Thus Spake Zuska

Why Health Care Reform In The U.S. Is Doomed

Among other reasons….

You can have a rational soul like Laura provide a comparison of her personal experience with the U.S. and Canadian health care systems, like this:

Let’s cut the crap and put it this way:

System #1: When I worked in the US, patients would come in and present their insurance cards; we would call the insurance company and wait on hold for 30 minutes (if we didn’t get disconnected) to verify that they had officially chosen me as their primary care physician. They might pay a copay, or they might pay a percentage of the fee, for which they would be billed after the insurance had done its part. I had to write notes that described a certain number of body parts, or a certain number of aspects of a particular body part, or a certain number of descriptive terms for the symptoms of the one or more body parts, all of which would be added up to determine how much the visit was worth. The bill would go to my billing service which took 8% of receipts, since the hardware and software for electronic billing with dozens of different boxes to be filled in, but filled in differently for each of the dozens of different insurance plans which my office participated in, was too onerous to be handled by a solo practice. Then the “explanation of benefits” would arrive, and I might be told that the insurance had paid, say 80% of the charge that the insurance said they would pay (as opposed to 80% of the charge I was actually charging), and I had to bill the patient for the 20% which, even though it might at this point cost more in staff time and postage to send the bill than the bill was worth, had to be done or I would be accused of fraud, since not billing the balance would mean that my charges weren’t really what I said they were, although the insurance wasn’t paying what I said the charges were anyway. Or maybe the insurance company would say that they wouldn’t pay because it was a pre-existing condition, or it wasn’t a covered benefit, or we hadn’t received prior authorization. Or they might want copies of the records before they would decide whether to pay. Or they might decide that I was no longer one of their participating providers, and the patient would have to go find another doctor, and I would have to copy the chart to send to the new doctor, for which I would not be paid. If I needed to send the patient to a specialist, we would have to look up which specialist were participating providers for that particular insurance, and get prior authorization. Certain tests also required prior authorization. All of this required hours on the phone. And sometimes the specialist would be a participating provider, but the specialist would be in a non-participating hospital, or would send the patient for xrays which ended up being read by a non-participating radiologist, or sometime the radiologist was participating but the xray machine was not.

And then there were the patients who did not have insurance.

System #2: Now I work in British Columbia, where everyone has a “care card.” When they come in, we take down the number on the care card. I can send the patient to any specialist. There is one form to fill out for billing, and the fees are negotiated between the government and the medical society. There are no copays, no deductibles, no percents. I don’t have to employ an army of people to sit on hold with insurance companies.

And everyone is insured.

And you’re telling me that tinkering with System #1 (let’s make it MORE complicated!) is preferable to System #2.

Right.

And you will still get this kind of nutter response from those who have been brainwashed by the rightwing wackaloons into fearing socialism and Obamacare and who think that the fucked up system we have now is somehow The Best Health Insurance in the World!TM

Giving me you take on your personal experiences in “system 1″ and “system 2″ is fine Laura, but cannot be confirmed. Let’s work with facts that can be knowable, Ok?
But…I read both system 1 and 2, and after all your rambling you’re just telling me that system 2 is “easier” so we should do it that way. NOTHING that is worth doing right is “easy” And throwing money at a government program is the “easy way out”.

Yes, dining room table, let’s by all means work with facts that can be knowable. Not that a real person’s actual lived experience in two different healthcare systems would be anything like a knowable fact, now would it? Oh no. Not when your fevered brain can still toss out pithy statements like “nothing that is worth doing right is ‘easy’ “, in lieu of actually grappling with the information in front of you.

What the hell is wrong with you people?

It’s a pity we can’t just seriously divide the country in two. On one side, all you people who don’t want “socialism” can go and live without Medicare, municpal sewer systems, roads that are maintained by government funds, running water, fire departments, police departments, national/state/city parks, public libraries, and other such disgusting features of life under brownshirt Obamcare socialism. The rest of us commies will hunker down together in our socialist nightmare and finally craft a universal health care system to go along with the rest of evil socialist empire.

Comments

  1. #1 David Marjanović
    September 4, 2009

    It’s a pity we can’t just seriously divide the country in two.

    Are you sure you can’t? The Czechs and the Slovaks did it in 1993, for example… looked very easy to me.

  2. #2 troy
    September 4, 2009

    We tried that a long time ago.. not sure why we fought to keep them at this point..

  3. #3 Jim
    September 4, 2009

    obviously we fought to keep them for the oil………

  4. #4 pregunta
    September 4, 2009

    How about modifying the approach Senator Claire McCaskill took at her town hall meeting?

    All beneficiaries of Medicare, Medicaid, Tricare, or the VA line up on one side of the room, everybody else on the other side of the room.

    (Wait a couple minutes while the two groups form…)

    Those of you on the Medicare/Medicaid/Tricare/VA beneficiary side who are against any government participation in health care, please form a third line near the door.

    (Wait a few minutes as the 3rd line forms…)

    Thank you, everyone. FBI agents, please obtain full identification from those in the third line, including Social Security Numbers and Medicare/Medicaid/Tricare/VA identification cards.

    Congratulations to everyone in the 3rd line, you are now relieved of participation in your government-run health plan! Representatives of Aetna, Blue Cross/Blue Shield, Cigna, United Healthcare and other fine for-profit health insurance companies unhindered by most government regulation can be found in the next room, waiting to charge you exhorbitant amounts for practically worthless health insurance and/or deny you coverage due to pre-existing conditions.

    Have a nice day!

  5. #5 Best electronic cigarettes
    September 4, 2009

    Although I like Canada’s system much better (and not because it’s easier), I wouldn’t trust the US Government to be able to run or negotiate with the medical system. I think it sucks that over 15-20% of our medical premiums go to administrative costs (as described above), whereas in other countries admin costs are 2-5%. That means that 20% of our premium goes to NOTHING! Nothing but bureaucratic, inefficient system.

  6. #6 Donna B.
    September 4, 2009

    hmm… System #1 sounds just like what practitioners in the U.S. go through when dealing with Medicare and Tricare. Isn’t that odd?

  7. #7 CW
    September 4, 2009

    It’s a pity we can’t just seriously divide the country in two.

    We did, in 1776.

  8. #8 JGlenn
    September 4, 2009

    At first read, I was with you. After reading the entire response that you linked to, the poster does have a point. Laura’s post does only seem to refer to paying the health care provider and not actually address the quality or accessibility of care provided.

    On a science-themed blog isn’t it reasonable to ask for some quantifiable evidence for the argument?

    I’m also impressed by your professionalism – calling posters who disagree with you idiots even when the US Census Bureau would disagree with your claim that Americans are uninsured because they can’t afford it.

    Nice.

  9. #9 Tony P
    September 4, 2009

    Yeah but Medicare runs at about a 3% overhead, same with the VA. Doctors accept a fixed amount agreed upon prior to starting to accept Medicare patients.

    My doc won’t accept any Medicare patients. He feels the reimbursement is too low.

    And btw, Medicare fraud – don’t do it. If you’re a doctor and most of the medicare fraud is perpetrate by you guessed it, doctors.

    Had one memorable case where a Doc got pinched by the IRS. At the same time he started up-coding all his patient visits. Quite amusing.

  10. #10 Peter
    September 4, 2009

    My mother needed serious surgery several years ago and ended up spending far longer in the hospital than was expected due to unforeseen complications that included a week’s stay in the ICU, the discovery of an aortic aneurysm, and six weeks in rehab. The total cost for this life-saving medical care? Well, it was priceless, but – we didn’t see a bill since we live in Canada. I have two cousins, on the other hand, who are doctors in California, and they both agreed that the ordeal would have cost anywhere from $75,000 – $140,000 – considering the initial surgery was for a bifemoral bypass – requiring a vascular surgeon. That’s a heck of a lot of money to be able to come up with, but health care should not be measured by money – it should not be equated to profits, it is a right, not a privledge.

    Please, take heed of the late Senator Kennedy and understand the importance of health care for all Americans; you have more to gain than you can imagine.

  11. #11 mariana
    September 4, 2009

    The greatness of a nation is marked by how it treats its most vulnerable citizens, and U.S. is getting a pretty big failing grade at this point. Frankly, I’m getting a bit angry at the outright lies being told in the U.S. about our (Canadian) health care. If you have to blatantly lie to back up your side of a debate, then your side of the debate is worthless to begin with. Tell the truth for god’s sake and don’t be so pathetic.

    I echo Zuska’s comments…What the hell is wrong with you people? (and that’s just on health care…when you add in birthers with the other antiscience nonsense I have to wonder if half of the populace is just too stupid to be allowed to live—ha, in that case keep the system you have then?).

    Ok, not a bit angry at the lies, very angry at the lies. “Nutters” doesn’t cover it. Pathetic insecure tiny-minded impotent little people who are so desperate to support their fragile political ideology they’ll lie to prop it up.

  12. #12 R E G
    September 4, 2009

    I echo Mariana’s anger at the lies being told about Canadian health care. It’s not relevant anyway. Frankly, if our health care acheived immortality for us America would still reject it. You need to have a “Made in America” system for it to have any hope at all.

    It is heartbreaking to watch your best opportunity ever to acheive UHC being sabotaged by special interests. The weird thing is Americans, by and large, are extremely generous. They do show up for the car washes to pay for operations. How hard can it be to channel that spirit into health care reform?

    I know it is the height of rudeness to meddle in the internal affairs of a sovereign democratic state …. but …

    I keep having this fantasy that on the Canadian Thanksging (Oct 12 this year) all the Canadian tourists and “resident aliens” wander about your towns and cities wearing T shirts that proclaim:

    GIVING THANKS FOR UNIVERSAL HEALTHCARE 24/7

    At least the talking heads on the news networks could interview someone who wasn’t making a profit from the staus quo.

    I’d buy that shirt if someone designed it. Then I’d go shopping in the outlet mall over the river.

  13. #13 Cherish
    September 4, 2009

    That’s the only thing I’ve read this week on the topic that’s made sense. Thank you.

  14. #14 JGlenn
    September 5, 2009

    Uhm, if the Canadian system is so perfect, why does the Canadian Medical Association say otherwise?

    As far as being “small minded” and “insecure” – try reading the entire set of posts accused of being a “nutter” and point out where it is not reasonable, even if you don’t agree.

    Now, taking one paragraph out of context in a series of posts, that’s not “pathetic” at all, is it?

  15. #15 Joel
    September 5, 2009

    JGlenn, I’m writing from Ottawa here, and yes the canadian system is seriously screwed up. It’s not as good as some other systems.

    And when you Americans reform your system, I sincerely – no, desperately – hope that you do a much better job on it. You have a great opportunity to look abroad and see what works and what doesn’t, and produce the best health care system ever. Which will help catapult you to greater heights as an international superpower (libertarian gun-nuts like it better when you say it that way.)

    Or you can flub it and get your fat, sick, pasty white arses trashed….

  16. #16 Audge
    September 5, 2009

    When Americans start crossing the border to get health care from Canada, then I will support health care reform in the U.S.. Until then I will remain a right wing wackaroon and vigorously opposes screwing up what we have now.

  17. #17 DJ
    September 5, 2009

    Audge@16:
    Umm… they already are, a quick google search brought back many results, here is just one:

    http://www.healthcareforallwa.org/helpline/

    I know, it is just one state and not all along the northern border, but I’d be willing to bet it happens all along the 49th parallel.

    Will you stop being a “right wing wackaroon” now and seriously consider that we need a public option, a truly universal health care system? I hope so.

  18. #18 JGlenn
    September 5, 2009

    Nice link, DJ. If we ever get a real debate going, then maybe that will help convince enough people that we need reform.

    @Joel – The US needs to look at all of the systems around the world, and figure out what works and what doesn’t. As it sits now, though, there are too many people that refuse to admit that there is even the need for reform. Who knows if we’ll be able to overcome the ideological entrenchment that is currently preventing any real change.

  19. #19 ABM
    September 5, 2009

    Canadian here. The US has an opportunity: you can develop something that will work for _you_, avoiding the mistakes of others and the pitfalls you are already familiar with.

    But my guess is you won’t (by “you”, I of course mean your elected leaders). Americans will probably end up with a somewhat different, and still piss-poor, system where you are FORCED to give money to private insurers, whether you can afford it or not, in return for terrible coverage that doesn’t help you much… just so “everyone is insured” without resorting to the dreaded socialism.

    Seriously, people: don’t let the insane ramblings of the likes of Sarah Palin and Michelle Bachman sink the first real chance you’ve had of turning your medical nightmare around.

  20. #20 drdrA
    September 5, 2009

    I’m with you all the way Zuska- I echo the ‘what the hell is wrong with you people???’.

    The bill several years ago for my daughters ear-tube removal (a routine 15 minute procedure done under anesthesia in an operating room) was $13,000. And that was just the hospital bill, didn’t include the doctor or the anesthesia!! Three separate entities were involved (hospital,doc,& anesth), all with separate billing. I was sure that there was some mistake, but there was not.

    Heaven forbid one of us actually gets sick.

  21. #21 Dan J
    September 5, 2009

    I’m with you too, Zuska. I have an income, so I don’t qualify for state aid. I have a small income, and can’t afford health insurance. I can’t afford to pay to see a doctor for my health problems, so I don’t go, so they get worse.

    What the hell am I supposed to do, people? Go curl up in a corner and die, thus relieving conservatives of the burden of my existence? You people who think there’s nothing wrong with the current system are truly pathetic excuses for supposedly decent people.

  22. #22 TomR
    September 5, 2009

    Well said. My family and I lived in BC for 2 years, but when I tell people how easy it was to get care when my son fell off his bike and broke his arm or when one of us got sick it really is like I’m talking to a dining room table. They just don’t hear me.

  23. #23 Jay_C
    September 5, 2009

    “Dining room table here” Yeah, “great post” Zuska. As I thought, just more name calling, demonizing and cursing. Hmmm, how scientific of you. What a joke. You said: “by all means work with facts that can be knowable. Not that a real person’s actual lived experience in two different healthcare systems would be anything like a knowable fact, now would it?” By knowable, I mean for all I know, “Laura” is as much a doctor as I am (I’m not) By knowable, I also mean facts that can be verified. If she is a doctor, how can I confirm her story, I can’t can I? I have heard stories that were just as anonymous that painted a picture almost exactly 180 degrees from what Laura said, from doctors that worked in both Canada and here, so factually, from my point of view, (and, I would think most rational peoples as well) that neither of these stories do anything for meaningfull debate. It just says that 2 different people with the same history had 2 different the exact opposite set of experiences. Logically, where does that leave the debate? In my view, nowhere. So go ahead, demonize and swear and name-call more, I’m sure that will make you feel better, in the meantime, I’ll try and debate with other folks that may have something factual, and knowable to add to the discussion. Read my posts fully, and you will see I am trying to have an actual discussion, I have middle of the road views, and have made concessions on a few things, I am a reasonable person. Sorry if I don’t fit into your “echo chamber” club.

  24. #24 Jay_C
    September 5, 2009

    Thanks for having my back Jglenn and Joel (for at least seeing that I am trying to be reasonable here). Even among us three we may disagree on some of the finer points. That being said, my gut says having a real meaningfull debate here at this blog is going to be difficult, if not impossible. I’ll keep trying though.

  25. #25 Roderick Beck
    September 6, 2009

    You folks need to live abroad. I lived two years in France and now in Budapest. The French health care system is vastly superior in all relevant aspects from cost (14% of French GDP versus 18% for US GDP) to cancer therapy cure rates.

    I know lots of Americans in Europe and none of them miss the American health care of system.

    Your American system is a joke – 35% of each US health care dollars goes to insurance company administrative costs.

    A tax based system would cut it to 2%.

    The French government does common sense things like negotiate drug prices. The result is that monthly prescription of almost any drug range from 12 Euros to 25 Euros. That’s out-of-pocket for a foreigner like myself who is not in the French health care system. Before insurance reimbursement.

    I am just amazed at the ignorance and provincialism expressed on the board.

    A lot of you have been brainwashed by propaganda. You get two to three weeks of vacation of each when almost all Europeans guaranteed a minimum of five weeks. The French average about twelve weeks.

  26. #26 Roderick Beck
    September 6, 2009

    You folks need to live abroad. I lived two years in France and now in Budapest. The French health care system is vastly superior in all relevant aspects from cost (14% of French GDP versus 18% for US GDP) to cancer therapy cure rates.

    I know lots of Americans in Europe and none of them miss the American health care of system.

    Your American system is a joke – 35% of each US health care dollars goes to insurance company administrative costs.

    A tax based system would cut it to 2%.

    The French government does common sense things like negotiate drug prices. The result is that monthly prescription of almost any drug range from 12 Euros to 25 Euros. That’s out-of-pocket for a foreigner like myself who is not in the French health care system. Before insurance reimbursement.

    I am just amazed at the ignorance and provincialism expressed on the board.

    A lot of you have been brainwashed by propaganda. You get two to three weeks of vacation of each when almost all Europeans guaranteed a minimum of five weeks. The French average about twelve weeks.

  27. #27 Greg
    September 7, 2009

    I’ve read a lot of blogs and other info about the healthcare debate and there is something that I have not seen mentioned, yet at least. This is the piece of mind of knowing for sure you are covered. I know it sounds kinda hippy but it is as true as anything I know.

    I lived in the US for 35 years, about 8 of those I had insurance, some through work, some through buying a personal plan while I was self employed. In any case it was often on my mind. Not at the forefront, I wasn’t obsessed or anything, but every time I wrote a check to my provider (which always got larger), or got some new info about a change in the work plan, or went for a check up, I would have to think about it. It would also occasionally come up in conversations with friends who were between jobs and paying Cobra, or were keeping jobs they didn’t like because the insurance was too expensive to leave, or they couldn’t find new insurance because of a pre-existing problem, were denied something, had to pay for some procedure they thought was covered rather than spend it on something else they had planned on. The basic kind of things we are hearing all the time now. Again not every day, but it would come up enough times to remember it. I was lucky because I was healthy, but even that was not a comfort, it was a relief. It is this feeling that I’m talking about here, the feeling that you are “lucky” to have a good plan, that you are “lucky” not to be unhealthy, not just because being unhealthy is bad, but because it will affect your insurance.

    Until I moved to Canada I didn’t realize how much it was actually limiting my life. Like my friends, I was also being forced to make unpleasant choices around having insurance. I was forced to rely on being “lucky”, even though I was insured. Some of you may not notice it but it’s there, like a yoke around your neck, like a ball and chain keeping you from being truly free. Sounds hippy right. Take a moment and really examine your concerns about your insurance plan, think about the benefits it offers and how good a plan it is, or maybe how bad it is, how much it costs, all of it. What about your kids, when they grow up and are no longer covered by your family plan? What about taking time off to travel or go back to school? What about early retirement? What about being laid off? What about just wanting a new job? Do you see how insurance worms it’s way into all these questions? Private health insurance is the freedom to choose between different masters, sure you are free to choose, but you are never free.

    I’ve been covered by the Canadian single payer system for five years now, and I never have to think about any of those things, I’m free to make choices in my life without having to think of how it will affect my health insurance. Is it the perfect system? No, but it works. I went in for a check up last month with my doctor, who I chose, and talked about my health for 15 minutes after the actual exam, we even spent a couple on how crappy the weather was in cottage country this year. I left her office and the only thing I had to do at reception was say good by. I don’t mind paying more taxes for this piece of mind, but the truth is, I actually don’t pay much more, my take home pay is basically the same as if I was still in the States. I read an article that compared net take home pay between the US and Canada and it was a .1% difference, hardly a noticeable amount. Sure taxes on stuff is higher, a few % more than in where I had lived, but it hasn’t seemed to changed my standard of living.

    If you really value freedom, they you want some kind of single payer system, preferably one that just comes out of your taxes. Otherwise your not really free, you just think you are

    Greg

  28. #28 Zuska
    September 7, 2009

    Greg, you said it all.

    For the rest of you who are so concerned about me calling people bad names and not being scientific enough, may I direct your attention here as my complete and total and only response to your concerns.

  29. #29 Jay_C
    September 8, 2009

    Sad, so sad Zuska..What a waste of an opportunity to have a real debate.

  30. #30 JGlenn
    September 8, 2009

    @Greg: Insurance really seems to be the core issue. Maybe all sides would get along better if we called it insurance reform as has been mentioned elsewhere on ScienceBlogs. I’m not convinced that a single payer system is the answer, though. Even the Canadian model is most likely going to have to admit some level of reform and possibly admit some level of privitazation. But the sheer number of uninsured must come down, and the shenanigans that the insurance companies pull proves the need for tighter regulation. If that cuts into their hallowed profits, then so be it.

    Beyond the peace of mind that you mentioned, we also can make a public health argument for universal coverage similar to vaccination: the uninsured put an undue burden on the entire system that the rest of us must absorb. That way it is no longer a personal choice for those that choose to risk it. Further, in the discussion thread on one of her posts, GrrlScientist points out that some of the most troubling health concerns of Americans (Tobacco-related cancers, coronary disease due to obesity, and HIV) are strongly tied to poverty. I have not yet formed an opinion about how that informs the health care reform debate, but it is yet another piece of the puzzle we’ll need to address when designing a system.

    @Zuska – That was actually a pretty good post if you are trying to illustrate your point about Why Health Care Reform in the US Is Doomed. If not then, well, it is just hypocritical and immature. In the meantime, do you mind if the adults talk about important things? Thanks.

  31. #31 Jay_C
    September 8, 2009

    Greg, didn’t “say it all” Zuska, He just provided, yet again, another “example” that cannot be verified along with personal views and beliefs. Why can nobody here address this at a base level of statistics and knowable facts rather than with hyperbole and personal accounts? Again, we need to be reading from the same book, and since this is a “science blog”, you would think those that are for a single payer system would be eating up that opportunity. It really is a shame.

  32. #32 SKM
    September 8, 2009

    Zuska, you’re stifling dissent and silencing debate! Oh, and Mind Your Tone! Shame shameity shame shame!

    Concern troll is concerned.

    And, I totally bookmarked that link, thanks!

  33. #33 Greg
    September 8, 2009

    Jay_C

    I never claimed that I was describing anything other than my experience with the two systems and how they affect my life. The issue here is that there is another side to this debate, the difficult to quantify effects of the piece of mind of knowing that you are covered by a universal plan. One in which you will receive care regardless of your financial situation, you will never be denied for any reason, from the moment of conception to the last moments of your life. Thats the system I live with right now.

    As for the financial “base level of statistics and knowable facts” that information is readily available and has been discussed ad nasum. Most people opposed to a single payer system ignore these arguments anyway, you need only read enough blogs to know that that is true.

    However, since you demand “base level of statistics and knowable facts” in this discussion I’ll give you one: Nearly every other industrial power in the world has a universal health system that works. Each solves the problem in different ways, with different levels of efficiency, but each does it cheaper and covers everyone. We, the United States of America, arguably the richest, most powerful nation ever known, doesn’t do this. This is not a “hyperbole and personal account” its a knowable, indisputable fact. You need only look it up.

    The current system doesn’t work, you may not agree with the new systems proposed but you offer no alternative.

    The real shame is that you and those like you don’t have the courage to acknowledge it, and the humility to look beyond your tiny existence to see that you are not island, but a part of a greater whole. You are an American, and our fathers and fathers fathers, and the generations before them didn’t sacrifice for the Nation of Jay_C, they spilled their blood, sweat and tears for all of us. Wake up, it’s time, it’s your time to prove me and those like me wrong, prove that you are a better person than I think you are. If you have a better plan, one that makes America stronger, one that covers everyone, then tell us what it is so we can be convinced and follow your lead.

    I challenge you to be more than a contrarian, more than a mouthpiece of “no”. Show me the way. If you can convince me of a better way than I will fight along side you. Do it.

  34. #34 Jay_C
    September 8, 2009

    Hello Gregg,
    You said “Nearly every other industrial power in the world has a universal health system that works.”
    Again as I have said to others, define “works”.
    Furthermore, “Covering everyone, for less”…sounds good, but I could whip up a plan to handout a box of band-aids and a bottle of Advil to every American, and we could “cover everyone” in some manner too.. I at least make an initial stab at defining “works” here:
    http://scienceblogs.com/thusspakezuska/2009/08/who_needs_health_insurance_whe.php
    Please see comment #66, starting around line 15…

    Second, if you have read my other posts here you would see that I have proposed alternatives. Reform the current system, without a public option. For details, concessions, and Parts where I agree with Obama and his suggestions I provide the link below for your convenience.
    http://scienceblogs.com/thusspakezuska/2009/08/who_needs_health_insurance_whe.php
    Please see comments 55, 58, 61, 63, 64, and especially 66.

    I attempted to adress your concerns, please get back to me when you can address the substance of what I wrote.

    Thanks!

  35. #35 Jay_C
    September 8, 2009

    Hi Greg…
    You said:

    “As for the financial “base level of statistics and knowable facts” that information is readily available and has been discussed ad nasum. Most people opposed to a single payer system ignore these arguments anyway, you need only read enough blogs to know that that is true.”

    I provided links, I was hoping that you could provide the same, so that I can agree, disagree, or concede to points that you say have been raised and have been discussed ad-nauseum. I definitely will not ignore them.

    Thanks!

  36. #36 Jay_C
    September 8, 2009

    sorry Greg, I had some other comments that may assist you as well… same link as I provided above, (comments #73 and 76)

  37. #37 Greg
    September 8, 2009

    Jay_C

    Here is a link to the Ontario Ministry of Health and Long-Term Care. It will provide you with all the information you need on what it covers and how it works. The other Canadian health ministries are nearly identical with a few minor differences, few of which directly effect individual care. You can use this to compare with your individual plan and the major regional plans. I suspect that OHIP (the name of the Ontario plan) is as good or better than most private American plans. It is also worth noting that there are supplemental insurance plans that do not compete with the public plan but increase coverage such as getting private rooms, extended drug benefits, vision etc.

    http://www.health.gov.on.ca/en/public/

    I expect this will take a while, but I’m willing to wait.

  38. #38 Greg
    September 8, 2009

    Jay_C

    “I provided links, I was hoping that you could provide the same, so that I can agree, disagree, or concede to points that you say have been raised and have been discussed ad-nauseum. I definitely will not ignore them.”

    Thank you for the correct spelling of ad-nausem, my spell check couldn’t handle it…

    No, all the statistical information is out there, just a google search away. I’m not going to spend the time to do this for you, you are perfectly capable of finding the information on your own, just as I have. If you are more than an armchair warrior on this and actually care enough to do something about it then you should be prepared to do some research on you’re own.

  39. #39 Greg
    September 8, 2009

    Jay_C

    “Second, if you have read my other posts here you would see that I have proposed alternatives. Reform the current system, without a public option. For details, concessions, and Parts where I agree with Obama and his suggestions I provide the link below for your convenience.”

    I’ve read these posts and I’m sorry but if you have ideas in there I can’t separate them from the rest of it. I’m sure you do have some alternative idea, but it currently is not in a cogent form. Please, if you have the time, outline your plan/ideas as a single post.

  40. #40 Jay_C
    September 8, 2009

    Don’t worry about spell check, there are more important things than that… (I don’t attack people for not spelling incorrectly, that’s for folks who have no substantive responses) …But let me get this straight, you want me to research the points I have already taken the time to get across, (on this very blog no less)? Others have read the substance of what I wrote, attempted (and failed) to address that substance with data to the contrary. They either changed the subject, resorted to strawman tactics, personal attacks or just stopped arguing and conceded their position. So it is not as in-cogent as you make it out to be, otherwise they would not have attempted.
    So you won’t even provide one link to one single point you want to get across? So I have to do triple work on my part, AND provide the heavy lifting for your side of the argument? (I don’t even know what that side is)
    Agree to meet me half way, (actually you have to do less than that, as I already wrote the original posts, and provided you a link to the individual comments) .. If you don’t provide me with *at least* some hard data or links than I find it difficult to address your points. I would think most reasonable people would assume that if you cannot provide at least some of this information I requested, then you probably have none, really don’t care all that much about the issue, or are just lazy. If the information is so easily available you should be able to at least provide one link? If you refuse, or cannot provide backup for your claims, then in classic debate style, I’ll take that as a concession from you.

  41. #41 Jay_C
    September 8, 2009

    Didn’t see your link till just now, I’ll take a look…

  42. #42 Jay_C
    September 8, 2009

    ” You can use this to compare with your individual plan and the major regional plans. I suspect that OHIP (the name of the Ontario plan) is as good or better than most private American plans.”

    I looked at that link, it was very vague and contained no arguments or points that you say have been raised and have been discussed ad-nauseum. Again, I definitely will not ignore them. I’ll be waiting.

  43. #43 Greg
    September 8, 2009

    “So you won’t even provide one link to one single point you want to get across? So I have to do triple work on my part, AND provide the heavy lifting for your side of the argument? (I don’t even know what that side is)”

    You miss understand. I’m not willing to put in the time to link to statical data on costs, efficiency, coverage, satisfaction, survival rates, that sort of thing, because it’s all out there with minimal difficulty to find. Plus it’s been brought up again and again in these types of discussions without much effect. You either accept the data or you don’t.

    The short story here is this: you either believe that it is morally the right thing to cover everyone or you don’t. How we do it is another thing.

    Even if we choose any of the single payer/hybrid/heavily regulated private systems of Europe or Canada we will get over all better results for less money than we do now, and everyone will be covered. For proof we only have to study existing systems. It’s not a matter of conjecture, most of these universal system have been in place for a generation or more, the information is readily available. We have had the rest of the industrial world do all the painful experimentation for us, now all have to do is pick and choose the best from each system and make a better one.

    To not support this is unconscionable, by any measure I can think of.

  44. #44 Greg
    September 8, 2009

    “I looked at that link, it was very vague and contained no arguments or points that you say have been raised and have been discussed ad-nauseum. Again, I definitely will not ignore them. I’ll be waiting.”

    “You said “Nearly every other industrial power in the world has a universal health system that works.”
    Again as I have said to others, define “works”. ”

    The link was to give you the information to determine if the Canadian, as an example, “works”

    By comparing it to private US plans you can see for yourself what it offers and how it’s administered. Other than that, like I said before, the statistical information etc. is available elsewhere.

  45. #45 Jay_C
    September 8, 2009

    Sorry, I’m a glutton for punishment, here are *some* of my points you wanted… Chew on these and get back to me with your rebuttals..hopefully the post will fit them all…

    1) There are *some* folks that do need assistance (pre-existing conditions, can’t afford it even though working hard AND it’s not offered at work, disabled and can’t work) that being said, that number is not anywhere near 45-50,000,000 people. Where are they getting these numbers? As for the rest of us, (you know the majority that don’t fall into these relatively uncommon buckets) personally I am happy with my plan and don’t want to have to join a plan that has to meet ahem, “government quality criteria”. The health care reform plan moving through the House essentially outlaws the private individual medical insurance market. On Page 16 of the House’s 1,018-page reform legislation, the bill states that once the bill became law, insurers would no longer be permitted to sell new private individual coverage. Insurance companies that wish to stay in business will have to operate in the government’s health care exchange. But the exchange will not be a private market. It will be a program in which Americans can buy individual plans from private companies in competition with the public option provision that will provide taxpayer-subsidized coverage.
    But that’s only part of the story. The exchange will be a highly regulated clearinghouse of providers that meet the government’s standards. Only those providers that follow Washington’s stringent guidelines will be allowed to operate effectively putting all the others out of business. The government, through an unelected health choices commissioner, will set premiums, dictate benefits, determine deductibles and establish coverage. Exchange participants will be required to insure anyone who asks to be covered and to accept all renewals. In effect what you will have is total government control of the medical system.”

    2) “Finding ways to cause premiums to go down in the current private system, I agree they premiums are high, but they are not GUARANTEED to escalate if we reform the current system (not re-invent the wheel), and the alternative in my opinion is not worth it.”

    3) The difference between private insurance companies and the government: the private industry is there to make a profit, to make shareholders and customers happy. Anyone that works for a private business is unelected (unless elected by the board). But the balance between weather their customer base is happy AND weather they turn a profit are what determine whether they stay there or not. In government, they can do a bad job, and still get a raise. (Especially if they are not elected, and therefore unaccountable to the citizens.)”

    4) Free market prices are flexible, negotiable, and respond to consumer choice. Prices set by the government are inflexible, non-negotiable, and respond only to lobbying, or to the whims of the government bureaucrats who set the prices or do the rationing. Free market prices send signals to produce more or less of things, according to consumer demands. By comparison, government rationing only reflects what the politicians want.
    Healthcare responds to free market prices, or to government dictates, in exactly the same way as all other goods and services.”

    5) Americans have won 11 Nobel Prizes in Medicine in the last 10 years, 26 in the last 20 years, and 39 in the last 30 years. No other country even comes close to this. What’s left of free-market pricing in America is keeping the health care of the entire world afloat.”

    6) Healthcare procedures not covered by government programs, or by government-distorted insurance policies, show us that true free market pricing could give us ever-improving care at ever-lower prices (which is part of the reform I am for!). In addition, in a free market, if you can’t afford the cost of a treatment, and can’t find a cheaper alternative that’s nearly as good, your doctors may decide to lower the cost, or even provide the treatment pro bono. But will doctors be as flexible and generous when healthcare decisions are dictated by the federal Comparative Effectiveness Board, and there are fewer doctors seeing more patients because prices no longer reflect market realities?”

    7) If free market prices are really the same as government rationing, then why have societies run by government rationing and price fixing always had shortages and longer lines? Why did the Soviet Union’s system fail? Why did the post-WWII German Economic Miracle begin precisely when the German authorities abandoned government rationing, over the protests of the occupying powers? It’s a simple fact: human beings have experimented with government rationing and price-fixing over and over again, always getting the same catastrophic results.

    8) Some actually think that we don’t provide healthcare to our citizens with better results than the rest of the world. I’m not sure what their definition of “better” is, but, I’ll put one example out there (there are many in my opinion).. Outcomes for Breast Cancer Mortality rates. Seems like a biggie to me. Take a look at snippets from an article below, I cut out some info on Japan since we are comparing Canada and the US specifically and I cut out some other irrelevant…
    “Researchers found that USA has the best score with 5 years of survival rate for breast cancer at 83.9% and prostate cancer at 91.9%. …
    …UK reported 69.7% survival rate for breast cancer, 40% for colon and rectal cancers for both for men and women, and 51.1% for prostate cancer. Rates varied significantly for different regions in UK.
    Canada and Australia reported significantly high rates for almost all cancers……
    Researchers suggest that such a huge difference in cancer survival rates depends upon access to health care. Most countries have necessary means to detect cancers and time and provide with proper treatment, but not all patients are able to pay for diagnosis and treatment. “
    Just in case you accuse me of taking things out of context or something, Here is the full article:
    http://www.emaxhealth.com/51/23285.html”

    9) Some say “Prostate cancer, for instance, is usually slow to develop, so if it’s detected early then 5-year survival rates are going to be extremely high. OTOH lots of people are going to have the test when they’re negative, and some are going to have unpleasant treatment for tumors that would never develop to the stage where they’d cause problems.”… That’s the rub, isn’t it….? I know that doesn’t keep costs down (which I concede is a problem), but without a better way to keep the statistics just as positive as they are now in the United States, what other suggestions does the world have? I really don’t see any.. If we simply just “cut down on the frequency of tests”, or “force them to magically be cheaper” the statistics would start to get worse, as quality of care would decrease.

    10) Would you agree that any medical problem we bring up here should contain an actual interaction with the health care system, it should measure something that the health care system can actually affect and finally, the statistic should be collected consistently across countries?

    a. The first part, one should have contact with a health care professional, be it a doctor, nurse, lab technician, etc. A stat measuring the rate of cancer survival satisfies this, since diagnosis and treatment of cancer requires health care professionals. OTOH, a stat measuring for example, the rate of car accidents would not work as a criterion since health care professionals are not essential to identifying car accidents.

    b. For the second part, Some stats assume interaction with the health care system, but the problems they measure are not ones on which the health care system can have any meaningful impact. For example… the rate of “cancer incidence”. This stat assumes interaction with the health care system, however, an “incidence” of cancer cannot be known without the diagnosis of a health care professional, there is little a health care system can do about the rate of cancer. Rather, cancer incidence is affected by factors such as genetics, diet, lifestyle, etc. So, to be a good measure of the effectiveness of a health care system, a stat, I would think, should measure a phenomenon that health care professionals can actually affect.

    c. Finally, a stat must be collected consistently across countries. This seems simple, but is complicated. Different countries use many definitions of health phenomena. This leads to some countries leaving out a segment of their population from the collection of a stat while other countries add in those types of folks. When this happens, cross-national comparisons are largely meaningless. Therefore, for measures of health care systems across countries to be meaningful, there should be little to no variation in how statistics are collected.

  46. #46 D. C. Sessions
    September 8, 2009

    Why can nobody here address this at a base level of statistics and knowable facts rather than with hyperbole and personal accounts?

    Because the statistics and knowable facts have been covered to death, and before any productive discussion gets started another denialist/concern troll shows up demanding that they be gone over yet again.

    Basic conservation-law reality: in addition to the cost of medical care, the USA’s “system” of private prepaid health care siphons off ~25% [1].

    Basic bottom-line reality #2: The “greatest health-care system on Earth” has health care outcomes closer to the third world than to a developed country.

    Basic bottom-line reality #3: the USA spends nearly half again as much as the next-highest spending country on health care.

    Basic bottom-line reality #4: unreimbursed medical expenses for the insured are the #1 cause of personal bankruptcy in the USA, which drags down the rest of the economy in ways not usually traced to health care expenses [2].

    Basic bottom-line reality #5: the differential cost of health care for employees is one of the leading barriers to formation of new businesses (esp. in the SMB segment, which is where most employment growth occurs.) [3]

    Now go do your flipping homework instead of channeling Glenn Beck.

    [1] Industry average “medical loss ratio” is a bit less than 80%
    [2] I expect that when this finally filters through to our Lords and Masters, they’ll amend the bankruptcy code to make medical debts exempt from discharge in bankruptcy. Maybe even require that they be passed on to the fourth generation.
    [2] US Chamber of Commerce. Damn pinko-commie business haters.

  47. #47 Jay_C
    September 8, 2009

    And yet again D. C. Sessions, no response to my substantive questions / assertions (see 1-10 above) at least Greg is addressing my concerns (or at least going through the motions to make it appear as such) I’ll give him the benefit of the doubt..

  48. #48 Luna_the_cat
    September 8, 2009

    ~I’m currently visiting my family in Texas (please, help meeeeeeeeeee….), and just today was having a conversation with the woman who comes in to help my extremely infirm mother during the day.

    The discussion inevitably came around to healthcare coverage. This woman does not have insurance, herself. She flatly refuses to believe that 46 million Americans do not have insurance — I told her the organisations which came up with these numbers and her response was, “well, they can’t possibly know that. I don’t believe that. They have it wrong.” She asserted that the vast majority of the uninsured who go to the ER as their only point of healthcare were illegal aliens, and that if the illegal aliens were all cleared out then the whole problem would disappear. She then insisted that the government getting involved in healthcare would simply bankrupt the country and result in the Chinese creditors calling in their debt and owning America. And she called Medicare/Medicaid “simply dreadful” and “the worst-run medical system in the world”, and proof positive that government involvement in healthcare would be a disaster.

    Echoes of Jay_C above, I think.

    Speaking of which, Jay_C, one of the things you said: Free market prices are flexible, negotiable, and respond to consumer choice. –Yeah, the thing is, “consumer choice” really only exists when the choice exists to say “I don’t need this” and walk away. And when it comes to things like basic healthcare, treatment of cancer/infections/broken bones/etc., do you really think that fundamental “consumer choice” exists for the majority of people? Because I sure don’t. And, the whole “well if you can’t pay for it, maybe doctors will make it cheaper for you” — the doctors might, if they have sufficient control over pricing, which they often don’t. The hospital bean-counters sure as hell won’t.

    If only we could split America, into the idiots who are advocating for this status quo and who deserve to live with it, and the rest. Given that much of the real objection to reform seems to be a flat disbelief that the situation could possibly be as bad as other people describe it (often resting on the fact they have not experienced it themselves, or even consider their own experiences aberrant rather than common, and assign no credibility to organisations which report results they disagree with) — yeah, more and more I think America is doomed.

  49. #49 Jay_C
    September 9, 2009

    “The link was to give you the information to determine if the Canadian, as an example, “works””

    I looked at the link, couldn’t find anything, if you have something specific to support your claims please let me know.

  50. #50 Greg
    September 9, 2009

    Jay_C

    Too busy at work to go through your bits, but I didn’t see your alternative plan laid out only a diatribe about the free market and how it should work, and some irrelevant info about Nobel prizes (if you have more doctors and researchers it stands to reason you will get more awards).

    I will say that I agree that the free market does help drive down consumer products and services, but there is no supporting evidence that this is the case with Health Care. In fact it’s quite the opposite, as HC costs continues to rise faster than inflation while coverage slips. If your theory was correct we would be seeing the opposite. I don’t think you have have a case here because the facts just don’t support it. Truth is you’ve written a lot without saying much that is useful to the discussion. I’ll check back after the weekend.

  51. #51 Greg
    September 9, 2009

    “I looked at the link, couldn’t find anything, if you have something specific to support your claims please let me know.”

    There is really nothing more to say here except that the statistics are out there, easy to google up. Costs, mortality rates, cancer survivability, satisfaction, all of it.

    I do look forward to seeing your alternative, if it’s better and cheaper than the current Canadian system or those of Europe, I’m sure your name will be added to that impressive list of Nobel winners.

  52. #52 Greg
    September 9, 2009

    This is interesting, a set of speakers with credentials that are speaking about what Canadians thing of this debate.

    http://listics.com/200908275002

  53. #53 Jay_C
    September 9, 2009

    Greg,
    The whole “The Debate has already happened, it is over and the resulting data is out there for all to see” meme is not only a wrong stance, but a disingenuous one. Some of the ideas I support, are….again….stick with the current system, and reform it…through…providing insurance assistance to the 10-15 million that need it. Again…. For probably the 6th time, There are *some* American citizens that do need assistance (those with pre-existing conditions, can’t afford it even though they work hard AND it’s not offered at work, disabled and can’t work) that being said, that number is not anywhere near 45-50,000,000 people. Bring down insurance premiums by allowing inter-state competition between insurers. (There are 1,300 insurance companies in the United States…Health insurance responds to free market prices in exactly the same way as all other goods and services, prices go down… These are just some of my ideas (well, not mine, but ones I feel make sense)… There are so many other things that can be done to reform the current system, it’s not like we have even tried to reform it (Bush had a chance for 8 years, and blew it, not that I think he wanted to even try) You mentioned comparing cancer survival rates… OK, they are better in the US…. I discussed these myself ad-nauseum here on this blog…You talked about infant mortality, OK, I discussed that as well, look it up, it’s all here in black and white..
    Brushing off the details of my actual stances (after you asked me for them) shows me that you obviously didn’t read what I wrote (or did and don’t have a response). Either way, I have gone more than out of my way to address your concerns. Any reasonable person that reads this blog that is honest with themselves can see that. Let me know when you are prepared (or care) enough about healthcare reform to have a real debate
    Here’s a formula……
    Look at all I have written (that you asked for mind you) and please get back to me with some substantive responses … I have yet to get that from you.

  54. #54 Jay_C
    September 9, 2009

    Greg, as far as Comment #50, I can find a ton of articles from people that claim to be doctors from Canada with credentials that are speaking about what Canadians thing of this debate. That have the exact opposite stance. Cherrypicking information that fits your agenda is never a good thing.

    (let me make this crystal clear…I’m not saying weather I do or do not place any credence in what these articles say, I am just putting them here to raise a point that your link is irrelevant to the conversation, just like these below are) by the way, it is funny you could find the time to find that link, but no data on what I was looking for…hmmm…interesting… :)

    http://www.bio-medicine.org/medicine-news/Lack-of-facilities-in-emergency-rooms–warn-Canadian-nurses-21-6360-1/

    http://wellsy.wordpress.com/2009/08/17/canadian-health-system-not-sustainable-looking-to-privatize/

  55. #55 Greg
    September 10, 2009

    Here you go Jay_C, some statistics with references for you to peruse. All nicely compiled, Salon does lean to the Left, but I would imagine they are pretty accurate considering the referenced sources and they are pretty much the same numbers as other sources. Have fun:

    http://www.salon.com/news/feature/2009/09/08/healthcare_data/

    It is important to note that the numbers are pretty close as far as results go. With the exception being cost per capita and that the other countries have universal coverage. So in essence, very similar results but for about half the cost and everyone is covered. Also, and you’ll have to trust me on this because I’m not going to publish my pay cheque, but the deduction that includes OHIP (the Ontario health insurance plan)is a lot less than $12.5k a year, a whole lot less.

    Hard to argue against this without sounding morally bankrupt. Of course you could demand more data or just refuse to accept it.

    Still looking forward to your alternative plan.

  56. #56 Jay_C
    September 10, 2009

    Thanks Greg,
    I’ll look at those numbers, although I probbably wont be able to respond until monday. Going away for the weekend..

    “Still looking forward to your alternative plan.”

    Gave you my ideas..

    here it is again… (cut, paste)

    Some of the ideas I support, are….again….stick with the current system, and reform it…through…providing insurance assistance to the 10-15 million that need it. Again…. For probably the 6th time, There are *some* American citizens that do need assistance (those with pre-existing conditions, can’t afford it even though they work hard AND it’s not offered at work, disabled and can’t work) that being said, that number is not anywhere near 45-50,000,000 people. Bring down insurance premiums by allowing inter-state competition between insurers. (There are 1,300 insurance companies in the United States…Health insurance responds to free market prices in exactly the same way as all other goods and services, prices go down… These are just some of my ideas (well, not mine, but ones I feel make sense)… There are so many other things that can be done to reform the current system, it’s not like we have even tried to reform it (Bush had a chance for 8 years, and blew it, not that I think he wanted to even try) You mentioned comparing cancer survival rates… OK, they are better in the US…. I discussed these myself ad-nauseum here on this blog…You talked about infant mortality? OK, I discussed that as well, look it up, it’s all here in black and white..

    And my beef with your tactics (again)..

    Brushing off the details of my actual stances (after you asked me for them) shows me that you obviously didn’t read what I wrote (or did and don’t have a response). Either way, I have gone more than out of my way to address your concerns. Any reasonable person that reads this blog that is honest with themselves can see that.

    Let me know when you are prepared (or care) enough about healthcare reform to have a real debate

    Here’s a formula……
    Look at all I have written (that you asked for mind you) and please get back to me with some substantive responses … I have yet to get that from you.

  57. #57 Zarathustra
    September 11, 2009

    Maybe you could lead the reader down a more narrow rabbit hole of funneled logic to the tip where there is only the polarized choices of “Ultra-hippie nothing for anyone and lets-get-back-to-the-middle-ages” on one side and “Ultra Commie Evil Establishment” on the other…

    How about the choice to opt out of a social health care system (funded through taxes taken from the individual like a parent would a child to show them the value of saving)and become SELF-Reliant? You get sick, fine! pay the piper, but hey, wait…maybe you’ll have a lot more of that cash stuff left over since you aren’t being taxed out the ass for a service you may never use. (Never use of course if you exercise, don’t smoke, take routine care fo your body and promote overall good health and wellbeing….but nahhhhh, that’s just too complicated!)

    instead, let’s all pay together so that those who choose to live in decadence, debauchery, and a general state of dilapidation can squeeze more for themselves out of the pockets of the truly socailly responisible and self-respecting citizens of a state whose principles revolve around FREEDOM.

    BTW i live in BC Canada (experienced theis ‘great’ system firsthand) and have also experienced the social health care system of Ontario (Ohip). BC is far worse (and i thought it couldn’t get any worse).
    Both systems take from the responsibile and spread it out over the socailly inept leeches who suck on the teet of Canada like a doscile, domesticated calf would on the farmers bottle.

  58. #58 rx1
    September 12, 2009

    I know lots of Americans in Europe and none of them miss the American health care of system.

  59. #59 wondering
    September 12, 2009

    It’s amazing how obtuse the non-UNHC folks are.

    It’s common knowledge that the US pays far more for its healthcare than any other country, on a per capita basis. It’s also common knowledge that its healthcare results are merely on par with, and occasionally lesser than, other “first world” nations. There are more people without insurance in the US than live in my entire fucking country (Canada). That is a disgrace.

    Want to look at the statistics? Check out the CIA Factbook. Check out the stats on http://www.nationmaster.com. Look at every North American and European health journal out there. It’s bloody everywhere. But you refuse to look.

  60. #60 wondering
    September 12, 2009

    And Canadians who have always had the benefit of Universal Healthcare, who then proceed to piss all over it, preferring to see family, friends, and neighbours die or go bankrupt instead of getting the healthcare everyone has a right too?

    Fuck you. Why don’t you just move on down to the Gulch and spin the roulette wheel of life to see whether you end up with cancer or heart disease. Or have an industrial accident, or get hit by a car, or anything else that could result in your being hospitalized. Live the dream, man. Let go of the safety net.

    We won’t miss you.

  61. #61 Cara
    September 13, 2009

    Greg, didn’t “say it all” Zuska, He just provided, yet again, another “example” that cannot be verified along with personal views and beliefs. Why can nobody here address this at a base level of statistics and knowable facts rather than with hyperbole and personal accounts?

    So, Jay, you’re saying that everyone who says they’re a Canadian (or an American living in another country) and that the other systems are infinitely better is really…what, exactly? A troll for Big Government?

    If there’s a conspiracy to fool people into wanting universal health care, who’s behind it and what possible gain could there be in it? Is the man behind the curtain just trying to steal your tax dollars so he can laugh in your faces and refuse to give you health care? Is it SATAN??!?! Inquiring minds want to know.

  62. #62 Jay_C
    September 14, 2009

    Twist words and infer much Cara?..WOW…that was a doozie! :)
    Simply stated, these “personal stories” are statements that are not demonstrable *facts* (meaning they are not evidence to make a case to support a position). I can *claim* whatever I want, but my *claims* without supporting *knowable facts* , are worthless in a debate that require facts, such as a debate over health insurance reform.

    Greg, Over the weekend I the information that you provided to me. (the article from Salon.com) The claim of the article was that …”We [the United States] spend far more per person than other wealthy nations, but we’re less healthy. What’s wrong with this picture?
    You acknowledged right off the bat that “Salon does lean to the Left…” to dispel any misgivings I may have had about this observation, you countered with “…but I would imagine they are “pretty accurate” considering the referenced sources”.. And “…they are pretty much the same numbers as other sources…”
    Ok, so before even reading the article…a disclaimer is being made… warning bells go off immediately… Statistics don’t need apologizing for, they are what they are, and you claimed that these numbers are “the same as other sources” whatever that means, but in any case, I read them…. And simply stated I agree that costs are too high. However, there are many statistics in this article I disagree with. (Many of these statistics are not relevant to the issue of health insurance reform)..But I digress..
    In the interest of having a civil debate bout the subject of cost that we seem to agree on, I offer (again) my suggestions I have already provided in the posts above.., these are substantive suggestions that I have already gone over in detail… Here are my suggestions…yet again…(Cut, paste…again)
    Some of the ideas I support, are….again….stick with the current system, and reform it…through…providing insurance assistance to the 10-15 million that need it. Again…. There are *some* American citizens that do need assistance (those with pre-existing conditions, can’t afford it even though they work hard AND it’s not offered at work, disabled and can’t work) that being said, that number is not anywhere near 45-50,000,000 people. Bring down insurance premiums by allowing inter-state competition between insurers. (There are 1,300 insurance companies in the United States…Health insurance responds to free market prices in exactly the same way as all other goods and services, prices go down… These are just some of my ideas (well, not mine, but ones I feel make sense)… There are so many other things that can be done to reform the current system, it’s not like we have even tried to reform it (Bush had a chance for 8 years, and blew it, not that I think he wanted to even try) Greg, you mention in a post above the talking about cancer survival rates… OK, they are better in the US…. I discussed this myself ad-nauseum here on this blog…you also talked about infant mortality as a talking point? OK, I discussed that as well, look it up, it’s all here in black and white..

    Greg, your response to my suggestions in an area where we seem to have agreement (that being cost)…I’d be happy to go over the other statistics one at a time if you would prefer, but I figured we could make the most headway on this one.

  63. #63 Cara
    September 14, 2009

    Oh, snore. Despite the fact that anecdotes don’t count as hard data, the larger issue is that you simply don’t want to believe that anything could be better because you’re terrified of losing what you have.

    “Facts that can be knowable”, my foot. You don’t want to hear it. God herself could give you the facts and you’d ask from which version of the Bible she was reading.

    Also, Zarathustra, people get sick or break their backs whether they eat Twinkies or tofu. So your “decadence” diatribe is laughable at best.

  64. #64 Jay_C
    September 15, 2009

    “issue is that you simply don’t want to believe that anything could be better because you’re terrified of losing what you have.”

    wrong Cara… sounds like you don’t read what I say, I want health insurance reform.

    “”Facts that can be knowable”, my foot. You don’t want to hear it. God herself could give you the facts and you’d ask from which version of the Bible she was reading.”

    wrong again…I do want to hear everything, it is you who refuse to read what I am writing, and thus don’t want tho hear the truth of what I am saying. Don’t get angry if what is presented to me are stories and not facts. At least Greg presented facts (some of what I agreed with), let’s see if you can do the same.

  65. #65 Jay_C
    September 15, 2009

    You can agree or disagree with what I say Cara, but it is a little tought to lend a counter-argument much credence unless that counter-argument has some sort of data to back it up. I welcome you to prove me wrong with knowable facts.

  66. #66 Geologist
    September 16, 2009

    I think this report includes much of the statistics, I haven’t looked closely (not American so I’m not that interested) and there might be newer ones.

    http://www.who.int/whr/2000/en/whr00_annex_en.pdf

  67. #67 Jay_C
    September 16, 2009

    Thanks Geologist,
    The WHO rankings depend on a set of underlying assumptions. Some characterized by substantial uncertainty, and others rooted in ideological beliefs and values that not everyone shares.
    You want examples of a representation of their Ideological beliefs you say? OK….I will first say, that it is true, that the analysts that prepared the WHO rankings lend lip service to the hope that their framework “will lay the basis for a shift from ideological discourse on health policy to a more empirical one.” Yet out of the other side of their mouth, we see that the WHO rankings themselves have a strong ideological component! They include factors (some of which I have talked about repeatedly on this blog, life expectancy for one… Are not good measures of a healthcare system because they incorrectly assumes these deaths contain an interaction with a healthcare system… As I have said before If, for example, someone dies with no interaction with the health care system…Like those that die in a car accident, fall off a cliff, Overdose, die of some medical ailment before an ambulance ever arrives, or dying in ones sleep at home)… His or her death tells us little about the quality of a *health care system*. All such deaths are computed into the *life expectancy* statistic.) Stats like these just aren’t good data… they are unrelated to an actual health system performance. Even setting those concerns aside, the rankings are still highly sensitive to both measurement error and assumptions about the relative importance of the components. And finally, as I have said before on this blog, the WHO rankings reflect implicit differences in each country underlying data collection practices, and in addition to this, lifestyle preferences and standards.

  68. #68 red rabbit
    September 27, 2009

    LOL @ Jay_C: “show me the evidence”

    OK Here you go.

    Jay_C: “I don’t like that evidence, so it’s not evidence.”

    I counted that one or five or six times just in this thread.

    I’m not posting any numbers for you. You won’t like them anyhow. Just another anecdote, which proves nothing. This aired last week on CBC radio. It’s about an American who moved to Canada, married a Canadian, and now can’t go home… because her six-yesr-old son has a “pre-existing condition,” dermatomyositis. He’s getting first rate treatment in Canada, which would cost his family thousands per month in the USA.

    They also had a rep for Patients First, a lobby group that opposes a public option. She doesn’t believe in directly answering questions apparently, and seems to think people who get sick deserve it, a bit like Zarathusthra @57.

  69. #69 jay_C
    September 28, 2009

    That’s fine red rabbit, I think our definition of what is “evidence” is where we differ. You appear to be OK with “personal stories” vs. statistics as evidence.. My simple criticisms above are nothing really.. “real scientific debate” is *WAY* more rigorous than my standards above.. and not in the direction that would promote a progressive view of what Healthcare Reform should be, that is for sure.

    My simple position is this…In my opinion…..(and I’m sure many here that would agree, since this is a scientific blog)… when the some in the scientific community promote a certain view in spite of a spurious correlational data, it’s no longer science.. All I’m doing is (the gods / goddesses forbid) questioning the statistics that have been brough to my atention.. Nobody has stood behind their claims!

  70. #70 RichB
    September 28, 2009

    A Cautionary tale….

    [person walking along the road]
    “Gee, what a lovely day….”
    [trips over Troll in the road, Troll farts]
    “WOW! WHAT is that AWFUL smell?? It seemed to happen when I walked over here…”
    [walks back, trips again, Troll farts again]
    “DAMN! That is horrible … But I think I’m getting used to it”
    [walks forward again, trips again, Troll farts again]
    “WHOA! I think I might need nose plugs…”
    [finally sees Troll]
    “HEY! Is that you????”
    [kicks Troll, Troll farts again]
    “AHHH My Noooooose!!!!”

  71. #71 Jay_C
    September 29, 2009

    RichB,

    Huh? Do you have anything relevant to add to the discussion? Some might say your irrelevant, or off-topic message was a perfect example of trolling.
    ;)

  72. #72 tralala
    September 29, 2009

    Jay_C: I may not understand RichB’s little cautionary tale, but I’ll reread it till the friggin cows come home, rather than your UNreadable nonsense.

    There now, you have at least a week’s worth of material for your unending rebuttals. Thank me very much.

  73. #73 Jay_C
    September 29, 2009

    You know what? I’m convinced now, especially by the trend of onetime drive by commenter’s and with no lengthy back and forth healthy civil discourse with any one person… You are all right, and 56% of America, including myself is completely 100% wrong.

    http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform

    It’s all clear now… I was such a jerk, the formula is simple, I should just believe exactly what you believe, go with the flow here and not ask probing questions, accept anonymous / personal stories as rock solid evidence / accept methods of data collection that may not be valid because there is no such thing as bias or anything, and any stories I could bring up to the contrary are obviously invalid because… well… just because…

    I’ve got it now, thanks for finally driving the point home tralala… Down with the marketplace of ideas!!

    I’m done…. (Unless I am spoken of /referenced in an uncivil / unkind way… on these blogs further) If you want me back here, you know what to do.

  74. #74 tralala
    September 29, 2009

    hooray for me! i did it!

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