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US Politics Mega-thread - Page 2813

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Read the rules in the OP before posting, please.

In order to ensure that this thread continues to meet TL standards and follows the proper guidelines, we will be enforcing the rules in the OP more strictly. Be sure to give them a re-read to refresh your memory! The vast majority of you are contributing in a healthy way, keep it up!

NOTE: When providing a source, explain why you feel it is relevant and what purpose it adds to the discussion if it's not obvious.
Also take note that unsubstantiated tweets/posts meant only to rekindle old arguments can result in a mod action.
Deathstar
Profile Blog Joined May 2010
9150 Posts
January 31 2016 17:54 GMT
#56241
On February 01 2016 02:28 Liquid`Drone wrote:
It actually is possible to frame your statement or opinion in a way that makes sense, and where it becomes a difficult ethical dilemma. Your recent post does a better job at it than your first one. Basically, what's the ceiling for what government should provide in terms of life-prolonging medical services? $100k for one extra year? $1 million for 1 extra year? $5 million for 1 extra year? In a world with limited resources and where health care might compete with education, and where $500k might give 1 person 1 extra year of heavily medicated kinda painful existence, or where it might pay for 8 teachers supplying education for 100 children, yeah, this is a genuinely difficult situation to handle politically. I'm glad I'm not in charge of attempting to figure out how many essential government services we should cut down on attempting to prolong the life of terminally ill patients.

But accepting that there are some difficult ethical questions relating to this is way different from saying that the problem is that people refuse to die with grace. Hardly anyone dies with grace. Hardly anyone will accept that keeping their mom alive was 'just too expensive'. The reason why your statement is met with such immediate disdain is that it's almost morbidly callous in its disregard for life- if you're going to start a discussion on such a sensitive issue, you will probably find that you get better answers if you frame it differently from how you did.


Fair enough.

I was hoping for a counter-response that didn't go to mass euthanasia and "draw the line at A" lol. Universal healthcare is something that always makes me feel iffy and makes me think that it's completely unsustainable.

Even Japan, which bans health insurance profits and the government fights for low costs, will face the music as their populations becomes more and more gray. And the other industrialized countries will follow suit.
rip passion
Deathstar
Profile Blog Joined May 2010
9150 Posts
January 31 2016 17:55 GMT
#56242
On February 01 2016 02:51 DarkPlasmaBall wrote:
Show nested quote +
On February 01 2016 01:56 Deathstar wrote:
On February 01 2016 00:54 Jibba wrote:
FWIW, Obamacare has been pretty fantastic for me. My Obamacare BCBS policy was much better than the higher priced BCBS policy I had before.

However, all we get is the bleeding heart tripe that's trotted out every time there's a push for limited government. It doesn't matter if ten families are struggling to cope with their increased health premiums and it's crushing them. They'll find someone with a story to tell hitting all the major heartstrings. He's a hard worker, a small business owner, he didn't get checkups from financial necessity, his life-saving Obamacare came too late! It's a Hollywood plotline, the kind that ignores the millions of others that lost health care plans they liked from Obamacare. Struggling workers sandwiched between rising premiums and rising deductible for the entry-level plans are just a statistic (NYT). One large health insurance provider pulling out of the exchange
You just criticized anecdotes, and then proceeded to list a bunch of things without evidence. Even the numbers in the NYT article are only focused around median deductibles and not average plans or average costs. I was easily able to find a silver plan with a $1400 deductible and pretty reasonable premium, without receiving any credits.

Beyond that, it's demonstrably brought down health care inflation (reflected in multiple indexes) while actually expanding coverage/adding more people into it. People are upset that they have to pay more to receive the minimum coverage, but the alternative was them not having it or having less-than-adequate coverage, and then driving up costs through ER visits.


The thing is that most working adult will not need see a doctor. Adding people who do not need health insurance is just slapping an additional financial burden on them during our weak economic times. It's old people and people with chronic illnesses who make up most of our healthcare costs. 5% of the population make up over 50% of the healthcare costs and 1% make up over 20% of the healthcare costs.

+ Show Spoiler +
IMO these people refuse to die with grace and are propped up by modern medicine. People with "chronic illnesses" are also getting sapped by big pharma and boost healthcare costs.


Show nested quote +
On February 01 2016 02:22 Deathstar wrote:
We don't need to go to extremes here...


You just said that the ill and elderly should just die gracefully instead of wanting healthcare and medicine to try and get better.

You're worried about other people going to extremes?


I put it in spoilers as an opinion away from my primary point. And I even said IMO.
rip passion
KwarK
Profile Blog Joined July 2006
United States43644 Posts
January 31 2016 18:03 GMT
#56243
On February 01 2016 02:28 Liquid`Drone wrote:
It actually is possible to frame your statement or opinion in a way that makes sense, and where it becomes a difficult ethical dilemma. Your recent post does a better job at it than your first one. Basically, what's the ceiling for what government should provide in terms of life-prolonging medical services? $100k for one extra year? $1 million for 1 extra year? $5 million for 1 extra year? In a world with limited resources and where health care might compete with education, and where $500k might give 1 person 1 extra year of heavily medicated kinda painful existence, or where it might pay for 8 teachers supplying education for 100 children, yeah, this is a genuinely difficult situation to handle politically. I'm glad I'm not in charge of attempting to figure out how many essential government services we should cut down on attempting to prolong the life of terminally ill patients.

But accepting that there are some difficult ethical questions relating to this is way different from saying that the problem is that people refuse to die with grace. Hardly anyone dies with grace. Hardly anyone will accept that keeping their mom alive was 'just too expensive'. The reason why your statement is met with such immediate disdain is that it's almost morbidly callous in its disregard for life- if you're going to start a discussion on such a sensitive issue, you will probably find that you get better answers if you frame it differently from how you did.

The problem is that he thinks it's some new unique problem which invalidates the entire concept of public healthcare. It's classic American exceptionalism idiocy.

In the UK we have an organization called the National Institute for Clinical Excellency which is composed of doctors, statisticians, ethicists and so forth and their job is to calculate the maximum the public purse will pay for a treatment or service. If a new drug comes onto the market it is their job to weigh how much more the effective it is than the old treatment and how much that effectiveness is worth. If it's too expensive the NHS won't cover it (although you can still obtain it through private insurance or directly, just as you could in the US) because they deem it insufficiently effective. What this kind of "death panel" (as opposed to the American stay at home death panel where you decide which insurance you can afford yourself in your own family death panel and then pray that the worst doesn't happen) does is guarantees a much higher level of care to the public than the American system.

People morally object to the idea of anyone anywhere calculating what granny's life is worth but it isn't an impossible question. The UK system guarantees that if there is an effective treatment you will definitely get it, but at the cost of treatments which are less effective being denied. The current US system guarantees that if you can afford a treatment you can have it, whether or not it works, at the cost of effective treatments being denied to those who could not afford them.

I would much rather be told that the doctors used everything in their arsenal to save granny but she didn't make it than be told that she would have made it in a private hospital but you see granny was on Medicare because she was poor.
ModeratorThe angels have the phone box
KwarK
Profile Blog Joined July 2006
United States43644 Posts
January 31 2016 18:08 GMT
#56244
Basically Deathstar you are not the first person to notice that resources are finite and that costs could surpass resources unless resources are managed. You presenting this as some kind of roadblock does nothing but display your total lack of understanding of the subject. The rest of the world simply does their best to allocate the finite resources as efficiently as possible. It's not a hugely complicated problem to solve.

Furthermore the private insurance system does nothing to resolve the finite resources problem you brought up. They still decide how much they're willing to spend if you get sick. They still decide which drugs are approved to be used and which are not. Which specialists which might help are covered. Having a higher density of nurses may improve your odds marginally but your insurance company will have a maximum amount they'll pay for each day in hospital. Death panels are baked into the system, both the insurance system and the public system.
ModeratorThe angels have the phone box
KwarK
Profile Blog Joined July 2006
United States43644 Posts
January 31 2016 18:25 GMT
#56245
Hell, healthcare is pretty much a problem that can be only efficiently resolved centrally. In the UK system the costs can be directly compared and resolved. A proposal to make doctors use digital prescriptions run through a system that automatically detects decimal point errors which would prevent a lot of pharmacy errors and incorrect dosing errors (you'd be amazed how many people die due to bad handwriting or typos) can be directly compared to a proposal to hire more nurses to see which would create more healthcare value per $. You just can't do that in the US. The insurance company is willing to pay $X for each night you stay there and if your patient related costs in terms of beds/nurses etc are more than that then you need to reduce them.

It gives the insurance company the responsibility for creating their own death panel, deciding what they will cover and to what extent it will be covered. The insurance company then creates a range of options based on their desire to meet their own bottom lines and then they ask an employer, who doesn't know what any of these are or what they're worth, to sell them to employees. An insurance plan could be missing hugely important screening tests for the things which would absolutely be +EV to test for but the average individual isn't likely to know that. Death panels will always exist, the question is whether or not they should be informed (which you or I am not) and whether or not they should have our best interests at heart (which the insurance company certainly does not).

The American system allocates resources incredibly inefficiently compared to any other system. At some point some equation is gonna say that grandma isn't worth the cost of the extra drugs which may help her have another year but cost more than that help is worth. At that point she's on her own, if she's rich enough to buy them she can buy them herself. But that'll be long after the US system killed her.
ModeratorThe angels have the phone box
ticklishmusic
Profile Blog Joined August 2011
United States15977 Posts
Last Edited: 2016-01-31 18:36:45
January 31 2016 18:32 GMT
#56246
I see where Deathstar's argent is coming from, even though he could have put it in a less blunt/ offensive manner.

Since we're on the topic, ya'll should consider reading Being Mortal by Atul Gawande. It's a great book about quality vs. quantity of life and treatment for terminal patients.

Pop health (aka death panels) gets a bad rap because people think they're special and mostly suck at statistics.

+ Show Spoiler +
One point I'd like to comment on in particular is the US problem is very much cultural as well as structural -- so many Americans are "yes, throw the book at my problem (caused by my shit health habits), I don't care if it costs a bajillion dollars". Deathstar pointed out Japan as an example of where universal healthcare might not be sustainable, but I think the overall healthiness combined with their more conservative approach to management of terminal illness will keep costs ok. Now whether their economy can keep generating enough tax revenue is another question.
(╯°□°)╯︵ ┻━┻
Paljas
Profile Joined October 2011
Germany6926 Posts
January 31 2016 20:19 GMT
#56247
On February 01 2016 02:40 Ghostcom wrote:
Show nested quote +
On February 01 2016 02:03 m4ini wrote:
http://fusion.net/story/261418/quintonio-legrier-shooting-robert-rialmo-lawsuit/

On Thursday, Joel Brodsky, the attorney for officer Rialmo, told Fusion that he plans to file a counter lawsuit against LeGrier’s estate, citing emotional distress and assault. The officer claims LeGrier assaulted him prior to firing his gun.


Only in america. Cop shoots teen six times, twice in the back - in the process he also kills an innocent bystander (something i always claimed will happen if cops just empty their mags with foam around their mouths), a mother of five: and now, because that's so distressing to HIM, he's gonna sue the father. Because that whole thing totally was the kids fault, and if the kid would have miraculously survived the execution, he'd be sued for felony murder.

The fuck is wrong with chicagos police force?


I think you ought to be a little more objective in your assessment. Apparently he sues because the family lied multiple times about the events that unfolded. The city has also assessed that it was legitimate self-defense on the part of the officer. It would seem that there was no foam around the officers mouth (he only fired 6 of 16 shots), nor was it an execution as the officer (according to the city) tried to let the kid surrender and it wasn't until the kid tried to assault him with a bat that he fired.

How about we let the courts decide before we jump the gun?

dude killed a teen for no reason and no sues the family for it.
stating how insane this is isnt jumping the gun, its common sense.
TL+ Member
WolfintheSheep
Profile Joined June 2011
Canada14127 Posts
January 31 2016 20:21 GMT
#56248
On February 01 2016 02:54 Deathstar wrote:
Show nested quote +
On February 01 2016 02:28 Liquid`Drone wrote:
It actually is possible to frame your statement or opinion in a way that makes sense, and where it becomes a difficult ethical dilemma. Your recent post does a better job at it than your first one. Basically, what's the ceiling for what government should provide in terms of life-prolonging medical services? $100k for one extra year? $1 million for 1 extra year? $5 million for 1 extra year? In a world with limited resources and where health care might compete with education, and where $500k might give 1 person 1 extra year of heavily medicated kinda painful existence, or where it might pay for 8 teachers supplying education for 100 children, yeah, this is a genuinely difficult situation to handle politically. I'm glad I'm not in charge of attempting to figure out how many essential government services we should cut down on attempting to prolong the life of terminally ill patients.

But accepting that there are some difficult ethical questions relating to this is way different from saying that the problem is that people refuse to die with grace. Hardly anyone dies with grace. Hardly anyone will accept that keeping their mom alive was 'just too expensive'. The reason why your statement is met with such immediate disdain is that it's almost morbidly callous in its disregard for life- if you're going to start a discussion on such a sensitive issue, you will probably find that you get better answers if you frame it differently from how you did.


Fair enough.

I was hoping for a counter-response that didn't go to mass euthanasia and "draw the line at A" lol. Universal healthcare is something that always makes me feel iffy and makes me think that it's completely unsustainable.

Even Japan, which bans health insurance profits and the government fights for low costs, will face the music as their populations becomes more and more gray. And the other industrialized countries will follow suit.

You realize this is something that extends far and beyond health care, right?

If your concern is an economic collapse because of an aging population, then you have a lot more to worry about than universal health coverage. Like pensions, savings, and the entire investment infrastructure, for one.

Besides, graying population is an easy thing to fix. Allow more immigration.
Average means I'm better than half of you.
Doublemint
Profile Joined July 2011
Austria8718 Posts
January 31 2016 20:50 GMT
#56249
When he served in the Florida legislature, Rubio simultaneously worked as a lobbyist for a number of private interests – so if he’s elected, he will be the first president to have worked as a registered lobbyist.

Texas Sen. Ted Cruz attacked Rubio during Thursday night’s Fox News debate for flip-flopping — from opposing “amnesty” for undocumented immigrants, to supporting it. “Marco made the choice to go the direction of the major donors — to support amnesty because he thought it was politically advantageous,” Cruz said.

“Rubio’s votes on a wide range of issues may demonstrate that he votes in favor of positions that benefit his donors, but are not necessarily consistent with his conservative campaign rhetoric,” says Loyola Law School professor Jessica Levinson. For “voters who pay attention,” she adds, “this is disheartening and dispiriting.”


@TheIntercept

gotta say, they have some nice pieces on the election and the major candidates.
Pride goeth before destruction, and an haughty spirit before the fall.
Ghostcom
Profile Joined March 2010
Denmark4783 Posts
January 31 2016 20:55 GMT
#56250
On February 01 2016 05:19 Paljas wrote:
Show nested quote +
On February 01 2016 02:40 Ghostcom wrote:
On February 01 2016 02:03 m4ini wrote:
http://fusion.net/story/261418/quintonio-legrier-shooting-robert-rialmo-lawsuit/

On Thursday, Joel Brodsky, the attorney for officer Rialmo, told Fusion that he plans to file a counter lawsuit against LeGrier’s estate, citing emotional distress and assault. The officer claims LeGrier assaulted him prior to firing his gun.


Only in america. Cop shoots teen six times, twice in the back - in the process he also kills an innocent bystander (something i always claimed will happen if cops just empty their mags with foam around their mouths), a mother of five: and now, because that's so distressing to HIM, he's gonna sue the father. Because that whole thing totally was the kids fault, and if the kid would have miraculously survived the execution, he'd be sued for felony murder.

The fuck is wrong with chicagos police force?


I think you ought to be a little more objective in your assessment. Apparently he sues because the family lied multiple times about the events that unfolded. The city has also assessed that it was legitimate self-defense on the part of the officer. It would seem that there was no foam around the officers mouth (he only fired 6 of 16 shots), nor was it an execution as the officer (according to the city) tried to let the kid surrender and it wasn't until the kid tried to assault him with a bat that he fired.

How about we let the courts decide before we jump the gun?

dude killed a teen for no reason and no sues the family for it.
stating how insane this is isnt jumping the gun, its common sense.


Do you have any proof?
Stratos_speAr
Profile Joined May 2009
United States6959 Posts
January 31 2016 21:06 GMT
#56251
On February 01 2016 02:54 Deathstar wrote:
Show nested quote +
On February 01 2016 02:28 Liquid`Drone wrote:
It actually is possible to frame your statement or opinion in a way that makes sense, and where it becomes a difficult ethical dilemma. Your recent post does a better job at it than your first one. Basically, what's the ceiling for what government should provide in terms of life-prolonging medical services? $100k for one extra year? $1 million for 1 extra year? $5 million for 1 extra year? In a world with limited resources and where health care might compete with education, and where $500k might give 1 person 1 extra year of heavily medicated kinda painful existence, or where it might pay for 8 teachers supplying education for 100 children, yeah, this is a genuinely difficult situation to handle politically. I'm glad I'm not in charge of attempting to figure out how many essential government services we should cut down on attempting to prolong the life of terminally ill patients.

But accepting that there are some difficult ethical questions relating to this is way different from saying that the problem is that people refuse to die with grace. Hardly anyone dies with grace. Hardly anyone will accept that keeping their mom alive was 'just too expensive'. The reason why your statement is met with such immediate disdain is that it's almost morbidly callous in its disregard for life- if you're going to start a discussion on such a sensitive issue, you will probably find that you get better answers if you frame it differently from how you did.


Fair enough.

I was hoping for a counter-response that didn't go to mass euthanasia and "draw the line at A" lol. Universal healthcare is something that always makes me feel iffy and makes me think that it's completely unsustainable.

Even Japan, which bans health insurance profits and the government fights for low costs, will face the music as their populations becomes more and more gray. And the other industrialized countries will follow suit.


Completely unsustainable? Despite the fact that universal healthcare has been operating for well over a century in parts of the world and that it is both 1) less expensive and 2) more effective than our system?

Our system is objectively worse in terms of efficient distribution of resources. In fact, our system is one of the worst in the world at it.
A sound mind in a sound body, is a short, but full description of a happy state in this World: he that has these two, has little more to wish for; and he that wants either of them, will be little the better for anything else.
Jibba
Profile Blog Joined October 2007
United States22883 Posts
January 31 2016 21:09 GMT
#56252
On January 31 2016 22:44 {CC}StealthBlue wrote:
Show nested quote +
Ted Cruz has come under fire just two days before the Iowa caucuses for sending mailers to voters here that accuse them of a “voting violation”, earning the Texas senator and his campaign a formal denunciation by top officials in the first-in-the-nation voting state.

The mailers, which came to light on Friday and were confirmed by Cruz’s campaign as their own, include a voting score and the phrase “official public record”. They call out by name not only the recipients, but also their neighbors, as part of a broader attempt to shame Iowans for not having participated in prior elections.

Paul Pate, Iowa’s Republican secretary of state, condemned Cruz’s campaign on Saturday for distributing the mailers. He said the strategy “misrepresents the role of my office, and worse, misrepresents Iowa election law”.

“Accusing citizens of Iowa of a ‘voting violation’ based on Iowa caucus participation, or lack thereof, is false representation of an official act,” Pate said in a statement.

“There is no such thing as an election violation related to frequency of voting. Any insinuation or statement to the contrary is wrong and I believe it is not in keeping in the spirit of the Iowa caucuses.”

Cruz struck a defiant tone in a swift response: “I apologize to nobody for using every tool we can to encourage Iowa voters to come out and vote,” he said at a press conference in Sioux City on Saturday evening. The senator went on to argue that the Iowa Republican Party had previously used such mailers and characterized them as “routine”.

The literature was “a standard mailer that folks at the Iowa Republican party and other get-out-the-vote groups have used to help motivate low-propensity voters,” said Cruz spokeswoman Catherine Frazier. “We’re going to do everything we can to turn these folks out.”

Matt Schultz, Cruz’s Iowa state chairman and a former secretary of state here, added that the mailer was modelled after similar mailers in the 2014 midterm elections that were sent out by the Republican party of Iowa.


Source


This seems to be backfiring on them.

Also, the scores might be made up.

http://www.newyorker.com/news/news-desk/ted-cruzs-iowa-mailers-are-more-fraudulent-than-everyone-thinks
ModeratorNow I'm distant, dark in this anthrobeat
ticklishmusic
Profile Blog Joined August 2011
United States15977 Posts
Last Edited: 2016-01-31 21:13:04
January 31 2016 21:12 GMT
#56253
Cloning over the UK's NHS to the United States would not work well though. We have a much more unhealthy population. Then you add in much higher drug prices (we're paying for the rest of the world effectively, like it or not), physicians who expect 200K+/year after 10+ years of school and the system breaks down really fast. The short if it is America has a very different culture when it comes to health and medicine compared to other countries, and we're bullheaded enough to resist it.

On the other elections note, Cruz is imploding in Iowa and it feels so good.
(╯°□°)╯︵ ┻━┻
KwarK
Profile Blog Joined July 2006
United States43644 Posts
Last Edited: 2016-01-31 21:20:39
January 31 2016 21:20 GMT
#56254
The UK isn't Japan. We do fine (or badly) when it comes to drugs, obesity, alcohol and so forth. As for paying for the rest of the world, that's mostly a myth. You're certainly paying more than the rest of the world but there is no shortage of government/nonprofit research coming from the rest of the world. The reason you pay more is because you wait until the guy needs the cure and then ask him what he'll pay for it, the rest of the world purchases ahead of time in bulk.

As for doctors, we just have more of them (per capita) and we pay for their training out of the public purse. The current government is trying to cut their wages but there is no reason why American doctors couldn't be paid like they currently are.

You have to understand the degree to which the US healthcare industry is inefficient. Everything could cost 50% more than the NHS in the US system and still be more efficient.

It comes down to arrogance and American exceptionalism, exactly as Deathstar demonstrated above. The American belief that they're special and that their problems are special and that everything they think of nobody has thought of before. It's simply not true.
ModeratorThe angels have the phone box
Nyxisto
Profile Joined August 2010
Germany6287 Posts
Last Edited: 2016-01-31 21:31:47
January 31 2016 21:28 GMT
#56255
50% undersells it a little

http://www.politifact.com/truth-o-meter/statements/2015/dec/20/bernie-s/fact-checking-bernie-sanders-claim-us-spends-three/

That the British or comparable systems are superior is simply a fact. Even if the US would botch the implementation it would probably be cheaper. It is insane how inefficient the current system is. It's also funny how the same discussion comes up here every month or so, every time it goes exactly the same way and nothing ever changes, this distrust in any public institution in the US is like a religion.
GreenHorizons
Profile Blog Joined April 2011
United States23672 Posts
January 31 2016 21:34 GMT
#56256
On February 01 2016 02:40 Ghostcom wrote:
Show nested quote +
On February 01 2016 02:03 m4ini wrote:
http://fusion.net/story/261418/quintonio-legrier-shooting-robert-rialmo-lawsuit/

On Thursday, Joel Brodsky, the attorney for officer Rialmo, told Fusion that he plans to file a counter lawsuit against LeGrier’s estate, citing emotional distress and assault. The officer claims LeGrier assaulted him prior to firing his gun.


Only in america. Cop shoots teen six times, twice in the back - in the process he also kills an innocent bystander (something i always claimed will happen if cops just empty their mags with foam around their mouths), a mother of five: and now, because that's so distressing to HIM, he's gonna sue the father. Because that whole thing totally was the kids fault, and if the kid would have miraculously survived the execution, he'd be sued for felony murder.

The fuck is wrong with chicagos police force?


I think you ought to be a little more objective in your assessment. Apparently he sues because the family lied multiple times about the events that unfolded. The city has also assessed that it was legitimate self-defense on the part of the officer. It would seem that there was no foam around the officers mouth (he only fired 6 of 16 shots), nor was it an execution as the officer (according to the city) tried to let the kid surrender and it wasn't until the kid tried to assault him with a bat that he fired.

How about we let the courts decide before we jump the gun?


Wow... First the kid who was shot called 911 3 times and was just hung up on the first two times... because he didn't give a full name (not required in any way whatsoever).

The cop shot an innocent person.

Chicago's police are notoriously corrupt, and the courts have been total shit at resolving officer involved homicides, particularly when the victims are POC.

Give me a break.

"People like to look at history and think 'If that was me back then, I would have...' We're living through history, and the truth is, whatever you are doing now is probably what you would have done then" "Scratch a Liberal..."
cLutZ
Profile Joined November 2010
United States19574 Posts
January 31 2016 21:35 GMT
#56257
On February 01 2016 06:20 KwarK wrote:
The UK isn't Japan. We do fine (or badly) when it comes to drugs, obesity, alcohol and so forth. As for paying for the rest of the world, that's mostly a myth. You're certainly paying more than the rest of the world but there is no shortage of government/nonprofit research coming from the rest of the world. The reason you pay more is because you wait until the guy needs the cure and then ask him what he'll pay for it, the rest of the world purchases ahead of time in bulk.

As for doctors, we just have more of them (per capita) and we pay for their training out of the public purse. The current government is trying to cut their wages but there is no reason why American doctors couldn't be paid like they currently are.

You have to understand the degree to which the US healthcare industry is inefficient. Everything could cost 50% more than the NHS in the US system and still be more efficient.

It comes down to arrogance and American exceptionalism, exactly as Deathstar demonstrated above. The American belief that they're special and that their problems are special and that everything they think of nobody has thought of before. It's simply not true.

And almost none of those costs you are talking about are caused by the structure of the American system such that single payer would fix it. Doctors are paid so much because the education and licensing structure is overwhelmingly onerous. The same for NPs and Nurses and techs. Paying more for drugs and devices is a policy decision, as is the choice to allow people to get state of the art treatment for chronic conditions and end of life care. The only way single payer drives down those costs is because people don't want to pay that in taxes.

Plus you don't even take into account the upfront eminent domain costs.
Freeeeeeedom
ticklishmusic
Profile Blog Joined August 2011
United States15977 Posts
Last Edited: 2016-01-31 21:45:05
January 31 2016 21:38 GMT
#56258
Yes having the government or whatever the entity is called negotiate for supply in advance is nice in lieu of having Joe-who-has-cancer get drug when he needs it. However, the problem is if a drug company begins paying lower prices in the US they're going to have to start making up part of that somewhere else. Looking scientific publications spend as a proxy for R&D, the US leads the world by far, it's almost as big of a gap as our military spending (the two are probably somewhat related though).One of the costs of living in The Greatest Country in the World is subsidizing costs for the rest of the world (ignoring the quid pro quo we expect of course).

The UK has a different medical education system. That just goes further to show why the universal healthcare system can't be moved to the US. If you told people in the US "hey so we're going to completely revamp the medical education system by making it free and then pay everyone less"... the list of people and their objections is too long to list here.

I won't argue our healthcare system has plenty of problems, but universal healthcare is not a model that would work here without a really huge transition period and basically rewriting what entire US social contract. If we get a public option (which I see happening in the next couple decades to put a large window on it), we can see the reduction in the prices of some things like drugs, procedures and devices, but the cost is still going to be significantly higher.
(╯°□°)╯︵ ┻━┻
Gorsameth
Profile Joined April 2010
Netherlands22121 Posts
January 31 2016 21:47 GMT
#56259
On February 01 2016 06:38 ticklishmusic wrote:
Yes having the government or whatever the entity is called negotiate for supply in advance is nice in lieu of having Joe-who-has-cancer get drug when he needs it. However, the problem is if a drug company begins paying lower prices in the US they're going to have to start making up part of that somewhere else. Looking scientific publications spend as a proxy for R&D, the US leads the world by far, it's almost as big of a gap as our military spending (the two are probably somewhat related though).One of the costs of living in The Greatest Country in the World is subsidizing costs for the rest of the world (ignoring the quid pro quo we expect of course).

The UK has a different medical education system. That just goes further to show why the universal healthcare system can't be moved to the US. If you told people in the US "hey so we're going to completely revamp the medical education system by making it free and then pay everyone less"... the list of people and their objections is too long to list here.

I won't argue our healthcare system has plenty of problems, but universal healthcare is not a model that would work here without a really huge transition period and basically rewriting what entire US social contract. If we get a public option (which I see happening in the next couple decades to put a large window on it), we can see the reduction in the prices of some things like drugs, procedures and devices, but the cost is still going to be significantly higher.

Thanks for proving Kwarks point.
It ignores such insignificant forces as time, entropy, and death
oneofthem
Profile Blog Joined November 2005
Cayman Islands24199 Posts
Last Edited: 2016-01-31 22:06:22
January 31 2016 22:02 GMT
#56260
tradeoff between cost and research is told as a binary story but it need not be so. pharma companies already pay very low taxes and get immensely powerful from the patent and licensing system, there is no need to give them the additional benefit of an argument between false choices.

you would be hard pressed to line up the healthcare results and the cost of care and the overall sector of the economy devoted to it. research is invested heavily because the end results is jackpot huge. however, is that jackpot huge profit really due to high investment, or the patent system. in other words, how much of the profit is going to the cost of research and would you need the 2nd billion dollar to incentivize the same level of research, perhaps with some rebalancing towards academic and government sources of funding?

we all know the cost of a grad student's lab time, it is not high. the profit margin of pharma and other patent reliant companies is high though. patent being powerful, it may be a good idea to have a powerful counterlever against that.

as far as international leeching, it is a problem. but we have stuff like TTIP to fix it somewhat

the other thing, unhealthy population, the most meaningful interpretation of which is a large number of high cost patients, is indeed a problem. but this is also a problem that a centralized system is best equipped to handle. if you simply give every hugely fat person access to a public hospital but make that system have standardized treatment and cost profile, the overall system would be less costly and more efficient. as is insurance and the rest relies on this group to generate business, at the healthy's expense.
We have fed the heart on fantasies, the heart's grown brutal from the fare, more substance in our enmities than in our love
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