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Local Rebel
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0 posted 12-12-2009 11:04 PM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

quote:

It is time, once again, to flex our muscle and exert that influence to hold the line in our fight against the government takeover of healthcare. The Senate is busy working on the details of a government run health care bill and they would like to pass it as quickly as possible. Some of them are under the false impression that we’ve given up and gone away just because they haven’t heard much from us in the past few days. And those Senators who have not made a final decision on how to vote are in danger of leaning in the wrong direction. We must remind them that our steadfast opposition to a government takeover of health care is as strong now as it has been all along.

So here’s the plan. On Tuesday, December 15 at 8:45 AM thousands of us will meet in Washington, DC at the fountain in Upper Senate Park. From there we will march to the Senate offices, go inside, and demonstrate our opposition to the government takeover of health care. We call this plan “Government Waiting Rooms”. The intention is to go inside the Senate offices and hallways, and play out the role of patients waiting for treatment in government controlled medical facilities. As the day goes on some of us will pretend to die from our untreated illnesses and collapse on the floor. Many of us plan to stay there until they force us to leave. A backup location for this demonstration will be announced if they block us from entering the offices.
http://taxdayteaparty.com/2009/12/tea-party-patriots-to-storm-senate-offices/



quote:

On Thursday, I hosted my MSNBC "Ed Show" from the Kansas City Convention Center. There have been few days in my thirty year broadcasting career that have moved me as much as this experience did. I saw the real America. In the middle of the country, two thousand miles from the beltway, I witnessed middle class Americans standing in line for hours waiting to see a doctor. Some had not seen a doctor in years. They have jobs, some working two jobs, but can't afford the cost of insurance and basically are on the GOP plan: pray you don't get sick.

The stories were gut wrenching. I couldn't help but think this is where the Senate needs to do their business. Do it right in front of the eyes of the people in their own country who are struggling to make ends meet and live in dignity. The Senate should do business in front of the families that have played by the rules and have been dealt a personal set back for one reason or another. Have the guts to tell these people to their face that they aren't worthy of health care because they don't have money. They may see these faces briefly on the campaign trail, but they make no decisions in front of them when they are standing in line in pain, in agony and in desperate need.

America has a heartless side to it as well. That is demonstrated when U.S. Senators put the God Almighty Dollar in front of people who put them in office. How any law maker could deny full access and full health care coverage is beyond me. Senators who put themselves ahead of the people and who have been spoiled by the Washington good life have lost their soul and what it means to be an American. We throw billions of dollars at wars, often without hesitation, but some in the Congress are willing to treat humans in their own country like a piece of machinery that can be left in a junk yard.

My God, what has happened to America ? http://www.huffingtonpost.com/ed-schultz/senators-should-visit-a-f_b_389228.html



quote:

Thousands from in and around Missouri lined up to be seen by doctors on the second day of The Kansas City Free Health Clinic. The event is just one of a series of heath care fairs put on by the National Association of Free Clinics to serve Americans who are uninsured or unable to pay the costs of basic medical care.

According to NBC, the clinic saw over 2,000 people on Wednesday and Thursday. NBC reports that 40 percent of patients surveyed have not visited a doctor since 2003.

MSNBC's Ed Schulz spent the day at the Kansas City Civic Center meeting doctors and patients. Schulz commented on how the majority of the patients have jobs, some of them two or three. A doctor he spoke to referred to them as "the new poor."

Schulz said that the story of the free health care clinics has grabbed him like no other in his career. Over 25,000 MSNBC viewers donated about $2 million to the National Association of Free Clinics. http://www.huffingtonpost.com/2009/12/10/thousands-in-midwest-seek_n_387670.html



quote:

New Orleans, La. — - It happened as I watched a 50-something woman walk out, after spending several hours being attended to by volunteer doctors. "She's decided against treatment. A reasonable decision under the circumstances," the doctor tells us as she heads for the next patient. The president of the board of the National Association of Free Health Clinics tells me why: "It's stage four breast cancer, her body is filled with tumors." I don't know when that woman last saw a doctor. But I do know that if she had health insurance, the odds she would have seen a doctor long ago are much higher, and her chances for an earlier diagnosis and treatment would have been far greater.

After watching for hours as the patients moved through the clinic, it was hard to believe that I was in America.

Eighty-three percent of the patients they see are employed, they are not accepting other government help on a large scale, not "welfare queens" as some would like to have us believe. They are tax-paying, good, upstanding citizens who are trying to make it and give their kids a better life just like you and me.

Ninety percent of the patients who came through Saturday's clinic had two or more diagnoses.
Eighty-two percent had a life-threatening condition such as cardiovascular disease, diabetes, or hypertension. They are victims of a system built with corporate profits at its center, which long ago forgot the moral imperative that should drive us to show compassion to our fellow men and women.

Health reform is not about Democrats or Republicans or who can score political points for the next election, it's about people. It's about fairness and justice in a system that knows none. I'd defy even the most hardened capitalist-loving-conservative to do what I did on Saturday and continue to pretend that the system in place right now is working.

Countdown chose to highlight and raise money for the Association of Free Clinics because we knew the work they do is so vitally important and we wanted to show in real terms how great the need is. We invited several politicians to attend so they could see first hand how critical the situation is. All declined. Some explained that they talk with constituents all the time and know very well of the need for reform.

I have news for them, these people didn't need to speak. Their actions spoke far louder than any words. Having to get a check up and diagnoses at a free clinic because they have no other option tells you all you need to know. There are no words that can accurately describe the quiet desperation on the faces of the patients. Every single one I spoke to, and every one I heard talking with doctors, expressed their gratitude for the event and wished that they were held more often.

They have been given the resources in their local communities with which they can get follow up care, but they are also the few. Over 700-thousand people in Louisiana alone have no health care, most of them with jobs that don't offer insurance.

Or, worse, they have to decide whether to pay for that or food and housing. Four patients were taken out on stretchers and admitted immediately to hospitals. One woman who didn't know why she was feeling bad had a blood pressure of 280 over 180, numbness in her right arm, and "a slight headache." She now has a shot at survival, but without her attendance at the clinic, it was a matter of time before the inevitable happened.

I spoke with a nurse who was there not as a volunteer, but as a patient. He works two part time jobs at hospitals providing quality care to those who have the one thing he doesn't. Many of his patients share his condition of high blood pressure, but they are fortunate to have insurance to pay for him to care for them while he goes without.
http://www.msnbc.msn.com/id/33975919/ns/msnbc_tv-countdown_with_keith_olbermann


Local Rebel
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1 posted 12-13-2009 10:40 AM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

quote:


Free clinics tied to health care debate
November 20, 2009 4:42 AM ET

LITTLE ROCK, Ark. (AP) - A nonprofit group's campaign to hold free medical clinics for the uninsured in three states is turning into a not-so-subtle jab at moderate Democrats to support their party's efforts to reform health care.

More than 800 people have signed up for free care Saturday at a downtown convention center in Little Rock at an event organized by the National Association of Free Clinics — the Virginia-based association's second free event in the past month under a campaign promoted by MSNBC's Keith Olbermann.

More than 1,000 people showed up at the first, in New Orleans on Nov. 14, and a two-day free clinic is planned in Kansas City, Mo. Dec. 9-10.

Olbermann urged his viewers last month to contribute to the association, saying he wanted mass clinics in the states of the "six senators key to defeating a filibuster against health care reform in the Senate." Since then, more than $1.7 million has been contributed to the group for the clinics.

Olbermann has been targeting Democrats from those states who are seen as crucial to passing Democratic-led health care reform legislation spear-headed by Majority Leader Harry Reid. The Senate is expected to begin debating the legislation, which would include a government-run insurance option, Saturday night.

"I want Sens. (Blanche) Lincoln and (Mark) Pryor to see what health care poverty is really like in Little Rock," Olbermann said on his show last month.

The New Orleans clinic was aimed partly at Sen. Mary Landrieu, a Democrat who has not said how she plans to vote on health care reform, while the Kansas clinic was chosen because it symbolized the need for health care in the Midwest, said Rich Stockwell, senior producer for "Countdown with Keith Olbermann."

"We hear the 46 million in this country without insurance over and over, but those people go largely unseen to most of us. By bringing them all to one place, or a very small percentage, on one day is showing, 'hey, you guys in Washington, you need to get something done to help those people," Stockwell said.

Lincoln, who faces a tough re-election battle next year, has not said whether she supports the legislation, but does say she opposes a so-called public option. She has not said if she would support moving legislation forward for debate, but asserts that a larger overhaul of the nation's health care is needed.

"This one-day clinic is a blessing, but it is not a sustainable way to deliver health care for the thousands of uninsured and underinsured Arkansans," Lincoln said in a statement released by her office.
http://news.moneycentral.msn.com/provider/providerarticle.aspx?feed=AP&date=20091120&id=10753355



Local Rebel
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2 posted 12-13-2009 10:46 AM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

But it isn't as if Fox News was unaware -- yet they chose to promote Tea Parties instead of Free Clinics:

August 02, 2009 http://www.youtube.com/watch?v=XSS74wGO7zs

August 03, 2009 http://www.youtube.com/watch?v=tNAPMIMWQy0

quote:

Free Health Care Clinic in Inglewood
Hundreds faced a long wait for care at the Forum.

Updated: Tuesday, 11 Aug 2009, 11:08 PM PDT
Published : Tuesday, 11 Aug 2009, 8:08 AM PDT

Inglewood (myFOXla.com) - Like hundreds of others who showed up in the pre-dawn hours for free health care at The Forum in Inglewood, 50-year-old Arturo Castaneda was relieved that he would receive the care he needed.

Eventually.

Though blind, Castaneda's wasted eyes flitted over the hundreds of doctors and nurses who had volunteered to provide free dentistry, medical exams and vision care to the 1,500 uninsured, underinsured, unemployed and needy patients.

"This is beautiful, very beautiful. A very beautiful service they are doing for these people," he said.

The Los Angeles event marks the first time Remote Area Medical has provided such medical care in a major urban area. The medical group typically serves patients in rural parts of the United States and travels to underdeveloped countries.

The piercing sound of teeth being drilled and scraped echoed up to the rafters where the Los Angeles Lakers once played to the roar of capacity crowds. Mobile health trucks provided other medical examinations, and tables full of donated eyeglasses were available to those who had eye examinations done.
....
Tennessee-based RAM's founder Stan Brock said he helps organize 30 to 40 such health care events a year, with a total of 567 events held to date, adding: "We just wish we could do more."

"This need has existed in this country for decades and decades," said Brock. "The people coming here are here because they are in pain."

The event came at a time when the national debate over President Barack Obama's health reform plan has boiled over at town hall meetings, with opponents sometimes shouting down Democratic members of Congress who favor the program.

Rep. Maxine Waters, D-Calif., told a cheering crowd of volunteers and medical professionals at The Forum that she would continue to advocate for health care reform because "we can do a better job of providing health care to those who desperately need it."

There are about 47 million uninsured Americans, according to federal estimates.

"It's awful, people who say we don't need a national health program," said 61-year-old Paula Cook as she waited for a mammogram. After she lost her job two years ago, she lost her health insurance and hasn't been able to find insurance that will accept her.

"Now, no one will insure me because they say I have a pre-existing condition -- a hip replacement!" said Cook.
....
The tired, sweaty crowd outside The Forum grew noisy when volunteers announced that they would need to return the next day to see a dentist.

"I don't have money to come back tomorrow! I borrowed money to get here today!" yelled Ontario resident Jocelyn Langham, 53. A cracked tooth and the fruitless 10-hour wait had frazzled her nerves.

Brock called on more area medical professionals to volunteer to work the event in coming days, and for Congress to pass a law that allows doctors to provide care in any state. The event will be held daily through Aug. 18.
http://www.myfoxla.com/dpp/news/local/Free_Health_Care_Clinic_at_Forum_20090811


Denise
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3 posted 12-13-2009 11:43 AM       View Profile for Denise   Edit/Delete Message      Find Poems  View IP for Denise

Don't they normally offer free municipal clinics in those areas? My city does. Anybody can go. It would probably be less of a wait than having it on one weekend at a civic center too, maybe 50-100 people instead of thousands.

This seems more like a publicity stunt to push the moderate Dems toward the government takeover of the entire health care industry, to me.
Ron
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4 posted 12-13-2009 12:35 PM       View Profile for Ron   Email Ron   Edit/Delete Message      Find Poems   Click to visit Ron's Home Page   View IP for Ron

More free clinics is always gratifying and a great example of how America should work. Private citizens with more voluntarily helping private citizens with less. It sure beats the heck out of getting the government involved, doesn't it, Reb?
Local Rebel
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5 posted 12-13-2009 12:42 PM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

Sure Ron.  That's an ideal.  Along with the world where no one cheats, steals, kills, lies, or covets.  Right?    

But still -- is it ideal at all?  If you're re-making society from behind the veil of ignorance -- would you choose to be the helpee?  and not the helper?
Martie
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6 posted 12-13-2009 01:22 PM       View Profile for Martie   Email Martie   Edit/Delete Message      Find Poems   Click to visit Martie's Home Page   View IP for Martie

Hi Reb...just stopping by to say hi!  
Ron
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I can honestly answer that question with a resounding yes, Reb. I would much rather have caring people helping me rather than a bureaucrat who is both bored with his job and long since hardened by those trying to cheat the system. Wouldn't you?

I'm not suggesting, of course, that government shouldn't play a role in helping people. In my opinion, however, that help should support people helping people, not supplant it. And it sure as heck shouldn't discourage people helping themselves.

People need health care. They also need food and shelter. And let's not forget love. I will always question whether any of those needs should be routinely supplied by government.
Local Rebel
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8 posted 12-13-2009 02:44 PM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

Hi Martie! Good to see ya!

quote:

I would much rather have caring people helping me rather than a bureaucrat who is both bored with his job and long since hardened by those trying to cheat the system. Wouldn't you?



Bit of a strawman there Ron.  Why would you suggest that a doctor is a bureaucrat bored with his job?

The difference we're talking about is the difference between an insurance company employee -- who's objective is to deny claims -- and, well, since there's no single-payer plan on the table -- an insurance company employee who will not legally be allowed to deny claims.  Aren't we?

Don't Doctors want to be Doctors?  Or are you suggesting they're just in it for the money?  I don't follow.  On the one hand you say it's preferable for them to volunteer to work in free clinics -- on the other you suggest it's somehow immoral (or perhaps demoralizing) for them to be paid by a government backed insurance option?

Isn't the preferred society one where you simply get medical care that you need?  Not where how much money you have dictates what kind of care you get?

quote:

I would much rather have caring people helping me rather than a bureaucrat who is both bored with his job and long since hardened by those trying to cheat the system. Wouldn't you?



Aside from setting up a strawman Ron -- this ignores the question -- the veil doesn't ask you to choose between this world or a hypothetical world -- it merely asks you if you want to be any member of a particular world -- so it isn't a matter of 'rather'.  It is -- do you want to live in a world where you are the poor person in need?  You don't get to pick your mental capacity, your physical strength, your gender, your race, your place of birth-- what world would you would design?
Ron
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quote:
Bit of a strawman there Ron. Why would you suggest that a doctor is a bureaucrat bored with his job?

No, Reb, I don't think the doctor is any more of a bureaucrat than is the bank clerk that cashes someone's welfare check. The bureaucrat, clearly, is farther upstream.

quote:
The difference we're talking about is the difference between an insurance company employee -- who's objective is to deny claims -- and, well, since there's no single-payer plan on the table -- an insurance company employee who will not legally be allowed to deny claims. Aren't we?

Which one of those insurance company employees is making the decision at those free clinics, Reb? Those are the ones I think I like best.

quote:
Isn't the preferred society one where you simply get medical care that you need? Not where how much money you have dictates what kind of care you get?

You mean like Star Trek? Absolutely, Reb. We also shouldn't have to worry about food or shelter or pollution or crime or war. The stumbling block, of course, is that the Star Trek universe is still fiction. We need a nice supply of dilithium crystals to make it a reality.

quote:
You don't get to pick your mental capacity, your physical strength, your gender, your race, your place of birth-- what world would you would design?

One where entropy no longer holds sway?

Failing that, I think I'd want to design one that I felt had a chance of actually working. Long term. For everyone, or at least most everyone. I don't think it would be realistic to design a world that, at best, would work for only a short time even if, during that short time, I was personally guaranteed comfort and ease. I guess I still believe that opportunity is more important than a guarantee I know can't last.


Local Rebel
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10 posted 12-13-2009 05:43 PM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

quote:

One where entropy no longer holds sway?



No. We don't get to change the laws of physics either Ron, or biology, or human nature.  We have to design a world that deals with disease, including mental, which means that some people will not play by the rules.  Sociopaths do exist.  

Dilithium crystals notwithstanding -- I'm not sure why you think a sustainable model is having people wait ten years for health care before they can get to a volunteer clinic paid for with charitable donations -- but that we can't fund a better system out of the dollars we already spend on insurance premiums, emergency room care, lost productivity.

In fact, I don't think you think that, so I'm not sure why you're making that argument.

What isn't sustainable is the current trajectory.

quote:

Which one of those insurance company employees is making the decision at those free clinics, Reb? Those are the ones I think I like best.



So then you're advocating what, exactly?  I don't want to put words in your mouth -- but it seems your preference is abandoning for-profit health care in favor of free clinics funded by -- what?  MSNBC viewers?

Oh, and, next time you see Mysteria ask her when Canada is going to get warp drive -- since they have been running, it seems, on dilithium crystals for some time now.
Ron
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quote:
No. We don't get to change the laws of physics either Ron, or biology, or human nature.

LOL. That was sort of my point, Reb. If you insist on a utopia, we might as well wish big.

quote:
What isn't sustainable is the current trajectory.

I agree. I've already said elsewhere, the only thing worse than what we're doing right now is doing nothing.

quote:
Dilithium crystals notwithstanding -- I'm not sure why you think a sustainable model is having people wait ten years for health care ...

Waiting ten years to get help is a choice, one I actually understand fairly well. Or are you suggesting these free clinics were the only help available for the past decade?

quote:
... before they can get to a volunteer clinic paid for with charitable donations -- but that we can't fund a better system out of the dollars we already spend on insurance premiums, emergency room care, lost productivity.

Of course we can. And we should. A different kind of insurance, however, isn't a better system. It's just more of the same.

quote:
So then you're advocating what, exactly? I don't want to put words in your mouth -- but it seems your preference is abandoning for-profit health care in favor of free clinics funded by -- what? MSNBC viewers?

Nope, no more than I would suggest farmers should stop trying to make a living in favor of soup kitchens and food banks. We feed people who can't afford to feed themselves, but we don't yet give free food to everyone as some kind of basic human right. If you want to eat filet mignon, you still have to find a way to pay for it. That system seems to work pretty well in America?

quote:
Oh, and, next time you see Mysteria ask her when Canada is going to get warp drive -- since they have been running, it seems, on dilithium crystals for some time now.

No, as you already know, Reb, they're doing pretty much what you suggested earlier - funding a system with money we waste on insurance premiums, unnecessary ER care, and lost productivity. It might arguably be better than our system, but it's certainly not warp drive. It's socialism. It's taking care of people because they can't be trusted to take care of themselves. That's certainly one way of looking at society, but it's not one I've ever found very attractive.

Insurance is evil. It doesn't much matter if it's paid for by the individual, a business, or our government, it's still going to be evil.


Local Rebel
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12 posted 12-13-2009 10:57 PM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

quote:

Nope, no more than I would suggest farmers should stop trying to make a living in favor of soup kitchens and food banks. We feed people who can't afford to feed themselves, but we don't yet give free food to everyone as some kind of basic human right. If you want to eat filet mignon, you still have to find a way to pay for it. That system seems to work pretty well in America?



But the fact is Ron, we've defined food as a right -- just not tasty food.  And we've defined healthcare as a right too -- provided that someone can actually get to the emergency room -- so the question is -- why have we defined the most expensive, least efficient, and least effective healthcare as a right?  

Speech is a right.  You can go shout as loud as you want from the street corner -- um no... disturbing the peace.  You can put a full size ad in the New York Times -- um... no -- have to be able to afford that -- but, you can talk to your friends -- and say the king has no clothes.  Priceless.

quote:

Waiting ten years to get help is a choice, one I actually understand fairly well. Or are you suggesting these free clinics were the only help available for the past decade?



It depends.  The animal that chews off its' paw to escape a trap makes a choice too.  It isn't the choice we would choose from the other side of the veil though?

It's interesting -- what the Fox/Tea Party crowd chooses instead of something that actually backs up their contention that the private sector and private citizens can, should, and do provide a solution to the problem.  

quote:

That was sort of my point, Reb. If you insist on a utopia, we might as well wish big.



Who's talking about utopia?  There all the women are strong, all the men are good looking, and all the children are above average.... I think it's a place called lake Wobegon!      

No, here we deal with the real world.  And in order to solve real problems we have to imagine real solutions -- and in doing so -- imagine them in a way that is just for everyone.

Healthcare is a right -- but we have to decide what the parameters of that care are in the process.  

quote:

It might arguably be better than our system, but it's certainly not warp drive. It's socialism. It's taking care of people because they can't be trusted to take care of themselves.



I had an appendectomy when I was 15.  I'm pretty sure I was unable to diagnose or perform that surgery myself -- so you're right of course -- that was helping me because I couldn't help myself.  

If only everyone could be rich enough to afford catastrophic health care?  What utopia are you talking about Ron?
Bob K
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13 posted 12-14-2009 12:22 PM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K



     Is the use of the "S" word supposed to drive people away screaming?  Socialism, socialism, socialism.  Maybe we can replace dilithium crystals by tapping the power of Ayn Rand turning over in her grave?  You make it sound terrible.

     There are actually things that groups can do that individuals can't.  Form families, for example.  Provide for mutual defense.  Provide for common welfare.  Share thoughts and feelings.  Provide resources.

     Bears are not good at these things.  They have trouble getting together long enough to mate.  Then the mother and cubs don't stay together more than a few years before the cubs have to find new territory.  Wolves are much better, though they have this hierarchy business they keep needing to work out.  And people are like that too.  People are designed to work in groups with some degree of cooperation and with a bit of a dominance struggle going on.

     If you know what to look for, you can chart the dominance patterns within the conversations at any cocktail party or any family dinner.  It's not difficult.  With a little bit of training, in fact, it's pretty obvious.  And that's inside small groups.

    Here's a no brainer for you.  If you have two major political philosophical/political systems in the world that govern the behavior of a social species, and one of them enshrines co-operation as the primary motive, what's your best guess as to what the other one's going to put forward as it's major motive for human behavior?  Do you think that it might me, perhaps, a slightly more modest degree of cooperation?

      No?

       If your answer was competition, you'd probably be right up there with the Communists and the Capitalists of our particular best-of-all-possible worlds, wouldn't you?

     Except that we never actually got to either pure state, even though we've acted as though we have.  And we still need to find some way of dealing with this tension between the two directions in which we are pulled here.

     If the leftist should acknowledge the need for individual effort and personal autonomy — and it would be silly not to, given that everybody feels that tug; it may not be too much to consider that the rightest consider that all does not come as a result of the efforts and heroism of the individual, and that provision needs to be made even for the people that seem to hold back the efforts of the most independent and competent of the bunch.

     In health care, I suggest that we need to have a system that uses the money that we already spend as a country on health care, or less, to provide a system that works better.  I'm not suggesting that all profit be taken out of the system, clearly a difficult task, but that there are some profit centers that need not exist, and some redundancies that need not exist.  Why the percentage of hysterectomies in one area should exceed that in many others should be a matter of interest, for example.  Does this reflect a difference in the environmental health of women — too much of something in the water — or does it suggest that this is a profitable operation and is over performed for some women when other operation would work as well or better?

     What price is paid for a medication should be a matter of bidding.  A governmental bid, especially if unfixed, would be best to get the best price:  If we are not serious about our anti-trust legislation being applied to drug companies, then we should at least have bidders commanding a market large enough to make the market work as it should.

     We should set up a health provision system funded through premiums paid for through taxes.

     Private health insurance, through its very nature, will always be looking for reasons not to pay; it is not your ally, it is your adversary.  When it must pay, it takes profits from the pockets of its owners, so its business is to make payment as difficult as it in conscience and in law make it.  Trying to make health insurance serve the function of health provision seems to me to be asking a mackerel to tap dance.  It is against the nature of the beast.

     Bureaucracy, by the way, seems to me to be a much maligned term.  Sometimes they get very overgrown and demand trimming.  Parts of them can and should be automated.  Shortcuts are possible and necessary.  Revision with an eye to simplification needs to be frequent.  With all the caveats, they survive because they have institutional memory and because they have proven to be the most effective way of getting things done in large human groups since the Roman empire in the West and since the earlier Chinese empires in the East.

     Complaining about them has been, for nearly as long, proven to be one of the most futile exercises in human history.  Invention of an equally effective and simpler and cheaper alternative, needless to say, would be welcome.
Should anybody feel so moved, donations of a nickel for future complaints about that particular matter would doubtless be welcome by the charity of your choice.  I like the Susan B. Komen Breast Cancer folks, but other people may have their own choices.

     In this way, the complaints would not only be entertaining for us, but do some real world good.  I will make an anonymous donation of a dollar myself simply from having taken part in such a discussion after I sign this note.

Sincerely yours, Bob Kaven  
Bob K
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since 11-03-2007
Posts 3860


14 posted 12-14-2009 12:23 PM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K



Maybe someplace else, to preserve anonymous status, eh?
Ron
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15 posted 12-14-2009 03:54 PM       View Profile for Ron   Email Ron   Edit/Delete Message      Find Poems   Click to visit Ron's Home Page   View IP for Ron

quote:
But the fact is Ron, we've defined food as a right -- just not tasty food. And we've defined healthcare as a right too -- provided that someone can actually get to the emergency room -- so the question is -- why have we defined the most expensive, least efficient, and least effective healthcare as a right?

I don't know, Reb. Why can't people walk into a grocery store and walk out again with everything they need to eat for the next week? Why can't the needy go to a bank and withdraw money? I think something like 25 cents of every welfare dollar in this country goes to welfare overhead and, like the costs of an ER visit, that money is largely wasted.

When the government gets involved, even the cost of charity goes up.

quote:
If only everyone could be rich enough to afford catastrophic health care?

Not too mention a Harvard graduate degree? It would also be nice to have a dependable car, a nice house, and the wherewithal to feed and clothe 1.5 children. Maybe we should pass some laws?

Fortunately, you don't have to be terribly rich to afford a good college, a dependable car, a nice house, or even the support of a couple of kids. It takes some work and not a little sacrifice, but the principles of supply and demand will always keep mass needs affordable for the masses. When the price goes catastrophic and people stop buying, the suppliers are either forced to lower their prices or contend with new suppliers who will. It's basic market dynamics.

What would happen if you could get all the food you wanted and someone else had to pay for it? Would you eat hamburger or filet mignon? How long would you even bother to look at the prices on the packages? What do you think would happen to food prices across America?

Yea, Reb, it would be really great if everyone was rich enough to afford catastrophic health care. It would be even better, though, if health care was more affordable for the masses like everything else the masses need.

quote:
Is the use of the "S" word supposed to drive people away screaming? ... You make it sound terrible.

Did I, Bob? What, exactly, did I say that was so terrible?

quote:
In health care, I suggest that we need to have a system that uses the money that we already spend as a country on health care, or less, to provide a system that works better.

Great idea, Bob. You should probably get that trademarked or something before someone steals it.

quote:
Why the percentage of hysterectomies in one area should exceed that in many others should be a matter of interest, for example. Does this reflect a difference in the environmental health of women — too much of something in the water — or does it suggest that this is a profitable operation and is over performed for some women when other operation would work as well or better?

Or is it because too many women shrugged their shoulders and said, "Sure, so long as it doesn't come out of my pocket?"

quote:
What price is paid for a medication should be a matter of bidding.

That's one way, but it's historically been of limited use. Try getting your grocers, for example, to engage in a bidding war on filet mignon. Ain't gonna happen. Supply and demand, on the other hand, works across a much wider base. Too expensive. Buy something else. And when enough people buy something else, the price WILL drop.

That's not going to happen in America, though, because most people don't care about expensive. They only care if it's covered by their insurance policy.

quote:
Private health insurance, through its very nature, will always be looking for reasons not to pay; it is not your ally, it is your adversary. When it must pay, it takes profits from the pockets of its owners, so its business is to make payment as difficult as it in conscience and in law make it.

Not true, Bob. Claims adjusters who pay too few claims get in just as much trouble as those who pay too many claims. Why? For the same reasons a casino willingly pays out 98 percent of their gross slot revenue. It should hardly comes a surprise, of course, that both casinos and insurance companies have a formula for greed; they're in exactly the same business, after all.

quote:
Bureaucracy, by the way, seems to me to be a much maligned term.

So is fascism, Bob. And cancer. One has to wonder, perhaps, if much maligned terms are sometimes much maligned for good reason?

quote:
they (bureaucracies) survive because ... they have proven to be the most effective way of getting things done

Not true, Bob. The most effective way of getting things done has long been recognized as a benevolent dictatorship. Cleary, though, the efficacy of a system doesn't always offset the dangers inherent in that system.

Just out of curiosity, Bob, why are we talking about bureaucracy in a thread about health care? Did you bring it up for a reason?

Bob K
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since 11-03-2007
Posts 3860


16 posted 12-15-2009 03:28 AM       View Profile for Bob K   Email Bob K   Edit/Delete Message      Find Poems  View IP for Bob K


Dear Ron,


quote:
  Ron, posting # 15
Just out of curiosity, Bob, why are we talking about bureaucracy in a thread about health care? Did you bring it up for a reason?



quote:
  Ron, posting # 7
I can honestly answer that question with a resounding yes, Reb. I would much rather have caring people helping me rather than a bureaucrat who is both bored with his job and long since hardened by those trying to cheat the system. Wouldn't you?



quote:

Bit of a strawman there Ron.  Why would you suggest that a doctor is a bureaucrat bored with his job?
[quote]

[quote]
No, Reb, I don't think the doctor is any more of a bureaucrat than is the bank clerk that cashes someone's welfare check. The bureaucrat, clearly, is farther upstream.



     Why am I talking about Bureauocracy?  I don’t know, Ron.  It seems a total puzzle to me, since nobody ever talks about bureaucrats around here.  Benevolent dictators, by the way, are not the most effecient because of the severe limitations placed on them by time.  A bureauocracy can last for many centuries and has a built in institutional memory.  The relevency of bureauocracy to health care actually does seem important, because while single bureauocracies may be quite effecient, competing bureauocracies are very expensive and ineffecient, and can be a black hole for for time and proceedure and money.  This is one of the reasons why th single payer system is better and cheaper than competitive private bureauocracies.

     Your point about effeciency not offsetting the inherent dangers is excellent and very well taken.

     My use of the phrase “maligned term” was awkward and poorly chosen.  You were correct to bludgen me about the head and shoulders with it.  It is the institution that is perhaps inappropriately maligned.  Cancer and fascism are of course not admirable things for most of us.  Bureauocracies are gawky, awkward and unlovely.  They are also frequently dehumanizing and insulting and difficult to navigate.
The second folks find a method to replace them that stands the market test, please sign me up.  In the meantime, you’ll notice how people keep voting with their dollars.

     While cassinos and insurance companies may share a formula for their greed, you may notice that casinos settle for a 2% return and seem happy enough, for the most part, to keep it  there.  You will notice perhaps that insurance companies are trying to increase their profit margin in some of the recent legislation to go throuigh the senate finance committee by an extra 15% per year.

     You may also notice that the insurance companies seem to have, for some mysterious reason, managed to avoid a whole lot of anti-trust action against them for a very long time, despite the fact that if their current plans come to fruition they will be guarenteed a pipeline into the pocket of every person in the united states.  

     While I do believe that the health care such a plan might supply could be useful, I do not trust them to supply it without a probable 30% mark-up on the deal.  If you believe the mark-up would be less, I’d be happy to hear your estimation and quite possibly go with your figure.  I do trust that you won’t suggest it is 2%, however.

     Claims adjusters who are doing what kind of work and decline claims get in just as much trouble as claims adjusters who are too easy?  Fopr auto repairs, perhaps, and for house and casualty insurance perhaps, outside situations where the insurance companies decide to try to make extra profits by denial of claims as a company policy for a period of time.  This was the case with State Farm not all that many years back, and they made hundred of millions of dollars by cheating people out of disability money and worse.  State Farm had to pay a lot of money in fines.  I wouldn’t actually take a bet that they lost money on the whole thing though, and they’re certainly doing fine now.  After all, you’re in good hands, aren’t you?  

     Maybe you haven’t had trouble getting health insurance companies to pay, but I certainly have, and so has my wife and so have many of the people that I know.  Some coimpanies are better than others.  Blue cross and blue shield of Massachusetts, for example, was always straightforward with us and with the people we knew, who worked in my wife’s firm.  When we came out west to live in California, we began having problems with Blue Shield of California.  Not all of us, but many of us.

     Whoever was the guy who was watching those claims in Massachusetts is not doing the same sort of thing here in California.  In fact, many physicians in California will not accept health insurance because of problems they’ve had such as they ones I’ve mentioned to you just now.  It’s not unusual to have to pay up front and then try to recoup you money, or at least as much of it as you can, from the company whenever it gets around to fighting with you about your claim.

     So much for now.

Sincerely, Bob Kaven
Local Rebel
Member Ascendant
since 12-21-1999
Posts 5742
Southern Abstentia


17 posted 12-15-2009 09:40 PM       View Profile for Local Rebel   Email Local Rebel   Edit/Delete Message      Find Poems  View IP for Local Rebel

quote:

I think something like 25 cents of every welfare dollar in this country goes to welfare overhead and, like the costs of an ER visit, that money is largely wasted.

When the government gets involved, even the cost of charity goes up



Great!  If this is just about the money then we shall quickly come to agreement, we can even dispense with the discussion of rights(although Mr. Scrooge -- may I please have my Habeas Corpus now?  Or at least some for Tiny Tim?):

quote:

Background A decade ago, the administrative costs of health care in the United States greatly exceeded those in Canada. We investigated whether the ascendancy of computerization, managed care, and the adoption of more businesslike approaches to health care have decreased administrative costs.

Methods For the United States and Canada, we calculated the administrative costs of health insurers, employers' health benefit programs, hospitals, practitioners' offices, nursing homes, and home care agencies in 1999. We analyzed published data, surveys of physicians, employment data, and detailed cost reports filed by hospitals, nursing homes, and home care agencies. In calculating the administrative share of health care spending, we excluded retail pharmacy sales and a few other categories for which data on administrative costs were unavailable. We used census surveys to explore trends over time in administrative employment in health care settings. Costs are reported in U.S. dollars.

Results In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.

Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)

Conclusions The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system. http://content.nejm.org/cgi/content/short/349/8/768



quote:

A common justification for Medicare is that the public health insurance system has an overhead cost which is about 2% of claims, while the private sector has administrative costs between 20%-25% of claims.  This tells us that Medicare is the best system for America…right?

Merrill Mathew’s of the Council for Affordable Health Insurance (CAFI) summarizes the findings of Mark Litow’s paper “Medicare’s Hidden Administrative Costs.”  Litow finds that taking into account extra legal costs from Medicare adjudication and CMS salaries, the administrative cost ratio increases to 5.2%.

Private Insurance on average has administrative costs of 16.7% (varying between 30% for individual policies to 12.5% for large group policies).  Yet these figures are inflated.  If we exclude taxes and profits, as well as sales commissions, then the total administrative costs decrease to 8.9% overall and 8.0% for large group policies.  I do not agree that commissions should be deducted from this this figure but profits and taxes certainly should.  Medicare does not pay taxes and does not make a profit so any fair comparison should exclude these items.  Further, tax revenue from insurance companies adds to the public’s coffers; profits should be seen as a cost of capital.

Even with Litow’s manipulation of the numbers, Medicare seems like a better deal.  Let’s see why:

    * Economies of scale: There are large economies of scale in the insurance business; however ,large insurance companies can certainly replicate the majority of the scale economies Medicare enjoys.
    * Cost of Capital: Medicare incorrectly counts its cost of capital as 0.  The true cost would take into account the direct cost of hiring IRS workers to collect the taxes which pay for Medicare as well as taking into account the distortionary effects of income taxation on workers labor supply decisions.  For the private sector, the costs of capital is transparent: it is simply the interest rate.
    * Demographics: Medicare serves the elderly population and thus has a high cost per enrollee.  In 2003, the average medical cost for Medicare was $6,600 per person per year, while the same figure for private insurance was $2,700.  Thus, if public and private health insurance had the same administrative cost per person, Medicare would still be seen as ‘more efficient’ since Medicare’s administrative cost ratio would be less than half the size of the private insurance’s cost ratio. http://healthcare-economist.com/2006/07/27/medicares-true-administrative-costs/

as previously cited here: http://piptalk.com/pip/Forum6/HTML/001559.html#17



Yet another recycled conversation:

quote:

Here and in another thread where you said private insurance was evil Ron, you seem to be suggesting that the market has made a huge error.  How is that possible?

Didn't private insurance come about because there was a market?  Why?  Because people couldn't pay for healthcare with chickens and green beans anymore.

How did towns get doctors back in the day?  Why -- they sent some kid to medical school -- at municipal expense -- under the guarantee that he'd come back and practice right there in the town.

Sounds like socialized medicine right from the start doesn't it? http://piptalk.com/pip/Forum6/HTML/001559.html#18



What about that socialized military we have Ron?  If we quit subsidizing that do you suppose battleships will become so cheap that everyone can afford one?      

That would give a whole new meaning to the second amendment wouldn't it?  

quote:

Not too mention a Harvard graduate degree? It would also be nice to have a dependable car, a nice house, and the wherewithal to feed and clothe 1.5 children. Maybe we should pass some laws?



Yes we should.  College should be free to anyone who qualifies.  Maybe not Harvard but at least State University.

quote:

It takes some work and not a little sacrifice, but the principles of supply and demand will always keep mass needs affordable for the masses. When the price goes catastrophic and people stop buying, the suppliers are either forced to lower their prices or contend with new suppliers who will. It's basic market dynamics.

Nope, no more than I would suggest farmers should stop trying to make a living in favor of soup kitchens and food banks. We feed people who can't afford to feed themselves, but we don't yet give free food to everyone as some kind of basic human right. If you want to eat filet mignon, you still have to find a way to pay for it. That system seems to work pretty well in America?

What would happen if you could get all the food you wanted and someone else had to pay for it? Would you eat hamburger or filet mignon? How long would you even bother to look at the prices on the packages? What do you think would happen to food prices across America?




Firstly -- food is a medical treatment.  We do provide to everyone -- based upon what they can pay for.  People go into the market with their allotment of foodstamps if they need them, and buy the food they want -- knowing that when their foodstamps run out that's all they get for the month.  So if they want to use it to buy a rib-eye steak -- that's what they can do -- or they can buy enough cheap (usually not very healthy) food and coast through the month with it.

Those of us who can afford to buy our food can do so -- usually very cheaply -- due to substantial government assistance to farmers in the way of subsidies and loans -- which has been necessary to our system just like welfare and social security since the great depression.   Capitalsm didn't work for the family farm either Ron.  Of course -- most of those subsidies go to the huge corporate farms now.

Oh, and let's not forget that our produce is artificially low priced due to illegal slave labor provided usually by immigrants at harvest time.

Enjoy your lettuce and tomatoes!

quote:

Yea, Reb, it would be really great if everyone was rich enough to afford catastrophic health care. It would be even better, though, if health care was more affordable for the masses like everything else the masses need.



Sure thing Ron, all we have to do is subsidize the heck out of Doctors and Hospitals just like we did the farmers, and we can get there!      

[This message has been edited by Local Rebel (12-15-2009 10:22 PM).]

Ron
Administrator
Member Rara Avis
since 05-19-99
Posts 9708
Michigan, US


18 posted 12-15-2009 11:16 PM       View Profile for Ron   Email Ron   Edit/Delete Message      Find Poems   Click to visit Ron's Home Page   View IP for Ron

quote:
While cassinos and insurance companies may share a formula for their greed, you may notice that casinos settle for a 2% return and seem happy enough, for the most part, to keep it there.

The smarter ones do, Bob. Plus, and I don't really know much about it, I suspect the Gaming Commission regulates those games not already regulated by mathematical probabilities.

More importantly, however, casinos are for the most part illegal. Wouldn't it be great if everyone had to drive to Vegas or Atlantic City to buy insurance?

Don't get me wrong, Bob, my intent was not to defend the insurance industry. I just thought some of your earlier comments misrepresented the reality of how they function. I wrote software for the industry for more than a decade and, while all companies are clearly not the same, they don't have to cheat any more than a casino has to cheat. The math is already stacked in their favor. It could just as easily be stacked in your favor if you were willing to take the risks they take.

quote:
Maybe you haven’t had trouble getting health insurance companies to pay, but I certainly have ...

I've had a lot more trouble getting the casinos to pay.

More seriously, no, I've never had trouble getting a health insurance company to pay. I don't pay them, they don't pay me, and neither one of us gives the other any trouble.

quote:
For the United States and Canada, we calculated the administrative costs of health insurers, employers' health benefit programs, hospitals, practitioners' offices, nursing homes, and home care agencies in 1999. We analyzed published data, surveys of physicians, employment data, and detailed cost reports filed by hospitals, nursing homes, and home care agencies. In calculating the administrative share of health care spending, we excluded retail pharmacy sales and a few other categories for which data on administrative costs were unavailable. We used census surveys to explore trends over time in administrative employment in health care settings. Costs are reported in U.S. dollars.

LOL. Sorry, Reb, but throughout both of your daunting quotations, I couldn't help wondering ... how much did those darn studies cost and did it count as administrative overhead?

Just out of curiosity, do you have any studies of what the administrative overhead would be for cash-and-carry health care? You know; you go to the doctor and you write him a check on the way out the door?

BTW, Reb, please remember I wasn't the one complaining about the high cost of helping people. That was you. I merely pointed out that the high cost is systemic and not constrained to just emergency room treatment.

quote:
What about that socialized military we have Ron? If we quit subsidizing that do you suppose battleships will become so cheap that everyone can afford one?

Cute, Reb.

The reality, however, is that if everyone stopped subsidizing the military, we probably wouldn't need any battleships.

Your point, of course, is still valid. There are some things, like battleships, space shuttles, and 2,500 miles of Route 66 that can only be realized through group efforts organized by government. I'm good with that.

Honestly, though, Reb, do you really think that paying your doctor bill falls into that same class of human endeavor?

quote:
Yes we should. College should be free to anyone who qualifies. Maybe not Harvard but at least State University.

I agree, and if you really want to give away our money, I think that would be a much better use for it. I do have to wonder, though, why not Harvard? Is it going to work that way with health care, too? Let's send the poor to doctors who just barely had passing grades?

(It's fodder for another thread, but in my experience people place a value on things commensurate with what it costs them. I suspect free college would be like free high school; less than an ideal learning environment. I'd love to be proven wrong.)

quote:
Those of us who can afford to buy our food can do so -- usually very cheaply -- due to substantial government assistance to farmers in the way of subsidies and loans -- which has been necessary to our system just like welfare and social security since the great depression.

I think the necessity of welfare and (especially!) social security is highly questionable, Reb. Their sustainability even more so. We should probably save that one for another thread, though.

quote:
Oh, and let's not forget that our produce is artificially low priced due to illegal slave labor provided usually by immigrants at harvest time.

Again, that's probably fodder for another thread. Living in California, I knew a few itinerants and, oddly enough, I've met substantially more since moving back to Michigan. I live in farm country now, after all, and Sturgis, less than twenty miles south of my house, is the center of a fairly wide Mexican community. It's the only decent place to get a good chimichanga. Some of the field workers I've known were illegal. None were slaves. They might not have had the choices they would have liked to have, but they still had choices.

quote:
Capitalsm didn't work for the family farm either Ron. Of course -- most of those subsidies go to the huge corporate farms now.

That's not entirely true, Reb. I have numerous farmer friends. From my perspective, I don't think it's greatly different than the rest of America. We see the Fords and the Time Warners and the General Foods, but statistically most of the money, most of the employment, and most of the productivity in this country still rests in the hands of small to medium businesses. The mix may be different for farms and ranches, but the mix hasn't yet disappeared.

Still, you're right in that some industries are certainly defined by an economy of scale. If the family farmer disappears, as some fear may be the case, it will be sad. But it won't really be a big deal for anyone except the family farmer. We don't have very many family car manufacturers, either.

quote:
Sure thing Ron, all we have to do is subsidize the heck out of Doctors and Hospitals just like we did the farmers, and we can get there!

Sounds like a plan, Reb. I would much rather see our money used that way than to just start paying people's bills for them. Double the number of doctors and hospitals and I can practically guarantee you the price of health care would plummet. Ironically, subsidizing the people who actually DO the health care would be a lot cheaper than letting insurance companies continue to subvert supply and demand.


 
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