Health care - administrative incompetence

[Delscottio]

The NHS operates under a pro bono publico philosophy. So if you accept healthcare from the NHS are you accepting charity?

There is no market in the US that I'm aware of, other than the illegal drug market, that is truly free. Everything is regulated. I accept that some regulation is necessary. Even cosmetic surgery and Lasik is regulated.

This does not mean that the market couldn't be "more free" than it is now.

Two pages ago you said we paid for by being taxed the hell out of. Make up your mind.

 

[kellyb]

This does not mean that the market couldn't be "more free" than it is now.

Not with insurance involved. (Your money being spent by other people on other people.)

So, how are you going to bring down the costs of Ducky's surgery/treatment by increasing the freeness of the market?

Unless you're advocating high-tech, expensive treatments becoming "niche market" products for the rich, it's not possible.

I can't tell if you are unable to grok this, or are just too ashamed to admit that's what you actually want.

 

[Tatyana]

I retooled the last paragraph of this but I'm posting here a private message I sent to Rolfe. She suggested sharing it with you fine folk.

Obviously I don't post much but I've been lurking here for four years or so. I have Duchenne muscular dystrophy. I am one of the few lucky people who made it past my 25th birthday. Former actor Jerry Lewis runs a private telethon in Los Angeles every year while smaller metropolitans have their own local drives. Something that scares me is what seems like a lack of interest in relatively rare diseases because fighting an illness such as this is seen as a luxury. The only way to pay for it is to shell out money people like us don't have.

I must say I have a pretty poor quality of life. I'm on my computer most of the day. I don't have a van that's appropriate for the present state of my condition and despite there being home care agencies out there paid for by Medicaid, they are generally poorly-run organizations. They don't have the money to hire people who actually care about the disabled folk they're aiding. I have working parents, really the only people I feel comfortable with caring for me. In five years I've probably lost about ten friends to this. In 1998 I had to deal with my brother's death as he also had this disease.

I have an enlarged heart and I'm currently on an ACE inhibitor and a statin, your bread-and-butter reliable medicines. Many people with DMD are prescribed steroids to combat the wasting away of the muscles, which really taxes their already compromised heart. Given how our medical field has gone the past forty years in the United States, I feel like finding treatments for this disease have been retarded. We are behind in innovation but there's no reason why out of 330 million people we can't find solutions.

There's just no money in it.

All this crap about charity being enough makes me laugh. They go to popular causes, some of which are admittedly fairly deserved, but those are a minority. I am tired of people with chronic illnesses like me being treated like second-class citizens, like leeches on the rich. I have a pre-existing condition and it enrages me when people just don't understand that while they're chasing their vaguely-defined embodiment of liberty, there's a segment of the population that is suffering, not only physically but emotionally. I have a struggle every day with mood swings. I've thought about suicide more than somebody should and I feel like I'm cracking more and more every day.

I think people would be more willing to do the things we're discussing if there were an awareness of the amount of suffering going on. Apparently people don't think that many are dying in and because of debt, thanks to this system.

This depresses me as well.

This may be of some comfort, there is an interesting trial going on in London.

http://www.nhs.uk/conditions/muscul...&condition=muscular dystrophy&pn=2&rec=0&ct=0

 

[Gandalfs Beard]

Football is actually a horrible example to bring up to show how tge free market makes things cheaper.

I remember prior to the formation of the premier league match tickets being the cist of a few pints or so. Then Sky tv got involved and marketed the crap out if the game. The result was increased demand resulting in a new equilibrium of a much higher price, pretty much close to pricing out regular long time fans.

Now can anyone think of another industry with huge demand but a limited supply?

There are actually features of organized sports which mirror some aspects of the Health Care debacle in the US.

1) Sports Leagues are exempt from Anti-trust laws, just like Health Insurers.

2) Millions of dollars in subsidies (Tax-Payer dollars) are given to the Corporations that own the Sports Teams in the form of Special Tax Breaks, and the building of Sports Arenas in order to entice Sports Teams to remain in the cities they represent (Sports Teams regularly employ Extortionist Tactics by threatening to leave and go to other cities where they might get better deals).

Again, this is in no way a form of "Free Markets." Rather, it is Corporate Welfare.

GB

 

[Uncayimmy]

Two pages ago you said we paid for by being taxed the hell out of. Make up your mind.

Pro bono publico means for the public good. Interestingly, I just checked Wiki to make sure I was remembering it right (I was) and happened to see this in the second paragraph:

Pro bono publico is also used in the United Kingdom to describe the central motivation of large organizations such as the National Health Service, and various other NGOs, which exist "for the public good", rather than for shareholder profit.

I've dealt with xjx388 before, and this method of debate is typical. You'll need to repeat your questions several times in order to get a straight answer. However, that doesn't mean that he won't argue something else that's seemingly conflicting. You know, like how a pro bono operation by a physician owned hospital is like NHS or how capping jury awards and carving out special liability protections has no effect on the free market.

This is very much a hearing of what you want to hear and disregarding the rest. This video is a great example. Watch until the end to fully understand or just forward to 1:50 to see what I mean. Sometimes you just can't win a debate.

 

[Rolfe]

Rolfe.

 

[Gandalfs Beard]

Pro bono publico means for the public good. Interestingly, I just checked Wiki to make sure I was remembering it right (I was) and happened to see this in the second paragraph:

Pro bono publico is also used in the United Kingdom to describe the central motivation of large organizations such as the National Health Service, and various other NGOs, which exist "for the public good", rather than for shareholder profit.

I've dealt with xjx388 before, and this method of debate is typical. You'll need to repeat your questions several times in order to get a straight answer. However, that doesn't mean that he won't argue something else that's seemingly conflicting. You know, like how a pro bono operation by a physician owned hospital is like NHS or how capping jury awards and carving out special liability protections has no effect on the free market.

This is very much a hearing of what you want to hear and disregarding the rest. This video is a great example. Watch until the end to fully understand or just forward to 1:50 to see what I mean. Sometimes you just can't win a debate.

No doubt xjx388 will now retcon his argument to say that pro bono publico was theoretically what he meant when he merely said "pro bono." When in practice the term "pro bono" as he used it implied Charity provided by a Private Agency.

GB

 

[Fiona]

That video reminds me of a DOC thread: so does this thread

 

[jimbob]

xjx388,

Are you going to answer Ivor's posts about why the free market doesn't work for healthcare, or my questions about the costs involved in healthcare?

Do you understand that your assertion that the free market would reduce costs and you assertion that medics should be paid more can only be reconciled if you think that a free market should not be implemented? Increasing the pay of medics would not happen in a free market that reduced costs. Manpower is the largest cost in most industries.

 

[Ampulla of Vater]

I feel sick...sick enough to throw up actually.

Here is how Medicaid works in Practice, not in theory. Every year you have to re-up, fill in forms and go through the humiliating process of proving that you are poor enough to receive it. Medicaid covers the premiums due for Medicare (that's right, you still have to pay premiums for Medicare even after you qualify through disability, or social security pensions).

The premiums are directly taken from your SS Disability or Pension checks.

On Oct 7th, a Medicaid Benefits agent claimed after a phone interview with my mother that as long as the forms were returned by Oct 31st, my mothers Medicaid benefits would continue without any break in coverage.

That agent lied. The forms were returned before Oct 31st with all the same information that my mother had given during the phone interview. The agent then claimed (after I phoned several weeks later to confirm that coverage was continuing as it should) that not all the information was received, AND THAT SHE HAD NOT EVEN GOT AROUND TO REVIEWING THE FORMS YET.

She threatened to send my mother's benefits claim to the fraud dept. The agent never even informed me that all she had to do was send an affidavit to be signed.

Several more weeks go by. Another phone call to the benefits department (this time with the help of a seniors aid group) and it was finally revealed that all my mother needed was to have an affidavit form signed. The form was mailed out, signed and returned.

Several weeks later, still nothing. Another call from Senior Network Services got through, and after a lengthy run-around with another agent, the Medicaid agency finally got around to approving the re-up. Benefits would be retroactive to the date of Oct 31st, the date of continuance.

I have just received a letter from the Social Security Administration, that my mother's Medicare premiums would be retroactively charged back to Nov 1st, and that her Social Security retirement check for January would have the deductions for two months worth of premiums from her already miniscule retirement check. And starting in February her retirement check will have the regular monthly premium for Medicare taken out.

I am outraged . After two months of argy bargying over a clerical snafu, the Medicaid benefits agent has ****** everything up. Now I will have to contact Social Security (because the local Medicaid agency will likely not bother to deal with it for weeks) and explain that my mother's Medicaid coverage should be retroactively applied and her checks not be debited.

I doubt I will be able to do this until after the New Year, because both the Social Security Department and the Medicaid Department have lovely holidays during which time no business will be conducted.

So that's how it works in America folks. If you're poor, and some bitchy agent ***** up your paperwork, you're ******.

So xjx388 explain again the wonders of America's ****** up health care packages for the needy. What's that? Charity you say. Bollocks.

GB

Exactly what we have been saying. You are dealing with the Federal government (Medicare) and the state government (Medicaid). And you want the government to handle a national healthcare system???? They can handle very little effectively and efficiently.

 

[Gandalfs Beard]

In fact Pro Bono Publico is actually a legal term. I'm not sure how the Wikipedia article managed to conflate it with a Public System paid for by Public Money--especially when further down the page it discusses Pro Bono as a form of Charity provided by Private Practice Lawyers:

United States
Lawyers in the United States are recommended under American Bar Association (ABA) ethical rules to contribute at least fifty hours of pro bono service per year(s).[1] Some state bar associations, however, may recommend fewer hours. The New York State Bar Association, for example, recommends just twenty hours of pro bono service annually,[2] while the New York City Bar promulgates the same recommendation as the ABA.[3] The ABA has conducted two national surveys of pro bono service: one released in August 2005[4] and the other in February 2009.[5]

The ABA Standing Committee and its project, the Center for Pro Bono, are a national source of information, resources and assistance to support, facilitate, and expand the delivery of pro bono legal help.[6] The ABA Standing Committee also sponsors Pro Bono Week during the week of October 24–30.[7][8] The ABA Standing Committee on Legal Assistance for Military Personnel and Section of Litigation jointly sponsor the ABA Military Pro Bono Project, which delivers pro bono legal assistance to enlisted, active-duty military personnel.[9]

In an October 2007 press conference reported in The Wall Street Journal and The New York Times, the law student group Building a Better Legal Profession released its first annual ranking of top law firms by average billable hours, pro bono participation, and demographic diversity.[10][11] The report found that most large firms fall short of their pro bono targets.[12] The group has sent the information to top law schools around the country, encouraging students to take this data into account when choosing where to work after graduation.[13] As more students choose where to work based on the firms' rankings, firms face an increasing market pressure to increase their commitment to pro bono work in order to attract top recruits.[14]

United Kingdom
Many UK law firms and law schools have celebrated an annual Pro Bono Week—which encourages lawyers to offer pro bono services and increases general awareness of pro bono service since 2002.[15][16] LawWorks (the operating name for the Solicitors Pro Bono Group) is a national charity that works with lawyers and law students, encouraging and supporting them in carrying out legal pro bono work. It also acts as a clearing house for pro bono casework. Individuals and community groups may apply to the charity for free legal advice and mediation, where they could not otherwise afford to pay and are not entitled to legal aid.[17]

Thus the Wikipedia's opening paragraphs commit the same fallacy that xjx388 does, by conflating a Public Service provided by a Public Institution paid for by Public Funds with a Private Firm offering Charity Services.

GB

 

[jimbob]

In fact Pro Bono Publico is actually a legal term. I'm not sure how the Wikipedia article managed to conflate it with a Public System paid for by Public Money--especially when further down the page it discusses Pro Bono as a form of Charity provided by Private Practice Lawyers:



Thus the Wikipedia's opening paragraphs commit the same fallacy that xjx388 does, by conflating a Public Service provided by a Public Institution paid for by Public Funds with a Private Firm offering Charity Services.

GB

Yes, I have never heard of pro bono publico referring to anything other than the provision of services (by professionals) for the public good (i.e. without charging for them).

 

[jimbob]

Does anyone know how many hours a week a surgeon can actually perform surgery for? And how many is typical?

 

[xjx388]

Exactly what we have been saying. You are dealing with the Federal government (Medicare) and the state government (Medicaid). And you want the government to handle a national healthcare system???? They can handle very little effectively and efficiently.

Thank you!

The United States government has not been shown to provide anything effectively and efficiently. We have no choice with some of the things it provides (defense, police, etc) because it's the governments job. But we do have a choice when it comes to healthcare, education, energy, etc.

Let me ask you this: Do I have a right to the fruits of your labor?

 

[kellyb]

Thank you!



Let me ask you this: Do I have a right to the fruits of your labor?

Some of it, yes. Legally, at least.

 

[Architect]

Thank you!

The United States government has not been shown to provide anything effectively and efficiently. We have no choice with some of the things it provides (defense, police, etc) because it's the governments job. But we do have a choice when it comes to healthcare, education, energy, etc.

And yet strangely almost every other comaprable western democracy manages it. Bizarre, eh?

Let me ask you this: Do I have a right to the fruits of your labor?

And let me ask you, are you happy for millions of your fellow countrymen go without adequate medical treatment?

 

[Gandalfs Beard]

Exactly what we have been saying. You are dealing with the Federal government (Medicare) and the state government (Medicaid). And you want the government to handle a national healthcare system???? They can handle very little effectively and efficiently.

No, it's not what I have been saying in the least. The American Public Service sector is underfunded and targeted for demolition by Right Wingers and the rules for the Public Service sector are enacted by a Corporate Controlled legislature.

A government bureaucracy in a democratic society is accountable to the public. No such accountability exists in the Private Health Insurance industry. Take the Right Wing pseudo-"free market" ideology off the table, and you will end up with a more egalitarian and accountable institution.

Sorry, but your attempt to rewrite my anecdote in your ideological framing is fallacious.

GB

 

[Ampulla of Vater]

No (sigh) it's not charity because we all, even people who don't earn enough to pay income tax, pay into the system. Are you being deliberately obtuse? It's free at the point of use, but it's not 'free'. It's paid for by the tax revenue to which every single person in the UK contributes.

How do people who aren't paying taxes "pay into the system"? How does "every single person in the UK" contribute to the tax revenue? Just curious because it's not that way here.

 

[Agatha]

So your argument boils down to "the government we elect cannot be trusted to run a piss-up in a brewery" and "healthcare is different from police/fire/defence/public parks".

The first is a terrible indictment on your country, and the latter a matter of opinion and degree.

We consider it's good for society to have as many members of that society as possible to be healthy, well-educated and productive. You consider that sick people should stay poor, or just die (your words).

 

[Rolfe]

How do people who aren't paying taxes "pay into the system"? How does "every single person in the UK" contribute to the tax revenue? Just curious because it's not that way here.

Three little letters. V. A. T.

Rolfe.