Healthcare & rationing

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Skipjack
Posts: 6809
Joined: Sun Sep 28, 2008 2:29 pm

Post by Skipjack »

Who cares about the mortages in Poland?
I did not talk about those.
And if you want to talk about ridiculous, just look into the mirror, really.
You should get out more, travel a bit, see other countries and learn. To me you seem like someone who has not been anywhere than in maybe to another state. The US is great and I love the country for many reasons. People like you however, are not one of them.

Scupperer
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Location: Huntsville, AL
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Post by Scupperer »

Confounding information on U.S. cancer rates that might be of interest:
Hispanic Immigrants to US suffer 40% higher cancer rates.

I don't think the my daddy is better than your daddy argument is going to go anywhere, particularly when no one can agree on a standard of measurement. What really should be compared, if one wants to reach any sort of comparable conclusion, would be the rates of improvement of life expectancy, survival rates, etc. etc. within specific countries to the U.S. This is available at http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf. On page 4 is a nice graph of life expectancy rate changes, to start things off.

That's about a 10% improvement in life expectancy over 30 years. How much is attributable to health care quality is, of course, debatable. Heart attack survival, cancer survival rates, and other direct results of health care intervention would be easier to compare based on rates of change within countries, as opposed to per capita or personal anecdote.

This assumes, of course, that the measurements within that specific country are both accurate and to a predetermined criteria that has been unchanged over the time examined.

I have little interest in examining those things, however.

For me, my decision to fight the socialization of health care is based mostly on the incompetence and corruption of our government. Until that is solved and proven, via the fixing of the current problems inherent in medicaid and medicare, along with the indictment and removal of about 30% (at least) of our leadership for their criminal and ethically questionable activities, I have zero confidence that any ideas they come up with or attempt to implement will be anything other than disastrous, especially after reading the first two drafts of the bill.

It would be much easier to fix the market and legal problems currently strangling the health care industry - opening competition across state lines, decoupling employment/union membership from health-care plans, enacting tort reform to prevent excessive rewards, and properly regulating insurance companies, instead of legislatively protecting them from competition with anti-trust exceptions and tort prevention.

When health care is as inexpensive as water and sewer treatment, or electricity, and resources are greater than demand - as (usually) with police and fire protection, then I'll jump on the "socialize it" bandwagon. And this will happen, probably much sooner than anyone expects, particularly with advances like this on the immediate horizon.

Until then, we should focus on fixing medicaid and other programs for those who legitimately need it, and fixing the health plan market so that it makes sense and can compete, as that is, IMO, the best way to achieve cost reduction and quality improvement, simultaneously.
Perrin Ehlinger

vankirkc
Posts: 163
Joined: Fri May 01, 2009 12:08 pm

Post by vankirkc »

Scupperer wrote:Confounding information on U.S. cancer rates that might be of interest:
Hispanic Immigrants to US suffer 40% higher cancer rates.

I don't think the my daddy is better than your daddy argument is going to go anywhere, particularly when no one can agree on a standard of measurement. What really should be compared, if one wants to reach any sort of comparable conclusion, would be the rates of improvement of life expectancy, survival rates, etc. etc. within specific countries to the U.S. This is available at http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf. On page 4 is a nice graph of life expectancy rate changes, to start things off.

That's about a 10% improvement in life expectancy over 30 years. How much is attributable to health care quality is, of course, debatable. Heart attack survival, cancer survival rates, and other direct results of health care intervention would be easier to compare based on rates of change within countries, as opposed to per capita or personal anecdote.

This assumes, of course, that the measurements within that specific country are both accurate and to a predetermined criteria that has been unchanged over the time examined.

I have little interest in examining those things, however.

For me, my decision to fight the socialization of health care is based mostly on the incompetence and corruption of our government. Until that is solved and proven, via the fixing of the current problems inherent in medicaid and medicare, along with the indictment and removal of about 30% (at least) of our leadership for their criminal and ethically questionable activities, I have zero confidence that any ideas they come up with or attempt to implement will be anything other than disastrous, especially after reading the first two drafts of the bill.

It would be much easier to fix the market and legal problems currently strangling the health care industry - opening competition across state lines, decoupling employment/union membership from health-care plans, enacting tort reform to prevent excessive rewards, and properly regulating insurance companies, instead of legislatively protecting them from competition with anti-trust exceptions and tort prevention.

When health care is as inexpensive as water and sewer treatment, or electricity, and resources are greater than demand - as (usually) with police and fire protection, then I'll jump on the "socialize it" bandwagon. And this will happen, probably much sooner than anyone expects, particularly with advances like this on the immediate horizon.

Until then, we should focus on fixing medicaid and other programs for those who legitimately need it, and fixing the health plan market so that it makes sense and can compete, as that is, IMO, the best way to achieve cost reduction and quality improvement, simultaneously.

I'm fine with a private system. It needs two important features, however:

1) If you sell insurance, you sell it to everyone irrespective of their condition, everyone pays the same price, and the insurer cannot unilateral cancel because of a health related event.

2) Pricing for life-critical goods and services need to be controlled to account for the fact that there is no elasticity of demand for them.

Scupperer
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Location: Huntsville, AL
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Post by Scupperer »

vankirkc wrote:I'm fine with a private system. It needs two important features, however:

1) If you sell insurance, you sell it to everyone irrespective of their condition, everyone pays the same price, and the insurer cannot unilateral cancel because of a health related event.

2) Pricing for life-critical goods and services need to be controlled to account for the fact that there is no elasticity of demand for them.
1. I agree that everyone deserves the opportunity to purchase insurance, and that it should not be canceled because of a health related event. I partially agree with price parity - yes on pre-existing conditions which people have no control over, but some people are greater risks by choice, and should therefore pay for those risks - ie: skydivers, athletes, smokers, bad drivers, etc.

2. Define life-critical goods and services. Price controls generally accomplish nothing because they deter increasing supply to meet demand , as well as suppress finding innovative solutions for fear of the same controls. Demand for insulin, for example, is very much on the rise - something I'd call a life-critical good. Should we risk there being a shortage of insulin by capping its price? Sure, those who get their supply won't be bankrupted - those who don't will be dead. At least when it's the opposite predicament - those who can't afford it - charity and government assistance can step in. There may be no elasticity in individual demand, but there are still market forces at work on the goods and services.
Perrin Ehlinger

MSimon
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Post by MSimon »

Skipjack wrote:Yeah, sure have loan and then another loan and then another loan without any chance of ever paying it back. We all know how well that went for the US, do we?
It is a risk. Suppose a person decided to forgo insurance and use the money to start a business? Another risk.

Americans are risk takers. Our money. We decide what risks to take. Seems like a fair deal. YMMV.
Engineering is the art of making what you want from what you can get at a profit.

MSimon
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Post by MSimon »

Insurance is against risk. There is no risk with pre-existing conditions. How to fix that? I can't think of any plan that isn't open to political manipulation and at least some gaming of the system.

That will be solved over time if we make health care plans totally portable. i.e. tied to the individual rather than the job.
Engineering is the art of making what you want from what you can get at a profit.

vankirkc
Posts: 163
Joined: Fri May 01, 2009 12:08 pm

Post by vankirkc »

Scupperer wrote:
vankirkc wrote:I'm fine with a private system. It needs two important features, however:

1) If you sell insurance, you sell it to everyone irrespective of their condition, everyone pays the same price, and the insurer cannot unilateral cancel because of a health related event.

2) Pricing for life-critical goods and services need to be controlled to account for the fact that there is no elasticity of demand for them.
1. I agree that everyone deserves the opportunity to purchase insurance, and that it should not be canceled because of a health related event. I partially agree with price parity - yes on pre-existing conditions which people have no control over, but some people are greater risks by choice, and should therefore pay for those risks - ie: skydivers, athletes, smokers, bad drivers, etc.

2. Define life-critical goods and services. Price controls generally accomplish nothing because they deter increasing supply to meet demand , as well as suppress finding innovative solutions for fear of the same controls. Demand for insulin, for example, is very much on the rise - something I'd call a life-critical good. Should we risk there being a shortage of insulin by capping its price? Sure, those who get their supply won't be bankrupted - those who don't will be dead. At least when it's the opposite predicament - those who can't afford it - charity and government assistance can step in. There may be no elasticity in individual demand, but there are still market forces at work on the goods and services.
Somehow Japan, which does control the price of insulin, never appears to have a shortage of it.

TallDave
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Post by TallDave »

Skipjack wrote:Who cares about the mortages in Poland?
I did not talk about those.
You claimed the financial crisis was America's fault.
And if you want to talk about ridiculous, just look into the mirror, really.
You should get out more, travel a bit, see other countries and learn. To me you seem like someone who has not been anywhere than in maybe to another state. The US is great and I love the country for many reasons. People like you however, are not one of them.
You should learn some relevant statistics. You don't seem to understand the difference between fact and opinion.

I'm happy right here in the best country in the world. If the rest of the world gets better maybe it will be worth visiting someday. You can start with yourself.

gblaze42
Posts: 227
Joined: Mon Jul 30, 2007 8:04 pm

Post by gblaze42 »

Yeah, so say your son gets a heart attack at age 33 (because of simply bad luck as I was told) and can therefore not afford health insurance anymore. You are going to tell him just that?
Well my son who should have a career for himself at 33 should be able to take care of himself and his family. If they had no insurance I would try and help , hopefully though he would have had insurance or money put away as an emergency fund.

I also want to remind you that the same system works in Germany where there are 82 million people. So the number of inhabitants cant be a factor here (sure 82 is not 300, but the US has much more land in return and anyway I cant see how these numbers would have any effect).
Yes number of inhabitants can be a huge factor sorry, if we were only 8 million or even 82 million we wouldn't be having this discussion. And what does land mass have anything to do with health care access?

Yes of course it does. However there are almost no lawsuits. Why? Because people dont have to sue someone to prevent themselves from filing bankrupthy after prolonged illness. In the US it is of course different. I mean these people have the choice: Sue someone (no matter whether justified or not), or file bankrupthy. Heck, I know what my choice would be.
Oh and yeah, taking someone to court is way to easy in the US...
No not really laws are much more stringent to sue for medical malpractice now a days.

TallDave
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Post by TallDave »

vankirkc wrote:Somehow Japan, which does control the price of insulin, never appears to have a shortage of it.
They don't actually have price controls per se on insulin. They take bids from manufacturers like Novo Nordisk and Eli Lilly.

http://www.faqs.org/abstracts/Business- ... Japan.html

gblaze42
Posts: 227
Joined: Mon Jul 30, 2007 8:04 pm

Post by gblaze42 »

Skipjack wrote:
We seem to be much wealthies than Europe. Thanks for asking.
Germany is back to an economic growth of 2.5% by now, after it was also hit by a worldwide economic crisis that was caused by the failed politics of the US in the last 8 years.
The US is still far, far away from such numbers at the moment.
So? Germany GDP is $3,818,000 million as of 2008, US GDP is $14,330,000 million, and the US is the only single country in the world whose GDP is that high, check CIA fact-book 2008.

So really who cares about its' economic growth, even at the this "economic crisis" Germany is still way behind GDP wise.

TallDave
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Post by TallDave »

1) If you sell insurance, you sell it to everyone irrespective of their condition, everyone pays the same price, and the insurer cannot unilateral cancel because of a health related event.
That's not insurance. Insurance means insuring against some outcome at some risk. It's not a scheme by which the low-risk subsidize the high-risk.

Also, insurers can't "unilaterally cancel." That's breach of contract. At most they might not renew.

What we should have is competitive individual insurance in which you pay for the right to renew indefinitely. Then people would have some connection to what they choose to insure against. For instance, I'll never see a shrink, but I can't avoid insuring against that because of mandates.
Last edited by TallDave on Fri Aug 28, 2009 2:37 am, edited 1 time in total.

TallDave
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Post by TallDave »

gblaze42 wrote:So? Germany GDP is $3,818,000 million as of 2008, US GDP is $14,330,000 million, and the US is the only single country in the world whose GDP is that high, check CIA fact-book 2008.

So really who cares about its' economic growth, even at the this "economic crisis" Germany is still way behind GDP wise.
What you really want to look at is purchasing power parity GDP per capita.

http://en.wikipedia.org/wiki/List_of_co ... per_capita

(this link doesn't post properly)

That's the closest approximation to wealth. It adjusts for currency differences and etc.

We're about #4 with current oil prices, but the top 3 are all tiny countries which have either resource wealth or tiny highly urban populations (like if Manhattan were a country). Interestingly, Singapore has Medical Savings Accounts and is #3.

choff
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Location: Vancouver, Canada

Post by choff »

First off, I must apologize for quoting MSimon without followup. I tried to find the original thread, I believe it was during the height of the financial crisis, and I knew we would eventually have another debate on health care costs. When I tried to find it I discovered just how much material there was to search through in 2 to 3 months. It could very well have been someone MSimon was debating at the time.

In my job, I have had to service the same types of equipment from just about every major industrial country. After a while you can tell which country its made in without checking the back panel. Every country has its very own modus operandi when it comes to doing things. The same can be said for health care. People from different countries often have different health care complaints, even different procedures by region.

Unless President Obama suffers the equivalent of a White Water/Monica Lewinsky debacle, some type of health care bill will pass in the fall. (Why they didn't go after Clinton for the Mina, Arkansas airfield is another story. ) If it does, the problem is how to make it work. Even though Americans and Canadians speak the same language and appear indistinguishable even to each other, there are cultural differences.

If an attempt is made to transplant the Canadian system into the US, its not so much socialism vs capitalism as square peg /round hole.

No federal Canadian politician dares suggest US style health care, its the Bon Mott for electability, its very strongly entrenched. The only people that talk that way hope to profit from it. The more Conservative administrations tend to do the best job running our system, but thats just my opinion.
CHoff

gblaze42
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Post by gblaze42 »

TallDave wrote:
gblaze42 wrote:So? Germany GDP is $3,818,000 million as of 2008, US GDP is $14,330,000 million, and the US is the only single country in the world whose GDP is that high, check CIA fact-book 2008.

So really who cares about its' economic growth, even at the this "economic crisis" Germany is still way behind GDP wise.
What you really want to look at is purchasing power parity GDP per capita.

http://en.wikipedia.org/wiki/List_of_co ... per_capita

(this link doesn't post properly)

That's the closest approximation to wealth. It adjusts for currency differences and etc.

We're about #4 with current oil prices, but the top 3 are all tiny countries which have either resource wealth or tiny highly urban populations (like if Manhattan were a country). Interestingly, Singapore has Medical Savings Accounts and is #3.
The link you gave for PPP per capita, the statement hangs out there;
PPP figures are estimates rather than hard facts, and should be used with caution.
Add that not all of those are estimated of the same year. But your right it would be a better for individual wealth rating. I was just basing it on the US economy as a whole. But I digress.

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