Healthcare & rationing

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Skipjack
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Post by Skipjack »

Well the vaccinations listed for Austria are vaccinations you should get anyway, no matter where you are living. They are standard for all developed countries actually.

hanelyp
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Post by hanelyp »

Skipjack wrote: Btw, I am not sure whether
Most of the people in the US do not like having the government to have that much control over whats best for us

is that applicable to healthcare. Clearly the majority voted for Obama, who seems to have a rather reasonable idea in regards to healthcare (public healthcare for those that want it).
The big zero got a plurality of the vote, but I don't believe all that many understood what they were getting. And his ideas of massive mandates and power grab for 'healthcare reform' are anything but reasonable.

Reforms I consider reasonable include:
- allowing interstate insurance.
- leveling the playing field between employer and individual purchase of health care.
- tort reform to reduce extraneous legal expenses for doctors and hospitals.
- reduce extraneous regulations.
- health savings accounts.

vankirkc
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Post by vankirkc »

hanelyp wrote:
Skipjack wrote: Btw, I am not sure whether
Most of the people in the US do not like having the government to have that much control over whats best for us

is that applicable to healthcare. Clearly the majority voted for Obama, who seems to have a rather reasonable idea in regards to healthcare (public healthcare for those that want it).
The big zero got a plurality of the vote, but I don't believe all that many understood what they were getting. And his ideas of massive mandates and power grab for 'healthcare reform' are anything but reasonable.

Reforms I consider reasonable include:
- allowing interstate insurance.
- leveling the playing field between employer and individual purchase of health care.
- tort reform to reduce extraneous legal expenses for doctors and hospitals.
- reduce extraneous regulations.
- health savings accounts.
The country's economy lies in ruins and still the deregulation demagoguery persists.

Sure, let's remove any product and service liability, repeal all the laws, and move health and retirement savings into the hands of those very astute bankers.

Why don't we fire all the cops too? Or better yet, take them private, pay as you go. Fire departments too. What the hell, why not make the courts private also? Then we won't have to pay for anything.

Nirvana!

TallDave
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Post by TallDave »

Here we sit at the highest living standards in history, and after a small dip (arguably created by government intervention) some think capitalism has failed and we need a more gov't -controlled model like those in places that are poorer.

Anyways, here's an interesting table regarding life expectancy. It ranks U.S. states individually.

http://www.businessweek.com/bwdaily/dnf ... 099763.htm

And here's a graphical representation of male LE:

http://mapoftheunitedstates.org/2008/ma ... y-usa-map/

Hawaii and Minnesota sit at the top at about 80, while Mississippi and Louisiana sit at the bottom at around 74. A pretty large gap. You can see there's a definite geological spread there. Since healthcare is fairly standard across the U.S., this argues pretty conclusively that LE correlates strongly to cultural behaviors: you can just about draw a line around those place where lard is used extensively in cooking and lifestyles are sedentary.

It's also interesting that Hawaii and the U.S. Plains states appear to have some of the highest LE in the world, especially if you adjust for the way IM is reported here in the States.
- leveling the playing field between employer and individual purchase of health care.
This is an extremely good idea. I don't know why people think it would be so difficult to just transfer the employer tax credit to individuals. Then we could get rid of mandates and presto! you can now buy a guaranteed-renewable policy that insures against whatever you want (while leaving out what you don't) and the insurance company can never cancel it or deny coverage. There will be enormous competition for individual policies which will create efficiencies all over the system. Prices go down, quality goes up. The invisible hand at work.
health savings accounts.
This works pretty well in Singapore and is probably the best solution, except that people don't like making cost/benefit decisions and are willing to pay a high premium to avoid them. Still, if we could get some small parsimonious fraction of the population onto them it would create price pressures that are largely absent today.
Last edited by TallDave on Sat Aug 29, 2009 6:15 pm, edited 1 time in total.

Betruger
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Post by Betruger »

There's a TED talk just up that illustrates data neighbouring this issue...
http://www.ted.com/talks/hans_rosling_at_state.html

MSimon
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Post by MSimon »

I just read an (e-mail I think) stat which I have not verified.

If you take out murders (we are having a drug WAR) and accidental deaths life expectancy in the USA is about the same as elsewhere. I would assume they are excluded from both sides of the equation for a valid comparison.

If you compare hospital outcomes (cancer survival rates etc.) , US medical care is superior.

Is it worth it? A LOT of Americans think so.

So what is to be done?

1. End the drug war.
2. Figure out the problems with highway safety. It may just have to do with distances driven and there is not much that can be cost effectively done.

Cutting medical care will not solve the problem.
Engineering is the art of making what you want from what you can get at a profit.

Skipjack
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Post by Skipjack »

The WHO statistics of avoidable deaths (via earlier intervention) says different. I am not sure anymore, I think it puts the USA at the 37th position. I dont know where the idea comes from that medical care in the US is superior. I have not seen one statistic that says that. Not a single one. In contrary, many statistics say the oposit. The WHO says otherwise too. So you guys are claiming that you know better than the WHO.

MSimon
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Post by MSimon »

Skipjack wrote:The WHO statistics of avoidable deaths (via earlier intervention) says different. I am not sure anymore, I think it puts the USA at the 37th position. I dont know where the idea comes from that medical care in the US is superior. I have not seen one statistic that says that. Not a single one. In contrary, many statistics say the oposit. The WHO says otherwise too. So you guys are claiming that you know better than the WHO.
The WHO stats conform to their methodology. The prevalence of state care is given a 25% rating.

http://smartgirlnation.com/2009/06/01/p ... re-system/
Engineering is the art of making what you want from what you can get at a profit.

Skipjack
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Post by Skipjack »

So, you are feeling treated unfairly by the WHO?

Skipjack
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Post by Skipjack »

It is just really strange to me.
According to you, only the libertarian US citizens know what is best. You are the only ones who know everything about healthcare and what works and what does not. Everyone else in the world is wrong. Even the people in your own country, the majority of which is for at least an improvement to the healthcare system (and I am not saying that this has to be socialized healthcare, just an improvement and more fairness and rules), are wrong according to you.
It does happen quite rarely that a minority is right and a majority is wrong. I am just not so sure, whether this is the case this time.
I just hope you dont have a bad wake up moment, when you are 55 and left without health insurance (because no insurance company will take you anymore) and no way to pay your health care bills, which will rise with age...

MSimon
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Post by MSimon »

Skipjack wrote:So, you are feeling treated unfairly by the WHO?
It is the lot of My Generation.
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 »

Skipjack wrote:It is just really strange to me.
According to you, only the libertarian US citizens know what is best. You are the only ones who know everything about healthcare and what works and what does not. Everyone else in the world is wrong. Even the people in your own country, the majority of which is for at least an improvement to the healthcare system (and I am not saying that this has to be socialized healthcare, just an improvement and more fairness and rules), are wrong according to you.
It does happen quite rarely that a minority is right and a majority is wrong. I am just not so sure, whether this is the case this time.
I just hope you dont have a bad wake up moment, when you are 55 and left without health insurance (because no insurance company will take you anymore) and no way to pay your health care bills, which will rise with age...
Of course not. Citizens know what is best for themselves individually. Some think earning their own way is best. Others think theft through government gives them the best advantage.

So far it seems that the earners are in the majority. Significantly.
I just hope you dont have a bad wake up moment, when you are 55 and left without health insurance (because no insurance company will take you anymore) and no way to pay your health care bills, which will rise with age...
I'd be no worse off than most people in America were in 1935. In fact I'd be better off. The medicines and treatment are there if I can pay for it. And what was rare in 1935 is common today. What is rare today will be common in 2070.

My health care is not a collective responsibility. If I have made bad decisions then I can serve as an example. If I am unlucky - well tough - it has been fun while it lasted. And I'm going on 65. And I have lead a life I have totally enjoyed. From a totally dissipated youth (isn't that what youth is for?) to having made one or two very tiny contributions to the advance of technology.

For a time I was even a communist. I'm not immune to the attraction of equal outcomes. What I see is that such a system is stagnant. How can it not be? In medical care new treatments (if they are better) mean unequal outcomes for most until the learning gets replicated. And you know - unequal outcomes are BAD. According to some philosophies.

I celebrate unequal outcomes. It means there is an advantage to be gained which will diffuse as time goes on. Computers - because they are advancing so rapidly - are a visible example of the general trend. Remember the gnashing of teeth and the wailing over the digital divide? You don't hear that much any more.
Engineering is the art of making what you want from what you can get at a profit.

Skipjack
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Post by Skipjack »

Unequal outcomes are OK, unequal opportunities are not.

TallDave
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Post by TallDave »

Skipjack wrote:The WHO statistics of avoidable deaths (via earlier intervention) says different. I am not sure anymore, I think it puts the USA at the 37th position.
Link and methodology, please.
I dont know where the idea comes from that medical care in the US is superior.
I've just posted several reasons.
I have not seen one statistic that says that. Not a single one.
I've posted a slew of them. Here's some more.
1. Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.
...
3. Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit from statin drugs, which reduce cholesterol and protect against heart disease, are taking them. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.
..
9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. An overwhelming majority of leading American physicians identify computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade—even as economists and policy makers unfamiliar with actual medical practice decry these techniques as wasteful. The United States has thirty-four CT scanners per million Americans, compared to twelve in Canada and eight in Britain. The United States has almost twenty-seven MRI machines per million people compared to about six per million in Canada and Britain.
...
10. Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other developed country. Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States
In contrary, many statistics say the oposit.
You claim that, but I see no actual evidence the U.S. trails in any relevant statistic. I have cited many statistics that say we are in the lead.
The WHO says otherwise too. So you guys are claiming that you know better than the WHO.
Link and methodology, please.

TallDave
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Post by TallDave »

According to you, only the libertarian US citizens know what is best.
LOL Well, of course. Every ideologue believes that their ideology is best. That's what makes liberal democracy so much fun.

But libertarians have reason and evidence uniquely on their side; they are our core values. Other political faiths tend to be driven by wishful thinking in ways we aren't: leftists want to coerce the world into being fair, so-cons want their morality coercively imposed on everyone. Libertarians just want as little coercion as possible (consonant with securing individual rights), and history has shown this results in the best overall outcome.
Even the people in your own country, the majority of which is for at least an improvement to the healthcare system
Heh, no. Majorities now oppose the "reform" plan, precisely because they do not believe it will improve anything. Large crowds are showing up at lawmakers' meetings demanding they oppose it.

We know Hayek in this country. We've seen the road to serfdom and we prefer to keep our liberty.

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