Health care - administrative incompetence

[kellyb]

http://zone5.org/2007/11/bursting-point-the-world’s-unsustainable-population/

Some extremely obscure blog.
Great evidence there.

 

[Garrison0fMars]

TFian is an peak oil "fanatic", who believes a population die off is imminent, and a return to agrarian lifestyles. His worldview is best illustrated by his messiah, "Grand Archdruid John Michael Greer", whom he often cites.

 

[kellyb]

Then they were right. I'm not a "right winger', or a "left winger", those labels mean nothing to me.

OK. I think you're a troll, so I have no issue with taking that at face value.

 

[kellyb]

TFian is an peak oil "fanatic", who believes a population die off is imminent, and a return to agrarian lifestyles. His worldview is best illustrated by his messiah, "Grand Archdruid John Michael Greer", whom he often cites.

He's for real???

 

[Garrison0fMars]

He's for real???

As far as I can tell. He had a very very long thread on energy contraction a while back. If you really want to know how he thinks, look up John Michael Greer and Howard Kunstler. That should give you an idea.

He's a Luddite extremist, not so much a right winger afaik.

 

[TFian]

You are mis characterizing me. I'm not a "luddite" extremist, I do recognize the limits to growth though,a nd that a population of 6 billion is simply not sustainable. Saying I advocate for the death of children is an extreme mis-characterization. Some will live, the healthy ones will go about just fine, the parents who can pay will have kids who live, and the parents who don't will have to bury their kids, like in the past. Since not only is there no shortage of children, but in fact too many of them, there's no reason to invest scare resources into saving every child that's born.

If you can't pay for a luxury (life), there's no reason you should expect society to pay it for you.

 

[Silly Green Monkey]

If you can't pay for a luxury (life), there's no reason you should expect society to pay it for you.

Not even when those who are rich enough to pay for the luxury of health are rich because those teeming masses who are not rich enough have produced all of their wealth? And even already paid for that luxury?

 

[TFian]

Not even when those who are rich enough to pay for the luxury of health are rich because those teeming masses who are not rich enough have produced all of their wealth? And even already paid for that luxury?

Since when do the poor produce the wealth of the rich? Maybe you should pick up a copy of "Atlus Shrugged".

If you already paid for it, you'll get the treatment. Simple as that.

 

[bookitty]

You are mis characterizing me. I'm not a "luddite" extremist, I do recognize the limits to growth though,a nd that a population of 6 billion is simply not sustainable. Saying I advocate for the death of children is an extreme mis-characterization. Some will live, the healthy ones will go about just fine, the parents who can pay will have kids who live, and the parents who don't will have to bury their kids, like in the past. Since not only is there no shortage of children, but in fact too many of them, there's no reason to invest scare resources into saving every child that's born.

If you can't pay for a luxury (life), there's no reason you should expect society to pay it for you.

Ahhh...yet another "social darwinist."

First off the resources aren't scarce. We have them, we are spending them right now. We spend more per capita than nearly all of the universal systems currently in use all over the world. We might even save money and resources by switching to a universal plan.

You know what works better than not killing children? Not having them in the first place. With a universal plan, we can make birth control quickly, cheaply and easily available. Even better, we can do the same for abortion which many women currently do not have easy access to.

Also, crazy as it sounds, not all sick children die. Yep, sometimes those little bastards live, rack up the bills with their now long-term illness and side effects. Wouldn't it be cheaper to treat them early instead of waiting for their parents to go bankrupt and then get funds from the state?

If you're so worried about resource, why are you OK with the disgusting bloat of our current health care system. We are spending more on administration and paperwork than on actual doctors. Pharmaceutical companies are coming out with more expensive variants on already existing drugs instead of investing in new drugs. Why waste all those resources just so yet another CEO can piss champagne off the prow of his 14 karat yacht?

I'd go on but I can hear all this going *bing, ting* off your teflon shell.

 

[TFian]

Ahhh...yet another "social darwinist."

A strand of it maybe. I'm not for forceful social darwinism, but I do believe in the ideal of "might makes right".

First off the resources aren't scarce. We have them, we are spending them right now.

Actually medical resources are incredibly scarce, that's why every nation rations care.

We spend more per capita than nearly all of the universal systems currently in use all over the world. We might even save money and resources by switching to a universal plan.

I doubt it. 300 million people is hardly a cheap endeavor to insure. Especially with the increasing illegal immigration problem, all the more non contributors you now have you cover.

You know what works better than not killing children? Not having them in the first place. With a universal plan, we can make birth control quickly, cheaply and easily available. Even better, we can do the same for abortion which many women currently do not have easy access to.

I agree, birth control is a good thing. However, you don't need a universal system. You can either hand out condoms, or sterile individuals.

Also, crazy as it sounds, not all sick children die. Yep, sometimes those little bastards live, rack up the bills with their now long-term illness and side effects. Wouldn't it be cheaper to treat them early instead of waiting for their parents to go bankrupt and then get funds from the state?

There's a few problems with this. First off, you're assuming they have funds available from the state. I fully support the elimination of Medicaid and SCHIP, thus leaving no avenue for the kids to become wards of the state. Second off, you're assuming there's not a cheaper option than treatment. There is, it's called euthanasia, and we practice this with adults (Netherlands, Oregon, Washington, Switzerland) there's no reason not to do this with kids.

If you're so worried about resource, why are you OK with the disgusting bloat of our current health care system. We are spending more on administration and paperwork than on actual doctors. Pharmaceutical companies are coming out with more expensive variants on already existing drugs instead of investing in new drugs. Why waste all those resources just so yet another CEO can piss champagne off the prow of his 14 karat yacht?

I agree there's a lot of waste. Stop subsidizing the HMOs like we started to do in the 70s and these issues will correct themselves.

 

[bookitty]

A strand of it maybe. I'm not for forceful social darwinism, but I do believe in the ideal of "might makes right".



Actually medical resources are incredibly scarce, that's why every nation rations care.



I doubt it. 300 million people is hardly a cheap endeavor to insure. Especially with the increasing illegal immigration problem, all the more non contributors you now have you cover.



I agree, birth control is a good thing. However, you don't need a universal system. You can either hand out condoms, or sterile individuals.



There's a few problems with this. First off, you're assuming they have funds available from the state. I fully support the elimination of Medicaid and SCHIP, thus leaving no avenue for the kids to become wards of the state. Second off, you're assuming there's not a cheaper option than treatment. There is, it's called euthanasia, and we practice this with adults (Netherlands, Oregon, Washington, Switzerland) there's no reason not to do this with kids.




I agree there's a lot of waste. Stop subsidizing the HMOs like we started to do in the 70s and these issues will correct themselves.

Here ya go:
Total expenditure on health as % of GDP (most recent) by country

We already spend more than any other country on earth. For this huge outlay of funds we've got 28% covered by government funds, 68% that are covered by private insurance (25% of those are under-insured) and 16% with nothing.

Every country with universal health manages to cover everyone with far less cash spent per person. No other country spends as much as we do. No other first world country has as many people without access to basic coverage as we do. We spend more, a lot more and we get less.

So instead of killing other people (I noticed that you are still here) why don't we take the money we are already spending and invest it in keeping people healthy. It's not as fun as oversimplifying the rantings of a bored Russian housewife but at least it makes sense.

 

[jimbob]

Rolfe, you are a smart person - surely you recognize that someone has to pay for medical services in your country. You guys are bandying about phrases like "it's free" and "don't pay a brown penny" but certainly you must know that nothing in life is free.

It is free at the point of use (with minor exceptions - prescriptions cost £7.20 if you are a taxpayer, and not otherwise exempt). Look at my signature to see what the actual cost for 2007 was (I haven't bothered updating to 2008, but the story is pretty similar). The patient pays nothing for a consultation. I am currently at teh stage of life where I contribute more to the NHS than I gain, but hey, I'm spending less than I would if I had to take out medical insurance, and the services that my tax pays for are also available to me.

How much of your tax pays for health services that you can access next time you are ill?



OECD healthcare statistics

http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html
2007 Data (latest available)
UK 8.4% of GDP of which 81.7% is state expenditure = 6.86% of GDP from taxes
US 16% of GDP of which 45.4% is state expenditure = 7.264% of GDP from taxes

 

[TFian]

Here ya go:
Total expenditure on health as % of GDP (most recent) by country

Yes I am aware of this. Why are you telling me this?

We already spend more than any other country on earth. For this huge outlay of funds we've got 28% covered by government funds, 68% that are covered by private insurance (25% of those are under-insured) and 16% with nothing.

Agreed, it's a terrible system. Repeal the HMO act of 1973, abolish Medicare, Medicaid and SCHIP, and we'll be on a more sustainable path.

No other first world country has as many people without access to basic coverage as we do. We spend more, a lot more and we get less.

No country though that has universal healthcare spends less than ones that don't like Senegal.

So instead of killing other people (I noticed that you are still here)

I'm sorry but what does that mean?

why don't we take the money we are already spending and invest it in keeping people healthy.

So we can give government more unprecedented power, and crash the biosphere? No thank you.

It's not as fun as oversimplifying the rantings of a bored Russian housewife but at least it makes sense.

Uh, Ayn Rand was no housewife. She was a revolutionary.

 

[jimbob]

Since when do the poor produce the wealth of the rich? Maybe you should pick up a copy of "Atlus Shrugged".

If you already paid for it, you'll get the treatment. Simple as that.

I've not come across Atlus Shrugged.

http://xkcd.com/610/

And the title text:

Hey, what are the odds -- five Ayn Rand fans on the same train! Must be going to a convention.

 

[bookitty]

So we can give government more unprecedented power, and crash the biosphere? No thank you.

Dang it! Where is that laughing dog?

Who do you think runs the government? Is it we the people? Or is it primarily influenced by the corporations who have the funds for lobbyists, lawyers, campaign funds, and candidates.

When it comes to crashing the biosphere, those capitalists you're so in love with are leading the pack. Name one single thing the government does that is as bad for the environment as strip mining. Who pollutes more rivers - the government or huge agra-biz corporations dumping tons of fertilization? Your buddies, those captains of industry, the automobile manufacturers spent millions of dollars pushing gas-guzzling SUV's.

Taking health care out of the hands of profiteers would be a sign that our government actually had some control. Which is why it'll never happen.

 

[TFian]

I've not come across Atlus Shrugged.

"...Atlas Shrugged is not merely a novel. It is also (or may I say: first of all) a cogent analysis of the evils that plague our society, a substantiated rejection of the ideology of our self-styled "intellectuals" and a pitiless unmasking of the insincerity of the policies adopted by governments and political parties... You have the courage to tell the masses what no politician told them: you are inferior and all the improvements in your conditions which you simply take for granted you owe to the efforts of men who are better than you."

Couldn't agree with Mises more there. That's why everyone hates Rand. She simply told the truth.

 

[jimbob]

Oh, you mean Atlas Shrugged.


Isn't that the one where on of the main characters has a developed perpetual motion machine, which is needed to make the society work?

 

[Tatyana]

You, someone else, it's all overhead that simply doesn't exist in a universal system like the NHS.

GPs are paid a set amount per patient on their list, and extra for meeting targets like immunisation and screening tests carried out, and extra is they're in a deprived area to try to even out social inequalities.

They're self-employed, technically, although there are all the incentives and standards that have to be met. They have to manage their budget, but they don't have to itemise what's spent on any particular patient, or bill anyone in that respect.

Imagine it!

Rolfe.

I think GPs are on a basic salary, and benefits are linked to performance/quality, rather than procedure based payment for the dwindling numbers of GPs in the US (which is creating huge problems).


http://www.nejm.org/doi/full/10.1056/NEJMsa055505
Special Article

Pay-for-Performance Programs in Family Practices in the United Kingdom

 

[Ivor the Engineer]

When I think of the amount of time I don't spend thinking about how my future healthcare needs will be met, It absolutely amazes me.

(It amounts to s 10-minute conversation with the BUPA rep at BVA congress, during which he gave me some literature regarding premum rates negotiated for BVA members and tried to persuade me what a good idea it was, and me deciding that even though it wasn't a lot of money, why donate it to BUPA?)

Rolfe.

Probably based model which includes the fact that vets euthanise themselves far more often than non-vets when the going gets tough.

 

[TFian]

Oh, you mean Atlas Shrugged.


Isn't that the one where on of the main characters has a developed perpetual motion machine, which is needed to make the society work?

http://en.wikipedia.org/wiki/Atlas_Shrugged