RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ronn! Blankenship Sent: Saturday, July 14, 2007 9:08 AM To: Killer Bs Discussion Subject: RE: U.S. health care Well, it would put the small pharm out of business too. And, then, who would develop new drugs? I assume you favor governments? Historically, governments have had a much worse track record in technical innovation than private concerns. Planned economies tend to be ponderous and very bad at reacting to changes in demand, available possibilities, etc. They are particularly bad at innovation. So who do you see who should/will make vaccines, search for new antibiotics, search for _cures_ for diseases etc., when the profit lies in coming up with pills which must be taken every day for the rest of the patient's life in hopes of warding off some future serious disease? Well, a couple things come to mind. First, countries with government health care could invest in research in vaccines to see if they can prove me wrongthat government sponsored drug development can be effective. It would be nice to have other developed countries take up more of the burden of paying for medical developments. If they wanted to sell it in the US to recoup some of their coststhat's not a problem with me. Using a capitalistic model, the first thing that comes to mind is reduce the risks inherent in developing new vaccines. Protection from liability...as long as the company was above board in providing the results of studies to authorities, and guaranteed purchase of vaccines for X sound like some possibilities. As for preventing diseasessome of the medicines people take everyday now do that. High cholesterol is not the disease, clogged arteries isso that is really prevention. I don't think most prevention would be a one-shotbut allowing for big payments for a one-shot makes sense. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
At 01:02 PM Wednesday 7/18/2007, Dan Minette wrote: -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Charlie Bell Sent: Friday, July 13, 2007 10:53 PM To: Killer Bs Discussion Subject: Re: U.S. health care 'm not sure you have an adequate picture of the US system and how it works for the average person who works for a big company. I have an adequate picture of the US system being ranked well below several European ones... Which is certainly enough for Schadenfreude, but not for solving the problem. Let me give you an example from one of the clearest numbers for which the US performs relatively poorly: infant mortality. The US's rate, about 7/5000 live births is far above the EU rate of 5.6/1000. This is a horrid statistic. We find, though, that the white, non-Hispanic rate is close to the EU: 5.8/1000. The black rate, on the other hand, is very high: 13.8. There is an obvious conclusion to be reached: this is a function of the disparity of income between whites and blacks causing differences in medical care. However, looking at different numbers, we see that it's not this simple. The Hispanic rate (5.7/1000) is below that of white, non-Hispanics at 5.7. Is a difference of 0.1 per thousand statistically significant given the data being analyzed? (I'm not saying it's not. Just asking.) -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Charlie Bell Sent: Friday, July 13, 2007 10:53 PM To: Killer Bs Discussion Subject: Re: U.S. health care 'm not sure you have an adequate picture of the US system and how it works for the average person who works for a big company. I have an adequate picture of the US system being ranked well below several European ones... Which is certainly enough for Schadenfreude, but not for solving the problem. Let me give you an example from one of the clearest numbers for which the US performs relatively poorly: infant mortality. The US's rate, about 7/5000 live births is far above the EU rate of 5.6/1000. This is a horrid statistic. We find, though, that the white, non-Hispanic rate is close to the EU: 5.8/1000. The black rate, on the other hand, is very high: 13.8. There is an obvious conclusion to be reached: this is a function of the disparity of income between whites and blacks causing differences in medical care. However, looking at different numbers, we see that it's not this simple. The Hispanic rate (5.7/1000) is below that of white, non-Hispanics at 5.7. While Hispanic households average more income than black households (I'd guess it's because of the greater likelihood of a Hispanic household containing multiple adults) its far closer to the black number than the white, non-Hispanic. Further, one sees that even black women who completed college have a significantly worse rate than white women who haven't completed grade school. 10.6/1000 vs. 6.3/1000. These data indicate that something besides income is affecting the situation. One good candidate, bemoaned by black ministers and physicians, is the general distrust of physicians by the black community. They are far less likely to use medical services than Hispanics or non-Hispanic whites, even when it is available. That problem will not be solved by switching the system of insurance. That's just one example of the complexity of the problem, there are a score. There is no flip solution to the problems with the US health care system. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
At 10:53 PM Friday 7/13/2007, Charlie Bell wrote: On 14/07/2007, at 4:04 AM, Dan Minette wrote: That assumes you keep providing care the way you do. Increase preventative medicine and primary nursing, and you reduce other healthcare threefold. How? ...because hospital stays reduce and recovery times increase. Good prevention and primary treatment is the most effective way of maximising returns on healthcare investment. The contrarian in me sometimes wonders how much will indeed be saved by so-called preventative medicine for the major serious chronic conditions, because I'm sure most of us can think of people we know who had heart attacks or were diagnosed with diabetes or something like that who had none of the known risk factors for the disease prior to the time it hit, as well as the cliche grandfather who smoked like a chimney and drank until he was killed when he was hit by a bus leaving a brothel one night when he was in his 90s . . . and of course how much preventative medicine will be used as a justification for further regulations on the average person's life . . . (I get a laugh when I can spare the air from being diagnosed with chronic bronchitis because that has traditionally been a euphemism for smoker's cough and I never smoked a day in my life.) 'm not sure you have an adequate picture of the US system and how it works for the average person who works for a big company. It works fine as long as neither you or any of your family members who are on your insurance get sick or injured . . . :P -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
At 05:14 PM Friday 7/13/2007, Dan Minette wrote: dan, i'm confused i realize that it doesn't work that way in other countries, but are you defending the way it works in america, or denying that lobbies have enormous influence in congress? Lobbies do have an influence in Congress, and changes that they oppose are often beneficial. However, getting rid of the lobbies does not get rid of the fundamentals of the problem. If you take the profitability out of drug development by private companies, you will stop private drug development. The history of the latter half of the twentieth century has shown the //disadvantages of economies where the government owns/controls major i realize there are costs in creating new drugs and marketing them. do you believe there are instances when drugs are kept on the market when the side effects can be dangerous and law suits contribute to the cost? That's part of it, but it the cost of eliminating any drug that might have a dangerous side effect is having no new drugs. The gauntlet that a drug has to run through before being approved is fairly formidable. Even then, when it is given to millions, after a careful study of thousands, side effects may be seen at levels too low to have observed in the study of thousands. i have a friend who was given viagra when it was still being tested; he had a massive heart attack. And, without large, statistically significant studies we won't know if that is a coincidence. the fact there is little interest in new research on vaccines because it doesn't pay, yet any new drug for ed is a great investment, make me wonder if capitalism is the right incentive for health care? this is what sicko points out... There are a couple of obvious conclusions that can be made here. First, people are more willing to spend money on ed than on vaccines. Second, this is a case where the uninformed public outcry on the danger of vaccines makes people very leery about spending money in this area. Third, wouldn't this be a perfect place for the more socialist countries than the US to show the disadvantages of capitalism by developing new vaccines through public spending? Since virtually all of the innovation first targets the US market, I think Gautam quoted here a site where 85% of the major innovations in the last 5 years were in the US and the other tended to target the US first. Isn't it logical to assume that, if the US market for this innovation dries up, that the source of the innovation would also. i have no problem with cheap third world drugs flooding the market and putting big pharm out of business. Well, it would put the small pharm out of business too. And, then, who would develop new drugs? I assume you favor governments? Historically, governments have had a much worse track record in technical innovation than private concerns. Planned economies tend to be ponderous and very bad at reacting to changes in demand, available possibilities, etc. They are particularly bad at innovation. So who do you see who should/will make vaccines, search for new antibiotics, search for _cures_ for diseases etc., when the profit lies in coming up with pills which must be taken every day for the rest of the patient's life in hopes of warding off some future serious disease? -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 13 Jul 2007, at 04:01, Dan Minette wrote: Governments could step in, but in countries with price controls/negotiations...they haven't. Instead, they rely on the US providing the profits that pay for innovation, then negotiate a price for themselves. It's not rock bottom, but that's why the same meds are cheaper in Canadaroughly the same reason why US TV shows sell for less overseas than in the US. The BBC recently paid £400,000 ($812,000) per episode for first run of season 2 of _Heroes_. Rising Prices Maru -- William T Goodall Mail : [EMAIL PROTECTED] Web : http://www.wtgab.demon.co.uk Blog : http://radio.weblogs.com/0111221/ Every Sunday Christians congregate to drink blood in honour of their zombie master. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 13/07/2007, at 1:01 PM, Dan Minette wrote: of GDP. If everyone were to get the care available to those with the very best insurance policiesthen it would probably jump to 20% or so...immediately (That assumes that the health care denied by reasons of costs represents only a 20% reduction in total care). As it is, without universal coverage, it's projected to reach 20% in a few years. That assumes you keep providing care the way you do. Increase preventative medicine and primary nursing, and you reduce other healthcare threefold. Whatever the french are doing? Do that. Charlie ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jon louis mann Sent: Friday, July 13, 2007 1:03 AM To: Killer Bs Discussion Subject: U.S. health care it that is the dynamic, dan, then anerica is sunsidizing the rest of the world, which would be justice. If you are talking about Sub-Sahara Africa, and other third world countries, I would certainly favor ways of lowering the cost of drugs in those countries. But, I don't think we need to subsidize Canada, Japan, the EU, and other developed prospering countries. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Charlie Bell Sent: Friday, July 13, 2007 7:55 AM To: Killer Bs Discussion Subject: Re: U.S. health care That assumes you keep providing care the way you do. Increase preventative medicine and primary nursing, and you reduce other healthcare threefold. How? I'm not sure you have an adequate picture of the US system and how it works for the average person who works for a big company. While the lack of health insurance for about 15% or so of Americans is a horrid fact that must be addressed, these people do not represent the majority of health care costs. For example, most of the lifetime cost for medical service in the US is accrued after age 65. Everyone over 65 is eligible for Medicare. Under basic Medicare, the co-pay (the out of pocket cost) for a primary physician visit is $5. For most on Social Security and Medicare, this is not a major worry...other factors (an unwillingness to bother a neighbor for a ride is my mother's favorite excuse) are more important. Most of the time, the elderly make an appointmentbut when a member of the family living with us this summer became ill, she walked in without an appointment to an urgent care facility, and saw a nurse practitioner within 1.5 hours. So, an inability to afford primary health care is not the most important factor in the cost structure of the US. For the elderly, the cost problem in seeing a physician/nurse is not that they cannot afford $5, but that when they do get sick, the treatment is expensive. My wife has arthritis, and just one of the meds that provides her relief costs about $200/month. My mother is on a number of expensive meds...that are mostly covered by insurance...she has a small co-pay. A major source of cost, in the US, is the legal system. Hospitals are not required to accept every potential patient, but, once a patient is in a hospital, no service can be denied because of cost. If it is, the hospital and the doctors open themselves up to lawsuits that run in the multiple millions. As a result, tens of thousands of dollars are spent prolonging the life of dying people by a few weeks or months. My brother-in-law, a physician, talked about having to code (bring back from clinical death) someone twice a day for a month until the family accepted the fact that he was dying and nothing could be done but prolong the death. In most cases, it takes weeks for the family to come to grips with that, and allow the person to die. There are other factors, like the horrid bureaucracy of paperwork, poor health habits, etc. that contribute to this problem. But, a lack of available primary care medicine is not the critical problem. This has been tested experimentally for the last 15-20 years in the US when HMOs first came out. Primary co-pays were very small (near token), and primary care was encouraged. Indeed, my health insurance paid me $100 to get a physical. Studies of people who had this insurance showed, at most, a modest health gain over those in more traditional plans. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jon louis mann Sent: Friday, July 13, 2007 12:23 PM To: Killer Bs Discussion Subject: U.S. health care if that is the dynamic, dan, then anerica is subsidizing the rest of the world, which would be justice. If you are talking about Sub-Sahara Africa, and other third world countries, I would certainly favor ways of lowering the cost of drugs in those countries. But, I don't think we need to subsidize Canada, Japan, the EU, and other developed prospering countries. Dan M. i doubt they would be doing it if it were not profitable. big pharm doesn't have strong enough lobbies in other developed countries to fix the price of their pills, etc... Huh? That's not how it works. Let's say the a new cholesterol drug is developed, that not only reduces the level of cholesterol, but over a year, virtually eliminates the buildup that causes heart attacks. It's a hot commodity, and will sell well. In the US, they charge what the market will bear. Folks lobby their insurance companies to put it on the formulary, and it goes on It costs about 10 cents/pill to make, but can be sold for $5.00/pill. The company can see 1 billion of these pills per year in the US for gross profit of almost five billion dollars per year. Now, other countries are interested in this pill, and start to negotiate prices for use in their nations. Even if they negotiate for only $2.00/pill, it's a lot of profit for the drug company. If it sells another billion pills/year overseas, that's another 1.9 billion/year profit. So, what happens if the US negotiates on drug pricesand the price available in the US is only $1.90/pill. Don't they still make billions? Yes, but...that's knowing the pill will work. When the particular drug starts testing, odds are long against it working without unacceptable side effects. People doing cost-benefit analysis beforehand make decisions concerning whether starting on the path to develop the drug based on the expected profits. Profits in the drug industry are high as a percentage basis...I think something like 15%-$20 of revenue for net profits is typical. FWIW, this is not too unusual for high risk ventures. Most new drugs never make it to market. It's the relatively few multi-billion drugs that pay for all. The US can, today, mandate lower prices on may drugs, remove patent protection on these drugs, etc. and get lower prices. One side effect will be a drop in research into new drugs...the amount it drops is dependant on how much the projected income for a successful new drug drops. This is not, at all, a bad thing. I hope the price in the rest of the developed world rises to meet the falling US price, so the cost of research is born more evenly. But, if not, we will see more and more field match what is seen in vaccines...you can find companies to manufacture them, but there is little interest in new research because it doesn't pay. the poorer countries pay what the market will bear and the profit there is minimal. maybe it limits the black market...? Right now, companies are afraid that cheap Third World drugs would find themselves back in developed countriescompeting with their own product there. It took strong arm tactics by governments in the developed world to initiate such programs. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
dan, i'm confused i realize that it doesn't work that way in other countries, but are you defending the way it works in america, or denying that lobbies have enormous influence in congress? Lobbies do have an influence in Congress, and changes that they oppose are often beneficial. However, getting rid of the lobbies does not get rid of the fundamentals of the problem. If you take the profitability out of drug development by private companies, you will stop private drug development. The history of the latter half of the twentieth century has shown the disadvantages of economies where the government owns/controls major i realize there are costs in creating new drugs and marketing them. do you believe there are instances when drugs are kept on the market when the side effects can be dangerous and law suits contribute to the cost? That's part of it, but it the cost of eliminating any drug that might have a dangerous side effect is having no new drugs. The gauntlet that a drug has to run through before being approved is fairly formidable. Even then, when it is given to millions, after a careful study of thousands, side effects may be seen at levels too low to have observed in the study of thousands. i have a friend who was given viagra when it was still being tested; he had a massive heart attack. And, without large, statistically significant studies we won't know if that is a coincidence. the fact there is little interest in new research on vaccines because it doesn't pay, yet any new drug for ed is a great investment, make me wonder if capitalism is the right incentive for health care? this is what sicko points out... There are a couple of obvious conclusions that can be made here. First, people are more willing to spend money on ed than on vaccines. Second, this is a case where the uninformed public outcry on the danger of vaccines makes people very leery about spending money in this area. Third, wouldn't this be a perfect place for the more socialist countries than the US to show the disadvantages of capitalism by developing new vaccines through public spending? Since virtually all of the innovation first targets the US market, I think Gautam quoted here a site where 85% of the major innovations in the last 5 years were in the US and the other tended to target the US first. Isn't it logical to assume that, if the US market for this innovation dries up, that the source of the innovation would also. i have no problem with cheap third world drugs flooding the market and putting big pharm out of business. Well, it would put the small pharm out of business too. And, then, who would develop new drugs? I assume you favor governments? Historically, governments have had a much worse track record in technical innovation than private concerns. Planned economies tend to be ponderous and very bad at reacting to changes in demand, available possibilities, etc. They are particularly bad at innovation. perhaps governments would then realize its responsibility is to promote research that saves rather than kills people. Before I answer this, let me check my assumptions. I assume that you think that far too much is spent on the US military, and that a military with, say, the combined capacity of the EU would be adequate? Is that a good read of your position? Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
Lobbies do have an influence in Congress, and changes that they oppose are often beneficial. However, getting rid of the lobbies does not get rid of the fundamentals of the problem. If you take the profitability out of drug development by private companies, you will stop private drug development. The history of the latter half of the twentieth century has shown the disadvantages of economies where the government owns/controls major sections of the economy. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jon louis mann Sent: Friday, July 13, 2007 3:26 PM To: Killer Bs Discussion Subject: U.S. health care dan, are you certain only 15% of americans lack health care coverage? The number's I've seen quoted are in the high 40s of million. I was rounding to the nearest 5% when I said that. If you look at a website that advocates insuring these people: http://www.nchc.org/facts/coverage.shtml They quote nearly 47 million. With slightly over 300 million people in the US, this comes close to 15.5%..maybe 15.6%. I'll accept 16% as slightly more accurate, but I don't think my rounding to 15% vs. their rounding to 16% is worth quibbling over. . do you believe a single payer system would reduce costs effectively? Well, I do know that the present system is, in many ways, the worst of both worlds. It's a mess. It should be very possible to construct a single payer system that's better. i agree that red tape is a bureaucratic nightmare and poor health habits contribute to the problem, even if there was available primary care. i have a friend who has excellent insurance and refuses to see a doctor. i don't know the solution. do you have any suggestions how to reduce escalating costs from the legal system, without increasing the amount of malpractice. i was a victim, myself and was intimidated from seeking redress. The obvious recourse that would be available would be to let medical review panels handle complaints (I think most other countries do this)..I know it's much harder and riskier to sue in Great Britain. what can be done about prolonging life when death is inevitable? in my brother's case, the doctors asked me to sign in order to remove him from life support and i refused. that was 10 years ago, my brother's liver recuperated and he recently completed interferon treatment for hepatitis c. fortunately he lives in hawaii, which has an excellent health care system. he is a lifelong alcoholic and is only off the sauce when he is on probation or institutionalized. if was anyone but my brother i might say pull the plug. From what I understand, the US is unique in that hospitals and physicians worry about the consequences of using their best medical judgment. From what my physician friend in the UK told me, your brother would not have been a candidate for intensive care in Great Britain. That saves money. So, I don't think a system more like other Western systems would be likely to spend money on someone in your brother's conditions. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 14/07/2007, at 4:04 AM, Dan Minette wrote: That assumes you keep providing care the way you do. Increase preventative medicine and primary nursing, and you reduce other healthcare threefold. How? ...because hospital stays reduce and recovery times increase. Good prevention and primary treatment is the most effective way of maximising returns on healthcare investment. 'm not sure you have an adequate picture of the US system and how it works for the average person who works for a big company. I have an adequate picture of the US system being ranked well below several European ones... Charlie. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Deborah Harrell Sent: Tuesday, July 10, 2007 12:19 PM To: Killer Bs Discussion Subject: RE: U.S. health care Dan Minette [EMAIL PROTECTED] wrote: [not sure who wrote] SImply put, the weakest area of the American health system is preventative care. Poorer people with chronic conditions can end up with repeated emergency hospital treatment for conditions which are manageable with drugs which, while not cheap, are far cheaper than repeated hospital admitance. OK, let's try to do an experimental test on this. Drug coverage was just added to Medicare. To the extent that your hypothesis is true, we would see a drop in hospital costs that correspond to the increase in prescription payments. The major problem with the current added coverage is that _by law_ the gov't can't negotiate with the pharmas for drug pricing...which will not lower health care costs at all overall, just shift it back to the taxpayers ultimately. Sure, but lowering costs is somewhat of a game. Other countries ration health care, even though it's universal. I remember a friend of mine who was a UK doc interning in the US after interning in the UK. She told me how she witnessed how a lack of insurance drastically changed treatment plans for a baby with a bloody diaper in the US, while in the UK floor nurses decided who got more than the basic treatment based on their assessment of the value of the life they were returning to. We would, of course, lower drug prices if the government did hard line negotiating on buying large quantities of the drugs. A side effect would be, of course, to lower the potential profitability of any new drug that was developed. Right now there are scores, if not hundreds of drug companies, all trying to hit home runs (i.e. get a drug through testing and onto the market). I have several friends who work for small drug companies. These companies are often/usually financed by venture capital. If these capitalists see the potential payoff drop by a factor of two or three, then the economics of producing new drugs changes tremendouslyand the money supply available for this will decrease dramatically. Developing a drug is a high risk venturehundreds of millions can be spent only to find dangerous side effects during or even after the final, large clinical tests...resulting in the money being totally written off. Governments could step in, but in countries with price controls/negotiations...they haven't. Instead, they rely on the US providing the profits that pay for innovation, then negotiate a price for themselves. It's not rock bottom, but that's why the same meds are cheaper in Canadaroughly the same reason why US TV shows sell for less overseas than in the US. This doesn't mean that I'm opposed to negotiations...I don't see why the US should shoulder the lions share of the cost of medical innovationso I think that negotiating a lower price should be part of the deal. It's just that I'm aware that there is a downsidewe'll have to find some other way to make innovation profitable...or else it won't be done. Governments could sponsor drug development, but government support/sponsorship of innovations does not have a good track record. Part of the reason for this is that spending large amounts of tax money is, inherently a political decision. When the means of doing this is clear, (as with Social Securityyou provide income to seniors by sending them checks every month), then the government can do a phenomenal job (the overhead on Social Security is 97%). When a government is asked to guess the form of the next innovation in a field, the track record is dismal. Innovations often come from left field, and are obvious only after they succeed. Lots of people trying and failing, losing their own and/or their investors money in the process, but some hitting has been seen to work better. But, going back to my support for government negotiations, it's getting close to the point where we cannot afford health care. It's now about 16% of GDP. If everyone were to get the care available to those with the very best insurance policiesthen it would probably jump to 20% or so...immediately (That assumes that the health care denied by reasons of costs represents only a 20% reduction in total care). As it is, without universal coverage, it's projected to reach 20% in a few years. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
Dan Minette [EMAIL PROTECTED] wrote: [not sure who wrote] SImply put, the weakest area of the American health system is preventative care. Poorer people with chronic conditions can end up with repeated emergency hospital treatment for conditions which are manageable with drugs which, while not cheap, are far cheaper than repeated hospital admitance. OK, let's try to do an experimental test on this. Drug coverage was just added to Medicare. To the extent that your hypothesis is true, we would see a drop in hospital costs that correspond to the increase in prescription payments. The major problem with the current added coverage is that _by law_ the gov't can't negotiate with the pharmas for drug pricing...which will not lower health care costs at all overall, just shift it back to the taxpayers ultimately. snip Since I have said I support universal health care, the obvious conclusions from the above statement is that we need a radical retooling. Yes; it needs to be metamorphosed, not just tweaked here and there. Debbi Still In May Posts, Oh Dear Maru Shape Yahoo! in your own image. Join our Network Research Panel today! http://surveylink.yahoo.com/gmrs/yahoo_panel_invite.asp?a=7 ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
Ronn! Blankenship wrote: At 10:21 AM Wednesday 5/23/2007, Dan Minette wrote: -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jon louis mann Sent: Sunday, May 20, 2007 11:04 PM To: Killer Bs Discussion Subject: U.S. health care Why do we behave the way we behave? What has become of us? Where is our soul? DUMPED ON SKID ROW - Hospitals drop homeless patients on the city's Skid Row, sometimes dressed in only a flimsy gown and without a wheel chair, even if they're not healthy enough to fend for themselves. Anderson Cooper reports on the practice known as hospital dumping. The first thing that comes to mind is that this is an expectable, albeit immoral, response to the mess that hospitals find themselves in with regard to treatment of the indigent. I have had some extended conversations with my brother-in-law (a physician who has a low income private practice in Northern Michigan (he sees a lot of Medicaid patients, and the area is very poor). We agreed that what is needed is a system in which everyone can get a Chevy, but you have to pay your own money if you want a BMW. I have heard in recent months on other lists reports of children (sometimes grandchildren or nieces/nephews, etc., of listmembers) who were born with multiple problems which required the baby to stay in the hospital for months after birth during which they had to undergo multiple expensive medical procedures of various sorts and in many cases will require extensive care once they are released from the hospital and will have to go back to the hospital several times for more procedures and/or care for unexpected crises caused by the problems they were born with. In some cases, such special care and repeated hospitalizations will have to continue for the rest of their lives (which in some cases will be cut short while in other cases they may live well into adulthood or even a full, normal life-span but will never be able to become a contributing member of society and in particular will always be a net economic drain). Even if the necessary care only lasts a few months (a year or less, maybe) and afterward the child is able to live an entirely or mostly normal life and grow up to become a contributing member of society, the costs for the care required during that first year or so may easily run into the hundreds of thousands of dollars (maybe even top a million dollars in some cases, particularly when the problems are due to multiple births and each of the n-uplets requires such care because they were all born with low birth weight). Such care is certainly in the BMW (or perhaps Ferrrari or Lamborgni) price range, but what should we (as a nation, a government, a health-care system, etc.) do about it? Let us presume as was the case in the cases I have heard of on other lists that the families are ordinary middle-class working people who when it comes to cars typically look for a late-model used Chevy rather than a new car of any type and certainly never imagine themselves owning a BMW (except perhaps in their daydreams when they win the Powerball lottery) and that no one can be considered at fault for the problems that the child was born with: the parents were as far as anyone knew or could tell healthy, did not smoke, drink alcohol, use drugs, work in a factory or other environment where they were exposed to toxic chemicals or use such at home or in some second job or hobby, did not engage in any other risky behaviors, did not have any known genetic defects, had early and regular pre-natal care (during which we presume nothing amiss was detected, or at least not until it was too late medically or legally to do anything about it), nothing untoward happened during labor and delivery, etc. How should such cases be addressed by the US health care system? Well, at present, any baby considered to be a micro-premie, i.e. 1200 grams or smaller at birth, gets whatever NICU charges the parents' insurance won't cover covered by Medicare -- but you have to apply to get that. So that's one thing that's being done. But, yeah, that can be a million dollars per baby in some cases. It's a lot more likely to happen in the case of multiple births. (Me, my Twin B was over 8 lbs. and we all went home after 2 days -- and if we'd stayed another day, it would have been because MY doctor wanted ME to, not that the pediatrician was concerned about either of the babies. I can't stand hospitals as a patient (or at least that one, aside from when I was born I've stayed overnight in exactly 1 hospital) and told the doc that if she really needed to monitor the platelet count, my husband could take me somewhere the next morning for a blood draw, but I really wanted to go home. She discharged me.) Julia ___
Re: U.S. health care
Dan Minette wrote: -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nick Arnett Sent: Thursday, May 24, 2007 2:57 PM To: Killer Bs Discussion Subject: Re: U.S. health care You don't think there's a place for simple stories in the political process? Depends on the story. I would place Moore's story telling with the young buck buying steak with food stamps story. There was a documentary at the South by Southwest film festival (I think I got the name right) in Austin, by self-proclaimed leftists, on Moore. One tidbit about his technique is that he did get an interview of the Roger in Roger and me. It didn't fit his film, so he didn't include it. Yeah. SXSW. :) I know people who work it. If you're going to be heading to anywhere near downtown Austin on an evening when that's going on, parking is going to be a bear, unless you're going to someplace like Whole Foods or Book People that has its own parking garage. Julia ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
At 08:44 PM Friday 5/25/2007, Robert Seeberger wrote: I've worked in a few hospitals here in Houston and everyone of them is undergoing large expansions. One is left to wonder who is paying for all this construction if not the end customers. In every hospital I have worked in, doctors are daily treated to sumptuous meals (for free of course) in a lavish (as compared to any other hospital facility) dining room. And the food served is of a quality not seen in any other part of the hospital, prepared in a separate kitchen solely for the doctors. I've seen this at St. Joseph, a relatively poor hospital, and at M.D. Anderson, a rich state run hospital. I know this to be the case at the other hospitals in the Houston Medical Center because my company works in pretty much all of them. If one were to drive through the medical center and observe all the construction (every bit of it medical expansion) one would be hard pressed to understand how we would need medical care rationing. FWIW: Why you still can't find a builder Home building is in free fall but construction employment is steady, a sign housing won't tank the job market. By Chris Isidore, CNNMoney.com senior writer May 31 2007: 3:36 PM EDT NEW YORK (CNNMoney.com) -- There's no doubt the bottom has fallen out of the home-building market in the last year. But if you're trying to find an out-of-work carpenter or skilled craftsman today, you'd think the nation was still in the middle of a building boom. Employment in home building has fallen 4 percent from a year ago, according to government figures, but construction employment overall has slipped just 0.2 percent over that period. The difference? A 2.7 percent jump in the number of workers on construction sites for hospitals, roads and other projects aside from homes and residences. And the shift may be even more dramatic than those numbers suggest. http://money.cnn.com/2007/05/31/news/economy/jobs_construction_outlook/index.htm?postversion=2007053115 Bigger Is Better Maru -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
Mauro Diotallevi wrote: On 5/30/07, Julia Thompson [EMAIL PROTECTED] wrote: Mauro Diotallevi wrote: -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ OK, that ranks up there with, Nothing says 'Aliens, land here!' like a 9' pyramid! (My friend Patric, Saturday afternoon.) I think I would like your friend Patric. He's great. Wanna go camping in Texas? :D Julia ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: Mauro's latest .sig, was Re: U.S. health care
On 5/29/07, [EMAIL PROTECTED] [EMAIL PROTECTED] wrote: BTW, are you also a fan of GWAR? Heh. I saw GWAR -- which I believe stands for God What A Racket -- in a bar in KC when they were touring to support _America Must Be Destroyed/Phallus in Wonderland_. That must have been... 1992? 1993? I was forewarned and stayed well back from the stage... For their very last set, they came out without any of the costumes and did an acoustic set. Half of the audience loved it and half decided they were ready to move on to another bar. I had a great time. -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/30/07, Julia Thompson [EMAIL PROTECTED] wrote: Mauro Diotallevi wrote: -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ OK, that ranks up there with, Nothing says 'Aliens, land here!' like a 9' pyramid! (My friend Patric, Saturday afternoon.) I think I would like your friend Patric. -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
Mauro Diotallevi wrote: -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ OK, that ranks up there with, Nothing says 'Aliens, land here!' like a 9' pyramid! (My friend Patric, Saturday afternoon.) Julia ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
I'm jumping ahead to this thread, but have much to say in the conservation one still (and I've only time for one more post today)- Dan Minette [EMAIL PROTECTED] wrote: It will have to be addressed by some sort of health care rationing. The only question is when and how. We may not be there now, but there will be a point at which we cannot afford to give the best health care that's available to everyoneeven if that's the focus of the entire economy. Unfortunately too true. How we do that rationing is a very difficult decision. This is one reason that I think we should start working towards the most reasonable rationing system we can have as soon as possible. Yes. Some basic care, especially preventive or preemptive, ought to be available to all (it's actually cheaper in the long run). Immunizations, treatment for infectious diseases such as tuberculosis, and screening for serious common illnesses before they manifest are examples, which I think most could agree with. Health education is also very important, to improve people's lifestyle choices. However, we can't afford to keep alive everyone whom we technologically are capable of prolonging death; end-of-life care is extremely expensive for small return of quality living. The real poser, for me, is taking care of those who could exist for years/decades but whose quality of life requires massive support, like physical, occupational, and other ancillary therapies. I believe Ronn mentioned extreme preemies, and others include head/brain injuries, massive trauma, various cancers... Rationing, which as you pointed out is going on in a piecemeal way, will need to be more - rational. But it will not be pleasant. I have my own criteria for myself; I'm not sure how many would find them acceptable. And when a child's life or well-being is at stake, few can be impartial. I've posted previously that I would be very strict on who 'deserves' to get organ transplants (frex no alcoholics or IV drug users), yet I'd be hard-pressed to create rules for, say, preemies...even though statistically speaking, a 24 weeker is most likely to need major ongoing care, there will be a few who manage to have a near-normal life. I'd have a much easier time working on drugs: as somebody else pointed out, these ought to be used on the basis of proven efficacy (*real* endpoints, not just presumed-relevent markers). Urf, gotta run- Debbi Guidance Systems Breakdown Maru :( Be a better Globetrotter. Get better travel answers from someone who knows. Yahoo! Answers - Check it out. http://answers.yahoo.com/dir/?link=listsid=396545469 ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
FWIW, from CNN AM QuickNews this morning: An open letter to the candidates Business legend Andy Grove shares a few modest proposals to fix health care, from Fortune Magazine. http://money.cnn.com/2007/05/29/news/economy/grove_column.fortune/index.htm -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: Mauro's latest .sig, was Re: U.S. health care
On 5/24/07, Ronn! Blankenship [EMAIL PROTECTED] wrote: At 03:36 PM Thursday 5/24/2007, Mauro Diotallevi wrote: -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc There is already a god of Jell-O™. Just go to Utah and visit any activity where food is served at a church building of the major religion for which the area is known and you will conclude that the serving of Jell-O™, particularly green Jell-O™, must be one of the required practices of that religion . . . There was a band who had a fairly popular album out about 10 or 15 years ago or so that was originally called Green Jello (the band, not the album), but they were forced to change their name to Green Jelly due to a lawsuit from Kraft Foods. The album was called _Cereal Killer_ and the big hit from the album was their version of the Three Little Pigs -- the second pig was a ganga-smoking beach preacher, I don't remember the other two -- with video done in claymation. Maynard Keenen, lead singer of Tool and A Perfect Circle, did background vocals and I think Tool's drummer was also involved. Former brineller Reggie gave me a copy of the video for Christmas one year. Ah, the memories... :-) -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: Mauro's latest .sig, was Re: U.S. health care
My...GOD. The memories indeed... I like the live concert footage too... BTW, are you also a fan of GWAR? Damon. Damon Agretto [EMAIL PROTECTED] Qui desiderat pacem, praeparet bellum. http://www.geocities.com/garrand.geo/index.html Now Building: Trumpeter's Marder I auf GW 38(h) Sent from my BlackBerry wireless handheld. Sent from my BlackBerry wireless handheld. -Original Message- From: Mauro Diotallevi [EMAIL PROTECTED] Date: Tue, 29 May 2007 12:08:39 To:Killer Bs Discussion brin-l@mccmedia.com Subject: Re: Mauro's latest .sig, was Re: U.S. health care On 5/24/07, Ronn! Blankenship [EMAIL PROTECTED] wrote: At 03:36 PM Thursday 5/24/2007, Mauro Diotallevi wrote: -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc There is already a god of Jell-O™. Just go to Utah and visit any activity where food is served at a church building of the major religion for which the area is known and you will conclude that the serving of Jell-O™, particularly green Jell-O™, must be one of the required practices of that religion . . . There was a band who had a fairly popular album out about 10 or 15 years ago or so that was originally called Green Jello (the band, not the album), but they were forced to change their name to Green Jelly due to a lawsuit from Kraft Foods. The album was called_Cereal Killer_ and the big hit from the album was their version of the Three Little Pigs -- the second pig was a ganga-smoking beach preacher, I don't remember the other two -- with video done in claymation. Maynard Keenen, lead singer of Tool and A Perfect Circle, did background vocals and I think Tool's drummer was also involved. Former brineller Reggie gave me a copy of the video for Christmas one year. Ah, the memories... :-) -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
On 25 May 2007 at 16:10, Dan Minette wrote: If I need to see a doctor, I inform my workplace and go. I make up the hours. That's pretty standard for non-shift workers here. As opposed to being told to take holiday.. That's pretty standard here too...at least as far as I've seen. For lower income workers? Not so much. Well, I don't know about authorising drugs. But I do know this: many more drugs in America are prescription. This is because there are only two catagories of drugs, over the counter and prescription (excepting a few drugs under specific state laws). The UK has a third category, which is behind the counter - a trained pharmacist can dispense the drug, and it's kept literally behind the counter, not on the shop floor. And that's not a small category here either. Well, that seems like a reasonable thing, but I don't think it will have a major impact on costs...unless antibiotics for kids are on that list, and It's not costs. It's that for a lot of drugs which, in America you need to see a doctor to get a prescription for, you can get from a pharmacy (in your lunch hour) here. I'm not sure that the general dispensation of antibiotics is a good ideacreating immunity and all. The seniors I know should have their meds tracked by a physician or nurse practitioner because of the long term nature of their use, the chances for interaction, etc. Actually, that's why most antibiotics remain prescription. Several are not, but they're older drugs which are general useless these days as antibiotics and are prescribed for other effects (anti inflamatory, for example). Talking about resistance, we've actually had a policy in place for the better part of a decade that doctors can write you a non- prescrption, explaining why they won't give you antibiotics in a given situation (viral illness, usually). AndrewC Dawn Falcon ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
jon louis mann wrote: michael moore was on bill maher tonight talking about how the richest country in the world is 37th in health care, because the system is being looted by the health care providers and pharmaceutical companies. they toss enough crumbs to the doctors to keep them happy, but their bottom line is profit, so people die if they can't afford the premiums. we have the best medical technology in the world, designed to keep our obese population alive, IF their treatment is authorized. it certainly works well for the wealthiest people in the country, moore expressed hope that this time his message will be heeded because it crosses party lines, everyone needs medicale care. he may be in trouble for attempting to take a bunch of rescue workers injured after 9/11 to the guantanamo bay internment facility and brazenly asked for health care. he was ignored so they moved on to havana where they received excellent medical care, which is free in cuba. Moore also noted that his film had been praised by Fox News and that he had been complimented by tearfull Republicans at Cannes. Maybe a person should see a movie before comparing it to The Birth of a Nation? Doug ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Robert Seeberger Sent: Friday, May 25, 2007 11:32 PM To: Killer Bs Discussion Subject: Re: U.S. health care Ackkk!!! That isn't the way one fairly compares such things Dan. My company charges around $80/hour for my services, but I'm grossing $24/hour or so. (My total package is around $45/hour). OK, I can see why you would say thatalthough private draftsmen don't discount that much from temp agencies. Good engineers who are independent command $75-$125/hour, even if they only have a BA degree. I should have talked about the programming help at $100/hour from 7 years ago...when the programmers owned the company they worked for. The physician's $50/hour was the sum total of his package. He paid both sides of SS from it. It was contract labor. So if your specialist friend Takes $50/hour, what does the draftsman Take? From the temp, probably little more than full timebut the draftsman on his own would probably take $40-$50/hour. In the case of the temp agency...probably about $30. But, in other cases, closer to $40. I understand the point you are trying to make here and am not trying to disparage your sincerity in any way. But apple and oranges comparisons can distort perceptions and I'm wary of such in a post-Enron enviroment. OK, but I'm familiar with what engineers make, and every engineer I know of commands more than $50/hour as contract labor. As for the rest of what I wrote earlier, what I hoped would be taken from what I said was that there are a *lot* of inefficiencies in the system that could be eliminated. There are still significant inefficiencies in the system. From what I've heard from folks who worry about costs (like my friend who was chief administrator for a major hospital in NW Houston), _that's_ not where the waste is. Let's look at your suggestion, that hospitals share facilities. Wouldn't that mean that patients who need tests are likely to have to be transported in ambulances? That might be more efficient...but if it was _a lot_ more efficient, couldn't the hospitals save money by outsourcing that part of the work? That was the idea behind the negotiations insurance companies do with hospitals and clinics. They have a profit motive to keep costs downbecause if they increase them...they risk losing customers as their rates go up. From what I've heard from friends in various places in the industry is that the relatively higher costs are due to: 1) The amount of money spent on prolonging death. Intensive care can cost $10k-$20k/day. That adds up while/if the family argues over what to do. I was fortunate that my sister's a hospice nurse, so my dad died at the nursing home without heroic intervention. The US tends to concentrate on that aspect of health care than any other country. 2) Hospitals and physicians are very worried about lawsuits. I know my brother-in-law has been threatened by more than one patient who was refused drugs they didn't need (likely drug addicts). He lives in fear of losing everything. 3) The system we have is, indeed, an unholy mess. Nurses spend most of their time on documentation, not patient care. I don't think though, we can use Alexander's solution to a knotty problemwe're going to have to undo a lot of the knots. 4) The US pays for most of the innovation in health care for the world. Canada gets much cheaper drugs than the US for some of the same reasons that TV shows are sold cheaper there. The costs are already paid for with US sales, as well as a good profit. Canada sales are icing on the cake. It would certainly be the interest of the US to share these costs, but others will have to pay more for drugs as a result. The same is true with a number of other medical innovations over the last 20 years. RD costs and initial profits can be made in the US market. The US is kinda like the fellow who needs the hottest electronics while the world is like the majority of consumers. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
I got the link perfectly. The video hung up the entire screen on Loading ... and I had to get out completely. What is it with msnbc videos? That's the second one that's done this to me. http://idiotgrrl.livejournal.com/ 'Earth is just a starter planet.' Stephen Colbert From: Ronn! Blankenship [EMAIL PROTECTED] Reply-To: Killer Bs Discussion brin-l@mccmedia.com To: Killer Bs Discussion brin-l@mccmedia.com Subject: RE: U.S. health care Date: Thu, 24 May 2007 21:54:06 -0500 At 10:37 AM Wednesday 5/23/2007, PAT MATHEWS wrote: One way would be to have a string of simple health clinics that could do checkups and make ordinary repairs - stitches, shots, setting broken bones, monitoring diabetics, etc - and refer people to other facilities if there were problems. They need not be staffed by doctors: they could be staffed by medics, paramedics, medtechs, nurse-practitioners, etc - with a doctor on call who also made the rounds of the clinics on a regular schedule. Anyone else see the NBC Nightly News tonight (Thursday 24 May 2007)? If not, this seems to be a direct link to the story of relevance here: http://video.msn.com/v/us/msnbc.htm?g=017AC738-1170-4471-97D9-5EB66C5C9243 If that doesn't work, try going to http://www.msnbc.msn.com/id/3032619/ and look for the When you're sick, they're quick! link. -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 25/05/2007, at 7:09 AM, Dan Minette wrote: That's true, but if one is really broke, beans and cornbread are very cheap. You can get the makings for a family of four for about a dollar. And that's a sustainment diet. It's hard to get fruit and fresh veggies cheap. It's not hard to keep a couple of chooks and have a few herbs and veggies. We grow herbs, tomatoes and jalapenos (and a pitcher plant) on a tiny balcony. That can be enough to turn a sustainment diet into a healthy one. Charlie ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
Original Message: - From: Charlie Bell [EMAIL PROTECTED] Date: Fri, 25 May 2007 22:27:58 +1000 To: brin-l@mccmedia.com Subject: Re: U.S. health care On 25/05/2007, at 7:09 AM, Dan Minette wrote: That's true, but if one is really broke, beans and cornbread are very cheap. You can get the makings for a family of four for about a dollar. And that's a sustainment diet. It's hard to get fruit and fresh veggies cheap. It's not hard to keep a couple of chooks and have a few herbs and veggies. We grow herbs, tomatoes and jalapenos (and a pitcher plant) on a tiny balcony. That can be enough to turn a sustainment diet into a healthy one. Looking up reccomended fruits and veggies, I see several sites that say at least 5 servings/day. I recall two of you, so that's ten servings a day or 3500 servings/year.That's a heck of a balcony garden. :-) Is there any chance that this garden provides a tasty accent to your diet, and you get most of your fruits and veggies from another source? If not, can you give us gardening tips? Dan M. mail2web - Check your email from the web at http://link.mail2web.com/mail2web ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrew Crystall Sent: Thursday, May 24, 2007 3:32 PM To: Killer Bs Discussion Subject: RE: U.S. health care On 23 May 2007 at 21:38, Dan Minette wrote: SImply put, the weakest area of the American health system is preventative care. Poorer people with chronic conditions can end up with repeated emergency hospital treatment for conditions which are manageable with drugs which, while not cheap, are far cheaper than repeated hospital admitance. OK, let's try to do an experimental test on this. Drug coverage was just added to Medicare. To the extent that your hypothesis is true, we would see a drop in hospital costs that correspond to the increase in prescription payments. But that doesn't prove anything. The barriers to seeing a doctor in America in the first place are still there (there is no chance to the philosophy of access, or of methods of treatment), I'm not sure what you are getting at. With basic Medicare, one can chose any physician or hospital that takes Medicare (the overwhelming majority do). My mom can has her choice of many different physicians on Medicare. Are you talking about the co-pay (about $15.00 for an office visit), difficulties in getting to the physician or what? and getting a prescription can be difficult for many drugs in the first place. Well, it's true that some of the newest, most expensive drugs are not on the formulary, but I haven't heard a lot a squawk from the AARP (American Association of Retired People): the strongest lobby group in the US (by far). And, I haven't heard of any real restrictions on med from either my mom, or my sister (who's a geriatric nurse). Are you talking about differences in requirements for FDA vs. UK approval of drugs? I know the FDA is rather conservative that way...and that is a topic that can be discussedbut it's a tradeoff situation I think. If so, could you gave an estimate of the impact of quick approval of these drugs? If not, could you give examples of approved drugs that are widely prescribed and paid for under British National Health, but not on the Medicare formulary? Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
On 25 May 2007 at 12:52, Dan Minette wrote: But that doesn't prove anything. The barriers to seeing a doctor in America in the first place are still there (there is no chance to the philosophy of access, or of methods of treatment), I'm not sure what you are getting at. With basic Medicare, one can chose any physician or hospital that takes Medicare (the overwhelming majority do). My mom can has her choice of many different physicians on Medicare. Are you talking about the co-pay (about $15.00 for an office visit), difficulties in getting to the physician or what? If I need to see a doctor, I inform my workplace and go. I make up the hours. That's pretty standard for non-shift workers here. As opposed to being told to take holiday.. and getting a prescription can be difficult for many drugs in the first place. Are you talking about differences in requirements for FDA vs. UK approval of drugs? I know the FDA is rather conservative that way...and that is a topic that can be discussedbut it's a tradeoff situation I think. Well, I don't know about authorising drugs. But I do know this: many more drugs in America are prescription. This is because there are only two catagories of drugs, over the counter and prescription (excepting a few drugs under specific state laws). The UK has a third category, which is behind the counter - a trained pharmacist can dispense the drug, and it's kept literally behind the counter, not on the shop floor. And that's not a small category here either. We also have, in the last decade, shifted quite heavily towards collective doctor's practices - five or six doctors, as many nurse practices and often a dentist in one large collectively owned building. They can see you quickly (if you're not worried about seeing precisely the same person, they have all your records so it doesn't bother me) and have deacently long opening hours. I won't get into the entire societal attitude thing. AndrewC Dawn Falcon ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
At 07:38 AM Friday 5/25/2007, PAT MATHEWS wrote: I got the link perfectly. The video hung up the entire screen on Loading ... and I had to get out completely. What is it with msnbc videos? That's the second one that's done this to me. Since the ms in msnbc stands for Micro$oft you ***have*** to use IE: attempting to view stuff on the NBC web site with another browser will cause the browser to lock up. -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Andrew Crystall Sent: Friday, May 25, 2007 2:13 PM To: Killer Bs Discussion Subject: RE: U.S. health care If I need to see a doctor, I inform my workplace and go. I make up the hours. That's pretty standard for non-shift workers here. As opposed to being told to take holiday.. That's pretty standard here too...at least as far as I've seen. Well, I don't know about authorising drugs. But I do know this: many more drugs in America are prescription. This is because there are only two catagories of drugs, over the counter and prescription (excepting a few drugs under specific state laws). The UK has a third category, which is behind the counter - a trained pharmacist can dispense the drug, and it's kept literally behind the counter, not on the shop floor. And that's not a small category here either. Well, that seems like a reasonable thing, but I don't think it will have a major impact on costs...unless antibiotics for kids are on that list, and I'm not sure that the general dispensation of antibiotics is a good ideacreating immunity and all. The seniors I know should have their meds tracked by a physician or nurse practitioner because of the long term nature of their use, the chances for interaction, etc. We also have, in the last decade, shifted quite heavily towards collective doctor's practices - five or six doctors, as many nurse practices and often a dentist in one large collectively owned building. They can see you quickly (if you're not worried about seeing precisely the same person, they have all your records so it doesn't bother me) and have deacently long opening hours. We've had urgent care centers here for, I don't know, 15 or so years? The closest one is open 12 hours/day 6 days a week and 6 hours on Sunday. Their ad says Walk ins welcome. If you walk in, you might have to wait an hour or two (from experiences with relatives with emergencies), but appointments are fairly easy to get. Dentist sre usually separate, but I've been able to see a new dentist with an appointment made two days before hand, from one of many openings. There are a number of relatively low cost dental practices with 10+ dentists not too far from here. I picked on about 10 minutes away. Given this, I'm not sure why the data on Medicare is not applicable. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ronn! Blankenship Sent: Thursday, May 24, 2007 7:45 PM To: Killer Bs Discussion Subject: RE: U.S. health care Let us presume as was the case in the cases I have heard of on other lists that the families are ordinary middle-class working people who when it comes to cars typically look for a late-model used Chevy rather than a new car of any type and certainly never imagine themselves owning a BMW (except perhaps in their daydreams when they win the Powerball lottery) and that no one can be considered at fault for the problems that the child was born with: the parents were as far as anyone knew or could tell healthy, did not smoke, drink alcohol, use drugs, work in a factory or other environment where they were exposed to toxic chemicals or use such at home or in some second job or hobby, did not engage in any other risky behaviors, did not have any known genetic defects, had early and regular pre-natal care (during which we presume nothing amiss was detected, or at least not until it was too late medically or legally to do anything about it), nothing untoward happened during labor and delivery, etc. How should such cases be addressed by the US health care system? It will have to be addressed by some sort of health care rationing. The only question is when and how. We may not be there now, but there will be a point at which we cannot afford to give the best health care that's available to everyoneeven if that's the focus of the entire economy. How we do that rationing is a very difficult decision. This is one reason that I think we should start working towards the most reasonable rationing system we can have as soon as possible. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
- Original Message - From: Dan Minette [EMAIL PROTECTED] To: 'Killer Bs Discussion' brin-l@mccmedia.com Sent: Friday, May 25, 2007 5:18 PM Subject: RE: U.S. health care -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ronn! Blankenship Sent: Thursday, May 24, 2007 7:45 PM To: Killer Bs Discussion Subject: RE: U.S. health care Let us presume as was the case in the cases I have heard of on other lists that the families are ordinary middle-class working people who when it comes to cars typically look for a late-model used Chevy rather than a new car of any type and certainly never imagine themselves owning a BMW (except perhaps in their daydreams when they win the Powerball lottery) and that no one can be considered at fault for the problems that the child was born with: the parents were as far as anyone knew or could tell healthy, did not smoke, drink alcohol, use drugs, work in a factory or other environment where they were exposed to toxic chemicals or use such at home or in some second job or hobby, did not engage in any other risky behaviors, did not have any known genetic defects, had early and regular pre-natal care (during which we presume nothing amiss was detected, or at least not until it was too late medically or legally to do anything about it), nothing untoward happened during labor and delivery, etc. How should such cases be addressed by the US health care system? It will have to be addressed by some sort of health care rationing. The only question is when and how. We may not be there now, but there will be a point at which we cannot afford to give the best health care that's available to everyoneeven if that's the focus of the entire economy. How we do that rationing is a very difficult decision. This is one reason that I think we should start working towards the most reasonable rationing system we can have as soon as possible. What I gather from what you are saying Dan, is that the people who pay for the health care system are going to have to settle for less in order to preserve the status quo otherwise. I am taking health care rationing in it's simplest terms here, and doing my best to avoid extrapolation of your words. So please expand on this if I am misunderstanding you. I've worked in a few hospitals here in Houston and everyone of them is undergoing large expansions. One is left to wonder who is paying for all this construction if not the end customers. In every hospital I have worked in, doctors are daily treated to sumptuous meals (for free of course) in a lavish (as compared to any other hospital facility) dining room. And the food served is of a quality not seen in any other part of the hospital, prepared in a separate kitchen solely for the doctors. I've seen this at St. Joseph, a relatively poor hospital, and at M.D. Anderson, a rich state run hospital. I know this to be the case at the other hospitals in the Houston Medical Center because my company works in pretty much all of them. If one were to drive through the medical center and observe all the construction (every bit of it medical expansion) one would be hard pressed to understand how we would need medical care rationing. A walk through the parking lot where doctors park their vehicles...wellthey are obviously not worried about fuel efficiency. I live next door to St. Johns Hospital. They have commercials on TV promoting their hospital, saying they have over 900 doctors on staff. This is a small hospital. St Josephs used to advertize on the NPR affiliate saying similar things. M.D.Anderson is currently advertizing on the NPR station. All this advertizing costs *us*. I've worked in Central Stores at St Joes and what the hospital pays for simple pieces of plastic is amazing. So when people complain about the pharmas, I tend to be somewhat sympathetic. It seems to me that the entire medical industry is being treated as a cash cow by anyone who can get a hand in the till. Maybe what we need is a new economic model for medical care. Not for the patients and insurance providers, but at the operational level. There is far too much ostentation currently and the expansion I see belies rationing. And perhaps doctors should consider a pay cut? (G As if the fat cats would even consider it) It may be that some austerity now would prevent a bubble collapse later. (Hey!? Did I just coin a term? Medical Care Bubble?) Qualifiers: I'm in a big city with a very very large medical research and care center. It may be that my views are skewed by proximity to a growth sector of the industry. xponent M.D.Anderson Cancer Center Maru rob ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
Original Message: - From: Robert Seeberger [EMAIL PROTECTED] Date: Fri, 25 May 2007 20:44:13 -0500 To: brin-l@mccmedia.com Subject: Re: U.S. health care - Original Message - From: Dan Minette [EMAIL PROTECTED] To: 'Killer Bs Discussion' brin-l@mccmedia.com Sent: Friday, May 25, 2007 5:18 PM Subject: RE: U.S. health care It will have to be addressed by some sort of health care rationing. The only question is when and how. We may not be there now, but there will be a point at which we cannot afford to give the best health care that's available to everyoneeven if that's the focus of the entire economy. How we do that rationing is a very difficult decision. This is one reason that I think we should start working towards the most reasonable rationing system we can have as soon as possible. What I gather from what you are saying Dan, is that the people who pay for the health care system are going to have to settle for less in order to preserve the status quo otherwise. I am taking health care rationing in it's simplest terms here, and doing my best to avoid extrapolation of your words. So please expand on this if I am misunderstanding you. I think you may be. Right now, we have a make shift form of health care rationioning. It includes HMO rules, general insurance limitationsexclusions by employers, admissions decisions, etc. Everyone is not getting the best care they can. If they did, we'd be spending more on health care. Even so, heath care spending as a fraction of GDP is rapidly rising in the US. Bewteen 1960 and 1990, it rose from 5.1% to 13.4%. This growth led to intererst in health care reform. But, as HMOs and other insurance companies started to work on costs, the percentage held essentially flat through the '90s. By the end of that period, they had found virtually all of the cost savings from these techniques, and costs rose again. In '06, it was about 16% of GDP. It is projected to go to 20% in 2015. I don't have total numbers beyond that, but Medicare costs, as a function of GDP are expected to triple by 2045 and increase 4-fold by 2080. Now, a lot of that is the increased number of baby boomers who are elegible, but that's a real expense. A third of GDP is a reasonable estimate. And, this is extrapolating from a situation in which there is means based determination of the quality of health careand the fraction of insured patients falling. If we were to continue that, there gap between the haves and have nots will just increase. I've worked in a few hospitals here in Houston and everyone of them is undergoing large expansions. One is left to wonder who is paying for all this construction if not the end customers. In every hospital I have worked in, doctors are daily treated to sumptuous meals (for free of course) in a lavish (as compared to any other hospital facility) dining room. And the food served is of a quality not seen in any other part of the hospital, prepared in a separate kitchen solely for the doctors. I've seen this at St. Joseph, a relatively poor hospital, and at M.D. Anderson, a rich state run hospital. I'm not arguing that there is not a lot of money flowing into health care. I'm arguing that the supply of money is not unlimited. I also know, from a friend of mine who was in charge of Northwest Medical Center, that hospitals are cutting corners where you can't see. The snazzy look of major medical center hospitals is part of the marketing...and thus makes money. There are enough wealthy people who will pay extra for the best to make that make sense. But, a good regional hospital has to watch costs carefully in order not to lose money. She's worried that care is close to suffering. Part of it is the paperwork overhead that staff must deal with. Patient care is usually a small fraction of the total staff time. I know this to be the case at the other hospitals in the Houston Medical Center because my company works in pretty much all of them. If one were to drive through the medical center and observe all the construction (every bit of it medical expansion) one would be hard pressed to understand how we would need medical care rationing. A walk through the parking lot where doctors park their vehicles...wellthey are obviously not worried about fuel efficiency. Well, I see the other side. I had a neighbor who was a blood specialist..and couldn't find work in his specialty. He supplemented his income as a doc-in-the-box, at an urgent care center. He made $50/hour for doing this. That's less than temp agencies charge for draftsmen. My brother-in-law's practice is just getting by. He does drive a SUV, but they bought it used, it has 130k miles on it, and he has to drive on roads that are often covered with deep snow (they have gotten as much as 10 meters of snow one year). The right specialists in the right hospitans can still make tons of money. But, physician saleries
Re: U.S. health care
- Original Message - From: [EMAIL PROTECTED] To: brin-l@mccmedia.com Sent: Friday, May 25, 2007 9:46 PM Subject: Re: U.S. health care Well, I see the other side. I had a neighbor who was a blood specialist..and couldn't find work in his specialty. He supplemented his income as a doc-in-the-box, at an urgent care center. He made $50/hour for doing this. That's less than temp agencies charge for draftsmen. Ackkk!!! That isn't the way one fairly compares such things Dan. My company charges around $80/hour for my services, but I'm grossing $24/hour or so. (My total package is around $45/hour). So if your specialist friend Takes $50/hour, what does the draftsman Take? What does the Doc-in_the_box charge for the doc's services compared to what the Temp Agency charges for a draftsman? I understand the point you are trying to make here and am not trying to disparage your sincerity in any way. But apple and oranges comparisons can distort perceptions and I'm wary of such in a post-Enron enviroment. As for the rest of what I wrote earlier, what I hoped would be taken from what I said was that there are a *lot* of inefficiencies in the system that could be eliminated. I understand that medical facilities feel the need to market but they do not to the extent they are. What I see happening is an overabundance of capacity and then a need to fill it. In the current enviroment there is a need to coordinate medical care. Not every facility needs to have the latest and greatest geegaw, just send the patients to the nearest geegaw. But it seems that every hospital wants to have that new geegaw and then they have to compete for patients. This is inefficient and this costs. (I've seen situations where a new catscan or MRI was used 10 or 20 hours a week in a facility that had several of each. But they had staff on hand for 40 to 60 hours a week to facilitate it's use) xponent Geegawgantic Maru rob ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/20/07, jon louis mann [EMAIL PROTECTED] wrote: Why do we behave the way we behave? What has become of us? Where is our soul? DUMPED ON SKID ROW – Hospitals drop homeless patients on the city's Skid Row, sometimes dressed in only a flimsy gown and without a wheel chair, even if they're not healthy enough to fend for themselves. Anderson Cooper reports on the practice known as hospital dumping. http://www.cbsnews.com/stories/1998/07/08/60minutes/main13502.shtml NPR has been following this story for a while. Here's an audio link to the first story I remember hearing them air. http://www.npr.org/templates/story/story.php?storyId=5066463 -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/23/07, PAT MATHEWS [EMAIL PROTECTED] wrote: As it is, I know a fair number of people who go to herbalists and other alternative practitioners for a lot of their health care, partly because of all the hassle and expense involved in using the health care system My best friend's wife goes to an herbalist for what she calls health support and to a regular doctor for critical care issues. The herbalist practices traditional Chinese herbalism and regularly refers his patients to MDs if they have health problems that he thinks they are better equipped to handle. I think the two biggest problems with the standard health care system in the U.S. today are laziness and money. The laziness issue is that too many people eat unhealthy foods and live unhealthy lifestyles and then go complain to their doctors when they become unhealthy. They expect modern medicine to be able to fix any problem they happen to acquire along the way, instead of taking the responsibility and doing the work it takes to stay healthy. Our doctors and nurses -- and our health care dollars -- are taken up treating people who could have avoided their health problems by making healthier decisions. Reducing the number of people in the health care system would go a long way towards fixing the system. The money issue (part one) is that big health care companies are typically much more interested in making money than in actually helping people -- for example, I had a friend who had suffered pain from carpal tunnel syndrome for a number of years, and the medical establishment couldn't offer much to her except the eventuality of surgery. She was recently talking to a man we both know who had previously mentioned having carpal tunnel syndrome but who is now mostly without symptoms. She asked him how he did it, and he taught her a few relatively quick and simple exercises to stretch the long muscles in the forearms, and since she started doing those every day, her symptoms have cut back drastically. These exercises probably wouldn't work for everyone, but exercises like this aren't even taught as a possibility in most medical school programs. Many doctors would probably use some of these exercises if they knew that they exist and work. But the medical establishment as a whole has a vested interest in medical procedures that make lots of money for the doctors and guarantee lots of follow-up care. Again, I'm not faulting individual doctors (mostly), it's the system as a whole that is broken. And the worst part of the system is the pharmaceuticals industry. But that's a whole other e-mail. The money issue part two is insurance companies. I worked as a temp in an underwriting center for an insurance company -- in fact, it was while temping there that I met the former list participant who started me lurking here oh-so-many years ago -- and believe me, the industry is all about making money and minimizing risk. Insurance companies are not interested in helping people get the medical treatment they need. Insurance companies are interesting in getting the biggest dividends they can for their shareholders. So people start out unhealthy, get treated by doctors who are overburdened and were trained in a system that is more interested in propagating itself than in finding the best and least expensive way to get people healthy. Then they -- both the patients and the doctors -- get told by insurance companies what treatments they can and can't use, and then patients are prescribed medicines that cost them far much more than they should. And anyone that argues that medicines have to cost as much as they do in order to pay for research and development hasn't looked at the figures. I don't have the link handy and I have to get back to work so I don't have time to google it right now, but I saw an article within the past year or so that showed a breakdown of how a typical pharmaceuticals company spends its money, and if I recall correctly something like 15 percent of the money went to RD and 20 percent went to shareholders in the form of dividends. That's dividends, money going to shareholders in addition to any money they might make due to the growth of the stock value. -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/23/07, Dan Minette [EMAIL PROTECTED] wrote: This problem is a good one for discussion here. However, it will not be solved by polemics that provide simple stories with heroes and villains like that provided by Moore. There is a hard way out for this, just no easy way out. You don't think there's a place for simple stories in the political process? Seems to me that simple stories often have been the most powerful means of changing a system. For example, what does the name Rose Parks refer, but a simple story illustrative of a systemic problem? Simple stories bring big issues home, don't they? Nick -- Nick Arnett [EMAIL PROTECTED] Messages: 408-904-7198 ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/23/07, PAT MATHEWS [EMAIL PROTECTED] wrote: Heavens - even to me, reared in the system, they are often repugnant. You reminded me of the fact that now that I'm 50, I have to have a colonoscopy. Reared in the system, indeed. Nick -- Nick Arnett [EMAIL PROTECTED] Messages: 408-904-7198 ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/24/07, Mauro Diotallevi [EMAIL PROTECTED] wrote: The laziness issue is that too many people eat unhealthy foods and live unhealthy lifestyles and then go complain to their doctors when they become unhealthy. And I think we can credit some very effective and profitable marketing for part of this behavior. Wish I knew how to address that problem, but I don't. Education, perhaps, but if they're competing with each other, marketing has a lot more money. They expect modern medicine to be able to fix any problem they happen to acquire along the way, instead of taking the responsibility and doing the work it takes to stay healthy. Our doctors and nurses -- and our health care dollars -- are taken up treating people who could have avoided their health problems by making healthier decisions. Reducing the number of people in the health care system would go a long way towards fixing the system. By letting those who are to blame for their own illnesses just die? ;-) Seriously, though, I'd have a hard time differentiating personal from systemic causes for unhealthly lifestyles when there's so much effort invested in advocating them in advertising, marketing and so forth. People are social creatures; it's naive to imagine that some sort of Just say no mentality would make all those problems go away. I'm not saying you're making that argument, but I've certainly heard it. The money issue (part one) is that big health care companies are typically much more interested in making money than in actually helping people Those that are private corporations and thus are legally obligated to be more interested in making money than anything else. They're subject to shareholder litigation if they don't maximize profits. This is not, to me, an obviously good legal structure for organizations that provide basic human services. Ditto for the insurance companies, of course. Nick -- Nick Arnett [EMAIL PROTECTED] Messages: 408-904-7198 ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
Nick Arnett wrote: By letting those who are to blame for their own illnesses just die? ;-) Seriously, though, I'd have a hard time differentiating personal from systemic causes for unhealthly lifestyles when there's so much effort invested in advocating them in advertising, marketing and so forth. People are social creatures; it's naive to imagine that some sort of Just say no mentality would make all those problems go away. I'm not saying you're making that argument, but I've certainly heard it. There is a big part in parents responsability. Now (partly because of economic pressure) I seldom bring my kids to unhealthy foodstores like McDonalds, but even when I was less miserable the max was 1 MacDonalds per month. And there's a very Evil aspect of this: food with trans fat costs _much_ less than a similar food without trans fat. If I were paranoid, I would suggest that the reason is that Food Companies and Medical Companies are owned by the same evil and greedy people. Alberto Monteiro ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
On 23 May 2007 at 21:38, Dan Minette wrote: SImply put, the weakest area of the American health system is preventative care. Poorer people with chronic conditions can end up with repeated emergency hospital treatment for conditions which are manageable with drugs which, while not cheap, are far cheaper than repeated hospital admitance. OK, let's try to do an experimental test on this. Drug coverage was just added to Medicare. To the extent that your hypothesis is true, we would see a drop in hospital costs that correspond to the increase in prescription payments. But that doesn't prove anything. The barriers to seeing a doctor in America in the first place are still there (there is no chance to the philosophy of access, or of methods of treatment), and getting a prescription can be difficult for many drugs in the first place. (leaving aside the whole issue of the suitability of the prescription system in America - suffice to say that I don't think it IS suitable). AndrewC Dawn Falcon ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/24/07, Nick Arnett [EMAIL PROTECTED] wrote: On 5/24/07, Mauro Diotallevi [EMAIL PROTECTED] wrote: The laziness issue is that too many people eat unhealthy foods and live unhealthy lifestyles and then go complain to their doctors when they become unhealthy. And I think we can credit some very effective and profitable marketing for part of this behavior. Wish I knew how to address that problem, but I don't. Education, perhaps, but if they're competing with each other, marketing has a lot more money. They expect modern medicine to be able to fix any problem they happen to acquire along the way, instead of taking the responsibility and doing the work it takes to stay healthy. Our doctors and nurses -- and our health care dollars -- are taken up treating people who could have avoided their health problems by making healthier decisions. Reducing the number of people in the health care system would go a long way towards fixing the system. By letting those who are to blame for their own illnesses just die? ;-) Seriously, though, I'd have a hard time differentiating personal from systemic causes for unhealthly lifestyles when there's so much effort invested in advocating them in advertising, marketing and so forth. People are social creatures; it's naive to imagine that some sort of Just say no mentality would make all those problems go away. I'm not saying you're making that argument, but I've certainly heard it. Nope, I'm not advocating anything as drastic as, you've made your bed, now butter it (to quote an old teacher of mine who preferred his metaphores well-mixed) (or is that, You buttered your bread, now lie in it.) (Or is that, lay.) :-) I'm just advocating people taking more responsibility for themselves. I've seen too many people who eat nothing but junk food and never exercise complaining about the low quality of health care that they receive, when they are being a big part of their own problem. I know there's no quick and easy way to make people act responsibly. People just need to take more personal responsibility, and not only in healthcare issues. -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/24/07, Alberto Monteiro [EMAIL PROTECTED] wrote: Nick Arnett wrote: By letting those who are to blame for their own illnesses just die? ;-) Seriously, though, I'd have a hard time differentiating personal from systemic causes for unhealthly lifestyles when there's so much effort invested in advocating them in advertising, marketing and so forth. People are social creatures; it's naive to imagine that some sort of Just say no mentality would make all those problems go away. I'm not saying you're making that argument, but I've certainly heard it. There is a big part in parents responsability. Now (partly because of economic pressure) I seldom bring my kids to unhealthy foodstores like McDonalds, but even when I was less miserable the max was 1 MacDonalds per month. And there's a very Evil aspect of this: food with trans fat costs _much_ less than a similar food without trans fat. If I were paranoid, I would suggest that the reason is that Food Companies and Medical Companies are owned by the same evil and greedy people. You raise an interesting and important point. It is less expensive -- sometimes *much* less expensive -- to each unhealthy foods than it is to eat healthy. Maybe instead of subsidizing the military-industrial complex, the government could subsidize healthy food. :-) I'm only half-way kidding. -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
Mauro Diotallevi wrote: And there's a very Evil aspect of this: food with trans fat costs _much_ less than a similar food without trans fat. If I were paranoid, I would suggest that the reason is that Food Companies and Medical Companies are owned by the same evil and greedy people. You raise an interesting and important point. It is less expensive - - sometimes *much* less expensive -- to each unhealthy foods than it is to eat healthy. Maybe instead of subsidizing the military- industrial complex, the government could subsidize healthy food. :-) Maybe the g*vernments _want_ this to happen. Old rich people sequester their money and prevent the heirs to expend, so when old rich people die, there's an inflationary pressure. Old poor people are a burden to Social Services, because they generate no income and cost a lot. So, the Maximizer Social Strategy is to let poor people die younger than rich people. I'm only half-way kidding. Me too - as always. Alberto Monteiro ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 25/05/2007, at 6:36 AM, Mauro Diotallevi wrote: You raise an interesting and important point. It is less expensive -- sometimes *much* less expensive -- to each unhealthy foods than it is to eat healthy. Not really. It's just a lot more effort to go to the market, or plan out your meals, than it is to just order pizza. Charlie ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nick Arnett Sent: Thursday, May 24, 2007 2:57 PM To: Killer Bs Discussion Subject: Re: U.S. health care On 5/23/07, Dan Minette [EMAIL PROTECTED] wrote: This problem is a good one for discussion here. However, it will not be solved by polemics that provide simple stories with heroes and villains like that provided by Moore. There is a hard way out for this, just no easy way out. You don't think there's a place for simple stories in the political process? Depends on the story. I would place Moore's story telling with the young buck buying steak with food stamps story. There was a documentary at the South by Southwest film festival (I think I got the name right) in Austin, by self-proclaimed leftists, on Moore. One tidbit about his technique is that he did get an interview of the Roger in Roger and me. It didn't fit his film, so he didn't include it. Seems to me that simple stories often have been the most powerful means of changing a system. For example, what does the name Rose Parks refer, but a simple story illustrative of a systemic problem? Simple stories bring big issues home, don't they? Simple true stories that go to the heart of the matter, do. Polemic films, like birth of a nation, don't. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Charlie Bell Sent: Thursday, May 24, 2007 3:54 PM To: Killer Bs Discussion Subject: Re: U.S. health care On 25/05/2007, at 6:36 AM, Mauro Diotallevi wrote: You raise an interesting and important point. It is less expensive -- sometimes *much* less expensive -- to each unhealthy foods than it is to eat healthy. Not really. It's just a lot more effort to go to the market, or plan out your meals, than it is to just order pizza. That's true, but if one is really broke, beans and cornbread are very cheap. You can get the makings for a family of four for about a dollar. It's hard to get fruit and fresh veggies cheap. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
At 03:36 PM Thursday 5/24/2007, Mauro Diotallevi wrote: You raise an interesting and important point. It is less expensive -- sometimes *much* less expensive -- to each unhealthy foods than it is to eat healthy. Maybe instead of subsidizing the military-industrial complex, the government could subsidize healthy food. :-) I'm only half-way kidding. -- Mauro Diotallevi At 03:54 PM Thursday 5/24/2007, Charlie Bell wrote: Not really. It's just a lot more effort to go to the market, or plan out your meals, than it is to just order pizza. Charlie I was reading a series of articles and letters in the _Salt Lake Tribune_ recently which covered an experiment in Utah: government officials were challenged to live for a week on the same amount that a similar-sized family would receive from the state in food stamps. Those who believe that the point which Mauro makes is not important that starchy foods like potatoes are much cheaper to get enough of to fill up to the point where you and your kids do not feel hungry and miserable all the time than fresh fruits and vegetables and that the primary problem is that it is so much easier simply to eat out or order in might consider trying the same challenge: find out what the state you live in pays a family the size of yours in food stamps and live on that amount. (As some of the aforementioned items in the SLTrib brought out, it is not permitted to supplement the food which the food stamp amount will purchase from any other source, including what you may have on hand before beginning the experiment most folks who have to apply for food stamps or other assistance from the government have little if anything on hand by the time they reach that point and certainly do not have the opportunity or in many cases the skills to plan ahead for hard times like that and to be more fair and accurate, since food stamps are paid on a monthly basis in most states the experiment should last a full month rather than just a week.) -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Mauro's latest .sig, was Re: U.S. health care
At 03:36 PM Thursday 5/24/2007, Mauro Diotallevi wrote: -- Mauro Diotallevi Hey, Harry, you haven't done anything useful for a while -- you be the god of jello now. -- Patricia Wrede, 8/16/2006 on rasfc There is already a god of Jell-O. Just go to Utah and visit any activity where food is served at a church building of the major religion for which the area is known and you will conclude that the serving of Jell-O, particularly green Jell-O, must be one of the required practices of that religion . . . -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
On 5/24/07, Mauro Diotallevi [EMAIL PROTECTED] wrote: I'm just advocating people taking more responsibility for themselves. I've seen too many people who eat nothing but junk food and never exercise complaining about the low quality of health care that they receive, when they are being a big part of their own problem. I know there's no quick and easy way to make people act responsibly. People just need to take more personal responsibility, and not only in healthcare issues. I agree -- and I think society also needs to take more responsibility for systemic issues, such as marketing of harmful stuff. I read the U.S. Constitution as saying that we, as a nation, have a responsibility to look after our people, even as those people are individually responsible for their choices. Nick -- Nick Arnett [EMAIL PROTECTED] Messages: 408-904-7198 ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
At 03:21 PM Thursday 5/24/2007, Alberto Monteiro wrote: Nick Arnett wrote: By letting those who are to blame for their own illnesses just die? ;-) Seriously, though, I'd have a hard time differentiating personal from systemic causes for unhealthly lifestyles when there's so much effort invested in advocating them in advertising, marketing and so forth. People are social creatures; it's naive to imagine that some sort of Just say no mentality would make all those problems go away. I'm not saying you're making that argument, but I've certainly heard it. There is a big part in parents responsability. Now (partly because of economic pressure) I seldom bring my kids to unhealthy foodstores like McDonalds, but even when I was less miserable the max was 1 MacDonalds per month. And there's a very Evil aspect of this: food with trans fat costs _much_ less than a similar food without trans fat. If I were paranoid, I would suggest that the reason is that Food Companies and Medical Companies are owned by the same evil and greedy people. Another possibility is that foods prepared with trans fats reportedly have a longer shelf-life than the same foods prepared without trans fats, making them cheaper to transport and stock because they do not require so much in the way of other preservation techniques and can be kept on the shelves longer without losses due to spoilage and so larger shipments can be made less often than would be required to keep fresh stock of more perishable foods on the shelves, which could cut down on transportation costs . . . -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
At 10:21 AM Wednesday 5/23/2007, Dan Minette wrote: -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jon louis mann Sent: Sunday, May 20, 2007 11:04 PM To: Killer Bs Discussion Subject: U.S. health care Why do we behave the way we behave? What has become of us? Where is our soul? DUMPED ON SKID ROW - Hospitals drop homeless patients on the city's Skid Row, sometimes dressed in only a flimsy gown and without a wheel chair, even if they're not healthy enough to fend for themselves. Anderson Cooper reports on the practice known as hospital dumping. The first thing that comes to mind is that this is an expectable, albeit immoral, response to the mess that hospitals find themselves in with regard to treatment of the indigent. I have had some extended conversations with my brother-in-law (a physician who has a low income private practice in Northern Michigan (he sees a lot of Medicaid patients, and the area is very poor). We agreed that what is needed is a system in which everyone can get a Chevy, but you have to pay your own money if you want a BMW. I have heard in recent months on other lists reports of children (sometimes grandchildren or nieces/nephews, etc., of listmembers) who were born with multiple problems which required the baby to stay in the hospital for months after birth during which they had to undergo multiple expensive medical procedures of various sorts and in many cases will require extensive care once they are released from the hospital and will have to go back to the hospital several times for more procedures and/or care for unexpected crises caused by the problems they were born with. In some cases, such special care and repeated hospitalizations will have to continue for the rest of their lives (which in some cases will be cut short while in other cases they may live well into adulthood or even a full, normal life-span but will never be able to become a contributing member of society and in particular will always be a net economic drain). Even if the necessary care only lasts a few months (a year or less, maybe) and afterward the child is able to live an entirely or mostly normal life and grow up to become a contributing member of society, the costs for the care required during that first year or so may easily run into the hundreds of thousands of dollars (maybe even top a million dollars in some cases, particularly when the problems are due to multiple births and each of the n-uplets requires such care because they were all born with low birth weight). Such care is certainly in the BMW (or perhaps Ferrrari or Lamborgni) price range, but what should we (as a nation, a government, a health-care system, etc.) do about it? Let us presume as was the case in the cases I have heard of on other lists that the families are ordinary middle-class working people who when it comes to cars typically look for a late-model used Chevy rather than a new car of any type and certainly never imagine themselves owning a BMW (except perhaps in their daydreams when they win the Powerball lottery) and that no one can be considered at fault for the problems that the child was born with: the parents were as far as anyone knew or could tell healthy, did not smoke, drink alcohol, use drugs, work in a factory or other environment where they were exposed to toxic chemicals or use such at home or in some second job or hobby, did not engage in any other risky behaviors, did not have any known genetic defects, had early and regular pre-natal care (during which we presume nothing amiss was detected, or at least not until it was too late medically or legally to do anything about it), nothing untoward happened during labor and delivery, etc. How should such cases be addressed by the US health care system? -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
At 10:37 AM Wednesday 5/23/2007, PAT MATHEWS wrote: One way would be to have a string of simple health clinics that could do checkups and make ordinary repairs - stitches, shots, setting broken bones, monitoring diabetics, etc - and refer people to other facilities if there were problems. They need not be staffed by doctors: they could be staffed by medics, paramedics, medtechs, nurse-practitioners, etc - with a doctor on call who also made the rounds of the clinics on a regular schedule. Anyone else see the NBC Nightly News tonight (Thursday 24 May 2007)? If not, this seems to be a direct link to the story of relevance here: http://video.msn.com/v/us/msnbc.htm?g=017AC738-1170-4471-97D9-5EB66C5C9243 If that doesn't work, try going to http://www.msnbc.msn.com/id/3032619/ and look for the When you're sick, they're quick! link. -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
Re: U.S. health care
At 05:08 PM Thursday 5/24/2007, jon louis mann wrote: there is a part of me that believes [...] there are already too many people on this planet. Let me ask you some of the questions I ask everyone who says that: (1) What do you think is the maximum number of people who could? should? be on this planet? (A range is acceptable, but some sort of more-or-less definite number is requested.) (2) How do you propose to get from the current population to the figure you gave in #1? (3) Would you volunteer to make the excess one less right now? Justify your answer. -- Ronn! :) ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
-Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jon louis mann Sent: Sunday, May 20, 2007 11:04 PM To: Killer Bs Discussion Subject: U.S. health care Why do we behave the way we behave? What has become of us? Where is our soul? DUMPED ON SKID ROW - Hospitals drop homeless patients on the city's Skid Row, sometimes dressed in only a flimsy gown and without a wheel chair, even if they're not healthy enough to fend for themselves. Anderson Cooper reports on the practice known as hospital dumping. The first thing that comes to mind is that this is an expectable, albeit immoral, response to the mess that hospitals find themselves in with regard to treatment of the indigent. I have had some extended conversations with my brother-in-law (a physician who has a low income private practice in Northern Michigan (he sees a lot of Medicaid patients, and the area is very poor). We agreed that what is needed is a system in which everyone can get a Chevy, but you have to pay your own money if you want a BMW. The system we have now is that a hospital is not required to take any given patient (I think there are exceptions for some public hospitals such as Ben Taub in Houston). However, once a patient is in, they must be afforded the best care available...until they meet discharge criteria. This is an overwhelming cost to the hospitals, with virtually no hope of recovering the costs. Insurance companies have the leverage to bargain down bills...as anyone who has seen a hospital bill before and after adjustments can tell. So, the bills for those paying privately are through the roof...especially if they do not pre-pay an negotiated amount. For example, we got a bill for 50k for the use of an operating room, a day in intermediate care, and 2 days in a regular room.and had to prove that we pre-paid a negotiated 12,500. The insurance rates were lower than this, of course...so the hospitals can only recoup so much of indigent care from insurance coverage for other patients. Given this, we can see why hospitals would be strongly motivated to release indigent patients that meet discharge criteria...particularly those who are candidates for extensive expensive care. While this is certainly wrong, I think the real problem is the system. And, fixing this is not as easy as Moore might suggest. As it stands, over 16% of GDP is spent on health care.and this is with a significant fraction of Americans obtaining sub-standard care If everyone was given the BMW service, this would rise to 20% to 25% quickly. As it stands, costs are expected to rise to 20% within 10 years, which means that BMW care for all would cost 25%-30% within 10 years. There are a lot of things that can be done to address these costs, but they will involve sacrifices by average people who now have good insurance. We will have to allow, as do other countries, government bureaucrats to decide services that will be offered as well as waiting lists for non-emergency procedures. This problem is a good one for discussion here. However, it will not be solved by polemics that provide simple stories with heroes and villains like that provided by Moore. There is a hard way out for this, just no easy way out. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
One way would be to have a string of simple health clinics that could do checkups and make ordinary repairs - stitches, shots, setting broken bones, monitoring diabetics, etc - and refer people to other facilities if there were problems. They need not be staffed by doctors: they could be staffed by medics, paramedics, medtechs, nurse-practitioners, etc - with a doctor on call who also made the rounds of the clinics on a regular schedule. As it is, I know a fair number of people who go to herbalists and other alternative practitioners for a lot of their health care, partly because of all the hassle and expense involved in using the health care system. If anyone wants to howl about witchcraft, all I can say is, the witch gives decent service at affordable prices, and is usually either an experienced practitioner of traditional medicine (hence with a long tradition of knowing when to send the patient to Public Health) or a college-educated person of a New Age persuasion. And both the latter are far more skilled at taking care of the patient's emotional, spiritual, and family-oriented needs than the health care system (which for the most part does not address them.) For example: a Navajo veteran might see the VA for combat wounds, but for PTSD would also have an Enemy Way Sing done, and the sing can be very effective. http://idiotgrrl.livejournal.com/ 'Earth is just a starter planet.' Stephen Colbert From: Dan Minette [EMAIL PROTECTED] Reply-To: Killer Bs Discussion brin-l@mccmedia.com To: 'Killer Bs Discussion' brin-l@mccmedia.com Subject: RE: U.S. health care Date: Wed, 23 May 2007 10:21:12 -0500 -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of jon louis mann Sent: Sunday, May 20, 2007 11:04 PM To: Killer Bs Discussion Subject: U.S. health care Why do we behave the way we behave? What has become of us? Where is our soul? DUMPED ON SKID ROW - Hospitals drop homeless patients on the city's Skid Row, sometimes dressed in only a flimsy gown and without a wheel chair, even if they're not healthy enough to fend for themselves. Anderson Cooper reports on the practice known as hospital dumping. The first thing that comes to mind is that this is an expectable, albeit immoral, response to the mess that hospitals find themselves in with regard to treatment of the indigent. I have had some extended conversations with my brother-in-law (a physician who has a low income private practice in Northern Michigan (he sees a lot of Medicaid patients, and the area is very poor). We agreed that what is needed is a system in which everyone can get a Chevy, but you have to pay your own money if you want a BMW. The system we have now is that a hospital is not required to take any given patient (I think there are exceptions for some public hospitals such as Ben Taub in Houston). However, once a patient is in, they must be afforded the best care available...until they meet discharge criteria. This is an overwhelming cost to the hospitals, with virtually no hope of recovering the costs. Insurance companies have the leverage to bargain down bills...as anyone who has seen a hospital bill before and after adjustments can tell. So, the bills for those paying privately are through the roof...especially if they do not pre-pay an negotiated amount. For example, we got a bill for 50k for the use of an operating room, a day in intermediate care, and 2 days in a regular room.and had to prove that we pre-paid a negotiated 12,500. The insurance rates were lower than this, of course...so the hospitals can only recoup so much of indigent care from insurance coverage for other patients. Given this, we can see why hospitals would be strongly motivated to release indigent patients that meet discharge criteria...particularly those who are candidates for extensive expensive care. While this is certainly wrong, I think the real problem is the system. And, fixing this is not as easy as Moore might suggest. As it stands, over 16% of GDP is spent on health care.and this is with a significant fraction of Americans obtaining sub-standard care If everyone was given the BMW service, this would rise to 20% to 25% quickly. As it stands, costs are expected to rise to 20% within 10 years, which means that BMW care for all would cost 25%-30% within 10 years. There are a lot of things that can be done to address these costs, but they will involve sacrifices by average people who now have good insurance. We will have to allow, as do other countries, government bureaucrats to decide services that will be offered as well as waiting lists for non-emergency procedures. This problem is a good one for discussion here. However, it will not be solved by polemics that provide simple stories with heroes and villains like that provided by Moore. There is a hard way out for this, just no easy way out. Dan M
RE: U.S. health care
You said: even though i am a skeptic about chanting, gris gris and juju cures, i never negate the power of suggestion. Those aren't supposed to work on the body, or at least not directly. They are supposed to work on the mind, emotions, cultural background etc, which will then help the body do its job, or at least not fight it. It's analogous to explaining the treatment in the language (to quote the old Episcopalian prayer book) Understanded of the people. Because to many traditional people, the ways of our health care system are not only alien, but in some cases, repugnant. Heavens - even to me, reared in the system, they are often repugnant. http://idiotgrrl.livejournal.com/ 'Earth is just a starter planet.' Stephen Colbert From: jon louis mann [EMAIL PROTECTED] Reply-To: Killer Bs Discussion brin-l@mccmedia.com To: Killer Bs Discussion brin-l@mccmedia.com Subject: U.S. health care Date: Wed, 23 May 2007 10:37:47 -0700 (PDT) Why do we behave the way we behave? What has become of us? Where is our soul? DUMPED ON SKID ROW - Hospitals drop homeless patients on the city's Skid Row. -- jlm --The first thing that comes to mind is that this is an expect-able, albeit immoral, response to the mess that hospitals find themselves in with regard to treatment of the indigent. ... what is needed is a system in which everyone can get a Chevy, but you have to pay your own money if you want a BMW. The system we have now is that... (sic) once a patient is in, they must be afforded the best care available... This is an overwhelming cost to the hospitals. (sic) i just had routine microsurgery for my lower lumbar region and the bill was well over $20,000. my in network portion is over $10,000. they kicked me out after one day with very little followup. i would have been better off spending the money on prevention and seeking alternative medicine. i suppose hospitals have to compensate for losses when they provide services for indigent patients like my alcoholic and homeless brother. the hospital wanted me to sign a release to take him off life support, but i couldn't do it. miraculously his liver recovered, probably due to the expensive intensive care he received. the last time he tried to go into rehab he was refused, so he robbed a bank for $100 and went to the police station to turn himself in. he spent thirty months in a federal detention center, which is the longest he has been sober in forty years... the insurance and pharmaceutical companies seem to be doing quite well, which is part of the reason my brother became addicted to prescription medicine when he worked for a think tank and had great coverage. --This problem is a good one for discussion here. However, it will not be solved by polemics that provide simple stories with heroes and villains like that provided by Moore. There is a hard way out for this, just no easy way out. Dan M. i think michael moore has done a real service with his controversial documentaries. he doesn't pretend not to have an agenda when he has louis armstrong singing it's a beautiful world with a collage of all the world's inhumanities as background, or bush sitting dazed like a deer in the headlights for seven minutes while america is under attack. the message is much more powerful than rants by dennis miller or bill o'reilly, who also have an agenda. i very much like the idea of a string of simple health clinics staffed by medics, med techs, nurse-practitioners, and physician assistants - with doctors on call, so they can be free for important emergencies. i do believe there are some good alternative medicine resources, and some out right snake medicine scams. there are plenty of quacks in the medical profession, as well and doctors who think they are god, or are in the profession for the money. even though i am a skeptic about chanting, gris gris and juju cures, i never negate the power of suggestion. --jlm Knowledge is Power No need to miss a message. Get email on-the-go with Yahoo! Mail for Mobile. Get started. http://mobile.yahoo.com/mail ___ http://www.mccmedia.com/mailman/listinfo/brin-l ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
On 23 May 2007 at 10:21, Dan Minette wrote: And, fixing this is not as easy as Moore might suggest. As it stands, over 16% of GDP is spent on health care.and this is with a significant fraction of Americans obtaining sub-standard care If everyone was given the BMW service, this would rise to 20% to 25% quickly. As it stands, costs are expected to rise to 20% within 10 years, which means that BMW care for all would cost 25%-30% within 10 years. Assuming, once more, no cost benefits. But there are. SImply put, the weakest area of the American health system is preventative care. Poorer people with chronic conditions can end up with repeated emergency hospital treatment for conditions which are manageable with drugs which, while not cheap, are far cheaper than repeated hospital admitance. And it improves their health as well. AndrewC Dawn Falcon ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
Ah. We here in the Southwest tend to feel we're the only ones who know anything about Native Americans (blush). Apologies. http://idiotgrrl.livejournal.com/ 'Earth is just a starter planet.' Stephen Colbert From: jon louis mann [EMAIL PROTECTED] Reply-To: Killer Bs Discussion brin-l@mccmedia.com To: Killer Bs Discussion brin-l@mccmedia.com Subject: U.S. health care Date: Wed, 23 May 2007 12:16:19 -0700 (PDT) You said: even though i am a skeptic about chanting, gris gris and juju cures, i never negate the power of suggestion. Those aren't supposed to work on the body, or at least not directly. They are supposed to work on the mind, emotions, cultural background etc, which will then help the body do its job, or at least not fight it. It's analogous to explaining the treatment in the language (to quote the old Episcopalian prayer book) Understanded of the people. Because to many traditional people, the ways of our health care system are not only alien, but in some cases, repugnant. Heavens - even to me, reared in the system, they are often repugnant. i understand that, pat. i had a brother-in-law who was raised on a reservation in saskatchewan, and was a medicine man. he tried his remedies on me, but i lacked faith. i have friends who rely on positive imaging which is the same thing. i think one of the reasons i have such excellent health is i have always felt indestructible, which has allowed me to take the kind of risks which probably resulted in my back problems. i think stress is also a factor because i don't shrink from conflict in my life. Why do we behave the way we behave? What has become of us? Where is our soul? DUMPED ON SKID ROW - Hospitals drop homeless patients on the city's Skid Row. -- jlm --The first thing that comes to mind is that this is an expect-able, albeit immoral, response to the mess that hospitals find themselves in with regard to treatment of the indigent. ... what is needed is a system in which everyone can get a Chevy, but you have to pay your own money if you want a BMW. The system we have now is that... (sic) once a patient is in, they must be afforded the best care available... This is an overwhelming cost to the hospitals. (sic) i just had routine microsurgery for my lower lumbar region and the bill was well over $20,000. my in network portion is over $10,000. they kicked me out after one day with very little followup. i would have been better off spending the money on prevention and seeking alternative medicine. i suppose hospitals have to compensate for losses when they provide services for indigent patients like my alcoholic and homeless brother. the hospital wanted me to sign a release to take him off life support, but i couldn't do it. miraculously his liver recovered, probably due to the expensive intensive care he received. the last time he tried to go into rehab he was refused, so he robbed a bank for $100 and went to the police station to turn himself in. he spent thirty months in a federal detention center, which is the longest he has been sober in forty years... the insurance and pharmaceutical companies seem to be doing quite well, which is part of the reason my brother became addicted to prescription medicine when he worked for a think tank and had great coverage. --This problem is a good one for discussion here. However, it will not be solved by polemics that provide simple stories with heroes and villains like that provided by Moore. There is a hard way out for this, just no easy way out. Dan M. i think michael moore has done a real service with his controversial documentaries. he doesn't pretend to not have an agenda with louis armstrong singing it's a beautiful world and a collage of all the world's inhumanities as background, or bush sitting dazed, like a deer in the headlights, for seven minutes while america is under attack. his message is much more powerful than rants by dennis miller, or bill o'reilly, who also have an agenda. i very like the idea of a string health clinics staffed by medics med techs, nurse-practitioners, and physician assistants - with doctors on call, so they can be free for important emergencies. i do believe there are good alternative medicine resources, and some out right snake oil scams. there are plenty of quacks in the medical profession, as well, and doctors who are in the profession for money, think they are god, . even though i am a skeptic about chanting, gris gris and juju cures, i never negate the power of suggestion. --jlm Knowledge is Power Yahoo! oneSearch: Finally, mobile search that gives answers, not web links. http://mobile.yahoo.com/mobileweb/onesearch?refer=1ONXIC ___ http://www.mccmedia.com/mailman/listinfo/brin-l ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
Get Back To Work. Pat, taking care of business all day and ready to veg out by the boob tube. http://idiotgrrl.livejournal.com/ 'Earth is just a starter planet.' Stephen Colbert From: jon louis mann [EMAIL PROTECTED] Reply-To: Killer Bs Discussion brin-l@mccmedia.com To: Killer Bs Discussion brin-l@mccmedia.com Subject: U.S. health care Date: Wed, 23 May 2007 15:51:43 -0700 (PDT) Ah. We here in the Southwest tend to feel we're the only ones who know anything about Native Americans (blush). Apologies. http://idiotgrrl.livejournal.com/ none necessary, i also live in the southwest. my brother-in-law was a canadian native american. i am one of those rarities, a mexican canadian!~) now, i know what STFU means; please tell us, WTF is GBTW? jon m. This needs to be inscribed on my computer I finally found an acronymic slogan that is more to the point and more concise than Robert Heinlin's old favorite, TANSTAAFL, short for There ain't no such thing as a free lunch. Meaning, if something looks like one, look for the hidden costs. Today. Pink Splice on the Fourth Turning Forums website added a very nice and all-too-true prescription for Crisis Era America: STFU GBTW. What that means, I leave as an exercise for the reader. Or will answer you offline at [EMAIL PROTECTED], since the F stands for precisely what you think it does. Knowledge is Power You snooze, you lose. Get messages ASAP with AutoCheck in the all-new Yahoo! Mail Beta. http://advision.webevents.yahoo.com/mailbeta/newmail_html.html ___ http://www.mccmedia.com/mailman/listinfo/brin-l ___ http://www.mccmedia.com/mailman/listinfo/brin-l
RE: U.S. health care
SImply put, the weakest area of the American health system is preventative care. Poorer people with chronic conditions can end up with repeated emergency hospital treatment for conditions which are manageable with drugs which, while not cheap, are far cheaper than repeated hospital admitance. OK, let's try to do an experimental test on this. Drug coverage was just added to Medicare. To the extent that your hypothesis is true, we would see a drop in hospital costs that correspond to the increase in prescription payments. I looked it up, and there is a small effect on the rise in hospital costs, but it's only a fraction of the increase in cost. This doesn't prove that the same thing will happen if we do this for other age groups, but it is data. I realize that I don't tend to calculate synergy benefits. I've seen scores of these calculations from various sources, and they are usually pipe dreams. The subset that is not tends to be characterized by tangible quantitative arguments...not general ones. Having said that, I'll agree that there will be some benefit, so maybe it's just 25% of GDP in 10 years if we do nothing but add universal health care. Since I have said I support universal health care, the obvious conclusions from the above statement is that we need a radical retooling. Dan M. ___ http://www.mccmedia.com/mailman/listinfo/brin-l