VENEZUELA : HEALTH CARE REVOLUTION.

POSTED BY: Howard
UPDATED: Tuesday, October 25, 2005 02:11
VIEWED: 8994
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CITIZEN

Wednesday, October 19, 2005 5:22 PM

Quote:
Originally posted by sgtgump:
And a right? No one has any rights but what they secure for themselves.

Ok, lets go with that.

Quote:
We can speak freely because people fought and killed to earn that right and would do it again.

So other people fought for your right of freedom of speech?
In that case what is wrong with other people securing your right to good health?

So is it alright if someone is left to die from an easilly curable ailment because they can't afford the treatment?

Isn't it a good thing that the strong (or well off) protect/help the weak (or the less well off).
Isn't the concept of the strong protecting the weak one of the very basis of society/civilisation?

More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
I can't

SIGNYM

Thursday, October 20, 2005 12:06 AM

Quote:
Isn't it a good thing that the strong (or well off) protect/help the weak (or the less well off).
Isn't the concept of the strong protecting the weak one of the very basis of society/civilisation?

Eh- but some people prefer the dog-eat-dog model, where we start out at barbarism each generation and work our way down from there!

Please don't think they give a shit.

SGTGUMP

Thursday, October 20, 2005 12:55 PM

Quote:
Originally posted by citizen:

So is it alright if someone is left to die from an easilly curable ailment because they can't afford the treatment?

If you feel like helping people that's great. But to force others to help people by stealing their money is wrong.

And as I said earlier, I would fight for the right to speak if I had to. And whenever I speak it doesn't cost anyone else anything.

CITIZEN

Thursday, October 20, 2005 5:14 PM

Uhuh, maybe you should go to the senate and tell them to stop stealling your money to build roads and finance the military, pay for unemployment benefits...

I mean, some of these roads you don't even drive down.

Or, and here's a really good case, the police. I mean, hey you never committed a crime, so why the hell should you pay for the police.
Even if you've been a victim of crime it's not like it's everyday, yet you pay for the police everyday, why should you?

Man, their stealing YOUR money to protect these OTHER people who are probably just leeching scum anyway. Let the bastards die, they deserve it. If they can't afford their own private security force, then they deserve to be robbed/murdered.

You can afford your own private security force, so 'em.

So what if it costs more than the Police in the first place. Least your money isn't going to help anyone else.
And that's the main thing.

EDIT:
In fact privatising the police sounds like a really good idea.
You pay on a call out basis. Say, your mugged well you personally have to pay for the police responce. You can't pay, well, just try not to bleed there, cause your gonna have to pay the street cleaner to mop it up.

I mean why should anyone else pay for the police time, man power and equipment because you were mugged.
Just doesn't make sense.

Oh and sometimes, freedom of speech does cost money. Even yours, in fact.

You want to live in an anarchistic society, no problem, I can suggest a few if you like.

More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
I can't

CANTTAKESKY

Thursday, October 20, 2005 7:31 PM

Quote:
Originally posted by rue:
More coverage, better outcomes, and cheaper. Who can argue with that? Well at least one person. And before us: on the one hand - results. On the other - ideology.

I'll argue with that. I know it won't make a dent in Rue, but it may help other readers of this thread see that evaluating health care is a lot more complicated than this.

1. More coverage. Does more coverage actually result in more health care? Does national health care actually result in more doctor and hospital visits, more drugs being dispensed, and more surgeries being performed (per capita, of course)? Do we have data on how many people go without health care because of lack of coverage vs. those in countries with national coverage? I haven't researched this, so I don't know. But one has to question the assumption that national health automatically means more health care.

Then there is the question of quality of care, because more doesn't necessarily mean better.
To illustrate, let me share an anecdote. When we were living in Vancouver, Canada, my husband witnessed EMTs arriving to help a man who had had a heart attack in the lobby of an apt building. They did about a minute of CPR on him, pronounced him dead, covered him up, and leisurely loaded him up in the ambulance. My husband was shocked. In the USA, EMTs would have taken the man to the hospital immediately, doing CPR on the way, and let the hospital staff try to resuscitate him before a doctor pronounces someone dead. Quality matters.

2. Better outcomes. There are many other measures of health besides life expectancies and infant mortalities. Who is healthier for example? A 72 year old man who uses a wheelchair, is dependent on dialysis machines, and eventually dies slowly of pancreatic cancer; or a 32 year old man who runs marathons, never catches a cold, but dies in a car accident? That is to say, the number of years one lives is not necessarily a good indication of health, let alone a primary indication of health. We have to also consider other variables such as disease rates, number of days lost from work because of illness, productivity (amount of work able to be done), mobility, amount of health care interventions needed (drugs, surgery, life support, home health care devices), etc. Better outcomes can't just be measured by one factor.

3. More coverage caused better outcomes. Just because X and Y often go together, doesn't mean X causes Y. In science, people say "correlation does not equal causation." Just because national health plans happen in countries that also have high life expectancies, doesn't mean the health plans caused the higher life expectancies.

For example, it could be that lower pollution levels cause higher life expectancies. And maybe it just so happens that countries that control environmental pollution are also ones that provide national health care. Or another example. Maybe lower infant mortality occurs because those other countries allow midwives to attend births, and not just obstetricians--so the variety of health care caused the better outcome, not the coverage itself. (Not saying this is necessarily the case. Just arguing that logic dictates we must consider many other variables that also influence health.)

4. There is a saying often attributed to Mark Twain: "There are 3 types of lies: lies, damn lies, and statistics." Statistics are extremely malleable creatures. The way you can tell a statistic is a lie is when a statistic is used to justify policy--which describes about 99% of statistics floating out there. Statistics used to serve an agenda automatically leaves out other facts and numbers that do not serve the agenda. Honest statistics can only decribe what was found in a specific situation (with methodology revealed and critiqued), while putting it in context of many other findings and acknowledging there is so much more to find. So really, are there any arguments that don't rest on ideology?

-------

Incidentally, I just spent 6 weeks in Chile, South America

RUE

Friday, October 21, 2005 7:42 AM

Quote:
I'll argue with that.

1. More coverage.

2. Better outcomes.

3. More coverage caused better outcomes.

4. Statistics

Cant - before I became an atmospheric chemist, I spent over a decade working in US health care - in the VA, in a large county hospital, in large private hospitals, small private clinics, and small non-profits. And I know a little bit (very little) about the Indian Health Service on the Navajo reservation. And I've spent a lot of time in Canada, have Canadian friends from Toronto to Vancouver, and have had decades to evaluate their health system up close and personal, as well as from professional research.

Your questions smack of severe ignorance about medical practice, protocols, health care in general, and the US and Canadian systems in particular. And this is reflected in the statement: "I haven't researched this, so I don't know". If you haven't bothered to look it up - and relevant figures are easy to find through Google though they takes weeks to study - I can see why you are not embarrassed at your own statements. But they are shamefully glib and hollow. Does the word 'sophistry' mean anything to you? Look it up.

But, to address your questions, and show why they are so seriously off the mark:

1) "Does more coverage actually result in more health care?"

Inevitably, more coverage (of more people) results in more care (for more people). But this is not the only vital question to ask.

Then you mis-direct by asking about specific medical interventions. You question "Does national health care actually result in more doctor and hospital visits, more drugs being dispensed, and more surgeries being performed", and then you go on to conflate those with better care.

So to look at some specific examples: Doctor and hospital visits - the tiny impoverished island of Puerto Rico has put the US to shame on infant mortality. They send out basically-trained health workers (and I mean minimally educated with checklist training) to all expectant mothers. Those workers supply vitamins, provide basic pre-natal tests (for diabetes, proteinuria, and pre-eclampsia; and check weight), give routine vaccinations, campaign against smoking and drinking, and teach the mothers-to-be essentials such as providing clean water and how to breast feed. Such brick-simple but well-researched and vital care, widely provided, brought Puerto Rico up to nearly first-world infant mortality rates. In that case, better preventative coverage avoiding doctor and hospital visits made for vastly better care. The necessity of doctor and hospital visits, OTOH, means people have become ill and are now 'patients'.

Looking at the general category of "more drugs": Vaccinations are a cheap, mass-care interventions that have revolutionized childhood survivability. Antibiotics on the other hand, have created monster bacteria and should have been used much more sparingly. More vaccinations - better care. More antibiotics - worse care. Basic cheap diuretics for heart failure - longer healthier survival. Expensive modern drugs - shorter debilitated survival. Etc. More 'drugs' does not generally equate to better medicine.

Surgeries - When surgeons went on strike in one state to protest insurance premiums, the death rate went - down. Analysis revealed that while critical life-saving surgeries were still being done, elective surgeries and their associated "morbidity and mortality" were halted. Hence, the lower death rate resulted quite ironically from reduced surgeries.

Is 'more' health care a measure for good health care? Are more surgeries, drugs, and doctor and hospital visits adequate measures for good health care? Mostly, no. Is getting the RIGHT care where it is needed important for good health care? Yes.

In the same breath you ask the unrelated question "Do we have data on how many people go without health care because of lack of coverage".

In a word - yes. In the US there is an obvious percentage of people going without any routine health care at all because they completely lack either private

CANTTAKESKY

Friday, October 21, 2005 2:22 PM

(Oh crap. I don't know how it happened, but my original response to Rue was accidentally deleted. I don't have time to rewrite it, so I will summarize as follows.)

There is a reason why I use "generic logic" more than "real information," as Rue puts it. I've had a good amount of graduate training in scientific research methodology and statistics; I know how easy it is to mold statistics to advocate whichever position one wants. A forum like this is best suited for opinion and reasoning, rather than statistical soundbites that I believe are easily misleading (whichever position they support). Anyone who wants to research the facts properly can do so from sources much more extensive than anonymous posters on Fireflyfans.net.

Yes, Rue, I know you think I'm ignorant. I'm just this side of a prehistoric human. When I speak, all you hear is, "Grunt, grunt. Blah, blah." I get it already.

I could pursue this dispute with "real information," but what's the point? Inevitably, you end up nitpicking my wording or my examples rather than address the thrust of my "generic logic." Speaking goes on, but communication--not so much.

However, against my own better judgment, I will grunt-grunt and blah-blah one more time.

You make a good point to distinguish different TYPES of health care, vs simply "more" or "better." There is preventative health care vs. crisis health care. In the USA, we have too little of the former, and make most of our money from the latter. I definitely support a shift towards preventative health care in any health care reform package.

Having said that, I believe that a shift towards prevention and cure can and should happen, regardless of who pays for it. A national plan might make the shift easier, simply because of the centralized control. But I would rather explore more autonomous and less forceful ways to make this change.

(And Rue, I would appreciate it if you could refrain from calling me ignorant again. We may not think alike or communicate well, but we can at least be civil.)

CITIZEN

Friday, October 21, 2005 8:13 PM

CantTakeSky:
Your right. Statistics can be misleading.
Case in point, Women drivers (don't flame me yet)...
People say Women drivers are safer because they have less accidents than Men, yet the statistics also show that Women drive less miles than Men, and that per-mile driven they have more accidents.

This indicates that infact on average Women drive less miles than Men do on Average, and therefore are likely to be less experienced than your 'average' Man. Not that Women are safer drivers.

So yes, statistics can be misleading.

So lets just assume for a moment that neither public nor private health care are better than the other.
With a private system, no matter how cheap it is, there will be some people who can't afford it, and therefore don't have it.

So my question is:
Is it okay that these people don't get health care?

and...

If not, how would you suggest we deal with this through a private system?

More insane ramblings by the people who brought you Beeeer Milkshakes!
Even though I might, even though I try,
I can't

RUE

Saturday, October 22, 2005 2:07 AM

Cant,

I called your statements ignorant b/c you frankly admitted you hadn't looked up that on which you were opining. What else can I say? You qualified your own position.

Argue as you will about the use of statistics, you also haven't looked up the data and analysis to see if your objections apply. Maybe you have little regard for epidemiology and that is why you generically and without basis cast aspersions on it, but the people who do the work (described in exhaustive detail in every report) are experts. I have studied the reports. I invited you to do the same. That way we could be on equal footing, doing more than exchanging "sound bites" as a form of advertisment for our positions. We could actually be using scientific shorthand to educate and debate each other. But you seem you would rather not.

In case you are interested, you can get US "life tables" and other reports from the CDC http://www.cdc.gov/nchs/products/pubs/pubd/lftbls/lftbls.htm; in Canada you can find information through Statistics Canada http://www.statcan.ca/start.html

If you could pursue the debate with 'real information' I'd welcome it. I just haven't seen any from your end. So please, bring some on board rather than just blah blah blah.

Nearly everything I know I learned by the grace of others.

CANTTAKESKY

Saturday, October 22, 2005 9:11 AM

Quote:
Originally posted by citizen:
Is it okay that these people don't get health care? ...If not, how would you suggest we deal with this through a private system?

Excellent questions. I have so many thoughts on this I need some time to organize and summarize them. Please let me get back to you.

Let me say though, that I am not unconcerned about poor people or lack of access to health care. I used to be a social worker in a former life and spent years working with the poorest of the poor in the US. I am obviously concerned about poverty issues, or I wouldn't have chosen that line of training/work.

Can't Take My Gorram Sky

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