Healthcare & rationing

Skipjack · Post by **Skipjack** » Sat Sep 12, 2009 2:21 pm

As I said before, the British and the Canadian system are bad examples. Their systems work much worse than ours here. They are not highly regarded here at all.
Just to make that clear. Our system != Canadas or British system. Of course you guys like to drag the worst systems along for a comparison. That is not fair.

Skipjack · Post by **Skipjack** » Sat Sep 12, 2009 2:29 pm

Also, TDPerk, you are trying to correct me on a argument I had with Msimon, where he claimed:

BTW you would be surprised how hit or miss Doctors are re: medicines. For many conditions it is: try this and tell me how well it works.

I countered his argument by saying that (at least our) doctors know very well how well a medication works. However there are potential side effects that they can not foresee and that can affect a certain part of the population.
He countered by saying that our doctors then just have a smaller amount of medications to choose from, which is untrue. I gave an example, where a side effect (SIDE EFFECT) that is well documented and known did appear (they do in 1 in 100 to 1 in 1000 or so). Anyway he had a different medication that he also knows would work, but that does not have the side effect listed. You can call that trial and error, maybe. But only in regards to side effects, not the actual effects the medication is meant to have.
Anyway, I still say that self medication is dangerous and bullshit. You are not flying your passenger plane yourself either. Why do you think you have better judgement when it comes to medication?

TDPerk · Post by **TDPerk** » Sat Sep 12, 2009 4:50 pm

MSimon wrote:
BTW you would be surprised how hit or miss Doctors are re: medicines. For many conditions it is: try this and tell me how well it works.

Skipjack wrote:
I countered his argument by saying that (at least our) doctors know very well how well a medication works.

The misapprehension of yours I am trying to correct, is your belief there is a contradiction between those two statements. There is none.

Also we are not dragging up the worst of socialist medicine, we are dragging up really the better examples of it. If you want worst, try almost any of the others.

TDPerk · Post by **TDPerk** » Sat Sep 12, 2009 4:54 pm

Anyway, I still say that self medication is dangerous and bullshit.

The notion the government can rightfully prevent it and make it more dangerous to do so by enforcing gatekeeper regulations that ensure it is done in relative ignorance...that is the more dangerous and bullshit.

You are not flying your passenger plane yourself either. Why do you think you have better judgement when it comes to medication?

Why do you imagine that is a good example when certainly private pilots are minted everyday, and government licenses are at best proxies for competence--the proof is in the pudding regardless of the card stock license.

TallDave · Post by **TallDave** » Sat Sep 12, 2009 7:21 pm

For many conditions it is: try this and tell me how well it works.

I gave an example, where a side effect (SIDE EFFECT) that is well documented and known did appear (they do in 1 in 100 to 1 in 1000 or so).

In other words, he gave it to you and said "Try this and tell me how it works."

All medicine is to some extent empirical (trial and error), because our knowledge is limited. Maybe in 50 years, it will be deterministic, if we can fully model everyone's biology down to the molecular level. Until then "Try this and tell me how it works" is pretty much the rule.

TallDave · Post by **TallDave** » Sat Sep 12, 2009 7:28 pm

You are not flying your passenger plane yourself either. Why do you think you have better judgement when it comes to medication?

If they released many new kinds of passenger planes every year and every flight was tailored to my individual needs, I might reasonably have my own ideas about what plane we should fly.

Never underestimate the power of amateurs. Did you know a group of schoolchildren doing a class project recently identified a pandemic before the medical authorities? They were studying markers found in various train stations.

Skipjack · Post by **Skipjack** » Sun Sep 13, 2009 2:38 pm

If you want worst, try almost any of the others.

Not true. Austria, Germany and France, e.g. are much better. Most of the other European countries are doing better too, if I remember correctly.
Canadas system is much inferior to the Austrian in about every aspect.

In other words, he gave it to you and said "Try this and tell me how it works."

OK, I guess we are talking past each other then. The medication worked as the doctors expected that it would. Only the side effects wich can only be anticipated to a certain chance, are hard to predict.
I dont see this as "tell me how it works" but more a "tell me whether you have any problems with it".

Even side effects can be predicted too though and sometimes it is a mistake to ignore them:
Do you know the difference between Omeprazol and Pantoprazol? If you bought a medication against "stomack problems". Would you even know which is contained in what medication? Because in my case it can have big implications on which one you take. Both are proton pump inhibitors and the casual observer might say "they are the same". They are not.
They are resorbed differently. Omeprazol is resorbed via the same encymes in the liver as Plavix, another medication that I take. A good doctor will know the latest studies that say that this will recduce the effectiveness of Plavix. A casual consumer will most likely not know that, or not make the connection.

Oh, on the airplane: Come on! None of you ever went into the cockpit to suggest a different course or whatever to the pilot, because he read it on the internet, or because he plaif MS flight simulator. None of you would ever get the idea of flying the plane himself instead. It is ridiculous to assume that.
So please give me a break, ok?

To give my point about denial of coverage by insurance providers some more spice here is a nice article by the washingon post:
http://www.washingtonpost.com/wp-dyn/co ... 455_2.html

I really like this part:

Yvette Thomassian of Glendale, Calif., lost her Blue Cross policy because she did not declare a deviated septum.

A deviated septum? A deviated septum? Someone tells me that and he is in danger of having a very deviated septum 2 seconds later, I can tell you that. From what I know 3 out of 5 people have a deviated septum (thats about how many have a slightly to more than slightly crooked nose). If you want to know whether you have one try to mirror half of your face in an application like Paintshop or Photoshop, etc. It is not a serious medical condition and most people dont even know they have it.
It is ridiculous to deny anyone medical coverage because of that and simply a matter of them desperately trying to get out of a contract that has become a disadvantage for them.

MSimon · Post by **MSimon** » Sun Sep 13, 2009 3:59 pm

I dunno. I would never let a doctor work on me if I didn't understand what was going on. But that is just me.

I had to get Tagamet for a stomach problem when it was still a prescription drug and told the doctor I didn't understand why it had to be a prescription drug because when it came off patent it would be over the counter. My doctor told me "that will never happen". Well in the USA it is now an over the counter med.

And yes. It might take me 15 years of intensive study to know what a doctor knows. But I don't have to know everything a doctor knows. Just what is pertinent to my condition. And in that case it is possible to for me to know more than the doctor does.

In other words - I become an expert in things that pertain to me.

Skipjack · Post by **Skipjack** » Sun Sep 13, 2009 6:27 pm

Well of course if you spend years studying a certain condition, you might actually get as much an expert as a doctor is. But then I can probably become an expert for a certain type of nuclear reactor in the same time. I am not sure that people would let me operate the nuke in their hometown just like that though.

Also let me ask this again: Would you refuse to fly on a plane just because you can not steer it yourself? What is the difference? You think that medicine is easier than flying a plane?

MSimon · Post by **MSimon** » Sun Sep 13, 2009 7:15 pm

Skipjack wrote:Well of course if you spend years studying a certain condition, you might actually get as much an expert as a doctor is. But then I can probably become an expert for a certain type of nuclear reactor in the same time. I am not sure that people would let me operate the nuke in their hometown just like that though.

Also let me ask this again: Would you refuse to fly on a plane just because you can not steer it yourself? What is the difference? You think that medicine is easier than flying a plane?

I got to operate a nuclear reactor with just one year of reactor training and no degree in the subject.

The difference is that to fly a 747 I would have to know more than how the electrical system works in an aircraft. I could handle a Piper Cub though. And have. To understand how to treat my condition I do not have to know everything a doctor does. Just those things pertaining to my condition.

Americans have a tradition of not deferring to experts. Not all of us. And not all the time. But enough of us enough of the time to keep the spirit alive. You Euros keep sending such rebels and trouble makers to America. And we are very glad to get them. A good thing all around. The Euro aristocrats get a docile population and we Americans get liberty lovers. Keep it up.

Skipjack · Post by **Skipjack** » Sun Sep 13, 2009 7:29 pm

To understand how to treat my condition I do not have to know everything a doctor does. Just those things pertaining to my condition.

This is silly. You could learn it of course, but why? Why do everything yourself if you can rely on people that are more and better educated on the subject than you will most likely ever be (unless you go and study medecine yourself). As I said, it is not a good idea to just understand your own condition. What about the side effects of the drugs? Maybe you should also take some meds for those? E.g. a proton pump inhibitor to protect your stomach against the side effects of the other drugs you are taking (e.g. the Aspirin).
Again, sorry I think so far your reply has been rather lame. Yeah I could, I want to. I dont think you can. You might think you can, but ultimately you will fail. Also, do you have a CT scanner at home? An ultrasound, even? What about an EKG? An endoscope? Know how to operate any of these... savely?

Skipjack · Post by **Skipjack** » Sun Sep 13, 2009 7:30 pm

I got to operate a nuclear reactor with just one year of reactor training and no degree in the subject.

That I find kinda scary, btw.
I sure hope you still had some superiors with you to monitor you.

MSimon · Post by **MSimon** » Sun Sep 13, 2009 8:03 pm

Skipjack wrote:
I got to operate a nuclear reactor with just one year of reactor training and no degree in the subject.
That I find kinda scary, btw.
I sure hope you still had some superiors with you to monitor you.

Of course I had superiors. And don't be scared. I was not only tops in my class, I was told I was the best that had graduated from the school for two or three years. It is the other guys you have to worry about. OTOH the US Navy has an excellent safety record when it comes to reactors.

It is amazing what you can learn in a short time if you devote yourself to a subject.

MSimon · Post by **MSimon** » Sun Sep 13, 2009 8:11 pm

This is silly. You could learn it of course, but why?

Because I don't want to be ignorant about what goes on in my life. Because I want to be smart enough to ask the right questions.

It is like dealing with an auto mechanic. You get better results if you have a good idea of what they are about.

And re: EKGs. I have rebuilt them. I know how they work and the purpose of the electrodes. In fact I also helped design a machine that made the electrodes.

You learn a lot of different things being a contractor.

I helped build a machine to detect failures in ultrasound probes. So I know some about those. And why learn as much as I can? Because I want to. Lots of people prefer to remain ignorant and totally trust others. I'm not one of them.

BTW why do I need to own the machinery? It is enough to know how they work and be able to ask intelligent questions.

Skipjack · Post by **Skipjack** » Sun Sep 13, 2009 8:29 pm

Msimon, I guess you are an exception then and I do find your ability to learn admirable. So dont think I am rude. But honestly, do you think that you represent the average person?
Dont assume that because you are smart, everybody else is. Remember, we were talking about the average person and I am still not convinced that they have your ability to learn and understand these matters.
The average is those people that buy books on accupuncture, urin therapy and rekhi and then they think they know it all and better than their phycisian.

PS: Quite an admirable curriculum vitae there, Sir. Very impressive.