It's been proven countless times that insurance companies are shady.

But even if insurance companies were perfectly honorable in their payouts, I would imagine (but don't know for sure) that there are STILL some people that must be turned down for procedures that later die as a result.

I'd have to see more hard number on how they operate, but I wouldn't be quick to jump on this one instance as a stereotypical example of the failure of corporate health care.

12/27/2007 2:45:47 PM

It's a given that every type of surgery isn't always feasible. On the few borderline cases that exist one would hope that private funding would be available. I could care less if the government or private industry is the one that's backing the healthcare system, but whichever one is doing it needs to have the patients health in mind, not their pocketbooks, which is the case now.

12/27/2007 2:53:41 PM

Quote :

"First and foremost, comparing such systems to our own, and seeing that their health is better across the board. There's only so much you can do to explain away the fact that America has worse health statistics than any modern country with socialized medicine (which, incidentally, is all of them . . . except us). I'm afraid I tend towards the pragmatic, and find ideology a poor substitute for results."

This is a completely bogus argument. Our medical treatment has NOTHING to do with the difference in health. It's our DIET that makes us so unhealthy, in spite of having the best medical system in the world. You need to check your facts.

Also, having spoken with friends and coworkers who were born and raised in Canada, the UK and Norway (three of the better socialized systems in the west), they all VASTLY prefer the US healthcare system. Not one foreign national I've met that I've asked about it preferred their own country's healthcare system to ours.

12/27/2007 3:02:25 PM

Quote :

"Except this isn't really possible, in any meaningful sense. The insurance company presents you with a limited set of options, all written in contracts of their own very careful design by people with the resources to scan your life meticulously for the slightest technical error that would justify them denying service. So no, you don't get to "work out" a damn thing. You have your choice between several steaming piles of shit."

A lack of competition and choice in the insurance industry won't be solved by giving all of it to the government.

Quote :

"How do you know this? From the information provided we have no reason to believe that the hospital (or anyone else) would have loaned this family money or let the operation be performed on credit or some such."

Most places will, certainly state run hospitals. And if not, why aren't we berrating the evil profiteering hospitals with their mercede's driving doctors?

Quote :

"You're saying the doctors are in the wrong for not performing an act of charity. I'm saying CIGNA is in the wrong for not doing the job for which it is paid. "

I'm saying CIGNA was paid to fulfill the terms of it's contract with the family, which they did.

So yes, if we're going to say that CIGNA was wrong for not performing an act of charity, then the doctors are just as wrong. Ask yourself this, what kind of doctor stands around looking at a dying 17 year old girl and says "Nope, aint nothing getting done till I get the money in my account."

Quote :

"Do you even realize how ridiculous all this sounds? "

You're the one saying a company was wrong for doing exactly what they're paid to do.

Quote :

"The difference between the insurance providers is negligible. All you've got is the illusion of choice. "

Again, the lack of options in the insurance world isn't going to go away by letting the government run it all. As was noted earlier, at least some of your lack of choice is already due to government interference.

Quote :

"It will, invariably, happen. However, I believe it will happen much less frequently due to a broadening of covered treatment options, as well as a fundamental change in motives. The goal of the bureaucracy in charge of the system will not be to make money, but rather to spend it. "

But spend it on what? Your health, or a third home for the congressman heading the comitee? Let us not be decieved into thinking the government will be any more benevolent with your money than an insurance company would be.

Quote :

"And I've never once said that I opposed the existence of private insurance companies alongside the state payer. I doubt they'd be widely used, for obvious reasons (you're going to be paying the state either way), but you'd have your choice."

Your choice to continue to fund something which you despise and pay for a service you won't ever use (as I assure you, no private company will insure what the government will already insure for you. Talk about the illusion of choice.

Quote :

"At the ballot box. "

Right, that's why we're out of Iraq, Bush has been impeached and the judges who decided the Kelo case have all been disbarred?

Furthermore, voting out the crongress critter in charge won't change the fact that you're still funding a program you don't support.

Quote :

"Again, an illusion of choice. If you are incapable of paying for something then it isn't really an option, is it? "

There is always a way to pay for it. But if the government makes it illegal for you to get the procedure done in the first place, you have no hope. And you better believe that when you're talking about doctors on the government's dime, there will be very strict guidelines about what , when and how many operations they're allowed to do, lest they be accused of only operating on those bribing them with more pay.

Quote :

"And suing for reimbursement? Jesus, we've got a person who's already in debt because they had to pay for the procedure out of pocket, and you want them to somehow come up with the money to fight a legal battle against a large corporation? "

Some pimple faced geek in east bumblefuck can get a lawyer to take up his case pro bono against the RIAA, I highly doubt the family of a tragic girl on life support couldn't find a lawyer willing to go against an eeeeeeeeevil corporation.

Quote :

"Then why haven't we seen this is any of the other countries that have socialized medicine? Why aren't their governments paying a thousand dollars an x-ray? Why no $500 checkups?"

Give it time and the costs will go up. Or do you seriously think that somehow, because it's healthcare, the fact that the government almost always pays more for something that you or I or a private company does will just magically not happen?

12/27/2007 3:57:35 PM

Quote :

"A lack of competition and choice in the insurance industry won't be solved by giving all of it to the government."

Clearly you misunderstand. I don't actually have that much of a problem with the lack of competition. You're the one concerned with it. I was only talking about the issue for your benefit.

Quote :

"I'm saying CIGNA was paid to fulfill the terms of it's contract with the family, which they did."

This is clearly an area of most of our disagreement, and it's also an area in which you have not addressed my concerns.

When it comes to writing the contracts, CIGNA has all of the say, all the leverage, all the power. They have large and competent legal teams in charge of wording them carefully to allow gray areas, loopholes, and blatant gaps in coverage, all of them put together in language that the average person cannot understand or pay someone to explain. The consumer does not have a chance against these people, but he has no choice but to go up against them.

In most other business matters, there is a real choice -- you don't need a car to live, even if it is so incredibly convenient to make choice very lopsided. But sooner or later virtually everyone needs medical care in order to go on living, and when you cannot get it, you will die. That's what makes health insurance companies' shady dealings different from others: they've got the gun to our heads.

Quote :

"But spend it on what? Your health, or a third home for the congressman heading the comitee?"

In all seriousness, congressmen don't get rich by stealing tax dollars, they get rich by getting paid off by lobbyists.

Quote :

"Let us not be decieved into thinking the government will be any more benevolent with your money than an insurance company would be. "

I never said they'd be especially more benevolent. I said they'd have different motives. Government agencies typically have every incentive to spend, rather than to save, because if you don't spend all of your allotted funds you'll get less next year, and if you spend too much you can always get a bailout. Some heads may have to roll, but the organization isn't going under.

Also, the means of evaluating the bureaucracy will almost inevitably be different. Insurance reps are evaluated very specifically on their ability to save their company money. Rarely, in government, is this such an important measure of an employees success. Ultimately, Congress wants a health system that results in health, because that's what's most likely to keep getting them elected.

Now, once again, in most things I am appalled by those perverse incentives, but healthcare is the exception to the rule. I'd rather have someone spend way too much to maintain my health than not nearly enough.

Quote :

"Your choice to continue to fund something which you despise and pay for a service you won't ever use (as I assure you, no private company will insure what the government will already insure for you"

Oh, I never said it would cover what the government already did. You were the one talking about what we would do when the state refused to pay for something; I was offering private companies as a means to fill those gaps, if one were so inclined.

And besides, it's not something I'd ever use. That was all for your benefit, you being the one so desperate to be able to convince himself that he has a choice.

Quote :

"Right, that's why we're out of Iraq, Bush has been impeached and the judges who decided the Kelo case have all been disbarred?"

Oh, so when it's government we demand instant, major changes?

Quote :

"Furthermore, voting out the crongress critter in charge won't change the fact that you're still funding a program you don't support."

Ultimately I don't care if you or any other individual doesn't support a program. Of all of the government entities you don't support, healthcare would at least be among the noblest. What I do care is that, were the system to be a failure, the national will would be sufficient to vote it either back to the drawing board or out of existence altogether.

Quote :

"There is always a way to pay for it."

Absolute fucking bullshit.

Quote :

"I highly doubt the family of a tragic girl on life support couldn't find a lawyer willing to go against an eeeeeeeeevil corporation."

Most cases of insurance company asshattery aren't as public or clearly diabolical. Yes, maybe this family could have done a better job of it, but they are merely representative of the much, much larger problem.

Quote :

"Give it time and the costs will go up."

What do you base this on? Ultimately, I can point to a dozen countries where single-payer healthcare has not had these problems, and in fact seems to be doing better than ours, and has been doing so for something like half a century. You, on the other hand, can point to . . . the fact that you're pretty sure lots of these bad things will happen.

12/27/2007 4:41:08 PM

Quote :

" But sooner or later virtually everyone needs medical care in order to go on living, and when you cannot get it, you will die."

I know it's a small point in your post, but I think it's worth pointing out that medical care and medical insurance are nearly inseparable--it's nearly impossible to get care without insurance. That shouldn't be the case.

Quote :

"Why aren't their governments paying a thousand dollars an x-ray? Why no $500 checkups?"

Prices are 'cheaper' in countries with socialized medicine because government sets the prices. Comparing prices of health care and drugs in socialized medicine countries to other countries is somewhat like comparing apples and oranges. The US government also fixes the prices they'll pay--my TRICARE (insurance provided by the government to service members and their families) doesn't pay shit. From what I hear, Medicare/Medicaid doesn't pay shit either. This shifts the cost of health care from those who use public insurance to those who use private insurance (or, really, it pushes the costs onto employers).

12/27/2007 6:31:58 PM

Quote :

"In all seriousness, congressmen don't get rich by stealing tax dollars, they get rich by getting paid off by lobbyists."

False. Congressmen get rich by doing both.

Quote :

"What do you base this on?"

As a government employee, I can guarantee you that the costs will go up. Everything we do costs twice as much to accomplish. Hell, we just finished fighting our own fucking design department to get them to DO SOME FUCKING WORK and stop giving us a million reasons why they can't do work. Any agency that can somehow pay a thousand dollars for a toilet seat is guaranteed to jack up the cost of anything.

Quote :

"Government agencies typically have every incentive to spend, rather than to save, because if you don't spend all of your allotted funds you'll get less next year, and if you spend too much you can always get a bailout."

And you don't see how that will raise the costs? You are fucking stupid! What ends up happening is that they SPEND the money on USELESS SHIT and don't spend it on important things. Over time, we end up with $50 an X-ray, sure, but the X-ray machine is 50 years old. However, the lobby sure has a lot of pretty designer chairs, doesn't it?

Also, you fail to comprehend what this will ultimately do to the quality of our healthcare. Look at public education today. What do we have? A TEACHER SHORTAGE! Why? Because teachers aren't paid shit and they aren't given the tools to accomplish their jobs. What in the hell makes you think it will be ANY different? When doctors end up getting paid jack shit and they don't have the tools to do their jobs, do you think their will be many quality doctors? I sure as hell don't think so, and you'd be a fool to think it would be otherwise.

12/27/2007 8:59:26 PM

Quote :

"What in the hell makes you think it will be ANY different? When doctors end up getting paid jack shit and they don't have the tools to do their jobs, do you think their will be many quality doctors? I sure as hell don't think so, and you'd be a fool to think it would be otherwise."

So why isn't this a problem in other countries with socialized medicine?


Or do you just hate America and think that we're inferior to our industrialized brothers.

12/27/2007 9:12:11 PM

^^ Do you understand the difference between a single payer system and a gov. HMO? The problems you describe aren't likely to happen in the single payer system.

You're more likely to get doctors gouging the gov. than the gov. buying $1000 toilet seats.

12/27/2007 9:15:30 PM

Quote :

"So why isn't this a problem in other countries with socialized medicine?"

And who says it isn't? Why is it that people from other countries are always coming HERE to get major surgeries and such?

12/27/2007 9:18:03 PM

Quote :

"In most other business matters, there is a real choice -- you don't need a car to live, even if it is so incredibly convenient to make choice very lopsided. But sooner or later virtually everyone needs medical care in order to go on living, and when you cannot get it, you will die. That's what makes health insurance companies' shady dealings different from others: they've got the gun to our heads."

Given that sooner or later everyone dies, I'd say no one NEEDs health insurance and more than they need a car. All health insurance does is push back how long before you die. That is to say, all the health insurance in the world won't save you from dying in the end, even if they pay for every experimental and long shot treatment every crackpot can come up with.

Quote :

"In all seriousness, congressmen don't get rich by stealing tax dollars, they get rich by getting paid off by lobbyists. "

They do both, and I assure you that lobbyists will also be involved in any government healthcare system.

Quote :

"I said they'd have different motives. Government agencies typically have every incentive to spend, rather than to save, because if you don't spend all of your allotted funds you'll get less next year, and if you spend too much you can always get a bailout. Some heads may have to roll, but the organization isn't going under. "

But you still are suggesting their incentive would be to spend on you the tax payer instead of other things.

Quote :

"Rarely, in government, is this such an important measure of an employees success. Ultimately, Congress wants a health system that results in health, because that's what's most likely to keep getting them elected. "

So do lower taxes, and not having media headlines like "Government spends millions to give liver to girl who dies 5 months later, patients on waiting list pissed". Corruption, waste, inefficiency these are all traits of the government. Yes, the government likes to spend, but in the end, you still need to make sure they spend it on you.

Quote :

"Now, once again, in most things I am appalled by those perverse incentives, but healthcare is the exception to the rule. I'd rather have someone spend way too much to maintain my health than not nearly enough. "

And once again, I'm saying that you are assuming that their incentive is to spend on you.

Quote :

"Oh, I never said it would cover what the government already did. You were the one talking about what we would do when the state refused to pay for something; I was offering private companies as a means to fill those gaps, if one were so inclined. And besides, it's not something I'd ever use. That was all for your benefit, you being the one so desperate to be able to convince himself that he has a choice. "

What I was asking was what do you do when you're pissed and don't want to pay for a system that makes a choice like CIGNA did? People who are pissed at CIGNA have the choice of showing their displeasure by dropping CIGNA. When the government makes the same decision, as they inevitably will, how do you drop the government?

Quote :

"Oh, so when it's government we demand instant, major changes? "

A CIGNA customer could never pay another dime to CIGNA starting tomorrow, instant change. You can't do that when the government does something you don't like.

Quote :

" What I do care is that, were the system to be a failure, the national will would be sufficient to vote it either back to the drawing board or out of existence altogether. "

Leaving you stranded with the same crappy system until that does happen.

Quote :

"Most cases of insurance company asshattery aren't as public or clearly diabolical. Yes, maybe this family could have done a better job of it, but they are merely representative of the much, much larger problem. "

But if more people went public with it and took their insurance company to task, it would be more public.

12/27/2007 9:53:58 PM

to be fair, with the advent of SLAPP suits, airing the dirty laundry of big corporations isn't very easy to do any more

12/27/2007 9:57:43 PM

Given, but the solution to that isn't taking big corps out of the picture and replacing them with big government.

12/27/2007 10:30:54 PM

not disagreeing. just saying...

12/27/2007 10:34:35 PM

Just saw these from Noen:

Quote :

"Our medical treatment has NOTHING to do with the difference in health. It's our DIET that makes us so unhealthy, in spite of having the best medical system in the world."

You really think our diet alone can explain away all the difference? And what exactly is it that fetuses are eating that causes us to have such an abysmal infant mortality rate?

Quote :

"Not one foreign national I've met that I've asked about it preferred their own country's healthcare system to ours."

And not one that I've met preferred ours, and so on, and so forth, because anecdotes don't mean shit.

Quote :

"False. Congressmen get rich by doing both. "

Let's see some relevant examples of congressmen outright stealing taxpayer dollars for personal use. I'm sure they exist, but I'm doubting that they represent a significant amount in the grand scheme, and I'm certainly doubting that they even compare to the money taken as personal profit by the heads of HMOs and insurance companies.

Quote :

"And you don't see how that will raise the costs?"

I think it will have less impact than profit motive does, yes. Again, all I have to do is point to the numerous countries with socialized medicine, all of whom pay less per capita on health care than we do.

Quote :

"Why is it that people from other countries are always coming HERE to get major surgeries and such?"

A variety of reasons. A lot of people go into Canada and Mexico for prescription drugs, too.

Quote :

"That is to say, all the health insurance in the world won't save you from dying in the end"

Of course it won't, but preservation of citizen's lives is a legitimate -- possibly the most legitimate -- reason for a government to exist. That means that taking reasonable steps to keep people alive.

Quote :

"They do both, and I assure you that lobbyists will also be involved in any government healthcare system."

I've no illusions about the role lobbyists are likely to play. Of course, they're doing the same god damned thing right now, they're just doing it on the part of the insurance companies.

Quote :

"But you still are suggesting their incentive would be to spend on you the tax payer instead of other things."

Yes, I'd say their basic incentive is to spend money on the taxpayers, although there are of course institutional incentives inherent to any organization, government, business, or otherwise.

Quote :

"So do lower taxes, and not having media headlines like "Government spends millions to give liver to girl who dies 5 months later, patients on waiting list pissed"."

Honestly, you really think that people would be outraged at trying too hard to save a little girl?

People like lower taxes just fine, but they've got enough brains in their heads that for the most part they're going to factor in the fact that they no longer have an insurance bill every month.

Quote :

"A CIGNA customer could never pay another dime to CIGNA starting tomorrow, instant change."

Instant change to what? It's the same plate of shit from a different server. The only thing you can change to that's any different is simply not having insurance, which isn't really a viable option to those who value not dying for want of a few thousand dollars.

Quote :

"Leaving you stranded with the same crappy system until that does happen."

At least there'd be some hope on the horizon. If private insurance were left to its own devices for the next million years, there's no particular reason to expect it would change. It certainly hasn't in the past several decades, except, possibly, to get worse.

Quote :

"But if more people went public with it and took their insurance company to task, it would be more public."

Right, but the more commonly public it becomes, the less attractive it is for pro bono work because it stands out less, and so on. That's my point. If everybody with a gripe wanted to sue CIGNA, they wouldn't be able to find enough people to handle the legal work for free, and a small percentage of the population can afford good legal counsel.

12/27/2007 10:44:46 PM

Quote :

"You really think our diet alone can explain away all the difference? And what exactly is it that fetuses are eating that causes us to have such an abysmal infant mortality rate?"

seriously, no need to read any more after that gem.

maybe it's what the fetus's MOTHER IS EATING that is affecting the infant mortality rate? genius

12/27/2007 10:46:15 PM

yea you know it might be our alcohol abuse, drug abuse, smoking and poor diets that aid infant mortality rates so much. YA THINK?

And just how many foreign nationals have you actually talked to about this? My guess, based on your trite response, would be zero.

12/27/2007 10:50:09 PM

don;'t forget our incidence of teen pregnancy, too...

12/27/2007 10:51:55 PM

Would that it were so easy. Our maternity care, in particular, is sorely lacking when compared to other modern nations.

I just find it hard to believe that the alcoholic, sausage gobbling Germans are kicking our ass in every department because of diet. Ditto the chain-smoking, ham-loving Spaniards, or the wine-guzzling, cheese-inhaling, and also chain-smoking French.

Part of the difference may be attributable to lifestyle choices, but it seems unlikely that the huge totality of it is.

[Edited on December 27, 2007 at 10:53 PM. Reason : ]

12/27/2007 10:52:10 PM

ha. I;'d say that practically ALL OF IT are attributable to lifestyle choices. you know, like diet, exercise, etc...

12/27/2007 10:54:11 PM

^^ my guess would be hitler and olives

12/27/2007 10:57:37 PM

its pretty much the huge totality of it. why not look at some nutrition and lifestyle facts between nations to pair up with your mortality rates.

See all that wine, cheese, cigs, ham and bacon is not terrible for you when you exercise, walk and use public transportation everyday to get around.

12/27/2007 10:58:24 PM

Re: US Infant Mortality

http://www.qando.net/details.aspx?Entry=3848

(Sorry for using a blog as a source, but there were several similar reports in academic journals last time the statistics came out I just can't find them right now)

There are wide discrepancies in how different countries report infant mortality. Recent increases in infant mortality in the US are, however, probably significant.

Teen pregnancy rates have actually fallen since the 50's although we still have higher rates of teens giving birth than most industrialized nations.

[Edited on December 27, 2007 at 11:05 PM. Reason : .]

12/27/2007 11:02:57 PM

Quote :

"why not look at some nutrition and lifestyle facts between nations to pair up with your mortality rates"

http://www.who.int/tobacco/en/atlas5.pdf

Every country in Europe smokes more than we do, except Sweden and Finland. Every country in Western Europe (and some in Eastern Europe) have higher life expectancies than we do. OK, so it isn't looking like the cigs can be blamed...

From MSNBC:

http://www.msnbc.msn.com/id/21101876/

Quote :

"The United States spends significantly more per capita than any European country on health care, about $2 trillion annually, or 16 percent of the gross domestic product. While the big discrepancy has been linked to higher U.S. prices for medical treatment, the report said a sicker population may also be a factor."

Elsewhere in the article, it says that "treatment of these [diseases linked to obesity] and other chronic diseases adds between $100 billion and $150 billion to the annual health care tab in the United States." So, out of two trillion dollars, anywhere between five and seven percent can be blamed on our big fat asses. Well, that's weird...what does it leave?

Quote :

"See all that wine, cheese, cigs, ham and bacon is not terrible for you when you exercise, walk and use public transportation everyday to get around."

OK, first of all: how is riding a bus or subway any healthier than driving?

Secondly: well, again, it doesn't look like obesity and related problems account for very much of the difference in price, even if they do account for all of the difference in health. That would still mean that with gov't healthcare we'd be living for just as long, but for a lot less money.

12/27/2007 11:18:59 PM

^you still have to walk to train and bus stations and stand around waiting for them. Also, the walk is brisk since you usually need to get somewhere on time.

12/27/2007 11:30:29 PM

couple of quick points because I have an early morning:

Quote :

"Let's see some relevant examples of congressmen outright stealing taxpayer dollars for personal use. "

Not a congressman, but off the top of my head, how about the mayor of NYC using the police as his personal taxi service for his mistress?

Quote :

"Of course it won't, but preservation of citizen's lives is a legitimate -- possibly the most legitimate -- reason for a government to exist. That means that taking reasonable steps to keep people alive. "

So is giving a liver (a scarce resource) to a girl dying of leukemia, suffering from complications from an earlier transplant with only a 65% chance of living 6 months with a successful transplant, let alone a year a reasonable step in keeping them alive?

Quote :

"I've no illusions about the role lobbyists are likely to play. Of course, they're doing the same god damned thing right now, they're just doing it on the part of the insurance companies. "

I don't know, my insurance company seems to prefer generic drugs rather than the latest and greatest being pushed by the pharmaceutical companies. Somehow I can just envision laws and policies dictating that pharma company X's drugs will be the only ones that the government will pay for unless there are mitigating circumstances, and oh by the way, pay no attention to the new Pharma X paid for house that the head of the GHMO committee just received. In fact, as a rule, since my insurance company is motivated to keep their costs down, they seem to avoid expensive exclusivity contracts with companies.

Quote :

"Yes, I'd say their basic incentive is to spend money on the taxpayers, although there are of course institutional incentives inherent to any organization, government, business, or otherwise. "

But would you say an organization which lives or dies on it's customers has more or less incentive than the government to spend money on it's customers?

Quote :

"Honestly, you really think that people would be outraged at trying too hard to save a little girl? "

Yes, I do. People are assholes.

Quote :

"Instant change to what? It's the same plate of shit from a different server. The only thing you can change to that's any different is simply not having insurance, which isn't really a viable option to those who value not dying for want of a few thousand dollars. "

As much as you would pretend it isn't so, the companies are different where they can be. And if there were more choice, they would have even more differences. Furthermore, at least for some, they can choose to not pay at all, an impossibility under a government run system. But you miss the point. If CIGNA looses half it's customers in the next month because they deny experimental treatments, you better believe the other companies are going to implement coverage for experimental treatment.

Quote :

"At least there'd be some hope on the horizon. If private insurance were left to its own devices for the next million years, there's no particular reason to expect it would change. It certainly hasn't in the past several decades, except, possibly, to get worse. "

There's no indication the government would get any better either. In fact, I would bet that given equal levels of customer action private care would improve long before government care would.

^ So 5-7% of our spending (not our extra spending, just the spending overall) goes to us being fat lazy slobs in general, and then from your article:

Quote :

"For example, the study found 12.2 percent of Americans are diagnosed with cancer, more than twice that of Europe. But that is likely due in part to more screening here, the study said."

So how much of our extra spending in health care is attributable to us actually treating the things that ail us? It's real easy to keep your health care spending low if you aren't treating things in the first place.

[Edited on December 27, 2007 at 11:42 PM. Reason : asdfadsfa]

12/27/2007 11:35:36 PM

Lets look at disease incidence by country:

http://www.nationmaster.com/graph/hea_bre_can_inc-health-breast-cancer-incidence

US has low incidence of breast cancer

http://www.nationmaster.com/graph/hea_obe-health-obesity

Obesity comparison

http://www.nationmaster.com/graph/hea_per_of_lif_liv_in_ill_hea_mal-percentage-life-lived-ill-males
http://www.nationmaster.com/graph/hea_per_of_lif_liv_in_ill_hea_fem-percentage-life-lived-ill-female

Percentage of life lived in ill health (which, being that we have some of the lowest incidents of most cancers, genetic diseases, terminal illnesses and communicable diseases, only leaves the suggestion of LIFESTYLE as a contributing factor)

12/28/2007 12:00:02 AM

Quote :

"All the insurance companies have to do is stop being assholes and do what they're payed to do, but instead they're too preoccupied with their bottom line."

Yes, insurance companies should stop caring about their bottom line and bankrupt themselves paying for every single claim.

12/28/2007 12:11:06 AM

Quote :

"Not a congressman, but off the top of my head, how about the mayor of NYC using the police as his personal taxi service for his mistress?"

Like I said, it happens. I just think it doesn't happen enough, in sufficient quantity, to be a dealbreaker. And really the only difference between a Congressman buying a house with our money and CIGNA's CEO doing the same is that it's harder for the Congressman to do because it's illegal.

Quote :

"Somehow I can just envision laws and policies dictating that pharma company X's drugs will be the only ones that the government will pay for unless there are mitigating circumstances, and oh by the way, pay no attention to the new Pharma X paid for house that the head of the GHMO committee just received."

To a certain extent I'm not sure it's a bad thing. A fair amount of money still needs to be flowing into pharma companies to keep them flush with R&D money. Generic drugs are good for whoever buys them, but they don't really contribute as much in the research department. Otherwise, I don't see how it's any different from insurance lobbyists paying our representatives to be supportive of insurance companies.

Quote :

"But would you say an organization which lives or dies on it's customers has more or less incentive than the government to spend money on it's customers?"

Both groups live and die based on the people they supposedly serve. Pissed off people can change insurance providers (although they generally don't, since so much of it is done through employee plans), and pissed off people can vote against the people who pissed them off.

Quote :

"Furthermore, at least for some, they can choose to not pay at all, an impossibility under a government run system."

A paltry minority. And besides, my concern isn't so much for whether you have the choice to pay, it's for whether you have the option to be treated.

Quote :

"So how much of our extra spending in health care is attributable to us actually treating the things that ail us? It's real easy to keep your health care spending low if you aren't treating things in the first place."

Cancer screening is one of those areas where American awareness gives it near parity, but in either event, the lack of screening doesn't seem to be too big of a problem, since the Europeans are all living longer than we are.

---

Noen -- unless I'm missing something, you didn't post the link for the disease incidence.

12/28/2007 12:49:05 AM

Quote :

"Otherwise, I don't see how it's any different from insurance lobbyists paying our representatives to be supportive of insurance companies."

Replacing one evil with another doesn't do anything to solve your problem. Why change if the end result is going to be the same?

Quote :

"Both groups live and die based on the people they supposedly serve. Pissed off people can change insurance providers (although they generally don't, since so much of it is done through employee plans), and pissed off people can vote against the people who pissed them off."

Right, but when was the last time you saw the government seriously change? Sure you can fire the democrats and elect republicans. You want to talk about illusion of choice, let's talk about firing your representatives.

Quote :

"A paltry minority. And besides, my concern isn't so much for whether you have the choice to pay, it's for whether you have the option to be treated. "

You always have the option to be treated.

Quote :

"Cancer screening is one of those areas where American awareness gives it near parity, but in either event, the lack of screening doesn't seem to be too big of a problem, since the Europeans are all living longer than we are. "

Going back to the whole lifestyle thing:

On average, europeans are living between 1 and 3 years longer than us:

US 78.2, UK 79.4, Sweeden 80.9 according to the UN

Walking 30 minutes a day can add 1.3 years to your life: http://walking.about.com/od/healthbenefits/a/livelonger1105.htm

Being overweight can reduce your life expectancy by more than 3 years:
http://www.annals.org/cgi/content/abstract/138/1/24

I would wager a bet that europeans as a whole: walk more, are less overweight and eat better (more moderation) than most americans. So I'd say it's pretty easy to explain at least differences in life expectancy from just lifestyle choices.

12/28/2007 2:43:48 AM

We libertarians may need to circle the wagons... the go'vt statists have us surrounded!

One thing that would help is to let gov't allow more choice in health-care insurance packages.

Many state gov'ts force insurers to offer only packages that include every possible problem. It's like an auto insurer only being able to offer full coverage. If I'm a younger person, who can probably get by at this stage without all of the old-people coverage..then why not let me buy a less-expensive package?

Health insurance gets so expensive because of gov't mandates. So then cash-strapped people use health insurance for minor everyday problems.
The system should be re-set so that we are paying for most of our minor medical stuff out-of-pocket. That awareness of prices would spark more competition and lower prices. This would allow insurance companies to cover the more expensive stuff like with this little girl.

Less gov't mandates would also generate more competitors to enter the field. Competition is a wonderful thing. Just look at the black-eye CIGNA is getting over this. Do you think an enterprising competitor will take advantage of the situation?

Earthdogg Insurance- "We Won't Let Any Parent's Little Girl Die"

[Edited on December 28, 2007 at 10:41 AM. Reason : .]

12/28/2007 10:40:24 AM

or maybe we should stop letting the government muck around in healthcare in the first place, since that is what is driving the prices so fucking high, anyway. Then, we should make the government programs like medicaid and medicare pay exactly what we do for healthcare, instead of letting them pay pennies on the dollar which forces doctors to jack up their rates for every one else.

12/28/2007 12:15:48 PM

...and while we're at it.

The gov't should let Nurse Practioners take on more of the trivial duties that tie doctors down now. Not every medical situation requires a doctor's attention. This would ease the demand on doctors and thus help bring down medical costs.

12/28/2007 8:00:19 PM

bullshit. It's always necessary to have a full-fledged doctor there to irrigate an abrasion or to tell someone they do, in fact, have a cold and need to take Nyquil.

12/28/2007 10:46:13 PM

They should re-allow the sale of pseudoephedrine OTC.

12/28/2007 11:52:29 PM

Quote :

"They should re-allow the sale of pseudoephedrine OTC."

It's the only shit that works for mah colds.

12/28/2007 11:57:33 PM

It is a moot point about whether government or private health care is better. There is a severe and deadly organ shortage, which makes prioritizing transplants very important. Even in a socialized medicine system, this girl would not be guaranteed an organ. Only a small handful of countries presume consent in organ donation.

I have also seen conflicting reports regarding the availability of a liver. You have to be on the list to be considered for an organ. If she was not on the list, she would not be tested for that organ. Sadly, transplant surgeons have to make judgment calls about who should receive a liver and quality of life is a factor in their decisions.

It just seems like this transplant was a band aid on top of dozens of other problems that would kill this girl on their own. I am on the fence about the insurance denying coverage, but it seems that they had a strong case in their favor. Bobby has a point about letting doctors making the calls.

She would have been a terrible candidate to receive an organ. She had a prolonged lung infection and prior history of cancer (twice). You cannot have a transplant if you have a cold, let alone an infection. Immunosuppressant therapy would have allowed this infection to potentially kill this girl after the surgery.

I don't think the family will win a suit. Depending on what they filed, they will have to prove that the girl would have lived had she had the transplant. If I was the defense counsel, I would just point out the lung infection, the lack of available liver and the preexisting vegetative state. There are just too many factors that will make it hard to win. If the family was smart, they would just take a settlement (undeserved).

12/29/2007 10:27:43 AM

Also, I have seen UNC Hospital do amazing things in regards to expensive surgeries and payment.

One of my clients needed a spinal fusion to prevent paralysis in all four limbs. This was a $500k+ surgery and the client had no coverage. It seriously took two phone calls to the financial director to work something out. UNC charged $75k in the end, which the client can pay for over the course of time.

I imagine UCLA could have done something similar if possible, but I wonder how the future treatment of the transplant would have played a role.

12/29/2007 10:46:36 AM

Quote :

" The gov't should let Nurse Practioners take on more of the trivial duties that tie doctors down now. Not every medical situation requires a doctor's attention. This would ease the demand on doctors and thus help bring down medical costs."

It ain't the government that does that. It's the private medical boards.

12/29/2007 2:19:36 PM

wait for it.......

12/30/2007 10:31:14 PM

you know, the private medical boards that are effectively run by the government and allowed by the government to be the end-all, be-all of medicine...

^ you are welcome

12/31/2007 6:41:27 PM

He's right. State governments are responsible for limiting the functions of NPs through scope-of-practice laws.

When assessing the rising costs of health care, the media is quick to point to the demand side of the equation, but often doesn't consider the supply side. The government, through the direct influence of the AMA, is artificially limiting the supply of medical professionals through strict licensure laws. This is done with the premise that these laws ensure the quality of health care professionals, but there is little empirical evidence that suggests any quality improvement with such strict laws.

We don't have a shortage of physicians because there are not enough students who want to study medicine, we have a shortage because the government determines which schools can be "approved" to have medical schools and how many doctors they can produce (why do you think NCSU doesn't have a medical school?) A friend of mine, who is now in med school, was told by the school that 40% of their first-year students had to apply at least twice before being accepted due to the restricted number of applicants they could take.

If we really want to decrease the cost of medical care, we first need to increase the supply of medical professionals vis-a-vis rising demand. The government has no business playing the role of a central planner in determining what it thinks the supply of medical professionals should be.

http://www.cato.org/pub_display.php?pub_id=1105&full=1

http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm

1/5/2008 9:38:31 AM

^ an excellent point. i have always been curious about supply of doctors vs. quality of doctors.

1/5/2008 5:30:39 PM