Anti-Government, but don't touch my Medicare
POSTED BY: Niki2
UPDATED: Friday, May 7, 2010 16:50
VIEWED: 8545
PAGE 14 of 16
to attack the tea-party as a whole, for general differences in policy or principle among some of the people who associate themselves with the label.. is like marginalizing hollywood and its contributions to film, because of a few mentally deficient schizophrenics that occupy the place. its rediculous. how about the substance of the debate, which is a return to the US constitution? explain to me why thats a bad idea
id love to get rid of Medicare. unfortunately, we've created an entire class of people dependant on this service.. so maybe pulling the rug out immediately, isnt the greatest idea. of course.. creating another trillion dollar entitlement on top of it, and clainming to pay for it by trasferring non-existent money from an account thats virtually insolvant anyways is just incredible account gimmickry only a leftist could appreciate
you know, we could talk all day about some of the inconsistencies in liberal ideology. lets start with the most glaring, that being a party that promotes civil liberties, meanwhile simultaneously encouraging government to grow so large and intrusive, that it becomes the final arbitor of those 'rights'. so what do we get? dont let the government decide what a woman does with her body! except when she needs a doctors visit.. someones gotta pay for that. and dont try to regulate your own bodily intake of salt, trans fats or marijuana- we're too stupid to take care of ourselves- government knows best. we want equality! except when it comes to the poor, minorities, homosexuals and transgenders- they deserve special privelages under the law. we hate lobbyists and special interests, break their stranglehold on policy! just dont take governments ability away to interject itself in every segment and niche of the marketplace(thereby enabling the 'lobbying')
and yet, to the left, limited government advocates are the asbolutely intolerable ones. why the constant demoniziation of americans, upset at a government which has bankrupted its peoples futures? meanwhile, you throw your support behind.. what? the millions of illegal immigrants who are up in arms, demanding access to taxpayer funded entitlements such schools, hospitals, prisons, jobs? and yet, no mention of that fact that maybe, if liberals hadnt pushed this wellfare/entitlement state on us, we could have unfettered immigration. but because we are bankrupt, and can barely pay for these services for american.. we must be 'racists! racist.. if we dont want to open our borders and wellfare state to the entire world. im anxious for those charges of racism, should we be compelled to enforce the northern border.. curious how thatll be spun
this is insanity!
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CantTake: Did I say I rejected the government completely for the high costs? If so, I misspoke; I meant to say I reject the government as the SOLE, or even the BIGGEST cause. What do I blame? I’ll get to that in a minute. As to Quote:
Clinical trials are done by the pharmaceutical companies; are you saying the government is responsible for that? They’d have to do clinical trials no matter what, wouldn’t they? Licensing isn’t that expensive, as far as I know; malpractice insurance definitely IS, but that’s because people can sue. You don’t think lawyers would find a way for them to sue, you blame the government for making malpractice illegal? If they hadn’t, doctors could do whatever they want; do you prescribe to the “doctor as god” principle, or do you believe we are entitled to some protection? Certainly I agree that it’s gone out of bounds, but the basic reasons for “malpractice” are, to me, valid. I blame the lawyers for expanding it and profiting from it, not the government.
I don't think the enormous cost of clinical trials and licensing of drugs/physicians and malpractice lawsuits/insurance, which are ultimately absorbed by the consumer, can be disputed.
"I'm just right. Kinda like the sun rising in the east and the world being round...its not a need its just the way it is." The Delusional "Hero", 3/1/10
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DT: I’m not sure what you meant by missing your point(s). I was responding to your words:Quote:
I responded that the nonprofits I’ve worked for and with haven’t been responsible for corruption and that the corruption I’ve heard of in MEDICARE is mostly fraud on the part of providers and patients.
if there's no profit in the company, they'll find it in corruption.
Then:Quote:
and
Given 1) and 2) the government has created a situation in which healthcare is not something that people can afford.Quote:
Personally, I cannot logically conclude anything other than a US regulation would be the potential cause
As toQuote:
I disagree that it’s obvious one causes the other. As to
Specifically, the fact here is the advent of the intervention of *our* govt. into *this* healthcare system, which was accompanied by soaring prices, sort of like the coincidence of college tuition and the trading of student loans [you didn’t finish that sentence]. It's sort of obvious that one caused the other, even though, yes, correlation does not prove causality, because when you have enough statistical data, and any reason, then it makes sense, failing something else.Quote:
Here is what I believe, as do many researcherst:
Personally, I cannot logically conclude anything other than a US regulation would be the potential causeQuote:
Health care costs in the US are disproportionately high for many reasons.
Use of costly new technologies and drugs: Such use may be the largest single factor increasing health care costs. Use may be appropriate or inappropriate, but in either case, cost is increased.
Increased costs of health care goods and services: Drug costs have increased. One reason is the increasing cost of developing a new drug, often in the vicinity of $1 billion. The cost of drug development decreases the economic incentive to develop drugs with lower profit potentials or public health in general (eg, vaccines, antibiotics).
Marketing of new drugs and devices: Intensive marketing to physicians and consumers (with direct-to-consumer advertising) has been suggested as a cause of overuse of costly new technologies and drugs. Some of these new measures may be no more effective than older, less costly ones.
Overuse of specialty care: Specialists are increasingly providing more care; reasons may include a decreasing number of primary care physicians and an increased desire by patients to see a specialist.
Specialty care is often more expensive than primary care; specialists have higher fees and may do more testing (often pursuing less common diagnoses) than primary care physicians. Also, evaluation and treatment of a patient who could have been managed by a single primary care physician may require more than one specialist.
High administrative costs: The percentage of health care dollars spent on administration is estimated to be 20 to > 30%. Most administrative costs are generated by private insurance, and most of those costs are generated by marketing and underwriting, processes that do not improve medical care. Also, the existence of numerous private insurance plans in the same geographic area typically increases health care providers' costs by making processing (eg, claim submission, coding) complicated and time-consuming
Physician fees: Physicians in the US are more highly compensated relative to other professionals than physicians in many other countries. This disparity occurs partly because physicians in other countries typically spend far less on their medical education and malpractice insurance than those in the US and have lower office overhead.
Malpractice costs: The issue of malpractice adds to the cost of medicine directly and indirectly (by triggering defensive medicine).
The direct cost is the malpractice insurance premiums paid by physicians, other providers, health care institutions, and medical drug and device manufacturers. These premiums, which cover claim settlements and malpractice insurance company overhe
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Anti: I never attacked the Tea Party in the way you described, so I won’t address that.
As to Quote:
I have to stop you right there. Do you want facts and figures showing that Republican administrations have grown the government far more than Democratic ones? I can provide them, and the cites, if you’d like. It’s a fact.
being a party that promotes civil liberties, meanwhile simultaneously encouraging government to grow so large and intrusive
As toQuote:
I hate to tell you, but it’s REPUBLICANS which are limiting the right of a woman to choose what to do with her body, via laws and other tactics, not the “liberals”.
dont let the government decide what a woman does with her body! except when she needs a doctors visitQuote:
I believe the salt and trans fats things are not ILLEGAL, they are required to be SHOWN on packaging, so people can make up their own minds whether to ingest them or not. Or am I wrong? Marijuana and other drugs are illegal, and KEEPING them illegal is the purvey of the right, very much so.
someones gotta pay for that. and dont try to regulate your own bodily intake of salt, trans fats or marijuana- we're too stupid to take care of ourselvesQuote:
We can disagree about that one, as I happen to think it is government’s job to protect EVERYONE, and given the situation of “poor, minorities, homosexuals and transgenders”—you’re forgetting women, by the way—I think the government trying to give them equal protection under the law is a good thing. We do NOT give them special rights; in fact, when it comes to homosexuals, we definitely PREVENT them from exercising their rights in several ways, especially marriage, serving in the military, and more, and transgenders are hugely persecuted. It’s not special treatmen to give all people the same rights. At least that’s what I believe; you obviously believe differently.
they deserve special privelages under the law
Lobbyists USE the government to get special treatment, special laws; it’s not because government sticks its nose in for the most part, it’s to gain laws that increase their profits. There are tons of facts and cites on that one, too, if you want them.Quote:
Uh, once again, the government which bankrupted people’s futures was just a REPUBLICAN one, remember? As to demonization, dear gawd, the left has been demonized at LEAST as much as the right has ever been; can you actually DENY that???
why the constant demoniziation of americans, upset at a government which has bankrupted its peoples futures?Quote:
Well, I’m not sure there’s any “throwing of support” behind anyone specific; we’re against SPECIAL TREATMENT of anyone, singling out a class of citizens—for myself, it is largely because it pre-empts the right of ANY citizen the police decide MIGHT be illegal. I’ve never seen any illegal immigrants DEMAND access to those things you listed; when it comes to entitlements, they get none, when it comes to prisons, there are more minorities behind bars than anyone else—you think they DEMANDED that?? Nor did they “demand” jobs, they take lower-paying jobs than a citizen would consider to survive, and it’s our GOVERNMENT which makes that possible. Hosppitals and schools I’ll give you; tho’ again never DEMANDED, I’m not much in favor of letting people die on the streets, tho’ free schooling is something I’m on the fence about.
you throw your support behind.. what? the millions of illegal immigrants who are up in arms, demanding access to taxpayer funded entitlements such schools, hospitals, prisons, jobs?
How in hell you equate “unfettered immigration” with “wellfare/entitlement state is beyond me. You’d have to explain that one.Quote:
Again, we’re bankrupt because of a Republican administration...we came out of the last Democratic one with a surplus, remember? And before that, the first Bush ran up the tab, too. It is also through DEREGU
but because we are bankrupt, and can barely pay for these services for american.. we must be 'racists
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Quote:Thank you for clarifying.
Originally posted by Niki2:
I meant to say I reject the government as the SOLE, or even the BIGGEST cause.
Quote:
What do I blame?
...Increased costs of health care goods and services: Drug costs have increased. One reason is the increasing cost of developing a new drug, often in the vicinity of $1 billion. The cost of drug development decreases the economic incentive to develop drugs with lower profit potentials or public health in general (eg, vaccines, antibiotics).
....Clinical trials are done by the pharmaceutical companies; are you saying the government is responsible for that?
First let me say I agree one of the biggest contributors to the high costs of health care is the "increasing costs of developing a new drug." The question is, where do these new drug costs come from?
Yes, in my view, the govt is responsible for clinical trials, which constitute a significant portion, if not the majority portion, of these "increasing costs." By requiring them, the govt forces drug companies to spend a lot more than if they didn't have to pursue clinical trials.
Quote:
They’d have to do clinical trials no matter what, wouldn’t they?
No, they wouldn't. If the govt didn't force them, they wouldn't HAVE to. Isn't that the point of legislation, to make sure people can't opt out?
Quote:
Licensing isn’t that expensive, as far as I know;
The education required for licensing is very expensive indeed.
Quote:
you blame the government for making malpractice illegal? If they hadn’t, doctors could do whatever they want;...
Malpractice suits are part of our law, and law is govt.
Ah. I am not necessarily BLAMING the govt for these huge costs. At least, not yet. Right now, I just want to establish whether or not it is partially or largely because of govt and regulation and laws that health care costs are so bloated. You categorically denied it is largely responsible. I am trying to make a case that it is largely responsible.
If we agree on that, we can move on to whether these govt-responsible health care costs are necessary or helpful, and how government can change certain things about how it works to help bring costs down. Identifying responsibility, partial or whole, doesn't have to be about blame. It can be about power, the power to cause a desired effect and the power to change.
If the govt did not require clinical trials or that physicians attend medical schools to practice medicine, would health care costs go down? Answering yes doesn't mean we WANT to do that. But it does establish that the govt is responsible for those costs. Maybe then, we can discuss how the govt can change current drug approval regulation or current physician licensing regulation in a way that clinical trials and licensing do not have to be so expensive. It doesn't have to be all or nothing.
Anyway, I think you've answered my question quite satisfactorily. I understand where you're coming from much better. You see these costs as necessary with or without govt, and therefore you do not see that the govt is responsible. Thank you for answering.
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“Don't ask yourself what the world needs. Ask yourself what makes you come alive and then go do that. Because what the world needs is people who have come alive." --- Dr. Wayne Dyer
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As to TWO of those aspects of rising healthcare, yes, I see them as necessary. Me, I wouldn't want someone treating me who had no education as a doctor, nor would I want to take a drug which hadn't gone through clinical trials! I'm certainly not saying the government's demanding these isn't government "interference", seen from your angle.
I'm not sure about malpractice lawsuits. I live in a state with the highest per capita number of lawers in the country, and worked for them for eight years. I have full faith in them to find a way to sue doctors for "malpractice", whatever it's called and whatever the laws, or get those laws MADE. 
That said, what about the other causes? And how do you propose to lower the costs of those two? I'm certainly amenable to lowering them, but I don't see how it could be done. Also, doesn't the government subsidize some of that education through loans? That way, they're making it easier and less expensive (tho' the loans have to be paid back eventually), aren't they? I think that comes partially under "funded mandate", doesn't it?
"I'm just right. Kinda like the sun rising in the east and the world being round...its not a need its just the way it is." The Delusional "Hero", 3/1/10
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Quote:
I did read your posts in their entirety, and I apologize I did not express myself clearly enough to show it.
In my view, it's like this. There is science, and there is "science." Real science, good science, makes observations, tests hypotheses in experimentation, measures data, and calculates statistical probabilities that the measured data reflects the influence of the independent variable rather than random fluctuations. Then they retest it, and so forth. This is the scientific method.
Not every field allows for this kind of experimentation and data measurement. So other fields do the best they can, taking measurements, calculating correlations, look for patterns. In recent years, they have had the benefit of computer modeling as an added tool. Strictly speaking, none of these fields do rigorous science, since there is no experimentation to test hypotheses. However, they still carry the label of a "science" because they dutifully carry out the first steps of the scientific method the best they can--observation and hypothesis.
I like to call disciplines that engage in experimentation "science," and disciplines limited to observation and hypotheses, "quasi-science."
Much of the social and behavioral sciences, medicine, paleontology, paleogeology, and climate studies are quasi-sciences. They cannot engage in experimentation and lack the most critical tool of the scientific method.
CTS,
I haven't read the rest of the thread yet, but I need to jump in on this quotation. I think you either don't understand the philosophy and methodology of science or you are misrepresenting it. Experimentation is by no means the only way of conducting true science, and it never has been. You are referring to the hypootheticodeductive model, which isn't even the only form of deductive science (comparative studies are just as valid, and often use deductive reasoning), and you've completely left out inductive reasoning, which has been around just as long and can be just as powerful. Some of the most important advances in science have come about by induction (plate tectonics, evolution by natural selection and relativity are a few rather important examples). Thankfully, practicing scientists and philosophers of science have a rather wider view than the one you present.
perfessergee
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Niki
Merck's research is good, their politics, appalling.
1) Increased costs of health care goods and services: Drug costs have increased.
Yes, why is that? Oh yeah. You raised the price, which you could do because you bought so many politicians and so many heads of the FDA were Merck execs, not to mention Rummy...
2) lol@$1 billion.
3) Marketing of new drugs and devices
Sorry, not buying...
4) Overuse of specialty care
again, not buying it, if these reasons were a factor, they would show up in other private care systems like in the UK, Korea, and they just don't.
5) High administrative costs
Agreed, but this is part of the system I'm describing. While not the driving force by itself, is part of teh overall AMA structure.
6) Physician fees
More AMA. It's a giant union, what did you expect.
7) Malpractice costs
I agree, get rid of Malpractice insurance, then maybe they'd stop killing people. Really. I mean, shouldn't they ask themselves "Does this procedure really *need* general anesthesia? Or are they just doing it so the patients won't kibbitz their butchering of it.
Near here a doctor just lost his license after botching 143 operations, killing an undisclosed number of patients. That's how long it took before they removed his license. He lost a million in a malpractice suit about ten years ago for killing a young woman during a C-Section, but malpractice insurance carried him, and he went on butchering.
8) Defensive medicine
Another very old and bogus argument It's just not true. It's far cheaper to use preventative care.
9) Aging of the population
Another red herring. If this were true, you'd be able to witness it in other parts of the world where you see this, and it's just not what you see.
Here's the logical shootdown of #9: Humans may be living longer, but they're dying in roughly the same amount of time. Today's 70 yo or 80 yo is actually in perfect health, people are declining in their 90s, the way they once declined in their 70s or 80s. As a reasult, they're seeking said care at an older age, but not more of it. You don't get a lot of people taken deathly ill at 70 and dying of it at 100. Sure, you get some, but then again, you always did.
Okay, Merck had a couple valid points, and a lot of spin. Hopefully Krugman has something more insightful
a) administrative costs.
Okay, conceded, but that doesn't make me wrong, it's still an organized labor and regulation problem.
b) U.S. doctors’ high average incomes
again, agreed.
c) The U.S. also spends $57- $66 billion a year more for drugs than other developed countries
Sure, but why is that? Perhaps because there's no consumer to put an objective judgment on whether the medicine is worth that or not.
d) The study estimates the cost of providing full medical care to all of America’s uninsured at $77 billion annually.
That seems pretty reasonable. I'll bet you can trim that down by doing away with the overcharges. Very often the "new drugs" are just the old drugs with a new set of shoes. Also, if doctors "hours" were measured honestly, they would be very short. Yes, the doctor has to see me and do some paperwork. Let him do that in my presence, and I can clock him. I guarantee you the only reason I'm waiting there for and hour and a half is that he's seeing six other patients at the same time. That means that he spent 15 minutes total on each of us, probably 5 min on the visit and 10 min on the paperwork. Let him charge 15 min to each of us, not an hour.
e) payment incentives that reward the delivery of more services, without consideration to clinical value or cost-effectiveness;
sure, but then the system is rigged to make you pay more, so there's no incentive to change that.
f) market power of insurers, providers, and the health industry
Sure, many middlemen overcharging at every level, that's why the little aircompressor can cost $400 instead of $40, it's the contract biz, it's like the military.
g) a low ratio of primary to specialty care physicians and serv
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Quote:
Originally posted by perfessergee:
I think you either don't understand the philosophy and methodology of science or you are misrepresenting it. Experimentation is by no means the only way of conducting true science, and it never has been.
Certainly, I have heard this argument before. I came first from a social science background. So it is not that I don't understand the philosophy and methodology of science. It is that I have chosen the definition that best represents the high degree of confidence people have come to expect from the method. Experimental science is the classic definition of science.
http://en.wikipedia.org/wiki/Science
So what is "true" science? Some people define it as any type of systematic study of a subject matter. But I feel that definition is too broad. It lends the high credibility of "science" to fields that, because of experimental limitations, cannot earn that high level of confidence.
This broadening of science beyond the scientific method, in my opinion has had disastrous consequences. The overuse of the label has diluted the rigor of the method and contributed to so much scientific illiteracy that most people can't tell speculation and philosophy from scientific research. Everything that comes down from academia and carries the label "science" is accepted as Truth or Near Truth, and "scientific truths" are easily manipulated by political agendas.
That is why I deliberately choose the classic, purist, narrower definition.
I understand you disagree. That happens. But please don't mistake disagreement for ignorance. Thank you.
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Quote:
Originally posted by Niki2:
And how do you propose to lower the costs of those two? I'm certainly amenable to lowering them, but I don't see how it could be done.
OK, I will tell you my ideas. But please don't freak out; it's scary.
1. Open up the market, part 1. I understand that most people want drugs tested by clinical trials and doctors who have been to medical school. Funny enough, I don't. So, I say, let the govt open up the health care market to whoever wants to practice "medicine" with whatever intervention they choose. The FDA will still be there, overseeing clinical trials. Medical schools and licensing boards will still be there too. You can still get the same kind of officially trialed and licensed health care you want, at the high prices it comes with. But for anyone who wants something cheaper, the other unofficially trialed option is available too.
2. Open the market, part 2. Make drugs available at different phases of the clinical trial process, with prices commensurate with the level of testing. It takes a drug around 8 years to go through the trials. Consumers are absorbing 8 years of very expensive research at the end. If someone wants to try a drug, knowing that it has not yet been tested, early in the trial saga, he should be able to buy it and get it cheaper than if someone prefers to wait until the end of the 8 years. This also solves the orphan drug problems and experimental drug problems. Of course, it goes without saying the drugs should come with thoroughly informed consent of all the risks.
3. Reform medical education. European medical schools usually last around 6 years, and start right after high school. Shave 2 years off the college experience, and you save yourself a bunch of money. A few American school have a a similar program, like Brown U, but the model could be used more widely.
Oops. I've gotta run. Will stop for now.
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“Don't ask yourself what the world needs. Ask yourself what makes you come alive and then go do that. Because what the world needs is people who have come alive." --- Dr. Wayne Dyer
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