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Posted: 04 April 2013 08:14 AM   [ Ignore ]   [ # 46 ]
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raibos-And for the record, if you have a point or counter point related to the original discussion make it. 
Your colorful ad-hominems are an annoying distraction.

Yes.  I thought that was an over the top reply.  I’m sorry for the rudeness.

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Posted: 04 April 2013 08:55 AM   [ Ignore ]   [ # 47 ]
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VYAZMA - 04 April 2013 08:14 AM

raibos-And for the record, if you have a point or counter point related to the original discussion make it. 
Your colorful ad-hominems are an annoying distraction.

Yes.  I thought that was an over the top reply.  I’m sorry for the rudeness.

That’s okay. I guess this topic can push some buttons. cheers.

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Posted: 04 April 2013 09:04 AM   [ Ignore ]   [ # 48 ]
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My apologies I have to reply to your comments in two parts.

Its not disingenuous at all. It truly is exhausting trying to have a conversation with someone who ignores the points being made.
Just because your responses are tacked to each one of my arguments doesn’t mean you are actually addressing them. All you have done is gone on a rant and pasted my remarks in here and there.

I have not ignored them, Ive pointed out the weakness in your argument by raising issues you’ve completely ignored and continue to ignore.
I’ll expand on them further, since you seem to be engaging in a very pedantic and inflamatory style of communication.

Please do show me where you have done anything to counter my argument that private medical insurance is more costly?  You’ve done nothing but pose questions that demonstrate your assumptions but do nothing to counter my arguments.As I stated above twice already the US spends twice as much as Canada on health care and is ranked lower in the quality of its health care system.

I have never claimed it is less costly.  Ive asked you to consider why it is so costly under the current US system in the first place.
You reply with insults and anecdotes about high school dropout employees and fat cat CEOs.

Care to explain why administrative costs are so high in the ‘private’ insurance industry?
I made a statement of fact. “Why” is a separate issue entirely but the fact of the matter is that insurance companies are not in the business of making you well or paying claims. Insurance companies also hire expensive CEO’s and spend a small fortune on advertising and promotion. Medicare does none of these things and can spend more of its revenues on actual care. In addition there is an economy of scales that a large plan like medicare has which can not be matched by insurance companies unless they have a huge monopoly, but again the why isnt nearly as important here as the fact that the disparity exists

The question of ‘why’ is *absolutely* central to any discussion.  If you have been walking to work 10 miles everyday for a month because its faster than taking your car, its important to find out why its faster. ie, maybe theres a flat tire, or its out of gas or some other mechanical issue not being addressed.  Its highly suspect to promote a new solution without investigating why the first one fails.

In this context, its entirely irrelevant (except to point out your own bias) that insurance companies are for profit ventures.  Advertising, promotion, CEO salaries are part of any free market system, which always creates a downward pressure on prices. (Practically every good and service you used today for example).  Are you actually claiming otherwise and that nationalizing services with a central monopoly delivers cheaper goods and services historically?  In what economic reality has that ever happened? 
But more importantly, you assume because its not medicare and is labelled private it must be deemed free market. Private and free are two distinct descriptions. So its important to analyze why’private’ health insurance costs appear to be the exception in the US.  Here

are two extremely important reasons:

1) Tax breaks for employer sponsored health insurance.
This is largest tax break in the federal tax code. ($147 billion in 2007).  This sounds like a break, but the reality is it punishes people who obtain insurance outside of their employment with an equivalent tax increase.  It also incentivizes employers to purchase health insurance in lieu of higher salaries.  It also results in a disconnect in the consumer between services requested and real costs, leading to increased non-emergency consumption as you’ve noted.  It also ties employees to their jobs for fear of losing health care coverage, while discouraging high risk employees from getting insurance.  It also discourages growth of individual insurance options not tailored to one-size fits all work environments.

2) Regulation.
Ive brought up this topic twice now without reponse.  In essence, physicians, hospitals, (insurance companies) are the main proponents of increased regulation in the health industry which will always the same effect:  diminishing supply, increasing cost and slowing innovation. This is true for any profession with huge government influence.  Example:  physicians lobby state legislatures to restrict the scope of practice of registered nurses, who in turn restrict the scope of practice of clinicians.  Insurance companies lobby for to stifle new entrants.  Not to mention, the FDA’s role in the pharmaceutical industry.  (AHIP spent $102 million last year for example), while the AMA highly restricts the number of medical students most years, leading to previous shortages and of course increased unnaturally inflated salaries).  Like here in Canada, the number of doctors isn’t determined by market supply and demand like other skilled service. Its determined by politicians.
I’m not saying youre not a dedicated skilled professional, just that in order to practice, you must be a member of a very prominent government controlled guild by definition.

Care to explain why Medicare financial model is spiralling into insolvency?
It has nothing to do with how much is spent on management. Medicare takes care of the oldest and sickest members of society. That demographic is increasing as a percentage of the total population. If you have more people using a service and less paying for it you need to raise revenue somewhere. Thanks largely to people from your philosophical background our politicians don’t have the guts to do what they should and raise revenues.

Or maybe it has to do with your salary?  Doctors in the US make twice as much as Canadian doctors for fewer procedures for example, since you love comparing the two.  Also note the average wage for any medical profession in the US is generally five times the average citizen’s wage.  Of course Im not arguing for government mandated salary caps, I’m just highlighting how you’re quick to blame an entire segment of the voting population while ignoring the largest costs in the area.  You also failed to mention of the $528 billion spent on Medicare, about $48 billion was found to be ‘improper payments’.  I suppose that is considered efficient for a government system?

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Posted: 04 April 2013 09:06 AM   [ Ignore ]   [ # 49 ]
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Care to explain why the rate of Danes, Swedes, Brits etc switching to private insurance is growing dramatically?
First show me evidence of that?

http://www.cmaj.ca/content/179/2/129.full
http://www.thelocal.se/36648/20111010/
http://www.guardian.co.uk/society/2012/dec/18/private-healthcare-lessons-from-sweden

(I’ll retract my british statement though, I can’t find that article, and one that says its actually dropped 2% with the recession).

Secondly even if you do its proof of nothing except that people want another option. People spend money on things for al sorts of reasons and not all of them are sensible. Your friend in Canada who had to wait a week or two for hernia surgery is a good example.

So my brother is being unreasonable for wishing to treat a hernia in a timely fashion so he can continue with his job and family as soon as possible?  My father in law was being unreasonable for not wanting to wait 14 months on the maximum prescibed morphine dosage for a shoulder replacment?  My coworker was being unreasonable for not wanting to wait all evening strapped to a gurney jaundice and vomiting before being seen by a physician?  My wife and I were being unreasonable waiting 12+ hours in the nations capital and another 8 before getting a simple ultrasound that confirmed immediate emergency surgery was necessary?
Nice cherry picking there by going for the easiest of all my personal experiences.

People often claim that wait times in countries with universal health care are longer but there is no evidence to back that up and studies looking at this have often come to the opposite conclusion.

Is that a fact now?
http://www.oecd-ilibrary.org/sites/health_glance-2011-en/06/08/g6-08-01.html?contentType=&itemId;=/content/chapter/health_glance-2011-59-en&containerItemId;=/content/serial/19991312&accessItemIds;=/content/book/health_glance-2011-en&mimeType=text/html

Even if it were so, there is no evidence that wait times have had any effect on outcomes since by most measures countries with universal healthcare have better outcomes.

In all my examples, it was people around me experiencing severe and in some cases debilitating physical pain. You may also think waiting twice as long to confirm whether something is serious or not is not an issue.
However thats not reality.

Your friend with the hernia is a good example of why some people might foolishly spend money for private insurance in societies with universal healthcare.  Hernias are generally not a medical emergency. In

most cases even here in the US people wait several weeks or months or even years to have their hernia operated on. If timing does not affect the outcome then what we are talking about here is paying more to get something done sooner just because you want it sooner not because it makes any difference.  Some of the added costs of Americas health care are do to just that. We have excess capacity and while it might diminish wait times for some things it adds to the cost because you have a lot of down time and unused capacity. its a very wasteful system especially when it does not lead to better outcomes.

Its highly insulting how you presume to know what level of physical pain and disruption from their daily lives someone ‘should’ tolerate with your blanket generalizations.

Care to explain why there is a growing medical tourism industry, even in places with universal health care such as where I live? What evidence do you have that its “growing”?

http://web.nchu.edu.tw/pweb/users/hychuo/lesson/5877.pdf
http://www.reuters.com/article/2013/03/07/us-medical-tourism-idUSBRE9260C220130307
http://en.wikipedia.org/wiki/Medical_tourism_in_India

(You’d do well spending one moment researching basic facts before publicly demanding justification).

There is medical tourism all over the world and there are plenty of Americans traveling abroad because they couldn’t get the care they needed here.

I agree, you country suffers from two broken governmental systems.

If you want to use anecdotal evidence I had a patient just yesterday who has a hernia but he has no insurance so he is traveling back to his home country of Serbia where he can have it done for a fraction of the cost. That’s a US citizen traveling to Europe because he cant get the care he needs here.  Your friend might have to wait but this fellow couldn’t get the care he needs at all in our system.

Yes, besides the failings of both medicare and state lobbied corporate insurance, it would be prudent to mention the gdp ppp of Serbia is about a fifth of what it is in the States.

I can go toe to toe with you all day if you want to waste everyones time with anecdotes.

Do not dismiss the personal experiences of my family members as anecdotes.  Ive also included several articles and arguments dismissing your argument that medicare is somehow more efficient than free market alternatives, when in reality it is both steeped in fraud, and competing against a government lobbied corporate system.

I am not aware of any surveys or studies comparing medical tourism in the US to that in countries with universal healthcare but regardless, I have worked with the public long enough to know you can never make everyone happy. Even in a perfect healthcare system there will be people who want a second opinion or want their gallbladder in a “spa like” environment as some of these medical tourism companies are now offering.

Spa like environment? Boy is that condescending and insensitive.

the existence of medical tourism does nothing to establish the merits of a free market system over universal healthcare or visa versa.

It suggests people are growing increasingly disatisfied with both universal care health, and corporate-state offerings.

Medical tourism from countries with Universal healthcare is about want not need. As a physician I am not in the least concerned about what people want. My job is to give them what they need.

You opinions are insultingly elitist and typical of many of those in the health care industry, resulting in the entrenched bureacratic guilds we suffer from today.

Cheers.

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Posted: 04 April 2013 09:08 AM   [ Ignore ]   [ # 50 ]
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macgyver - 04 April 2013 06:02 AM
rbairos - 03 April 2013 01:03 PM
Lois - 03 April 2013 12:18 PM

Do you have a better option?..So which form of government would you prefer?

Would you be in favour of a democracy picking your outfit every morning?  Of deciding your career?  What if you were allowed to vote on the best of two popular campaigns?
I think your answer is self-evident, if suppressed by today’s thinking.

And once again you give a response that doesnt answer the question presented to you. Proving again why any discussion with you is a waste of time

Did I hurt your feelings or something? Why do you insist on replying to questions that were not put to you, simply to insult me?
The answer is evident in my response.  I prefer a system of government not based on democratic will, but on recognizing people’s rights to be left unmolested by political whim.

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Posted: 04 April 2013 09:17 AM   [ Ignore ]   [ # 51 ]
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That’s exactly what I meant.  Nobody likes all of the natural societal laws or mores or rules that come from a social species but they are there nonetheless.  That’s what I meant by seemingly chaotic.  People’s and individual’s desires or reactions to change the laws are constant-but again there will never be a perfect balance. A libertarian for example sees their personal freedoms being infringed upon.  But that is a subjective viewpoint.

Subjective or not in application, you can endeavour to define freedoms on a set of core self-consistent moral principles. (at least thats the assumption).

Never in the past in any nation have people been completely free from the mechanics of a society.

No one is arguing to not be free of the ‘mechanics of society’.  You confuse state with society.

So, yes a collective or society(let’s use society-collective carries too many connotations.) has a natural right to enforce laws concerning the general welfare of the population.  It is a natural right. It’s a natural process or law of our behavior.

You’re just making a proposition here.  I could just as easily state ‘a society has a natural right to foribly coerce all its members to be red heads’ with just as much authenticity.

Like I said, it doesn’t suit everyone everytime but, that’s the way it is. If a group of people were completely contented with the way their personal liberties were being handled, I can guarantee you that another group would feel their liberties were being infringed upon.  That’s why the natural order seems chaotic- because there are many different interpretations of liberty. Not everyone feels they should rely on their own personal rugged individualism. And why should they?  We are a social species.  It can’t be helped. If we have evolved to form complex social extensions like governments and complex economies then many people will look to the application of this on a social level.

Again, I think you’re confusing state with society, and ‘natural rights’ with whim.  Individualism is not at odds with cooperation or societal constructs per se, in fact demands it. Its the initiation of force that is rejected.  There may be fundamental flaws with that philosophy, but you’re not hitting them here.

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Posted: 04 April 2013 09:49 AM   [ Ignore ]   [ # 52 ]
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raibos-Subjective or not in application, you can endeavour to define freedoms on a set of core self-consistent moral principles. (at least thats the assumption).

Yeah.  Everyone can have that endeavor.  Again it’s subjective.

No one is arguing to not be free of the ‘mechanics of society’.  You confuse state with society.

They are the same thing for the purposes of this argument.  Human behavior- both individual and social behavior-forms states and societies. For the purposes of this argument I don’t think it does any good to differentiate between state and society. Society is a loosely used term though. That doesn’t help.

You’re just making a proposition here.  I could just as easily state ‘a society has a natural right to foribly coerce all its members to be red heads’ with just as much authenticity.

No way.  As far back as you can go in history govts have always at least included some basic protections, and benefits to their populations.  General welfare is in our Constitutional Preamble for example.(let’s not get into interpretations of that-suffice it to say that it is there in black and white.)
But anyways-yes your redhead argument pretty much holds water.  The Chinese currently have as much right to enforce strict birth control laws as the people have the right to rise up and change those laws.  The Chinese law is an example of natural forces at work.  It happened!  Therefore it is natural. And it’s not an anomaly.
We don’t have to enumerate the zillions of codes, laws, mores, etc that have existed through time do we?
Yeah lot’s of people wouldn’t like the redhead law.  They can change it if possible.  When enough people don’t like the law-it usually gets changed.

Again, I think you’re confusing state with society, and ‘natural rights’ with whim.  Individualism is not at odds with cooperation or societal constructs per se, in fact demands it. Its the initiation of force that is rejected.  There may be fundamental flaws with that philosophy, but you’re not hitting them here.

The only word I need to address here is “whim”.  This is the exact opposite of the forces I’ve described above. The fact that you see it as whim is unfortunate.
It’s not whim.  You couldn’t begin to even try and tell me where this “whim” emanates from.

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Posted: 04 April 2013 10:38 AM   [ Ignore ]   [ # 53 ]
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VYAZMA - 04 April 2013 09:49 AM

Maybe it helps if I summarize.
Some people adhere to the belief society should be organized by a central authoritative figure (imagined or otherwise).
Some people believe democracy is just and best reflects the will of “the people”.
Some argue on philosophic and pragmatic grounds, both are illusions and the individual peaceful activities should never be coerced.
Your argument that libertarians care about their rights and not the ‘rights’ of society does not define what rights are.
‘Natural rights’ does not mean things ‘that happened’.
Different systems of political thought are differently grounded in philosophic principles.
Some are much more self-consistent than others.
Dismissing it all as ‘its all subjective’ isn’t useful in advancing political theory.

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Posted: 04 April 2013 11:05 AM   [ Ignore ]   [ # 54 ]
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[ Edited: 04 April 2013 01:25 PM by VYAZMA ]
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Posted: 04 April 2013 11:05 AM   [ Ignore ]   [ # 55 ]
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raibos-Maybe it helps if I summarize.
Some people adhere to the belief society should be organized by a central authoritative figure (imagined or otherwise).

No, not really.  They don’t adhere to that belief.  They live by that instinct. If you could poll people discretely-all would take for granted the central authority. Everyone would.
They may have problems with the central authority.  But the over arching idea of a central authority wouldn’t come into question.  Ideas on who should be the central authority or how it could be improved would come into play. Read that again please. It’s very important.

Some people believe democracy is just and best reflects the will of “the people”.

Yeah.  Why wouldn’t they?  As a sidenote I get your critique of our(or yours-in your country) democratic process.  I’m not a fan of the obvious imbalances of “democracy” either.  Of course what I perceive as imbalances might be different from your perceptions of imbalances. 

Some argue on philosophic and pragmatic grounds, both are illusions and the individual peaceful activities should never be coerced.

I don’t know what you mean here.

Your argument that libertarians care about their rights and not the ‘rights’ of society does not define what rights are.

Population defines what rights are.  Usually by majority.  If the majority doesn’t like it…revolution usually occurs.

‘Natural rights’ does not mean things ‘that happened’.

I’m lost with this one. Sorry.  I don’t understand.

Different systems of political thought are differently grounded in philosophic principles.

Yup.

Some are much more self-consistent than others.

Ahhnn…need more data.  Examples.  On the surface I must take this as your opinion.

Dismissing it all as ‘its all subjective’ isn’t useful in advancing political theory.

Oh believe me I love discussing political theory.  But I will get irrational and use ad hominem again.  That’s why I like to stay on the human behavioral level.
If we can agree on why we have differing views of philosophy and political values than we can begin to see that it doesn’t really matter.
It all boils down to economics, police and armies.

[ Edited: 04 April 2013 11:11 AM by VYAZMA ]
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Posted: 04 April 2013 04:12 PM   [ Ignore ]   [ # 56 ]
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rbairos finally.. a post that provides direct responses to the points made. Thank you.

I looked at the links you provided regarding citizens of other countries switching to private insurance. I do not see anything in the articles that implies the switch is dramatic although it does say it is increasing but when you read the fine print what they are talking about is “publicly funded” private healthcare. Its a hybrid system where private companies compete for public funds in the swedish system. I don’t have a problem with this if it provides greater efficiency but it doesn’t really support your contention that government should get out of the business of collecting revenues and insuring some form of universal healthcare. I never said that the private industry couldn’t be involved in a universal healthcare system, only that private industry in the US spends a smaller percentage of the dollar it collects on healthcare than the government run plan does. A hybrid system is nothing new and as the article says it has been the norm in Germany for some time.

As I said there will always be people who are unhappy with any system that is created, including one where everyone is completely free to choose. I think the dissatisfaction you are experiencing with Canada’s system is that you have no alternative at all if you can’t get what you want within the system. Not al universal healthcare systems work like that though. Sweden as you have pointed out offers other options and so does Britain. In the UK doctors can hang a shingle and run a private practice outside the control of the government system. I don’t personally have a problem with that as long as there is a universal system available to everyone.

Your graph showing wait times for a specialist appointment is interesting but it doesn’t break out the reasons for visits. If these are visits for elective, non urgent situations then longer wait times are not necessarily an issue and since health outcomes are as good or better than ours in most of these plans I have to conclude that is the case. In a well run plan you would expect wait times for non-urgent conditions to be longer as it should be since resources would be prioritized towards more urgent care and preventative care. If you look at this graph you will see that wait times for urgent or sick visits demonstrate a very different picture.

HPE-Access-2011-from-MacBook-Pro.018-500x375.jpg


http://theincidentaleconomist.com/wordpress/enough-with-the-wait-times-already/

Although among universal healthcare countries it does seem that those of you in Canada seem to suffer from some of the worst wait times. That seems to be a peculiarity of the canadian system not universal healthcare systems in general.

I think you have misinterpreted my intent with the comments I made. I did not mean to imply that its always acceptable for patients to wait for care. No system is perfect but I often find in our own system that people who are very demanding in general are also very demanding in health issues. The same person screaming at the waitress because his hamburger took too long is the same one demanding that their hysterectomy or hernia surgery be done yesterday. Obviously this isn’t every case but a demanding public unwilling to wait for anything is one of the reasons our medical care is so expensive. It requires to much excess idle capacity which then leads to overuse. A good doctor is able to assess when something is truly urgent and can intervene to expedite care when needed. I do it on occasion here when an HMO wants me to wait a week for a CT scan that really needs to be done immediately. Any well run universal health system needs to find a way to balance the need to control costs ( ie. by managing resources and limiting costs even if it results in longer wait times) while still allowing physicians to override guidelines when the situation dictates. I would think that Canada must have some process in place where your brothers doctor could expedite his procedure if he thought his health were actually in danger.

My point about the patient of mine who has to travel to Serbia for his hernia surgery was presented to make a point. The per capita income of serbs is irrelevant here. My point is that given the choice between a system such as the one you have where people have to wait longer for elective surgery but treatment is available to everyone and a system like ours where the “haves” can get elective surgery quickly but the 16% of people who are uninsured may not get it at all I would clearly choose yours.

You have presented links concerning medical tourism but still have not shown how this supports your argument. Where does it say that people from Universal healthcare countries are participating in medical tourism at a greater rate than here in the U.S.? Where does it say that medical tourism is necessary in order for those people to get care? Does it result in better outcomes or is it as I said, simply an appeal to wants rather than needs? My comment about spa treatments is not in the least bit condescending. Its a statement of fact. There are many reasons that people participate in medical tourism. A growing trend among medical tourists is the desire to have their gallbladder surgery or hysterectomy in a spa like environment. Both mexico and Thailand among other nations are promoting this aspect of medical tourism with great success.

http://www.eturbonews.com/28133/thailand-strengthens-its-appeal-spa-and-medical-tourism-destinat

It would be interesting to see some studies that examine these questions but without answers to them the subject of medical tourism does nothing except to tell us that people of means in all healthcare systems occasionally elect to spend their disposable income to get care elsewhere.

You’ve spent a lot of time telling us what you don’t like bout your own system and ours and have essentially panned the concept of universal healthcare throughout the worlds countries. What you have yet to do is explain with some detail what you would replace them with. We all know its easy to complain about something. Its much harder to come up with a workable solution. If you dont like what we have you need to provide a better option for people to consider. Complaining without offering viable alternatives is not very helpful.

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Posted: 04 April 2013 07:30 PM   [ Ignore ]   [ # 57 ]
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rbairos - 04 April 2013 09:08 AM
macgyver - 04 April 2013 06:02 AM
rbairos - 03 April 2013 01:03 PM
Lois - 03 April 2013 12:18 PM

Do you have a better option?..So which form of government would you prefer?

Would you be in favour of a democracy picking your outfit every morning?  Of deciding your career?  What if you were allowed to vote on the best of two popular campaigns?
I think your answer is self-evident, if suppressed by today’s thinking.

And once again you give a response that doesnt answer the question presented to you. Proving again why any discussion with you is a waste of time

Did I hurt your feelings or something? Why do you insist on replying to questions that were not put to you, simply to insult me?
The answer is evident in my response.  I prefer a system of government not based on democratic will, but on recognizing people’s rights to be left unmolested by political whim.

Just for the record, when you ask a question on a public forum it’s as if the question were being asked to everyone on the forum. Anyone is allowed to answer. There are no private conversations.  If you want a question to go to a specific person or persons only, ask the question in a private message, not on a forum. This is how forums work.  You are wrong to criticize any member for answering any question you pose or topic you bring up on a forum. And your own posts, even those in response to someone else’s post are open to criticism, too. If you can’t stand the heat get out of the kitchen—and off of the forum.

.....

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Posted: 05 April 2013 01:12 PM   [ Ignore ]   [ # 58 ]
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Right above is the 2nd time I’ve seen raibos used the term “whim” to describe political machinations.  This shows to me that he is either not wanting to admit subjectivity in his political theory, or he is just woefully inadequate in comprehending politics in general.
raibos said to me pointing out subjectivity was not helpful in discussing political theory.  Yes it is!

It’s not helpful pointing out subjectivity to the person when they
want to point out their opinion on what they feels is wrong with politics.  It’s like listening to old people complain about food.

[ Edited: 05 April 2013 01:21 PM by VYAZMA ]
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Posted: 09 April 2013 10:09 AM   [ Ignore ]   [ # 59 ]
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macguyver:

I looked at the links you provided regarding citizens of other countries switching to private insurance. I do not see anything in the articles that implies the switch is dramatic

Second article first line: “Private healthcare insurance plans have grown a whopping 400 percent in a decade ..”

although it does say it is increasing but when you read the fine print what they are talking about is “publicly funded” private healthcare. Its a hybrid system where private companies compete for public funds in the swedish system. I don’t have a problem with this if it provides greater efficiency but it doesn’t really support your contention that government should get out of the business of collecting revenues and insuring some form of universal
healthcare.

You’re ignoring the second article, which speaks directly to private health care insurance. It shows once again, how government offerings cannot compete with private options, without legislation hobbling the competition.

I never said that the private industry couldn’t be involved in a universal healthcare system, only that private industry in the US spends a smaller percentage of the dollar it collects on healthcare than the government run plan does. A hybrid system is nothing new and as the article says it has been the norm in Germany for some time.

The government run plan is also rife with corruption, as I specifically mentioned.  As well, the private industry, as run in the US is strictly aligned with state legislation to hobble free market initiatives.  Hybdrid systems are a step in the right direction, as evidenced by Sweden’s economic reform in the 1990s.

Your graph showing wait times for a specialist appointment is interesting but it doesn’t break out the reasons for visits. If these are visits for elective, non urgent situations then longer wait times are not necessarily an issue and since health outcomes are as good or better than ours in most of these plans I have to conclude that is the case.

Pardon me?  Increased wait times for a specialist are always an issue, as I have demonstrated several times how they meant increased time experiencing severe pain or living with uncertainty of potentially serious illness.  Also you keep assuming that if its private its market-driven, which I have shown otherwise.

In a well run plan you would expect wait times for non-urgent conditions to be longer as it should be since resources would be prioritized towards more urgent care and preventative care.

This makes absolutely no sense economically.  It assumes a static amount of resources.  You could use that exact logic to argue the bread lines of the former soviet union increased nutrition overall in comparsion to the wests free market approach, where food remains relatively ubiquitous.  You’ve completely ignored the role of competition, deregulation and innovation, which I’ve previously pointed out, is greatly suppressed in your government lobbied health care options, public or private.

If you look at this graph you will see that wait times for urgent or sick visits demonstrate a very different picture.

Very different?  Switzerland, Netherlands and New Zealand have low wait times, while western nations including US have long times, while Sweden, Norway and Canada (bastions of universal health care) have abysmal wait times.

Although among universal healthcare countries it does seem that those of you in Canada seem to suffer from some of the worst wait times. That seems to be a peculiarity of the canadian system not universal healthcare systems in general.

Strange how Sweden and Norway are excluded from your analysis.  All three countries have employed universal health care for decades.

..The same person screaming at the waitress because his hamburger took too long is the same one demanding that their hysterectomy or hernia surgery be done yesterday.

I don’t think your helping your image here with these anecdotes.

Obviously this isn’t every case but a demanding public unwilling to wait for anything is one of the reasons our medical care is so expensive.

In the same way, a demanding impatient public is the cause for rising prices for food, clothing, water, shelter, technology, transportation, entertainment.  Oh wait, actually the exact opposite is true.

It requires to much excess idle capacity which then leads to overuse.

No, hidden prices leads to overuse.  Idle capacity is a sign of lack of incentive and innovation especially given the abysmal wait times you provided above.

A good doctor is able to assess when something is truly urgent and can intervene to expedite care when needed.  I do it on occasion here when an HMO wants me to wait a week for a CT scan that really needs to be done immediately.

Again, at best youre making the best of a poor situation.  But youre championing one faulty system over another.

Any well run universal health system needs to find a way to balance the need to control costs ( ie. by managing resources and limiting costs even if it results in longer wait times) while still allowing physicians to override guidelines when the situation dictates. I would think that Canada must have some process in place where your brothers doctor could expedite his procedure if he thought his health were actually in danger.

Of course there is. We have some excellent bread line managers in my country.

My point about the patient of mine who has to travel to Serbia for his hernia surgery was presented to make a point. The per capita income of serbs is irrelevant here.

No its not.  Serbia offers a horrible system of health care, described as corrupt.
http://en.wikipedia.org/wiki/Healthcare_in_Serbia

My point is that given the choice between a system such as the one you have where people have to wait longer for elective surgery but treatment is available to everyone and a system like ours where the “haves” can get elective surgery quickly but the 16% of people who are uninsured may not get it at all I would clearly choose yours.

You understand Serbs do not have the same access to their own healthcare as US or Canadians have right?
Also, why do you keep pushing a false dichotomy in terms of health care? It’s the same here in Canada, where the alternative to our state-controlled health care monopoly is a state-controlled corporate monopoly?

You have presented links concerning medical tourism but still have not shown how this supports your argument. Where does it say that people from Universal healthcare countries are participating in medical tourism at a greater rate than here in the U.S.?

People in the US rely on medical tourism to avoid escalating costs of a highly regulated health industry.
People in Canada rely on medical tourism to avoid abysmal wait times.

Where does it say that medical tourism is necessary in order for those people to get care? Does it result in better outcomes or is it as I said, simply an appeal to wants rather than needs?

Again, the crux of the problem is that you have taken it upon *yourself* to define what someone wants and someone needs.  It is hard to find an ethical overlap with someone who repeatedly assumes this role.

My comment about spa treatments is not in the least bit condescending. Its a statement of fact. There are many reasons that people participate in medical tourism. A growing trend among medical tourists is the desire to have their gallbladder surgery or hysterectomy in a spa like environment…

Funny how the articles I find deal with liver transplants, hip and knee transplants etc.
Perhaps you would be so kind as to promote their wants as ‘needs’ someday in your great wisdom.

You’ve spent a lot of time telling us what you don’t like bout your own system and ours and have essentially panned the concept of universal healthcare throughout the worlds countries. What you have yet to do is explain with some detail what you would replace them with…

You’ve obviously ignored what my main point has been throughout.  Government dominated services, in comparison to market driven analoges are inevitably slower and more costly.  Ive enumerated how the US system of ‘private’ health care is in essence, government run.  Ive given counter examples to your for-profit complaints that have had the opposite effect in every other industry they are employed.
My ‘solution’ ?  Model what already works (deregulation, for-profit, competition), avoid what doesn’t (central legalized monopolistic bureaucracy).

Cheers.

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Posted: 09 April 2013 10:10 AM   [ Ignore ]   [ # 60 ]
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Lois:

Just for the record, when you ask a question on a public forum it’s as if the question were being asked to everyone on the forum. Anyone is allowed to answer. There are no private conversations.  If you want a question to go to a specific person or persons only, ask the question in a private message, not on a forum. This is how forums work.  You are wrong to criticize any member for answering any question you pose or topic you bring up on a forum.

And your own posts, even those in response to someone else’s post are open to criticism, too. If you can’t stand the heat get out of the kitchen—and off of the forum.

Except he didnt answer a thing. He just used the opportunity to repeat his attempt at personal criticism.
But its fine, Im used to emotional rhetoric from my exchanges with psychics, homeopaths, and creationists when their belief that they’re advancing the ‘common good’ is questioned on practical grounds.

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