|
On August 18 2009 05:50 Excalibur_Z wrote:
Kwark, I read your long post, and frankly I find it to be quite frightening. I understand that on a collective level, it makes more sense to let an old man die than to neglect the health care of a hundred adolescents for the same cost. I get that. However, on an individual level, it's barbaric. If a man has the means to pay for an extension of his life or the life of a loved one, why does that need to go further than the parties directly involved? By intentionally refusing health care to someone, you strip them of their right to life as guaranteed by our basic founding US documents. Every family member wants to hear "we did everything we could" from the doctor of a loved one who has passed away, not "it just wouldn't be feasible, so the state has denied treatment."
The fact is, in ANY case, whether it is the state or the family or the insurance company, then wha the family will hear is
"we did everything that we were paid for"
And that is all the family SHOULD hear
After all, If the family's options are for the entire family to be homeless and working 16 hours a day the rest of thier lives... or for Grandma to not get that 1% chance of life extension for a year... it should be their choice to take one over the other.
If they got cheap insurance that only covers so much, so that they could save on premiums, then they chose to let grandma die (assuming the incurance company properly fullfilled its obligations about what it would pay for)
If the state decides to spend money on saving adoecsents, or reducing crime, or building monuments to the glorious leader, instead of saving grandma, that is the state's decision with "Its" money. As long as the family was free to spend more of their own money, if they so chose, to give grandma more health care.... then there is no problem with the system.
The big problems with the healthcare market (regardless of degree of state intervention or corporatization) is
1) The difficulty of assessing the cost of an"event" as well as the existence of an event (ie I get in an auto accident, I know that I was in an accident, and it is relatively easy to find out how much to repair or replace the car..... Medical "accidents" ie conditions that I acquired might not be known about for long periods of time, and the 'cost of repair' is unknown...and 'replacement' is not an option... no blue book value for my body...well there is but people don't like that idea much)
2) Different people have different costs totally independent of their actions (many people have congenital conditions that means it costs more to keep them healthy...)
3) The fairly large role of personal actions in the remainder of conditions, and the difficlty of assessing them....auto insurance companies can look at your driving record, where you were at fault, and where you weren't... establishing the "fault" in medical conditions (ie luck v. you) is a lot more difficult, as it is dependent on a lifetime of small choices
1+3 just make health insurance incredibly complicated
2 makes healthcare (distinct from health insurance) an uneven social burden, making it difficult for the free market to handle it the way people would like it to be handled.
|
On August 18 2009 05:13 citi.zen wrote:Show nested quote +On August 18 2009 04:56 arsonist wrote:
As far as I can tell, the only justification in this post for giving no merit to the aforementioned people's ideas is bolded, and I find it hilarious when debates like this crop up and labels like Socialist and Fascist are tossed around as scare tactics to trick people into thinking they're inherently evil or something.
He studied under a Marxist economist?! Oh god, here comes Stalin.
Noam Chomsky is a libertarian!? RUN.
My only point is this: the merit of an argument is weakened when you cite obscure and biased sources. Chomsky is very well known and respected, but mainly for his linguistic studies. + Show Spoiler +I am not saying either of them is the next Stalin.
Every source in economics is going to be biased toward the individual's school of thought.
When people throw out buzz words like, "He's a Socialist!" or "He's a Fascist!", usually the implication is that whatever they do, it's going to be detrimental. There's still a lot of indoctrinated RED FEAR out there. It's like calling people unAmerican simply as a means of attacking and dismissing them without actually looking at the substance of their ideas.
|
is awesome32277 Posts
nevermind, I'll stay out of this, tired.
|
Bosnia-Herzegovina1437 Posts
On August 17 2009 03:37 DrainX wrote:Show nested quote +On August 17 2009 03:32 Jayve wrote:Hans-Titan:
For helvede hvad er det for en gang lort at lukke ud? Hvad mener du? Det eneste jeg sagde i forhold til Danmark er at vi har et afslappet forhold til alchohol og at vores drikke alder er betydeligt meget lavere end den er i Amerika. Hvad er der forkert i det? Resten af det siger jeg da ikke på Danmarks vegne. Oo Danmark är som Sverige fast folk är gladare och dör tidigare 
Damn English please?
|
On August 18 2009 06:32 arsonist wrote:+ Show Spoiler +On August 18 2009 05:13 citi.zen wrote:Show nested quote +On August 18 2009 04:56 arsonist wrote:
As far as I can tell, the only justification in this post for giving no merit to the aforementioned people's ideas is bolded, and I find it hilarious when debates like this crop up and labels like Socialist and Fascist are tossed around as scare tactics to trick people into thinking they're inherently evil or something.
He studied under a Marxist economist?! Oh god, here comes Stalin.
Noam Chomsky is a libertarian!? RUN.
My only point is this: the merit of an argument is weakened when you cite obscure and biased sources. Chomsky is very well known and respected, but mainly for his linguistic studies. + Show Spoiler +I am not saying either of them is the next Stalin. Every source in economics is going to be biased toward the individual's school of thought. When people throw out buzz words like, "He's a Socialist!" or "He's a Fascist!", usually the implication is that whatever they do, it's going to be detrimental. There's still a lot of indoctrinated RED FEAR out there. It's like calling people unAmerican simply as a means of attacking and dismissing them without actually looking at the substance of their ideas.
I'll try one more time, with an analogy that should be appropriate for this forum: trying to have an argument with a Bisu fanboy over the best Protoss player of all times will not be a very satisfying exercise for me. + Show Spoiler +Alternate version, since I am sure it will come up: it is no fun arguing with someone who HATES Jaedong about who is the best zerg player of all-time either.
Edit: for all your complaining about term dropping, you keep mentioning "fascism" a whole lot, even though I never did! What gives?
|
On August 18 2009 02:57 Aegraen wrote:Show nested quote +On August 18 2009 01:56 nttea wrote:On August 17 2009 19:23 Kwark wrote:
I don't intend to defend the bill in question because I agree with you that the current chimera is an inefficient overcomplicated mess and that this bill simply expands the coverage of the mess without dealing with it. What I hope will happen is that after the US state takes responsibility for the healthcare of its people (which is what this reform is heading towards) someone will say "this is fucking ridiculous, lets overhaul the system into one that works". Ideally I'd like an overhaul now but I accept that it's baby steps and therefore I intend not to defend the bill on its own merits (because I agree with you there) but rather defend nationalised healthcare as a concept and this bill as a stepping stone. With that in mind, I won't argue the case for nationalised healthcare over the current system (because again there we are agreed) but rather nationalised healthcare over an individual insurance system (which I agree would be better than the current system but which I believe is worse than a nationalised system).
Firstly, I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.
Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.
Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).
Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you. Wow, you totally nuked the thread with great argument and sense! I'd vote you for president. Egalitarism and Utilaritarism are the basis and constructs of pretty much every human atrocity committed, especially in the 20th century. The foundation is antithesis to civil liberty, personal liberty, and freedom. I'm glad you would vote for someone who would deny an older person care because of cost and efficiency.
You are an extremist incapable of seeing the advantages in each niche of ideas Aegraen, no wonder you joined the army.
|
United States43187 Posts
On August 18 2009 05:50 Excalibur_Z wrote:
Kwark, I read your long post, and frankly I find it to be quite frightening. I understand that on a collective level, it makes more sense to let an old man die than to neglect the health care of a hundred adolescents for the same cost. I get that. However, on an individual level, it's barbaric. If a man has the means to pay for an extension of his life or the life of a loved one, why does that need to go further than the parties directly involved? By intentionally refusing health care to someone, you strip them of their right to life as guaranteed by our basic founding US documents. Every family member wants to hear "we did everything we could" from the doctor of a loved one who has passed away, not "it just wouldn't be feasible, so the state has denied treatment."
And yet ultimately that is impossible for the vast majority of people in both systems. Flying the best doctors in and buying the best equipment staffed by the best teams is not an option for most poeple. It is always "we did the best we could with the funding we have". When you get into a car accident in a private system and go to hospital they'll give you the best trauma doctor they have there. If you're a billionaire and go to the same hospital you'll get a much higher level of service, they'll fly in the best trauma doctor in the world if it gives you another .1% chance of survival. Money will always up your chances of survival.
I admit in NHS you do get the situation where a cancer patient will be denied an expensive new drug if it is unlikely to work or work effectively (if it does work NICE will use it) and this will somtimes cost them a few months. What you must understand is that in a private system the same thing will happen. The same doctor will tell you the drug exists and is expensive and unlikely to work and most families will not be able to afford it. Unless you're a millionaire on some insanely expensive health plan the insurance company is not going to pay for futile care of you. Your standard premiums will afford you a standard quality of care but if you want optimal to the point of inefficient they'll baulk at that. Obviously some people will have the money to throw around and they'll get the drug but they get it in both systems. Whether in a state system or a private system they're going private.
You say it sucks to hear "it wouldn't be feasible, so the state has denied treatment". I say it sucks way worse to hear "it would be feasible, but there's no way you could afford it". That is the choice here.
|
United States43187 Posts
On August 18 2009 09:11 D10 wrote:Show nested quote +On August 18 2009 02:57 Aegraen wrote:On August 18 2009 01:56 nttea wrote:On August 17 2009 19:23 Kwark wrote:
I don't intend to defend the bill in question because I agree with you that the current chimera is an inefficient overcomplicated mess and that this bill simply expands the coverage of the mess without dealing with it. What I hope will happen is that after the US state takes responsibility for the healthcare of its people (which is what this reform is heading towards) someone will say "this is fucking ridiculous, lets overhaul the system into one that works". Ideally I'd like an overhaul now but I accept that it's baby steps and therefore I intend not to defend the bill on its own merits (because I agree with you there) but rather defend nationalised healthcare as a concept and this bill as a stepping stone. With that in mind, I won't argue the case for nationalised healthcare over the current system (because again there we are agreed) but rather nationalised healthcare over an individual insurance system (which I agree would be better than the current system but which I believe is worse than a nationalised system).
Firstly, I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.
Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.
Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).
Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you. Wow, you totally nuked the thread with great argument and sense! I'd vote you for president. Egalitarism and Utilaritarism are the basis and constructs of pretty much every human atrocity committed, especially in the 20th century. The foundation is antithesis to civil liberty, personal liberty, and freedom. I'm glad you would vote for someone who would deny an older person care because of cost and efficiency. You are an extremist incapable of seeing the advantages in each niche of ideas Aegraen, no wonder you joined the army.
Coastguard... in Wisconsin...
|
Orly ? ...
well, heres an image
|
United States43187 Posts
On August 18 2009 02:57 Aegraen wrote:Show nested quote +On August 18 2009 01:56 nttea wrote:On August 17 2009 19:23 Kwark wrote:
I don't intend to defend the bill in question because I agree with you that the current chimera is an inefficient overcomplicated mess and that this bill simply expands the coverage of the mess without dealing with it. What I hope will happen is that after the US state takes responsibility for the healthcare of its people (which is what this reform is heading towards) someone will say "this is fucking ridiculous, lets overhaul the system into one that works". Ideally I'd like an overhaul now but I accept that it's baby steps and therefore I intend not to defend the bill on its own merits (because I agree with you there) but rather defend nationalised healthcare as a concept and this bill as a stepping stone. With that in mind, I won't argue the case for nationalised healthcare over the current system (because again there we are agreed) but rather nationalised healthcare over an individual insurance system (which I agree would be better than the current system but which I believe is worse than a nationalised system).
Firstly, I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.
Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.
Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).
Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you. Wow, you totally nuked the thread with great argument and sense! I'd vote you for president. Egalitarism and Utilaritarism are the basis and constructs of pretty much every human atrocity committed, especially in the 20th century. The foundation is antithesis to civil liberty, personal liberty, and freedom. I'm glad you would vote for someone who would deny an older person care because of cost and efficiency.
That's just not true. The Holocaust was because Hitler wanted the Jews dead, not because he thought dead Jews upped the efficiency of anything. The Hodomor (look it up) was because Stalin wanted people to stop bitching about collectivisation and people bitch way less when they're dead. Most of Stalin's other insanity was because he was a paranoid manman in the late stages of alcoholism. The Japanese brutality against China and Japan was a martial society running rampant against a civilian population.
Saying that I believe in efficiency and am therefore Hitler is comparable to the old trick of saying all Atheists are murderers, only a bit more stupid.
|
Price-regulated healthcare > Time-regulated healthcare. There is no debate for this IMO.
Evil capitalist insurance companies and hospitals strike deals every day with those who can't pay. We don't need politicians arbitrarily guessing at the ideal economics of our country's healthcare.
|
On August 18 2009 12:11 Kwark wrote:
That's just not true. The Holocaust was because Hitler wanted the Jews dead, not because he thought dead Jews upped the efficiency of anything. The Hodomor (look it up) was because Stalin wanted people to stop bitching about collectivisation and people bitch way less when they're dead. Most of Stalin's other insanity was because he was a paranoid manman in the late stages of alcoholism. The Japanese brutality against China and Japan was a martial society running rampant against a civilian population.
Saying that I believe in efficiency and am therefore Hitler is comparable to the old trick of saying all Atheists are murderers, only a bit more stupid.
Hitler believed that the Jews were genetically inferior and holding back the aryan race from reaching its peak of human perfection. Hitler killed the jews off in classic evolutionary except he did it himself instead of letting time do it. He also needed a scapegoat for all the loses of WWI after germany left catholasism. I advise that you read a synopsis of "My Battle."
But this has little to do with insurance.
I've seen posts in this thread. People saying what the bill says, then others saying "I don't see it that way," because perception > reality for the people posting here. People who think they will be paying $50 from their paychecks for full healthcare coverage. People who think that costs will magically go down with no corresponding downside to supply.
If the bill is sooooooo good, the current majority who want it should push it through. They have the votes. And that should be the real question of support for the bill. If you want it, it's your baby. No bullshit "we're all in this together." If two sides disagree, you force down one path and show who is right. So if you want this bill, tell your congressmen to push it through with the simple or super majority. Anything that sucks can be repealed, and learning will be its own pain.
|
United States43187 Posts
On August 18 2009 12:35 0neder wrote:
Price-regulated healthcare > Time-regulated healthcare. There is no debate for this IMO.
Evil capitalist insurance companies and hospitals strike deals every day with those who can't pay. We don't need politicians arbitrarily guessing at the ideal economics of our country's healthcare.
The public option is far less arbitrary than the private one. If you'd actually read what I wrote you'd see that it was NICE (an organisation of specialist doctors, economics experts, social experts and statisticians) who judge what gets treated on public funds. There is no group better qualified to judge and it is certainly less arbitrary than the invisible hand in which the merit of a procedure is judged by the cost rather than the outcome.
Claiming that it puts the power into the hands of tyrannical politicians who don't know what they're doing is a paranoid delusion at best and a really stupid argument at worst.
|
On August 18 2009 13:02 Kwark wrote:Show nested quote +On August 18 2009 12:35 0neder wrote:
Price-regulated healthcare > Time-regulated healthcare. There is no debate for this IMO.
Evil capitalist insurance companies and hospitals strike deals every day with those who can't pay. We don't need politicians arbitrarily guessing at the ideal economics of our country's healthcare. The public option is far less arbitrary than the private one. If you'd actually read what I wrote you'd see that it was NICE (an organisation of specialist doctors, economics experts, social experts and statisticians) who judge what gets treated on public funds. There is no group better qualified to judge and it is certainly less arbitrary than the invisible hand in which the merit of a procedure is judged by the cost rather than the outcome. Claiming that it puts the power into the hands of tyrannical politicians who don't know what they're doing is a paranoid delusion at best and a really stupid argument at worst.
You mean this benevolent NICE?
http://www.findingdulcinea.com/news/health/2008/December/British-Health-Care-Likely-to-Approve-Sutent.html
According to a report in The Observer, NICE will approve coverage of the drug Sutent and at least one of Avastin, Nexavar and Torisel when it meets on Jan. 14. The decision would represent a major victory for cancer patients and advocacy groups, who were outraged in August when NICE rejected coverage of the drugs.
Under intense political pressure, NICE agreed to reconsider the drugs. New evidence about the drugs’ effectiveness was presented and The Observer reports that the drug companies discussed a new “pricing arrangement that might persuade Nice to approve their products.” NICE announced in October that it was delaying a decision on the drugs until January.
NICE’s August decision to decline coverage of Sutent and the other three drugs created a major controversy in Britain. It epitomized the growing public dissatisfaction with NICE, which has made many controversial decisions to refuse coverage of expensive drugs.
It's awesome that NICE doesn't consider drugs on their MERIT, but on their COST. Sounds like a wonderful system....
|
United States43187 Posts
On August 18 2009 13:21 Aegraen wrote:Show nested quote +On August 18 2009 13:02 Kwark wrote:On August 18 2009 12:35 0neder wrote:
Price-regulated healthcare > Time-regulated healthcare. There is no debate for this IMO.
Evil capitalist insurance companies and hospitals strike deals every day with those who can't pay. We don't need politicians arbitrarily guessing at the ideal economics of our country's healthcare. The public option is far less arbitrary than the private one. If you'd actually read what I wrote you'd see that it was NICE (an organisation of specialist doctors, economics experts, social experts and statisticians) who judge what gets treated on public funds. There is no group better qualified to judge and it is certainly less arbitrary than the invisible hand in which the merit of a procedure is judged by the cost rather than the outcome. Claiming that it puts the power into the hands of tyrannical politicians who don't know what they're doing is a paranoid delusion at best and a really stupid argument at worst. You mean this benevolent NICE? http://www.findingdulcinea.com/news/health/2008/December/British-Health-Care-Likely-to-Approve-Sutent.htmlAccording to a report in The Observer, NICE will approve coverage of the drug Sutent and at least one of Avastin, Nexavar and Torisel when it meets on Jan. 14. The decision would represent a major victory for cancer patients and advocacy groups, who were outraged in August when NICE rejected coverage of the drugs. Under intense political pressure, NICE agreed to reconsider the drugs. New evidence about the drugs’ effectiveness was presented and The Observer reports that the drug companies discussed a new “pricing arrangement that might persuade Nice to approve their products.” NICE announced in October that it was delaying a decision on the drugs until January. NICE’s August decision to decline coverage of Sutent and the other three drugs created a major controversy in Britain. It epitomized the growing public dissatisfaction with NICE, which has made many controversial decisions to refuse coverage of expensive drugs.It's awesome that NICE doesn't consider drugs on their MERIT, but on their COST. Sounds like a wonderful system....
It considers them neither on merit nor cost alone but rather merit divided by cost, otherwise known as cost efficiency. I feel I have been abundantly clear on this fact. However you somehow still manage to misunderstand. As with earlier in the topic, I suspect the problem is that you not only don't know anything but can also read a clear explanation of how it works and still not know anything. Now would be a good time for you to adopt your "but in my defence I don't know what the fuck I'm talking about" defence again.
|
On August 18 2009 13:02 Kwark wrote:Show nested quote +On August 18 2009 12:35 0neder wrote:
Price-regulated healthcare > Time-regulated healthcare. There is no debate for this IMO.
Evil capitalist insurance companies and hospitals strike deals every day with those who can't pay. We don't need politicians arbitrarily guessing at the ideal economics of our country's healthcare. The public option is far less arbitrary than the private one. If you'd actually read what I wrote you'd see that it was NICE (an organisation of specialist doctors, economics experts, social experts and statisticians) who judge what gets treated on public funds. There is no group better qualified to judge and it is certainly less arbitrary than the invisible hand in which the merit of a procedure is judged by the cost rather than the outcome. Claiming that it puts the power into the hands of tyrannical politicians who don't know what they're doing is a paranoid delusion at best and a really stupid argument at worst.
Money is, in a society where exchange is voluntary, a decent measure of a person's contribution during their lifetime. It is also relatively FAIR and UNBIASED: it represents earned income for goods and services other people voluntarily purchased & enjoyed. This is a fairly egalitarian measure - everybody's preferences are weighed the same. Sure, me and the "experts" may hate Brittney Spears, but she seems to have made many more people happy in her singing days. Everybody gets to "vote" with their money! When a rich person can buy more healthcare, this DOES reflect their higher "worth", as measure by this standard.
This system is FAR from perfect, but, to paraphrase Churchill, all others seem much worse! Having "experts" decide a human life's worth (which you need to perform your "optimizing" calculus as to who lives and dies), scares me! And strikes me as creepy and absurd...
|
United States43187 Posts
On August 18 2009 13:50 citi.zen wrote:Show nested quote +On August 18 2009 13:02 Kwark wrote:On August 18 2009 12:35 0neder wrote:
Price-regulated healthcare > Time-regulated healthcare. There is no debate for this IMO.
Evil capitalist insurance companies and hospitals strike deals every day with those who can't pay. We don't need politicians arbitrarily guessing at the ideal economics of our country's healthcare. The public option is far less arbitrary than the private one. If you'd actually read what I wrote you'd see that it was NICE (an organisation of specialist doctors, economics experts, social experts and statisticians) who judge what gets treated on public funds. There is no group better qualified to judge and it is certainly less arbitrary than the invisible hand in which the merit of a procedure is judged by the cost rather than the outcome. Claiming that it puts the power into the hands of tyrannical politicians who don't know what they're doing is a paranoid delusion at best and a really stupid argument at worst. Money is, in a society where exchange is voluntary, a decent measure of a person's contribution during their lifetime. It is also relatively FAIR and UNBIASED: it represents earned income for goods and services other people voluntarily purchased & enjoyed. This is a fairly egalitarian measure - everybody's preferences are weighed the same. Sure, me and the "experts" may hate Brittney Spears, but she seems to have made many more people happy in her singing days. Everybody gets to "vote" with their money! When a rich person can buy more healthcare, this DOES reflect their higher "worth", as measure by this standard. This system is FAR from perfect, but, to paraphrase Churchill, all others seem much worse! Having "experts" decide a human life's worth (which you need to perform your "optimizing" calculus as to who lives and dies), scares me! And strikes me as creepy and absurd...
I understand if you don't like the idea of weighing health against cost and calculating the value of a life. You're disagreeing with the third part of my argument (spoilered below) and that part is a subjective moral judgement which each person arrives at themselves. The third point is not something worth arguing because it is subjective and has no right answer, if you've considered it and rejected it then that's fair enough. What of the others?
+ Show Spoiler +I don't intend to defend the bill in question because I agree with you that the current chimera is an inefficient overcomplicated mess and that this bill simply expands the coverage of the mess without dealing with it. What I hope will happen is that after the US state takes responsibility for the healthcare of its people (which is what this reform is heading towards) someone will say "this is fucking ridiculous, lets overhaul the system into one that works". Ideally I'd like an overhaul now but I accept that it's baby steps and therefore I intend not to defend the bill on its own merits (because I agree with you there) but rather defend nationalised healthcare as a concept and this bill as a stepping stone. With that in mind, I won't argue the case for nationalised healthcare over the current system (because again there we are agreed) but rather nationalised healthcare over an individual insurance system (which I agree would be better than the current system but which I believe is worse than a nationalised system).
Firstly, I believe a key advantage of nationalised healthcare over a private system is that public health challenges can be met with a co-ordinated, universal approach in a public system. From pandemics to obesity, public can invest in the good health of the people which pay for themselves and more in lower healthcare costs. For example, we can get nicotene gum subsidised on the NHS as well as other help to stop smoking. While this does cost tax money whereas in a private system the cost of dealing with their lung cancer would fall firmly on the smokers (in his insurance premiums) it still costs less money. Prevention is far cheaper than cure. So while I acknowledge the argument "why should the healthy man pay for another mans vice?" I don't agree with it because by doing so the overall costs of healthcare are decreased. And when society is wasting less money treating preventable illnesses everyone benefits. That money gets spent or invested and returns back into the cycle. Wasting money makes society as a whole poorer, not just the individual wasting it.
This example of low cost prevention is even more extreme when you look at vaccination programs or free checkups for early treatment of cancer. In the UK women at risk of cervical cancer are notified and recommended to see their doctor for a checkup because it is far cheaper to only find it in 1% of the people you screen but find it when it is easily treatable than wait until the symptoms force them to you but require far more trained staff spending far more hours dealing with it.
Secondly, the costs of curing someone are less than the costs of treating the symptoms of a condition for years on end. Lower class people without insurance will have trouble paying for the treatment they need immediately and will instead spend far more money with worse results managing the symptoms over a long period of time. Again, this is money being wasted. I get that you believe people should be allowed to waste their money as they see fit but ultimately, unless you believe in it so strongly you'll allow them to die on the street, eventually you pick up the tab. If you accept the responsibility of providing critical care to a patient regardless of insurance, and I hope you do, then ultimately you're agreeing to pick up the tab on his healthcare. Once you accept the state has a vested interest it makes sense to act pre-emptively to lower that. A state system does that. An insurance system doesn't because they only pay indirectly, through higher hospital costs. Either way the people end up paying for it, through premiums or taxation. But in one system they pay less.
Thirdly. medicine has a diminishing return on investment, the improvement in healthcare is not proportionate to the increase in cost. To put that in context. Public takes X money and treats everyone with Y quality of health care. Private will take X money, treat half the people with only 1.5Y quality. Better for the people being treated but far less cost efficient.
This is where we get moralising versus free market. I accept that the guy who has saved all his life will want to spend his fortune on some expensive treatment by the most expensive doctors to try and buy himself another 6 months of breathing. However that same money could buy people who don't need such talented doctors or such expensive equipment many times his 6 months. Why should he get to waste his money on buying himself a few more days when the same money could buy some poorer people years. Of course here we're moving into socialism and there is no right answer. After all, you could take it to the extreme and point out that if I really believed in that then I'd do away with the NHS and spend all the money on curing tb and malaria in Africa for the few dollars it takes to save a life.
I believe a mixed system of public and private along with rationing in the public sector is the best answer to this question. You may disagree and I won't begrudge you for it because this is an entirely subjective issue. However, in my opinion rationing provides by far the most effective healthcare with the money provided. We have an institute called NICE (National Institute for Clinical Excellence) which weighs the costs of treatments against the gains in patient welfare and judges where the money should be spent. By dealing with all the cheaply cured patients first and moving up the scale you get the maximum bang for your buck. This system is more efficient than a private system but it also takes away individual choice. However you must remember that there is always the private option. By opting to go private you are essentially forfeiting the tax you paid towards the nationalised health service but ultimately that is not all that much money. The procedures which will be out of reach of the middle class in a public system will still be out of their reach in a private system. The rich will get the same quality of care in both systems. It is only a very small segment of society on the cusp who could just about scrape the money together in a private system but could not in a public who will be adversely effected. Whereas the number of people positively effected is far greater.
However as I've already said, I will understand if you don't agree with my third point about the morality of rationing (although not if you disagree with the greater efficiency from rationing).
Fourthly, sick people are bad for society in general. Poor people who are ill with a contagious virus ignore it and infect those around them, perpetuating the problem. While that may not bother you, eventually one of those people getting paid so little he can't afford to take a sick day will be the guy coughing over your food. To use a crude analogy, you may not like your toilet on a personal level, you may not think it deserves your investment, but you still buy products to keep it hygenic because if you don't it'll be worse for you.
|
On August 18 2009 13:28 Kwark wrote:Show nested quote +On August 18 2009 13:21 Aegraen wrote:On August 18 2009 13:02 Kwark wrote:On August 18 2009 12:35 0neder wrote:
Price-regulated healthcare > Time-regulated healthcare. There is no debate for this IMO.
Evil capitalist insurance companies and hospitals strike deals every day with those who can't pay. We don't need politicians arbitrarily guessing at the ideal economics of our country's healthcare. The public option is far less arbitrary than the private one. If you'd actually read what I wrote you'd see that it was NICE (an organisation of specialist doctors, economics experts, social experts and statisticians) who judge what gets treated on public funds. There is no group better qualified to judge and it is certainly less arbitrary than the invisible hand in which the merit of a procedure is judged by the cost rather than the outcome. Claiming that it puts the power into the hands of tyrannical politicians who don't know what they're doing is a paranoid delusion at best and a really stupid argument at worst. You mean this benevolent NICE? http://www.findingdulcinea.com/news/health/2008/December/British-Health-Care-Likely-to-Approve-Sutent.htmlAccording to a report in The Observer, NICE will approve coverage of the drug Sutent and at least one of Avastin, Nexavar and Torisel when it meets on Jan. 14. The decision would represent a major victory for cancer patients and advocacy groups, who were outraged in August when NICE rejected coverage of the drugs. Under intense political pressure, NICE agreed to reconsider the drugs. New evidence about the drugs’ effectiveness was presented and The Observer reports that the drug companies discussed a new “pricing arrangement that might persuade Nice to approve their products.” NICE announced in October that it was delaying a decision on the drugs until January. NICE’s August decision to decline coverage of Sutent and the other three drugs created a major controversy in Britain. It epitomized the growing public dissatisfaction with NICE, which has made many controversial decisions to refuse coverage of expensive drugs.It's awesome that NICE doesn't consider drugs on their MERIT, but on their COST. Sounds like a wonderful system.... It considers them neither on merit nor cost alone but rather merit divided by cost, otherwise known as cost efficiency. I feel I have been abundantly clear on this fact. However you somehow still manage to misunderstand. As with earlier in the topic, I suspect the problem is that you not only don't know anything but can also read a clear explanation of how it works and still not know anything. Now would be a good time for you to adopt your "but in my defence I don't know what the fuck I'm talking about" defence again.
I'm genuinely curious how any of this is any different than the Collectivization under Stalin. It was, after all for the greater good of society. You have a body of politicians and bureaucrats who make arbitrary decisions on peoples lives. You claim it increases access, but at what cost? This is the problem with Socialism, which Margaret Thatcher put it quite nicely. So, you reduce quality of care so you can throw the people under the umbrella of Universal Care. Nevermind the power this is given to politicians. Instead of better quality care which perhaps not everyone will have even access, but everyone will get care you instead opt for a system that reduces quality so everyone can get equal treatment.
You act as if no charity work is provided in a privatized system, or at least a partial privatized system.
http://www.nytimes.com/2005/11/07/business/07drug.html?_r=1&pagewanted=print
The drug companies, which distributed free drugs with a retail value of $4.1 billion last year to an estimated three million to four million Americans, will continue their charity programs in some cases, focusing on other patients with financial needs who don't qualify for the Medicare prescription drug program.
You probably don't even know that Doctors and Surgeons donate their time and give free assessments, free surgeries, etc. for extremely poverty stricken people do you?
No, but in your world view, the companies are evil greedy capitalist pigs and only the government is benevolent enough to cover everyone!
I'm just curious, would you say you have equal access or increased access by increasing waiting times just to get procedures is in excess of 12 months? How is this access at all?
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1282291
Our analysis shows that variations in inpatient and outpatient surgical waiting times are not random but obey power relations independent of specialty and hospital location. Thus the lengths of waiting lists could be emergent (i.e. class IV) properties of the NHS independent of patients, doctors, nurses or managers. Surgical waiting lists may therefore obey the laws of the edge of chaos—i.e. scale invariance, resistance to change, and maximum efficiency.
Scale invariance means that the waiting lists of a surgical or medical unit that consists of many consultants obey the same power relation as the waiting lists of individual consultants. A recent paper2 supports this idea by showing that the waiting lists of individual dermatology consultants obey a power relation, similar to the one reported here.
Resistance to change can be illustrated as follows. Let us consider a surgical unit in which a certain number of consultants see a certain number of outpatients each week. If an extra consultant is added to the unit, to try to shorten the waiting lists, the general practitioners may lower their threshold for referring patients. The consultants may also respond by spending more time with each outpatient and seeing fewer patients in each outpatient clinic. As a result of these changes, the waiting lists will probably stay the same length.
The fact that waiting lists are at the edge of chaos may also explain the failure to shorten waiting lists despite the introduction of diverse government policies, such as internal market competition and more administrators. Measures proposed in The NHS Plan3—for example, banning new consultants from private practice for several years or reorganizing pay initiatives—are also unlikely to work. If these measures are introduced, the waiting lists will probably self-reorganize to remain the same length.
What of maximum efficiency? Self-organized criticality is a law of nature that enables complex systems to optimize their efficiency1, and our findings indicate that NHS surgical waiting lists are no exception. Chaos and complexity theory suggest that no matter how many managers are appointed they will be unable to enhance efficiency, and that increasing control and uniformity may shift the NHS from an efficient, self-organized critical system to a mediocre, highly ordered one.
|
United States43187 Posts
You can't attempt a comparison of the NHS with your private system on output alone. The fact that you spent over three times as much per person should also be mentioned. It's incredibly dishonest to say that the output is better and therefore the system is better. But don't let that stop you.
|
i have no problem at all with my tax dollars going toward paying for your future medical expenses.
|
|
|
|
|
|
EPT![[image loading]](http://washingtonindependent.com/wp-content/uploads/2009/08/emma.jpg)
