As much as I hate the socialism and destruction being pushed through in Washington, trying to nationalize a fifth of the world's largest economy in a few weeks before people realize what's going on and denying what is actually in the bill is a ballsy move. It's not going to work, but it's a ballsy move. I'm sure Obama and Pelosi are hating themselves for not doing this before they used up their political capital quadrupling the deficit and blowing 700 million dollars while trying to call it "stimulus"

8/27/2009 3:54:20 PM

So I listened to the T.R. Reid piece on Fresh Air and it was more in depth, but still a rather shallow treatment of the issue. I still got the sense that he was glossing over a lot of the objections to health care. He pretty much admitted that the elderly would be denied care and that some nations do have obscene waiting lists (I found the comparison of the horse to a human to be interesting). If I had more time, I'd probably read the book. I find the Swiss model to be especially interesting.

Administrative costs are undoubtedly a huge factor in US care. This bill doesn't seem to do anything to remedy that and it appears would actually add to them.


I also listened to a lecture on some unaddressed issues in health care and one was doctor compensation. We generally accept the fact that if we want a good doctor we'll have to pay for it, and that higher compensation leads to better doctors. What I did not realize was the fact that the AMA, acting somewhere between a cartel and a union, effectively limits the number of new doctors in the United States each year. They don't state it any more, but at it's inception, one of the AMA's stated goals was restricting the number of medical students admitted every year in order to restrict supply and thereby drive up wages. The effect is noticeable:



Covered a bit more here: http://mises.org/article.aspx?Id=1547

8/27/2009 4:12:26 PM

^

I think you're right, but I think they are betting on the this killing out some of the other government programs over time leading to a one system solution. In the short term I think it will surely make things worse, but in the long run it's a gamble to make things better. It seems fairly obvious that this is the long term strategy.

Something has to be done because costs are rising triple what wages are rising and we are the only 1st world country without full coverage. Something has to be done, I fear this isn't it though.

PS if elderly being denied care where such a issue you'd think our life expectancy would be higher.

PSS: You should listen to Dan Ariely on what the effect of compensation is on performance. He was also on Fresh Air and TED. His book Predictably Irrational is one of the most insightful books I've ever read about human behavior and it got a ton of press this year. He was a visiting professor at Duke last semester.

Here's in summary what he says (he has data to back it up in the book):
"A salary alone will not motivate people to risk their lives. Police officers, firefighters, soldiers--they don't die for their weekly pay. It's the social norms--pride in their profession and a sense of duty--that will motivate them to give up their lives and health."
"Money, as it turns out, is very often the most expensive way to motivate people. Social norms are not only cheaper, but often more effective as well."

from this outline:
http://bookoutlines.pbworks.com/Predictably-Irrational



[Edited on August 27, 2009 at 4:25 PM. Reason : aaa]

8/27/2009 4:18:46 PM

^ The US Life Expectancy is where it is due to the lifestyle of most Americans...

it is increased because of the health care we receive, but it is lowered because of diet and exercise...

i would wager, if the rest of the world ate as poorly and exercised as little as the US did, the life expectancy of the rest of the developed countries would drop drastically and the US would be in the lead (due to differences of our health care system).

8/27/2009 5:20:48 PM

^^ Predictably Irrational is on my reading list, albeit a ways down behind stuff I have to read for work. I heard a few speeches he gave on FORA.tv podcasts and found his insights fascinating.

Quite frankly, I think the true market price for Physicians is lower than the current level but the AMA is acting no different than the UAW in forcing labor costs up. I've yet to hear any politicians address this though.

8/27/2009 5:30:25 PM

Jesus, I leave this thread for like a day and look at it now.

8/27/2009 6:25:04 PM

I know, right? There's actually been rational discussion going on

8/28/2009 11:06:50 AM

Quote :

"At a town hall meeting Wednesday Sen. Jim Inhofe (R-Okla.) told Chickasha residents he does not need to read the 1,000 page health care reform bill, he will simply vote against it. "I don't have to read it, or know what's in it. I'm going to oppose it anyways," he said."

http://www.chickashanews.com/local/local_story_239102559.html

I had a hard time deciding whether to post this here or in the Republican credibility thread.

8/28/2009 1:08:57 PM

^ Its a good thing no Democrats have ever said anything so amusing....

Quote :

"I love these members, they get up and say, ‘Read the bill,’” said Conyers. “What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?”"

http://hotair.com/archives/2009/07/27/video-conyers-scoffs-at-doing-his-job/

Expected response: "Oh, but he really meant something different as he explained after the fact! My side is so much smarter than the other side, so don't even try to compare the two."

8/28/2009 1:23:58 PM

Quote :

"Conservative media figures are blasting Democrats for trying to draw political gain from the death of Senator Ted Kennedy. But on Thursday, it was one of their own -- former Arkansas Gov. Mike Huckabee -- who went there. The 2008 Republican presidential candidate suggested during his radio show, "The Huckabee Report," on Thursday that, under President Obama's health care plan, Kennedy would have been told to "go home to take pain pills and die" during his last year of life. "[I]t was President Obama himself who suggested that seniors who don't have as long to live might want to consider just taking a pain pill instead of getting an expensive operation to cure them," said Huckabee. "Yet when Sen. Kennedy was diagnosed with terminal brain cancer at 77, did he give up on life and go home to take pain pills and die? Of course not. He freely did what most of us would do. He choose an expensive operation and painful follow up treatments. He saw his work as vitally important and so he fought for every minute he could stay on this earth doing it. He would be a very fortunate man if his heroic last few months were what future generations remember him most for." As it happens, Huckabee made his remarks shortly after he derided Democrats for using Kennedy's death to make the pitch that "Congress must hurry and pass the health care reform bill and do it in his memory," "That not only defies good taste," said Huckabee, "it defies logic.""

http://www.huffingtonpost.com/2009/08/28/huckabee-kennedy-would-ha_n_271605.html

What a piece of shit.

8/29/2009 9:07:38 AM

Quote :

"I know, right? There's actually been rational discussion going on"

Was referring to the sheer growth of the thread but way to be a predictable fuckstick.

8/29/2009 9:27:37 AM

^^ Yeah, that is a complete fallacy. Under the current plan Ted Kennedy would have kept his congressional health care plan and he'd have been taken care of. The rest of us? Denial of care at advance stages of terminal illness and later in life is not unheard of in nationalized plans. Even T.R. Reid touched on this in his Fresh Air bit on NPR.


I thought this was interesting, and under reported:




So, even in a "crisis" our current system produces better cancer survival rates than any of the nationalized programs. (http://tinyurl.com/497vds)

8/29/2009 10:11:22 AM

They have less practice on cancer id bet their incidence rate is an order of magnitude lower.

8/29/2009 3:22:09 PM

You might have a point there, do you have any data to back it up?

8/29/2009 3:50:02 PM

Iceland, Sweden, Belgium, Finland and Switzerland aren't that far below us at all though. I would be surprised if we couldn't figure out a system with lower costs that maintained our high ranking.

8/29/2009 9:15:18 PM

Well right. I'm not part of the "everything is just ok and all change is communism" crowd, but I certainly oppose the current bill.

I think that Germany and Switzerland are two countries which probably have the model most acceptable to both the US taste for freedom of choice and the desire to offer universal care.

I'm also skeptical of a bill that relies heavily on a morality play pitting "the benevolent and kind leaders of the government" against "those greedy and profit motivated corporate fat cats."

Both sides are long on emotion and extremely short on thought.

8/29/2009 9:18:55 PM

Quote :

"but I certainly oppose the current bill"

which one?

8/29/2009 9:27:13 PM

Quote :

"begonias All American 13158 Posts user info edit post if I had health insurance I would totally do the mud wrestling thing "

/thread

8/29/2009 10:35:21 PM

^^ any of the current bills: http://tinyurl.com/nxx2ms

All of them are long on expansion of government power and none of them address some of the key issues as I see them. Namely:

- Tort Reform
- the AMA's stranglehold on the supply of doctors and the consequential increase in medical labor costs
- the cost of administration (despite claims, In 2005, Medicare's administrative costs were $509 per primary beneficiary, compared to private-sector administrative costs of $453.)
- the fact that the US system produces better results for critical diseases
- the inability of insurance companies to maximize efficiency due to 50 separate and complicated state insurance regulation regimes.
- the under-payment of government programs to hospitals for their services.

Instead, we're hearing my aforementioned morality play.


Quite frankly, I think the idea of the Swiss system, with national competition between insurance companies who are prohibited from profiting on health care directly (but can use it as an incentive to purchase fire, car, home, etc. insurance), with the abolition of federal health care regimes, and a federal subsidy for low income families in its place would be the most efficient and acceptable solution for Americans.

I don't think that politicians are far sighted enough and courageous enough to pull it off though.

8/30/2009 11:37:48 AM

A friend at work just broke his foot, and the dysfunction of the health industry is now on full display. We have a PPO from our private employer.

He's been getting the run around for weeks on all kinds of bullshit minutiae, xrays arent getting transferred, paperwork isn't getting sent, secretaries are failing at life, bullshit charges are popping up (paperwork handling fee for outsourced service that the medical office uses).

The few times I have been to the doctor, I have had similar problems. The insurance part hasn't even been a main source of problems -- it's how the medical facilities themselves operate. The entire industry is stuck in the stone age.

^And none of that would address any of our problems, which just shows that the ideologues from both sides don't really care about solving real problems.

8/30/2009 12:01:00 PM

Quote :

"And none of that would address any of our problems, which just shows that the ideologues from both sides don't really care about solving real problems."

Why not? Nothing I've posted is ideologically driven and most of it would be a step towards a solution.

But yes, there are massive inefficiencies in the medical system. As I understand it (and there are probably people who can speak better to this on here than me) there is a sizable push right now to enhance digitization and communication within the hospital system.

8/30/2009 12:07:35 PM

Quote :

"- the AMA's stranglehold on the supply of doctors and the consequential increase in medical labor costs"

Although I disagree with most of your point of view here in the soap box, I consider you a pretty straightforward guy who seems to have a good bit of sense. That being said, this seems pretty crazy. Do you have anything to back it up, or is it like that other guy who was implying that basically anybody should be allowed to perform medicine and the free market would sort out the bad ones?

8/30/2009 12:17:47 PM

considering that the AMA has helped maintain the number of hospital residencies at the exact same number since, what, 1996, I'd say his claim has extreme merit.

8/30/2009 1:12:20 PM

^5
You don't consider the government's refusal to use its bargaining power to negotiate pharmaceutical costs a problem not being addressed by the bill?

On one hand, doing so would hurt these companies' bottom line and may be detrimental to our economy; on the other hand, private profits shouldn't come at the expense of taxpayers' dollars.

Or maybe they should; they already do.

Anyway, I'm open to both sides of the argument.

8/31/2009 12:38:30 AM

^^^ http://mises.org/article.aspx?Id=1547


^ You make a point. One of the reasons I think that the pharmaceutical industry is supporting this bill is because they find potential long run profits in it. The government could use it's collective bargaining
to control costs, but that will only give the industry incentive to produce just enough of the right quality and quantity of drugs to remain on the good side of the government.

In the event of a single-payer / government-controlled situation, if the defense industry is any model, quality will be mediocre at best and prices will rise.

8/31/2009 9:51:34 AM

^Sebelius already pushed that in Kansas, as have several other states.


Bob Dole weighs in with an Op Ed, encouraging Obama to take a stronger role and push a specific bill.
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/28/AR2009082802603.html?hpid%3Dopinionsbox1&sub=AR

8/31/2009 11:08:16 AM

Quote :

"In the event of a single-payer / government-controlled situation, if the defense industry is any model, quality will be mediocre at best and prices will rise. "

defense funding is fucked up because of the emotionalization of the defense industry. Cut a defense program and people start screaming about being weak on national defense.

8/31/2009 11:12:23 AM

And health care wouldn't be emotional?

8/31/2009 11:25:51 AM

Healthcare would largely be easier to contain because the research and development works on the open markets. Defense contracting is a closed market with large barriers and a smaller user base.

8/31/2009 11:29:36 AM

Yet right now we already see quack medical "practioners" with little to no basis in actual science - and I'm looking at you, "alternative" medicine and chiropractors - pushing to have their services included in benefit mandates of private plans at the state level. This comes without even the big push for "universal" care at a federal level.

Clearly, the fact that medical science works as an open process hasn't stopped the special interests of alternative medicine quackery from being jammed into existing plan mandates. So why should we expect any differently under the scenario of the feds running the show?

This may be small potatoes, in your mind, but I think it is symptomatic of a larger problem. I don't think the political system works as rationally even with a product purchased on the open market when it comes to regulations.

8/31/2009 12:12:39 PM

That is a completely random rant that has nothing to do with what I posited.

8/31/2009 12:18:22 PM

Only if you're a complete idiot.

8/31/2009 12:23:09 PM

I like your strawman arguments. They are grand.

8/31/2009 12:31:55 PM

*yawn* Again I'd advise you to look up the meaning of terms like "straw man" before you post them. Alas, you will not. Again.

8/31/2009 12:34:11 PM

Your rant and rave is the definition of strawman. I'm speaking about research and development.

Nothing I posited had anything to do with alternative medicine, yet that is the tact you chose to attack what I wrote.

Now take the arrogant attitude elsewhere, Cochise.

8/31/2009 12:37:55 PM

I know I shouldn't respond to people so stupid to not even be able to read and comprehend an argument, much less tie their own shoes or spell their own name correctly, but alas...

Healthcare costs are a function not just of R&D, but of what gets put into plans via mandate. This has a very vocal and active lobby, with very few opponents similarly as interested. Thus, despite your claim that healthcare's R&D contracting is in the open market, already the experience shows that methods completely absent from any idea of actual R&D get shoved into health plan mandates at the state level.

Your argument was to contradict JCASHFAN's claim that healthcare would be just as emotional/political as defense spending. Your argument was that contracting happens under a more open process. My counter-argument was that special interests, particularly those of quack medicine, frequently jam their interests into state mandates, indicating that the process is not as open and rational as you might claim. In other words, it too is political.

Wow. That was so hard to follow.

Do us all a favor and stop wasting everybody's time. Even not dnl posts more relevant arguments than you, and that says something.

[Edited on August 31, 2009 at 12:46 PM. Reason : >.<]

8/31/2009 12:45:59 PM

Quote :

"Your argument was that contracting happens under a more open process."

You are such a dumbass you cannot even get my argument right. Congratulations dumbfuck.

8/31/2009 12:50:23 PM

Oh? Prove me wrong. I suppose I used the word "contracting" instead of "R&D contracting." My bad.

Waste of oxygen.

8/31/2009 12:52:31 PM

Look at where the word contracting appears in my post.

What an arrogant sack of shit.

8/31/2009 12:55:12 PM

Prove me wrong. Or eat a dick.

Or both!

8/31/2009 12:56:01 PM

Point to me where I used the term Research and Development Contracting.

You cannot do that because it never happened, you arrogant, strawman-creating-dick-cheese-spreader.

Now, until you can understand the difference between companies doing research and development on their own products as opposed to military contracts where bottom line is not really an issue there is no point having a conversation with you.

[Edited on August 31, 2009 at 1:00 PM. Reason : .]

8/31/2009 12:57:56 PM

Ah, I see, so now we're in the realm of pedantry. R&D is conducted on the open market. I mistakenly used the word "contracting" even though, I don't know, we're purchasing R&D services on the open market. You know, using your own words and all.

You finished, now? Because there's still that issue of proving me wrong. Or eating a dick.

Because the only person in this forum who doesn't follow the argument at hand is you. Which is this: R&D is not the end-all-be-all driver of costs. My, what a difficult argument to follow!

[Edited on August 31, 2009 at 1:09 PM. Reason : Ugh.]

8/31/2009 1:08:04 PM

Instead of actually acknowledging your mistake you are in the process of developing a more in depth strawman argument. bravo.

Quote :

"Because the only person in this forum who doesn't follow the argument at hand is you. Which is this: R&D is not the end-all-be-all driver of costs. My, what a difficult argument to follow! "

What you fail to understand is Research and Development when it comes to private companies is a necessary evil in order to make money through marketing the product. Plus private industry is an open market place where multiple parties can develop their own products.

In military Research and Development, the money is made in the Research and Development stage and it is not an open market.

In other words, lose the attitude. You haven't earned it.

[Edited on August 31, 2009 at 1:32 PM. Reason : .]

8/31/2009 1:28:56 PM

Quote :

"Prove me wrong. Or eat a dick."

8/31/2009 1:31:12 PM

Quote :

"Instead of actually acknowledging your mistake you are in the process of developing a more in depth strawman argument. bravo."

8/31/2009 1:33:07 PM

So you've got nothing. Okay then. Let's just take this as an acknowledgement of that fact and move on.

8/31/2009 1:34:19 PM

Still tilting at windmills I see.

8/31/2009 1:34:59 PM

You've been given nigh-on half a page to clarify and explain your position, and why it has been mischaracterized. Instead you result to childish insults and stamping your feet. Not once have you deigned to make a cogent rebuttal.

Clearly, any rational person here would conclude that you have nothing to contribute to the discussion. As have I.

Carry on.

8/31/2009 1:41:20 PM

My point is clear. It is not my fault you are illiterate, or completely unwilling to admit your error, Messr. de la Mancha.

[Edited on August 31, 2009 at 1:43 PM. Reason : .]

8/31/2009 1:42:48 PM

You wouldn't happen to be another alias of McDanger, would you? I mean, the parallels are obvious: neither of you ever actually respond with a cogent rebuttal, simply a litany of insults, when called to question your position, you simply respond, "It's obvious!", and I don't think I've ever seen both of you posting in the same thread...

Two sides of the same troll, I guess.

8/31/2009 1:44:33 PM