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[P]
Health Care?

By ajkohn in Op-Ed
Fri Jul 20, 2001 at 01:51:53 PM EST
Tags: You Know... (all tags)
You Know...

Way back in 1992 health care reform was a hot topic in political forums as the US elected a new President. In 1994, Hillary Clinton's reform proposal was shot down by Congress and the idea of a health care overhaul basically abandoned

Soon, the economy was surging and while health care was still a sore spot, when times are good people simply don't rock the boat.

In my opinion things have gotten worse since we last truly visited this issue. Let me quickly illustrate a few points and give some anecdotal evidence.


As of 1998, more then 1 in 6 non-elderly USisan were uninsured - 44 Million, up from 37 Million in 1993. A study done by the Kaiser Commission also details that many are hard-working individuals working for smaller companies that do not offer insurance. Of those that do, companies are passing on more of the costs to workers. From the same report, workers in 1998 paid 3 times as much for health benefits as they did in 1977.

But what of those who do have coverage? How are they treated? How are the health care systems working for people like you and I?

Not very well. One doesn't need to look far to find a HMO horror story - you may have one yourself. In fact, a human resources representative at a company I worked at told me that many 'younger people with more disposable income choose PPO plans' because while more expensive and more laden with paperwork, they could actually get access to health-care.

Evidence from a February 2000 Kaiser Family Foundation/Harvard School of Public Health study" show that 74% of USians feel that the problems with managed care have not gotten better. Furthermore, an August 1998 finding shows that 57% of USians have, or know someone, who has had problems with managed care.

26% had problems getting permission to go see a specialist.

30% had problems getting a health plan to pay for a visit to the emergency room.

The odd thing is, we seem to have given in, thrown in the towel. Why else would people put up with waiting weeks or months to see the doctor, then waiting in a doctor's waiting room for an hour and then seeing a Physician's Assistant (PA), not even a real Medical Doctor (MD).

In an age where time is one of our more valued commodities, why do we allow health care to eat up these precious hours?

Patients don't seem happy, the doctors seem fed up and harried, and the medical group and insurance representatives and lackeys seem disgruntled (at least when I call!)

While the statistics in the latter report indicate that the public still desires some governmental action, do we really believe it is the answer?

Why aren't we 'thinking out of the box', or finding the 'new paradigm' about health care. Plenty of dot com people out there to attack this issue now.

Have we become so apathetic that we want government to slap a quick 'sue your HMO' patch on the system and toddle on its way?

Or is it time that we took back our access to health care, tore down what was built and try something else? Whatever replaces it would be hard pressed to fail as miserably as the current system.

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Poll
What should we do about health care?
o Let the government handle it. 15%
o That Patients' Bill of Rights will solve everything! 3%
o Leave it the way it is, "the devil you know" I say. 1%
o Revolt and ... do SOMEthing. 14%
o Who cares? I don't get sick anyway. 14%
o Restructure the system that we have. 12%
o Change the system completely. 39%

Votes: 64
Results | Other Polls

Related Links
o more then 1 in 6 non-elderly USisan were uninsured
o Kaiser Commission
o February 2000 Kaiser Family Foundation/Harvard School of Public Health study"
o Also by ajkohn


Display: Sort:
Health Care? | 159 comments (129 topical, 30 editorial, 0 hidden)
fiscal awareness (3.63 / 11) (#1)
by dr k on Thu Jul 19, 2001 at 04:32:08 PM EST

One thing the US and its citizens need to recognize is that there is no "cheap fix" for health care. It is expensive to keep people alive, and the longer you want to live, the more money someone will have to pay to keep you healthy.

The HMO system was devised with the idea that a corporation should be able to make a profit off of public health. But this gets tangled up with some simple human rights issues when the corporations decide that certain people just aren't profitable enough.

We really aren't going to get anywhere without government intervention. The big question for the USA is, like for many issues, "Is it already too late?"
Destroy all trusted users!

And by this, of course... (3.11 / 9) (#6)
by trhurler on Thu Jul 19, 2001 at 05:02:05 PM EST

you really mean that people such as myself should be forced to pay for medical care for people who can't or won't pay, one has to presume. I guess rights are only important in your book if someone is suffering. What I want to know is, of all these non-elderly people, not counting the children for the moment, how many do you think are incapable of paying for health care, as opposed to simply unwilling to, say, actually work that weekend or put in that evening just like the rest of us?

Hint: I've got friends in all kinds of shitty jobs. Most shitty jobs offer insurance these days, and in fields where they usually don't, there is always someone offering it trying to get the better applicants. If you don't have insurance, you aren't trying very hard, or maybe you just haven't ever bothered to develop any marketable skills. (Included in the list of marketable skills are ability to hold a decent conversation, perform simple arithmetic, stay awake for eight hours, and so on. This isn't rocket science.) There are, of course, exceptions, such as "the factory town's factory closed down," but that's not the same kind of problem.

This is in evidence when talking to people who work with those who have no insurance. Typically, the complaint is not "these jobs offer no insurance," but rather "you have to have a job for x months to get insurance." Gee, maybe if you weren't a fucking loser who came in late every day and stole money from the register, you could keep a job for six months, eh king? (I know plenty of people who do, so "they always dump them rather than give them benefits" is not going to fly as an excuse.)

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
my bleedin' heart (4.75 / 4) (#13)
by dr k on Thu Jul 19, 2001 at 05:56:39 PM EST

If you thought about the intense diversity of the US you might realize that not everyone lives a life that is familiar to you or your buddies.

As a freelancer, I have to pay for my own insurance. I have to charge enough so that I can afford to buy my own benefits. I don't expect anyone to care about that, but I do expect people to recognize it as a valid choice, and to further consider what is required to even make that kind of choice in the first place.

The problem isn't about lazy people, or illegal immigrants, or unfair taxation. It is an issue of public health, health for people who don't have a wonderful array of choices. If you want to live in a nation where potential tuberculosis victims can't get treatment because they have no legal protection, then I hope you like disease.
Destroy all trusted users!
[ Parent ]

To hyperbole... and beyond! (3.00 / 6) (#18)
by trhurler on Thu Jul 19, 2001 at 06:21:41 PM EST

It is an issue of public health
By which, of course, you mean... (see my last post.)
If you want to live in a nation where potential tuberculosis victims can't get treatment because they have no legal protection, then I hope you like disease
Please inform me of the location in the US in which you reside and in which it is possible for anyone, even if homeless and mentally ill, to not be able to get treatment for TB. I am eagerly awaiting this nonexistent information. Oh, wait, that's right - your claim is bullshit.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
on the nature of bullshit (3.50 / 4) (#21)
by dr k on Thu Jul 19, 2001 at 07:22:21 PM EST

You are the one who invoked the demon of the loser who came in late every day and stole money out of the register. I didn't raise the stakes, just called.

But in answer to your ill-formed query of whether I believe you should be forced to pay for medical care for the "undeserving": Yes, I do. It is in your interest. And, in fact, if you were to do this willingly, it would probably cost you a lot less, especially if you consider all of the energy you currently waste on your excessive philanthropy.
Destroy all trusted users!
[ Parent ]

Oh? (2.50 / 6) (#26)
by trhurler on Thu Jul 19, 2001 at 07:38:25 PM EST

So, what you are saying is, despite the fact that there are people who can't keep a job for three weeks due to tardiness, drunkenness, thievery, and so on, and despite the fact that there is no place in the US where you can't get treatment for TB, you see no difference between the two notions.

And regarding my interest: if it is my interest which is so urgently at stake(which is patently false, save possibly for the case of certain infectious diseases which are already treated in the US anyway,) why are you so eager to force me to do it? Surely you have something better to do than look out for me - after all, it seems quite obvious that I can do that for myself!

I agree with you on one point: if I willingly bend over and take it in the ass with lube, that might hurt less than if I refuse and you beat me down and ride me dry - but somehow, I don't think I ought to have to do either of those.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
nice place (3.16 / 6) (#31)
by dr k on Thu Jul 19, 2001 at 08:16:01 PM EST

I wish I lived in your world. So many shiny things. And the occasional anal rape.
Destroy all trusted users!
[ Parent ]
Shiny stuff up the butt. (3.60 / 5) (#34)
by mrgoat on Thu Jul 19, 2001 at 09:03:51 PM EST

(Disclaimer: Long time lurker who just got enough free time on his hands to post) I may have to vote this up, just because of the "trhurler anal rape" reference. Especially if it's done with the shiny things. In my experience however, the vast majority of people are not the drunken, tardy, shit-for-a-life balls of useless human flesh that trhurler seems to be generalizing them as. There's another social aspect here not being looked at, but I think the conditions leading people to end up working new jobs every 3 months with no health benefits are a topic for another article. Then again, maybe they aren't.

"I'm having sex right now?" - Joh3n
--Top Hat--
[ Parent ]

the hoi polloi (3.00 / 1) (#151)
by anonymous cowerd on Sun Jul 22, 2001 at 03:40:27 PM EST

...the vast majority of people are not the drunken, tardy, shit-for-a-life balls of useless human flesh that trhurler seems to be generalizing them as...

But they are, they are! Only the Superior are truly Human, and they are indeed few and far between. After all, that's what the Ideology says, so a fortiori it must be the Truth!

That's why Society needs an Iron (invisible) Hand. Voters are not competent to manipulate any aspect of society through direct legislation. (Except, of course, national defense, domestic law enforcement, and maintenance of the stability of investor's fortunes; those governmental obligations are, for some reason, arbitrary exceptions to the otherwise universal axiom.) Because the hoi polloi, as the wise all know, are only contemptible trash.

Yours WDK - WKiernan@concentric.net

America is false to the past,
false to the present,
and solemnly binds herself
to be false to the future.
- Frederick Douglas

[ Parent ]

Exactly (4.00 / 1) (#108)
by NoBeardPete on Sat Jul 21, 2001 at 12:25:15 AM EST

I agree, and I'll explain why.

I see trhurler is of a Libertarian bent, and as such seems to think that the government's only legitimate concerns are enforcing property rights and preventing violent crime, theft, fraud, etc. Please correct me if I'm wrong on this.

Anyway, all of this stuff is pretty moot without some sort of orderliness to society. If the gap between the rich and the poor becomes too great, revolution will ensue. Maybe with a lot of harsh policing, it can be postponed for a while, but ultimately, utter chaos will break out, and it'll be everyone for themselves (and maybe their family and trusted friends). Look at countries that have this kind of chaos, either through extreme poverty, religious or ethnic infighting or whatever - much of war torn Africa, the Balkans, Yugoslavia. The basic rights that Libertarians thump on the most - safety from physical harm, property rights, etc - all go right out the window when society breaks down far enough.

So, if you do believe that the government has a business protecting people from violence and the like, then it makes sense that it has the right, or even the responsibility, to take steps to maintain order. Historically, extreme poverty is a big cause of order breaking down. Now, it's pretty frickin' hard to end poverty, but some of the symptoms of poverty can be addressed a little more easily. Lack of health care is a large sympton of poverty.

Now, you might go on to argue that certain government approaches to health care are uneffective, or inefficient, or could be better done with a different method. Arguing that the government has absolutely no business in it in the first place, however, overlooks the reality of life. A certain degree of order is required for any other kind of rights to have meaning.
Arrr, it be the infamous pirate, No Beard Pete!
[ Parent ]

Or... (2.00 / 1) (#135)
by trhurler on Sat Jul 21, 2001 at 08:34:02 PM EST

Maybe if you just get government out of all the things it is presently screwing up so badly, there won't BE so many poor people... keep in mind, capitalism thrives by paying people to do things, which means that to the extent that a capitalist economy grows, it has to be paying out more and more to the people at the bottom. The image people have of one guy getting rich while everyone else suffers simply is not real; there's not just one employer, nor is wealth a static quantity to be divvied up - "growth" is not a metaphorical term. I strongly suspect that taxation, regulation, and minimum wage laws account for more poverty than anything else, though I don't think the numbers have been obtained to prove it. (Minimum wage laws are a weird topic, though. In boom times, they have little or no effect, because demand pushes wages up above the minimums anyway, but in crunch times, they make the problem worse by increasing unemployment while still not offering enough money for anyone to really live on. Essentially, a total failure with serious negative consequences, and yet supported by most mainstreamers.)

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
your grasp on history seems shaky at best... (none / 0) (#156)
by chutzpah on Mon Jul 23, 2001 at 11:50:23 AM EST

Before minimum wage laws were introduced, at the start of the industrial revolution employers were sucking people dry, they were making $0.01/hour while the employer was making millions. Don't say tha't they didnt have to work for the factories because many people were forced off their farms by copropations looking to make large farms instead of the small, family run farms they all were living on before the industrial revolution. Those that didn't live on farms before the industrial revolution need some way of buying food to beable to feed themselves and their family, and the only way to do that is get a job, the only jobs that were available were working for the exploitive corporations.

Just look at what's going on in countries that do not have labour laws, small children are working 18 hours/day making less than $0.10/day, if any at all (there is an amazing number of basically enslaved workers in the world who are basically blackmailed into working for free).

I agree that the american health care system is teh best in the world if you have plenty of money (which is why rich people from other countries tend to get treatement in the US, but the people that do not have money for proper treatment are basically fucked. Also I would like to see you try to get a decent job if you show up for all your job interviews wearing an old dirty sweater you found in a dumpster because thats all you can afford, or if you have some debilitating illness that takes away your ability to do any useful work.

[ Parent ]
treatment for TB (3.33 / 3) (#50)
by streetlawyer on Fri Jul 20, 2001 at 04:39:06 AM EST

Notoriously, in New York City at present, "treatment for TB" means "exactly as many antibiotics as will stop the coughing at present and then straight out of the door before you become a potential lawsuit liability".

--
Just because things have been nonergodic so far, doesn't mean that they'll be nonergodic forever
[ Parent ]
your choices are not my problem (3.00 / 1) (#22)
by cory on Thu Jul 19, 2001 at 07:27:13 PM EST

You've made a choice to work for yourself. Good for you, I wish you the best of luck. But part of this is taking responsibility for your own health insurance. Don't like that idea? Then go work for someone else and join in their group rates (or see below). Don't expect tax payers to support you.

I'm also self-employed and have found a way to provide insurance for myself and my family. It costs about $20 per month and covers any health problem we have (including dental, chiropractic, and optical). If you want more information, just email me at the address provided and I'll forward you to the company I bought the insurance from. Basically, it's an HMO for small businesses, and there are enough of them in the plan to get really good group rates. If you're really concerned with health insurance, go that route, don't expect someone else to take care of you your entire life.

Cory


[ Parent ]
c-c-choices (4.00 / 3) (#28)
by dr k on Thu Jul 19, 2001 at 07:50:45 PM EST

Let me give you a big pat on the back for missing my point entirely. I bear the burden of paying for my own insurance, and I love it. But I am honestly concerned about the wellbeing of others, and I'd like to see those who cannot afford to make these choices treated with some respect.

I don't just take responsibility for myself. I'm not an asshole Libertarian. I take responsibility for whomever I can. Sure, I exaggerate. But at least I'm willing to make that claim, instead of muttering "get a job" while I sit at a red light in my SUV.
Destroy all trusted users!
[ Parent ]

Ah (none / 0) (#78)
by trhurler on Fri Jul 20, 2001 at 03:53:19 PM EST

Well, why don't you act on your humanitarian impulses with your own damned money instead of trying to take mine at gunpoint? There is a disconnect here between your humanitarian impulses and your desire to do violence to some people in order to "help" others.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
guv'rnmint (3.50 / 2) (#86)
by dr k on Fri Jul 20, 2001 at 05:47:24 PM EST

Well, why don't you act on your humanitarian impulses with your own damned money instead of trying to take mine at gunpoint?

I may be hopelessly romantic, but I like to think that the role of any government (democratic or not - and there is plenty of evidence that the US is not) is, at its core, concerned for the well-being of its people. The problem is that "well-being" can be defined in a number of ways. "Pursuit of happiness" sounds good, but then you just twist that around and say that money makes you happy.

The problem isn't that you are greedy, or that you are ignorant. It is that you lack empathy, and you don't even think about why you should need it. Perhaps you should be put in prison.
Destroy all trusted users!
[ Parent ]

Uh... yeah. (2.00 / 2) (#90)
by trhurler on Fri Jul 20, 2001 at 06:22:05 PM EST

I may be hopelessly romantic, but I like to think that the role of any government (democratic or not - and there is plenty of evidence that the US is not) is, at its core, concerned for the well-being of its people.
That's not romantic. That's just fucking stupid.
but then you just twist that around and say that money makes you happy.
Money doesn't make me happy.
It is that you lack empathy
I certainly do not. In fact, while I doubt this will make any sense to you, it may well be that I have too much.
Perhaps you should be put in prison.
You're more honest than most of your fellow statists.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
All your taxes (4.50 / 2) (#118)
by NDPTAL85 on Sat Jul 21, 2001 at 07:50:21 AM EST

In the year 2015 A.D. People were dying Citizen: What happen! Corporation: Main screen turn on! Government: Good evening gentlemen. Citizen: For great justice! Government: You are your brother's keeper, make your time. Corporate: Take off every zig for profit! Government: All your taxes are belong to us.

[ Parent ]
you got it trhurler (4.50 / 4) (#15)
by strlen on Thu Jul 19, 2001 at 06:06:10 PM EST

congrats for trhurler for giving us the "FIRST TAXATION IS THEFT POST!!!"

--
[T]he strongest man in the world is he who stands most alone. - Henrik Ibsen.
[ Parent ]
OK, if that's the way you want it (2.50 / 2) (#23)
by flimflam on Thu Jul 19, 2001 at 07:28:28 PM EST

I'm trying to wrap my head around your logic here. You bitch about having to pay for health care for other people who are too lazy to buy their own, but what do you think happens when you buy insurance? The whole point of insurance is to spread risk, so that those that don't get sick pay for the care of those who do. Is it that much more objectionable that you subsidize the health care of the poor than that I subsidize yours because we're on the same health plan? Anyway, you're already subsidizing the healthcare of the poor already -- the way that uninsured people tend to get health care is through hospital emergency rooms. Who do you think pays for it? That's right my friend, you do. Personally, for my money I'd much rather pay for those people to be in a real health plan -- it'd be a hell of a lot cheaper, and better for public health to boot.

Or perhaps it isn't the practical issue that bothers you -- you're just morally offended by the idea that someone can get something (like a trip to the doctors) without paying for it?

-- I am always optimistic, but frankly there is no hope. --Hosni Mubarek
[ Parent ]
Two differences (none / 0) (#27)
by trhurler on Thu Jul 19, 2001 at 07:46:12 PM EST

First of all, if I choose not to buy insurance, that is my choice. I cannot choose not to pay taxes.

Second, insurance companies work hard to assure that whomever is higher risk pays more, and whomever is lower risk pays less. Governments do exactly the opposite. As such, insurance is a much, much better way for responsible people to spend money than taxes ever will be.

Oh, and if it would be cheaper for all those poor people to be in "real health plans," why haven't hospitals put them there? Obviously, according to you, this would save them money, increasing their profits. The reason is blatantly obvious - IT WOULD NOT BE CHEAPER! Imagine that. "Real health care" is more expensive than the occasional (once every several years, on average, excepting children, for whom the rate is probably once or twice a year,) emergency room visit.

Now, you can try to make some claim about the "efficiency" of a government run system making it cheaper. I will then point out that government run systems waste 90% of their money or more, whereas private systems typically have waste in the 1-10% range with the low end being predominant, and you will be utterly left without any argument whatsoever. So, please don't bother; in any case, the "efficiency" of pointing guns at peoples' heads is not an efficiency I care to profit by.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
a subject line which will be read by USians (5.00 / 2) (#40)
by surplus value on Thu Jul 19, 2001 at 11:38:11 PM EST

As such, insurance is a much, much better way for responsible people to spend money than taxes ever will be.

Why must people become irresponsible under socialized health care, but corporations in private, for profit systems can never, ever err against the patient in favor of increased profitability? And why should Americans become irresponsible in direct contrast to the responsibility quotient of citizens in every other first world nation with public health care? And why is 100% pervasive public health care bad for the economy? We've progressed beyond incantations and faith healing; the more people treated, the greater the demand for health products, services and professionals.

Your moral arguments are empirically false and your economic assertions are not only lacking arguments, they are likely empirically false as well.

---
War Inc.: No one fucks with The Great Satan.
[ Parent ]

Oh? (3.00 / 1) (#79)
by trhurler on Fri Jul 20, 2001 at 04:03:48 PM EST

Why must people become irresponsible under socialized health care
Same reason they become irresponsible under socialized anything else. Namely, because whether or not you are responsible, you are guaranteed that someone else will make sure nothing bad happens.
but corporations in private, for profit systems can never, ever err against the patient in favor of increased profitability?
Of course they can. The HMO system is a pigfuck. However, in the US, until the damned government got into medicare, medicaid, and so on, and started forcing doctors to do insane things at insane rates or else, ordinary people COULD afford medical insurance and care without help from any HMO. The fault here is the government's.
And why is 100% pervasive public health care bad for the economy?
You take a productive segment of the US economy, which makes money, and is a whole 1/7th of that economy, and you turn it into a government run black hole, with no profits or production - just a bottomless pit into which you pour tax dollars. You want to know why that's bad for the economy. Are you stupid?
the more people treated, the greater the demand for health products, services and professionals.
The whole notion of supply and demand is predicated on a free market. Your system is not a free market. Quit pretending you can have your capitalism and eat it too. (Or, empirically, why do you think it is that so many of the best doctors, programmers, and other professionals in most countries come to the US, rather than stay in their homelands? The US is hardly a free market, but it is closer than any other place.)
Your moral arguments are empirically false
That's funny. Most socialists I know don't think morality is empirically determinable. They claim that it is some matter of principle(generally, altruism, though they don't all call it that,) and that it is right regardless of the results it produces. This is why they're willing to ignore the hundreds of millions of corpses their ideas have created.
your economic assertions are not only lacking arguments
You might want to look up the "Austrian school."
they are likely empirically false as well.
Throughout human history, degree of prosperity of a civilization has been directly correlated with freedom to trade as you will, absence of oppressive taxation, and individual liberties. Socialism is certainly an empirical falsehood, with only a handful of overhyped "successes" that are really not all that successful and dozens upon dozens of gory, bloody failures, but my position is not.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
A little perspective, please. (4.00 / 1) (#94)
by marimba on Fri Jul 20, 2001 at 06:54:10 PM EST

"Throughout human history, degree of prosperity of a civilization has been directly correlated with freedom to trade as you will, absence of oppressive taxation, and individual liberties."

You absolutely ignore the fact the no capitalist economy has functioned as a closed loop. It was built upon colonialization through force of arms. Yes, Great Britain and Europe were porsperous, at the expense of colonies in India, Africa, Asia, and the Americas, lest you forget the American Revolution (remember when it was illegal to own looms in the Colonies?)

Simply put, a few prosper through the misery of many. The model holds true to this day. Visit lbbs.org for a little insight.



[ Parent ]
So then... (none / 0) (#129)
by trhurler on Sat Jul 21, 2001 at 03:51:18 PM EST

What you are saying, if I read properly, is that because history has been statists piled upon statists, we must continue with statism(albeit of the left wing variety, rather than the right,) rather than move on to something less reprehensible. Got it.
Simply put, a few prosper through the misery of many.
Yes, yes, spare me the class warfare shit. Everywhere trade and industry go, standards of living rise. Not everyone gets rich, but if they weren't better off in the factory than on the beet farm with the mud huts, they'd be beet farmers - nobody forces them into the factory.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
spare us the invisible, healing hand (4.00 / 2) (#98)
by surplus value on Fri Jul 20, 2001 at 07:31:52 PM EST

If I wanted religion, I'd go to church. What you have said is that healthcare should be 100% private, despite overwhelming evidence that it isnt any such thing, in order to satisfy trhurler's mystical appreciation for the invisible hand.

Same reason they become irresponsible under socialized anything else.

But they do not become irresponsible. Why do you persist in calling Canadians, or citizens of every other first world nation save the USA, for that matter, irresponsible? Furthermore, I could just as easily say unabated capitalism makes business behave irresponsibly, and I would be historically correct.

You take a productive segment of the US economy, which makes money, and is a whole 1/7th of that economy, and you turn it into a government run black hole, with no profits or production

Business doesnt care who pays the bill; nobody is actually treated for free in socialized healthcare systems, you know.

The whole notion of supply and demand is predicated on a free market.

The whole notion of modern government is predicated on citizens calling the tune. If these citizens wish to take control of their healthcare, then they will. Factors influencing supply and factors influencing demand will operate within the framework of their decided system, just as they always have. Supply and demand does not say a nation should ransom its public health to profit driven capitalists. If you require proof for this, you merely have to look at every successful public healthcare system in the world, most of which are instituted in ostensibly capitalist nations.

Your understanding of public policy seems to be "dont make any, everything will take care of itself, and those it makes ill deserve nothing less because there is more laziness in their bones than there is calcium."

Throughout human history, degree of prosperity of a civilization has been directly correlated with freedom to trade as you will, absence of oppressive taxation, and individual liberties.

It certainly has not, not ever. Nor is trade capitalism.

Furthermore, throughout human history, civilization has been directly correlated to living, healthy human beings, and Americans are not doing as well on that score as even the Cubans.

You might want to look up the "Austrian school."

If I took the Austrian School seriously, I would be the 53rd person in the world to have done so, and I dont think they deserve that kind of numeric credibility. You might want to distinguish "Crank Science" from the dismal science.

Patient: Doctor, doctor, it hurts when I do this.
von mises: Hurt is measured according to the coercive interference of government policy on profit and loss statements.

---
War Inc.: No one fucks with The Great Satan.
[ Parent ]

Oh? (none / 0) (#130)
by trhurler on Sat Jul 21, 2001 at 04:11:52 PM EST

What you have said is that healthcare should be 100% private, despite overwhelming evidence that it isnt any such thing,
You seem to have a difficulty with the distinction between "is" and "should be."
Furthermore, I could just as easily say unabated capitalism makes business behave irresponsibly, and I would be historically correct.
What "unabated" capitalism? There has never been such a thing, in the history of the world.
Business doesnt care who pays the bill; nobody is actually treated for free in socialized healthcare systems, you know.
Who sets the prices, and who decides who will receive what services, and who decides who will provide them to whom? Those are little details you just might be overlooking, and they're essential.
The whole notion of modern government is predicated on citizens calling the tune.
This deliberately vague statement is a one-sentence picture of what is wrong with the modern world. People took the message from their forebears that "government should represent the people," and forgot all about the restraint and individual rights message those same people brought with them, so today, we have irresponsible governments - merely a reflection of the irresponsible people they represent. The intellectual bankruptcy has reached the point where cities in the US are now trying to sue the paint industry for having sold lead paint - despite the fact that the government itself was the one saying at the time that lead paint was not only legal, but safe, and that it was what everyone should use! The utter lack of responsibility shown by our governments would be laughable, were they not armed to the teeth and intent on protecting their own interests, even at the expense of citizens. Do not preach to me about modern government; I know it all too well.
It certainly has not, not ever.
You are now firmly in denial of reality. Compare the US to China, or Russia, or for that matter the western European nations. Why is the US presently the dominant economic and military power in the world? Because it has, historically, been freer than them. That is changing, and the US is losing its lead. Compare the UK to the rest of Europe - Europe is catching up, but historically, the UK was better off - and freer. Why has China, civilized for thousands of years, never been a real world power? Take a guess. The only exception was the USSR, and that was a nation built the way of the ancient Romans. Notice that there are no more Romans - or Soviets. A temporary blip, and then they're gone.
Americans are not doing as well on that score as even the Cubans.
Visit Cuba and come tell me that again. Cubans live in almost subhuman poverty, with highly iffy sanitation, unless they're in or near the tourist areas or are "important" government officials. The fact that the free clinics will set their kids' arms when they get broken and hand out antihistamines when they have colds is almost irrelevant by comparison. Most of what the US considers modern medical equipment and a large percentage of modern medicines(US made and otherwise) are simply not available, at any cost, despite the fact that Europe and others have systematically undermined the US embargo in order to bring in "modern" medical supplies and so on. Why have you heard otherwise about Cuba? Because leftists will lie about anything to advance their agenda; to them, the fact that health care is universal is more important than whether it is useful, so they conveniently ignore the latter when making their ridiculous claims.
If I took the Austrian School seriously, I would be the 53rd person in the world to have done so
That's odd. I know more people than that who take it seriously myself, and that's just counting people from the midwestern US with enough education to ever have heard of it. Perhaps you're living in a bubble world, surrounded by people who agree with you, blissfully unaware of the vast numbers who do not... here's a hint: no matter who you preferred in the last US election, at least half the people in the country disagreed with you in no uncertain terms. The world is not the monoculture that both leftists and rightists try to pretend so often. Even if it was, that would not make its views correct. Despite your obvious religious fervor for majority rule, might does not make right.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
god, this is the last time i ever debate a libby (5.00 / 2) (#137)
by eLuddite on Sat Jul 21, 2001 at 09:06:15 PM EST

After I hit the submit button on this post, I am going to enlist in a school for JACK BOOTED THUGS and learn how to approach doctors as one in a group of MEN BEARING GUNS in order to force them in a position of affordable, state subsidized healthcare. Finally, I will realize my dream of becoming a STATIST.

Who sets the prices, and who decides who will receive what services, and who decides who will provide them to whom?

Who cares? The goal isnt to make a few people rich, it is to make all people well. You seem to have a problem with public goods and services, those goods and services that a free market well adapted to selling widgets and fribbles has never provided nearly well enough.

"extreme capitalism": the obsessive, uncritical penetration of the concept of the market into every aspect of American life, and the attempt to drive out every other institution, including law, art, culture, public education, Social Security, unions, community, you name it. It is the conflation of markets with populism, with democracy, with diversity, with liberty, and with choice---and so the denial of any form of choice that imposes limits on the market. More than that, it is the elimination of these separate concepts from our political discourse, so that we find ourselves looking to the stock market to fund retirement, college education, health care, and having forgotten that in other wealthy and developed societies these are rights, not the contingent outcomes of speculative games.

-- James K. Galbraith ( &lt-- economist. trhurler? windbag)

People took the message from their forebears that "government should represent the people," and forgot all about the restraint and individual rights message those same people brought with them, so today, we have irresponsible governments - merely a reflection of the irresponsible people they represent.

Yeah, it's the height of irresponsibility to recognize positive rights in other people. Do you stay up nights wondering why after 25 years of handing out pamphlets to blue haired old ladies, the Libertarian Party hasnt managed to elect more than a handful of dog catchers?

The intellectual bankruptcy

Your intellectual bankruptcy is that mantle of chastened certitude that insists on subscribing to the rank fallacy that recognizes coercion in the State alone, denying without justification, intellectual, cultural and, most importantly, economic coercion. Guess what? The overwhelming majority of people are unaffected by the State to anywhere near the same degree as they are affected by decrees made by their employers during their employers' pursuit of profit.

Do not preach to me about modern government; I know it all too well.

You know nothing except willful obtuseness to the reality of economic coercion. Evidently it has escaped your notice that barely 1% of corporate conglomerates exercise a near controlling influence on investment priorities, wages, interest rates, and conditions for workers and smaller businesses; or that these same corporate dogs routinely wag the state tail, financing politicians who do their bidding on economic and foreign policy while threatening to withhold credit and move jobs from any community deemed insufficiently compliant.

I dont share your moral certainty that these people should control public health. Do you understand this? I am impervious to your petitions for their increased wealth. You can not justify any of your dogma. A baker's dozen of European countries the size of Vermont, in excellent economic shape every last one of them, have better healthcare than the mighty USA.

You are now firmly in denial of reality.

No, I am not in denial of history. You said:

Throughout human history, degree of prosperity of a civilization has been directly correlated with freedom to trade as you will, absence of oppressive taxation, and individual liberties.
Bullshit. Slavery and imperialism financed the precipitation of capitalism. Capitalists plundered foreign lands of material wealth, bought and sold their human inhabitants for a profit, and then they exploited the labor of those human beings in exchange for 40 lashes and rock soup. Your grasp of history is firmly stuck in some imaginary, pastoral, primitive past where everyone supposedly lived an idyllic life trading horshoes for corn insead of instead of disease for occupation. Even if that were so -- which it isnt -- that aint capitalism.

Compare the US to China, or Russia

I am not an apologist for socialist dictatorships. However, I'd like to see the USA do better if it were arrayed against globe of hostile communist countries. And guess what? The USSR was in worse economic shape before and after their revolution, comparable to modern day Pakistan instead of the global power it once was.

That's odd. I know more people than that who take it seriously myself,

Yeah, well, maybe you should make the acquaintances of economists. I already gave you a link, here's further testimonial from a neoclassicist. But you know what? If you want to listen to a bunch of cranks who accuse Adam Smith of being a proto Marxist and not a theorist of "real" capitalism, be my guest.

Despite your obvious religious fervor for majority rule, might does not make right.

Typical libertarian rhetoric.

No, "Might makes ability to make something", Right or Wrong. You can't even try for Right until you have Might to back it up in the real world. That's the reason that some real governments have survived and all utopian governments that have tried to abolish force have failed.

However, government is not alone in requiring might. All property is based on might as well. Nobody is beholden to your notions of what constitutes your property. Property is just as "involuntary" as the social contract. There is no moral obligation for anyone to respect your property: only a practical one.

Recognition that the fundamental nature of property is based on force is essential to recognition that there are costs and benefits to the principle of property. It is not as negative a "right" as libertarians like to portray it.


---
God hates human rights.
[ Parent ]

Spreading the risk (4.66 / 3) (#60)
by The Larch on Fri Jul 20, 2001 at 01:25:15 PM EST

Second, insurance companies work hard to assure that whomever is higher risk pays more, and whomever is lower risk pays less. And what happens when you suddenly find yourself being too much of a risk to qualify for insurance? Anyone can develop a chronic illness that'll make it extremely hard to find insurance.

It seems to me that the most fundamental reason for having any kind of a community or society in the first place is that individuals can count on receiving help when they need it. Whatever the mechanism, *everyone* should have access to health care, it's a basic human right. Otherwise we might as well revert to leaving sick people behind to die.

[ Parent ]

Well, (2.00 / 1) (#77)
by trhurler on Fri Jul 20, 2001 at 03:49:36 PM EST

And what happens when you suddenly find yourself being too much of a risk to qualify for insurance?
Hey, what happens when you get run over by a car? The premise implicit in the question is that you have a right to health care. You do not. Nobody does.
It seems to me that the most fundamental reason for having any kind of a community or society in the first place is that individuals can count on receiving help when they need it.
Well, you're wrong. The fundamental reason for having any kind of a community at all is that specialization and trade, both voluntary, make us all better off. Health care is not a basic human right - it has a cost, and therefore, it is not a right of any kind. Any other viewpoint means enslaving some to provide for the "rights" of others, because material value(ie, what you use to pay "costs") does not exist independent of human effort.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
I pity you (4.50 / 2) (#93)
by marimba on Fri Jul 20, 2001 at 06:47:11 PM EST

your lack of humanity:

"Health care is not a basic human right - it has a cost, and therefore, it is not a right of any kind."

Food has a cost, and therefore is not a right of any kind. Safety has a cost (maintaining a police force) and therefore is not a right of any kind. Having drinking water has a cost and therefore is not a right of any kind.

I think I understand your sig.



[ Parent ]
Oh? (2.00 / 1) (#128)
by trhurler on Sat Jul 21, 2001 at 03:44:13 PM EST

Food has a cost, and therefore is not a right of any kind.
I congratulate you on your pattern recognition skills.
Having drinking water has a cost and therefore is not a right of any kind.
Keep it up, and soon you'll be at the head of the class!
Safety has a cost (maintaining a police force) and therefore is not a right of any kind.
This one isn't quite right, unfortunately. The police do not provide "safety." You can just as easily be murdered in a place with police as one without them. What police provide is the first element of a system of justice, in which, at least insofar as the fallible nature of human beings allows, we make sure that if someone violates your person or property, he gets what he deserves. You have a right to your own life, and a right to your property; you do not have a right to a police force, although there are noncoercive ways in which such an entity can be funded, just as there are noncoercive ways of acquiring food and water.
I think I understand your sig.
Somehow, I doubt it.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
I am consistently amazed (none / 0) (#157)
by Trencher on Mon Jul 23, 2001 at 04:25:17 PM EST

at your ability to rant and spout half-assed arguments without addressing any of the legitimate, accurate, and intelligent responses which demonstrate just how half-assed those arguments are.
At first I thought your sig was sarcasm, but it seems you are truly the facist that would be required to agree with such a statement.


"Arguing online is like the Special Olympics. It doesn't matter if you win or lose, you're still a retard." RWR
[ Parent ]
Our rights are as we define them (4.00 / 2) (#117)
by NDPTAL85 on Sat Jul 21, 2001 at 07:31:14 AM EST

Anything we want to be a right will be a right if enough people want it to be. Civil Rights weren't rights at all until they were voted for. If and when folks want universal health care to be a right of all citizens then it WILL be a right no matter how much you wish to the contrary.

[ Parent ]
Horseshit (2.00 / 2) (#126)
by trhurler on Sat Jul 21, 2001 at 03:27:15 PM EST

A "right" is something you are entitled to by simple virtue of what you are - a human being. A majority vote does not determine such things, and never has or will. You are speaking, perhaps, of "entitlements" as the US government knows them now, but not of "rights." Redefining the term "rights" to mean "whatever we say" is a common tactic among those who want to pretend there are no real rights; dishonesty breeds dishonesty.

By the way, the majority of "civil rights" are anything but. You do not have a right to be served in a privately owned establishment, regardless of your race, creed, sex, age, attitude, funny smell, or expensive suit.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
Poppycock! (5.00 / 1) (#146)
by NDPTAL85 on Sun Jul 22, 2001 at 08:40:25 AM EST

You define rights as you wish them to be defined. There is no absolute, ordained from high definition of what a right is. Rights are what people want them to be.

One cannot fight the majority rule. Like the overwhelming force of a hurricane, tornado, Borg cube, they are forces so massive that if you stand in their way you will be destroyed. Sometimes physically other times intellectually. The people have already decided what their rights are. You go and try to tell them what they consider a right isn't actually a right. See how long they listen/care/not start beating on you.

"You do not have a right to be served in a privately owned establishment, regardless of your race, creed, sex, age, attitude, funny smell, or expensive suit." Hahah. Of course its a right. It says so right in the Constitution. :) You see whats put on paper and agreed to by a majority becomes a right. Don't worry you'll get the concept someday that rights are subjective and not absolute. A right isn't a virtue of our humanity but of our collective intellectual agreement.

[ Parent ]

Who pays for health care, anyway? (4.85 / 7) (#32)
by John Thompson on Thu Jul 19, 2001 at 08:20:51 PM EST

That's rather callous. Working in health care I see many people who for one reason or another don't have insurance. Only a fraction of them could be construed as being in that state due to lack of effort. Contrary to your assertion, there are many jobs that do not offer health insurance, or only offer inadequate or unreasonably expensive plans.

There are other people who simply cannot get insurance for one reason or another. If you have, say, insulin-dependant diabetes or a history of cancer or some other chronic "pre-existing" health condition you may well find yourself excluded from an employer's group plan.

That's the situation I am in now. I have been with my present employer for over ten years, but during that period my wife developed severe arthritis in her hips, requiring two hip replacements (she was literally unable to walk more than a few dozen yards without severe pain). Fortunately she was covered under my insurance but it is quite likely that should I change jobs she would be excluded from a future employer's group plan. And please remember: we do not always get to choose when we change jobs. My employer could reorganize and eliminate my position at any time.

Tell me, what would you do and how would you feel if you or a family member had a chronic health condition and you suddenly found yourself without insurance?

Here's another thought for you: what do you think happens to the health care chages indigent patients accrue for their health care services? I'll tell you what happens here: we eat the cost.

A hospital cannot turn away a patient in an emergency situation so we treat them and eat the cost. To the tune of many hundreds of thousands of dollars a year (this is a medium-size hospital in a semi-rural area). Granted, most of these are simple "stitch-and-bandage" jobs that never go further than the ER, but several times a year we seem to get an indigent patient who ends up staying for weeks or months before s/he can be discharged. That adds up, fast.

Obviously, if we could not recoup these costs somehow we'd be out of business in no time. So who pays for them? Answer: you do, through higher insurance premiums, hosptial fees, etc.

If there is one adage that has proven it's worth over and over again in health care, it is "an ounce of prevention is worth a pound of cure." The costs of health care for everyone could go down if everybody had free access to basic health care services. The indigent people we see now would be able to have their health problems dealt with at an early stage, rather than showing up in the ER on death's door due to lack of preventative health care. The population in general would benefit both from better basic health but also from the financial relief of not having to pour buckets of money into health crisis management. So who stands to suffer? Probably the insurance companies. If less money flows through their coffers they won't be able to build more fancy new buildings on sprawling lawns.

You can say what you like about nationalized health care, but the citizens of counties that offer this seem generally pleased with it. The UK has had a great deal of political discussion recently because of proposals to dismantle the National Health service. My parents are, respectively, Canadian and British and my grandparents on both sides benefited greatly from the national health programs in those counties.

You may counter that people have to wait long times to see specialists or have elective procedures done. That may be so, but the same is true here. Try getting a non-emergent appointment with a neurologist, for example. A couple months, easy. Same with elective surgeries. Only those who can afford private payment have the luxury of immediate access to every health care need.

So maybe the government burueacracy scares you? I don't see it as different in character to the corporate burueacracy, and at least the government is ostensibly answerable to it's citizens.

Sorry, I find your position ill-considered and irresponsible.

-John


[ Parent ]
what the hell? (4.66 / 3) (#49)
by streetlawyer on Fri Jul 20, 2001 at 04:21:08 AM EST

If you don't have insurance, you aren't trying very hard, or maybe you just haven't ever bothered to develop any marketable skills.

Errr ... the implied second half of this sentence appears to be "and therefore you deserve to suffer from curable ailments". Is that right?

--
Just because things have been nonergodic so far, doesn't mean that they'll be nonergodic forever
[ Parent ]

Do you still beat your wife? (none / 0) (#76)
by trhurler on Fri Jul 20, 2001 at 03:44:24 PM EST

The premise implicit in your question, which is that if people don't deserve to be sick then I am obligated to keep them from it, is false. Trying to slip your entire argument position in as an implied premise is pretty slimy.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
Choose proper subject titles please (4.00 / 2) (#116)
by NDPTAL85 on Sat Jul 21, 2001 at 06:50:25 AM EST

What does wife beating have to do with anything we're talking about? Anyway yes you are obligated to keep others from getting sick financially. You are also obligated to pay for facilities for the poor and for education for kids you do not personally produce and so on. Its called taxes and our government has already been given the right to tax us. All that remains is to get the government to use the money more efficiently.

[ Parent ]
You're begging the question (1.00 / 2) (#127)
by trhurler on Sat Jul 21, 2001 at 03:43:58 PM EST

My previous title, while you may either be unaware of it and too dimwitted to figure it out, was a reference to a classic mistake in argument. Namely, asking a question in such a way that simply by answering it, your opponent must accept a premise which he does not wish to accept.

As for your claim, you and I have a disagreement over the meaning of the word "right" and also over the issue of what is possible. Government cannot be made to use money efficiently - it is a practical and theoretical impossibility, because efficient use of money leads to the creation of wealth, and by definition, government spending of the kind you are advocating consists in taking money by force and spending it on things everyone wants or is afraid to say he doesn't want and nobody thinks is worth paying for - ie, on money losing propositions. Government wastes 90%+ of "its" money, not because it is BAD government, but because it IS government.

Oh, by the way, the term "rights" originated in the form that we inherited it with thinkers like Locke. The idea was that they were guarantees against government abuses - none of these men would ever have used the phrase "government has been given the right," because they only pertain to individuals. Also, none of these men would ever have allowed that rights are whatever a mob is persuaded by demagogues in nice suits to vote for. Your lack of any kind of intellectual perspective is appalling; you seem to just assume that since your high school civics teacher and the Republicrats on TV use the term "rights" to mean "whatever is politically convenient at the moment," this is the real meaning of the term.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
jargon (2.00 / 1) (#132)
by dr k on Sat Jul 21, 2001 at 07:06:57 PM EST

by definition, government spending of the kind you are advocating...

Yes, I'm sure the aerospace industry would be much more profitable without all those government contracts. Or does that fit in with the 10% of non-wasted tax dollars? Please demonstrate, using pie charts and easy-to-read slides if necessary, how the creation of jobs by the government does not qualify as the creation of wealth.

I'm quite upset to learn that 90 cents of every dollar I give to the government is being thrown into a pit in upstate New York, to be covered over by government surplus cheese and honey.

You, sir, are a complete fruitcake.
Destroy all trusted users!
[ Parent ]

Heh (3.00 / 1) (#133)
by trhurler on Sat Jul 21, 2001 at 08:14:47 PM EST

This is not an example you want to use, because it is so full of pork and outright fraud that it is laughable. Further, it consumes hundreds of billions of dollars, and doesn't employ nearly as many people as government figures claim; in truth, if 100,000 people owe their jobs to government aerospace contracts, I'd be surprised - for the money, that's not many. Not only that, but those jobs are highly cyclical; you go through a boom period, and then they almost all get laid off, and then another boom happens, and so on. After you figure in the amount these guys consume in unemployment and their income from other jobs taken in between government contracts, it is probably fairer to say that maybe half as many are actually employed by the military operations, and then less when you consider that a great many would have jobs anyway, because the company is diverting resources that would otherwise go to commercial ventures.

On the other hand, despite not spending nearly as much money(and despite none of it having been stolen,) the commercial aircraft business generates more aircraft at lower cost, employs more people, and in general, is almost as profitable. Funny, that.

--
'God dammit, your posts make me hard.' --LilDebbie

[ Parent ]
friction (none / 0) (#138)
by dr k on Sat Jul 21, 2001 at 09:21:22 PM EST

Have you ever considered the notion that friction creates wealth?

So where does that money go? Oh, oh, wait, I know! The Rich! The Rich are taking all that money! And burying it in a big hole in upstate New York...
Destroy all trusted users!
[ Parent ]

You are still missing the point, rights are transi (none / 0) (#145)
by NDPTAL85 on Sun Jul 22, 2001 at 08:32:00 AM EST

Ok just forget that entire title thing. Your content to make up your own rules on that thing cool have fun.

The efficient use of money does not mandate the creation of wealth. Investment mandates the creation of wealth. Efficient use of money simply requires whatever task to be completed with the least amount of money/time used. Money being generated for profit is not the goal in efficiency.

I don't care if a government venture creates wealth. I just want it to work. The Post Office isn't profitable even though attempts are being made to make it so. I don't care about that I just want my mail delivered. I don't care if its profitable or not its a government service. Amtrak is the same way. I just want these things to work because they are provided by the government. They are already being paid for by our taxes I don't care about them making any extra money. This isn't asked of a police station or a fire station so why should it be asked of ANY government plan?

As for rights, they are indeed what we define them to be. Locke was opinionated and entitled to what he believes. He was just wrong thats all. Rights are indeed subjective from person to person and nation to nation. On a small scale there are rules, policies, laws then constitutional rights. In the US you have the right to own a weapon, in other nations you don't. In the US you have the right to an abortion in other nations you don't. Some of our rights were in the Constitution from the beginning but others had to be added in later, under the pressure of an angry and upset populace, in other words the voters. So it doesn't matter if you don't like those demagogues in suits, if they have something good enough to say and the people go with it and vote for it, then it will become a right. Same procedure for taking rights away. In the US BASIC rights are rarely changed because we are not a "Tyranny of the People" but rather a Represenative Democracy but from time to time they DO change. Whether you think certain rights are correct or not is irrelevant.

[ Parent ]

Inappropriate (none / 0) (#159)
by deeznuts on Wed Jul 25, 2001 at 11:43:32 PM EST

"Do you still beat your wife?" phrases a question such that it ignores important state space -- that of having never beaten one's wife. streetlawyer's post merely seeked confirmation on his interpretation of your post.

"and therefore you deserve to suffer from curable ailments...right?" does not exclude a state space. If that is not part of your point, answer "no". If it is, answer "yes". The question is not based on a flawed premise.

The fact that you would compare it with "Do you still beat your wife?" indicates that you know your libertarian dogma points to "yes" and that the clearly ethical and correct response is "no". You're too selfish to accept the contradiction between your doctrine and the fact of the human condition, so you declare the question invalid.

[ Parent ]

You can patch code... (3.60 / 10) (#4)
by jd on Thu Jul 19, 2001 at 04:58:00 PM EST

...But patching a system tends to be less reliable.

Health care IS expensive, but it needn't be TOO expensive. I've raised this point before, but it bears repeating. If you hired a top-rate investment firm, and basically gave them 10-20 times the normal budget for the health-care system, they should (on average) be able to generate enough revenue to keep medicare up and running, for all perpetuity, even allowing for inflation and population growth, without any further Government involvement.

Ok, so there we have a one-off cost which then results in the entire Medicare system becoming (effectively) free, from there on out.

Ok, now what about the rest of the health care system? Hospitals, Doctors, et al, sponge off Medicare, charging ficticious items in the near-certainty that nobody is going to question anything.

This requires less beaurocracy (which is totally ineffective) and more streamlined coordination. Another reason for moving out of the Government. The system should be capable of responding fast enough to catch such fraud, and deal with those who try to use the inertia of the process to get rich quick.

Then there are the health-care organizations. Many of which make suspiciously large amounts of money, and which offer suspiciously few benefits. About the only way to fight this kind of abuse is to counter it with anti-abuse.

In short, if Medicare became an independent, zero-cost organization, it could allow patients to pick doctors, choose hospitals, etc, just like any other HMO. Except that it would have no premiums, no penalties and no pre-conditions.

The commercial sector would scream unfair competition, but it's not, really. All they have to do is offer something original, something unique, rather than the same lump of rock as everyone else. Differentiate, for a change!

inflation and population growth? (5.00 / 3) (#51)
by gauntlet on Fri Jul 20, 2001 at 09:29:24 AM EST

I work for a health-care provider in Canada, where we take pride in our socialized healthcare.

I'm here to tell you that inflation and population growth are not the biggest threats to the health-care industry. Drug cost increases will account for almost half of the increase in our budget this year over last. The population is growing, yes, but the real problem is that the population is aging. Older people get sick more often. Also, we are the victims of our own success. A person that would have died from a condition 20 years ago is now living another 10 years to obtain a second and third life-threatening disease.

All these people have to be medicated, and for all intents and purposes, the health-care institutions have to pay whatever the drug companies ask for drugs. International drug patents last, what, 20 years now? As a result of this monopoly, the average cost of drugs for the treatment of any one patient for any one illness is increasing exponentially, and far exceeding the levels of inflation or population growth.

Into Canadian Politics?
[ Parent ]

That is the falacy of modern health-care practices (3.66 / 3) (#64)
by jd on Fri Jul 20, 2001 at 02:45:06 PM EST

The challange that faces health-care systems is NOT to cure people, but to cripple the disease just enough to allow the body's immune system to fight the disease itself.

"Curing" people leads to weaker immune systems, as the body simply won't -need- to develop anything stronger. This will result in older people who can't resist disease.

Sure, when someone ages, their immune system will become more frail. Nothing can stop that. But if you -start- at the immune-system equivalent of an Olympic weight-lifter, you can afford some weakening.

The problem is, people want to get well NOW, not tomorrow, so they take all kinds of medicines which produce as close to an instant fix as possible. You can't build up resistance, under situations like that. Worse, most medicines this powerful are likely to be highly toxic to the body. Sure, you get well, you also kill off a fair chunk of what you're trying to save.

It's also important to remember that bacteria are becoming a lot more resistant to "traditional" medicines, so ever-stronger remedies are needed, which simply pushes everything just that little bit further down the spiral. You can't "win", like that. Eventually, you MUST be overwhelmed by super-bugs that can ignore every medicine you use.

Crippling, however, doesn't allow bacteria to evolve resistance. There's nothing to resist! So there's nothing the bacteria can evolve to defeat this kind of attack.

Crippling may include all sorts of things, but one possibility is to generate a totally inert, coated RNA strand, which matches up with some key section of the bacteria's DNA or virus' RNA. (You want it coated, to avoid the bacteria removing it. The idea is to clog up bits of the genetic code, so that important operations don't get performed. The bacteria still functions, in all other respects, so there's no evolutionary pressure to fight this new weapon.)

Other things which are important to a health-care system:

  • Healthier food
  • Higher standards of living
  • MUCH higher standards of air quality
  • Exercise
  • Exposure to bacteria & viruses regularly

That last one is important, and goes wildly against the received wisdom of the day. You can't build resistance, if you never have exposure to them. People in areas where the local water supply is heavily contaminated with bacteria build up extremely powerful immune systems. People in totally shielded, totally protected areas either die of boredom, or from the first rogue RNA strand that they encounter.

[ Parent ]

Moron (2.50 / 4) (#115)
by NDPTAL85 on Sat Jul 21, 2001 at 06:39:54 AM EST

You are an idiot. Not all illnesses are caused by disease. There's accidents, assaults, congenital defects, mental illnesses, various forms of cancer...etc. None of these are brought on by letting our immune systems slack off.

[ Parent ]
Well, now (3.28 / 7) (#11)
by weirdling on Thu Jul 19, 2001 at 05:40:29 PM EST

The entire system is a total mess and a waste. The whole thing was built to equalize medical care, yet the lower economic brackets are getting screwed worse than before, while the higher economic brackets can pay for better goods.
Instead of realizing the whole thing is worthless and needs to be pitched until someone who has half an ounce of wisdom can propose something that will actually work, the immediate response is to shovel more government power into the hands of those who made this unbelievable monument to stupidity in the first place.
Case in point: Hillary Clinton, who is not a doctor, but a lawyer mildly more intelligent than a tadpole (her entire personal fortune was made by others who subsequently engaged in shady, if not fraudulent activity so she could have it), decided to empanel a committee that was composed almost entirely of lawyers (WTF? They know about healthcare?), met behind closed doors (Unconstitutional except for matters of national security), and produced no less than 23 pounds of laws. 8 pounds were new taxes. It's a lot easier to think of the paperwork as weight, because the stack was high enough to replace the leg on your dinner table (well, maybe not quite that high, but it was huge). Nevermind the questionable legality of someone who is not elected nor appointed coming up with a law, which is something the constitution specifically gives to the congress, we still have the whole question of the wisdom of a system that would so unbelievably hamper health care in this country. For starters, you would be required *by law* to buy healthcare. Further, you could *only* get healthcare from your provider, and you could *only* have one provider. If your provider doesn't approve something (likely once government beaurocrats begin handling it), you're screwed. You can't even self-medicate, as that would be seeing a practitioner other than your provider. It was rightly shot down by the congress as quite possibly the biggest pile of crap ever proposed as a law.
Now, for the final zinger, to convince anyone still on the fence that Hillary Rodham Clinton is a hypocrite and a scoundrel: those in the House, the Senate, and the White House and certain other key positions were *exempt*. Yes, people, they don't have to follow this egregious law. What more forceful proof do we need that it will screw people than the fact that those who enacted it wanted no part of it?
They aren't really going to help you. Ever. They only want to control. Please, for heaven's sake, let's not hand more control to the likes of Kennedy, Feinstein, Clinton, and McCain. They've already grabbed enough.

I'm not doing this again; last time no one believed it.
What weight? (5.00 / 2) (#16)
by SnowBlind on Thu Jul 19, 2001 at 06:08:59 PM EST

Was that on standard #20 paper, or did the use #30 cotton based?

=)


There is but One Kernel, and root is His Prophet.
[ Parent ]
Neither (none / 0) (#96)
by cpt kangarooski on Fri Jul 20, 2001 at 07:06:33 PM EST

#9 Onion skin ;)

--
All my posts including this one are in the public domain. I am a lawyer. I am not your lawyer, and this is not legal advice.
[ Parent ]
closed door meetings (3.00 / 3) (#55)
by garlic on Fri Jul 20, 2001 at 10:51:13 AM EST

met behind closed doors (Unconstitutional except for matters of national security)
I think you may be wrong here.

1. I can meet with anyone I want behind closed doors
2. I can write laws that I want in these meetings
3. After i'm done, I can give it to my representative or senator and say "enact these laws".

The point where it becomes shady (but i don't think against the constitution) is if it's done by elected officials, and you don't get to see the laws they propose. However, Hilary wasn't elected (at that point, darn carpet-bagger) and everyone could see the proposal (i assume).

An interesting correlation between Clinton's actions then and today is the Energy Plan made by Cheney and his undisclosed list of meeting attendees. This is what makes me think it's not unconstitutional. Since it isn't the executives branches job to make laws, they can pretend to make any laws they'd like, and then try to get congress to enact them. This doesn't stop it from being shady, though.

HUSI challenge: post 4 troll diaries on husi without being outed as a Kuron, or having the diaries deleted or moved by admins.
[ Parent ]

Not quite... (4.00 / 1) (#69)
by darthaggie on Fri Jul 20, 2001 at 03:17:06 PM EST

I think you may be wrong here.

1. I can meet with anyone I want behind closed doors
2. I can write laws that I want in these meetings
3. After i'm done, I can give it to my representative or senator and say "enact these laws".

As a private citzen, you would be correct.

However, Hillary's HMO Exploratory Committee was government funded. As such it was subject to such things as the Freedom of Information Act. I am unaware of any reliable membership list of this committee. As such, that would be a violation of existing law.

I am BOFH. Resistance is futile. Your network will be assimilated.
[ Parent ]

Simple problem - no solution (4.40 / 10) (#17)
by Sawzall on Thu Jul 19, 2001 at 06:09:07 PM EST

Actually, two problems. First, there will always be an unmet need for healthcare. No matter how much we spend, it is possible to spend more. No treatment too far, so to speak. So we must ration it somehow.

There are two possible ways - money or outcome. Meaning, if you have more money, you get more healthcare. This generally is the way we do it in the States. The alternative is outcome. This means that Grandma is not going to get her liver transplant. Not worth the cost for someone who might only live for another 5 years anyhow. She is not going to get her heart operation either. This basically was the key point in Hillary's plan. That is why it was illegal to purchase healthcare outside the system. This issue is also what leads to most of the complaints about HMO's.

Second problem. Due to insurance, we do not face the true cost of healthcare. We want the best treatment since it will likely only cost us the out of pocket maximum. This makes, along with life and death itself, the medical decisions hard. Hell, we can't make these decisons in a rational way about our pets - why do you think we can do it about Little Becky or Aunt Edna?

the driving force behind advancing medical care (3.50 / 2) (#85)
by mattw on Fri Jul 20, 2001 at 05:44:19 PM EST

The open market, however, has driven medical care forward, over and over again. If we opt to provide healthcare rationing based on outcomes, to fix our costs, we may provide free health care for more people, but we remove the market incentive to advance technology, if there is no market to PAY for that technology.


[Scrapbooking Supplies]
[ Parent ]
A possible compromise solution (3.00 / 1) (#110)
by simon farnz on Sat Jul 21, 2001 at 12:51:53 AM EST

This is not an easy problem to solve; a compromise is probably the only way to handle it.

I personally think that a slight variant on the UK system would work: the government provides a known standard of healthcare. If you want better healthcare, either you buy insurance, or save money to pay for it.

There should be no restrictions on the degree of healthcare you can purchase outside the system, but it should be taxed at point of provision to help fund the government healthcare. If you desperately need healthcare, you have to accept second best; those who can afford better care get better care.

The one major change here from the UK situation is that people should know the limits of the government healthcare; you can then decide in advance if you need better care enough to justify paying for it. Lowering the standard should be harder than raising it, to make long term planning easier.

I realise that this is a rather general plan; the known standard needs to be set at a reasonable level by people who understand this sort of thing better than I do for example
--
If guns are outlawed, only outlaws have guns
[ Parent ]

socialize it or commercialize it; just change it (4.00 / 15) (#25)
by DranoK on Thu Jul 19, 2001 at 07:34:11 PM EST

Heh, I don't mind HMOs too much, and the place I work for has a great health care package.

Only problem is my boyfriend who I've lived with for 3 years isn't covered. We pay a lot of money out-of-pocket because he freelances and thus needs to buy his own health care.

The system as it is just needs to be redone; expansions are just going to cost more money.

Either socialize it 100%,
or commercialize it 100%

Then things would be fair. Either everyone gets healthcare, or everyone needs to buy healthcare (competition bringing prices down to reasonable levels).

I just get pissed when I pay out of my paycheck money for some 80-year-old man to live another year when these same healthcare plans won't even cover my boyfriend. Fuck that.

Choose. Either socialize it or commercialize it. Just end the shit we have now.

DranoK


Poetry is simply a convenient excuse for incoherence
--DranoK



If given the choice... (2.83 / 6) (#29)
by sasseriansection on Thu Jul 19, 2001 at 07:55:08 PM EST

If given the choice between a system which has its shortfalls, and a system that gives the government control of my health care (or anything for that matter), the wise choice is to always go with the faulty program. The government has a notorious history for taking a well meaning program, implementing it, and then a few years later when another congress takes over, losing sight of what the program was originally all about.

Think about the welfare programs. What was originally meant to empower people to get on their feet with income and training, now encourages them to sit on their laurels and have their needs handled by political machines.

Private enterprise has always been more responsive to the needs of clients and consumers than a government who was sworn to do the same thing.
------------ ------------

I am not about big government (5.00 / 2) (#30)
by ajkohn on Thu Jul 19, 2001 at 08:08:59 PM EST

Given the current workings of our (yes, I'm from the USA) government I would not want full governmental control. I simply believe that there is a better system out there then the one we currently have.

Whether you commercialize, privatize or socialize, or some hybrid, I feel the needs of Americans and even those involved in the health care industry would be better served.

I can't agree that enterprise will always be more responsive then government. While government can be slow, inefficient and, at times, just plain idiotic, we can toss 'em out on their ear. This is why pork-barrel politics are ever so popular.

On the other hand, enterprise (AKA business) is there for a profit motive. Thus, if the odds that the defect in a car (say exploding gas tank ala the Pinto) will not result in damage awards in excess of what it would cost to recall and fix this defect ... then ka-boom on the interstate.

Case after case can be cited. Within the health care industry, many create processes that (intentionally ? - though they would disagree) frustrate individuals and thus contribute to lower claims and thus higher profits.

It is profitable for HMOs to deny claims or not approve procedures, and all too often this bottomline (AKA $$$) mentality is the rule of the day.
"Just because something bears the aspect of the inevitable one should not, therefore, go along willingly with it." - The Transmigration of Timothy Archer
[ Parent ]

I'm new to this (3.50 / 4) (#38)
by jfanman on Thu Jul 19, 2001 at 11:20:02 PM EST

what is a USian?

its.. (4.40 / 5) (#41)
by rebelcool on Fri Jul 20, 2001 at 12:23:36 AM EST

the forbidden word used by annoying weblog hacks. Dont ever use it.

COG. Build your own community. Free, easy, powerful. Demo site
[ Parent ]

USian (1.60 / 5) (#45)
by Lelon on Fri Jul 20, 2001 at 02:34:07 AM EST

+1FP, for your poor choice of words, some explaining...

Its pronounced "us-ian", its a play on words based on the idea that all America cares about is itself (hence the 'us'). Its a rather poor play on words (considering no one who has posted below even got the joke).


----
This sig is a work in progress.
US-ian (none / 0) (#82)
by bigdavex on Fri Jul 20, 2001 at 05:23:20 PM EST

Its pronounced "us-ian", its a play on words based on the idea that all America cares about is itself (hence the 'us'). Its a rather poor play on words (considering no one who has posted below even got the joke).
That's interesting. I thought the point was the term "American" should refer to all citizens of the American continents. Therefore, there's a need for a term refering only to residents of the US.

I'm not saying anything about the origin of the word; that's just how I took it.

[ Parent ]

Just a question (3.71 / 7) (#52)
by finkployd on Fri Jul 20, 2001 at 09:55:12 AM EST

What is it that makes people thing the government will do a better job with health care than private sector? I'm not saying it won't, but the US federal government does not have the best track record when it comes to moving quicky, being fair, and efficently spending money. How is the assumption that federally run health care will be better than what we have now? My own personaly belief is that we should focus on fixing the system we have through legislation before completly scrapping it and embarking on some risky government controlled plan.

Finkployd
Sig: (This will get posted after your comments)
Justice. (4.75 / 4) (#58)
by priestess on Fri Jul 20, 2001 at 01:13:06 PM EST

When people voice concern about health care, it's usually that the service seems unjust,
if health was a thing that money could buy,
the rich would live and the poor would die
Essentially people want health care to go to those who need it most, not those who can most afford to pay for it or those who happen to have the lowest insurance rates because they live in the right area/have the right genetic makeup/get a group discount/whatever.

This is one reason why people get upset about the idea of insurance companies having access to a person's Genetic Code, their DNA. It's just not fair that I should have to pay more for my heart bypass because I'm more likely to need it.

Nobody, I think, would willingly put the law courts under an insurance scam like this. I'm sorry madam, we'd like to prosecute your son's murderer but he didn't have any insurance so we can't spare the court time. In some things there are more important considerations than corporate profits and money flow, sometimes we like to see fairness and justice.

I'm personally glad to live in a country with socialised health care, even if I'm upset it seems to be falling apart just as quickly here as everyone seems to be implying the US system is. We don't have to worry nearly as much about questions on the legality of health providers examining our DNA without our request, the system, while it has many flaws, at least isn't seen as being for sale. Well, not much.

Maybe a government isn't the right organization to run the system either, some other non profit perhaps with a government monopoly and some democratic accountability and a decent charter but this sounds pretty much like government anyway to me.

Pre......

----
My Mobile Phone Comic-books business
Robots!
[ Parent ]
Sad but true. (4.25 / 4) (#66)
by Biff Cool on Fri Jul 20, 2001 at 02:49:30 PM EST

US federal government does not have the best track record when it comes to moving quicky, being fair, and efficently spending money

They unfortunatly move alot quicker, act alot fairer, and work more efficiently than private insurance companies do.  They also have less reason to try to screw you.


My ass. It's code, with pictures of fish attached. Get over it. --trhurler


[ Parent ]
Rising Costs of Health Care (4.54 / 11) (#53)
by catseye on Fri Jul 20, 2001 at 10:35:34 AM EST

Health care costs keep rising, hence the "need" for managed care. Managed care was an attempt to give people proper care at reasonable costs. At least in children, HMO's stress vaccinations and good preventative care to prevent more serious (and costly) conditions. I'm not really sure the problem lies with the HMO's, specifically, but with our entire health care system and the reasons behind the rising costs. In my opinion, some of the reasons are:

1. Malpractice insurance and lawsuits. There are far too many trivial malpractice suits, and juries tend to overaward. While I can understand suing a doctor and hospital for malpractice for, say, amputating the wrong limb, killing a patient by not reading the chart and administering a medication the patient was allergic to, or other examples of gross negligence, people sue too often for things that are normal complications of surgery or other procedures. For example, I read an article in my local newspaper (an actual paper, so no link) about a 70+ year old man who is suing a prominent doctor for making him impotent, even though (a) impotence was a known possible side effect of the surgery, (b) the blood clot that was removed needed to be removed, (c) the doctor did not charge the patient for the surgery (he routinely does charity work) and (d) he's over 70 -- impotence at that age is not unusual. Many of these petty cases never make it to court. They settle for a small to moderate amount and sign non-disclosure agreements.

2. Indigent health care. Indigent health care sucks up a HUGE amount of money. State and Federal government will pick up some of the tab, but not all of it. Hospitals have to write it off and charge more for other services. I've got an in-law that works in hospital administration. She told me that they typically have to provide better care for an indigent than they do for someone with health insurance because health insurance typically doesn't pay for new or experimental procedures and drugs, or won't approve various treatments when other less expensive treatments are available. This doesn't apply to indigent health care. They have to get the best treatment available.

3. Health care for illegal immigrants or foreign indigents. I have an in-law that works for a hopsital on the US/Mexican border. Every day, Mexican women come into the emergency room in the last stages of labor, have their children, then either go home or try to stay legally (even though they crossed the border illegally) because their children were born here. Hospitals have to provide emergency care, of course, but they never see any real reimbursement.

4. Misuse of emergency room facilities. I can't tell you how many times I've been to the emergency room (as both a patient and for support), that it's been filled with people with minor problems who could have seen a regular doctor. Emergency rooms are supposed to be for accident victims, immediate life-threatening conditions, and serious illness outside of normal business hours. They are not for vaccinations, checkups, and the common cold. People go to the emergency room instead because they can leave there without paying anything. Emergency services are abused by people with insurance as well as those without. One insurance company I was with had to restructure the way it handled emergency room visits. Instead of the $50.00 copay, they changed it to 80/20 after the deductible was paid in order to make people financially responsible. While this wouldn't hinder someone going in with a heart attack, it would hinder someone going in with a simple stomach virus.

Instead of giving patients more ways to sue providers, we need to work on reducing expenses for hospitals and doctors that result in fewer lawsuits and better care for everyone. My personal preference would be socialized medicine, but that's not going to happen anytime soon.



Certainly agree with point 4! (4.00 / 4) (#72)
by ajkohn on Fri Jul 20, 2001 at 03:22:47 PM EST

I must admit, the times that I have had the sad opportunity to visit the emergency room - I find people there with coughs, or simple flu symptoms (yes, yes, the flu can kill, I know that - but generally not 30somethings who should know to get rest, drink lots of fluid and take some thera-flu or other medicine.) Another was there for bad gas - I kid you not. So I'm with ya on point 4.

Point 1: While I hate frivolous lawsuits, I believe it's dangerous to limit the ability of persons believed injured to seek recourse. Law reform, the ability to quickly flush - say, suing because your Starbuck's Latte scalded you, is certainly needed but should be pursued in parallel.

As for points 2 and 3, I guess I'm a bleeding heart liberal. I will pay a bit more to know that fellow humans, down on their luck, can be treated - treated like human beings.

I am for reducing expenses, becoming more efficient and streamlining the process. I was in the Emergency Room in May of this year, and to date have still not received the bill. Obviously the red-tape, paperwork and systems for these companies could and should be honed. But that would cost money.
"Just because something bears the aspect of the inevitable one should not, therefore, go along willingly with it." - The Transmigration of Timothy Archer
[ Parent ]

have to disagree ... (3.66 / 3) (#107)
by BlueOregon on Fri Jul 20, 2001 at 11:41:17 PM EST

... with point number three.

Economic research has shown (see work by Prof. Borges -- he might have been in San Diego, but I forget) that actually, illegal immigrants, as a whole, pump money into the system. See, even though they are illegally here, they work at jobs where they need to present documentation (often) -- so, fake social security numbers are given, etc. The majority of illegal immigrants pay taxes (and of course, they pay sales tax). They pay for things like Welfare and Medicare and Medicaid ...

On top of that, because they are here "illegally", many avoid seeking health care (I'll give you your pregnant Mexican women, since you site them as an anecdote) -- at least relative to the general population. As a result, they (compared to the rest of the population) use fewer health-care resources per person, but still pay into the system.

So, politics of immigration aside, illegal immigrants, like 'legal' immigrants, tend to have a positive net macro-economic effect (it is also, however, the case that in many areas they have a negative net micro-economic effect, such as on education, where 'illegal' students use school resources, but aren't 'counted', so the school doesn't get money for them).

Just thought I would clarify.

Cheers,
--SK

[ Parent ]

Here's the mandatory "Canada does it better&q (3.82 / 17) (#61)
by Jive Billy on Fri Jul 20, 2001 at 02:07:34 PM EST

I haven't seen it yet, so I figured I'd better bring it up...

The Canadian health care system seems to have found the answer, as we have a health care system that is envied by most nations. Most Americans can't wrap their head around the idea that in Canada everyone has equal coverage. The homeless bum on the street to the rich lawyer all have equal access to health care. If you can afford it, you pay a quarterly provincial premium (~$400/year were I live), but this is subsidized completely if you can't afford it.

Running health care as a business turns human lives into dollar figures, and it doesn't take a PhD in business to realize what happens once you view people in this way. If you can afford it, the US health care system can be great. If you can't afford it, better start digging a 6' hole.

No, not exactly.... (4.00 / 3) (#73)
by yankeehack on Fri Jul 20, 2001 at 03:23:21 PM EST

As a resident of a border state, there's been cases of Canadians (specifically Quebec residents) being sent to my local hospital to get lifesaving treatment for cancer because their health system did not have the *capacity* to treat these people. It wasn't because the US hospital was better, it was because there was room.

How would you like to be told that "Sorry, we can't treat you?"

Perhaps what we really need is a new feminism...It will focus on something that liberal feminism has failed to do--instill a sense of dignity, honor and s
[ Parent ]

You over-simplify. (4.40 / 5) (#75)
by mindstrm on Fri Jul 20, 2001 at 03:34:24 PM EST

There is an excellent post by another person elsewhere here.... look for it. It shares my sentiments exactly.

For the record, I am Canadian. I dislike both ours and the US system equally. Here are the issues as I see them.

1) There is no limit to how much you can spend on healthcare. There will never be 'enough' money.

This means that, given any healthcare system, be it private or public, you have to have some way of limiting how many resources can be applied to any given case. How you do this is the question.
You can go on dollar amounts only; the rich can have better care; they can afford to pay all the costs involved. You can go on a society-at-large model; we have 2 patients and one kidney... who gets it? The Rich, 95 year old man who can afford it, but will most likely be dead within the next few years...or the 21 year old student, who can have a full, long life. Under the US system, he who can afford it (or has the better plan) gets it. In Canada, the student gets it.

Now.. regarding the poster who says he will pay for his healthcare himself and fuck the poor... either you are rich, or you have *no idea* what healthcare costs. I make good money... and I know that, if it weren't for a medical plan, spending 2 weeks in the hospital after getting in a car accident and breaking both my legs woudl leave me severely in debt. Healthcare is NOT cheap, *especially* in the US & Canada.


[ Parent ]
speaking of canadian health care... (3.80 / 5) (#83)
by mattw on Fri Jul 20, 2001 at 05:34:40 PM EST

One reason your system has it so easy is that in fact, Americans are funding a fat chunk of your healthcare system: prescription drugs. Yes, that's right, our drug companies do the research for new drugs, spending an average of $250M dollars to get a drug to market, and then they are forced to sell it in canada at a fixed low price.

If the rest of the world disappeared, Canada would never enjoy the benefit of a new drug ever again, because companies won't take a loss to research drugs for the benefit of mankind -- sadly, drug researchers have to eat too. Fortunately, Canadians have the U.S. Back at home, we get soaked for the cost, not only the legitimate cost, but the cost that everyone else isn't bearing. I wonder what would happen if we passed a law here that said drug companies had to charge citizens in the U.S. the lowest price offered in other nations. I'd imagine Canada's costs would go through the roof, since the exorbitant prices in the U.S. market are what is keeping the drug companies afloat.


[Scrapbooking Supplies]
[ Parent ]
healthy profit (3.00 / 3) (#106)
by dr k on Fri Jul 20, 2001 at 11:37:43 PM EST

... an average of $250M dollars to get a drug to market...

To get the statistical bullshit out of the way first, what kind of average is this? How many years of reseach - 10 years @ $25M/year? What kind of "drug companies" does this include - perhaps companies that went bankrupt and produced 0 drugs? Is $250M a lot of money? What is the average advertising budget for a drug?

... research drugs for the benefit of mankind

What a swell bunch of guys. Benefiting mankind through the increased incidence of diarrhea, drowsyness, sensitivity to sunlight, mild insomnia, dry mouth, erectile dysfunction, and anemia. You just bought a whole truckload of snake oil, son.


Destroy all trusted users!
[ Parent ]

getting drugs to market (3.33 / 3) (#109)
by mattw on Sat Jul 21, 2001 at 12:28:16 AM EST

To get the statistical bullshit out of the way first, what kind of average is this? How many years of reseach - 10 years @ $25M/year? What kind of "drug companies" does this include - perhaps companies that went bankrupt and produced 0 drugs? Is $250M a lot of money? What is the average advertising budget for a drug?

Actually, I misspoke (that's what I get for not checking my material). It's actually an average of $500M. That's total development, over 6-15 years. It does not count advertising, but that's trivial compared to R&D, especially given that for most drugs, the only market for advertisements is doctors, so that's a very targetted market, especially given that keeping up on available medication is part of their job. I'm not clear on whether that folds in the cost of drug development for drugs which never make it to market at all. This is from a research paper from a financial service briefing on the drug industry I was reading to decide whether or not to invest in a new drug company (Isis Pharmaceuticals, which makes drugs with their 'anti-sense' technology). In any event, a company which produces 0 drugs doesn't get a "drug to market", so that wouldn't fall into this category.

What a swell bunch of guys. Benefiting mankind through the increased incidence of diarrhea, drowsyness, sensitivity to sunlight, mild insomnia, dry mouth, erectile dysfunction, and anemia. You just bought a whole truckload of snake oil, son.

Whatever. When you get [AIDS|cancer|psoriasis|allergies|high blood pressure|heart disease|name your condition], we'll see if you'd rather just die or suffer through it than risk the terrible danger of being the 1 in 50 people who suffers dry mouth.


[Scrapbooking Supplies]
[ Parent ]
healthy profit redux (3.25 / 4) (#113)
by dr k on Sat Jul 21, 2001 at 03:25:03 AM EST

I still don't know what kind of average it is - a mean or a median? Any decent brief should reveal this information - and depending on the slant of the brief they would want to choose the higher/lower value of the two depending on their intentions.

Conceptually I still don't have a good reference for what spending $500M over 6-15 years really means, in comparison to, say, genetically engineered fruit or the development of new textiles. Time for an iffy analogy:

In the movie industry, a big budget feature film might cost $40M. Let's say that $40M represents about 6 months of full-blown production time. So for $80M a year, a hypothetical movie studio could produce 2 feature films a year (they wouldn't do that, of course - they would produce a range of higher and lower budget productions). So, in comparison, the average drug company spends enough money on research for 1 drug to produce 2 feature films every year for 6-15 years, or 12-30 films. So, movie production is cheap compared to drug research.

The point of this thread was a dicussion of how drug companies recoup their research costs. I'm at a bit of a loss for numbers here, but if I assume the average profit to a drug company is $10 for a filled prescription, it would take 50 million filled prescriptions to turn a profit. How many movie tickets is that? At $5 each, 100 million, or perhaps 5 million tickets per hypothetical movie.

That would be pretty good business if a movie studio could maintain those numbers, considering that "going to the movies" is a voluntary luxury.

So, how long does it take to generate 50 million prescriptions? In the US, probably 5-10 years. So, there's the research cost that the US unselfishly eats up, so the rest of the world can have creap drugs, and so the drug companies can turn a profit. A profit big enough that people would invest money in these companies. A profit from treating symptoms.

It would be foolish to suggest that the government nationalize the movie industry. It's a luxury.
Destroy all trusted users!
[ Parent ]

Drug companies (4.00 / 1) (#155)
by chutzpah on Mon Jul 23, 2001 at 10:38:47 AM EST

Large drug corporations are not the best thing for advancing human health and well-being. If all medical research could be somehow publically funded then the would would have potential to be a better place, think about it this way, if some large drug company developed a cure for AIDS that could be produced at lower than the cost of producing Tylenol, what would be their best option:

1) release the cure and cure for a resonable price and cure everyone on the planet of AIDS, saving millions of lives

2) hide the cure, and keep producing extremely expensive AIDS medications keeping all AIDS patents dishing out thousands of dollars a month to the drug company.

I dont think there is ANY drug company that would opt for #1 over #2, it's very possible that somewhere there is a cure for cancer, AIDS, and even a vaccination against the common cold, but the drug companies will never release any of them, as it would serioulsy hurt their bottom line.

[ Parent ]
Wow! (3.00 / 4) (#112)
by Jive Billy on Sat Jul 21, 2001 at 02:33:06 AM EST

And all this time us Canadians just sit on our porches drinkin our beers and talking about touques.

Christ man...do you think the US is some sacred land of intelligence and higher learning while the rest of the world plays in mud puddles? Canada has drug companies and universities as well, and contrary to popular US belief, they aren't all researching Beaver Fever.

"If the rest of the world disappeared, Canada would never enjoy the benefit of a new drug ever again, because companies won't take a loss to research drugs for the benefit of mankind".

Wow, please wait while I build an altar to your drug companies, which through their greed are saving mankind.

[ Parent ]

Huh? (3.25 / 4) (#119)
by priestess on Sat Jul 21, 2001 at 07:52:39 AM EST

Prescription drugs are sold to the healthcare systems in socialized healh care counties complete with the patent protection that the world has agreed on.

If the rest of the world disapeared the US would have a reduced profit from those drugs and probably never see a new drug again.

Glaxo-Welcome is a British firm working through the same system, selling it's new drugs worldwide to generate the profits to pay off their shareholders and do more research. Selling their new drugs to the British Healthcare system just the same as to the American system and the Canadian system. Companies don't care who pays the bills, government or enterprise, they just care that the bill gets paid.

I don't see how socialized medicine giving more money to the drug companies is them being subsidised by America in any way.

Pre........

----
My Mobile Phone Comic-books business
Robots!
[ Parent ]
CA health care works; Florida has 2 hockey teams (1.00 / 2) (#91)
by Wondertoad on Fri Jul 20, 2001 at 06:24:20 PM EST

Two effects with the same cause: old canucks retire to the US.

[ Parent ]
A Reference to the Australian System as well (3.00 / 4) (#105)
by cam on Fri Jul 20, 2001 at 10:51:16 PM EST

In my dealings with both the Australian and US system of medical treatment and health care, the Australian system is much less hassle. Australia has social health, but there are also private insurance plans and private hospitals for those that want to use them. Like the Canadian system, the lowest bum to the wealthiest monopolist has access to the exact same level of care in the public health care system, no matter their employment status.

I don't believe health insurance is a cost that should be born by employers or by the corporate world. It discriminates against entrepreneurial spirit by forcing cost on the self-employed or the small business. It is an artificial barrier to entry unless your significant other is supported under another plan.

IMO It should be either born by the individual and/or the government. Unfortunately for most Americans they have a deep cultural distrust of the government, which Australia, Canada and most of Europe dont seem share. Certainly not to the level of most Americans.



cam

[ Parent ]

Just remember this... (3.81 / 11) (#62)
by lb008d on Fri Jul 20, 2001 at 02:13:13 PM EST

In health care, as in any sector of life:

When profits come first, people come second



My solution (2.40 / 5) (#63)
by jwb on Fri Jul 20, 2001 at 02:15:42 PM EST

I have a problem with regulated healthcare because it is Soviet-style socialism. Healthcare to each according to his needs, taxation upon the people according to their means. Ugh, I hate it, especially because the healthcare "needs" of the people are essentially limitless.

In my ideal world, the only people involved in healthcare would be the patient and the provider (doctor, nurse, medic, et al). No insurance, no company group plans, no government assistance. If some group of doctors and wealthy people wanted to provide health care to the poor or indigent for free, then bully for them. Don't involve me though. When I get ill, I will go to my doctor and I'll pay him for his services. If I need a quadruple bypass, new kidneys, chemotherapy, rhinoplasty, and an iron lung, I might not be able to afford it. I'll probably die. That's how life works.

Admire ... (4.00 / 1) (#68)
by ajkohn on Fri Jul 20, 2001 at 03:09:01 PM EST

your spirt here. And while, as I've stated in other comments, I would not be in favor of the current US government running the whole show, I feel there has to be a better system.

Whether it is a type of socialized medicine, as commented by a K5 Canadian, or some hybrid of privitization and governmental controls - I don't know. I simply don't have the answer.

What I do believe is that we can't remain apathetic. Can't sit on the sidelines. Can't watch Congress as they think they 'fix' the system.

Your market-driven health philosophy would work wonders if everyone felt that way in health and sickness. It would also work if those working $30K/year jobs didn't get fed up with a true class-based health care system. Widening the gap between rich and poor and creating a class war would only over burden our hospitals.
"Just because something bears the aspect of the inevitable one should not, therefore, go along willingly with it." - The Transmigration of Timothy Archer
[ Parent ]

Healthcare is distracting (4.00 / 1) (#71)
by jwb on Fri Jul 20, 2001 at 03:22:31 PM EST

I think the poor and their advocates may be paying too much attention to health care, and ignoring a whole school of fish that want of frying. The poor live disproportionately in areas with high crime, pollution, and dangerous structures. They hold, in the main, demeaning or dangerous jobs. They are much more likely than the wealthy to get sent to prison for minor or victimless crimes, resulting in a loss of freedom, voting priviledges, and an increase in violence and disease.

Perhaps the poor should focus on digging themselves out of this mess before trying to secure subsidies for the services of a doctor.

[ Parent ]

Uh... (5.00 / 2) (#97)
by cpt kangarooski on Fri Jul 20, 2001 at 07:21:23 PM EST

What solution for eliminating poverty do you propose? The normal method doesn't do anything, it just shuffles things around. Even if everyone magically made a million dollars in addition to their regular pay next week, it just results in inflation.

The goal of health care is for people to not fall ill, and should they do so (those bastards!) for them to be cured. This is dramatically at odds with the goals of a business. It's not the only such disconnect.

Notably, this was recognized in the preamble to the US Constitution -- the government based upon it is established "in Order to form a more
perfect Union, establish Justice, insure domestic Tranquility, provide
for the common defence, promote the general Welfare, and secure the
Blessings of Liberty to ourselves and our Posterity...." A corporate army which only protected the rich from foreign invasion, a judiciary that only prosecuted and tried crimes if the plantiff could pay, these would be Bad Things.

Telling people that it's not only their own fault that they're going to die, and that (falsely, unless you know something the world's economists don't) it's possible for them to get out of that trap without sucking others into it, strikes me as another Bad Thing. Sounds alright if you're on top perhaps, but it's not a productive line of argument.

Given that the government must generally bend to the will of the people, what's wrong with democratically approved socialized medicine? Socialization has been working well enough in other areas that don't work capitalistically, after all.

--
All my posts including this one are in the public domain. I am a lawyer. I am not your lawyer, and this is not legal advice.
[ Parent ]
Miss the point? (none / 0) (#123)
by jwb on Sat Jul 21, 2001 at 01:52:00 PM EST

My point went right past you. Assume that everyone in the country has equal, tax-funded access to all the quality health care they need. You still would have the poor living in dangerous polluted areas, working shit jobs, and getting roughed up by the police. These issues are more important than health care.

[ Parent ]
Okay... (none / 0) (#143)
by cpt kangarooski on Sun Jul 22, 2001 at 03:38:56 AM EST

...So your point is really one of prioritization? Sorry if I missed that. However, I think that survival, even if it just means continuing to live a crappy life, is the highest priority. If nothing else, it gives you the continuing opportunity to improve the other factors. I'm vaguely thinking of Maslow here....

--
All my posts including this one are in the public domain. I am a lawyer. I am not your lawyer, and this is not legal advice.
[ Parent ]
What's a government good for, then? :) (3.00 / 1) (#104)
by joegee on Fri Jul 20, 2001 at 09:51:06 PM EST

We're paying part of our taxes for national defense, crime prevention, and civil engineering, OK.

Ditch Department of Education, Department of Health and Human Services / Social Security Administration, Department of Housing and Urban Development, Department of Agriculture, most of the Department of Treasury, Department of the Interior, most of the Department of State, and three quarters of the lesser functionaries whose only job seems to be to get involved in sex scandals with our elected officials.

When the Federal Government stops spending four fifths of what we give them on pork, or things that mean absolutely nothing to us, then I'll go along with a pay or die system, otherwise I'd like to see us get SOMETHING for our money. :)

<sig>I always learn something on K5, sometimes in spite of myself.</sig>
[ Parent ]
We're doomed (2.25 / 4) (#65)
by MicroBerto on Fri Jul 20, 2001 at 02:45:53 PM EST

There's no solution for this problem, especially when you allow so many companies to run amuck and have monopolies over certain drugs, skyrocketing the prices.

The only solution I have is to stay healthy and stay out of it. Take a daily vitamin, exercise, eat right, and stop getting sick -- It actually feels good!

Berto
- GAIM: MicroBerto
Bertoline - My comic strip

In addition.. (none / 0) (#153)
by ajduk on Mon Jul 23, 2001 at 07:50:50 AM EST

Don't get old, don't inherit any predispositions to any diseases, and don't be unlucky..



[ Parent ]
Please keep in mind... (4.00 / 6) (#70)
by darthaggie on Fri Jul 20, 2001 at 03:20:41 PM EST

...that what Hillary proposed was an HMO. A government-run HMO, with all the downsides of a private HMO.

With one very important exception: you couldn't switch to another HMO, if you felt you weren't getting adequate care.

Bend and Submit, Commrade.

I am BOFH. Resistance is futile. Your network will be assimilated.

US Health Care is Best in the World. (3.72 / 11) (#74)
by WombatControl on Fri Jul 20, 2001 at 03:32:48 PM EST

Not to sound jingoistic, but it's true. You cannot find better health care than in the US. Yes, it's more expensive, but it's also better, more widely available, and more advanced than any other system in the world. I live just a few hours away from the Mayo Clinic. When a leader from one of those "nice" socialist countries doesn't go to the supposedly wonderful socialized health care of their own nation - they go to Rochester, Minnesota. That same clinic is where my elderly grandparents go. Only in the United States can someone who worked in printing for years, and isn't even close to rich by any standard can get that level of care.

A system like Canada's is not a workable solution. It puts government bureaucrats in positions where they can deny treatments - which is even worse than HMOs. Want a CAT or MRI scan in Canada? Expect a good wait, if you're approved. Need an experimental drug that could save your life? Too bad, it's too expensive. In the end, a socialized system leads to more of the same problem's we're facing already.

One of the main reasons drugs are more costly in the United States is because we're paying for the price controls of other nations. Price controls lead to less research and development of new drugs. Pharmaceutical companies do make hefty profits, but most of those profits go towards regulatory affairs, research and development, and promotion. Price controls mean that drug companies can't continue to fund the research needed to search for cures for cancer, AIDS, diabetes, etc. While it's in style to complain about "evil corporations", those same corporations have saved my life, and they've probably saved yours. Much of that money they earn goes towards making sure more lives get saved. When nations like Canada institute artificial price caps, it causes drug companies to need to pass the cost on somewhere - and since the US has realized that price caps don't work, we bear the brunt of the cost.

What the 1994 "reform" attempts were about was the socialization of medical care in the United States. It would have led to a series of restrictions that would have harmed patient choice, reduced care options, and generally caused the quality of health care in the United States to fall. Real health care reform should remove barriers - not create new ones. If federal laws restricting association health plans (plans which allow small business to pool resources to self-insure workers) were dropped, it would instantly reduce the numbers of Americans without health insurance. Allowing for tax-credits for insurance purchases would cut the numbers of uninsured Americans by half overnight. Real reform would be decreased federal involvement and unnecessary refulation which would help providers cut costs, and ensure patients have the ability to make more health care choices. It's not a matter of enacting punitive legislation against the very people who provide the services in the country, but working with them to ease the regulatory burdens placed on them by duplicate, unecessary, and unwise federal regulation.



Profits (4.00 / 5) (#80)
by finial on Fri Jul 20, 2001 at 04:21:54 PM EST

You say:
Pharmaceutical companies do make hefty profits, but most of those profits go towards regulatory affairs, research and development, and promotion.

Um, profit is profit. If you spend money on "regulatory affairs, research and development, and promotion" it's no longer profit, it's an expense. (Expense reduces profit.) By this definition, every company there is would have a 100% profit.

Promotion == Marketing. Drug companies are now spending more on marketing than they are on research (not to be confused with marketing research). There's something wrong with that.



[ Parent ]
All for removing barries - but a ... (3.50 / 2) (#81)
by ajkohn on Fri Jul 20, 2001 at 04:31:10 PM EST

laissez-faire approach to health care seems dangereous. So while I'm not about total government control, I don't trust business either as I detailed here.
"Just because something bears the aspect of the inevitable one should not, therefore, go along willingly with it." - The Transmigration of Timothy Archer
[ Parent ]
Who da best! (4.25 / 4) (#87)
by _cbj on Fri Jul 20, 2001 at 05:56:03 PM EST

"US Foo is Best in World" - perhaps one of the favourite American impersonations. Seriously, I've heard that a lot in parodies by people who've known Americans (chumminess is also commonly portrayed, so I'm don't think I'm trolling.)

Anyway, the World Health Organisation did some research, pretty well known outside America, with interesting results:

Story1
Story2
League Table

[ Parent ]

According to the WHO ... (4.00 / 2) (#92)
by joegee on Fri Jul 20, 2001 at 06:29:32 PM EST

America spends 13.7 percent of its GDP on healthcare, but for that expenditure ranks only 24th using the WHO's Disability and Life Expectancy scale.

As an American I have to say that's really, really pathetic. Thanks for the stories and the numbers.

-Joe G.

<sig>I always learn something on K5, sometimes in spite of myself.</sig>
[ Parent ]
What explanation... (2.50 / 2) (#100)
by John Miles on Fri Jul 20, 2001 at 08:26:53 PM EST

... does the WHO have for the fact that people in those 24 other countries can often be seen coming here for health care? Funny how that works.
For so long as men do as they are told, there will be war.
[ Parent ]
Yes, I'd like to know that (3.00 / 2) (#102)
by _cbj on Fri Jul 20, 2001 at 09:04:12 PM EST

When they can stay at home at get equally good health services for free, I have no explanation as to why they would pay astronomical prices for the the American experience. Maybe larger portions, like with the junkfood and fake breasts?

Oh, there is that whole "his only remaining hope is a pioneering American operation involving monkey gonads" deal. How much the relaxed legal restrictions around experimental surgery account for the hordes of Japanese and French scalpelbaggers you experience, I'm not really in a position to tell.

[ Parent ]
They have coverage that pays (4.00 / 2) (#103)
by joegee on Fri Jul 20, 2001 at 09:25:01 PM EST

for ou-of-country procedures (Canada, Kuwait, Bahrain), or they are wealthy, or their cases are unusual or visible enough to merit some form of sponsorship.
  • Nigerian Siamese twins and maimed foreign children touch our hearts, hence public hospitals clamor for them as publicity to increase their endowments.
  • Foreign dignitaries have large bank accounts, and payment in cash is a commodity any American hospital can learn to love.
  • As for here, in Ohio we get lots of Canadians coming across the border for medical procedures they would have to wait months to get in Canada.
There's nothing wrong with the American health system if you don't fall between the cracks. If you do, I know from personal experience that the fall can be fatal.

Healthcare consumes 13 percent of our GDP, yet foreign nationals get better treatment from our healthcare system than our working poor, and overall we don't live as long as residents of countries that spend fractions per capita that we spend.

That certainly doesn't make me proud. :)

<sig>I always learn something on K5, sometimes in spite of myself.</sig>
[ Parent ]
You've fallen for The Drug Industry Myth (4.50 / 2) (#121)
by eean on Sat Jul 21, 2001 at 01:01:37 PM EST

Most of the money spent on research for new drugs in this country is made at the public expense or by non-for-profits (like the American Cancer Association - one huge tax loop hole for drug companies to have their research done in a tax-deductable way). All that drug companies have to do is take the drugs the final mile. Not a cheap final mile (human testing, getting FDA approvial), but still only a fraction of the cost of developing drugs.

We you take this into consideration, putting price controls on drugs and/or lowering the time they have a monolopy would be reasonable considering that they are taking advantage of research payed for tax-payers.

The screwed up definition of profits that was given has already been commented on. But WombatControl was correct in saying they get huge profits. 106 billion a year while only actually spending 25 billion on research.

A Nation artical on this topic.

[ Parent ]
The Mayo Clinic is an exception (5.00 / 3) (#144)
by Secret Coward on Sun Jul 22, 2001 at 06:06:03 AM EST

I live just a few hours away from the Mayo Clinic.

I live a few minutes from the Mayo Clinic. I would like to point out a few things:

  • The Mayo Clinic is a non-profit organization.
  • The Mayo Clinic merged with two other Rochester hospitals, and has affiliations with over 60 hospitals and clinics in Minnesota, Iowa, and Wisconsin. Combined, they form the Mayo Health System.
  • The Mayo Health System was formed in order to fight HMOs.

That's right. The Mayo Clinic got fed up with HMOs telling them how to treat patients. So they banded together with nearby hostpitals and clinics, and left the HMOs with no choice but to deal with the Mayo Clinic.

This situation is the exception, not the rule. Most hospitals in the U.S. are for-profit corporations. Many HMOs have large investments in hopitals. So while you're getting all high-and-mighty about health care in the U.S., please note that your example is the exception, not the rule.

[ Parent ]

The problem with the free market (4.09 / 11) (#84)
by scross on Fri Jul 20, 2001 at 05:37:42 PM EST

The biggest program with free markets is that free markets are based upon supply and demand. The idea is so basic it's taught to most western school children before the age of ten. When demand for a good or service is higher than supply, prices rise. When demand is lower than supply, prices fall.
If the price for an airline ticket is too high, I'll drive or just not go. But I couldn't say no to, the one drug that would keep me alive. No one can say, I saved a fortune by not getting that medication - too bad I'll be too dead to enjoy my money.
Healthcare is too different than conventional markets to permit unfettered supply and demand. The problem is that demand for healthcare is inelastic.
Another fundamental flaw is that for-profit organisation make decisions based upon what make the most money, not what is best for Humanity. Drug companies are pouring billions into the next "Viagra." When there's diseases that are long dead in the West that are still ravaging Africa.
I'm not suggesting completly nationalising the world wide pharmacutical industy either. That isn't the answer. There needs to be a balance.
I find it inexcusable for top brass and investors to get rich off of other peoples bad health. Drug companies should be regulated as to how much profit they can have. The remainder should be dumped into R&D or other areas for the public good. Their discoveries should be put into the public domain. How wasteful is it to have two competing companies doing parallel research?

Cheers, Sarah
The current U.S. system is NOT a free market (5.00 / 2) (#158)
by greggman on Tue Jul 24, 2001 at 06:54:35 AM EST

One problem with the current system is that there is no competition. This is because we have insurance. You say that health care is different because if I need that drug then I it doesn't matter what it costs, I need it. While that may be true that's not the normal case.

The normal case is you need to see your doctor for something pretty average or at least not in the realm of there being one one drug in the world that will help you. Say you need an MRI. Do you care what it costs? Not in the least, you only care if your insurance covers it. If you did care what it costs then you would go to the cheapest, most convienent MRI place that had a good reputation. This is what the market is supposed to do. If there are 2 MRI places, all else being equal, people will choose the cheaper of the two. If price is equal, people will choose the most convienient. If they are equally convienient, people will chose the one with the best reputation. Well, maybe not in that order but hopefully you get my point.

The current system, because it is NOT a free market system, removes the motive to LOWER THE PRICE because no patient needs to shop around for the best price. Of course that's not true with elective surgury like LASIK which is why you see health competition for that procedure and why the price has dropped dramatically since it first appeared.

I'm not saying government should get completely out of it. Certainly I think doctors should have to go through some kind of qualitcation test to prove they can do the work as well as I think there should be stiff penalties for malpractice BUT really, as it is, a doctor can (or could) charge anything they damn well pleases because they don't have to get the money from you. They gets it from your insurance.

The last doctor I went to, made me wait 50 minutes, talked to me for 5 to confirm that I had athlete's foot and that I should go to the local drug store and buy some over the counter ointments. For this *treatment* he billed the insurance company $200.00. Any wonder why HMOs are trying to lower costs. Unfortunately they are fighting a losing battle. As long as patients have no connetion to the costs doctors will have no reason to compete for patients on price.

[ Parent ]
Hillary would have killed my brother (3.20 / 5) (#88)
by Bobby Orr on Fri Jul 20, 2001 at 05:58:31 PM EST

The plan the Clintons offered would have set limits for who can and cannot recieve health care. They were glib about the fact that we can't save everyone. My brother has Downs Syndrome. He had to have open heart surgery to save his life. The Clinton's plan, this is a fact, would have barred any doctor from performing heart surgery on him. The health care system would need to neglect cases like my brother.

Their plan stunk. I am very glad we don't have it. Government officials would have recieved a much better plan than you and I. My brother would have recieved death.

A pox on their plan!!!! Maybe things aren't perfect now, but they would have been MUCH worse if that plan had been accepted.

"The moment a person forms a theory his imagination sees in every object only the traits which favor that theory." -- Thomas Jefferson

My mother was killed ... (4.36 / 11) (#89)
by joegee on Fri Jul 20, 2001 at 06:21:23 PM EST

by the American healthcare system.

In 1989 she was diagnosed with breast cancer. With her Blue Cross/Blue Shield coverage she underwent a modified radical mastectomy and chemotherapy. Upon completion of her treatment Blue Cross/Blue Shield tripled her rates, forcing her employer (ironically, a doctor) to terminate her.

She found work again, but without any medical benefits. When small red bumps occured at the mastectomy site, she went to a doctor who treated it as a rash -- for three months -- because she could not work and afford more indepth treatment.

Of course three months and many topical creams later, when the expensive bone scan picked up the first hot spot on her breastbone the rash was finally biopsied, a positive result was returned, and oncologists tried to play catch up for the three months' head start the cancer had.

Once she quit working, my mother "enjoyed" all the benefits of welfare, meaning she had to be destitute to get the treatments that might save her life.

The saddest part is that my mother would be just as doomed today, and end her life just as poor (even though she had worked for forty years prior to her illness.)

I was furious in 1993. I am just as angry today. If you think this cannot happen to you consider the following factors:
  • Do you have health benefits with your current employer? Are you insured as part of a group, or are you insured as an individual. If you are insured as an individual, you could be in trouble if you experience a catastrophic illness. Insurance companies are known to significantly raise the rates of persons who undergo treatment for a chronic or catastrophic illness.
  • If you are fired, are your current insurer's premiums affordable. Are they transportable? Will your next employer have comparable coverage? If you answer no to the last two, pray you do not get sick. You may find yourself working, with no coverage. See the next two points.
  • Do you have any savings? If you do, you will be unable to get public assistance until your savings account is low enough, somewhere around USD $2,000.
  • Do you own property? If you own a house, or a car, these are assets that may count against you if you require public assistance. In addition, if you mortgage your house and your condition leaves you unable to work, the loan will come due.
Health care changes from region to region, and some states have now implemented universal coverage, but it's still very easy for anyone facing a catastrophic illness to fall through the holes.

In closing the American health care system might provide the best care in the world to those who are covered, but if you work, own property, and lack proper coverage, the idea that there is a safety net that will rescue you from catastrophic illness can be a fatal delusion.

-Joe G.

<sig>I always learn something on K5, sometimes in spite of myself.</sig>
For an example... (3.33 / 3) (#95)
by beergut on Fri Jul 20, 2001 at 06:58:32 PM EST

... of socialized medicine run by the U.S. government, one only need look to VA hospitals.

Now, given that experience, can you really stomach the idea of all medical services being run the same way, and with no choice in the matter?

I can't.

Health care costs in the U.S. are exorbitant. Why is this so? Find the reason (I think you'll probably have figured out by now what big leviathanic factor I'd point to), and crush it.

i don't see any nanorobots or jet engines or laser holography or orbiting death satellites.
i just see some orangutan throwing code-feces at a computer screen.

-- indubitable

Care to explain? (5.00 / 1) (#99)
by fluffy grue on Fri Jul 20, 2001 at 07:56:54 PM EST

Would you like to say why we should look at VA hospitals for a good example of bad healthcare? My impression was that they were actually quite good...
--
"Is not a quine" is not a quine.
I have a master's degree in science!

[ Hug Your Trikuare ]
[ Parent ]

my father and my uncle (none / 0) (#150)
by anonymous cowerd on Sun Jul 22, 2001 at 03:20:09 PM EST

The VA hospitals, over the decades, gave better care to my father and my uncle, both WWII vets, when they were alive, than any private hospitals, clinics or nursing homes I ever saw in this country, no matter how expensive.

Of course there can be no comparison at all to the zero health care non-veterans who are also unfortunately non-wealthy receive in the U.S.A.

Yours WDK - WKiernan@concentric.net

America is false to the past,
false to the present,
and solemnly binds herself
to be false to the future.
- Frederick Douglas

[ Parent ]

behemoth (3.50 / 2) (#101)
by dr k on Fri Jul 20, 2001 at 08:34:40 PM EST

[anti-socialized medicine rant...] Health care costs in the U.S. are exorbitant. Why is this so? Find the reason (I think you'll probably have figured out by now what big leviathanic factor I'd point to), and crush it.

I'm at a loss. Sixth graders? St. Louis? Those little rubber things that you put on the bottom of a table leg to keep it from wobbling? While "levianthanic" is a nice word - it really rolls around on the tongue - does that mean you've actually read what's-his-name?

Oh, wait, are you talking about the government? Do you suggest we crush the government? "Crush all hu-mans!!!"
Destroy all trusted users!
[ Parent ]

CRUSH (none / 0) (#154)
by EriKZ on Mon Jul 23, 2001 at 09:46:27 AM EST

I am not a fan of Hiliary Clinton, but the one thing she is not, is dumb. If there was just one thing to fix, she would of found it. On the surface, the high cost of health care is complex. It isn't really, you just have to back away from the problem and look at it "From the big picture." I'll distill it down for you. Good heath care is expensive. That's it. No matter what system you use to apply health care to the population, the cost won't budge. Bad health care is less expensive, good health care is expensive, the BEST HEALTH CARE IN THE WORLD, is priced accordingly.

[ Parent ]
Case Study (3.00 / 5) (#111)
by Chris Conlon on Sat Jul 21, 2001 at 01:12:44 AM EST

If you want the government to provide health care for you, go to Canada. At the boarder you'll pass Canadians going the opposite direction paying for health care services in the US out of pocket.

Homogenous enviroments are bad (2.00 / 1) (#120)
by Weezul on Sat Jul 21, 2001 at 10:40:07 AM EST

Homogenious biological enviroments are bad (Irish potato famine). Homogenious political enviroments are bad (Nazis). Homogenious social enviroments are bad (racism). Homogenious economic enviroments are bad (boom and bust economy). Homogenious health care will be bad too (some people will be left out in the cold).

Now our current health care system *is* pretty homogenious too, but a federal one would make the current problems worse. OTOH, If the states ran their own independent health care plans then we might have a better system since we would have diffrent states doing doffrent things.

Example: If we go to a federal health care plan then it will be 50+ years before we ever see gov. funded abortions anyplace (leaving some people out in the cold). If we go to state run plans then we will see gov. funded abortions tomarrow (in a few states).

A good diverse system would include "horizontal diversity" (diffrent plans that cost the same) but need not necissarily make it easy for people to choose plans, i.e. diversity it's self is more importent then (easy) choice.

Example: If your states plan refuses heart transplans to retarded kids and you do not have the money to pay for it yourself then you could choose to move to another state. You would have the option but it would be at a high cost that you could still afford to pay no matter how poor you were (i.e. moving).

"Fascism should more appropriately be called Corporatism because it is a merger of state and corporate power." - Benito Mussolini
free parking (none / 0) (#136)
by dr k on Sat Jul 21, 2001 at 08:34:11 PM EST

You would have the option but it would be at a high cost that you could still afford to pay no matter how poor you were (i.e. moving).

Eh?

Are you saying that moving is cheap? Or that, despite the high cost, even the poor can afford to move?

When did it become trendy for people to talk about the US as having a fluid workforce? Was this a high school lesson that I've forgotten, and am now questioning at my own peril?
Destroy all trusted users!
[ Parent ]

Nope (none / 0) (#140)
by Weezul on Sat Jul 21, 2001 at 11:07:15 PM EST

How can you seriously mutate my words to imply that I'm saing poor should move all over the place? What are you just trolling or did you really not read the post?

I'm mearly saying that medical care will inherently be unfair to a few people and we should make shure those people have options. That's the whole point of my "horizontal" comment.

I don't think that moving is cheap and I don't think that state run health care is ideal, but (a) I do think moving is a hell of a lot cheaper then the kind of operations we are discussing and (b) it's pretty fucking clear that their are currently no acceptable "sub-governments" bescides the states.

Would you prefer that one or two groups of people be totally denied the option of the health care they need or would you prefer that they have options?

"Fascism should more appropriately be called Corporatism because it is a merger of state and corporate power." - Benito Mussolini
[ Parent ]
Sorry... (3.33 / 3) (#122)
by hadashi on Sat Jul 21, 2001 at 01:02:56 PM EST

But we stopped this nonsense when Klinton was elected, and it has no chance now.

Here is a better idea; reduce the damn taxes so that people can better afford to pay for health care. That, by itself, would go a long way.

There is no way that we are going to allow that large of a chunk of the GDP to be stolen by the do-gooders and turned into the same hopeless pile of shit that exists in Canada and other socialist countries. And, Canadians, please don't start posting about how wonderful your system is. There are plenty of Canadians who are now working in California so that they can have decent health care - their words, not mine.

The answer is no. You're just going to have to find another way than more taxes and nationalizing the healthcare system. I suggest you start by donating some of your own money to the cause rather than voting to steal others wealth.

Sound angry? You're damn right I'm angry. I get angry when others start plotting to take more of my earnings away from my family.


-- If the .sig fits...

Somehow... (5.00 / 1) (#141)
by Kaki Nix Sain on Sun Jul 22, 2001 at 01:23:21 AM EST

... I'm a bit doubtful that an extra 40$ a year that I get to keep in my pocket instead of sending off to the .gov is going to make the difference for me in affording my own healthcare. Maybe you could try to show just how much in taxes you are thinking that they could give back and how that would do the trick for everyone so that they are able to pay themselves.

For starters, the "tax us less" idea wouldn't seem to do that much good for anyone that doesn't pay a whole great lot in taxes to begin with, like the really poor.

Don't take me the wrong way, I'm not trying to ruffle your fur here, I'm just wanting some numbers. This is, after all, a big numbers game, right?

Good day to you.



[ Parent ]

A few facts... (2.50 / 6) (#124)
by Pig Hogger on Sat Jul 21, 2001 at 02:44:53 PM EST

  • In the whole known universe, the only industrialized country which does not offers it's citizens a FREE national health care system is the US. In this respect, the US sticks out like a sore thumb.
  • The canadian health care system costs the SAME per capita as the american one.
  • In Canada, 100% of the people have 100% of the coverage, as opposed to less than 60% in the US who only get what their insurer pays for.
  • In Canada, people have full choice over which doctor they see, and they can seek as many second opinions they want.
  • In the US, many insured people cannot chose their doctor, since their choice is restricted by their HMO.
  • In the US, people are routinely fired because their employer's insurer will threaten to withdraw coverage to all employees because one has become an unprofitable case.
  • In the US, the cost of health case is bloated up by the bureaucratic labyrinths of private health care (find out if so-and-so is covered or not for that), and by the fact that private health insurance companies have to show PROFITS.
  • In Canada, governmentally-administered health insurance has no such bureaucratic overhead, because everyone is equally covered (so every claim is straightforward), and there is no need to show a profit at the end.
  • In Canada, IF YOU WANT, you can also buy a PRIVATE health insurance which pays for the freebies the public system doesn't pay for.

There are a lot of ennemies to the canadian health-care system, and those keep spewing forth half-truths and blatant disinformation, and a lot of people fall for this, as plenty of posters on this story blatantly shows.

There is no question that the canadian system is SUPERIOR, and for anybody to prove otherwise, he'd better be prepared disprove the points enumerated above.
--

Somewhere in Texas, a village is missing it's idiot

In Canada (5.00 / 1) (#139)
by cyclopatra on Sat Jul 21, 2001 at 09:40:52 PM EST

  • In Canada, healthcare is managed by the provincial gov't. The feds provide some basic regulation, but the truth is, the quality of care you get is determined by which province you live in. In other words, if you live in Alberta (interestingly, probably the least socialist province in Canada), the province will spend, on average, $3K canadian (~$2K USD) per year on your health insurance (I admit to not knowing what the premiums are in Alberta, so I don't know how much of this you pay yourself). In BC (one of the most socialist provinces), the province spends, on average, $432 Canadian per person, per year. At $36/mo premiums, in other words, you pay for every cent that's spent on you.
  • In Canada, you often have to wait up to two days in an emergency room before being seen by a doctor. Stories of people dying in the emergency room because some intern or paramedic didn't think their maladies were that bad are common.
  • In Canada, the public hospitals do not have the equipment, the people or the space to care for sick or injured people. The government continually steals money from the healthcare funds, underpays and overworks the doctors and nurses, and then throws up its hands in horror, wailing about the patients who need care, when they threaten to strike, or move south to the US where they will be paid decently for their work.
  • In Canada, it's true, public healthcare has no need to show a profit. That doesn't mean there's no bureaucratic overhead, however. It just means that the bureaucrats are employed by the government, and are that much harder to shake into action, because they (essentially) can't be fired. Also, if it's your money going to pay for my healthcare (and in Canada, it is, whether it's through taxes or premiums) who do you trust more not to waste your money: the government (<sarcasm>with its totally unblemished record for managing public funds, of course </sarcasm>) or a regulated private industry that needs to show a profit within the bounds of the care they are required to provide?
  • In BC, what is covered by public healthcare is shockingly little. No GYN exams for women. No prostate exams for men. The BCMed plan explicitly does not cover "annual or routine examinations" unless they're medically required. On the other hand, you can visit a massage therapist up to once a month.
  • In Canada, you have you choice of doctor, as long as they're a registered provider. In other words, you can shop anywhere you like, as long as it's the company store. If the doctor you want happens not to be enrolled in the medicare plan, you get to pay. Suffice it to say that I wouldn't trust one of those "company" doctors to tell me I wasn't dead. I've learned this wariness from personal experience.

To sum up, in Canada, technically, you have free healthcare, behind all the handwaving and pay no attention to the man behind the curtain. But I wouldn't give a dog into the care of Canada's healthcare system, so where's the benefit?

I won't deny that there are problems with the US' healthcare system,or even that most HMOs are evil. But not all privately run health plans are HMOs, and I truly believe that Canada needs to remove the beam from its own eye before it complains about the mote in its neighbor's.
All your .sigs are belong to us.
remove mypants to email
[ Parent ]

"Superior" a matter of opinion (4.00 / 1) (#147)
by gbnewby on Sun Jul 22, 2001 at 12:45:15 PM EST

I'm a Canadian citizen, but have lived in the US for most of my life. I have lots of Canadian relatives. While your facts are right, I disagree that they always result in superior health care.

My grandmother, for instance, has cancer. She lives in Waterloo, a pretty big city. To get her cancer treatments, though, she has to travel to London (2 hours by car); she has no choice about this, as there are no cancer treatments available in Waterloo. She doesn't drive, so it's a major hassle to get to London. In the US, this simply doesn't happen: unless someone needs specialized services, they can get treatment in the local hospital or a variety of other places. I've heard many stories from my relatives about how it takes months to see a doctor for a serious condition (like cancer), and then the treatment isn't very aggressive compared to US treatments.

I'm not disagreeing that full coverage for all people is desirable. But it's obvious to me that the facts you cite do not result in "better" health coverage for those covered, in many cases.

[ Parent ]
Health care in germany (4.00 / 4) (#125)
by tjansen on Sat Jul 21, 2001 at 03:25:27 PM EST

Just to get things clear, a few things about the german healthcare system:
  • In Germany everybody must be insured by one of the public health insurances, unless he is self-employed or earns more than 6500 DM ($3000) per month.
  • Employees earning less than 6500 DM have to pay around 13% of their income, the employer pays the same amount. If you earn more and chose to stay in the public health system most insurances require you to pay only 13% of the 6500 DM. You can also get an additional private insurance or leave the public system completely and get a private insurance (which is typically cheaper when you are young, but more expensive as you get older)
  • You have a few dozens of public health insurances to choose from, but the differences between them are relatively small. These are public companies, some of them are founded by large companies, others by trade organizations and so on... as a member you can usually vote for their board.
  • People who are unemployed or live from welfare dont have to pay for their insurance
  • The insurant's spouse and children are automatically insured at no additional costs
  • Basically you get everything paid by the public health system but advanced dental treatments. These are often limited to filling tooths, for things capping they only pay a small percentage. The most important advantages of the private insurances are that they pay more for dental treatments, allow you to get a room of your own in a hospital and pay visits of the head physician, stuff like that.
  • for medicaments you usually have to pay a small fee, like 6 DM ($3). If you are in hospital I think you have to pay 20 or 30 DM per day...
  • You are free to visit every doctor you like, but you can usually only visit one doctor per quarter, specialists and emergencies not included.
  • Not every doctor must accept patients with a public insurance (because they pay less than private insurances), but most do. I would guess around 95%.
  • If you are sick for up to 6 weeks your employer is required to pay you. After the 6th week your health insurance pays you.


Hybridization! (3.00 / 2) (#131)
by ajkohn on Sat Jul 21, 2001 at 06:22:39 PM EST

I'm very happy to see that this topic seems to elicit some reaction. My main goal of the article was to spark debate and to ensure that Americans did not remain apathetic. Certainly those here at K5 seem rather rambunctious.

Let me say a few quick things:

Total government control (at least by current US government) doesn't seem like a good idea. I give Hillary credit for trying, but the plan wasn't such a hot idea.

Total privitization doesn't make sense, since a profit motive will always get in the way of proper medical care.

So, a hybridization must be reached, different from the current set-up, which is simply not working effectively.

I'm a bleeding-heart, so I believe we should act with compassion and try to provide humane care for all people, even if I have to pay a bit more. I also believe we should have access to the best medical care, which I admit is an expensive proposition.

What is the solution? I'm not entirely certain. I don't think the answer is tax-cuts or more government regulations. I believe everyone should have access to basic health care, so perhaps this basic level of service is is socialized. Levels above could be privatized with some limited regulatory rules applied.

Outside of that something must be done about the spiraling amounts of paperwork, sign-offs, heirarchy and inefficiency within most health care systems. We have gigantic insurance companies, then smaller medical groups, then doctors and then patients.

There are medical billing reps, authorization reps, customer service reps, reps for seemingly everything, all with new and fun hoops to jump through and paperwork to fill-out and send in. Not that I'm a great fan of Credit Card companies, but I can call and give information over the phone and transfer a balance from one account to another. It'd save a lot of time and money (though throw many out of work) if I could quickly pay the docs/insurance (who I'm generally very grateful to) straight away. "Hello, my name is x, this is my ssn#, this is my case #, here is my cc#, thanks have a nice day."

Would you ever patronize a store if you had these types of experiences? No! But we've thrown up our hands, given in, much like we used to about bank lines. Thank heavens for that ATM card.

I use this as just one example of what could be done.

##Tangent Rant##

What I will not stand for is having to pay a copying fee to get my OWN medical records as I've had to do three times now as I hopscotch around the country.


"Just because something bears the aspect of the inevitable one should not, therefore, go along willingly with it." - The Transmigration of Timothy Archer

state of the union (1.00 / 1) (#134)
by dr k on Sat Jul 21, 2001 at 08:23:57 PM EST

This story has generated some colorful rhetoric so far. My favorite aspect is the extreme sound and fury being generated by the mere notion of having socialized (or whatever) health care in the US. I don't see any mention of a House Bill #---, or urgings to write your Senator.

Despite the pathetic and regressive tax burden perpetrated on American citizens, people (L---arians) are jumping at the chance to say, "Not only will I not give you more taxes, I want you to give me back what you took." This seems somewhat pathological. No, sorry, I don't want to qualify that: It is pathological. The idea that one's success or failure in the rat race is being manipulated by a faceless and abstract Government, a Government that is able to perform ruthless and oppressive acts with extraordinary efficiency, yet appears to the public to be a blind and stumbling giant - this is madness.

Now, if you leave out the "ruthless and oppressive acts" you have a Govenment that is operating sans intentionality. But how could such a thing do something as clever as "collect taxes" in the first place? Is the Government, in the end, just a mass hallucination forced upon us by our ancestors? Is this the dark secret discovered by Chandra Levy?
Destroy all trusted users!
[ Parent ]

Absolutely (3.00 / 1) (#152)
by CaptainZapp on Mon Jul 23, 2001 at 05:26:42 AM EST

Total privitization doesn't make sense, since a profit motive will always get in the way of proper medical care.

Five to seven years ago there was an incident hitting the press big time here:

A private hospital, owned by an American hospital corporation, in Geneva refused to take in an emergency, prior to proof of funds. In perspective: A guy is dying at the hospital steps and they wanted to see a valid credit card first.

While this might be a common practice in other parts of the world, the press, the public and the authorities took an extremely dim view on the issue. In short:

If they ever attempt to deny help to an emergency ever again, their license is yanked, the hospital is shutdown, no refunds are provided.

I actually pretty much agree with the government on this one.

[ Parent ]

What's wrong with you people? (3.00 / 1) (#142)
by gordonjcp on Sun Jul 22, 2001 at 03:10:25 AM EST

I don't quite get it... In the UK, we have a perfectly good state-funded health care system, the NHS. Now it's a long way from perfect. There are long waiting lists for certain operations, but they tend to give truly life-threatening problems priority.
Now people whinge that they have to wait a year for a hip replacement, but unless your leg is actually siezed or hanging off, you can probably manage without it (albeit at a somewhat reduced quality of life). People here can accept that heart transplants come a bit above replacement hips in saving people.

So, there are waiting lists. The hospital staff are underpaid and overworked (who isn't?). But on balance, the system works.
Plus, there's nothing to stop you getting private health insurance as well - that way, you've got both. If you need work done, you can go private. If you have an accident, simply go to the nearest Accident and Emergency unit. No cards, no insurance, no hassles.

Of course, it doesn't work if you'd all rather spend your money on big shiny jeeps and 96" TV's, instead of helping people who just can't afford private health care. And, they won't pay for boob jobs or Viagra (well, they will but only under certain circumstances).

Give a man a fish, and he'll eat for a day. Teach a man to fish, and he'll bore you rigid with fishing stories for the rest of your life.


Public systems depend on America being private (2.00 / 1) (#149)
by lightsweep on Sun Jul 22, 2001 at 02:56:35 PM EST

This is complicated matter, but I'd like to throw in one factor which I haven't seen yet. I think that public health care in other socities is viable because we have a free-market health care system here in the US... Like so many other things we do well because of the "capitalist motive", our society invents more medical machines, techniques, new drugs, etc. than other countries. I think other countries where there is much less innovation, take advantage of the fact that America has created many of these new breakthroughs, which have vastly improved health care for *everyone* more than anything else. So to an extent, I feel the public health care of other countries are practical (at least partially) only because America's system is free-market oriented.

Health Care? | 159 comments (129 topical, 30 editorial, 0 hidden)
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