"France is healthcare leader, US comes dead last: study"

[Billdave2]

Well, there's the rub, eh? Essentially, your world view boils down to something like "As long as the rich are OK (and as long as I'm rich), then screw everyone else. 'cause life isn't fair".

Well, you know what? I think it's the duty of human beings, as social creatures, to strive for fairness. To not let people die or suffer when to help them is of minimal inconvenience to the whole. To work together to smooth out the pockets of unfairness where they can reasonably be eliminated. To live with bold ethical convictions and a keen sense of the needs and desires of my fellow man. to be a decent human being who actually feels bothered when students, old people, immigrants and manual labourers are left even more destitute after life-saving surgery than they were before.

If you want to live in a world where it's dog eat dog, every man for himself and well, life's not fair so why bother with compassion, then fine. I don't, and nor do most mature, sensible, grown-up adults.

If I am rich I wish someone would tell me where all my money is.

Where did I say that we should all be looking out for only number one and forget everybody else? I said life is not fair and it isn't governments place to try and make it so. If we do, who gets to decide what is fair? Is it fair that supermodels are pretty and some people aren't? Should the government provide plastic surgery to make every one look attractive? Is it fair that my friends mother died due to malpractice, or that Darat's mother has had to have extensive medical procedures? Is it fair that I had to work and put myself through school, when my parents paid for my brother to go? What is fair? How do you decide? Why should the government be the one to decide who deserves compassion? I know plenty of people who give of themselves everyday to help others, and I applaud them. I even try to do some things myself when I can. Just because I realize that life isn't fair and that some people get the short end of the stick, doesn't mean I like it that way.

 

[volatile]

If I am rich I wish someone would tell me where all my money is.

Where did I say that we should all be looking out for only number one and forget everybody else? I said life is not fair and it isn't governments place to try and make it so. If we do, who gets to decide what is fair? Is it fair that supermodels are pretty and some people aren't? Should the government provide plastic surgery to make every one look attractive? Is it fair that my friends mother died due to malpractice, or that Darat's mother has had to have extensive medical procedures? Is it fair that I had to work and put myself through school, when my parents paid for my brother to go? What is fair? How do you decide? Why should the government be the one to decide who deserves compassion? I know plenty of people who give of themselves everyday to help others, and I applaud them. I even try to do some things myself when I can. Just because I realize that life isn't fair and that some people get the short end of the stick, doesn't mean I like it that way.

Nonsense. Where was I advocating aesthetic plastic surgery on the NHS?

Did you miss the bit where I said "To not let people die or suffer when to help them is of minimal inconvenience to the whole. To work together to smooth out the pockets of unfairness where they can reasonably be eliminated"? It is of minimal cost to society as a whole to provide a good, socialised care system which does not leave people bankrupt or without treatment entirely. You counter this with appeals to blame and individual responsibility, whilst waving away the cases of the blameless and the responsible who still find themselves screwed by this monstrosity of a situtation.

Does ideology really trump reality in your world? Is it better to stick to the ideology of dogged individualism even when it is proven to be worse for people? I simply cannot fathom the dogmatic adherence to ideology in the face of evidence, whatever form it may take. The individualism often displayed on this board is particularly bizarre example.

 

[Billdave2]

Evidence that this would have happened in a socialised system? Your paranoia has no relation to reality.



So it's the critically-ill, hospitalised insured old-age-pensioner's fault that he's bankrupted by an immoral, absurd, unfair system? Really?

This system, which has no doubt cost him thousands of dollars in insurance and still left him bankrupt, is better than one in which he is treated according to his need, free at the point of use? How? You keep saying so, by shifting blame and sticking dogmatically to the ideology of individualism, but you haven't actually made a case.

Here's mine - the socialised system is better because, despite its faults, old guys never end up bankrupt at the same time as recovering from invasive surgery. Seems quite simple to me. What's your case?

Well there is the anecdote of my friends father who had to wait to have angioplasty. The reason he had to wait 2 years was that because of his age he was lowerr priorty and kept getting bumped (he was in his md 60's).

If he had all those thousands of dollars of insurance why did he have to pay? I would call that moving the goal post. First it was he had no insurance and no way to get assistance, then it was he shouldn't have to look for assistance, now it is he had insurance but it was no good?

The socialized system is worse because evitually market forces will come to bear on it. Supply and demand will win out in the in. As the socialized system faces increased demand (since it is SO easy) and lack of competition for health care profesionals drives wages to stall the supply will become less, meaning shortages, which increase wait times and quality of care. Personally I want as many people as possible to have "good" health care (quick and high quality) than everybody having poor health care.

 

[Billdave2]

Nonsense. Where was I advocating aesthetic plastic surgery on the NHS?

Did you miss the bit where I said "To not let people die or suffer when to help them is of minimal inconvenience to the whole. To work together to smooth out the pockets of unfairness where they can reasonably be eliminated"? It is of minimal cost to society as a whole to provide a good, socialised care system which does not leave people bankrupt or without treatment entirely. You counter this with appeals to blame and individual responsibility, whilst waving away the cases of the blameless and the responsible who still find themselves screwed by this monstrosity of a situtation.

Does ideology really trump reality in your world? Is it better to stick to the ideology of dogged individualism even when it is proven to be worse for people? I simply cannot fathom the dogmatic adherence to ideology in the face of evidence, whatever form it may take. The individualism often displayed on this board is particularly bizarre example.

So making the vast majority of people with top quality health care reduce there standard to meet the few who are not getting the best is fair? That is what sociallized medicine does. Instead I would rather see free market solutions that bring the best health care to everyone. But I guess you don't care about all those other people who will get diminished health car and all the ones who won't get better health care. Does YOUR ideology really trump reality in your world? Which one of us really cares about helping people?

 

[fls]

If it doesn't make a difference, why do it at all?

Because then you don't need to waste money that could be better spent elsewhere building excess capacity into the system.

There is at a minimum some reduction in the chance of a fatal heart attack, the longer a person waits to have the procedure done, the greater the risk of fatality. I would say that makes all the difference in the world if you are the one needing the operation.

That's the kind of outcome I mean. When research shows no difference in mortality at 30 days, 6 months and one year, the complaints against the wait seem to be based on impatience, rather than health.

As to why they didn't buy the meds, they were retired and could not afford them. Isn't that supposed to be the problem with the US system?

Yes, which is why it doesn't serve as an example of the differences between the systems.

I am at work and my copy of the book is at home. I will look it up later. Doesn't it have an Index? I think it does but not sure.

I mentioned that I looked through the index. I'll wait to hear from you.

Linda

 

[volatile]

So making the vast majority of people with top quality health care reduce there standard to meet the few who are not getting the best is fair? That is what sociallized medicine does.

Evidence? You're wrong, by the way.

Instead I would rather see free market solutions that bring the best health care to everyone.

That's working real well, isn't it. In what way will "free market solutions" make $100,000 worth of surgery and medical bills cheap enough such that minimum-wage recipients can afford it?

Tell me what these "free market" solutions are, and how they work. You can spout the party line as much as you want, blindly striving for the free-market solution, but I've never seen anyone explain exactly how any free-market solution will solve these kinds of problems. Maybe you can?

But I guess you don't care about all those other people who will get diminished health car and all the ones who won't get better health care. Does YOUR ideology really trump reality in your world? Which one of us really cares about helping people?

Well, given that you're content to maintain a broken system on the back of an unworkable, immoral ideology in return for bankrupting the old, the infirm, the young and those on low wages as well for providing a system that has worse health-care metrics across the board, I think it's quite clear that the answer to that question is "me". That you're content to see students and old people suffer because, well, "life's not fair", as you said, I think I'm doing OK if we're totting up the compassion points, to be honest.

I fail to see how you can claim that social systems lead to worse healthcare "for the majority" when the statistics show that Americans die sooner and have much worse levels of health in general than their European neighbours. The figures are in. The experiment's been done. Social medicine works, for everyone.

Further, you have yet to explain why socialised systems mean worse care for the majority, or that anyone's healthcare is diminished. It simply isn't the case.

 

[fls]

So making the vast majority of people with top quality health care reduce there standard to meet the few who are not getting the best is fair?

Why would you ask people to reduce the quality of care?

That is what sociallized medicine does.

It does? Do you have any evidence for this?

Instead I would rather see free market solutions that bring the best health care to everyone.

How would this happen under a free market situation? The tendency has been for the market to maximize profit rather than health.

Linda

 

[volatile]

Philosophical question - is it better, morally, than everyone has access to "average" healthcare and the option to trade-up should they be able to afford it, or that 'most' people have excellent healthcare whilst some people (the poorest, most vulnerable and most needy) have no healthcare at all unless they fancy bankruptcy?

That's the trade you're making Bill, and that's why your ideology is abhorrent.

 

[Billdave2]

Because then you don't need to waste money that could be better spent elsewhere building excess capacity into the system.



That's the kind of outcome I mean. When research shows no difference in mortality at 30 days, 6 months and one year, the complaints against the wait seem to be based on impatience, rather than health.



Yes, which is why it doesn't serve as an example of the differences between the systems.



I mentioned that I looked through the index. I'll wait to hear from you.

Linda

That is my point, why waste the time money and pain if the procedure doesn't make any difference?

Do you have numbers to back up this claim that there is no difference in 30 days, 60 days or a year having the same mortality rate? I ask because most angioplasties are done in the US very quickly and I am not sure how you can judge this. Besides, if it was you or one of your loved ones, would want to take that chance?

I agree, about the similarities. My whole point is that socialized medicine has flaws too. The fact that this flaw is the same in both points to the need for some other solution.

 

[fls]

Linda has provided some evidence that it is around 13 days in the US. That would include heart attack victims who have to recover before having the procedure. That is significantly different than the 55-77 days that you have proof of, even if you dismiss my friends story as anecdotal, which by the way I have as much proof as you do about your mothers story. (which by the way I am not trying to make light of, I am sincerly sorry she is having problems)

I should point out that the UK is unusually long. The median wait time for PTCA for other countries is more around 20 days.

I will admit that using perfect was a strawman, but it is touted as being so much better than our current system, or even a revamped model of the current system that it might as well be. In many circles (especially Democartic circles) it is presented as such.

I think the point is that the US could be getting far more value for the money it spends, or spend less money and redistribute good-quality care to everyone (while ensuring that people are still free to buy excess care if they want). The only thing holding them back seems to be ideology, and that ideology seems to be based on misunderstanding and misinformation.

Linda

 

[volatile]

I think the point is that the US could be getting far more value for the money it spends, or spend less money and redistribute good-quality care to everyone (while ensuring that people are still free to buy excess care if they want). The only thing holding them back seems to be ideology, and that ideology seems to be based on misunderstanding and misinformation.

100% right. You nailed it.

 

[Billdave2]

Evidence? You're wrong, by the way.



That's working real well, isn't it. In what way will "free market solutions" make $100,000 worth of surgery and medical bills cheap enough such that minimum-wage recipients can afford it?

Tell me what these "free market" solutions are, and how they work. You can spout the party line as much as you want, blindly striving for the free-market solution, but I've never seen anyone explain exactly how any free-market solution will solve these kinds of problems. Maybe you can?



Well, given that you're content to maintain a broken system on the back of an unworkable, immoral ideology in return for bankrupting the old, the infirm, the young and those on low wages as well for providing a system that has worse health-care metrics across the board, I think it's quite clear that the answer to that question is "me". That you're content to see students and old people suffer because, well, "life's not fair", as you said, I think I'm doing OK if we're totting up the compassion points, to be honest.

I fail to see how you can claim that social systems lead to worse healthcare "for the majority" when the statistics show that Americans die sooner and have much worse levels of health in general than their European neighbours. The figures are in. The experiment's been done. Social medicine works, for everyone.

Further, you have yet to explain why socialised systems mean worse care for the majority, or that anyone's healthcare is diminished. It simply isn't the case.

Philosophical question - is it better, morally, than everyone has access to "average" healthcare and the option to trade-up should they be able to afford it, or that 'most' people have excellent healthcare whilst some people (the poorest, most vulnerable and most needy) have no healthcare at all unless they fancy bankruptcy?

That's the trade you're making Bill, and that's why your ideology is abhorrent

I have combined your posts and will answer to the best of my knowledge (I am not in the insurance business and am not a politician so my knowledge is not endless on the topic)

In the US currently, the government gives large tax breaks to companies to provide employees with group insurance plans. These plans are partly paid for by the company and partly by the employee. The company negotiates the best deal that provides the most coverage for everybody in the company. If you are self-employed you can go out and buy your own plan, one that is tailored to your specific needs. For instance if you are a single with no children you might get a better rate if your dental plan did not include orthodontics. the group plan your company has may have mopre bargaining power, but has to include more options. As an individual, you get no tax relief for procuring your own plan, and since you don't your plan cost's much more relatively. The result of this is there is very little real compition in the market place, and very few options on types of plans. To promote the free market, the individuals would be given a similar tax break if they purchase there own plan. This means more portability (if you change jobs you don't have to change insurance, or spend three months with none). This would also lead to an increase in competion as the number of consumers shopping in the market place increases, competion is good for the consumer because it brings the price down, along with the increase in types of plans which would mean there would be some cheaper alternatives. You also give companies the opportunity to get out of the insurance business. They can offer to give employees the difference in what they pay on the insurance (the tax breaks are smaller than what the company pays the insurance company, but it is considered a benefit). What this means is insurance is not tied to employment giving workers more job options, since they can work for smaller companies, or themselves without worring about health care. The other step is tort reform. John Edwards made his fortune suing obstricians who had vaginally delivered children with health problems(I believe it was MS). He argued in court that they should have performed a C-section and because they didn't that was the reason for the health problem. He even got down on the floor in a fetal position and "acted out" the part of the baby crying "please get me out!". Studies have since shown that this was completly bogus, but juries knew that the doctor wasn't the one paying, it was the insurance company, so why not help out these poor people, the only ones getting hurt were the insurance companies. Never mind increased malpractice insurance costs and the subsequent increase in C-section because doctors didn't want to take a chance. How much more do you think unnecessary C-sections cost? This is just one example. Currently one of the reasons health care is so expensive is that if you are sick, doctors will order everytest they can think of to cover themselves in case of a malpractice suit.

These are just two things that would greatly improve the health care system here in the US with out sacrificing individual choice and causing demand to eventually overpower supply. The socialized system is worse because eventually market forces will come to bear on it. Supply and demand will win out in the end. As the socialized system faces increased demand (since it is SO easy) and lack of competition for health care profesionals drives wages to stall the supply will become less, meaning shortages, which increase wait times and quality of care. Personally I want as many people as possible to have "good" health care (quick and high quality) than everybody having poor health care.

What is abhorant is to think that it is better to condemn everybody to lower quality healthcare, when you have the option to improve the health care of the ones at the bottom instead.

 

[Darth Rotor]

Well, there's the rub, eh? Essentially, your world view boils down to something like "As long as the rich are OK (and as long as I'm rich), then screw everyone else. 'cause life isn't fair".

Well, it isn't.

Well, you know what? I think it's the duty of human beings, as social creatures, to strive for fairness.

Why?

To not let people die or suffer when to help them is of minimal inconvenience to the whole. To work together to smooth out the pockets of unfairness where they can reasonably be eliminated. To live with bold ethical convictions and a keen sense of the needs and desires of my fellow man. to be a decent human being who actually feels bothered when students, old people, immigrants and manual labourers are left even more destitute after life-saving surgery than they were before.

All nobel sentiments, to be sure. Why getting bothered is a required response remains a mystery.

Why?

If you want to live in a world where it's dog eat dog, every man for himself and well, life's not fair so why bother with compassion, then fine. I don't, and nor do most mature, sensible, grown-up adults.

As a "why" this is what pigeons leave on statues: how many half arsed rhetorical tropes and appeals can one put into so small a space?

DR

 

[fls]

That is my point, why waste the time money and pain if the procedure doesn't make any difference?

What was wrong with the answer I gave?

If you want to have the ability to perform all procedures within a certain time period, you need to be able to perform more procedures than are necessary. Excess capacity, in addition to being more expensive, also tends to lead to an increase in unnecessary surgery.

Do you have numbers to back up this claim that there is no difference in 30 days, 60 days or a year having the same mortality rate? I ask because most angioplasties are done in the US very quickly and I am not sure how you can judge this. Besides, if it was you or one of your loved ones, would want to take that chance?

There's this analysis of the GUSTO-I trial, for one.

My point is only that reasonable maximum wait times should be based on outcomes like death, disability, pain, progression of disease, rather than "I'm impatient", and queuing reflects that. It is under elective situations that you see differences wait times, while urgent and emergent cases take place within the same time frame regardless of where you are.

My whole point is that socialized medicine has flaws too.

I don't think anyone is arguing otherwise.

Linda

 

[Billdave2]

I should point out that the UK is unusually long. The median wait time for PTCA for other countries is more around 20 days.



I think the point is that the US could be getting far more value for the money it spends, or spend less money and redistribute good-quality care to everyone (while ensuring that people are still free to buy excess care if they want). The only thing holding them back seems to be ideology, and that ideology seems to be based on misunderstanding and misinformation.

Linda

I agree that that we should, but is not the ideology that is wrong, it is the execution. The ideology that is wrong is that by lumping everybody together and letting the government take over so we "don't have to worry" about it is the problem. Right now the majority of insurance is tied to our jobs by the system. The system is set up to create these large blocks of consumers, instead of having individuals do it for themselves. The socialized system takes it further and puts us all in one block. What this means is less competion for our business (insurance). Less competition is always bad fro the consumer. If you have ever dealt with a insurnce company in the US and been frustrated, imagine how bad it would be if there were no options. Hillary Clintons plan made it illegally not to join the plan. That meant if you wanted private insurance you would have to pay for it on top of the government plan. I am not sure how the NHS does it in the UK, but assume it is similar.

By the way can anybody name me one thing the US government runs really well? Do you really want these guys running our health care system?

 

[Billdave2]

What was wrong with the answer I gave?

If you want to have the ability to perform all procedures within a certain time period, you need to be able to perform more procedures than are necessary. Excess capacity, in addition to being more expensive, also tends to lead to an increase in unnecessary surgery.



There's this analysis of the GUSTO-I trial, for one.

My point is only that reasonable maximum wait times should be based on outcomes like death, disability, pain, progression of disease, rather than "I'm impatient", and queuing reflects that. It is under elective situations that you see differences wait times, while urgent and emergent cases take place within the same time frame regardless of where you are.



I don't think anyone is arguing otherwise.

Linda

I would say that someone who just had a near fatal heartattack and was told that he needed the angioplasty to help prevent another, is not quite "just impatient". His wait was not due to lack of urgency, but because of his age. So we should tell old people they aren't worth saving if they can't wait?

 

[volatile]

Well, it isn't.

Why?

All nobel sentiments, to be sure. Why getting bothered is a required response remains a mystery.

Why?

As a "why" this is what pigeons leave on statues: how many half arsed rhetorical tropes and appeals can one put into so small a space?

DR

Why? Why? You sound like a whining child, Darth. That's the kind of post I'd expect from Jerome.

You want to boil it down to basic moral principles? You're essentially asking me why it's better to help people at negligible cost to oneself instead of leaving them suffer. If you even need to ask that question, then there's nothing I can possibly say that will change your mind. If it is not self-evident to some degree that helping others when to do so does not inconvenience you and, in fact, possibly even makes you better off, should be a useful basic ethical precept, then I'm sorry, I can't help you.

In this context, BillDave and you are arguing that the ideology of dogged individualism should triumph even when to work for the common good actually benefits everyone (including you). That's not only immoral, it's stupid.

 

[Darth Rotor]

In this model, you fail to account for accidents and emergencies,

No, I don't, but then, I didn't present you with a model.

When you want to stop making stuff up, we can continue.

DR

 

[Billdave2]

Why? Why? You sound like a whining child, Darth. That's the kind of post I'd expect from Jerome.

You want to boil it down to basic moral principles? You're essentially asking me why it's better to help people at negligible cost to oneself instead of leaving them suffer. If you even need to ask that question, then there's nothing I can possibly say that will change your mind. If it is not self-evident to some degree that helping others when to do so does not inconvenience you and, in fact, possibly even makes you better off, should be a useful basic ethical precept, then I'm sorry, I can't help you.

In this context, BillDave and you are arguing that the ideology of dogged individualism should triumph even when to work for the common good actually benefits everyone (including you). That's not only immoral, it's stupid.

Is it better to help someone at negligble cost to oneself, or to help that person more at no cost to yourself? That is the true issue here. Do you lower health care for most while only bringing it up a little for the rest, or do you seek a solution that brings everybody up to the top?

 

[volatile]

Oh, and as an addendum to that, three words.

Basic. Human. Decency.

It is not morally justifiable to let the most needy members of society suffer for the selfish ideologies of the rich. It is not ethically sustainable to let pensioners and students writhe into bankruptcy, ill-health and even death whilst their neighbours and fellow citizens sit by and do nothing, when to act would be of negligible inconvenience.

Or can you make a case to the contrary, instead of just bleating about "rhetoric"?