[Winstonm]

kenrexford, on Sep 17 2009, 03:46 PM, said:

PassedOut, on Sep 17 2009, 03:00 PM, said:

kenrexford, on Sep 17 2009, 02:40 PM, said:

Have you missed all of the discussion about social security going bankrupt in so many years?  It seems that maybe the folks back arguing in the first half of the 20th Century were right, just wrong as to how long it would take.

Nope, haven't missed that. The subject comes up every so often as the demographics change and, of course, social security is always trivially easy to fix.

Over time, the so-called "retirement age" has to keep going up, even more than it has been. I know that the democrats don't like to acknowledge this because it scares some seniors, but there is no way around it. On the other hand, the democrats successfully resisted putting social security money into the hands of Bernie Madoff, Bear Stearns, Lehman, and Merrill Lynch.

So, what fix do you have in mind for when we have to adjust changing medical expenses?

How about stopping the idiotic Afghanistan war for which we cannot even decide what constitutes "progress" other than "disrupting al-Qaida", while our General in the Bananastans, McChrystal, tells us that al-Qaida isn't even a problem in Afghanistan while Ray "The Desert Ox" Odierno tells us Iraqis have ostracized al-Qaida, so now we have to send troops to Somalia in order to find someone to kill other than Pakistani civilians in weddings.

[Lobowolf]

Winstonm, on Sep 17 2009, 07:19 PM, said:

Why would anyone want to compromise with Atilla the Hun?

Please explain. Given the "scum of the earth" subthread, this Atilla the Hun metaphor is puzzling. I assume that it can't be a moral aspersion of any sort (although had anybody else made the reference, that's certainly what I'd assume), since that subthread seemed to indicate that we're all equal. On the other hand, if it doesn't mean that, then it seems to be a non-sequitur. Perhaps it's only mass-murderers who are immune to moral condemnation, though, and Republicans are another matter altogether.


I only wish, as I read the comment, "to point out that the statement does infer a moral superiority. It then follows" (to some) "that one who believes himself morally superior must also believe (perhaps subconsciously) that he has the right to control the thinking and destinies of those who are inferior - for their own good, of course."

[kenberg]

Winstonm, on Sep 17 2009, 07:19 PM, said:

Quote

It has been my view that constructive negotiations across the aisle would be the best approach to getting the best bill

Why would anyone want to compromise with Atilla the Hun? The better avenue is to ignore the ignorant and forge ahead - if the ignorant find a way to stop the majority, that will be fine as they will then marginalize themselves even more and the next attempt at real change will be more successful.

Otherwise, all we will get is a bill that benefits the health care and insurance industries and makes no real difference in real peoples' lives.

This is just another example of some misinformed American casting aspersions on the misunderstood Huns. It is my view that any mistakes that Atilla may have made are directly attributable to the woefully misguided actions of George W. Bush.

[kenrexford]

awm, on Sep 17 2009, 05:33 PM, said:

A lot of discussion treats health care as if it's a uniquely American problem, and other countries have a working system. While it's true that the American health care system is unusually dysfunctional, there are serious problems with health care worldwide. Some interesting data is available.

The key point here is that health care costs are rising substantially faster than GDP in essentially every country. Health care costs per capita are rising quickly worldwide. While the United States has the highest health care costs per capita of any country, and is above the average in terms of the growth rate of health care costs per capita, the cost of health care is exploding worldwide (or at least in the modern, industrialized countries).

Some of this is due to an aging population. But it seems strange that the incredible advances in medical science are not making things cheaper. Technology does make most things cheaper (for example computers have come way down in price). It could be that our expectations are growing faster than the technology can bring costs down -- but even decades-old technologies (like an MRI) are expensive in the medical sector. It seems like there is a fundamental problem here which needs to be addressed. All the talk about moving the US to a system closer to the ones in other countries might help a bit with the current expense of health care (where most countries are doing substantially better) but the ridiculous growth rate in health care costs will take more than this to address.

But, does the US have a higher cost of health care "per capita" because everything costs more in the strongest economy in the world? And, because we spend money on "herois measures" because we Americans view ourselves as little Kings, "the People," and hence really worth all of this?

I bet we also have a ridiculously high expenditure for coffee per capita, especially considering how easily we drop $5 for a starbucks coffee. We need about 50 brothers to spare a dime these days. I bet that same U.S. dime still gets you a coffee in some parts of the world.

[kenrexford]

Winstonm, on Sep 17 2009, 07:19 PM, said:

Quote

It has been my view that constructive negotiations across the aisle would be the best approach to getting the best bill

Why would anyone want to compromise with Atilla the Hun? The better avenue is to ignore the ignorant and forge ahead - if the ignorant find a way to stop the majority, that will be fine as they will then marginalize themselves even more and the next attempt at real change will be more successful.

Otherwise, all we will get is a bill that benefits the health care and insurance industries and makes no real difference in real peoples' lives.

I think you are assessing the majority wrong.

[aguahombre]

dont mess with my Starbucks.

[kenrexford]

aguahombre, on Sep 17 2009, 10:38 PM, said:

dont mess with my Starbucks.

I'm not going to mess with your starbucks. All I want to do is to make sure everyone can afford starbucks. It seems wildly unfair that many people have to settle for lesser coffee or even no coffee at all. What I propose, therefore, is simply that the government take over starbucks and make the coffee, which will be just as good, if not better, than the old starbucks. However, now starbucks will be free.

I mean, sure. The lines might be really long, but lines are long at starbucks now anyway. Plus, although you might have to fill out more forms as to what you type of coffee you want, rather than simply telling people, that will create new jobs for people.

Don't be alarmed by the people who claim that your coffee will get cold while the paperwork is delivered to the "coffee is ready" announcer union. They are just anti-union. Also, don't listen to the people who say that you won't get cream in your coffee, they are just racists; that complaint if obviously a veiled effort to race bait -- "I like my coffee like I like my women" is so obviously the undertone here, according to Jimmy.

Also, think how green this will be. Instead of simply handing out new cups for every person, we would require people to buy starbucks cups and bring them with them. How hard is that? We'd save tons of trees. Or, we could make people buy carbon credits from those who do have returnable cups, to cash in those credits for paper cups if they so elect.

I predict that this who idea will actually create or save 100,000 starbucks jobs. Sure, we'd have to shut down all but one or two starbucks locations in each major town, and sure that would seem to mean laying off tons of people, but I estimate that starbucks would go bankrupt if we don't do this, so we actually will save all of these 100,000 jobs. Starbucks is simply too big to fail, you see.

Of course, closing all of these starbucks will be hard. However, I have any easy solution for this, which is obvious. We get owners of starbucks building to sell the buildings to the government, who will destroy the buildings and create parks. The owners will take the money they got from selling these properties and buy coffee at the new starbucks locations, which we will have to expand for the extra load they will experience, plus the extra paperwork people and inspectors' offices. But, this will create JOBS, will create more GREEN SPACE, and will only cost a few billion dollars.

I propose that we make Squeaky Fromme the new Starbucks Czar to head all of this up.

[aguahombre]

u are a dead man

[hotShot]

45,000 excess deaths annually linked to lack of health insurance: Harvard study

[Trinidad]

kenrexford, on Sep 18 2009, 05:35 AM, said:

But, does the US have a higher cost of health care "per capita" because everything costs more in the strongest economy in the world?

That is part of the reason. But I think there are two reasons that are more important:

- Lack of efficiency: The system is complicated. It's not obvious who should bill whom for what and this needs to be sorted out. At the same time, it is not clear whether a billed treatment or diagnostic service was actually necessary. Doctors have interests in diagnostic services and the other way around.

- The private insurances. If I start an insurance company, I want to make money with it. With private insurance companies, money flows from the health care system to share holders. When the government is the insurance company, there is no need to pay share holders.

So, the difference between the USA and countries like Finland and Sweden is that in Finland and Sweden a larger fraction of the money is actually used for the medical treatment. If people are interested in making money, they can invest in Nokia or Ikea, but not in health insurer's.

Rik

[helene_t]

kenrexford, on Sep 18 2009, 04:35 AM, said:

But, does the US have a higher cost of health care "per capita" because everything costs more in the strongest economy in the world?  And, because we spend money on "herois measures" because we Americans view ourselves as little Kings, "the People," and hence really worth all of this?

That is part of the story, but those "heroic" measures are just not cost efficient. If you want to save some lives, better stop overusing antibiotics. Multi-resistant bugs is a major burden on US hospitals, both in terms of money and in terms of deaths. And it is a problem that the hospitals create themselves.

Not that I think a single-payer, public option or whatever would address that problem. A tort reform might help, though. I can imagine that physicians give antibiotics out of fear that they will get sued if the patient dies of a bacterial infection after they failed to give antibiotics.

That was just one example. I think you guys need to focus on practical things instead of all those ideological smoke screens.

[hotShot]

Physicians tend to "over diagnose" and to gain additional data mostly to back up their diagnosis in case they get sued.

Similar extra costs are produced by therapy and medication.

Of cause patients want to have the feeling that everything that is possible is done to help them, so they accept or even ask for extras.

A nation wide system can establish standards on what is necessary.

[y66]

kenberg, on Sep 17 2009, 07:43 AM, said:

I now conclude that either we will have a bill drafted by Democrats and rammed through by Democrats, or we will have no bill at all.

I agree with this.

I think the Democrats will ram some version of the Baucus proposal though and declare victory. I hope it will be an improved version, for example, along lines proposed by Paul Krugman in his op-ed piece today. Ha! But maybe I'm more of a conservative than I want to admit. I feel strangely sanguine about the incremental nature of these changes.

[kenberg]

hotShot, on Sep 18 2009, 07:27 AM, said:

Physicians tend to "over diagnose" and to gain additional data mostly to back up their diagnosis in case they get sued.

Similar extra costs are produced by therapy and medication.

Of cause patients want to have the feeling that everything that is possible is done to help them, so they accept or even ask for extras.

A nation wide system can establish standards on what is necessary.

This seems to me to be a large part of the problem. Luckily I have had only limited direct experience with the health care system but when I am involved I am stunned by what is done. Of course we never know for sure that a test is unneeded until we run it but it seems very reasonable to me that at some point we get told "We have done what is reasonable. We could do more, but it will have to be on your own dime." Just one quick example: A couple of years back I was in the hospital for the first time since my tonsils were removed. Well after it became clear to me, and I expect most everyone, that my pains were not caused by heart problems, they decided they should do this test where they inject dye in your veins and then put you in a gaget so they can watch the flow. It was a Saturday when they decided this, it had to be done at a different hospital, and they scheduled it for Monday. I said ok, I'll check out and come go in on Monday. What was i thinking? No, I had to stay in the hospital for the weekend and get transported by ambulance. The charges to me for all of this were somewhere between zero and negligible. If I had been expected to pay, then maybe I would have hat the test, maybe not, but I certainly would have insisted that I leave on Saturday and get myself in on Monday. With similar experiences day in and day out across the country we soon are talking (to borrow from the late Ev Dirksen) real money.

As I say, I am regularly stunned by what gets done and what it costs. I don't see how wew can get costs under control unless we deal with this.

[barmar]

PassedOut, on Sep 17 2009, 05:11 PM, said:

I would leave out entirely all the heroic and costly end-of-life measures that drain so much from the system.

Death panels!

[mike777]

"The private insurances. If I start an insurance company, I want to make money with it. With private insurance companies, money flows from the health care system to share holders. When the government is the insurance company, there is no need to pay share holders."



Killing off the private health insurance industry may be a good idea but it does come with some costs.

Shareholders, pension funds lose tens of billions of value.
Dead industry pays no taxes
Tens of thousands lose their jobs
Out of work people pay no income tax.

[Winstonm]

Quote

Perhaps it's only mass-murderers who are immune to moral condemnation, though, and Republicans are another matter altogether.

I do admit that I got a chuckle from this one - very good. Although, mass murder and Dick Cheney would be a match on the old t.v. show, Concentration, I still give this one a +1 for humor.

When I speak of Atilla the Hun, I speak of those who would use overt lies and deception to try to influence the uneducated - the Palin-esque statements about Obama's death panels being a prime example.

There is no moral judgment in ignoring stupidity.*

And if you want to talk about appeasement that is truly aghast, appease those stupid enough to believe the loudmouth idiots spewing this type of trash.

*Note that the words stupid and ignorant, as well as the phrase loudmouth idiots do not imply a moral judgment - only an intellectual judgment.

[Winstonm]

Quote

But, does the US have a higher cost of health care "per capita" because everything costs more in the strongest economy in the world? And, because we spend money on "herois measures" because we Americans view ourselves as little Kings, "the People," and hence really worth all of this?

I bet we also have a ridiculously high expenditure for coffee per capita, especially considering how easily we drop $5 for a starbucks coffee. We need about 50 brothers to spare a dime these days. I bet that same U.S. dime still gets you a coffee in some parts of the world.

I would suggest a reality check may be in order - stongest economy in the world? I am not even sure if the U.S. is still the largest, much less the strongest. The only thing keeping the U.S. solvent is the fact that the dollar is still the world's reserve currency - if that changes, expect a total collapse of the debt bridge over troubled waters that sustains U.S.

The cost per capita question is a good one, but there is so much involved in the answer as to be almost a Gordion's knot.

And as far as the U.S. dime...
The U.S. is the biggest debtor nation in history - our dimes aren't
worth....well...aren't worth a plug nickel

[PassedOut]

Slowly moving toward the finish line: Senate Panel Clears Health Bill With One G.O.P. Vote

Quote

WASHINGTON — The Senate Finance Committee voted on Tuesday to approve legislation that would reshape the American health care system and provide subsidies to help millions of people buy insurance, as Senator Olympia J. Snowe, Republican of Maine, joined all 13 Democrats on the panel in support of the landmark bill.

The vote was 14 to 9, with all of the other Republicans opposed.

Now we'll see if this bipartisan coalition holds.

[PassedOut]

Obama's address today showed some strong emotion: Taking the Insurance Companies on Down the Stretch

Quote

As the health insurance reform debate enters into its final stages in Congress, the President denounces the desperate and deceptive last-ditch efforts of the health insurance companies to derail it.

Perhaps his tone will upset some folks, but I liked it. His opponents like to toss around the phrase "you lie," so it's more than justified for him to point out who the real liars are.