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Thread: It's time for national healthcare - Page 96







Post#2376 at 04-08-2011 08:41 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by The Rani View Post
Yeah, saw that one. This one's even better, I think:
Food, Inc.

I think that both are more than relevant in a discussion about health care.

I don't remember hearing about the lengths of gene patents in them, though.
The short answer is 14 or 20 years depending on the patent (my understanding of it). The long answer is that a patent will last as long as a company has enough money to pay for favorable changes to patent law.

There are also differences under the law between patents and other intellectual properties (trademarks, copyrights, etc.). Genetics do not necessarily fall under patent law. Depending on your ability to lobby or hire lawyers, you may be able to have intellectual property categorized more favorably. For instance registering genetically modified corn as a pesticide.







Post#2377 at 04-09-2011 09:55 AM by JonLaw [at Hurricane Alley joined Oct 2010 #posts 186]
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Quote Originally Posted by Copperfield View Post
The short answer is 14 or 20 years depending on the patent (my understanding of it). The long answer is that a patent will last as long as a company has enough money to pay for favorable changes to patent law.
That's more true for copyrights. In the case of coyprights, copyright law is owned by Disney.

See the Sony Bony copyright term extension act for further details. It added 20 years protection to save Mickey Mouse.







Post#2378 at 04-09-2011 12:15 PM by antichrist [at I'm in the Big City now, boy! joined Sep 2003 #posts 1,655]
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Quote Originally Posted by The Rani View Post
It's funny how the people who know the most about modern medicine are the people who also do their best to stay away from it.
Or maybe it's not so funny.
That was certainly my experience working in pharma market research.

Seems like most everything can be treated with diet exercise and OTC generics.







Post#2379 at 04-09-2011 03:34 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by JonLaw View Post
That's more true for copyrights. In the case of coyprights, copyright law is owned by Disney.

See the Sony Bony copyright term extension act for further details. It added 20 years protection to save Mickey Mouse.
Sure. Intellectual property for media is another interesting tangent but the rules can also apply to other things if you are clever. Take "Round Up Ready" genetically modified corn for example. Does it fall under patent law or does it fall under trademark law? The answer of course if whichever the company and lawyers determine is more favorable to Monsanto.
Last edited by Copperfield; 04-09-2011 at 03:45 PM.







Post#2380 at 04-09-2011 03:43 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by The Rani View Post
Sounds like there is no real answer to the gene patent issue. Scary.
For a minute I was wondering why people don't get as worked up about eating mutated food as they do about not having health insurance. But the answer is obvious. The health care and agriculture industries WANT it that way.
I have less issue eating genetically modified food than I do with the business practices surrounding it. Technically speaking nearly everything we eat is already genetically modified through selective breeding (the old fashioned way). Corn as an example is not a naturally occurring species of vegetable. It was created by agricultural communities via cross-breeding and trait selection. It is by definition, genetically altered. That is not to say that there should not be concern for someone breeding plants meant for consumption that contain pesticides because there should be. It just needs to be better defined and on a case by case basis.

The problem as you have noted is that the companies will do it the way they want.
Last edited by Copperfield; 04-09-2011 at 03:46 PM.







Post#2381 at 04-09-2011 09:35 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by The Rani View Post
Breeding also creates mutants, as anyone who has ever watched an AKC show knows.
Sure it can but we once again need to look at mutation on a case by case basis. None of us would be here without genetic mutations. Evolution is literally fed by it. The question is more ethical than scientific. Just because we can alter genes doesn't mean we should alter them but it also doesn't mean we shouldn't.

In fact one could ask the question, does medical technology make humanity (genetically speaking) better or worse? If a population of animals (any species) can artificially cure certain diseases, injuries or afflictions does that serve evolution? Does it serve the species as a whole? Does it improve the species or hurt it? As an example is it really such a good idea to have anti-bacterial soap everywhere? Long term is this really going to save more lives than it harms when all that scrubbing creates some super-bacteria that laughs at current medicine?

These are ethical questions which humanity should be asking right now but isn't.







Post#2382 at 04-09-2011 11:54 PM by annla899 [at joined Sep 2008 #posts 2,860]
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Quote Originally Posted by The Rani View Post
Don't go to the doctor for antibiotics unless you really need them. The list goes on.

A caveat: as a child I was often on many antibiotics because I always got bronchitis.

It stopped amazing me how little people knew about antibiotics when, after I mentioned I had a cold, someone I respected said to me, "Go to the doctor and get some antibiotics." Then it was clear that she didn't know the difference between a bacteria and a virus. Hell, I haven't had a science class since I was a junior in high school and I know there's a difference.

It's that pill thing again.







Post#2383 at 04-11-2011 06:01 PM by Deb C [at joined Aug 2004 #posts 6,099]
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U.S. Spends 141% More on Health Care

By Mark Whitehouse
141%: How much more the U.S. spends on health care, per person, than the average OECD nation

At a time when politicians in Washington are battling over — among other things — the future of the U.S. health-care system, it’s instructive to see just how well that system operates. According to the Organization for Economic Cooperation and Development, we’re doing a terrible job.

A new report finds that the U.S. spends far more on health care than any of the other 29 OECD nations, and gets less health for its money. Annual public and private health-care spending in the U.S. stands at $7,538 per person, 2.41 times the OECD average and 51% more than the second-biggest spender, Norway. Meanwhile, average U.S. life expectancy is 77.9 years, less than the OECD average of 79.4.
http://blogs.wsj.com/economics/2011/...n-health-care/
"The only Good America is a Just America." .... pbrower2a







Post#2384 at 04-11-2011 08:31 PM by radind [at Alabama joined Sep 2009 #posts 1,595]
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Quote Originally Posted by Deb C View Post
U.S. Spends 141% More on Health Care



http://blogs.wsj.com/economics/2011/...n-health-care/
I agree absolutely that the USA does a bad job with the allocation of health care spending. We could do a lot better and a real health care system is sorely needed.







Post#2385 at 04-12-2011 09:02 PM by TnT [at joined Feb 2005 #posts 2,005]
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Quote Originally Posted by Copperfield View Post
Sure it can but we once again need to look at mutation on a case by case basis. None of us would be here without genetic mutations. Evolution is literally fed by it. The question is more ethical than scientific. Just because we can alter genes doesn't mean we should alter them but it also doesn't mean we shouldn't.
There is, however, a line across which I think we might want to step gingerly ... that of substituting genetic material cross-species. Sure, corn isn't a "natural" plant, but at least it's been developed from similar types of plants. But when you start inserting genetic material from fish or bacteria, or, god help us, different kinds of viruses to help the plant resist whatever, I think that we've stepped over a line.
" ... a man of notoriously vicious and intemperate disposition."







Post#2386 at 04-12-2011 09:23 PM by Mikebert [at Kalamazoo MI joined Jul 2001 #posts 4,502]
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Quote Originally Posted by Justin '77 View Post
Yeh, that's what I thought. America is so very fundamentally exceptionally different from everywhere else in the world, and medicine is so fundamentally exceptionally different from every other possible service, that all the accumulated weight of experience in every other place in medicine, and in every other service in America simply... does not apply in this case.

That's flat-out retarded. A statement of religious faith, nothing more.
Here's something germane to the issue:

Do they? Well, Medicare spends almost twice as much per patient in Dallas, where there are more doctors and care facilities per resident, as it does in Salem, Oregon, where supply is tighter. Why? Because doctors (particularly specialists) in surplus areas order more tests and treatments per capita, and keep their practices busy. Many studies have shown that the patients in areas like Dallas do not benefit in any measurable way from all this extra care. All of the physicians I know are genuinely dedicated to their patients. But at the margin, all of us are at least subconsciously influenced by our own economic interests. The data are clear: in our current system, physician supply often begets patient demand (my emphasis).
Last edited by Mikebert; 04-12-2011 at 09:26 PM.







Post#2387 at 04-12-2011 10:52 PM by Justin '77 [at Meh. joined Sep 2001 #posts 12,182]
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The emphasis chosen there is very telling. In particular how it manages to highlight a symptom of the problem while in so doing managing to shove aside a clear statement of the actual problem -- which came right before. To wit, with my emphasis added:
..in our current system, physician supply often begets patient demand.
So yeah. Exactly what I've been saying.
"Qu'est-ce que c'est que cela, la loi ? On peut donc être dehors. Je ne comprends pas. Quant à moi, suis-je dans la loi ? suis-je hors la loi ? Je n'en sais rien. Mourir de faim, est-ce être dans la loi ?" -- Tellmarch

"Человек не может снять с себя ответственности за свои поступки." - L. Tolstoy

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is no doubt obvious, the cult of the experts is both self-serving, for those who propound it, and fraudulent." - Noam Chomsky







Post#2388 at 04-13-2011 01:53 PM by The Wonkette [at Arlington, VA 1956 joined Jul 2002 #posts 9,209]
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I heard this appalling story on NPR about mentally ill people spending days in the ER because there aren't sufficient beds in the mental health facilities.

As he lay on a gurney in the emergency department of Memorial Hospital of Rhode Island, Erik grew increasingly upset. He had called the police to report a theft from his apartment, but wound up being taken to the hospital.

The ER staff quickly determined that Erik, 40, who has been diagnosed with schizoaffective disorder and PTSD, needed urgent psychiatric care, but there wasn't much they could do.

Like many hospitals, Memorial doesn't have a psychiatric unit, and all of the psychiatric units in the nearby facilities were full. Erik, a bright, articulate and devoutly religious man, had to wait nearly two days on a gurney in the ER before he could be transferred.

Mentally ill patients often languish in hospital emergency rooms for several days, sometimes longer, before they can be moved to a psychiatric unit or hospital. At most, they get drugs but little counseling, and the environment is often harsh.

"The inside of the ER is kind of like Las Vegas," with a "24/7, 365 flow of activity," says Dr. Gary Bubly, an emergency physician at the nearby Miriam Hospital and president of the Rhode Island Medical Society. While the ER staff does its best to care for mentally ill patients, he says, it's the wrong place for someone in the midst of a psychiatric crisis.
Those of you in the field (e.g. Rani), is this something that you have observed?
I want people to know that peace is possible even in this stupid day and age. Prem Rawat, June 8, 2008







Post#2389 at 04-13-2011 03:26 PM by The Wonkette [at Arlington, VA 1956 joined Jul 2002 #posts 9,209]
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Quote Originally Posted by The Rani View Post
I'm curious though, what aspects of the story did you find appalling?
Having people with psychiatric emergencies spending days in an ER along with the people with injuries from accidents or heart attacks, etc... because there aren't enough beds in facilities that can handle mental illness. It's hard on the people with the mental illnesses, and it can also be hard on the other patients if the people with psychiatric crises become disruptive. Plus, it would seem to be a very expensive use of resources.
I want people to know that peace is possible even in this stupid day and age. Prem Rawat, June 8, 2008







Post#2390 at 04-13-2011 03:41 PM by Odin [at Moorhead, MN, USA joined Sep 2006 #posts 14,442]
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Here in MN that person would be able to have a state-funded in-home caregiver to make sure he takes his meds and not get into dangerous situations, and his healthcare would be paid for by the state. We actually care about the disabled and mentally ill here.
To recommend thrift to the poor is both grotesque and insulting. It is like advising a man who is starving to eat less.

-Oscar Wilde, The Soul of Man under Socialism







Post#2391 at 04-13-2011 03:44 PM by pbrower2a [at "Michigrim" joined May 2005 #posts 15,014]
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Quote Originally Posted by The Rani View Post
Hmm ... not really. 24-hour holds in the ER are standard, when you're trying to figure out whether or not someone should be hospitalized or can go home. Back in the old days, which was the last time I did emergency room work, if there were no psych beds they would be admitted to a medical bed with a sitter or restraints, rather than kept in the E.R. that long.

I'm curious though, what aspects of the story did you find appalling?
Psychosis and cardiac cases are incompatible. In some cases, a patient's optimism can be the margin between life and death.
The greatest evil is not now done in those sordid "dens of crime" (or) even in concentration camps and labour camps. In those we see its final result. But it is conceived and ordered... in clean, carpeted, warmed and well-lighted offices, by (those) who do not need to raise their voices. Hence, naturally enough, my symbol for Hell is something like the bureaucracy of a police state or the office of a thoroughly nasty business concern."


― C.S. Lewis, The Screwtape Letters







Post#2392 at 04-13-2011 04:25 PM by The Wonkette [at Arlington, VA 1956 joined Jul 2002 #posts 9,209]
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Quote Originally Posted by The Rani View Post
This entire article was written with an obvious slant and (maybe not so) hidden agenda. Since they didn't interview anyone from the hospital, and acutely psychotic people often remember things inaccurately, it's impossible to tell what the objective truth of this story is.

Just my opinion, since you asked.
I understand that NPR tried to interview a spokesperson from the hospital, but didn't get a response. FWIW.
I want people to know that peace is possible even in this stupid day and age. Prem Rawat, June 8, 2008







Post#2393 at 04-14-2011 02:11 PM by radind [at Alabama joined Sep 2009 #posts 1,595]
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pbrower2a wrote:
“What a bleak view of history! Of course, that is Oswald Spengler. I'm more a fan of Arnold Toynbee, the first historian that I ever read who made any sense other than the conventional and pedagogic role as a narrator of events, personalities, and places. Toynbee was less rigid, but he did suggest the hazard of the Universal State -- the penultimate stage of the history of a civilization (the last being its demise) -- in which a political entity encompasses a civilization and establishes a repressive and homogenized order that turns creativity into cliché. … Then came the Third Reich which, had it succeeded, would have likely put an end to any intellectual life other than antiquarian efforts while establishing a master-and-slave order that... So that leaves the United States, long one of the most benign Empires that the world has ever known. Maybe it would be exempt because of its democracy, tolerance, and pluralism. Yes, the United States is an Empire and has been one from its full achievement of independence in 1783, when it formally took over all lands now in the United States east of the Mississippi River except for Florida and the narrow strip of land on the Gulf Coast from New Orleans to what would become Florida. Checks and balances would stop executive despotism, almost all possible episodes of legislative gangsterism, and judicial tyranny. Most significantly, economic power remained diffuse because America was a nation of small businesses. Even the slave-owning planters who dominated the South could be described as small fish in a big sea. To be sure, those planters got the idea that their 'precious' way of life was under political attack, and we had a Civil War that decided that slavery was an abomination not to continued or be repeated. We introduced free public education and eventually allowed workers to form unions to challenge the bureaucratic power of giant corporations. We even made a hero out of Dr. Martin King, Jr.! So far, so good….


We have come to a critical moment -- one that decides whether America is to be a militaristic plutocracy with a repressive order and a missionary zeal to impose its self-proclaimed glory upon much of the rest of the world -- quite possibly the entire domain of Western Civilization that includes the Americas, most of Europe (Russia could imaginably establish a limit somewhere well to the west of the western 1950 boundary of the Soviet Union through its own methods of suasion), Australia, and New Zealand. Such resembles the geographic scope of the bleak "Oceania" of Orwell's 1984….

Maybe such will be reversed in this Crisis. As giant corporations tolerate no criticism, education will be debased to rote learning and propaganda. Creative people will know well that the only lucrative and safe expression will either to resuscitate models then understood as 'classic' while avoiding any criticism of the political realities and economic order. Dissidents of any kind will be imprisoned, killed, or exiled -- if they don't sell out fast enough….Many of us would despise such an America. We must prevent it.”
Your overall assessment seems bleak indeed. While I have no problem with the USA as an Empire, I don’t see any chance of the USA taking over the world or Western Civilization. The USA still has great military power but is struggling economically and on a relative basis seems to be losing ground relative to the rest of the world (China, India, Brazil, etc.). The peak may have been about the time of the collapse of the Soviet Union and it seems to me that this would have been the time for a world takeover, if the USA had any such aspirations.

I was personally opposed to the Iraq invasion; nation building in Afghanistan and participating in the no-fly zone in Libya, so I do agree that American power should be restrained. War should be waged only when our national sovereignty is at risk.

We have many issues and I place our economic future at the top of the list. I don’t think that there is a realistic likelihood that ‘Dissidents of any kind will be imprisoned, killed, or exiled’.







Post#2394 at 04-15-2011 10:49 AM by Deb C [at joined Aug 2004 #posts 6,099]
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The song, 'When Will We Ever Learn', is in the forefront of my mind.


Obama’s ‘Shared Sacrifice’ Hits the Poor and Middle-Class Hardest

!April 15, 2011 by Healthcare-NOW!
The Nation editorial –

President Obama’s speech unveiling his deficit reduction plan contained few big surprises—by its very premise, it was destined to preserve the faulty assumptions behind the whole deficit discussion—but some of his words were welcome. The president called Social Security and Medicare fundamental American commitments and, in a rebuke to Congressman Paul Ryan, left these entitlement programs largely untouched. He also refused to renew Bush’s tax cuts for the wealthy. It’s a pledge Obama has made—and broken—in the past, but let’s take at face value his sincerity on the matter. (All the better to hold him to it.)

From there the president outlined his plan to reduce the deficit by $4 trillion in the next twelve years, based on the principle of “shared sacrifice.” Here’s what that looks like: for every $1 raised by closing tax loopholes for wealthy Americans, Obama proposes $2 in spending cuts. Two-thirds of those cuts would come from education, health and other social programs while one-third would come from the military budget. The president’s vision of “shared sacrifice,” in other words, hits the poor and the middle class hardest. Meanwhile, wealthy Americans and the military are asked to sacrifice less, even though it was unfunded tax cuts and wars that got us a deficit in the first place.

The problem with starting with such skewed priorities is that Obama will be negotiating with the Republican Party, whose reverse–Robin Hood agenda proposes sacrifices almost entirely from the poor and middle class to pay for tax breaks for corporations and the rich. Indeed, just such a give-and-take is how we ended up with the 2011 budget compromise that averted a shutdown at the expense of $38 billion in spending cuts, the majority of which will come from the departments of education, labor and health. It’s a rotten deal, which the president curiously chose to hail as “the largest annual spending cut in history.” Any more victories like this and Obama will become a new American synonym for “Pyrrhic.” The cuts in the 2011 budget—“79 percent of what we wanted,” in Paul Ryan’s words—will be exacted immediately, despite an economy still struggling to recover from the worst downturn since the Great Depression, one in which 25 million people are still bereft of full-time work.
http://bit.ly/gUiFbf
Last edited by Deb C; 04-15-2011 at 10:53 AM.
"The only Good America is a Just America." .... pbrower2a







Post#2395 at 04-25-2011 02:58 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Infuriating

http://www.washingtonpost.com/blogs/ezra-klein

RyanCare vs. the public option
By Ezra Klein

If you want to understand why the budget debate so infuriates people who actually care about deficits — and, in particular, people who actually care about health-care spending — consider this: The central health-care reform in Paul Ryan’s budget, the one that’s got him so many plaudits for courage, would actually increase costs. The health-care reform that progressives have been pursuing for more than two years would cut them. And yet calling for Medicare to be privatized and voucherized is considered serious, while calling for a public option is considered tiresome. But let’s go to the tape.

Back during the health-care reform fight, the Congressional Budget Office looked at the likely effect of adding a public option that paid Medicare rates. “In total, a public plan based on Medicare rates would save $110 billion over 10 years,” the agency concluded. Importantly, the savings would come because premiums would be lower. The basic mechanism here is not complicated: Just as you get better deals by shopping at a mega-retailer like Wal-Mart, you get better deals by working with a mega-insurer like Medicare. Size matters.

As for Ryan’s plan, CBO’s take was just the opposite. “Under the proposal,” they said, “most elderly people would pay more for their health care than they would pay under the current Medicare system.” That is to say, health-care costs go up. Now, federal health-care spending goes down, as seniors are paying 70 percent of their costs out-of-pocket rather than 30 percent. Or, in CBO-ese, Medicare beneficiaries “would bear a much larger share of their health care costs than they would under the current program.” Of course, back in the real world, seniors are going to react poorly to being unable to afford health-care insurance, and those savings won’t manifest.

But even putting that aside, it makes for a very stark contrast. The progressive reform that won’t happen would cut health-care costs. The conservative reform that won’t happen would increase health-care costs. One idea makes insurance cheaper and one makes it more expensive. And yet the idea that makes insurance cheaper is pretty much off the table, while the idea that makes it more expensive — and that almost certainly wouldn’t work — is considered a very serious proposal worthy of brow-furrowing debate.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

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Post#2396 at 04-26-2011 02:02 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Elegance in presentation

Taking something simple and making it complicated is pretty easy and there sure is a lot of that going around today.

Now taking something complicated and presenting it simply, down-to-earth manner, and correctly is a mark of fine intelligence, and this guy's got it -

http://www.thefiscaltimes.com/Column...y-Experts.aspx

Health Care Vouchers vs. Program Cuts by Experts

By MARK THOMA, The Fiscal Times
April 26, 2011

As part of his plan to reduce the budget deficit, Republican Congressman Paul Ryan of Wisconsin proposes replacing Medicare as we know it with a voucher system. Under this system, seniors would receive a credit from the government that can be used to purchase health insurance from private sector providers.

The Ryan plan would reduce Medicare payments far below what is currently available, and this would leave many without the means to obtain the care they need. But even if the vouchers were adequate, I would still not be in favor of a voucher system for health insurance.

I am not opposed to vouchers in general. They are offered as an alternative whenever government wants to broaden the availability of private sector services, e.g. vouchers for housing and education, and sometimes vouchers are the best available solution. But not always. So how can we tell if a voucher program is likely to work? And what does this tell us about the Ryan proposal?

Health insurance vouchers are, in essence, the same as giving people cash to purchase health insurance. Using a voucher instead of cash ensures that the money is used to purchase insurance.

Since using a voucher is just like spending earmarked cash, the principles that tell us when ordinary markets are likely to fail can also tell us when a market involving cash-equivalent vouchers is likely to run into trouble. Those principles state that markets work best when there are a large number of buyers and sellers, consumers have full information about the product, the good or service is nearly identical across producers, and there are no barriers to entry or exit. There are other conditions as well, most of which can be summarized by the requirement that prices provide the correct signal to consumers and producers in order to encourage optimal behavior.

There are concerns about some of these conditions in health insurance markets, e.g. while purchasers of health insurance are numerous, providers are much fewer in number. And in some case, e.g. pharmaceuticals, there may be only one or a very few suppliers of a particular drug. In addition, though regulation attempts to ensure that the alternative plans are transparent, easy to understand, and easy to compare, many consumers have trouble comparison shopping for insurance due to incomplete information about insurance plans.

Another big problem, one that isn’t always present in voucher systems, is that insurance companies pay the bills but have difficulty getting doctors and consumers to make cost effective choices. One reason for this is that consumers are charged very little over and above their insurance premiums for health care, and hence have little regard for the cost involved as they make their health care decisions. Prices do not regulate behavior as they should, and this leaves cost control in the hands of insurance companies. In addition, profit incentives that cause excessive tests and other types of health service overprovision make costs even harder to control.

Our experience with HMOs in the 1990s shows that insurance companies are not very good at controlling health care costs within this type of a system. At first, it looked as though HMOs would be the answer to the health care cost control problem, but in the end the promise was not realized. More recent experience with the Medicare Advantage program where costs have risen instead of falling also shows that the private sector is not the silver bullet for cost control.

Thus, it’s not the vouchers per se that are the problem; it’s the implicit reliance upon insurance companies to enforce cost control that comes with them. But is there a better answer? Consumers themselves are in no position to make informed decisions about health care, especially with the stress, worry, and need for instant decisions that an illness can present. If a doctor says you need a costly emergency procedure at 3 a.m. to save your life, will you be inclined to shop around for the best deal?

The solution – and it's in the Affordable Care Act – is for people with the necessary knowledge about medical services and a commitment to the public interest to do what HMOs did in the 1990s, decide which procedures should and should not be covered by Medicare. This does not rule out a particular procedure, it only defines whether taxpayers or the individual should pay for it. Those who want broader coverage can still purchase insurance in the private sector.

Consumers are unlikely to trust any limitations on something as important as their health care from insurance companies or government appointed boards; they certainly didn’t like this part of HMOs. But our long run budget problem is driven mainly by the expectation of rising health care costs, and we have no choice but to find some way of bringing these costs under control. The only question at this point is how these decisions will be determined, and among the feasible choices a board of experts is the best choice that we have.

We know what works for health care cost control. Other countries deliver universal care at lower costs and similar quality, and I believe that once we’ve tried other avenues that fail, this is where we will end There will be lots of false starts, delays and dead-ends along the way—and a voucher program, if pursued, is one of those dead ends. But the day will come when we realize that using successful systems in other countries as models for reform is the best way to provide universal access to health care at the lowest possible price.
Only a matter of time.

Love that photo.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

“It’s not tax money. The banks have accounts with the Fed … so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. It’s much more akin to printing money.” - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#2397 at 04-28-2011 10:17 AM by Deb C [at joined Aug 2004 #posts 6,099]
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04-28-2011, 10:17 AM #2397
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Privatization of health care is a failed experiment in the United States.

While we discuss ways to lower healthcare costs, mostly aimed at doctors and patients, the private insurance industry gets away with murder. I can imagine how pleased the insurance corporations are that we spend so much time putting bandaids on a gapping open wound of our healthcare system.

Meanwhile, back in Washington, Republicans and Democrats are trying to convince us that their way of doing healthcare will be in our best interest. But...........................

Republican and Democratic Plans for Medicare and Medicaid Misguided

April 28, 2011 by Healthcare-NOW!

Push for Privatization will Accelerate Costs and Deaths

By Margaret Flowers, M.D.

Leadership in Washington recognizes the damage our soaring health care spending is doing to our entire economy. Although their rhetoric differs, recent budget proposals from both Republicans and Democrats mistakenly place the blame on Medicare and Medicaid. Cuts to and privatization of these important public insurances will place us on a dangerous path that will leave health care costs soaring and more patients unable to afford necessary care.

Medicare and Medicaid must be left out of the discussion entirely until leadership has the courage to address the real reasons why our health care costs are rising, the toxic environment created by investor owned insurances and the profit-driven health care industry.

Health care spending in the United States is the highest in the world and in some cases is two times higher than spending in other industrialized nations, which achieve nearly universal coverage with better health outcomes than the U.S. Our soaring health care costs outpace our growth in GDP, inflation and wages. By any measure it is an unsustainable situation.

If we look at the various health care models in the United States, we find that the rise in spending is lower for traditional (non-privatized) Medicare and Medicaid than it is for the private sector. Our public insurances are our most efficient insurances with administrative costs of around 3%, despite the fact that they cover our most vulnerable and least healthy populations. Administrative and marketing costs for private plans are 15% or more, and the plethora of private plans further increase cost and complexity as patients and health professionals try to navigate their arbitrary and ever-changing rules.

Medicare and Medicaid are the victims of our current fragmented and profit-driven model of paying for health care which has resulted in high prices for health services and medications.

Private health insurers are financial institutions designed to create profit by obstructing, denying and restricting access to health care. They add no value to our health and in fact their business practices have polluted health care financing causing all insurances to adopt their practices in order to ‘compete’. They have also fragmented the health care market and thus the ability to negotiate for fair prices for goods and services leading to the highest prices for pharmaceuticals and procedures.

The commonsense solution is to eliminate wasteful and costly private health insurance and adopt a universal health care system modeled on the strengths of Medicare and given the power to negotiate for reasonable prices.

It is counterproductive to even discuss cuts to Medicare and Medicaid before addressing the fundamental reasons for rising costs. Yet, both Democrats and Republicans have focused on cuts to Medicare and Medicaid in their budget proposals.

The Ryan budget proposal, the Path to Prosperity, would fully privatize Medicare by moving to a voucher system in 2022 forcing all seniors to purchase private insurance. The vouchers are not designed to keep up with the rate at which health care costs are increasing so that over time seniors will either have to pay more out of pocket for health insurance premiums or will choose skimpier insurance plans that leave them unprotected should they have a serious illness or accident. Nearly half of Medicare enrollees have an income that is less than twice the federal poverty level and so have little room to absorb an increased share of health care costs.

Medicaid is significantly limited under the Ryan budget proposal which plans to cut overall Medicaid spending by $800 billion over ten years and change to block grants for each state. Block grants will mean that individual states will continue to be under economic pressure to limit who and what services are covered. As fewer are covered by Medicaid, they will have to either purchase private insurance through the exchanges or either seek a waiver from or be penalized for not purchasing insurance.

The Obama administration supports cuts to Medicare through the Independent Payment Advisory Board (IPAB) which is tasked with keeping per capita Medicare spending below a target level which is set to be lower than the current rate of health care cost inflation. Rather than blatantly privatizing Medicare as called for in the Ryan proposal, the President’s plan will slowly strangle Medicare leaving seniors struggling to find physicians able to care for them.

The IPAB was actually created in the Affordable Care Act (ACA). The President’s budget proposal would increase the power of the IPAB to cut Medicare costs. Medicaid spending is also capped under the President’s budget.

Sadly, the Peoples Budget put forth by the Congressional Progressive Caucus rubberstamps the President’s approach to cutting Medicare and Medicaid spending.

Underneath cuts to Medicare and Medicaid is a dangerous trend of increasing privatization of health care in the U.S.

There is a growing trend to put more of our population into private insurances and a growing privatization of our public health insurances. Over the past few years as the number of people able to afford employer sponsored health insurance has fallen, private health insurance profits have continued to grow as they move into providing insurance to or administering plans for the Medicare and Medicaid populations.


The ACA puts more people into the private insurance market by mandating that all uninsured who do not qualify for public health insurance purchase private insurance through the exchanges starting in 2014 and subsidizes the purchase of private insurance using public dollars.

Half of the newly insured under the ACA are eventually supposed to come from an expansion of Medicaid eligibility. However, the Department of Health and Human Services has already allowed state expansions in Medicaid coverage to lapse. A recent White House Fact Sheet also supported allowing states to place their Medicaid population into private insurance through the health insurance exchanges.

Privatization of health care is a failed experiment in the United States.

The United States differs from other nations in allowing investor-owned corporations to profit at the expense of human suffering and lives. After decades of experience with this unique privatized model of financing health care, the results are clear and startling.

The United States has the highest per capita health care costs, the highest prices for medical goods and services (and lower overall usage rates) and no control over health care spending. Despite attempts to patch the current health care situation, the number of uninsured and those with skimpy health insurance that leaves them unable to afford health care or at risk of medical bankruptcy continues to grow. Suffering and preventable deaths are higher in the U.S. than in other industrialized nations.

In addition, there have been no significant gains in important measures of health such as life expectancy and infant and maternal mortality rates. Our health disparities continue to grow, especially for those who have chronic conditions. And our health care workforce continues to be inadequate as health professionals quickly burn out from trying to practice in our complex and irrational health care environment.

It is time to recognize the failure of the market model of paying for health care and embrace comprehensive and effective health reform. The model for our ‘uniquely American’ solution lies in traditional Medicare, a single payer health system for those who are 65 years of age and over. Since its inception 45 years ago, Medicare has lifted seniors out of poverty and improved their health status.

Physicians for a National Health Program advocates for an improved Medicare for all health system, one that builds on the strengths of Medicare such as its universality, administrative efficiency and the patient’s freedom to choose a health provider, and also corrects the weaknesses of Medicare such as the lack of comprehensive benefits, out of pocket costs and low reimbursement rates.

Both Democrats and Republicans are missing the point by putting the emphasis on controlling Medicare and Medicaid costs without effectively addressing the reasons for our rising health care costs. Rather than embracing the Republican rhetoric which blames our public insurances, Democrats would do well to call out the real reason for our health care spending crisis, our current fragmented and profit-driven model, and advocate for a national improved Medicare for all.

Dr. Margaret Flowers is a pediatrician who serves as Congressional Fellow for Physicians for a National Health Program (www.pnhp.org).
"The only Good America is a Just America." .... pbrower2a







Post#2398 at 04-28-2011 11:36 AM by The Grey Badger [at Albuquerque, NM joined Sep 2001 #posts 8,876]
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04-28-2011, 11:36 AM #2398
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I just burned a gallon of gas and two hours time looking for the latest People's Pharmacy book and ended up with Prevention Magazine's Doctor's Book of Home Remedies. This relates to the health insurance crisis how?

I have health insurance. I was also a Girl Scout back in the Dark Ages. Our brother scouts had a slogan it is wise to heed. SO - I have just invested $8 plus $3.799 plus 2 hours in my own long-term health care.
How to spot a shill, by John Michael Greer: "What you watch for is (a) a brand new commenter who (b) has nothing to say about the topic under discussion but (c) trots out a smoothly written opinion piece that (d) hits all the standard talking points currently being used by a specific political or corporate interest, while (e) avoiding any other points anyone else has made on that subject."

"If the shoe fits..." The Grey Badger.







Post#2399 at 05-05-2011 01:18 PM by Deb C [at joined Aug 2004 #posts 6,099]
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05-05-2011, 01:18 PM #2399
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Rationing

Here is a very good piece on how private health insurance is rationing for profit. But the response by Doctor McCanne explains how the new reform will also be a form of rationing. It's amazing that a Republican is being honest enough to admit that rationing is being practiced by the for profit insurance industry.

Because this was sent to me, I only have the link to the Hill article, but not Doctor McCanne's response. I'll get it if anyone is interested.

Cantor: Private healthcare rationing better than government's

The Hill
May 3, 2011
By Julian Pecquet

House Majority Leader Eric Cantor (R-Va.) said Tuesday that private
healthcare plans ration care for profit but that consumers should be free to
buy whatever coverage they can afford rather than depend on government
rationing.

In remarks to the College of American Pathologists, Cantor warned that
Democrats' healthcare reform law mandates benefits that are too generous and
will bankrupt the country as the government ends up having to offer ever
increasing subsidies. That can only lead to government rationing, he said.

"That doesn't mean those kinds of decisions aren't being made now by the
private sector," Cantor added, "because they are."

Cantor appeared to go further than Republicans have in the past by
acknowledging that not all patients are certain to get optimal healthcare
under a system of private insurance.

"I think that the fundamental nature of our system of third-party payer is
the problem," he said. Patients, he added, too often are left with "no
decision about what they want and what they can afford."

Later, Cantor said Republicans want a safety net for people who can't afford
care but that "we're not for everyone having the same outcome guaranteed."

http://thehill.com/blogs/healthwatch...an-governments


Comment: It is somewhat refreshing to hear such a frank discussion of
rationing by House Majority Leader Eric Cantor. He does not pretend that
only government programs might lead to rationing, but concedes that the
private sector already makes rationing decisions.

Cantor not only acknowledges that not all patients are certain to get
optimal healthcare under a system of private insurance, but Republicans are
"not for everyone having the same outcome guaranteed."

Democrats appear to be in agreement. Under the Affordable Care Act, many
will be left without coverage, and many more of those who have coverage
through private health plans will not be able to afford the out-of-pocket
expenses required for accessing health care, in spite of the subsidies.
These financial barriers to access result in not everyone having the same
outcome guaranteed, but the Democrats remain silent when confronted with
this unacceptable deficiency in their version of health care reform.

There is already enough money in the health care system to ensure that
everyone receives all essential health care services in a timely manner,
with the same high quality outcomes guaranteed for all. The government
rationing that Eric Cantor claims is inevitable occurs only if politicians
are unwilling to budget through a single government program (single payer)
the amount comparable to that we are already spending, publicly and
privately.

Now if only the Democrats would admit that they have made a mistake in
choosing a model of rationing that does not guarantee the same quality
outcome for everyone, then maybe we could have a discussion of a model that
would work. If so, then we could have the frank debate that Eric Cantor has
initiated. Cantor says, "we're not for everyone having the same outcome
guaranteed," but are the Democrats? Let's ask them.
"The only Good America is a Just America." .... pbrower2a







Post#2400 at 05-06-2011 03:01 PM by ASB65 [at Texas joined Mar 2010 #posts 5,892]
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05-06-2011, 03:01 PM #2400
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Here is my latest saga in trying to get medication for my son...

As some of you may know my 12 year old suffers from a (rare) chronic condition which causes him to have various swellings in different parts of his body. A few weeks ago he had a severe swelling in face. Although he gets swellings frequently this was the first time he had ever had one in his face. A face swelling is very serious because it could be fatal in the event that the swellings were to spread to his tongue or throat. Fortunately, although it was quite severe the swelling didn't spread and become an emergency situatution. When my son had the face swelling I contacted the specialist he sees in Dallas. At this time the doctor told me about a new medication that is available that can be taken in the event of a face swelling. The closest hospital that has this medication is over an hour away, so my son's doctor started the ball rolling trying to get a hospital in our town to carry this medication for Matthew. (The medication is given through an IV.)

Our hospital here will not carry the medication because it's so expensive. So we are in the process of trying to obtain the medication to keep at home. That way if he does a have a swelling we can take him to the emergency room along with the medication he needs. Our insurance will not cover the cost of medication. It cost $2000 per dose. We are now in the process of trying to obtain financial assistance (through the pharmaceutical company) to help us with the cost of the medication. I have spent a great deal of time signing consent forms, faxing our income information, and talking with different people from the company that manufactures the medication to people from the mail order pharmacy which we would get it from. Needless to say it is a long a process with a lot of red tape. But of course, it will all be worth it if I can get the medication my son needs. It could very well save his life one day.

I've heard all the arguments about how nationalized health care would be full of red tape and that people may not able to get the health care services they need. I don't see how it could be any worse than what we are going through trying to get the medication we need. And although we do have insurance, it sure isn't doing us any good in this situation...just saying.

I feel like I keep running into another brick wall with each turn.
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