Big vs Small Gov't [Derailed SurGen thread]

On July 14 2009 07:24 Caller wrote:
i think the idea of a surgeon general is stupid.

politics is like mercury. It's lethal by itself, and mixing it with other things doesn't make it more palatable.

On July 14 2009 07:17 Last Romantic wrote:
Hope and change grows curiouser and curiouser.

On July 14 2009 07:26 Misrah wrote:
wait so- government funded heath care is bad thing?

why?

On July 14 2009 07:28 Aegraen wrote:


Very. Anyways, this isn't the topic for such a discussion.

On July 14 2009 07:17 Last Romantic wrote:

And honestly? An overweight person is to dictate to a morbidly obese nation on how to take care of itself?

On July 14 2009 07:39 broz0rs wrote:


I searched Google images after reading this comment. She's a little chub, but not that overweight.

The problem with the obesity issue isn't necessarily about weight, but it's about perception that people have against fat people. I don't see why we need a skinny person to carry this message.

Obviously, I don't know her position is on obesity, but imo an overweight person can deliver the message that being overweight isn't a bad thing, but very unhealthy if a person becomes obese.

There's going to be a long line that's going to make fun of her when she addresses the obesity issue, but if she can overcome this she'll be a great surgeon general. No small task of course.

On July 14 2009 07:43 Aegraen wrote:
Is anyone else tired of all the 'czars' and bureaucrats that are unelected that soak up our money and show nothing but waste? Can we unite and get rid of the IRS, EPA, Department of ______ Fill in the Blank, etc.

On July 14 2009 07:47 redtooth wrote:
lol. let's get rid of the department of defence. and kill the irc cuz forget taxes, the government doesn't need citizens' moneys to fund the nation. they can just keep printing new ones.

On July 14 2009 07:39 broz0rs wrote:...but imo an overweight person can deliver the message that being overweight isn't a bad thing...

On July 14 2009 07:55 Durak wrote:


Dude, being overweight is a bad thing. If you think that we shouldn't strive to be as healthy as possible, that's another discussion.

On July 14 2009 07:39 broz0rs wrote:


I searched Google images after reading this comment. She's a little chub, but not that overweight.

The problem with the obesity issue isn't necessarily about weight, but it's about perception that people have against fat people. I don't see why we need a skinny person to carry this message.

Obviously, I don't know her position is on obesity, but imo an overweight person can deliver the message that being overweight isn't a bad thing, but very unhealthy if a person becomes obese.

There's going to be a long line that's going to make fun of her when she addresses the obesity issue, but if she can overcome this she'll be a great surgeon general. No small task of course.

On July 14 2009 07:45 Misrah wrote:
hmm if we could rid ourselves of all government run programs life would be so much better. it has been shown time and time again that private enterprise can run things better than the government. Why does america want a social health care program so badly? there is simply no merit to it.

On July 14 2009 07:56 Misrah wrote:
The thing is- people want things to be taken care of. For some reason the US public enjoys the idea of cradle to grave care, and obama is going to be giving it to them. Obama is 'helping them' when in reality he is only helping the minority or people in the US. The majority and going to be faced with crushing taxes- and now my generation and the next and the next are going to have to pay off all of the 'stimulus package'

What i find to be so wrong is this: When you are in dept (as america is) you should not spend more, instead you need to cut back and start saving. Obama is going in the complete opposite direction.

On July 14 2009 08:07 Grommit wrote:


100% Correct. I mean, look at the American auto industry. The government left them completely alone for all those years and look how great they are doing...

On July 14 2009 08:07 Grommit wrote:


100% Correct. I mean, look at the American auto industry. The government left them completely alone for all those years and look how great they are doing...

On July 14 2009 08:07 Grommit wrote:


100% Correct. I mean, look at the American auto industry. The government left them completely alone for all those years and look how great they are doing...

On July 14 2009 08:13 Last Romantic wrote:
CAFE is why I think GM is going to fail [again]. It encourages them to produce crappy cars that will not sell while also forcing them to invest millions in unnecessary remodelings to their most profitable cars (big showy Caddys, GMC trucks, stuff like that).

On July 14 2009 08:16 Misrah wrote:


LOL if you run your company like an idiot you deserve to fail. When gas prices keep going up- why would you keep making gass guzzling machines?

On July 14 2009 08:13 Last Romantic wrote:
CAFE is why I think GM is going to fail [again]. It encourages them to produce crappy cars that will not sell while also forcing them to invest millions in unnecessary remodelings to their most profitable cars (big showy Caddys, GMC trucks, stuff like that).

On July 14 2009 08:33 Grommit wrote:


You could actually argue that the CAFE standards were the government's way of trying to get the American auto industry back on track. The CAFE standards aimed to help improve fuel economy, which was actually a very good idea considering the tension between America and the oil-producing nations of the world today. Asian made cars such as Honda, Hyundai, etc. adapted to the market and were very successful. These companies are subject to the same penalties if their cars are sold in the United States, yet they don't pay any, while American companies pay huge sums in penalty fees. Now you're telling me that it's the government's fault that these companies couldn't adapt to the changing market and political landscape?

You really think the Escalade and similar cars that are profitable now are going to be the American cars of the future? If you honestly think that, then you are right and the CAFE standards are out of place. The fact is, oil isn't going to be around forever, and America is not the country that controls it's production. In that sense, CAFE is encouraging companies to think ahead and develop alternative energy or higher-mileage cars so America won't be stuck paying the OPEC nations 6 dollars a gallon for our 10-MPG Hummers in 10 years

Edit: I'm not saying that all government run programs and ideas are wonderful..in fact..most of them aren't...I was just trying to make a point that sometimes private industry can be just as stupid...kind of de-railed the thread =\

On July 14 2009 08:42 Aegraen wrote:


Increasing costs to produce cars mandated by a bloated government overstepping it's constitutional bounds, coupled with shitty cars = failed business. What happens? They don't let it fail! So, more of our money is thrown down the toilet and flushed away, and worse yet, 9 months into FY09 we're 1.1Trillion in the hole and expected to climb higher, and for FY10 expected to be even higher than 09.

You know what you let happen to a business with a bad business model? You let them fail. Leaner, smarter, more financial capable businesses will popup in their place.

Not only that, in order to comply with CAFE standards the car makers were forced to use lighterweight materials which in turn caused increased fatalities that otherwise would not have occurred. Oh yes, lovely government at work.

Asian made cars are more successful because they are better built, PERIOD.

CAFE is encouraging companies to think ahead and develop alternative energy or higher-mileage cars so America won't be stuck paying the OPEC nations 6 dollars a gallon for our 10-MPG Hummers in 10 years

On July 14 2009 08:47 Grommit wrote:


As of last year, there were more than 239,000 American's employed by Detroit's "Big 3." Letting them go bankrupt and letting 239,000 people get laid off isn't necessarily a good idea either.

I think we may just have to agree to disagree on this one

On July 14 2009 08:54 Aegraen wrote:


So, you advocate turning GM, Chrysler, etc. into Amtrak? The whole debacle all ready turned off at least a good 15-20% of Americans from ever buying from them again (I know I have, and as my whole family of 20+).

You don't get it. You can't subsidize shit!

You do know, that better leaner more financially viable companies would fill the void. It wouldn't be easy, but it would be a hell of a lot better than throwing money away on a failed company. For 200+ years we've gotten through just fine and turned out the world's lone superpower, suddenly the last 200 years we're doing things wrong and we have to have all this "hope and change"?

Pffft.

On July 14 2009 07:17 Last Romantic wrote:


So Obama's selected Dr. Regina Benjamin to be America's Doctor. She's done admirable work for the poor, and her efforts post-Katrina are commendable, but the S.G. is as much a figurehead as an actual health policy pusher.

And honestly? An overweight person is to dictate to a morbidly obese nation on how to take care of itself?

Hope and change grows curiouser and curiouser.

http://online.wsj.com/article/SB124749440449132729.html

On July 14 2009 09:02 Grommit wrote:


You are already assuming that the auto-industry bailout is going to fail and the companies are doomed. You aren't even giving it a chance. If in 5 or 10 years GM is still a terrible company, I will gladly concede. However, at least give it a chance to work before you start saying we "threw away money."

People are probably getting tired of us going back and forth..I'm gonna sit back and see if anyone else has any opinions about any of this.

On July 14 2009 09:08 broz0rs wrote:
lol at the topic change.

I reiterate that being fat isn't bad. How is it bad? Does it directly cause life-threatening illnesses? Not really, they just probably can't run a flight of stairs without huffing and puffing, but who can? Or is it because people don't look as attractive? Some people, no matter how hard they diet or exercise, can not look like Park Jung Suk. I know vegetarians that eat responsibly, but are considered overweight.You can even look at the blog section of this website for member pictures and you'll find overweight people who look pretty normal to me, you're tell them they're living unhealthy lives?

Obesity is another issue where it is life threatening and hinders a person's ability to live a normal life.

On July 14 2009 09:08 broz0rs wrote:
lol at the topic change.

I reiterate that being fat isn't bad. How is it bad? Does it directly cause life-threatening illnesses? Not really, they just probably can't run a flight of stairs without huffing and puffing, but who can? Or is it because people don't look as attractive? Some people, no matter how hard they diet or exercise, can not look like Park Jung Suk.

I know vegetarians that eat responsibly, but are considered overweight.

On July 14 2009 10:14 Mastermind wrote:
a fatty is suppose to tell people how to be healthy? lol

On July 14 2009 07:17 Last Romantic wrote:
And honestly? An overweight person is to dictate to a morbidly obese nation on how to take care of itself?

On July 14 2009 07:28 Aegraen wrote:
Very. Anyways, this isn't the topic for such a discussion.

On July 14 2009 11:03 aRod wrote:
Before people utter anymore weight nonse understand that weight is LARGELY genetic. Adoptions studies have been done putting children from fat parents in the hands of skinny parents and children from skinny parents in the hands of fat parents. The environmental upbringing had almost no influence on the childrens resulting adult weight. The children born from fat parents became fat and the children born of skinny parents became skinny. Genetics largely wins. There are a whole host of physiologic and metabolic factors that contribute to weight that cannot be controlled. Appetite for instance. Have you ever found yourself wandering around the kitchen just looking at food even though you KNOW everything that is in the fridge. You may have just ate, but yet there you are staring at your food. I find myself doing this all the time. The drive to eat isn't entirely in the realm of conscious throught. I say people litterally can't control their hunger or their resulting eating much less the behavior leading to the process.


Buddha looks different depending on where you are. By all realistic standards, he was actually a stick figure.

On July 14 2009 11:03 aRod wrote:
Before people utter anymore weight nonse understand that weight is LARGELY genetic. Adoptions studies have been done putting children from fat parents in the hands of skinny parents and children from skinny parents in the hands of fat parents. The environmental upbringing had almost no influence on the childrens resulting adult weight. The children born from fat parents became fat and the children born of skinny parents became skinny. Genetics largely wins. There are a whole host of physiologic and metabolic factors that contribute to weight that cannot be controlled. Appetite for instance. Have you ever found yourself wandering around the kitchen just looking at food even though you KNOW everything that is in the fridge. You may have just ate, but yet there you are staring at your food. I find myself doing this all the time. The drive to eat isn't entirely in the realm of conscious throught. I say people litterally can't control their hunger or their resulting eating much less the behavior leading to the process.


Buddha looks different depending on where you are. By all realistic standards, he was actually a stick figure.

On July 14 2009 11:07 psion0011 wrote:

Wow what complete bullshit you're spewing, fatty. Tons of fat people have lost their weight, are they fucking wizards then?

edit:
rats sometimes overeat to the point where they die. If you're suggesting that fat people are fat because they are as stupid as rats, then I'm inclined to agree.

On July 14 2009 11:49 aRod wrote:

I should retract the statement "I say people literally can't control their hunger or their resulting eating much less the behavior leading to the process," and modify it to "people literally can't stop experiencing hunger or cravings which in part drive what and when people eat."

On July 14 2009 11:03 aRod wrote:
Before people utter anymore weight nonse understand that weight is LARGELY genetic. Adoptions studies have been done putting children from fat parents in the hands of skinny parents and children from skinny parents in the hands of fat parents. The environmental upbringing had almost no influence on the childrens resulting adult weight. The children born from fat parents became fat and the children born of skinny parents became skinny. Genetics largely wins. There are a whole host of physiologic and metabolic factors that contribute to weight that cannot be controlled. Appetite for instance. Have you ever found yourself wandering around the kitchen just looking at food even though you KNOW everything that is in the fridge. You may have just ate, but yet there you are staring at your food. I find myself doing this all the time. The drive to eat isn't entirely in the realm of conscious throught. I say people litterally can't control their hunger or their resulting eating much less the behavior leading to the process.

On July 14 2009 07:27 Aegraen wrote:


Ha! Funny and so true, and yet people are so gullible time after time they seem to think Government is this omniscient force that cures all ills, when in fact its the direct cause of those ills.

How people expect the Government to provide satisfactory healthcare, but yet they can't even manage one financial institution, mail service, or their own budget. Silly times we are living in.

On July 14 2009 11:55 Liquid`NonY wrote:


Ahh, you seem to only be considering that people are fat based on genetic influence or environmental influence. But it's obvious that most people control their weight by personal behavior.

On July 14 2009 12:02 aRod wrote:
For some, losing weight isn't easy. It doesn't always require a little bit of work, but often drastic modifications of lifestyle, eating habits, and social behavior. Granted this isn't everybody, but for some losing weight is a great challenge that brings them to tears and often doesn't work. Some patients who undergo gastric bypass can't get under 240 lbs. I know, I see a patient that had this procedure, claims to eat a 1500 cal/day diet and exercise 30 minutes a day. Sometimes losing weight is almost impossible.

On July 14 2009 12:11 psion0011 wrote:

The patient was lying. Search up on studies of women mis-reporting their food consumption, the results are always pretty entertaining. Something like normal women under-reporting by 30%-50%, and fat women leaving out like 70% of their diet when counting their calories. And 30 minutes of slowly rotating on an elliptical is not exercise.

Losing weight doesn't often not work, they just often give up because, and I admit, it is hard.

On July 14 2009 12:47 BisuBoi wrote:
So does this surgeon general have any public stance on MSG and the food additives issue we have going on in America right now? What about the almost outright lying when it comes to food labels? There's a lot of good reasons for why America's population is obese. It's not just the citizen's fault. The food industry has a lot to do with it too. There's a lot of homework involved just trying to avoid artificial substances in your diet.

On July 14 2009 12:51 gchan wrote:


If by homework, you mean "google." With easy access to internet nowadays, ignorance is no excuse for obesity. Sure, food industry may or may not share some of the blame, but really, consumers have all the information they need at the tip of their fingers. Finger pointing at corporations is just being lazy and irresponsible.

Iphone? Blackberry?

On July 14 2009 13:02 L wrote:
You'll find that the highest rates of obesity in the states somewhat sadly correspond to socioeconomic classes which aren't walking around with those.

I mean, you might as well have said "Personal shopper, trainer?".

On July 14 2009 12:58 BisuBoi wrote:


Do you know all the names for MSG? Do you know all of its side effects? Are you aware of all the food additives being put in something as simple as chicken tenders and what the health effects of these compounds are?

Sorry, not trying to be aggressive towards you, but I think you might be underestimating exactly how many peculiarities are in prepared foods. I think it's kind of misleading to say "google." Google what? If people don't know to even look for something, Google's not going to do much good. Yes, consumers have all the information they need at their fingertips. Humans have everything they need to understand the laws of physics at their fingertips too. Doesn't mean it's easy.

I'm fit and in shape so I don't need the lecture about lazy and irresponsible. WHat I think is disgusting is that I need to pay a 30% premium on my groceries just to ensure they're not putting chemistry kits in my protein.

On July 14 2009 12:58 BisuBoi wrote:


Do you know all the names for MSG? Do you know all of its side effects? Are you aware of all the food additives being put in something as simple as chicken tenders and what the health effects of these compounds are?

Sorry, not trying to be aggressive towards you, but I think you might be underestimating exactly how many peculiarities are in prepared foods. I think it's kind of misleading to say "google." Google what? If people don't know to even look for something, Google's not going to do much good. Yes, consumers have all the information they need at their fingertips. Humans have everything they need to understand the laws of physics at their fingertips too. Doesn't mean it's easy.

I'm fit and in shape so I don't need the lecture about lazy and irresponsible. WHat I think is disgusting is that I need to pay a 30% premium on my groceries just to ensure they're not putting chemistry kits in my protein.

On July 14 2009 14:11 TimmyMac wrote:

Stop being a lazy piece of shit and buy regular meat, and you're all set. You don't have to eat chicken tenders or microwave dinners every day, eh.

Also stop fearing everything just because it's 'artificial'. That's how diabetics die because their homeopathic 'doctor' told them to stop eating splenda. Really, 99% of those additives are completely harmless, unless you're eating 60 servings a day.

On July 14 2009 14:17 BisuBoi wrote:


They're not harmless when you have an allergic reaction to glutamates. And don't call people a lazy piece of shit. That's rude. Want me to get out a list of all the steroids you'll find in "regular" meats? There's nothing "regular" about them.

On July 14 2009 15:18 BisuBoi wrote:
This is an example of why it's not as easy as just avoiding foods with MSG.

*blah blah blah*

I get very drowsy, cotton-mouth, swollen joints, and feel like I've eaten ten bowls of salt. This from a normal-sized meal with nothing inordinately salty.

On July 14 2009 07:27 Aegraen wrote:


Ha! Funny and so true, and yet people are so gullible time after time they seem to think Government is this omniscient force that cures all ills, when in fact its the direct cause of those ills.

How people expect the Government to provide satisfactory healthcare, but yet they can't even manage one financial institution, mail service, or their own budget. Silly times we are living in.

On July 14 2009 17:07 zatic wrote:
I have no idea what happened in this thread. Can someone please explain to a foreigner what a surgeon general does? And how it is relevant whether she is fat or not? Between the GM and health care posts I am really lost.

On July 14 2009 14:11 TimmyMac wrote:
Also stop fearing everything just because it's 'artificial'. That's how diabetics die because their homeopathic 'doctor' told them to stop eating splenda. Really, 99% of those additives are completely harmless, unless you're eating 60 servings a day.

On July 14 2009 18:05 Foucault wrote:


Err, I can throw up alot of research papers showing how sweeteners like aspartame (Splenda) directly affects transmittor substances in our brain and also increases levels of catecholamines (fight/flight hormones); dopamine, epinephrine, norepinephrine.

They have possible links to alot of neurological issues like hyperactivity, stress, tics etc. Sweeteners like aspartam cross over into the brain plasma easily and affects transmittor substances in many ways, of which many are still unknown.

Also your argument of additives being harmless, in general mean that they don't kill people or cause direct, serious illness. However they can cause alot of other issues of which I named some above.

Also, every person is different and reacts in different ways to food, additives, sweeteners etc. But one thing is certain; what we eat, affects us ALOT and that is something that really only has been discussed during more recent years.

MSG is bullshit and so is Splenda imo. Instead use Xylitol or Sorbitol, sweeteners, that don't seem to interact with the brain in the same way like aspartame (splenda). So many cases of instable emotions/behavior, overactivity etc etc could have their cause in what we get into our systems.

Along with pure sugar of course, that seems to be stuffed in everything...ugh. And glycose surup in like every bread in the store, the list of sugary/totally unnecessary stuff in food is gigantic.

Oh and this is not only in the US but everywhere in the world. Start reading what the food you buy contains. The other day I saw a bag of normal peanuts which turned out to contain MSG and 3 different color additives. Fucked up

On July 14 2009 18:28 WeSt wrote:
Is the health care in the hands of private corporations in the U.S? Is it expensive?

On July 14 2009 17:07 zatic wrote:
I have no idea what happened in this thread. Can someone please explain to a foreigner what a surgeon general does? And how it is relevant whether she is fat or not? Between the GM and health care posts I am really lost.

On July 15 2009 00:26 gchan wrote:


The Surgeon General is basically the executive branch's figurehead for Public Health and the nation's most powerful doctor. Technically, the Secretary of Health and Human Services is a higher position, but the Health and Human Services department usually deals with a lot more than just public health (like the financing of it, medicare, administration, etc). The Surgeon General can be seen as the scientific and medical counterpart of the Secretary. That's why if there are any major health concerns (such as the Swine Flu), it's the Surgeon General who makes the announcement to the public.

As for why she's fat or not, because she's supposed to be the figure head, OP has a problem of her being a role model. I personally disagree because I don't think doctors are really seen as role models anymore, but that's the argument for it.

On July 15 2009 00:02 ghrur wrote:


Yes, it's in the hands of private corporations.
Yes, it's by far the most expensive.
http://dll.umaine.edu/ble/U.S. HCweb.pdf

On July 15 2009 01:37 BisuBoi wrote:
God, hearing Republican talking points gives me a headache. The problem with them isn't even the position, it's that they're literally just stock arguments that nobody would come up with on their own. They get it by memorizing the talking points they get from their opinion leaders, then parroting it every chance they get.

Yeah, it MUST be government impediment that's the root of all evil. In fact, people would be better off with no government. Anarchy is the best form of gov't because then the free market would take care of everything and life would be perfect... The invisible hand. That should be our President.

I think it's pretty ridiculous that anyone would think a medical system without government regulation and oversight would be anything worth participating in. Even crazier is the notion that government paying for the patients would increase healthcare costs. Health care costs are high because of insurance for practitioners and because of the ridiculous amount of paperwork needed to validate claims with insurance companies. Most all of the problems in the health care industry are caused by the insurance industry. You could make the argument that insurance is high because of how the legal system handles malpractice cases but it's retarded to say programs that hardly everyone in the US even participates in are the reason the entire health care system is broken.

On July 15 2009 01:43 Aegraen wrote:


That's just it, the healthcare system isn't broken. The overwhelming majority are happy with their healthcare. You don't tear down an institution and replace it when it's working and certainly not in the way that Congress intends to do so.

Geeze, have you even read Tom Daschle's book?

Anyways, I don't feel like arguing anymore, I'm going to watch some Crusoe. I'm sure you'll enjoy the central planning and dileanation of healthcare and who gets what, who doesn't, what procedures your doctor can perform, how much he'll get paid, etc. Man that VA is just so great.

On July 15 2009 01:43 Aegraen wrote:
I'm sure you'll enjoy the central planning and dileanation of healthcare and who gets what, who doesn't, what procedures your doctor can perform, how much he'll get paid, etc.

I'm sure you'll enjoy the central planning and dileanation of healthcare and who gets what, who doesn't, what procedures your doctor can perform, how much he'll get paid, etc.

On July 15 2009 03:59 Diomedes wrote:


Isn't this an argument in favour of market run health care since that is the only system where you always get this 'advantage'? I mean, in Europe this is one of the arguments used against publicly funded universal health care.

On July 15 2009 03:40 Mindcrime wrote:


Right, because insurance companies don't do this.

On July 15 2009 04:22 stk01001 wrote:
Anyone who thinks the healthcare system in America isn't broken is incredibly naive and ignorant. (or maybe just stupid?)

Also, I've received "socialized healthcare" from England, Canada and Italy.. yes healthcare is free in these countries even to tourists and it was just as good if not better than any healthcare i've ever received here. I have family who live in Italy, friends in England, everyone i've spoken to are perfectly happy with the healthcare they receive. As much as the republicans and big insurance companies would like to make you believe that socialized medicine doesn't work, it actually works perfectly fine. I mean the republicans would have you believe that socialized medicine means people will be stuck in long lines, dying, waiting to receive healthcare but that's so far from reality. The sad part is people actually belive this silly propoganda, it's all scare tactics in order to protect the big profits of the private insurance companies. God all you have to do is wake up to reality in order to see this, it's obvious people are NOT dropping dead everywhere in Europe & Canada due to poor healthcare. You never hear about people protesting the healthcare system in these countries, or trying to overhaul it because it's broken (and I KNOW becuse i've been and lived in these countires, I don't just READ or HEAR about this shit from Rush Limbaugh and fox news). I'm really sick of this issue, I'm sorry but healthcare is a right not a privelage... I understand why people who are somehow affiliated with the private insurance companies would oppose this, but if you have no affiliation to the insurance companies yet you still oppose universal healthcare, then I'm sorry but your a complete fucking moron with no grip on reality..

On July 15 2009 04:01 gchan wrote:
Except that government run programs are always more inefficient than privately run ones. It's a trade off between equility/fairness and efficiency.

On July 15 2009 04:28 citi.zen wrote:
The real problem are demographics & costs.

The alternative to this system where the US pays for the rest of the world's health care is a system where, like the EU countries, the US government negotiates in bulk against the insurance/biotech/pharmaceutical companies. But that would dry up all their potential profits and you would be looking at a virtual stagnation of private industry medical advancement...which would mean that the US government would have to also pick up the tab for all medical research. If you think this is a good idea, look at history in the last 30 years. Governmental research is useful as a theoretical backbone (as in first developing the idea for a technology), but by and large, it's the private industry that makes the theoritical technology useful/applicable. And this is excluding the fact that with reduced US profits, the non-developed countries would suffer by a lack of investment from these transnational corporations.

People need to understand that cheaper health care, as in health care below private market rate, is NOT free. There is no such thing as a free lunch. What you save, somebody else pays. And honestly, I have no problems with a privatized US system that will pay for development of new technology and pays for health care for the rest of the world. Americans will lose out, but everybody else would benefit.

On July 15 2009 04:50 gchan wrote:
For costs, Europeans always tout that it's a feasible model, etc etc etc. Problem is we are picking up YOUR tab of the health costs. Your governments negotiate in bulk with insurance companies, pharmaceuticals, biotech companies to get below market rates which make it affordable over there. Where do you think these companies make up the lost revenue from EU markets? We pay for it.

On July 15 2009 04:01 gchan wrote:


Except that government run programs are always more inefficient than privately run ones. It's a trade off between equility/fairness and efficiency.

On July 15 2009 04:50 gchan wrote:


This. European countries don't have the vast expanses of the Midwest. Doctors don't want to go to the Midwest because there is no money to be made, the weather is terrible, and there is no health care support. Sure, Europe has areas that are more rural than others, but nowhere near the degree it is in the US. There are many areas in the Midwest where, literally, the closest doctor is hours of drive away. If you want to see a specialist, you have to go the only city in the state--which is 5+ hours away. It's not cost effective to provide coverage to all these areas.

On July 15 2009 06:37 BlackJack wrote:
I'm confused as to why non-Americans want the U.S. healthcare system to be more like their nation's healthcare system.

On July 15 2009 07:22 Diomedes wrote:


No. Americans want to have a system more like some of the European systems.

Europeans just support the average American. Or make fun of those people who still believe the 'we the US have the best health care system in the world'-propaganda which is why it has taken so many years for it to reform.

Years ago it wasn't even possible to discuss it in mainstream politics. Still, people are offended and call it 'unamerican'.

Polls haven't changed much. They show basically the same.

What has changed? Corporations like GM and others can't compete with even Canada, which doesn't have a very good system either, because the health care costs drive up the price so much. It makes each car like 1000 dollars more expensive. People blame the worker unions for being part in the failure of GM. Yes, they negotiated good health care for the workers. But why is that a problem? Because health care costs are so high. So GM can't be competitive. So what happens then? GM can only operate when their workers have zero health care. And what happens then? A simple disease isn't cured. And then in the case of an emergency they can't be refused. And then the costs sky-rocket even more.


So this is why mainstream politics is now changing. It's one corporate interest vs another. One lobby group vs another. So that's why universal health care has become politically viable.
That's how US politics work.

On July 15 2009 08:06 Diomedes wrote:
What about government purchasing power? I don't think that was brought up. Apparently that can reduce costs, and reduce corporate profits, a lot.

On July 15 2009 07:33 Caller wrote:
reasons why medical costs in america are so high

-private medical schools
-high tuition
-more rigorous certification process (8 years vs. 4-6 of higher education, residency and internship differences, also no pay)
-lower number of incoming medical students per capita. While the current number of doctors may be similar per capita, many of these doctors are aging and are retiring, while the incoming generation of medical students is decreasing compared to other countries.
-PPO/HMOs acts as monopoly. New doctors are forced to sign up for them in order to attract clientele because they have no way to get clients otherwise, and insurance companies enforce price controls. Because they control all the demand, and because supply is restricted by the government and regulations, prices naturally will be high.

On July 15 2009 08:14 shmay wrote:


Also, pretty much everything is paid through a third party ( businesses, insurance, and/or government), so hospitals are able to get away with charging for much, much more.

The best explanation behind this I've seen is by Milton Friedman: http://www.hoover.org/publications/digest/3459466.html

On July 15 2009 06:37 BlackJack wrote:
I'm confused as to why non-Americans want the U.S. healthcare system to be more like their nation's healthcare system. The U.S. largely foots the bill for R&D and is responsible for a lot of medical advancements that other countries benefit from. Considering this is a "progressive" forum, wouldn't most people be in favor of the wealthiest nation paying the most into R&D?

On July 15 2009 08:56 Last Romantic wrote:
American doctors are also legally obligated to use every last means available to 'save' someone even if it's a 92y/o geriatric who will live a few months more at best. The last year of life accounts for by and far the majority of healthcare costs.

On July 15 2009 06:37 BlackJack wrote:
I'm confused as to why non-Americans want the U.S. healthcare system to be more like their nation's healthcare system. The U.S. largely foots the bill for R&D and is responsible for a lot of medical advancements that other countries benefit from. Considering this is a "progressive" forum, wouldn't most people be in favor of the wealthiest nation paying the most into R&D?

On July 15 2009 08:56 Last Romantic wrote:
American doctors are also legally obligated to use every last means available to 'save' someone even if it's a 92y/o geriatric who will live a few months more at best. The last year of life accounts for by and far the majority of healthcare costs.

On July 15 2009 10:01 fusionsdf wrote:


Are they legally obligated to do it for free?

On July 15 2009 07:33 Caller wrote:
reasons why medical costs in america are so high

-private medical schools
-high tuition
-more rigorous certification process (8 years vs. 4-6 of higher education, residency and internship differences, also no pay)
-lower number of incoming medical students per capita. While the current number of doctors may be similar per capita, many of these doctors are aging and are retiring, while the incoming generation of medical students is decreasing compared to other countries.
-PPO/HMOs acts as monopoly. New doctors are forced to sign up for them in order to attract clientele because they have no way to get clients otherwise, and insurance companies enforce price controls. Because they control all the demand, and because supply is restricted by the government and regulations, prices naturally will be high.

On July 15 2009 10:19 Mystlord wrote:

Impressive list.

You forgot malpractice insurance and the ridiculous costs that it brings to the profession. Also consider the malpractice trial itself. The costs of lawyers, just bringing the case to court, and the money that can be gotten from punitive damages is just ridiculous.

Another problem is the ability of pharmaceutical companies to patent their drug for 7 years. That's like having a 7 year monopoly on a crucial drug. This allows them to set the prices for the costly R&D process.

A final problem is the overuse in a lot of costly technologies such as MRIs, CTs, and unnecessary tests. Doctors aren't thinking that they can solve the problem with a simple X-Ray, but they're thinking that "Oh, insurance will cover it, the MRI is affordable". But is it really necessary? Probably not.

There are probably a lot more problems, but those are some of the largest causes, in my eyes, to the health care cost issue.

On July 14 2009 07:49 Last Romantic wrote:
Defense is necessary. The remainder of publicly funded programmes are largely contestable.

On July 15 2009 10:21 Caller wrote:

yes, i agree that these reasons are also responsible for the high costs. But the reason the technology is overused is due to the fear of malpractice insurance, i.e. if they don't find something, 50 DKP minus.

On July 15 2009 06:27 BisuBoi wrote:
I'm sorry but gchan's post is beyond fail. It is wrong on almost every level. Gchan, maybe address the real reason you are against universal healthcare or any kind of reform in healthcare? Because the reasons you're using right now sound like an attempt to "win" the argument rather than anything you actually believe.

I don't understand how someone who supports free market policies could have such a weak grasp of economics. Are you unfamiliar with how tech firms are capitalized and generate profits? I can assure you, it has nothing to do with this postulated world market where the rest of the planet gets a free ride while Americans foot the bill.

Most all of the costs occur during the research phase and then potential costs from legal liabilities. If the drug works and has no problems, the pharmaceutical companies have virtually no costs in selling their drugs. And as if the privatized insurance companies are paying high prices to the pharma companies right now. They're in bed together to run up the price. It's completely unnecessary. And it's pretty outrageous what drugs get approved with symptoms like loss of vision, possible stroke, death, hyperventilation etc.

On July 15 2009 12:21 gchan wrote:


Way to be pretentious. Why would I present an argument I didn't belive in? Why don't you tell me why I don't want a government fronted health care system? I come here for a discussion, not to exchange trivial insults.

As for the way the tech industry works, yes, the marginal cost of each additional produced product is next to nothing, but the companies themselves price in what their expected losses are on failed research projects. If they have no profit, how can they have money to research? You need capital to develop a new product. The amount they overcharge Americans is calculated from the decreased revenues from the European market. The company itself will have a forecast on what income they need to cover their operating expenses so they can stay solvent and have new products out constantly. I'll concede the point that this may not necessarily be the fair market value because for all intents and purposes, the pharmaceutical industry is oligopolistic (which is market inefficient). And I'll also concede that the health insurance industry is also oligopolistic, so it is not market efficient. But this does not mean that it should be put in governmental hands. You can have a market efficient privatized health care system where insurance companies and pharmaceutical companies aren't colluding if you break up the large companies. I would much rather see a privatized market efficient health care system with a bunch of smaller companies than a government run one.

On July 15 2009 13:31 ghrur wrote:


If someone has to break them up, I'm guessing you mean the government?
Which kind of makes it government run again doesn't it? Because the government will have to come in every so often to break up the oligopolies since they are inevitable. Semi-free market? I like it, I like it.

On July 15 2009 13:39 gchan wrote:


Well, the government doesn't usually run companies after they are broken up. The system we have now is semi-free market because there is definitely varying degrees of collaboration between politicans, lobbyists, large pharma companies, and large insurance companies. I'm just advocating a truer free market.

On July 15 2009 13:39 gchan wrote:


Well, the government doesn't usually run companies after they are broken up. The system we have now is semi-free market because there is definitely varying degrees of collaboration between politicans, lobbyists, large pharma companies, and large insurance companies. I'm just advocating a truer free market.

On July 15 2009 10:31 Mystlord wrote:

Ah right, I forgot that, thanks :D. Personally, I think that the American health care system is too heavily regulated. Seriously, about half of the procedures that doctors do can be done by nurses. Malpractice lawsuits are also absolutely retarded. You can drag a doctor to court and get shot down, but the doctor still has to pay the money for the lawyer and all that crap.

On July 15 2009 12:21 gchan wrote:


Way to be pretentious.

On July 15 2009 16:09 benjammin wrote:


you gotta be kidding me. i won't put words in Physician's mouth, but i bet if you asked even most doctors they would agree that malpractice lawsuits are absolutely essential for accountability and maintaining high standards of patient care. i'd bet that an overwhelming percentage of people polled would support malpractice lawsuits against negligent doctors.

On July 15 2009 10:29 s_side wrote:


You sound like somewhat of a neo-libertarian. Good man!

On July 15 2009 15:20 Mystlord wrote:

I think the issue here doesn't lie in whether the government should take over the health care system, but rather why the health care system itself sucks.

Another issue is what you mean by a "truer free market". That term is so vague that it could mean any number of things. Please clarify. You haven't exactly proposed a plan, but you've just said that you just don't want a government controlled health care system. That's fine, but what do you propose instead?

Also, note that I haven't read too far back, so I might have missed a few things. Sorry if I missed one of your posts.

Foucault wrote:
At the same time I can see the obvious positives with universal healthcare, BUT the big question that many people don't seem to understand is whether or not the government should provide healthcare. Why should that be the government’s responsibility? Do we want to live in a society where our government takes care of us like children? No thanks.

Aegraen wrote:

No. See, you get this misleading crap from people who are trying to paint an ideological picture.

Aegraen continues:
The current US Healthcare system, is an amalgamation of Private and Government. Medicare and Medicaid, SCHIP (Which ironically covers people until their 32...wait? Is a 32 y/o a child? Our congresscritters are insane) puts a huge strain not only on the Federal, State and every health clinic, hospital, etc. because it pays for roughly half of the price of the costs. So, where do the clinics, hospitals, etc. recoup this money? You.

The New England Journal of Medicine wrote:
A system with multiple insurers is also intrinsically costlier than a single-payer system. For insurers it means multiple duplicative claims-processing facilities and smaller insured groups, both of which increase overhead. Fragmentation also raises costs for providers who must deal with multiple insurance products — at least 755 in Seattle alone — forcing them to determine applicants’ eligibility and to keep track of the various copayments, referral networks, and approval requirements. Canadian physicians send virtually all bills to a single insurer. A multiplicity of insurers also precludes paying hospitals a lump-sum, global budget. Under a global-budget system, hospitals and government authorities negotiate an annual budget based on past budgets, clinical performance, and projected changes in services and input costs. Hospitals receive periodic lump-sum payments (e.g. 1/12 of the annual amount each month).

The existence of global budgets in Canada has eliminated most billing and minimized internal cost accounting, since charges do not need to be attributed to individual patients and insurers. Yet fragmentation itself cannot explain the upswing in administrative costs in the United States since 1969, when costs resembled those in Canada. This growth coincided with the expansion of managed care and market-based competition, which fostered the adoption of complex accounting and auditing practices long standard in the business world.

The article wrote:
People who disenroll from Medicaid or SCHIP programs as a result of programmatic changes are not likely to replace public program insurance with private commercial insurance, because it is unlikely that people who live near the poverty level will be able to afford the premiums that are associated with private commercial health insurance.

[...]

Most states make programmatic changes in their Medicaid/SCHIP programs in an effort to decrease their costs for these programs. However, this study demonstrates that programmatic changes that result in disenrollment actually increase the total health care costs for the community. Most of the health care costs for the uninsured are paid by federal and state governments through Medicare and Medicaid in the form of disproportionate share hospital adjustments and indirect medical education payments in addition to other federal programs, such as funding for community health centers and the Maternal and Child Health Bureau. Indeed, federal and state funds have been estimated to cover 87% of the total costs of uncompensated care.11 Potential savings from programmatic changes in Medicaid/SCHIP also are offset by increased Medicaid medically needy spending, increased tax subsidies to private insurance, and increased costs that are associated with uncompensated care.2 In a previous analysis of Medicaid disenrollment in an agricultural community, we concluded that 10% disenrollment would increase the number of uninsured children by 21% and increase the community’s health care costs as a result of a shift in sites of care from less expensive ambulatory office sites to more expensive [emergency department]s and increased hospitalizations.

Aegraen continues
Secondly, the average American is among the top .05% wealthiest people in the world, so of course it's going to be 'expensive' in comparison to outside the US.

The U.S. hands down has the greatest doctors, nurses, surgeons, specialists, you name it, practitioners and technology and availability in the world.

You want to know how you cut down costs? You remove government impediment in the market. Quite frankly, I can't remember a time when government intervention into a market didn't result in disaster.

Not only that, most Americans are HAPPY with their current healthcare.

Ecael wrote
I don't know, the US suffers from one particular problem that we don't see in European countries in terms of its size. A more suitable comparison would probably be China or Russia, considering they are some of the few countries that can really match US in terms of both population and size.

gchan wrote:
For costs, Europeans always tout that it's a feasible model, etc etc etc. Problem is we are picking up YOUR tab of the health costs. Your governments negotiate in bulk with insurance companies, pharmaceuticals, biotech companies to get below market rates which make it affordable over there. Where do you think these companies make up the lost revenue from EU markets? We pay for it. It's one of the primary reasons why our coverage is so much more expensive than you. If you don't believe me, take a look at the financials of the largest transnational pharmaceutical companies and biotech companies in the world. They all have a disclosure separating out US/international revenues and costs, and the US pays 3-10 times more than the rest of the world combined. This is particularly disturbing considering that almost all the technology is produced in the US and Singapore, which should mean we pay less than everybody else (logistically).

The Public Library of Science wrote:
From this new estimate, it appears that pharmaceutical companies spend almost twice as much on promotion as they do on R&D. These numbers clearly show how promotion predominates over R&D in the pharmaceutical industry, contrary to the industry's claim.

The alternative to this system where the US pays for the rest of the world's health care is a system where, like the EU countries, the US government negotiates in bulk against the insurance/biotech/pharmaceutical companies. But that would dry up all their potential profits and you would be looking at a virtual stagnation of private industry medical advancement...which would mean that the US government would have to also pick up the tab for all medical research.

If you think this is a good idea, look at history in the last 30 years. Governmental research is useful as a theoretical backbone (as in first developing the idea for a technology), but by and large, it's the private industry that makes the theoritical technology useful/applicable. And this is excluding the fact that with reduced US profits, the non-developed countries would suffer by a lack of investment from these transnational corporations.

Oh by the way, you do realise that there are enormous amounts of research performed by universities, which isn't necessarily done for profit at all, but I guess they don't count, right?

On July 16 2009 01:45 gchan wrote:
Syntax, look at my other posts about competitive pricing.

And I said major medical discovery in the last 30 years. Market conditions in the early 20th century were substantially different than they are now. Also, you outline exactly my point in saying that government is good at developing the theoritical backbone, but not application.

Vaccinations--19th-20th century government program, government proliferation because of the need to fight disease during war.

Antibiotics--early 20th century government research, mass produced by government because, again, of war.

Germ theory--more specific please.

DNA--Initial research done by government, yes, but application mostly used in drugs is done by private industry. Actual direct usage of DNA targetting products is too infant to really say whether it's being picked up by private industry.

On July 16 2009 03:08 Ecael wrote:
Kwark, does the discovery of a smallpox vaccine via cowpox or the discovery of penicillin via an accident mean that they have discovered the theoretical backbone of the science? Government and academic institutions has always been the ones focused on the basic research to the commercial companies' focus on applications. Suggesting that either of those were "theoretical backbone" would be just as absurd as to claim that they were related to government programs. Those were the kickers to begin more proper research on the area, which makes up the backbone science, not the theoretical frameworks themselves. While that doesn't preclude government research from being able to turn out practical uses for the basic research, how will such be funded and what impact do they have on our existing market system?

gchan's statement about the kind of 'specialization' that both side has is really more of a result of market forces and practical conditions, corporates have an interest in promoting basic research in academic and even government institutions, but they don't have any use for them in market. It would not be impossible for government to focus on more application-oriented research. However, cases where we have seen the government to take such a stance usually involve dire situations, such as war. Here too we would not see the kind of changes suggested without a significant change to the system, and the costs to such a change simply doesn't seem to be addressed at all.

On July 16 2009 03:22 BisuBoi wrote:


lol what kind of drivel? The discovery of the vaccine was it. It did everything, conception of the vaccine process, development of the vaccine itself, and then applying it to patients. The only thing a company did was take it, manufacture more of it, and sell it. What is with all this corporate worship nowadays? It's pretty damn scary how propaganda can convince people that there are like certain maxims of truth or something. Like corporate = efficient. rofl. And government = wasteage. Yeah right -_-. You know, if government was really that useless, you'd think people wouldn't have invented and relied on it for thousands of years. Meanwhile, corporations have only been around for a few centuries... And they're one of the worst ideas ever. A legal entity with all the rights and privileges of an individual... with none of the liability.

On July 15 2009 01:00 Aegraen wrote:
Not only that, most Americans are HAPPY with their current healthcare.

On July 16 2009 05:20 BisuBoi wrote:
Yes but arbiter you forgot how essential our security is! Don't you watch US news? We live in a world where people hate us for our loose morals and decadently rich way of life. If not for our redoubtable military (which could fight several alien civilizations along with the rest of the world) we would find ourselves under attack within a year. In a world where missiles can cross entire oceans, we need bases in every country to stop the missiles at their source. It is entirely justified and necessary.

On July 16 2009 05:01 Arbiter[frolix] wrote:
A gigantic money-sucking military, spread across an archipelago of bases all over the world, seems like just about the biggest of big government projects one could possibly think of.

On July 16 2009 04:05 Sadist wrote:



this is the biggest piece of trolling bullshit ive observed in a while.

how the fuck.....can you claim that most americans are happy with their healthcare? Sure the wealthy ones are. Try looking at the fucking middle class for once. Healthcare plans are getting completely raped in new budgets in school districts all the time. Not only that.....tons of jobs that once offered amazing healthcare plans now offer absolutely horrible ones because its not possible to keep up with the ever increasing cost (such as the auto industry).

From personal experience.. the only people who seem to have great healthcare anymore or people who have pretty high paying jobs in the first place..or people who work for the government.

On July 16 2009 12:12 s_side wrote:


I wouldn't say that this is a troll, necessarily. The statistics that I've seen suggest that about a percentage point over half of Americans self describe as "very happy" with their health care. That's about 10% more than their Canadian counterparts.

What it really boils down to though, is that their will always be "rationing" in health care. It just depends on how you want to ration. In my opinion, it makes more sense to use a regulated free market system in which more productive members of society receive better care. It sounds callous and Darwinian, but compared to the arbitrary and, let's face it, ineffective yoke of a single payer system, it seems the lesser of two evils.

On July 16 2009 04:44 D10 wrote:
I think many people are missing the whole point of universal health care, the US is being left behind in terms of coverage (as in people covered) and thats quite ashaming for such a rich country, here in Brazil even the poorest people have acess to the top treatment, and for making drugs cheap we simply ignore patents and make generic medicine. Other coutries have other situations but most of them make the priority to give coverage to as many people as possible, cost reduction comes after broad coverage, otherwise you wont even know where to start reducing from.

But in the US people start attacking the government and questioning its credibility, but it seems to be credible enough to have a huge army and wage wars all around.

If you guys keep delaying health care reform, eventually you will will be paying for the whole world's scientific research/health care because it will be so insanely profitable that they will only do it there, we will keep breaking patents and treating our poor while you fight for the scraps of a system that is focused in doing the companies good instead of the people depending on them.

edit: here everyone that can, has a private insurance option, and they are extremelly regulated and effective, its really hard to screw someone who has insurance being the insurer, and it works wonders, specially because everyone knows that public hospitals = lines

On July 16 2009 12:20 Kwark wrote:

Except when the more productive member of society wastes money on inefficient treatment for himself when that same money could be used for the efficient treatment of a half dozen others who cannot afford it. It's unlikely he's all that productive and at the end of the day when a skilled worker dies needlessly society as a whole loses out, not just those directly effected. Some illnesses cost more to treat than others. To get the most bang for your buck it makes sense to cure all the cheap people first and then work your way up.

On July 14 2009 07:25 Aegraen wrote:
He picked her because she is Pro-Obamacare. While she has done fine work, she obviously hasn't spent much time in Canada or Britain. (But that is for another topic)

On July 16 2009 12:27 Eskii wrote:



I have spent decades in both, what is wrong with our health care? :0

On July 16 2009 12:20 s_side wrote:


Do you have any conception of how the pharmaceutical industry (or really any intellectual property based industry) works?

Freeloading off of American (and British and Swiss etc.) R&D investment is fine until the US adopts the same irresponsible policies of your government, and investment in new drugs and health care technology vanishes like a squirt of piss in a hurricane.

On July 14 2009 07:56 Misrah wrote:
The thing is- people want things to be taken care of. For some reason the US public enjoys the idea of cradle to grave care, and obama is going to be giving it to them. Obama is 'helping them' when in reality he is only helping the minority or people in the US. The majority and going to be faced with crushing taxes- and now my generation and the next and the next are going to have to pay off all of the 'stimulus package'

What i find to be so wrong is this: When you are in dept (as america is) you should not spend more, instead you need to cut back and start saving. Obama is going in the complete opposite direction.

On July 16 2009 13:07 gchan wrote:
Actually I think it's interesting that Cuba is in the same life expectancy range as US is considering they are often touted as having the best health care. Not sure on the facts, but I think they have the most physicians per capita.

On July 16 2009 13:16 Ecael wrote:
Zepplin, devaluation of the pound and other currencies after WW2. It isn't that there was no problem, it was that pretty much everything went to shit together.

On July 16 2009 05:01 Arbiter[frolix] wrote:
A gigantic money-sucking military, spread across an archipelago of bases all over the world, seems like just about the biggest of big government projects one could possibly think of.

On July 14 2009 07:25 Aegraen wrote:
He picked her because she is Pro-Obamacare. While she has done fine work, she obviously hasn't spent much time in Canada or Britain. (But that is for another topic)

On July 16 2009 15:01 Louder wrote:



This really says it all right here. Health care shouldn't be a private business issues, period. Fuck this country I'm moving to Canada.

On July 16 2009 05:01 Arbiter[frolix] wrote:
A gigantic money-sucking military, spread across an archipelago of bases all over the world, seems like just about the biggest of big government projects one could possibly think of.

On July 16 2009 13:07 gchan wrote:
Actually I think it's interesting that Cuba is in the same life expectancy range as US is considering they are often touted as having the best health care. Not sure on the facts, but I think they have the most physicians per capita.

On July 16 2009 16:30 Arbiter[frolix] wrote:
Personally, I think universal healthcare is a moral imperative for any civilised, developed nation.

On July 16 2009 16:33 Arbiter[frolix] wrote:


Amusing. You do realise that Cuba is a poor nation, subject to ongoing decades-long sanctions from the global superpower, right?

The "interesting" thing is that Cuba is even on the same chart as the wealthiest, most powerful nation on the planet when it comes to healthcare performance.

On July 16 2009 16:50 Ecael wrote:

Meh, moral imperative? How far does that extend. There can be a system which ostentatiously offer Universal healthcare, then couple it up with limitation of method of treatment used, increases fees on smokers, obese people, AIDS patients...wait. To be honest, I don't believe that 'universal' healthcare can be accomplished under either a perfect market solution or a government based solution. Even in a civilized, developed nation, I don't suppose all of its citizens would wish to shoulder the burden that someone else bears. Or need we attach strings to how universal things are?

On July 16 2009 16:50 Ecael wrote:

Meh, moral imperative? How far does that extend. There can be a system which ostentatiously offer Universal healthcare, then couple it up with limitation of method of treatment used, increases fees on smokers, obese people, AIDS patients...wait. To be honest, I don't believe that 'universal' healthcare can be accomplished under either a perfect market solution or a government based solution. Even in a civilized, developed nation, I don't suppose all of its citizens would wish to shoulder the burden that someone else bears. Or need we attach strings to how universal things are?


The Cuban system is a thing of marvels, but we don't see that kind of performance replicated anywhere else. EDIT - Right, Singapore, another weird as hell system, but if there is anything to be emulated, I'd take that. I can't say much about it though, being that I am unfamiliar with it other than hearing the tales of how awesome it is. So in my uneducated opinion, the first thing that comes to mind is like, the KGB. For a nation that we later decided was in shambles for the most part, there were some parts of it that worked amazingly well. As you pointed out yourself, there are other elements that the chart does not take into account which affects the performance that we see.

gchan wrote:
Anyway, I'm done arguing with you because you are obviously on tilt. Try not responding to every message so angrily. Oh, and government programs are _always_ more inefficient because there is no feedback mechanism to manage them.

Syntax, look at my other posts about competitive pricing.

Market conditions in the early 20th century were substantially different than they are now. Also, you outline exactly my point in saying that government is good at developing the theoritical backbone, but not application.

Vaccinations--19th-20th century government program, government proliferation because of the need to fight disease during war.

Antibiotics--early 20th century government research, mass produced by government because, again, of war.

Germ theory--more specific please.

DNA--Initial research done by government, yes, but application mostly used in drugs is done by private industry. Actual direct usage of DNA targetting products is too infant to really say whether it's being picked up by private industry.

Ecael wrote:
With the NEJM article, it shows the current system to be inadequate, which we seem to agree on, but actually doesn't show a viable alternative. If the US magically transforms into a Canadian system, then the study shows that a single payer system as opposed to the current system can potentially mean a large sum of savings. As the study admits, it focused on the administrative costs and is unable to take into account many of the other expenses, if we can point solely to administrative cost as the cause of the difference in quality of care and price, then sure.

About the population density part, that is actually not my point. The primary point was to point to the regional nature of healthcare practices in America, thus a more suitable comparison in these two other countries.

Once upon a time, Ecael wrote:
I don't know, the US suffers from one particular problem that we don't see in European countries in terms of its size. A more suitable comparison would probably be China or Russia, considering they are some of the few countries that can really match US in terms of both population and size. However, those tow differ from the US in too many ways for us to form a proper comparison either. I personally don't think that even with all the resources and potential that the US dumps at the field we should be in the top 3, the culture that has built up until this point as a result of the current system and the legal entanglement that comes with it is going to be difficult to fix. It will take decades before anything shows proper outside of drastic changes on the system.

In short though, "Facts are that the US corporate health system is much worse than some of the worst western government run health care systems.", even if comparisons between the two are really lacking in many ways.

However, in response to what was said of a government program ensuring coverage in areas with low population density. if a private market solution won't want to settle in an area that is not densely populated, what will draw people to enter government services that work in those areas?

As it is, we throw in huge incentives for medical students to work public care and government in forms of the social work program and the army scholarships. That is a hefty sum for a temporary service. As Caller pointed out, there is already a large issue with the amount of people entering the medical field and the price they are forced to pay.

A government based system will likely not only need to change the insurance system as we know it, but initiate drastic changes in the education field both from students and current practitioners.

You can't honestly say that academic institutions are not doing it for profit. We have a recent case of Cornell attempting to enforce the patents attached to it, I believe we have yet to see a case of it in terms of biotech and pharmaceutics, but what's stopping them?

As it is, I have many issues with the current system myself. However, to point to government control of healthcare as an end-all solution like that is no better than the Bush administration's attempt to paint EHR as an amazing miracle machine that will save lives and cut costs magically.

Kwark, does the discovery of a smallpox vaccine via cowpox or the discovery of penicillin via an accident mean that they have discovered the theoretical backbone of the science?

Government and academic institutions has always been the ones focused on the basic research to the commercial companies' focus on applications.

Suggesting that either of those were "theoretical backbone" would be just as absurd as to claim that they were related to government programs. Those were the kickers to begin more proper research on the area, which makes up the backbone science, not the theoretical frameworks themselves.

While that doesn't preclude government research from being able to turn out practical uses for the basic research, how will such be funded and what impact do they have on our existing market system?

Well, what does basic science mean to you then? Let's take the cowpox vaccination again, we've found through observation that we can use cowpox to stimulate something which consequently leads to protection against smallpox. What else do we know about it? From how you have put it, we understood the process to be taking something similar in nature to disease in question, become exposed to it, see if it stops the disease. The development of the vaccine itself? Sure, I guess we can test dosages of exposure. Application to patients is self-explanatory. Now what, can we apply this to other things? No. This is empiricism and application based, not basic science.

s_side
What it really boils down to though, is that their will always be "rationing" in health care. It just depends on how you want to ration. In my opinion, it makes more sense to use a regulated free market system in which more productive members of society receive better care. It sounds callous and Darwinian, but compared to the arbitrary and, let's face it, ineffective yoke of a single payer system, it seems the lesser of two evils.

From the interview:
BILL MOYERS: Why is public insurance, a public option, so fiercely opposed by the industry?

WENDELL POTTER: The industry doesn't want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don't want any more competition period. They certainly don't want it from a government plan that might be operating more efficiently than they are, that they operate. The Medicare program that we have here is a government-run program that has administrative expenses that are like three percent or so.

BILL MOYERS: Compared to the industry's--

WENDELL POTTER: They spend about 20 cents of every premium dollar on overhead, which is administrative expense or profit. So they don't want to compete against a more efficient competitor.

BILL MOYERS: You told Congress that the industry has hijacked our health care system and turned it into a giant ATM for Wall Street. You said, "I saw how they confuse their customers and dump the sick, all so they can satisfy their Wall Street investors." How do they satisfy their Wall Street investors?

WENDELL POTTER: Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.

I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.

For example, if one company's medical loss ratio was 77.9 percent, for example, in one quarter, and the next quarter, it was 78.2 percent. It seems like a small movement. But investors will think that's ridiculous. And it's horrible.

BILL MOYERS: That they're spending more money for medical claims.

WENDELL POTTER: Yeah.

BILL MOYERS: And less money on profits?

WENDELL POTTER: Exactly. And they think that this company has not done a good job of managing medical expenses. It has not denied enough claims. It has not kicked enough people off the rolls. And that's what-- that is what happens, what these companies do, to make sure that they satisfy Wall Street's expectations with the medical loss ratio.