions went
>>>> from 5% of GDP to well under 1%. The form of payment became, and still
>>>> is,
>>>> insurance or
>>>> out of pocket. Problem is, the dirt poor people cannot afford either. As
>>>> a
>>>> result they do
>>>> without.
>>>
>>>I did not say privatize healthcare, I said return the rationing decision
>>>back to the person needing that care.
How would you do that except by privatizing i.e. making everyone pay out of pocket?
>> Your idealism is contradicted by facts.
>>
>>>> The median age of death in industrial countries is around 70; in Africa,
>>>> it's 5. Half of
>>>> African deaths occur before the age of 5. The rate of women dying during
>>>> childbirth is
>>>> more than five times the rate elsewhere.
>
>Another irrelevant point. The death rate in African countries is due to the
>fact that the "people" living in these countries, are not able to take care
>of their own needs.
That's because millions of dollars is being siphoned out of Nigerian banks by greedy email
recipients. We should just say No to email offers. Tell them to escheat the estates of
deceased millionaires into their own economy instead of giving them to us.
>>>yes, but that is not solely or even mostly due to the healthcare system.
>>>It
>>>has more to do with the simple fact that they struggle just to put food on
>>>their table.
>>
>> People in all third world countries struggle to put food on the table.
>> They don't all have
>> substandard health care.
>
>Yep, and if you do not have enough food, you can have the best healthcare in
>the world and you will still die at a young age.
The leading causes of premature death in Africa are infectious diseases, especially AIDS,
NOT malnutrition. Your argument is a red herring.
>>>> That's the outcome when countries follow your advice to get government
>>>> out
>>>> of healthcare.
>>>
>>>Apples and oranges. The governments of Africa would find that their
>>>people
>>>would do a whole lot better, if the government helped people to help
>>>themselves, rather than ourtright helping them. It is an age old
>>>question.
>>>Is it better to feed a person, or is it better to teach a person to feed
>>>themselves.
>>
>> You mean work for multinational companies at subsistance wages. You mean
>> make clothes for
>> WalMart at $1-2 per hour. That's not teaching people to feed themselves,
>> that's teaching
>> them to be slaves.
>
>I said if government would help people help themselves. When you do that,
>it is up to the "people" to decide who they are going to work for, or if
>they are going to work for anyone at all.
I agree. There are only a few African governments doing the right thing. One is Mauritius,
which has per capita income of $7K and life expectancy of 73 years.
>> The people of northern Mexico used to be self sufficient on rice, corn and
>> beans.
>> Multiinationals convinced them to switch to asparagus and strawberries for
>> shipment to the
>> US. Now, the price of rice and beans, grown elsewhere, has more than
>> tripled. They went
>> from self-sufficient to unable to meet basic needs.
>
>Apples and oranges. No one "forced" them do to what they did do. If they
>did what they did do, and what they did was wrong, then they made the wrong
>choice. But it was their decision to make.
People overvalue short term benefits and undervalue long term consequences. The defect
appears to be genetic. The whole credit card industry is based on that flaw.
>>>You have more freedom when you are able to take care of your own needs.
>>>Anytime you depend on someone else to provide you with what you need or
>>>want, you have less freedom. When you allow the government to provide you
>>>with what you need or want, you have said your safety is more important
>>>than
>>>your freedom. Benjamin Franklin said it best when you make that choice,.
>>>"They that can give up essential liberty to obtain a little temporary
>>>safety
>>>deserve neither liberty nor safety".
>>
>> I didn't say anything about safety.
>
>No, you did not say anthing about safety, but that is the question before
>us. Is freedom more important than safety, or is safety more important than
>freedom....you cannot have both at the same time.
You present a false dichotomy. Throughout history, freedom was a function of safety.
People with inadequate military strength were defeated and enslaved by barbarians.
As for domestic security provided by government, most Westerners are unaware China had the
world's largest and most productive (per capita) economy for 18 of the last 20 centuries.
All that time, its style of government was mostly collective, not Western style
capitalism, especially in the area of agriculture.
>>Antismokers are the ones bleating safety wrt second
>> hand smoke.If you think that's a good thing, you've confirmed idealism is
>> a question of
>> whose ox is being gored. If it's your ox, your position is based on
>> morality. If it's
>> someone else's ox, it deserves whatever it gets.
>
>The second hand smoking claim is a scam.
It shows how easily people can be fooled.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
Which is relevant to the questions I asked,,,how?
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
I asked a very simple question.
Jerry Okamura
> OK Jerry,now you're responding to posts 2 or 3 out of cycle, and your
> responses bear litlle resemblance to the posts you are responding to..
> I've decided you're either a bot or you're posting while drinking. Or
> you're simply trying to pretend you haven't noticed your position on this
> issue is completely out of touch with reality.
>
> I do, in fact believe in free enterprise. Not the unrestrained, greed
> rules all brand that you practice in the US of course, but a common sense
> mix of freedom and sensibility.
>
> However -
>
> Health care is a basic human right. Not a commodity. It is far too
> important to leave to the whims of the "free market".
> More than important enough to completely transcend your silly fairy tale
> about what constitutes freedom. My government administering my health care
> does not by any stretch of the imagination make me any less free, it makes
> me more so. Every person should have a right to adequate health care when
> he needs it without checking his wallet to see if he can afford it.
> Anything less is uncivilized. All your malarkey about "medical inflation"
> has absolutely no relevance whatsoever to this issue.
>
not truly free when you depend on anyone else for anything you need. When
you pay for what you need or want, you have a whole lot more freedom then
when you depend on someone else to pay for what you need or want. And when
you depend on someone else to pay for your healthcare you have also given
them the right not to pay for your healthcare.
Jerry Okamura
>
> "Jerry Okamura" <okamu...@hawaii.rr.com> wrote in message
> news:DskIm.541$6c2...@newsfe03.iad...
>
>
>
>>>>willing to pay, don't you?
>>>
>>> The premium was exorbitant, $1,500 per month. They were telling me to go
>>> away.
>>> In round two, I couldn't buy insurance at any price.
>>
>> Inconsistent. You start out by saying the premium was "exorbitant" and
>> in the next sentence you said you couldn't buy the insurance at any
>> price. Which is the correct statement?
>
>
> He clearly stated this was two different instances, Jerry. I got that
> right away, maybe you should read just a little slower.
So, there were two different instances, so what? He made a "choice" not to
pay.
>
>
>
>
>>>
>>> We're told market economies create efficiency due to competition. This
>>> is a case where
>>> market economy created INEFFICIENCY. People are dying from infectious
>>> diseases that could
>>> inexpensively be prevented.
>>
>> NO!!! It has nothing to do with market economics. It has everything to
>> do with the fact that the people in Africa cannot survive on their own
>> without help from other countries.
>>>
>
> They cannot survive on their own because people from the western world
> interfered with ttheir way of life and imposed, by force, market
> economics, among other western ideas.
Yep, the old "we are only victims" excuse.
How is what I said contradicted by the facts? Nothing you posted
contradicted what I said. The indusrialized countries don't have a big
problem with their population starving, the third world countries have a big
problem with their population not have enough food. If you do not have
enough food, you can have the best healthcare system in the world, and the
people will still die at a very young age.
>>
>> Another irrelevant point. The death rate in African countries is due to
>> the fact that the "people" living in these countries, are not able to
>> take care of their own needs.
>
>
> Why did you place quotation marks around people?
> Are these somehow less than (or different from) people in your view?
>
Nitpicking.....
>
>
>
>>>>
>>>>yes, but that is not solely or even mostly due to the healthcare system.
>>>>It
>>>>has more to do with the simple fact that they struggle just to put food
>>>>on
>>>>their table.
>>>
>>> People in all third world countries struggle to put food on the table.
>>> They don't all have
>>> substandard health care.
So? If you do not have enough food you can have the best healthcare system
in the world, that they will still die at a young age.
>>
>> Yep, and if you do not have enough food, you can have the best healthcare
>> in the world and you will still die at a young age.
>>>
>>>>> That's the outcome when countries follow your advice to get government
>>>>> out
>>>>> of healthcare.
Yes
>>>>
>>>>Apples and oranges. The governments of Africa would find that their
>>>>people
>>>>would do a whole lot better, if the government helped people to help
>>>>themselves, rather than ourtright helping them. It is an age old
>>>>question.
>>>>Is it better to feed a person, or is it better to teach a person to feed
>>>>themselves.
>>>
>>> You mean work for multinational companies at subsistance wages. You mean
>>> make clothes for
>>> WalMart at $1-2 per hour. That's not teaching people to feed themselves,
>>> that's teaching
>>> them to be slaves.
>>
>> I said if government would help people help themselves. When you do
>> that, it is up to the "people" to decide who they are going to work for,
>> or if they are going to work for anyone at all.
>
>
> I keep hearing this "help people help themselves". Can you flesh out this
> idea a little for us? By what means do you propose doing this? What
> opportunities do you plan on creating? Or is that detail someone elses
> problem?
First of all, you help people help themselves when you create an environment
where businesses can survive and thrive. When businesses can do that, they
need workers. When people have jobs, they make money. When the make money,
they are more able to take care of their own needs, and not depend on the
government to provide what they need.
>
>
>
>>>
>>> The people of northern Mexico used to be self sufficient on rice, corn
>>> and beans.
>>> Multiinationals convinced them to switch to asparagus and strawberries
>>> for shipment to the
>>> US. Now, the price of rice and beans, grown elsewhere, has more than
>>> tripled. They went
>>> from self-sufficient to unable to meet basic needs.
>>
>> Apples and oranges. No one "forced" them do to what they did do. If
>> they did what they did do, and what they did was wrong, then they made
>> the wrong choice. But it was their decision to make.
>
> They were not given the information they needed to make an intelligent
> decision. Illiterate farmers with dollars dangled in front of them may not
> be the best judges of what is in their own long term interests. The
> multinationals used them for their own profit and are now discarding them.
> Do you ever wonder why the third world hates you enough that htey are
> willing to die just for a chance to strike back at you?
Why did they have to be "given" the information? Now had you said that
about the "people" a hundred years ago, that "may" have been more relvant,
but today, the "information" is readily available.
>
>
>
>
>
>>>
>>>>You have more freedom when you are able to take care of your own needs.
>>>>Anytime you depend on someone else to provide you with what you need or
>>>>want, you have less freedom. When you allow the government to provide
>>>>you
>>>>with what you need or want, you have said your safety is more important
>>>>than
>>>>your freedom. Benjamin Franklin said it best when you make that
>>>>choice,.
>>>>"They that can give up essential liberty to obtain a little temporary
>>>>safety
>>>>deserve neither liberty nor safety".
>>>
>>> I didn't say anything about safety.
You did not have to, you implied it, by what you said.
>>
>> No, you did not say anthing about safety, but that is the question before
>> us. Is freedom more important than safety, or is safety more important
>> than freedom....you cannot have both at the same time.
>
> Why? Even if, for a moment, we were to accept your premise that society
> working together for the greater good instead of individual greed is
> somehow an infringement on freedom, is it not possible there is a
> compromise available with reasonable amounts of freedom and reasonable
> amounts of safety?
>
yes, "if" you can indeed achieve that balance, without the lost of too much
freedom. The question always is, have we reached that proper balance? Is
it even possible to reach that proper balance most of the time. is it even
necessary to make the tradeoff?
>
>
>
>
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
Now I understand. Sorry for accusing you of being inconsistent.
When someone else pays for any part of what you need, you are still
dependent on that "someone else" to pay. When you do that, you are
depending that that "someone else" will pay when you need them to pay. But
they can also not pay for what you want or need, because that is what you
gave them the right to do when you depended on them for what you wanted or
needed. When you depend on yourself, to pay for what you want or need, no
one can stop you, other than yourself, from getting what you want or need.
Only because the more developed countries have been feeding them. Without
that help, the would be starving to death, until they reach a level of
population that can survive without any ouside help for food.
>
>>> We're told market economies create efficiency due to competition. This
>>> is
>>> a case where
>>> market economy created INEFFICIENCY. People are dying from infectious
>>> diseases that could
>>> inexpensively be prevented.
>>
>>NO!!! It has nothing to do with market economics. It has everything to
>>do
>>with the fact that the people in Africa cannot survive on their own
>>without
>>help from other countries.
>
> I hope you're not one who thinks Africans are genetically inferior to
> other humans.
NOPE.
Robert
>
>"Robert" <n...@e.mail> wrote in message
>news:aha4f5l1i7kae6apt...@4ax.com...
>>>> Bottom line, average Africans got excluded from the system. They're not
>>>> getting ANY
>>>> medical care becase they can't afford it. Setting aside humane and
>>>> altruistic, is that an
>>>> EFFICIENT way to deal with illness that can be fixed for a few dollars?
>>>
>>>The average African can't even feed themselves. If they cannot feed
>>>themselves, the will die from starvation.
>>
>> Africa is home to a billion people who have not starved to death, and are
>> not on the brink
>> of starvation.
>
>Only because the more developed countries have been feeding them. Without
>that help, the would be starving to death, until they reach a level of
>population that can survive without any ouside help for food.
US aid to all third world countries comes to $4.95 per US resident (1998 dollars). About
half goes to Africa. There are are three Africans for each American. Thus, the average
African received 83 cents in US aid PER YEAR. But wait, more than half the money was spent
on government and military, not food.
No wonder they're starving. We expect a family of four to survive for a year on one
Snickers bar or half a cup of rice.
Robert
You asked "would he have made a heck of a lot more money, had that operation been
available fifty years ago?" I replied, it was available 40 years ago.
What was your point?
Poetic Justice
And if we extended 83 cents to every Indian in India and Chinaman, we
would be bankrupt. OOOOOoooooppspsss we already are bankrupt.
> No wonder they're starving. We expect a family of four to survive for a year on one
> Snickers bar or half a cup of rice.
>
NO but that can get 3 or 4 Ramen Noodle packs.... I survived on it
when I had to.
--
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
and answer the question.
Jerry Okamura
"Robert" <n...@e.mail> wrote in message
False analogy. Not everyone needs the help in these countries. Besides it
is still not the point. The point is they cannot survive without outside
help.