Nationalize Health Care

POSTED BY: SergeantX
UPDATED: Tuesday, March 17, 2009 03:29
VIEWED: 4165
PAGE 1 of 1

SERGEANTX

Friday, March 13, 2009 3:29 PM

Sometimes the best outcome you can hope for is a bad one. I'm not crazy about establishing health care as a government service but I think it would be better than anything likely to come out of a half-assed "partnership" between government and private business. The fantasy that we can regulate away the systemic imbalances in the health care industry will only make matters worse. Insurance companies won't be willing to offer the universal, no-questions-asked coverage that Obama is demanding without a promise from government to herd us all in their direction. Mandatory health insurance will, in essence, give insurance companies the power to tax us. I won't play. I've been in jail exactly once in my life and it was for driving without liability insurance. I don't want to end up there again for refusing to pay "duty" to health insurance companies.

Making health care a government provided service will present all kinds of ugly problems and be tremendously wasteful. It's likely to push us over the edge financially. But, the public demand is clear. "Something must be done". And whenever that phrase is being chanted it's a certainty that something really bad will be done. I say we minimize the damage and nationalize the whole lot. At least then we have some hope of controlling it as voters, rather that being forced to play along as mandated customers (slaves) of the fucking insurance companies.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

CHRISISALL

Friday, March 13, 2009 3:33 PM

Agreed.

The laughing Chrisisall

CITIZEN

Friday, March 13, 2009 4:32 PM

Quote:
Originally posted by SergeantX:
Making health care a government provided service will present all kinds of ugly problems and be tremendously wasteful.

Why do you say that. The world wide trend for national health services are that they are cheaper and outperform private-only care.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

CHRISISALL

Friday, March 13, 2009 4:40 PM

Yeah, but OURS won't.
Too many deep pockets out there. Still, it will be better than what we have now.

The laughing Chrisisall

STORYMARK

Friday, March 13, 2009 4:57 PM

Yeah, we've got plenty of people who want the plan to fail, want it to be a wastefull disaster, and will do whet they can to make sure it is one.

"I thoroughly disapprove of duels. If a man should challenge me, I would take him kindly and forgivingly by the hand and lead him to a quiet place and kill him."

SERGEANTX

Friday, March 13, 2009 5:02 PM

Quote:
Originally posted by Storymark:
Yeah, we've got plenty of people who want the plan to fail, want it to be a wastefull disaster, and will do whet they can to make sure it is one.

Which plan? I'm specifically speaking out against mandatory insurance. I think government provided health care would be better. Insurance is the problem, not the solution.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

WULFENSTAR

Friday, March 13, 2009 5:10 PM

FTS... yeah, Im dying of a gun shot so I have to go to the MVA..er...the state socialist helathcare facility...and I die waiting to be seen by whatever "doctor" the government hoists on the people...no thanks..no way.

CITIZEN

Friday, March 13, 2009 5:20 PM

Quote:
Originally posted by Wulfenstar:
FTS... yeah, Im dying of a gun shot so I have to go to the MVA..er...the state socialist helathcare facility...and I die waiting to be seen by whatever "doctor" the government hoists on the people...no thanks..no way.

As I said, Public healthcare systems out perform private ones, and they're cheaper, it's win win.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

CHRISISALL

Friday, March 13, 2009 5:26 PM

Quote:
Originally posted by SergeantX:
Insurance is the problem, not the solution.

I would outlaw insurance as a rule.

And CERTAINLY the mandatory kind.

The NOT MANDATORY Chrisisall

SERGEANTX

Friday, March 13, 2009 5:29 PM

Quote:
Originally posted by citizen:
Why do you say that. The world wide trend for national health services are that they are cheaper and outperform private-only care.

Because I'm comparing it to a sane environment where health care would be treated as any other market supplied service. But that's not what we have, and something we'll likely never allow.

Compared to what we do have, essentially a government supported medical cartel, state run health care likely would be cheaper and more efficient (which is why I'm supporting it), but that's not saying much.

That said, government run health care would still operate without the "healthy" restraints of market reality. It will be much easier to spend beyond our means when it's simply a matter of more deficit spending.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

KWICKO

Friday, March 13, 2009 5:34 PM

Quote:
Originally posted by Wulfenstar:
FTS... yeah, Im dying of a gun shot so I have to go to the MVA..er...the state socialist helathcare facility...and I die waiting to be seen by whatever "doctor" the government hoists on the people...no thanks..no way.

And you think this is different from the current system... HOW, exactly? Because if you're shot you can go to the emergency room and wait in line with all the uninsured who use the e-room as their primary caregiver, since if you show up, they have to treat you? Would you prefer to call your private doctor that you have because you have insurance, and then have his office tell you that the earliest they can fit you in will be two weeks from the end of never?

What we have currently is socialized medicine for the poor. If you show up at the emergency room, they're required to treat you, at least to stabilize you.

Would you prefer we ran a credit check first, and left the uninsured out on the curb to be picked up with the rest of the trash?

I know you have problems with national health care; what I don't see is any solutions. What we have doesn't work, period. I've got insurance, and I'm scared shitless to go to the doctor, because what the hell happens to me if they DO find something wrong? Even with insurance, I'm screwed. And even not going to the doc, my insurance goes up 20-30% at renewal time.

EDITED TO ADD:

Oh, about that "whatever doctor the government foists on you" - Tell me again how that's different from your typical HMO and its "network" of accepted doctors, where if you go "outside of network", you're on the hook for part, or all, of the bill that accrues.

Mike

I can't run no more
with that lawless crowd
while the killers in high places
say their prayers out loud.
But they've summoned, they've summoned up
a thundercloud
and they're going to hear from me.

- Anthem, by Leonard Cohen

CITIZEN

Friday, March 13, 2009 5:37 PM

Quote:
Originally posted by SergeantX:
Because I'm comparing it to a sane environment where health care would be treated as any other market supplied service. But that's not what we have, and something we'll likely never allow.

Not everything can function on a free-market paradigm. I can think of dozens of things that really don't work well that way, assuming that everything will automatically benefit from putting it on the free market, is bound to fail. In fact, the assumption that everything can work on a free market paradigm, including Health Care, would be one reason for Americas current system I think.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

STORYMARK

Friday, March 13, 2009 5:47 PM

Quote:
Originally posted by citizen:
Quote:
Originally posted by Wulfenstar:
FTS... yeah, Im dying of a gun shot so I have to go to the MVA..er...the state socialist helathcare facility...and I die waiting to be seen by whatever "doctor" the government hoists on the people...no thanks..no way.

As I said, Public healthcare systems out perform private ones, and they're cheaper, it's win win.

Why apply logic when one can bitch and moan?

"I thoroughly disapprove of duels. If a man should challenge me, I would take him kindly and forgivingly by the hand and lead him to a quiet place and kill him."

KWICKO

Friday, March 13, 2009 6:01 PM

Quote:

That said, government run health care would still operate without the "healthy" restraints of market reality. It will be much easier to spend beyond our means when it's simply a matter of more deficit spending.

I'm struggling to see where the "healthy restraints" of market reality have really helped in the current economy. Are you saying that the free market makes it impossible to wildly overspend and get itself into an enormous credit crisis comparable to a huge deficit?

It seems to me free markets are AT LEAST as capable of spending us all into a deep hole as governments are. Let's see... Estimates are that the current shitstorm of economic calamities have put the economy some $50 trillion in the red- wealth that has simply VANISHED. Yet we're sitting here bitching because our government wants to spend one fiftieth of that amount, and saying that that PROVES that big government doesn't work - because it's apparently an enormous waste to spend a trillion dollars, but an investment in free markets and a lesson in their greatness when we put fifty trillion on the bonfire and watch it burn.

Mike

I can't run no more
with that lawless crowd
while the killers in high places
say their prayers out loud.
But they've summoned, they've summoned up
a thundercloud
and they're going to hear from me.

- Anthem, by Leonard Cohen

SERGEANTX

Friday, March 13, 2009 6:45 PM

Quote:
Originally posted by citizen:
In fact, the assumption that everything can work on a free market paradigm, including Health Care, would be one reason for Americas current system I think.

Obviously, I disagree. I did a rather lengthy research project on the history of health care insurance and regulation in college (late eighties). Here's the progression I saw:

The current situation was created by two significant changes in the way health care was delivered.

First was the shift away from emergency disability insurance to insurance that covered everyday expenses. Excess health care costs for any one patient could be amortized over all insured patients. The problem with this was inherent in the beginning. Insurance companies could offer relatively cheap premiums as long as they could keep expanding the pool of insured patients. Essentially it was built on the same principles as a Ponzi scheme. It also had the same weaknesses built in.

The interesting bit is how this factored in with the creation of the AMA and it's movement to regulate health care. The regulation campaign began as a reaction to the waves of immigration in the late nineteenth and early twentieth century. That meant lots of immigrant doctors eager to undercut the prices of their American counterparts. Thus the AMA was born.

Their primary aims were to control the education and licensing of doctors through control over medical schools and state medical boards. They sought to control the maximum number of practicing doctors to limit competition and keep prices high. They didn't have much success at first, but as more and more people were signed up to the health insurance model, they found a more sympathetic audience. People with insurance weren't as concerned with the direct repercussions of inflated prices and were far more willing to support regulations that promised higher base level quality in health care - even though that entailed higher base level prices as well.

This worked great as long as the pool of new insurance customers was expanding faster than prices were inflating. Insurance companies were able to keep premiums relatively low, even though costs were rising. As more and more people became insured, more and more regulations were passed, further limiting avenues for inexpensive health care options (and further raising medical costs).

But, like any Ponzi-based enterprise, the system eventually reached a point of diminishing returns. We're in the midst of that transition. How do we reverse the damage? From my point of view, it's fairly obvious - we deregulate and outlaw insurance schemes that insulate consumers from real costs, for the same reasons we outlaw Ponzi schemes.

The thing is, I realize this is currently beyond the national political imagination, so I'm saying, nationalize it. Anything to break the current cycle will help.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

SERGEANTX

Friday, March 13, 2009 6:58 PM

Quote:
Originally posted by Kwicko:
I'm struggling to see where the "healthy restraints" of market reality have really helped in the current economy.

They haven't helped because they aren't part of the mix. Haven't been for some time. See my previous post.

Quote:
Are you saying that the free market makes it impossible to wildly overspend and get itself into an enormous credit crisis comparable to a huge deficit?

It makes it much less likely.

Quote:
Let's see... Estimates are that the current shitstorm of economic calamities have put the economy some $50 trillion in the red- wealth that has simply VANISHED.

The wealth hasn't vanished. The houses people bought are all still there. All the goods and services are intact (if currently in something of a stasis). All that's happened is our estimation of how wealthy we really were has come back down to reality. We've been deluding ourselves nationally for the last few decades and, despite the best efforts of our government to protect us from reality (through monetary policy and manipulation), the market has insisted on being honest.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

CITIZEN

Friday, March 13, 2009 7:02 PM

Quote:
Originally posted by SergeantX:
The interesting bit is how this factored in with the creation of the AMA and it's movement to regulate health care. The regulation campaign began as a reaction to the waves of immigration in the late nineteenth and early twentieth century. That meant lots of immigrant doctors eager to undercut the prices of their American counterparts. Thus the AMA was born.

So it's a natural consequence of Free market bastardised through normal American protectionism. I'm not seeing how that proves that the Free Market can produce 'less wasteful' healthcare, even if (and I mean IF because I'm fairly certain healthcare was a rich mans luxury in the 19th century) healthcare worked in the 19th century on the free market, that doesn't mean it will now. Cutting edge in the 19th century, if you'll pardon the pun, was amputation. It was taking a belt of whisky before the surgeon saws your leg off. Now cutting edge are MRI scanners, laser surgery, these treatments are inherently more expensive than a saw and bucket. They're cost may be exaggerated as part of some insurance 'ponsi scheme', but even if it weren't many modern healthcare treatments would be simply out of the price range of most patients, even if they were sold at break even prices. Free Market principles won't make something cost less than their cost of supply.

That's fine for a car, if you can't afford a Porsche you can get a Honda, but if you can't afford an MRI? Putting healthcare over to the free market wouldn't make it that much less expensive, and it wouldn't make it less wasteful, it would make it less available.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

SIGNYM

Friday, March 13, 2009 7:04 PM

If you're really interested, try going here...

http://democrats.com/single-payer-petition

---------------------------------
It's the end of the world as we know it, and I feel fine.

SERGEANTX

Friday, March 13, 2009 7:13 PM

Quote:
Originally posted by citizen:
So it's a natural consequence of Free market bastardised through normal American protectionism.

It's consequence of the protectionism, which is the opposite of a free market.

Quote:
Free Market principles won't make something cost less than their cost of supply.

Prices depend on the buyers willingness to pay. Insured patients don't care and will gladly 'pay' anything as long as they're covered.

Quote:
That's fine for a car, if you can't afford a Porsche you can get a Honda, but if you can't afford an MRI?

Then you get an X-ray. Which would be better than nothing. Currently the options are Porsche or nothing.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

SERGEANTX

Friday, March 13, 2009 7:15 PM

Quote:
Originally posted by SignyM:
If you're really interested, try going here...

http://democrats.com/single-payer-petition

---------------------------------
It's the end of the world as we know it, and I feel fine.

Thanks Signym. I held my nose and signed. Also included a note explaining how I thought it was the second-most-shitty option.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

SIGNYM

Friday, March 13, 2009 8:38 PM

Me too.

Feel free to pass it on.

---------------------------------
It's the end of the world as we know it, and I feel fine.

KWICKO

Friday, March 13, 2009 9:11 PM

Ditto.

CITIZEN

Saturday, March 14, 2009 12:14 AM

Quote:
Originally posted by SergeantX:
Prices depend on the buyers willingness to pay. Insured patients don't care and will gladly 'pay' anything as long as they're covered.

No, it's not that simple. Do you really think any service provider will provide their service at a cost because customers can't pay the break-even or profit price? Get real. No free market can make things cost less to the consumer than they cost to manufacture or provide. Assuming that a free market will magically put any treatment in the price range of whatever you're willing to pay is a pipe dream. The price won't drop below what it costs to produce, end price is much more than just "what people will pay".

Quote:
Originally posted by SergeantX:
Then you get an X-ray. Which would be better than nothing. Currently the options are Porsche or nothing.

Except that's the option of Porsche or a three course meal at Lafeate, second table to the back. X-Rays and MRI machines are for completely different things.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

SERGEANTX

Saturday, March 14, 2009 1:33 AM

Quote:
Originally posted by citizen:
No, it's not that simple. Do you really think any service provider will provide their service at a cost because customers can't pay the break-even or profit price? Get real.

If no one can afford a service, or no one is willing to pay the price asked, the seller of the service has two options. He can figure out a way to lower costs, or write that service off as too costly. THAT's reality. And its the reality that's masked by the current insurance schemes. It would also be masked by providing health care as a government service.

Quote:
Assuming that a free market will magically put any treatment in the price range of whatever you're willing to pay is a pipe dream.

Assuming that you can make high costs go away with legislation and mandates is the pipedream. What free markets are good at is discerning what's realistic from what isn't. If no one can afford a treatment, then it's not cost effective and should be dropped, or retooled so it's more affordable. This is related to what I was getting at in a previous post. We think we can raise the quality of health care for everyone just by passing regulations. But that also raises costs. People with insurance don't care, but it leaves the rest of us in a lurch.

Quote:
Quote:
Originally posted by SergeantX:
Then you get an X-ray. Which would be better than nothing. Currently the options are Porsche or nothing.

Except that's the option of Porsche or a three course meal at Lafeate, second table to the back. X-Rays and MRI machines are for completely different things.

I assumed you understood I was speaking figuratively. The point is, the current situation is a choice between expensive health care, or none at all. In a more sane environment, there would be some middle ground. What we've done is essentially outlawed low-cost (and, yes, lower quality) health care.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

CITIZEN

Saturday, March 14, 2009 2:03 AM

Quote:
Originally posted by SergeantX:
If no one can afford a service, or no one is willing to pay the price asked, the seller of the service has two options. He can figure out a way to lower costs, or write that service off as too costly. THAT's reality. And its the reality that's masked by the current insurance schemes. It would also be masked by providing health care as a government service.

No, the reality is that the cost to the end consumer can't go below the cost of providing it. The reality is that all you'd have is fewer people getting medical care, not that you'd have everything suddenly becoming cheap enough for everyone to buy, for the same reason that not everyone drives Porsches.

Quote:
Assuming that you can make high costs go away with legislation and mandates is the pipedream.

Yep, just as much as assuming the same for the free market. As soon as someone says that high costs go away because of legislation, I'll be sure to call them on it. Since no one has done that, I haven't felt the need.

Quote:
What free markets are good at is discerning what's realistic from what isn't.

Not in all circumstances. Some things just aren't cut out for a free market paradigm.

Quote:
This is related to what I was getting at in a previous post. We think we can raise the quality of health care for everyone just by passing regulations.

a) No one is saying regulations magically make health care better.
b) Regulations do prevent bad and negligent care. Its all well and good saying "spread the word and go to a different supplier" but it's a bit late if you're dead already.
c) Saying removing regulation will allow people to get good care cheaper, is a pipe dream. Regulation doesn't cause people to over charge, but it's absence does allow them to harm people and get away with it.

Quote:

I assumed you understood I was speaking figuratively. The point is, the current situation is a choice between expensive health care, or none at all. In a more sane environment, there would be some middle ground. What we've done is essentially outlawed low-cost (and, yes, lower quality) health care.

I assumed you'd get what I was talking about. Sometimes there isn't a viable low cost alternative. In fact with most serious ailments this is true.

You're trying to portray it as someone outlawing McDonalds and forcing everyone to go to the Ritz, but that's a fallacy. Medical procedures aren't outlawed because they cost less and won't make someone enough money, they're outlawed because they have no medical benefit and kill people. Most sane national health systems have a perfectly workable middle ground, balancing cost and effect. It's a trade between the cost of the procedure and it's relative benefit, it's a medical decision, as much as a financial one.

You propose that a free market health care system would result in less waste. I propose that, due to the unique constraints and driving factors of health care, it would actually result in more waste. In a national health care system the decisions of viable treatments would be in the hands of experts making those decisions on scientific grounds, balancing effect and finance. In a free market system those decisions would be in the hands of a patient desperate for any slim chance of hope, no matter how objectively minor and overly costly it is.

In a free market system a rich man may throw away millions on treatments that are completely useless, just on the slim chance of one working. While a poor man may die for want of a simple procedure that's out of their price range. Seems pretty bloody wasteful to me.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

RUE

Saturday, March 14, 2009 2:14 AM

"What free markets are good at is discerning what's realistic from what isn't. If no one can afford a treatment, then it's not cost effective and should be dropped, or retooled so it's more affordable."

What the so-called 'free market' does is maximize profit, not provide a good or service.

And it's not a case of 'no one' being able to afford a service. You just have to service the right people.

The way to do that, if you're a doctor, is to cater to rich people. That's why you see lots of plastic surgeons in Beverly Hills providing very complicated expensive services; and very few doctors over by Ganado on the reservation - no matter how basic and inexpensive the service they provide.

***************************************************************

Silence is consent.

KWICKO

Saturday, March 14, 2009 3:55 AM

Quote:

If no one can afford a service, or no one is willing to pay the price asked, the seller of the service has two options. He can figure out a way to lower costs, or write that service off as too costly. THAT's reality. And its the reality that's masked by the current insurance schemes. It would also be masked by providing health care as a government service.

Of course, part of the problem with finding a "market price" for such things as MRIs is that there tend to be an awful lot of market prices for the procedure, depending on WHO is paying for it. If Medicare of Medicaid are paying, market price might be 90% of what they'd charge an individual without insurance. And an insured individual might get charged double that amount - but the insurance company might have an agreement to pay 40% of the amount - and the amounts charged and paid change from one hospital to another, and from one insurer to another, and from one procedure to another, depending on circumstances.

There was a guy on NPR earlier this week detailing this stuff. He's a professor at Princeton, if memory serves, and deals with this stuff for a living, and he was damned if HE could figure out the arcana of how and why these things are the way they are.

Mike

I can't run no more
with that lawless crowd
while the killers in high places
say their prayers out loud.
But they've summoned, they've summoned up
a thundercloud
and they're going to hear from me.

- Anthem, by Leonard Cohen

RUE

Saturday, March 14, 2009 3:59 AM

BTW - I'm really a fan of expert systems - they'll out-do a doctor any day. If we could get national health care using expert systems, I'd want to be first in line.

***************************************************************

Silence is consent.

SERGEANTX

Saturday, March 14, 2009 4:13 AM

Quote:
Originally posted by citizen:
No, the reality is that the cost to the end consumer can't go below the cost of providing it. The reality is that all you'd have is fewer people getting medical care, not that you'd have everything suddenly becoming cheap enough for everyone to buy, for the same reason that not everyone drives Porsches.

Well, there are other types of cars, just as there are varying costs and quality levels of health care. Car dealers can't sell just high-end sports cars because not everyone can afford them. It's the same with health care.

I've made that point three or four times now. I can't tell if your really trying to deny that it's the case, or just ignoring it. If you're ignoring it, then we should probably end the conversation. Otherwise, how can you pretend that any given health care service comes in one variety?

Quote:
Not in all circumstances. Some things just aren't cut out for a free market paradigm.

Sure, but health care isn't one them. We've been sold a bill of goods that it is, and it's exactly the reason things are so fucked up.

Quote:
Regulation doesn't cause people to over charge

sigh.... you know that's not what I said. Try to at least argue against my actual points. Regulation establishes a minimum level of quality that may be too expensive for some people.

Quote:
Medical procedures aren't outlawed because they cost less and won't make someone enough money, they're outlawed because they have no medical benefit and kill people.

If medical regulation were limited to such cases, I'd not be complaining. But that's not the way it works. It's far more political than that and involves deliberate turf protection on the part of several vested interests. The AMA uses regulation and its control of medical schools to artificially limit the supply of doctors. Big Pharma actively campaigns against low cost alternatives with no evidence of risk.

Quote:
In a free market system a rich man may throw away millions on treatments that are completely useless, just on the slim chance of one working. While a poor man may die for want of a simple procedure that's out of their price range.

And this comes down to the crux of our disagreements in general, doesn't it? What you find appalling about a free market is that it allows some people more perks and privileges "merely" because they have more money.

The thing is, that kind of inequality happens in any case, regardless of the economic system. The difference is, in systems where such differences aren't determined by income, they're sorted out in other, less explicit, ways. Your ability to get special favors is dependent on social status, political connection, or your ability to navigate the bureaucracy.

Maybe you'd like that better, but I find money to be a far more honest representation of someone's value to society than their ability to play politics. Most people make money because they provide a service that other people want or need. Those that don't are leeches and criminals and would do their thing regardless of economic system. But a free economy allows people to earn extra comforts and perks honestly and openly. I don't see that as a bad thing.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

FREMDFIRMA

Saturday, March 14, 2009 7:56 AM

Quote:
Originally posted by rue:
BTW - I'm really a fan of expert systems - they'll out-do a doctor any day. If we could get national health care using expert systems, I'd want to be first in line.

With me that'd depend on who programmed it, GIGO, remember ?

But yeah, they consistently outperform human docs, I'll give em that, but they just don't have the human touch - tho from what I understand some of them can fake it now!
(Like asking about known pets, or previous ailments and suchlike)

I'd say better to have human docs, who got large educational subsidies so they don't have to rake you over the coals to pay their friggin loans, backed up by an expert system.

As I said earlier in another thread, this idea completely freakin sucks, but the only thing that could possibly suck worse is NOT doin it.

I'm with Sarge, at our current level of *realistic* options, it's time to hold our nose and take the plunge.

-Frem

It cannot be said enough, those who do not learn from history, are doomed to endlessly repeat it

CITIZEN

Saturday, March 14, 2009 11:53 AM

Quote:
Originally posted by SergeantX:
I've made that point three or four times now. I can't tell if your really trying to deny that it's the case, or just ignoring it. If you're ignoring it, then we should probably end the conversation. Otherwise, how can you pretend that any given health care service comes in one variety?

Actually, Sarge, I've made the point three or four times that that isn't the case. Maybe you're ignoring it, since that's where you went? How do you justify that there's a cheaper option to many types of endemic care? There's plenty of diseases that weren't treated until the modern incredibly expensive and complex procedures came along. So, your alternative treatment to open heart bypass surgery would be? Faith healing perhaps?

Quote:
Sure, but health care isn't one them. We've been sold a bill of goods that it is, and it's exactly the reason things are so fucked up.

You keep saying that, but I look around and where ever you have healthcare on the free market (and it did and does happen, if you care too look) you get healthcare being a luxury of the rich, and normal, not even poor but everyday people, only getting healthcare through charity. So much for the free market providing cheap care to all.

And as far as I see your argument for free market healthcare is stemming from an assumption that it'll work. I can see plenty of examples for it work the way I say it does, from modern Africa to turn of the century Britain, have you got any for it working the way you say it does?

Quote:
sigh.... you know that's not what I said. Try to at least argue against my actual points. Regulation establishes a minimum level of quality that may be too expensive for some people.

Actually, I'm not entirely sure of the basis for a lot of what you're saying. For someone who makes a big thing about ignoring points and honest debate, you're spending an awful lot of time telling me what I'm doing or saying and ignoring points I've made. One of which, I might add directly deals with you're underlined portion, I'll repeat myself for you:

You're misrepresenting the role of regulation. You're trying to portray it as stopping viable treatments that work, because they don't cost enough, or because they're not as effective as other more expensive ones. That is nonsense. Complete sash. Fallacy. Regulation stops treatments that DON'T work, not ones that "aren't as effective". Regulation stops practices that have no medical benefit, but will only cause harm injury or death. There's plenty of treatments offered through national healthcare of varying effectiveness, and the choice of which one to use in a given circumstance is made by the people most qualified to do so, I.E. doctors. Handing that decision off to medical lay person will pretty much guarantee you'll end up with waste, as a patient desperate for treatment buys the most expensive treatment that gives little more effective and dies anyway, while another who could be effectively treated dies because they could only afford the basic tier, a shaman hangs a dream catcher above their head or something.

And no sarge, before you try to say it, people can't be experts in their own health and medicine, medicine is an incredibly complex subject that people have to study full time for years to get any proficiency at. The sum of Human knowledge in medicine is so vast even experts have to specialise.

Quote:

If medical regulation were limited to such cases, I'd not be complaining. But that's not the way it works. It's far more political than that and involves deliberate turf protection on the part of several vested interests. The AMA uses regulation and its control of medical schools to artificially limit the supply of doctors. Big Pharma actively campaigns against low cost alternatives with no evidence of risk.

It doesn't work that way in any national healthcare system I've ever come across. Just because the Quasi-Free Market Protectionist Corporatist American system works that way, doesn't mean regulation

AURAPTOR

Saturday, March 14, 2009 12:11 PM

No thanks.

It is not those who use the term "Islamo-Fascism" who are sullying the name of Islam; it is the Islamo-Fascists. - Dennis Prager

A concern of the GOP is that the people aren't informed enough to understand their policies, while a fear of the Dems is that the people ARE.

SERGEANTX

Saturday, March 14, 2009 3:29 PM

Quote:
Originally posted by citizen:
You're misrepresenting the role of regulation. You're trying to portray it as stopping viable treatments that work, because they don't cost enough, or because they're not as effective as other more expensive ones. That is nonsense. Complete sash. Fallacy. Regulation stops treatments that DON'T work, not ones that "aren't as effective".

Regulation limits less expensive alternatives and makes the overall costs of doing business higher. You claim it only limits specific treatments that are dangerous and ineffective but that's simply not true. There are plenty of doctors who could be providing at least some health care to patients who are legally prohibited from doing so. You might claim that's for a good reason, but I'm saying that ought to be up to the patient to decide - specifically the patient who can't afford the higher cost services that others have established as the baseline.

Quote:
And no sarge, before you try to say it, people can't be experts in their own health and medicine, medicine is an incredibly complex subject that people have to study full time for years to get any proficiency at. The sum of Human knowledge in medicine is so vast even experts have to specialise.

Whether they are experts isn't the issue. It's whether they have the right to decide for themselves.

Quote:
Quote:

If medical regulation were limited to such cases, I'd not be complaining. But that's not the way it works. It's far more political than that and involves deliberate turf protection on the part of several vested interests. The AMA uses regulation and its control of medical schools to artificially limit the supply of doctors. Big Pharma actively campaigns against low cost alternatives with no evidence of risk.

It doesn't work that way in any national healthcare system I've ever come across. Just because the Quasi-Free Market Protectionist Corporatist American system works that way, doesn't mean the only viable alternative is Laissez Faire Free Market, that would be a false dichotomy.

It would be. But I'm not saying that. In fact, I'm saying the opposite. Nationalizing health care will likely work better than what we have now, but it's far from ideal. Laissez faire wouldn't be "ideal" either, but it would be the best in terms of respecting individual sovereignty and freedom.

Quote:
I find it funny that when I point out one of the ways that, the free market paradigm as applied too healthcare, will produce more waste than a public one, kinda rubbishing your assertion (that you've still not backed up, btw) that the Free Market will automatically produce less waste, you've gotten personal.

I don't recall "getting personal" about it, but I've not addressed it because it's moot. Waste in the free market is an individual decision. If a millionaire spends gobs of money on useless treatment, it's not my concern. My concern is with wasting taxpayer money which is not an individual decision.

Quote:
Very emotive, full of the vim and verve I've come to expect of your arguments.

Why thanks!

Quote:
I don't want human worth to be balanced solely on their earnings. No I don't consider a CEO's life to be worth more than a cleaners. No I don't consider a Nurses contribution to society to be less worthy than Brad Pitts, even if his is better compensated. In fact in that last one, at least I'd say the worth to society is quite the opposite.

Society feels differently. I tend to agree with you (not a big Brad Pitt fan), but capitalism is more democratic then that and lets people express their values through their spending choices. We may not agree with those choices, but how do we justify overriding them?

Quote:
You try to dismiss the poor as criminals, presumably to make the thought of letting them die and denying them sufficient medical care more palatable, but in reality successful criminals can actually be quite well off. I'm not talking about the Junkie that steals car radios to fund they

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CANTTAKESKY

Saturday, March 14, 2009 3:49 PM

Thanks Sarge for the thread. And for your very clear analysis of what went wrong and how to fix it. I have to say, your arguments have me convinced.

My husband works at the only national laboratory owned and operated completely by the Dept of Energy. As such, he has gathered some insights about the overwhelming waste involved in research grants to private entities, as well as to private contractors. The short end of it is, if something is government-funded, it is better off being government-owned and government-operated, than some sort of perverse chimera of government-private partnership. Those types of efforts almost always ends up with private parties taking tax payer money and giving almost nothing back in return.

If we´re going to have government managing healthcare, then it needs to be entirely government owned and government operated. Cut the insurance companies out of it.

I´m going to hold my nose and jump as well.

--------------------------
Dr. Horrible Karaoke

CANTTAKESKY

Saturday, March 14, 2009 4:00 PM

Quote:
Originally posted by citizen:
Regulation stops practices that have no medical benefit, but will only cause harm injury or death.

`

This is patently untrue, Cit. How do you explain different regulations in different countries? How can the same practice be safe and have medical benefit in one country, but not another?

Take midwifery, for example. Midwifery, as I understand it, is permitted and even paid for by National Health in Britain. But it is outlawed in certain states in the USA. So, is midwifery a practice that has no medical benefit? Or are the regulations in the USA more controlling than it needs to be about a safe, beneficial, and low-cost option for the right group of women?

--------------------------
Dr. Horrible Karaoke

AGENTROUKA

Saturday, March 14, 2009 4:43 PM

Quote:
Originally posted by canttakesky:
Quote:
Originally posted by citizen:
Regulation stops practices that have no medical benefit, but will only cause harm injury or death.

Take midwifery, for example. Midwifery, as I understand it, is permitted and even paid for by National Health in Britain. But it is outlawed in certain states in the USA.

Just for clarification.. all midwifery? Or just certain levels of accreditation?

CITIZEN

Saturday, March 14, 2009 4:49 PM

Quote:
Originally posted by canttakesky:
This is patently untrue, Cit. How do you explain different regulations in different countries? How can the same practice be safe and have medical benefit in one country, but not another?

Really very easily. Some places don't use regulations properly, some come to slightly different decisions about them to others. Saying not everyone has the same regulations proves that they're not used to stop dangerous care is an argument so laughable, I'm not sure why I'm bothering to contend it.

Different countries have different languages, so that must make the statement "language is for communication" patently untrue, right?

I mean if language were for communication, everyone would come to the same conclusion, right? I mean how could French be used for communication in one country, but not another, huh? That's the crux of your argument, that regulation can't be about what I say, because not everyone comes to the same and final conclusion.

Quote:
Originally posted by canttakesky:
Take midwifery, for example. Midwifery, as I understand it, is permitted and even paid for by National Health in Britain. But it is outlawed in certain states in the USA. So, is midwifery a practice that has no medical benefit? Or are the regulations in the USA more controlling than it needs to be about a safe, beneficial, and low-cost option for the right group of women?

Given that the US doesn't have a national health service, so regulation is used to support government backed cartels, I fail to see how you can think your example proves anything. We're past agreeing that the US system is bad, but saying regulations are used to enforce cartels as a matter of fact, is an argument akin to saying all guns are used to murder people (or that is their purpose) because guns have been used that way.

EDITED: For clarity

CITIZEN

Saturday, March 14, 2009 5:22 PM

Quote:
Originally posted by SergeantX:
Regulation limits less expensive alternatives and makes the overall costs of doing business higher. You claim it only limits specific treatments that are dangerous and ineffective but that's simply not true.

It is true. Just because your corporatist system abuses regulations, isn't an argument against regulation, it's an argument against your corporatist system. You're proposing to throw the baby out with the bath water.

You want to go from one extreme to the other. I'm saying extremes are just bad in general.

Quote:
Whether they are experts isn't the issue. It's whether they have the right to decide for themselves.

All sounds cute and fluffy, the way you're sort of trying to portray yourself as the champion of freedom, but you're talking about Economic freedom and I'm talking about Social Equality and Social Freedom. There's more to freedom than where you spend your money, and one doesn't flow from the other.

Healthcare is unique. People are not equipped to make good decisions about their care in many if not most circumstances. That's why we have Doctors and Nurses. What's next? Passengers on an Airline should decide how to fly the plane and what course to take? Seems to make more sense to leave those decisions up the professional pilot, rather than Joe the plumber. Same with medical decisions being left to Doctors and Nurses.

If it's down to choosing your doctor, that's different. But it's still not putting the medical decisions in the hand of the patient, it's letting the patient decide which doctor to go to.

Now, before you tell me that's not possible under a national health system, let me tell you it is. I CHOSE my doctor and surgery.

Quote:
Laissez faire wouldn't be "ideal" either, but it would be the best in terms of respecting individual sovereignty and freedom.

And I think in the unique circumstance of healthcare, a free market paradigm would not only not be respectful of individual sovereignty and freedom (except in a fuzzy idealogical sense, but I'm more interested in reality, that is the practical sense), but would produce a not appreciably cheaper, and certainly less available service, that is also wasteful in terms of cost to patient recovery.

Quote:
I don't recall "getting personal" about it, but I've not addressed it because it's moot.

You started making comments about what I think, and why I think it. They were strawman and ad hominems. Ad Hominem is merely argument against the man, you ignored the point I was making and instead started saying "that you always say this" and "you always say that" and telling me why I say those things. There's really no clearer cut example of an Ad Hominem. I merely point out that people resort to those tactics, usual when they find themselves unable to support their argument.

Quote:
Waste in the free market is an individual decision. If a millionaire spends gobs of money on useless treatment, it's not my concern. My concern is with wasting taxpayer money which is not an individual decision.

Since national health services give a better and cheaper service...

Quote:
Society feels differently. I tend to agree with you (not a big Brad Pitt fan), but capitalism is more democratic then that and lets people express their values through their spending choices. We may not agree with those choices, but how do we justify overriding them?

I think a statement that capitalism is democratic is just plain silly. Brad Pitt gets paid more because people are willing to pay a certain price for a movie, and that movie can be copied and disseminated widly for little to no extra effort. Nursing can't be done like that. How much someone is paid tends to have very little to do with their "worth" or any sort of objective stand point about how much they mean to society. I find it funny that someone who's bitched about democracy when it doesn't elect Ron Paul is now talking about how noble it is. Majority rules right? Well I know how passiona

SERGEANTX

Saturday, March 14, 2009 6:22 PM

Quote:
Originally posted by citizen:
I think a statement that capitalism is democratic is just plain silly.

I guess it depends on what you mean by "democratic". In terms of allowing people to freely and accurately express their values it is. It's also more granular in its expression of those values, particularly in contrast to "majority rules", which results in one-size-fits-all decisions that often trample the values of the minority.

Quote:
Which is why I changed it after re-reading.

Thank you.

Quote:
That's the problem with saying that one's wage determines ones worth, the only way you can support the argument is by ignoring that it doesn't.

heh.... mm'kay.

Quote:
Society hasn't made any sort of decision about how much people should earn. It's arrived at where it is through market and economic forces.

And what are market forces, if not people making decisions about what they value and how much?

Quote:
How much someone is paid tends to have very little to do with their "worth" or any sort of objective stand point about how much they mean to society.

But there isn't such a thing as objective "value" or "worth". Such concepts are always relative and dependent on the person doing the evaluating. How much a person, service or product is valued by society is nothing more than a summation of all the relative judgments of the members of that society. Which is why money is very much a reflection of "worth" in terms of society. It's only one kind of valuation, granted, but I see a bit of hubris in the idea that society is wrong and should be overruled by those who know about "true value".

Quote:
I made no concious or subconcious decisions about how much the actors in the film were worth to society, and I'm willing to bet no one else does either. I paid what I thought the film was worth to entertain me for a certain length of time, the "worth" of the actors didn't even enter my mind.

But you made a decision about how much they, or rather the product they helped produce, were worth to you. How much they are worth to society is just the summation of everyone making those kinds of value choices.

Quote:
It will lead to more waste. You're trying to wriggle out of that, but it will, and it was you're assertion that it won't, an assertion you've yet to support.

Wriggling? Nope, no wriggling here. I said nationalized health care would lead to tremendous waste and be onerous to the government financially. That's all. Now, that's a guess, based on the other programs our government operates - and I think it's a reasonable one. I specifically didn't say it would be more or less wasteful that private care. I don't even bother comparing it private care because the two types of waste of an entirely different nature. One is waste paid for my private interests voluntarily, the other is waste of taxpayer money by government.

Quote:
I wish to see any working libertarian ideal that says the mob should be able to decide a persons "worth" or right to health, no matter how directly or indirectly.

We're not talking about mob rule, see my earlier comments.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

SERGEANTX

Saturday, March 14, 2009 6:27 PM

DP

CITIZEN

Saturday, March 14, 2009 6:52 PM

Quote:
Originally posted by SergeantX:
I guess it depends on what you mean by "democratic". In terms of allowing people to freely and accurately express their values it is. It's also more granular in its expression of those values, particularly in contrast to "majority rules", which results in one-size-fits-all decisions that often trample the values of the minority.

Except this one size fits all thing is exactly what you're aiming at. You're making the assumption that the best method to judge societal worth is money. That's a one size fit's all judgement, surely? What about volunteer workers? What about those who make a contribution, that's recognised by society, but for reasons outside of "worth" such as logistics, aren't paid what society would deem they're "worth". I'm saying that:
A) It's not, and
B) The last factor we should be including in medical decisions is an individuals "worth" to society.

You seem to be confusing what I'm saying, so I'm going to drop any talk about whether or not money is a good way of deciding the worth society has for a person, because it's really irrelevant. People should not be denied medical treatment because society has deemed that they're not worth it, no matter what mechanism is used for determining worth.

Lastly, what right does society have, even if it's in a round about way, to decide who is more worthy of treatment. I'm saying medical treatment should be a medical decision, not a societal "worth" one.

Quote:
And what are market forces, if not people making decisions about what they value and how much?

There's much more to market forces than that. Regardless, I think that using market forces to justify withholding life saving medical help to an individual is really rather, well, sorta fascist (and I mean fascist in the statist political ideology sense, not the insult, and I'm not calling you fascist). Too me the consequence is that you're really putting the good of society over the good of that individual, and I see no reason why that decision is bad if a government is doing it, but ok if it's an aggregate impersonal decision. It's wrong no matter how you're coming to the decision.

Quote:
But you made a decision about how much they, or rather the product they helped produce, were worth to you. How much they are worth to society is just the summation of everyone making those kinds of value choices.

But we made no judgement about their worth to society, so I don't see how those decisions can be used to make any statement of how valuable someone is to society.

Quote:
Wriggling? Nope, no wriggling here. I said nationalized health care would lead to tremendous waste and be onerous to the government financially. That's all. Now, that's a guess, based on the other programs our government operates - and I think it's a reasonable one. I specifically didn't say it would be more or less wasteful that private care. I don't even bother comparing it private care because the two types of waste of an entirely different nature. One is waste paid for my private interests voluntarily, the other is waste of taxpayer money by government.

Oh come on. You said that the free market system would be less wasteful. I'm saying it's more. I'm saying that healthcare, uniquely, would cost more per-successful treatment.

Quote:
We're not talking about mob rule, see my earlier comments

I'm sorry, but it still rather sounds like we are. "Society" getting to decide, even via aggregate means, how much an individual is worth, and how hard we should try to save their life, does rather smell of mob rule to me.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

SERGEANTX

Saturday, March 14, 2009 7:30 PM

Quote:
Originally posted by citizen:
Except this one size fits all thing is exactly what you're aiming at. You're making the assumption that the best method to judge societal worth is money.

My point was just that money is a reflection of how much people value that person or the services they provide. That seems pretty obvious to me. If you don't believe that that should determine the amount of health care they have access to, well, that's a different argument.

But if that is your opinion, how do we decide differentials in health care? Would everyone have exactly the same options? Would that be enforced? As a hypothetical, would you insist that doctors expend exactly the same effort to save a ne'er do well, three-time, drunk driver injured in a head-on collision, as they do to save the brain surgeon driving the car he hit?

I'm uncomfortable putting those kinds of decisions in the hands of centralized authority. How much money a person has, or how much their friends have, or how much people can be convinced to donate voluntarily on their behalf seems to me a more reasonable mechanism for making such calls.

Quote:
But we made no judgement about their worth to society, so I don't see how those decisions can be used to make any statement of how valuable someone is to society.

You seem to see "value to society" as something different than an aggregate of the value to members of the society. If so, what does this mean, and how is it determined?

Quote:
Quote:
I specifically didn't say it would be more or less wasteful that private care. I don't even bother comparing it private care because the two types of waste of an entirely different nature. One is waste paid for my private interests voluntarily, the other is waste of taxpayer money by government.

Oh come on. You said that the free market system would be less wasteful. I'm saying it's more.

Hmmm I don't know how else to put it. I really don't recall saying this and if I did I apologize because I know it not to be true. There's gobs of waste in private health care, laissez faire or not. But it's waste of a different sort and doesn't concern me. If someone in the private realm wants to waste money on pointless health care, it's none of my business. If my elected representative wants to waste tax money, it is.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

CITIZEN

Saturday, March 14, 2009 8:33 PM

Quote:
Originally posted by SergeantX:
My point was just that money is a reflection of how much people value that person or the services they provide. That seems pretty obvious to me. If you don't believe that that should determine the amount of health care they have access to, well, that's a different argument.

My argument more or less all the way through is that worth shouldn't be a factor in care. But I also indicated that I don't think money is really a great expression of the worth of an individual, I really don't think that those are the sorts of decisions people make when deciding how much they're willing to spend on something. Even so, should someone's monetary contribution determine their worth as an individual?

Quote:
But if that is your opinion, how do we decide differentials in health care? Would everyone have exactly the same options? Would that be enforced?

WE don't, Doctors do, and they do it on medical grounds.

Quote:
As a hypothetical, would you insist that doctors expend exactly the same effort to save a ne'er do well, three-time, drunk driver injured in a head-on collision, as they do to save the brain surgeon driving the car he hit?

Unquestioningly. Not only do I support that, but that's a basic tenant of medical ethics.

Court rooms are where we punish the guilty, the emergency room is where we treat sick people.

Take a more benign circumstance, who should get the heart transplant, the 12 year old son of a poor farmer, who will likely live at least another 60 years with it, or the 60 year old billionaire who'll be lucky to see another 12. The medical choice would be the 12 year old, the economic choice would be the billionaire.

Quote:
You seem to see "value to society" as something different than an aggregate of the value to members of the society. If so, what does this mean, and how is it determined?

I think there's value to society far outside of money. I don't believe money is an accurate assessment of a persons worth, I find the idea of a rich person being 'worth' more than a poor person as quite distasteful. My idea of worth to society is quite unquantifiable, and certainly can't be quantified with a monetary value. That's one reason that I don't want "worth to society" as an sort of judgement on level of health care. We can't hope to ever accurately judge a persons worth. Worth in that circumstance would be the harm to society and the human condition and their peers done by that person being removed from society, and that's something we can never know, even after it happens.

Quote:
Hmmm I don't know how else to put it. I really don't recall saying this and if I did I apologize because I know it not to be true.

Ok, I was sure you were driving at that at some point, but perhaps not.

Quote:
If someone in the private realm wants to waste money on pointless health care, it's none of my business. If my elected representative wants to waste tax money, it is.

Personally, in this particular instance, which why I say it's unique, I think waste is waste. Wasting resources on one patient with no real medical need, would impact another.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

KWICKO

Saturday, March 14, 2009 9:22 PM

Quote:
Citizen wrote:

In a free market system those decisions would be in the hands of a patient desperate for any slim chance of hope, no matter how objectively minor and overly costly it is.

Actually, Citizen, it's even worse than you've alluded to. In a free-market system, those decisions aren't even left to the patient, but are more often than not left to the shareholders of the company, whose interests tend (more and more, every day, it seems) to lie in the direction of short-term monetary gain over long-term health benefits.

In other words, life and death decisions, and whether or not they're covered by insurance or not, tend to be weighted as much by whether they have a good chance at paying off for the stockholders.

Mike

I can't run no more
with that lawless crowd
while the killers in high places
say their prayers out loud.
But they've summoned, they've summoned up
a thundercloud
and they're going to hear from me.

- Anthem, by Leonard Cohen

KWICKO

Saturday, March 14, 2009 9:45 PM

Quote:
Sarge wrote:

And this comes down to the crux of our disagreements in general, doesn't it? What you find appalling about a free market is that it allows some people more perks and privileges "merely" because they have more money.

Personally, I don't find that idea appalling at all; I find it "normal". This is the basic counter-argument that the anti-national-health crowd always falls back on, and I find it frankly disappointing that you'd rely on it, too, Sarge. I hoped you'd be above falling for it. Maybe I'm misinterpreting your intent here...

There's this false assertion that "if the government provided health care, then no one would be able to get better health care if they wanted it, and rich doctors and rich patients would be made to suffer." I find THAT idea appalling.

What we're looking for here is a way to ensure a BASIC level of health care - with an eye as much on health maintenance AND prevention and healthy living, as much as on post-hoc treatment - for EVERYBODY in this country. That means that the least of us gets basic care, NOT that those who want to upgrade can't do so.

This idea that basic healthcare for all equals good healthcare for none is as ludicrous as if I were to say that if we eliminated homelessness in this country, it would mean that nobody was allowed to own a mansion anymore. It's a soundbite, it's BS, and it's a pure scare tactic.

The REAL question is this: How are we going to do it? It *IS* doable, there's no doubt about that. The devil is in the details, though - how can we provide health care for the least of us without taxing the richest to death?

Mike

I can't run no more
with that lawless crowd
while the killers in high places
say their prayers out loud.
But they've summoned, they've summoned up
a thundercloud
and they're going to hear from me.

- Anthem, by Leonard Cohen

KWICKO

Saturday, March 14, 2009 9:48 PM

Quote:
Sarge wrote:

Maybe you'd like that better, but I find money to be a far more honest representation of someone's value to society than their ability to play politics. Most people make money because they provide a service that other people want or need. Those that don't are leeches and criminals

Okay, Sarge, here you're really losing me.

By this logic, Bill Gates is a better person than Mother Theresa, Steve Jobs' word worth more than that of Jesus, simply by dint of them being able to amass more wealth.

That idea offends me, to be honest with you.

Mike

I can't run no more
with that lawless crowd
while the killers in high places
say their prayers out loud.
But they've summoned, they've summoned up
a thundercloud
and they're going to hear from me.

- Anthem, by Leonard Cohen

CANTTAKESKY

Saturday, March 14, 2009 11:22 PM

Quote:
Originally posted by AgentRouka:
Just for clarification.. all midwifery? Or just certain levels of accreditation?

Now I am not an expert on the midwifery situation in the UK. As I understand it, the Nursing and Midwifery Council was established by Parliament to establish standards and maintain a register of approved midwives. I don't know what precisely those standards are, but suffice it to say you have to meet them to practice legally. There are over 35,000 registered midwives in Britain.
http://www.nmc-uk.org/aSection.aspx?SectionID=5

Women who want midwives to attend the births of their children, whether in the hospital or at home, could simply request a midwife and have it paid for by National Health Service. I am told in recent years that has changed, and NHS requires a lot of paperwork and cajoling now to pay for a midwife to attend a home birth, though they apparently still pay for them to attend hospital births. The fact remains that most midwives work within the NHS, even though there are a good number that work independently.

Incidentally, National Health pays for home birth midwifery services in some provinces in Canada, while not in others.

Contrast this situation to the one in the States. You have Nurse-Midwives who only attend hospital births under the supervision of an MD and are legal in all 50 states. In the States, home births are attended only by direct-entry midwifery. It is illegal in 11 states, regulated by licensure in 24 states, and unregulated in the rest. I've actually hired 3 midwives in all 3 situations: where it was illegal, where it was legally licensed, and where it was unregulated. My best experience was where it was illegal; unfortunately, my midwife who had attended over 420 births with a zero mortality rate was being sued for practicing medicine without a license. However, I really enjoyed being in a state where it was legally licensed, because there were so many midwives to choose from; in the other states, I had to really dig to find any.

I hope that answers your question.

--------------------------
Dr. Horrible Karaoke

SERGEANTX

Sunday, March 15, 2009 12:34 AM

Quote:
Originally posted by Kwicko:
Okay, Sarge, here you're really losing me.

Yeah, well, I'm arguing a point about how perks and special privilege are managed in society. I'm not saying money is the only way to measure worth, or even the best way. I'm trying to make the point that people will seek special privilege and I find competing for money more virtuous way to earn it than competing for political favor or connections. What I'm getting at is that in the absence of money, people will seek other ways to have more power and influence that are often more distasteful. Earning money honestly does reflect that people voluntarily value what you do - enough to pay you for it.

I also hope you're not misreading my quote as Citizen did. If so, then apparently my wording was less than clear. I wasn't saying that people who earn money were leeches and criminals, I was saying people who didn't earn it honestly were (ie people who earned money dishonestly). I brought that up merely to point out that dishonest people will exist in any system.

I should probably go back and reword that entire paragraph.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

KWICKO

Sunday, March 15, 2009 1:08 AM

Thanks, Sarge- that does clear things up a mite.

I just wasn't sure what you were trying to say. The interwebs do that sometimes.

Mike

The "On Fire" Economy -
The Dow closed at 10,587.60 on January 20, 2001, the day GW Bush took office. Eight years later, it closed below 8000 on the day he left office - a net loss of 25%. That's what conservatives call an economic "success".

SIGNYM

Sunday, March 15, 2009 4:50 AM

Quote:
Earning money honestly does reflect that people voluntarily value what you do - enough to pay you for it.

Ah, but STEALING it... which is how most rich peeps got rich... is another story.

---------------------------------
It's the end of the world as we know it, and I feel fine.

AGENTROUKA

Sunday, March 15, 2009 7:11 AM

Quote:
Originally posted by SergeantX:
Earning money honestly does reflect that people voluntarily value what you do - enough to pay you for it.

But did you pay your parents for raising you? Do you pay your best friend for comforting you during a difficult time? Do you pay your partner for improving your quality of life, and do you pay each other for housekeeping?

There is so much more to what people do than is recorded in monetary transactions.

And since someone brought up the example of friends and family pooling money... who here has friends and family that could sustain paying for prolonged dialysis treatment out of their pocket? If they can't, does this mean you were a bad child/parent/friend/spouse? Are you family and friends not valuable enough to society to earn that sort of money?

Money judges how people value you professionally - maybe, considering how badly nurses are paid. But that's it. And I do think that people are much, much more than their job-related income.

ETA: What I mean to say is, it's a really ill-advised measure to use, to determine who gets necessary medical treatment. I don't consider health care a "perk", that people earn who work extra hard (because they have the privilege to be able to do so), but something everyone should have.

SIGMANUNKI

Sunday, March 15, 2009 9:10 AM

@SergeantX:

You should really prefix this with, "This comment is only valid in the USA." Because, nationalised health care is a wondrous thing in many other countries.

"""
Making health care a government provided service will present all kinds of ugly problems and be tremendously wasteful.
"""

This is actually the boogy-man of the people for privatisation. Lets look at an example. In Canada the most privatised system is in Alberta. But, AB has the most expensive health care not to mention the wait times are rivalled by only the poorest provinces. Not exactly the poster child for the success of privatised health care. Not to mention that the USA is pretty much a perfect example of a non-functioning health care system. Privatisation is certainly an exceedingly poor choice.

I'll also point out that my wife has talked to someone who has worked both in politics at the federal level and in industry. He explicitly stated that government works several times (if not an order of magnitude or two) faster than industry. That probably has something to do with the fact that industry is risk adverse and can get away with it, while government has much less ability to get away with that. I could go on.

At any rate, the proof is in the pudding as they say. And what we see is that socialization of the health care system has numerous benefits. You guys in the USA might not like that. But, that doesn't make it any less true. Ya just gotta figure out a way to make it happen without the possibility of getting screwed by the HMO's (like that's not happening already...). In a word, regulation.

----
I am on The Original List (twice). We are The Forsaken and we aim to burn!
"We don't fear the reaper"

CITIZEN

Sunday, March 15, 2009 10:57 AM

Quote:
Originally posted by AgentRouka:
There is so much more to what people do than is recorded in monetary transactions.

...

ETA: What I mean to say is, it's a really ill-advised measure to use, to determine who gets necessary medical treatment. I don't consider health care a "perk", that people earn who work extra hard (because they have the privilege to be able to do so), but something everyone should have.

That's pretty much exactly what I was getting at.

Sarge, perhaps we've beaten each other, and between strokes the topic, to death on this, but my general feeling is that healthcare is not a privilege. That's one reason why I say Healthcare is a special case.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

SERGEANTX

Sunday, March 15, 2009 1:40 PM

Quote:
Originally posted by citizen:
Sarge, perhaps we've beaten each other, and between strokes the topic, to death on this, but my general feeling is that healthcare is not a privilege. That's one reason why I say Healthcare is a special case.

I understand. If you see health care as a right, your view makes sense, but I see a basic contradiction in defining a service provided by others as a "right".

Anyway. Beaten to death - agreed. Especially in a thread intended as a concession to pragmatism rather than an ideological screed. I just don't know when to shut up.

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

AGENTROUKA

Sunday, March 15, 2009 1:46 PM

Quote:
Originally posted by SergeantX:
If you see health care as a right, your view makes sense, but I see a basic contradiction in defining a service provided by others as a "right".

A fair trial is a service provided by others, isn't it?

SERGEANTX

Sunday, March 15, 2009 2:29 PM

Quote:
Originally posted by AgentRouka:
A fair trial is a service provided by others, isn't it?

Good question. Mind starting up another thread on this?

SergeantX

"Dream a little dream or you can live a little dream. I'd rather live it, cause dreamers always chase but never get it." Aesop Rock

BIGDAMNNOBODY

Sunday, March 15, 2009 3:06 PM

Quote:
Originally posted by AgentRouka:
A fair trial is a service provided by others, isn't it?

Are you talking about a court appointed defense lawyer versus the high priced defense lawyer?

CITIZEN

Sunday, March 15, 2009 4:31 PM

Quote:
Originally posted by BigDamnNobody:

Are you talking about a court appointed defense lawyer versus the high priced defense lawyer?

Or the Jury. Or the Judge.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

AGENTROUKA

Sunday, March 15, 2009 4:57 PM

Quote:
Originally posted by SergeantX:
Quote:
Originally posted by AgentRouka:
A fair trial is a service provided by others, isn't it?

Good question. Mind starting up another thread on this?

SergeantX

I thought it was relevant here, actually. Some rights need other people to be realised, so I don't see the contradiction you see, of having them dependent on certain professional services or institutions, like those involved in the justice system.

AGENTROUKA

Sunday, March 15, 2009 5:00 PM

Quote:
Originally posted by BigDamnNobody:
Quote:
Originally posted by AgentRouka:
A fair trial is a service provided by others, isn't it?

Are you talking about a court appointed defense lawyer versus the high priced defense lawyer?

I really meant the whole thing. People taking their time and education to create a process.

FREMDFIRMA

Sunday, March 15, 2009 5:35 PM

Oh don't get me started...

From Public Defenders who take dives to keep good relations for their impending career on the other side of the courtroom and eventually in hopes of the bench... to hand picked Jury pools who are then deliberately misinformed and shown a set-piece choice of evidence selected by the state to bring about a verdict... to judges who have a financial interest in guilty verdicts - the entire process is a rigged game from start to finish and everybody knows it.

And let's not even get into the gamesmanship of bullshit like refusing bail and postponing a trial to keep someone imprisoned as a method of forcing a guilty plea - or shifting a trial date AFTER the notice is sent in order to provoke a valid bench warrant so they can do the former, despite the original charges being so flimsy as to be laughable...

Case in point, Carol Asher, who faced prosecution and vilification, not to mention a shitstorm of legal fees, for not following the judges browbeaten threats and demands for a guilty finding.
http://proliberty.com/observer/20060202.htm

I've been there myself, having told a judge to his face that *demanding* I produce a certain verdict denies the right of a fair trial and thus ensures I can produce nothing but it's opposite.
(damn near got cited for contempt for daring to speak those words too, ponder THAT for a moment.)

So let's not even try to pretend that the American Justice System is anything but a fucking sham, ok ?

-Frem

It cannot be said enough, those who do not learn from history, are doomed to endlessly repeat it

AGENTROUKA

Sunday, March 15, 2009 5:46 PM

Quote:
Originally posted by Fremdfirma:
So let's not even try to pretend that the American Justice System is anything but a fucking sham, ok ?

-Frem

I wasn't talking about the American justice system. I'm talking about the concept of a fair trail.

It's a right that depends on other people, it's not a "let me do my own thing" right, it's one that requires the involvement of other people, like medical care.

CITIZEN

Sunday, March 15, 2009 5:57 PM

Quote:
Originally posted by AgentRouka:
It's a right that depends on other people, it's not a "let me do my own thing" right, it's one that requires the involvement of other people, like medical care.

I think I remember speaking to Sarge about this before. He said that you don't have a right to a fair trial, you have the right not to be imprisoned without a fair trial.

More insane ramblings by the people who brought you beeeer milkshakes!
No one can see their reflection in running water. It is only in still water that we can see.

AGENTROUKA

Sunday, March 15, 2009 6:23 PM

Quote:
Originally posted by citizen:
Quote:
Originally posted by AgentRouka:
It's a right that depends on other people, it's not a "let me do my own thing" right, it's one that requires the involvement of other people, like medical care.

I think I remember speaking to Sarge about this before. He said that you don't have a right to a fair trial, you have the right not to be imprisoned without a fair trial.

Oh... Hmm. Good point. :)

Still society wouldn't work really well without a concept of communal justice. In the same way, I don't think society works well when there are big gaps in terms of basic necessities, like health care.

Even if it's not a right, it still makes sense to have it available to everyone, because withholding it causes instability in the long term.

KWICKO

Sunday, March 15, 2009 7:27 PM

Not to mention that NOT having access to decent health care is actually more dangerous even to those who DO have access. Put it this way - you've got a poor person with TB, which COULD be controlled if they could afford to go to a doctor, get diagnosed, get put on the right meds, and be able to actually GET those meds. Instead, they walk around coughing on you and me, spreading their illness because they really have no choice - they have to go to work because if they miss a day, they either lose their job or lose a day's pay, meaning they go hungry, and very probably get sicker.

Lest you think that's a ridiculous scenario, I can assure you it's not. It's all too real for all too many Americans, the ones we call "the working poor". They have jobs, but can't realistically move up or move ahead. They're subsisting at just enough of a living to have a roof and a meal, and there's nothing left for health care, prescriptions, or anything else. And of course, they "make too much" to be on Medicaid.

Just something to ponder...

Mike

The "On Fire" Economy -
The Dow closed at 10,587.60 on January 20, 2001, the day GW Bush took office. Eight years later, it closed below 8000 on the day he left office - a net loss of 25%. That's what conservatives call an economic "success".

MAGONSDAUGHTER

Tuesday, March 17, 2009 12:50 AM

I find the most interesting aspect of the US debate on healthcare is this incomprehension about how any kind of national health might work. good lord, let all scratch our chins and imagine the worst case scenario. How could it ever work? It will be like inviting the soviet union into the country!!!! The sky will fall down.

How about looking at places where *gasp* the health care system might actually be working better than in your own country and look at what happens there.

The French system is ranked the best in the world by WHO and contains a mix of public-private health options. The French spend far less % of their GDP on health to get this success. Maybe it would be good idea to see what works in such a system and take some good ideas from somewhere else, instead of acting like the wheel has to be invented all over again.

FREMDFIRMA

Tuesday, March 17, 2009 2:58 AM

Quote:
instead of acting like the wheel has to be invented all over again.

Which, thankfully, it doesn't.

We do have an existing infrastructure in the medicare system, however it's slipshod, having been clobbered together piece by piece instead of formed as a functional whole, and it's primary focus currently is on avoiding expense even at the cost of patient care.

It's crap, and as a start point would supremely suck, but if we wanna get this into action any time this century, we're gonna hafta start there.

Of course, you couldn't call me an unbiased source, since I could make a valid case for attempted murder by neglect and denial of care against the medical care system as a whole, and that does include the medicare infrastructure as a part of it.

I mean, when the guy you brushed off cause he was "going to die anyway" is STILL in your case two years later, maybe, just maybe, it might be a good fekkin idea to assume he might live and start trying to assist that, instead of waiting almost a year and a half later for a court order from a federal judge demanding you do so.

Most of the real damage came from that, not the accident, and I am still quite pissed about it given that as of Apr 2008 my assumed life expectancy goes into negative numbers...
Borrowed time indeed *snort*.

As my ex put it, if only the good die young, that makes me virtually immortal.

-ArchLichFrem

MAGONSDAUGHTER

Tuesday, March 17, 2009 3:29 AM

One of the least satisfactory elements of democracy is that lots of things are cobbled together from existing elements and compromise often means that effectiveness is compromised. It takes a very, very strong government to implement real change. Sometimes that is necessary. I think it sounds like you guys are at that point. I don't claim to even begin to understand how your system functions currently, but everything I hear about it (and granted it could all be incorrect) leads me to believe that its a) leaking money like nobodies business b) has lots of gaps for poorer people to fall through and therefore get inadequate services.

I don't have either the constraints or protection offered by your constitution and I don't have any ideological objections to governments collecting taxes and providing some services. My belief system is this; wherever possible, universal healthcare should be aimed for. That is, everyone has an entitlement to be offered affordable healthcare for themselves and their families. No one should be turned away from emergency medicine, and no one should have to make decisions like 'should I keep the house or get the chemo to keep me alive'. That is my belief and no discussion around what rights are will make me change my mind.

I think there are lots of ways to offer this kind of entitlement. It happens all through the western world. There are pros and cons in all systems. I live in a country where there is publically funded healthcare (ie from our taxes) and there is also private healthcare. We spend less % of our GDP on health. I think it works okay, although I'm the first to admit there are flaws. I do know that whatever my income or job status, if I get sick or injured, I'll get the treatment I need regardless of whether I'm insured or not.

I don't understand why the world's strongest economic power has let ideology get in the way of offering an equitable service, why it seems to difficult?