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Well... I would call it a 'racket', and even at that, I would take it with a grain of salt... and maybe some tequila... Keeping a hospitals doors open, requires enourmous amounts of cash flow.

Hospitals aren't a racket, the problem is that there are dozens of rackets in a hospital at any time and thousands down the health care chain. Doctor compensation (read: kickbacks) for additional, though expensive and largely useless "expert" procedures being a large and incredibly damning and destructive example of such practices. The same practice (essentially bribes) holds true to suggested procedures and recommended medicines when generics or lower cost prescriptions are proven to be more effective, but aren't the "drug of the week" that pfizer is pushing. Medical machinery is not immune to this same set of problems, in fact such issues are prevalent from the top down in every aspect of our health care system. The ad-hoc and largely deregulated financial nature of the health care system as it's evolved over 200 years is to blame for most of this, hence the need for top down reform, rather than a simple patching of the dysfunctional web of money flows we have now.

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Sgt_Scruffy wrote:

ShumaGorath wrote:

Exactly. "free" healthcare is the most expensive kind. So now we'll give to everyone! And it'll get cheaper! Come on.

WE ALREADY PAY MORE PER CAPITA THAN ANY OTHER NATION ON THE PLANET AND HAVE A STANDARD OF CARE IN THE HIGH 20'S BY COMPARISON.

To say that the social healthcare model is more expensive and less effective.. Christ, how can you even begin to say that without involuntarily punching yourself in the face.

Because we spend so much on healthcare due to huge government programs - and Americans run to the doctor everytime they stub their toe.

Yes, we spend more money than anyone else on healthcare - and since I haven't looked at the data, I will give you the benefit of the doubt and assume yours is correct- although I wonder what the basis for standard of care is based on. Is it life span? If so, Americans are in the high 20s does not reflect poorly on the healthcare system - but the life style of the average american.

Your little insults amuse me shuma. Obviously, you haven't taken your medication today. Perhaps the big bad insurance companies have denied you care for an existing condition? grow up.

oh, and compromise is a lost art in America. Maybe not anywhere else.

So you tell me I'm wrong and then admit you don't know what you're actually talking about. Cute.

Specifically, Phillip Musgrove, the editor of the reprot called the rankings "so many made up numbers" and a "nonsense ranking."

That entire article spends its time saying that the numbers are invalid, but that we may well be worse. It also states that if you fudge the numbers to ignore certain health issues the numbers look better (something totally irrelevant to the conversation, since obesity and poor lifestyle is still a healthcare issue). Keep in mind expenditure since 2000 per capita on healthcare has risen significantly while quality of care in many areas has fallen.

Additionally, I said in my post that I then deleted because it didn't convey what I meant to say that American lifestyle is more to blame with any sort of low ranking then the quality of our health care. According to the book, "Top Ten Myths of American Healthcare," removing homicide and motor vehicle accidents as a cause of death results in Americans having a longer life expectancy than any other country on earth.Source was cited from this website http://smartgirlnation.com/2009/06/popular-ranking-unfairly-misrepresents-the-us-health-care-system/

For how credible that site seems (not particularly considering it comes to a conclusion based on spurious and logically irrelevant information) it makes some awful big claims. That said, it's an editorial article, so thats to be expected. Its conclusions about american life expectancies are irrelevant at best and misleading at worst, and it spends about half of it's length essentially saying that it's ok that the u.s. trails behind because we're being compared to social medicine systems which provide a much broader base of care as a standard, and that the numbers simply reflect "opinions on the value of individuals" rather than the "overall effectiveness of the system, a conclusion that isn't supported in the body of the article.

I believe another major factor in our life expectancy woes is the inability of the average american to stop stuffing twinkies into their mouth as fast as their grubby little hand can manage before they inevitably succumb to a massive heart attack. Hardly the fault of the health care system as anyone with half an education knows that being morbidly obese is bad for your health.

The high cost of incidental health care reduces the overall prevalence of personal care and prevention methodology in the home and hospitals. When it's too expensive to get yourself checked for prostate cancer you don't do it until you have it. There's a very real causal relationship between the cost of healthcare and the lifestyle choices of americans. Check out the Japanese healthcare system for a method behind caring for a disease prone (elderly) population within a social healthcare structure. Their number of personal doctors visits are among the highest in the world, and they have a fantastic record with chronic and lifestyle related issues.

If you're interested in why your rankings are "so many made up numbers" as admitted by the editor-in-chief of that very report, I would direct you to this paper as well. http://www.cato.org/pub_display.php?pub_id=9236 - it's the PDF down at the bottom. If you're not interested in reading it, I'll summarize. "Using existing WHO rankings to justify more government involvement in health care is to engage in circular reasoning because the numers are designed in a manner that favors greater government involvement." (p.3 Whitman).

That conclusion is like stating that believing the thermometers telling you it's cold because it says so is foolish because it's slanted towards providing a cold measurement. Even if it's miscalibrated slightly (a study this old by all logic is regardless) it's conclusions are still damning. We have gotten worse since that study, healthcare is more expensive, and quality of care per capita has fallen (largely due to the expense). Whether the number is in the high 30's as the WHO study states or the high 20's as I had stated in my post (in truth I simply misremembered the actual number) we are still lagging far behind the rest of the first world, largely due to the ludicrous amount spent and lack of functional basic care due to the cost being placed on the patient (that didn't happen nearly so often a century ago when private practices were the rule, healthcare has changed since then).

But you're right of course, Shuma. I did admit that I didn't know what I was talking about and I still don't. I'm talking about health care in the off-topic forum of a warhammer site. Will you admit to your own ignorance? Or should I just shut my mouth and let the *obviously* more intelligent get on with the conversation?

What ignorance? The belief that American healthcare quality per dollar spent is ludicrously bad, and that per capita we fall behind many other civilized nations is a simple fact. The quality of the WHO survey doesn't somehow dispute the fact that a system which would collapse within a single generation is a bad system, and it's mind bending that you can still think that despite having read these studies, which did little to actually refute my assertion.

Da Boss wrote:JEB- wow, your suggestions at the start were excellent. It's amazing no one has brought them to the floor.

Thanks dude, I just saw them as common sense ideas, nothing spectacular. The reason no one has brought them up yet is because no one is willing to listen...except maybe Joe Lieberman and Olympia Snowe....

Its not a matter of listening, its a matter of divergent priorities.

Or its that wonderful sense of absolutism that is encroaching upon society more and more now.

That does heighten the tensions, yes.

Very few people are capable of understanding the priorities of other, let alone putting them an even playing field with their own desires.

Agreed. Learning how to balance idealism with realism is not one of our government's strong plays....

My solution is just to get rid of the idealism, but then I'm also a heartless monster.

JEB_Stuart wrote:I just wanted to post my thoughts here, and see if anyone else feels the same way. My frustration has been growing ever so slowly with the simple fact that negotiation and compromise are quickly becoming things of a bygone era. Lets take for example the current debate swirling about Congress' efforts to reform the US health care system.

In terms of healthcare, I think it's important to see the politics for what it is. It's been pretty well documented that the Republicans, in the wake of the 2008 election, needed something to restore the viability of the party, and chose to take a really hard line of healthcare. I think in a lot of other situations the rhetoric would have been considerably different on this issue.

But that's just on healthcare, and there is a greater issue that's growing in politics and both sides are responsible for it. There's an idea of two utterly opposed camps, conservative and liberal who are completely unalike on the most basic of ideas. It can be seen on both sides of politics, in books like The Culture Warrior or Stupid White Men. It'd be a big heavy discussion to determine how it all came about (part politicians exploiting fear of the other side, part balkanisation of news media, and probably a lot else) but I'm pretty sure the solution is the same in all cases... when someone starts spouting exclusionist rhetoric based on his side vs some other side, we simply exclude them from the process. Not legally or anything, just culturally we return to demanding adults who give considered points of view.

Federally Funded Abortions: Instead of the Federal government deciding on this issue, lets the states decide. If the people vote for it, BAM! its allowed, if it isn't BAM! it isn't. This allows more conservative states to protect their dearly held values and allows more progressive states to protect their own sincere beliefs.

When it comes to abortion I'm not even sure why insurance would cover them. Unwanted pregnancy is something that is very controllable on a personal level and that's the kind of thing that it doesn't necessarily make a lot of sense to insure. They also aren't that big an expense, as I understand it an abortion is a few hundred dollars (though it's possible I could be wrong on this). It seems to me abortion is something that's best suited being paid for as incurred.

Compulsory Purchase: Don't force people to buy insurance through threat of fines or jail time. Rather give tax incentives to people who do buy it, and the withholding of tax refunds for those who don't. If they are financially stable enough to not need the insurance, I doubt that refund will be missed, and many lower and middle class families could use the money from a tax incentive to purchase new or better insurance.

There's a problem of differential treatment here. A tax refund is a result of paying more tax during the year than your were supposed to, and whether you have a payable or a refund shouldn't impact whether or not you end up paying a fine for not insuring yourself. Think of it like this, one guy earns $50k in the year, and pays enough tax throughout the year to end up expecting neither refund nor a payable - he didn't bother to insure so it's kept out of his non-existant refund and makes no difference in the end. Another guy earned the same $50k, only at his work the bloke in HR ticked the wrong form for his payroll and he ended up paying an eExcept maybe the second guy accrued a couple of extra deductions

I think the rest of your ideas represent a reasonable compromise. They're not the system I'd put in place (I just don't understand the worry over a public option that gives basic care - at the lowest level of healthcare government can provide a cheaper, better service with none of the admin expenses of a for profit system)... but a system that gives a level of improvement. But its important to note that you missed any mention of what I feel is the most important area for reform, the ability of insurance companies to reject people (even signed up, paying members) on the grounds of pre-existing conditions. Without reform on this issue the US system will continue to be a shambles that sends people broke for getting sick.


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Sgt_Scruffy wrote:Because we spend so much on healthcare due to huge government programs - and Americans run to the doctor everytime they stub their toe.

Yes, we spend more money than anyone else on healthcare - and since I haven't looked at the data, I will give you the benefit of the doubt and assume yours is correct- although I wonder what the basis for standard of care is based on. Is it life span? If so, Americans are in the high 20s does not reflect poorly on the healthcare system - but the life style of the average american.

The problem here is that you've formed a strongly held opinion despite knowing absolutely nothing about the issue. The US pays more per healthcare than any other nation in the world, around 16% of GDP. This compares with other developed nations who spend between 8 and 10%. The higher expenditure is not caused by government involvement in healthcare - as all those other countries have vastly more government intervention in healthcare.

And healthcare metrics account for lifestyle, and focus on purely medical issues. They look at issues like deaths in childcare, instances of malpractice and the like. In these issues the US ranks far behind other developed countries, and is on par with poor countries.

So now I'd recommend you go away, do some reading on the issue, confirm what I've said above and come to a new opinion. It doesn't have to be the same opinion that I have (it'd be boring if it was) but you really do need to start from the facts of the issue.

Da Boss wrote:The people who don't get immunized can provide a pool in the population for the disease to potentially mutate so that it can infect others though. So I say mandatory immunizations.

In the US, at least in some states, that has been tried and found unconstitutional. That could have been unconstitutional on state grounds. I'm too lazy to care why.

According to Wikipedia the US Supreme Court in Jacobson vs Massachusetts 1905 upheld the authority of the states to pass compulsory vaccination laws.

http://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

The issue has a long and troubled history in the UK and USA.

In my view the two important points are that it is the unvaccinated children who suffer when the epidemic hits, and children are not fundamentally the property of their parents.

Kilkrazy wrote:According to Wikipedia the US Supreme Court in Jacobson vs Massachusetts 1905 upheld the authority of the states to pass compulsory vaccination laws.

http://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

The issue has a long and troubled history in the UK and USA.

In my view the two important points are that it is the unvaccinated children who suffer when the epidemic hits, and children are not fundamentally the property of their parents.

That may have changed + there are state issues.

If the legal situation has changed it would be useful to have a reference to the case which has changed it. (Separate to the social situation.)

Jacobson vs Massachusetts lets states pass compulsory vaccination laws. It doesn't mean they have to, or they will, or that the laws will be enforced with rigour.

According to other Wiki pages, some 20+ US states allow exemptions to compulsory vaccination on various grounds such as patient's compromised immune system and parental conscience.

That lets Jehovah's Witnesses avoid religious contamination. It also offers a get-out clause for parents like those in the UK who believe their children will be harmed by MMR.

The question of how much the state should be allowed to interfere in family life in protection of children is a difficult one. If you enforce vaccination on Jehovah's Witnesses' children, why not enforce blood transfusions?

I vaguely remember a fairly recent case where strongly religious parents (not Witnesses) had their ill child die because they thought it would be better to pray for it than take it to hospital.

I think thats a different thread for discussion KK. Go for it!

Back on topic, I think compromise is lost because the sides get caught up in the idea of winning, not of producing a good outcome.

i think the main problem are the 2 very polar groups in US society (this does not include the mass of 'neutral' citizens') a two party political system leads to confrontational approach to governing the country were the party ideal is more important than the good of the people, also i don't understand why lobbyists have so much power in the US, were the good of a 200 shareholders (or the 20 important ones) is more important.
goverment controlled medical support works in other countries,lots of other countries (sarah palin can stop telling outright lies about the UK health care, i've been init and without i would have died) a small increase in taxes would remove the need for health insurance saving people money, and if you are middle class and above you can have a private medical insurance (like the UK's BUPA) and go to private hospitals.
politicians seem to forget that they are not there to force their viewpoint on others but to serve the greater good of the populace. JEB's ideas are some pretty great ideas in my opinion.




'whats the difference between healthcare and a car?
car insurance is mandatory, cos they're important'

Compromise is massively important for interaction between members of the human race - always has been. We compromise everyday.
IMO there are some things which are too important to use simply as a political 'football'.

Kilkrazy wrote:I vaguely remember a fairly recent case where strongly religious parents (not Witnesses) had their ill child die because they thought it would be better to pray for it than take it to hospital.

They should have just put his symptoms into Google like everyone else.

I was listening to NPR today and I was getting frustrated with the absolutist stance by the DJ. The possibility of being incorrect is inherent in nearly all things, and it is the acknowledgment of said possibility that is a sign of humility. Until that has been adopted by most of society, I fear that realism will never come to pass...

For some people it takes a lot to admit that they might be wrong - I should know, I do it all the time!