On Tue, 9 Jun 2009 07:44:51 -0500, "HeyBub"
wrote:

Tim Daneliuk wrote:
.

"Most" of it was no such thing. A good many of us that are
careful investors never touched a CDO, never overleveraged
our mortgages, and would have been just fine through all this
except for one thing: Our incompetent President is busy
both taking wealth away from those who have it, worse still
destroying the institutions that create it, and worst of all,
pursuing a profligate spending policy that assures the
devastation of wealth over the longer term. In effect,
those of us that acted responsibly are seeing our life's
work stolen from us and given to the irresponsible poor
and the irresponsible rich. And *that* is Obama's true
legacy in the making.


There's a method to his seeming madness. Believing, as he does, in equality
of wealth, by driving up the debt he insures that the affluent, for decades
to come, will have much of their capital drained away through taxes. This
will improve "equality" and diminish the spread between the wealthy and the
poor. We all will get closer to parity.

And Poverty


"Lenin called them "useful idiots," those people living in
liberal democracies who by giving moral and material support
to a totalitarian ideology in effect were braiding the rope that
would hang them. Why people who enjoyed freedom and prosperity worked
passionately to destroy both is a fascinating question, one still with us
today. Now the useful idiots can be found in the chorus of appeasement,
reflexive anti-Americanism, and sentimental idealism trying to inhibit
the necessary responses to another freedom-hating ideology, radical Islam"

Bruce C. Thornton, a professor of Classics at American University of Cal State Fresno

What's irritating is that no matter how many times you show these
numbers
to
right wing guys it just doesn't sink in

Hawke

Just to irritate you some more, it still has not sunk in. The
problem is while it is easy to come up with those numbers, it is a
lot harder to know why. Correlation does not mean cause and
effect.

An easy way to decrease the cost of healthcare in the US, would be
to eliminate all procedures which will only prolong someones life
by six months and also eliminate all procedures that do not have a
proven success record. If we had done this say thirty years ago,
we would not have any heart transplants , artificial heart valves,
etc.

Dan

Until you have been involved in the decision whether to treat a
loved one aggressively to prolong life or let go ("let nature take
its course"), you don't know what you are talking about.

It isn't a question of treatment or not. The question is payment.
There isn't any reason a person shouldn't be able to buy insurance to
cover anything they need.
Their needs, and the needs of their families for emotional placation,
are not the needs of society.

JC

If you think payment is the question, not treatment, then I have to
ask payment for what? The cost of (let's say) a liver transplant for
a patient who is going to die soon, whether or not the transplant
occurs, is WAY more than the cost of palliative treatment. I have to
ask what we are insuring against. A basic low(er) level of treatment
costs, or the costs of treating everything. IMNSHO, a asic level of
insurance (however defined) should be compulsory (yes, that bad word,
and whether the employee or the employer pays is ultimately only
semantics). On top of that a person should be allowed to insure
against the costs of more complex events/procedures. Freedom of
personal choice, etc., etc.

Society needs some kind of insurance, and the current system is
dysfunctional.

Government in the medical business is a permanent solution to a temporary
problem. When I was a kid, when you got sick you went to the doctor and
he
did what he could and it didn't cost much. Now he can do a lot more but
it's all cutting edge and the costs are horrendous. A hundred years from
now when the technologies have matured and an NMR scanner is a child's
plaything that you get at Toys R Us for 50 bucks it's going to be back to
where most people can pay for most medical issues out of pocket without it
hurting particularly.

But if we get government involved now then government will still be
involved
then.


So would you rather have the government be involved in health care or just
leave it in the hands of people like used car salesmen? There are private
alternatives that are worse than the government. How about having Bernie
Madoff handling your health care or the management of AIG? Think they would
be better than the government? I don't. The greed of businessmen is what
makes them unacceptable for making decisions on people's health care. You
need people that aren't going to profit from your health problems making the
decisions. Hopefully, medical professionals without a financial interest
would decide what you need.

Hawke

Han wrote:

Society needs some kind of insurance, and the current system is
dysfunctional.

Dysfunctional? 300 million (out of 340 million) have insurance. Of
those, 80% or so are satisfied. Hardly dysfunctional.

Folks are screeching about 40 million of our population are uninsured!
Of these, 14 million are illegal aliens, about 8 million are between
employer-provided insurance, a few million are eligible for Medicaid
and will get it as soon as they apply in the emergency room, many are
young, healthy, cash-strapped people who choose not to have insurance,
plus a few lesser categories.

After doing all the arithmetic, we find there are exactly eight people
in the whole country without insurance who need it.

As a result, there are those who would chance screwing up the system
for 339,999,992 people so these eight would not be inconvenienced.

Bah!

So I have to pay an 8% surcharge on hy hospitalization costs so that 8
people in the US can get care? Hey, bud, you should check your
arithmetic. And if you are between jobs with the full benefits you're
used to, you suddenly have to pay $1300/mo for a family of 2 to keep your
insurance?


Hey, it's not the guy's fault. He's ignorant. He's never had a health
problem that threatened everything he owns. He's never had a health
insurance company cancel his policy because he has a problem they don't want
to pay for or he's never had them raise premiums so high he can't pay them,
and he's never had his employer drop his insurance and make him pay for it
himself. Everyone who has had any of those things happen or simply doesn't
have the money to afford insurance understands what is wrong. The good thing
is that it's only a matter of time before him or someone in his family has
one of those things happen. He'll sing a different tune when he or his wife
has cancer and his insurance company says the treatment isn't covered. Just
wait, it'll happen sooner or later. But that is what it'll take for him to
get it.


Hawke

"Hawke" wrote in
:

So would you rather have the government be involved in health care or
just leave it in the hands of people like used car salesmen? There are
private alternatives that are worse than the government. How about
having Bernie Madoff handling your health care or the management of
AIG? Think they would be better than the government? I don't. The
greed of businessmen is what makes them unacceptable for making
decisions on people's health care. You need people that aren't going
to profit from your health problems making the decisions. Hopefully,
medical professionals without a financial interest would decide what
you need.

Hawke

That is a refreshing point of view, and I would love to 100% support it.
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. To find the right balance between
reasonably profitable and not losing money is the problem, both from the
doctors' point of view and the patients'.


--
Best regards
Han
email address is invalid

Hawke wrote:


Hey, it's not the guy's fault. He's ignorant. He's never had a health
problem that threatened everything he owns. He's never had a health
insurance company cancel his policy because he has a problem they
don't want to pay for or he's never had them raise premiums so high
he can't pay them, and he's never had his employer drop his insurance
and make him pay for it himself. Everyone who has had any of those
things happen or simply doesn't have the money to afford insurance
understands what is wrong. The good thing is that it's only a matter
of time before him or someone in his family has one of those things
happen. He'll sing a different tune when he or his wife has cancer
and his insurance company says the treatment isn't covered. Just
wait, it'll happen sooner or later. But that is what it'll take for
him to get it.



Public policy made on the basis of ancedotal or apophrycal instances or the
"how would you feel if..." mantra is virtually guaranteed to be bad public
policy.

"Han" wrote in message
...

That is a refreshing point of view, and I would love to 100% support it.
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. To find the right balance between
reasonably profitable and not losing money is the problem, both from the
doctors' point of view and the patients'.


--
Best regards
Han

i'm not an expert. i'm wondering why do hospitals need to be profitable?
just had a thought, when the government builds a road i don't think there's
any expectation it's going to turn a profit, it surely profits us all, and
it enables businesses to profit, but (non-toll, and probably a good many
toll) roads, i don't think, earn a profit. infrastructure. can't the
health of citizens, by some stretch of the imagination, be considered
"infrastructure"? or toward some common good?

b.w.

Hawke wrote:
What's irritating is that no matter how many times you show
these numbers
to
right wing guys it just doesn't sink in

Hawke

Just to irritate you some more, it still has not sunk in. The
problem is while it is easy to come up with those numbers, it is
a lot harder to know why. Correlation does not mean cause and
effect.

An easy way to decrease the cost of healthcare in the US, would
be to eliminate all procedures which will only prolong someones
life by six months and also eliminate all procedures that do not
have a proven success record. If we had done this say thirty
years ago, we would not have any heart transplants , artificial
heart valves, etc.

Dan

Until you have been involved in the decision whether to treat a
loved one aggressively to prolong life or let go ("let nature take
its course"), you don't know what you are talking about.

It isn't a question of treatment or not. The question is payment.
There isn't any reason a person shouldn't be able to buy insurance
to cover anything they need.
Their needs, and the needs of their families for emotional
placation, are not the needs of society.

JC

If you think payment is the question, not treatment, then I have to
ask payment for what? The cost of (let's say) a liver transplant
for a patient who is going to die soon, whether or not the
transplant occurs, is WAY more than the cost of palliative
treatment. I have to ask what we are insuring against. A basic
low(er) level of treatment costs, or the costs of treating
everything. IMNSHO, a asic level of insurance (however defined)
should be compulsory (yes, that bad word, and whether the employee
or the employer pays is ultimately only semantics). On top of that
a person should be allowed to insure against the costs of more
complex events/procedures. Freedom of personal choice, etc., etc.

Society needs some kind of insurance, and the current system is
dysfunctional.

Government in the medical business is a permanent solution to a
temporary problem. When I was a kid, when you got sick you went to
the doctor and he did what he could and it didn't cost much. Now he
can do a lot more but it's all cutting edge and the costs are
horrendous. A hundred years from now when the technologies have
matured and an NMR scanner is a child's plaything that you get at
Toys R Us for 50 bucks it's going to be back to where most people
can pay for most medical issues out of pocket without it hurting
particularly.

But if we get government involved now then government will still be
involved then.


So would you rather have the government be involved in health care or
just leave it in the hands of people like used car salesmen? There
are private alternatives that are worse than the government. How
about having Bernie Madoff handling your health care or the
management of AIG? Think they would be better than the government? I
don't. The greed of businessmen is what makes them unacceptable for
making decisions on people's health care. You need people that aren't
going to profit from your health problems making the decisions.
Hopefully, medical professionals without a financial interest would
decide what you need.

I'd rather have _me_ making the decisions thank you.

On Sun, 14 Jun 2009 21:48:24 -0500, "William Wixon"
wrote:


"Han" wrote in message
...

That is a refreshing point of view, and I would love to 100% support it.
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. To find the right balance between
reasonably profitable and not losing money is the problem, both from the
doctors' point of view and the patients'.


--
Best regards
Han

i'm not an expert. i'm wondering why do hospitals need to be profitable?

Because unprofitable businesses don't stay around long.

just had a thought, when the government builds a road i don't think there's
any expectation it's going to turn a profit, it surely profits us all, and
it enables businesses to profit, but (non-toll, and probably a good many
toll) roads, i don't think, earn a profit.

Whew! a breath. Many cities own hospitals. Sometimes that even
works. The federal government has no business owning hospitals or
doctors (or insurance companies, banks, car manufacturers,...)


infrastructure. can't the
health of citizens, by some stretch of the imagination, be considered
"infrastructure"? or toward some common good?

Theft is a common good? Leftists sure think it is.

Hawke wrote:
What's irritating is that no matter how many times you show these
numbers
to
right wing guys it just doesn't sink in

Hawke
Just to irritate you some more, it still has not sunk in. The
problem is while it is easy to come up with those numbers, it is a
lot harder to know why. Correlation does not mean cause and
effect.

An easy way to decrease the cost of healthcare in the US, would be
to eliminate all procedures which will only prolong someones life
by six months and also eliminate all procedures that do not have a
proven success record. If we had done this say thirty years ago,
we would not have any heart transplants , artificial heart valves,
etc.

Dan
Until you have been involved in the decision whether to treat a
loved one aggressively to prolong life or let go ("let nature take
its course"), you don't know what you are talking about.
It isn't a question of treatment or not. The question is payment.
There isn't any reason a person shouldn't be able to buy insurance to
cover anything they need.
Their needs, and the needs of their families for emotional placation,
are not the needs of society.

JC
If you think payment is the question, not treatment, then I have to
ask payment for what? The cost of (let's say) a liver transplant for
a patient who is going to die soon, whether or not the transplant
occurs, is WAY more than the cost of palliative treatment. I have to
ask what we are insuring against. A basic low(er) level of treatment
costs, or the costs of treating everything. IMNSHO, a asic level of
insurance (however defined) should be compulsory (yes, that bad word,
and whether the employee or the employer pays is ultimately only
semantics). On top of that a person should be allowed to insure
against the costs of more complex events/procedures. Freedom of
personal choice, etc., etc.

Society needs some kind of insurance, and the current system is
dysfunctional.
Government in the medical business is a permanent solution to a temporary
problem. When I was a kid, when you got sick you went to the doctor and
he
did what he could and it didn't cost much. Now he can do a lot more but
it's all cutting edge and the costs are horrendous. A hundred years from
now when the technologies have matured and an NMR scanner is a child's
plaything that you get at Toys R Us for 50 bucks it's going to be back to
where most people can pay for most medical issues out of pocket without it
hurting particularly.

But if we get government involved now then government will still be
involved
then.


So would you rather have the government be involved in health care or just
leave it in the hands of people like used car salesmen? There are private
alternatives that are worse than the government. How about having Bernie
Madoff handling your health care or the management of AIG? Think they would
be better than the government? I don't. The greed of businessmen is what

False dichtomy and strawman. These are not the only choices.

makes them unacceptable for making decisions on people's health care. You
need people that aren't going to profit from your health problems making the
decisions. Hopefully, medical professionals without a financial interest
would decide what you need.

Hawke



This is hands-down the low point of this thread. If no one made a
profit in healthcare there would be NO healthcare. Why should gifted
people become doctors, pharma reseachers, nurses, or pharmacists?
Without profit where is the incentive to risk $500M - $1B *per new
drug* on the research side of things. In short, there would be few or
no "medical professionals without a financial interest [to] decide
what you need" without the opportunity for profit.

I'll take greedy business people over boneheaded collectivist ideology
any day of the week.


--
----------------------------------------------------------------------------
Tim Daneliuk
PGP Key: http://www.tundraware.com/PGP/

William Wixon wrote:
"Han" wrote in message
...

That is a refreshing point of view, and I would love to 100% support it.
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. To find the right balance between
reasonably profitable and not losing money is the problem, both from the
doctors' point of view and the patients'.


--
Best regards
Han

i'm not an expert. i'm wondering why do hospitals need to be profitable?
just had a thought, when the government builds a road i don't think there's
any expectation it's going to turn a profit, it surely profits us all, and
it enables businesses to profit, but (non-toll, and probably a good many
toll) roads, i don't think, earn a profit. infrastructure. can't the
health of citizens, by some stretch of the imagination, be considered
"infrastructure"? or toward some common good?

b.w.



I do not wish our hospitals to be run at the same levels as the DMV or
the Highway Department...

--
----------------------------------------------------------------------------
Tim Daneliuk
PGP Key: http://www.tundraware.com/PGP/

"Tim Daneliuk" wrote in This is hands-down the low
point of this thread. If no one made a
profit in healthcare there would be NO healthcare. Why should gifted
people become doctors, pharma reseachers, nurses, or pharmacists?
Without profit where is the incentive to risk $500M - $1B *per new
drug* on the research side of things. In short, there would be few or
no "medical professionals without a financial interest [to] decide
what you need" without the opportunity for profit.

I'll take greedy business people over boneheaded collectivist ideology
any day of the week.


--
----------------------------------------------------------------------------
Tim Daneliuk
PGP Key: http://www.tundraware.com/PGP/

Last company I worked for before I retired was a biomedical company. We
spent $35 million on a new product. Due to mismanagement of the project.
Not my part, we injured a couple of women during the trials. Women's health
product. But without the carrot of a $700 million annual market, do you
think any money would have been spent? One women called me a male
chauvinist because we worked on women's incontinence. She just could not
accept it was profit driven. $700 million a year and 95% of incontinence is
females.

"William Wixon" wrote in
:


"Han" wrote in message
...

That is a refreshing point of view, and I would love to 100% support
it. However, hospitals and doctors need to be profitable, at least to
the extent they aren't losing money. To find the right balance
between reasonably profitable and not losing money is the problem,
both from the doctors' point of view and the patients'.


--
Best regards
Han

i'm not an expert. i'm wondering why do hospitals need to be
profitable? just had a thought, when the government builds a road i
don't think there's any expectation it's going to turn a profit, it
surely profits us all, and it enables businesses to profit, but
(non-toll, and probably a good many toll) roads, i don't think, earn a
profit. infrastructure. can't the health of citizens, by some
stretch of the imagination, be considered "infrastructure"? or toward
some common good?

b.w.

Hospitals need to run not at a loss. A small profit would be good so
they can invest in new facilities and equipment. I would be against
running a hospital as a milk cow.


--
Best regards
Han
email address is invalid

On Jun 14, 10:48*pm, "William Wixon" wrote:
"Han" wrote in message

...

That is a refreshing point of view, and I would love to 100% support it..
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. *To find the right balance between
reasonably profitable and not losing money is the problem, both from the
doctors' point of view and the patients'.

--
Best regards
Han

i'm not an expert. *i'm wondering why do hospitals need to be profitable?
just had a thought, when the government builds a road i don't think there's
any expectation it's going to turn a profit, it surely profits us all, and
it enables businesses to profit, but (non-toll, and probably a good many
toll) roads, i don't think, earn a profit. *infrastructure. *can't the
health of citizens, by some stretch of the imagination, be considered
"infrastructure"? *or toward some common good?

b.w.

Well I think you've hit the nail on the head. The problem here is that
those on the right really don't believe that there is such a thing as
"common good." They believe that the good of individuals is the only
goal. As long as I am doing well, it doesn't really matter how you are
doing - that's your problem.

On Jun 14, 8:17*pm, "HeyBub" wrote:
Hawke wrote:

Hey, it's not the guy's fault. He's ignorant. He's never had a health
problem that threatened everything he owns. He's never had a health
insurance company cancel his policy because he has a problem they
don't want to pay for or he's never had them raise premiums so high
he can't pay them, and he's never had his employer drop his insurance
and make him pay for it himself. Everyone who has had any of those
things happen or simply doesn't have the money to afford insurance
understands what is wrong. The good thing is that it's only a matter
of time before him or someone in his family has one of those things
happen. He'll sing a different tune when he or his wife has cancer
and his insurance company says the treatment isn't covered. Just
wait, it'll happen sooner or later. But that is what it'll take for
him to get it.

Public policy made on the basis of ancedotal or apophrycal instances or the
"how would you feel if..." mantra is virtually guaranteed to be bad public
policy.

Guaranteed by whom? The entire concept of insurance is based on "what
if."

On Jun 14, 6:36*pm, "Hawke" wrote:
What's irritating is that no matter how many times you show these
numbers
*to
right wing guys it just doesn't sink in

Hawke

Just to irritate you some more, it still has not sunk in. *The
problem is while it is easy to come up with those numbers, it is a
lot harder to know why. *Correlation does not mean cause and
effect.

An easy way to decrease the cost of healthcare in the US, would be
to eliminate all procedures which will only prolong someones life
by six months and also eliminate all procedures that do not have a
proven success record. *If we had done this say thirty years ago,
we would not have any heart transplants , artificial heart valves,
etc.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * Dan

Until you have been involved in the decision whether to treat a
loved one aggressively to prolong life or let go ("let nature take
its course"), you don't know what you are talking about.

It isn't a question of treatment or not. The question is payment.
There isn't any reason a person shouldn't be able to buy insurance to
cover anything they need.
Their needs, and the needs of their families for emotional placation,
are not the needs of society.

JC

If you think payment is the question, not treatment, then I have to
ask payment for what? *The cost of (let's say) a liver transplant for
a patient who is going to die soon, whether or not the transplant
occurs, is WAY more than the cost of palliative treatment. *I have to
ask what we are insuring against. *A basic low(er) level of treatment
costs, or the costs of treating everything. *IMNSHO, a asic level of
insurance (however defined) should be compulsory (yes, that bad word,
and whether the employee or the employer pays is ultimately only
semantics). *On top of that a person should be allowed to insure
against the costs of more complex events/procedures. *Freedom of
personal choice, etc., etc.

Society needs some kind of insurance, and the current system is
dysfunctional.

Government in the medical business is a permanent solution to a temporary
problem. *When I was a kid, when you got sick you went to the doctor and
he
did what he could and it didn't cost much. *Now he can do a lot more but
it's all cutting edge and the costs are horrendous. *A hundred years from
now when the technologies have matured and an NMR scanner is a child's
plaything that you get at Toys R Us for 50 bucks it's going to be back to
where most people can pay for most medical issues out of pocket without it
hurting particularly.

But if we get government involved now then government will still be
involved
then.

So would you rather have the government be involved in health care or just
leave it in the hands of people like used car salesmen? There are private
alternatives that are worse than the government. How about having Bernie
Madoff handling your health care or the management of AIG? Think they would
be better than the government? I don't. The greed of businessmen is what
makes them unacceptable for making decisions on people's health care. You
need people that aren't going to profit from your health problems making the
decisions. Hopefully, medical professionals without a financial interest
would decide what you need.

Hawke

Here's another angle:

I pay over $10,000 per year for health insurance. A significant
portion of that bill is for prescription drugs. So why the **** is it
that for the two generic prescriptions I fill each month, it's cheaper
to pay the drug store directly than to pay the copays from the
insurance company?

Last week, I noticed a sign at my supermarket saying that their
pharmacy would fill antibiotic prescriptions for FREE, and many others
for $3.95.

My point is that there MUST be a less expensive way to do this.

rangerssuck wrote:
On Jun 14, 6:36 pm, "Hawke" wrote:
What's irritating is that no matter how many times you show these
numbers
to
right wing guys it just doesn't sink in
Hawke
Just to irritate you some more, it still has not sunk in. The
problem is while it is easy to come up with those numbers, it is a
lot harder to know why. Correlation does not mean cause and
effect.
An easy way to decrease the cost of healthcare in the US, would be
to eliminate all procedures which will only prolong someones life
by six months and also eliminate all procedures that do not have a
proven success record. If we had done this say thirty years ago,
we would not have any heart transplants , artificial heart valves,
etc.
Dan
Until you have been involved in the decision whether to treat a
loved one aggressively to prolong life or let go ("let nature take
its course"), you don't know what you are talking about.
It isn't a question of treatment or not. The question is payment.
There isn't any reason a person shouldn't be able to buy insurance to
cover anything they need.
Their needs, and the needs of their families for emotional placation,
are not the needs of society.
JC
If you think payment is the question, not treatment, then I have to
ask payment for what? The cost of (let's say) a liver transplant for
a patient who is going to die soon, whether or not the transplant
occurs, is WAY more than the cost of palliative treatment. I have to
ask what we are insuring against. A basic low(er) level of treatment
costs, or the costs of treating everything. IMNSHO, a asic level of
insurance (however defined) should be compulsory (yes, that bad word,
and whether the employee or the employer pays is ultimately only
semantics). On top of that a person should be allowed to insure
against the costs of more complex events/procedures. Freedom of
personal choice, etc., etc.
Society needs some kind of insurance, and the current system is
dysfunctional.
Government in the medical business is a permanent solution to a temporary
problem. When I was a kid, when you got sick you went to the doctor and
he
did what he could and it didn't cost much. Now he can do a lot more but
it's all cutting edge and the costs are horrendous. A hundred years from
now when the technologies have matured and an NMR scanner is a child's
plaything that you get at Toys R Us for 50 bucks it's going to be back to
where most people can pay for most medical issues out of pocket without it
hurting particularly.
But if we get government involved now then government will still be
involved
then.
So would you rather have the government be involved in health care or just
leave it in the hands of people like used car salesmen? There are private
alternatives that are worse than the government. How about having Bernie
Madoff handling your health care or the management of AIG? Think they would
be better than the government? I don't. The greed of businessmen is what
makes them unacceptable for making decisions on people's health care. You
need people that aren't going to profit from your health problems making the
decisions. Hopefully, medical professionals without a financial interest
would decide what you need.

Hawke

Here's another angle:

I pay over $10,000 per year for health insurance. A significant
portion of that bill is for prescription drugs. So why the **** is it
that for the two generic prescriptions I fill each month, it's cheaper
to pay the drug store directly than to pay the copays from the
insurance company?

Last week, I noticed a sign at my supermarket saying that their
pharmacy would fill antibiotic prescriptions for FREE, and many others
for $3.95.

My point is that there MUST be a less expensive way to do this.

There is - get the government out of healthcare entirely and watch
competition drive prices down. Prices are artificially high today
precisely because the providers are guaranteed government payment
for some part of the service or pharma vended. The current system
is an unholy mess that tries to retain the benefits of competitive
market-based medicine while inserting government control into the
system. This is no more possible than being kind of pregnant.


--
----------------------------------------------------------------------------
Tim Daneliuk
PGP Key: http://www.tundraware.com/PGP/

rangerssuck wrote:

Well I think you've hit the nail on the head. The problem here is that
those on the right really don't believe that there is such a thing as
"common good." They believe that the good of individuals is the only
goal. As long as I am doing well, it doesn't really matter how you are
doing - that's your problem.

Right. Adam Smith settled this hash in the 18th Century with the publication
of "The Wealth of Nations." In that work, he posited the "Invisible Hand"
(viz.) concept which, briefly, says that when all act in their own best
interests, the community, as a whole, prospers.

Conversely, history has demonstrated that when all are compelled to work for
the "common good" the community suffers.

rangerssuck wrote:

Here's another angle:

I pay over $10,000 per year for health insurance. A significant
portion of that bill is for prescription drugs. So why the **** is it
that for the two generic prescriptions I fill each month, it's cheaper
to pay the drug store directly than to pay the copays from the
insurance company?

Less paperwork? There's overhead in massaging the transaction.

I asked my cardiologist how he could make out charging me only $180 for a
treadmill stress test (I was figuring his and his assistant's time,
equipment, overhead, and so forth). His reply: "Easy. You pay cash."


Last week, I noticed a sign at my supermarket saying that their
pharmacy would fill antibiotic prescriptions for FREE, and many others
for $3.95.

My point is that there MUST be a less expensive way to do this.

rangerssuck wrote:

Public policy made on the basis of ancedotal or apophrycal instances
or the "how would you feel if..." mantra is virtually guaranteed to
be bad public policy.

Guaranteed by whom? The entire concept of insurance is based on "what
if."

Guaranteed by the laws of unintended consequences. "How would you feel if
your grandmother was run over by an 18-wheeler?" would be a ghastly reason
to ban interstate trucking.

Insurance is NOT based on single episodes (unless you're talking about a
Lloyd's policy on the size of Pam Anderson's tits).

"Tim Daneliuk" wrote in message
...
rangerssuck wrote:
On Jun 14, 6:36 pm, "Hawke" wrote:
What's irritating is that no matter how many times you show these
numbers
to
right wing guys it just doesn't sink in
Hawke
Just to irritate you some more, it still has not sunk in. The
problem is while it is easy to come up with those numbers, it is a
lot harder to know why. Correlation does not mean cause and
effect.
An easy way to decrease the cost of healthcare in the US, would be
to eliminate all procedures which will only prolong someones life
by six months and also eliminate all procedures that do not have a
proven success record. If we had done this say thirty years ago,
we would not have any heart transplants , artificial heart valves,
etc.
Dan
Until you have been involved in the decision whether to treat a
loved one aggressively to prolong life or let go ("let nature take
its course"), you don't know what you are talking about.
It isn't a question of treatment or not. The question is payment.
There isn't any reason a person shouldn't be able to buy insurance to
cover anything they need.
Their needs, and the needs of their families for emotional placation,
are not the needs of society.
JC
If you think payment is the question, not treatment, then I have to
ask payment for what? The cost of (let's say) a liver transplant for
a patient who is going to die soon, whether or not the transplant
occurs, is WAY more than the cost of palliative treatment. I have to
ask what we are insuring against. A basic low(er) level of treatment
costs, or the costs of treating everything. IMNSHO, a asic level of
insurance (however defined) should be compulsory (yes, that bad word,
and whether the employee or the employer pays is ultimately only
semantics). On top of that a person should be allowed to insure
against the costs of more complex events/procedures. Freedom of
personal choice, etc., etc.
Society needs some kind of insurance, and the current system is
dysfunctional.
Government in the medical business is a permanent solution to a
temporary
problem. When I was a kid, when you got sick you went to the doctor
and
he
did what he could and it didn't cost much. Now he can do a lot more
but
it's all cutting edge and the costs are horrendous. A hundred years
from
now when the technologies have matured and an NMR scanner is a child's
plaything that you get at Toys R Us for 50 bucks it's going to be back
to
where most people can pay for most medical issues out of pocket without
it
hurting particularly.
But if we get government involved now then government will still be
involved
then.
So would you rather have the government be involved in health care or
just
leave it in the hands of people like used car salesmen? There are
private
alternatives that are worse than the government. How about having Bernie
Madoff handling your health care or the management of AIG? Think they
would
be better than the government? I don't. The greed of businessmen is what
makes them unacceptable for making decisions on people's health care.
You
need people that aren't going to profit from your health problems making
the
decisions. Hopefully, medical professionals without a financial interest
would decide what you need.

Hawke

Here's another angle:

I pay over $10,000 per year for health insurance. A significant
portion of that bill is for prescription drugs. So why the **** is it
that for the two generic prescriptions I fill each month, it's cheaper
to pay the drug store directly than to pay the copays from the
insurance company?

Last week, I noticed a sign at my supermarket saying that their
pharmacy would fill antibiotic prescriptions for FREE, and many others
for $3.95.

My point is that there MUST be a less expensive way to do this.

There is - get the government out of healthcare entirely and watch
competition drive prices down.

There is no real competition in the health care insurance industry, except
for the management of large corporate accounts. Large corporations are not
actually insured by insurance companies; they're self-insured, with the big
insurance companies managing the account for a fee. Corporations have the
best set of incentives to drive health care effectively and efficiently but
it isn't like buying iron ore or accounting services for them, and they,
too, are limited in how much they can shape the overall system.

Prices are artificially high today
precisely because the providers are guaranteed government payment
for some part of the service or pharma vended.

How does that explain the fact that health care prices in Europe run around
1/2 - 2/3 of ours, even where the government guarantees *all* of the payment
there?

Medicare pays only about 80% of what private insurance pays; Medicaid pays
even less. The price standards are set by private managed-care insurers, not
by the government. If it was government-pay only, prices would be at least
20% less just by that fact alone. And corporate benefits managers in Fortune
500 companies are the ones who are determining the managed-care rates.

The current system
is an unholy mess that tries to retain the benefits of competitive
market-based medicine while inserting government control into the
system. This is no more possible than being kind of pregnant.

For the past six years, Big Pharma companies have been my clients, and
private insurers have been my clients' customers (and my audience). You're
quite right that it's an unholy mess, but the reason is a complete
misalignment of incentives.

The incentives to cut costs in the business as a whole are weak. The
stronger incentives are to give at least the impression of relatively
superior care, and, for doctors and hospitals, to justify the use of as many
billable services as possible. For all of the providers, there is a strong
incentive to avoid liability, even at high costs. As any good market theory
will tell us, that's a prescription for prices that are rising faster than
inflation.

There are exceptional hospitals and many physicians who go against the
grain, providing superior care at a much lower-than-average cost. Geisinger
Medical Center in Pennsylvania is an often-cited example; there are others.
They have superior management that bucks the industry trends and habits. But
you can't run a nationwide health care system for 300 million people relying
on superior management. There aren't enough such managers in existence.

You can, however, get much better results by aligning incentives properly so
that all health care management is driven toward a goal of providing better
care for less money. That won't happen as long as the system is mostly
private, because the financial incentives for health care insurers, for
example, are to deny coverage as much as possible; to pay providers as
little as possible; and to exploit the vast statistical and actuarial
complications of health care, along with an advertising and promotion
program in an effective cost benefit ratio, to give the impression of better
service while actually providing as little as they can get away with.
Financial incentives for other providers in the system are similarly twisted
and perverted, although the case is most obvious on the insurance side.

That's not to say health care providers are so cynical that they're driven
only by money, or that they'll always grab the opportunity to deceive. I
worked in that industry long enough to know better. But if financial
incentives are pulling one way and ethical incentives are pulling in a
different way, ethical considerations are going to lose some, if not most,
of the battles. In the end, profit is the most demanding incentive, and the
ways to achieve it are mostly counter-productive to the goal of better and
more cost-efficient care. As the system is structured now, there is no
benefit to coming up with a solution that's 95% as good, but at half the
price. Only killing 5 people out of 100 is not a good advertising slogan in
the health care business.

Whether the system is mostly private or mostly government-run matters much
less than how well the incentives can be aligned with the goals of producing
the best service at the lowest cost. Unlike most industries, health care is
inherently resistant to the benefits of competition, for the reasons I cited
above. It isn't that competition and beneficial incentive structures are
impossible; it's just that no one has figured out how to accomplish them.
You don't go shopping for the best deal when you've just had a heart attack
and they're opening you up. And you don't start searching the Internet for
discount coupons when your child has a fever of 105.

--
Ed Huntress

Ed Huntress wrote:
SNIP

There is no real competition in the health care insurance industry, except
for the management of large corporate accounts. Large corporations are not
actually insured by insurance companies; they're self-insured, with the big
insurance companies managing the account for a fee. Corporations have the
best set of incentives to drive health care effectively and efficiently but
it isn't like buying iron ore or accounting services for them, and they,
too, are limited in how much they can shape the overall system.

Nonsense. Take a look at what is going on in places like Wal-Mart
and other large chain clinics that are operating on a no-insurance
basis (at least some of them are) and compare their prices to the
costs assessed in traditional government-supported care facilities.
It's not even close. Take a look at what happens to pharma prices
when the regulatory bozos get out of the way and let people
order their meds over the internet.


Prices are artificially high today
precisely because the providers are guaranteed government payment
for some part of the service or pharma vended.

How does that explain the fact that health care prices in Europe run around
1/2 - 2/3 of ours, even where the government guarantees *all* of the payment
there?

Now compare the depth, completeness, and speed of care here and there.
Care can cost more in the U.S. because everyone wants - and mostly gets -
instant, very high quality care on-demand. This is decidedly not the
case in the socialized systems with which I am most familiar (Canada and
the UK leap to mind). Also, those European "prices" often to not
fairly reflect the actual tax burden associated with them. Something
can only be "cheap" or "free" in that world if someone is propping it
up with Other People's Money.


Medicare pays only about 80% of what private insurance pays; Medicaid pays
even less. The price standards are set by private managed-care insurers, not
by the government. If it was government-pay only, prices would be at least
20% less just by that fact alone. And corporate benefits managers in Fortune
500 companies are the ones who are determining the managed-care rates.

No they wouldn't - the *apparent* price would fall because - like I said -
the collectivists never want to express the real cost of burdensome taxation,
government bureaucracy, and picking up the tab for the various kinds
of self-inflicted wounds so popular among today's professional victims.
You're an economist (or very well educated therein). You should know this
better than anyone: Price is a measure of scarcity that directs resources.
Without a fair and transparent market, price/scarcity cannot be ascertained.
When government is in charge, it artificially decides what is- and is not
scarce and who should get what. This is inefficient, expensive, and ultimately
ineffective, at least by comparison to the alternatives.

SNIP

You can, however, get much better results by aligning incentives properly so
that all health care management is driven toward a goal of providing better
care for less money. That won't happen as long as the system is mostly
private, because the financial incentives for health care insurers, for
example, are to deny coverage as much as possible; to pay providers as
little as possible; and to exploit the vast statistical and actuarial
complications of health care, along with an advertising and promotion
program in an effective cost benefit ratio, to give the impression of better
service while actually providing as little as they can get away with.
Financial incentives for other providers in the system are similarly twisted
and perverted, although the case is most obvious on the insurance side.

IOW, the only way to fix the incentives is by the point of the government's
gun. You want to replace voluntary private sector commercial arrangements
with the coercive power of an institution than can't run the DMV properly,
can't manage to appoint a cabinet full of people that have all paid their
own taxes, can't manage to balance a budget, and mostly works like a
large scale version of villagers with torches. Wonderful.

That's not to say health care providers are so cynical that they're driven
only by money, or that they'll always grab the opportunity to deceive. I
worked in that industry long enough to know better. But if financial
incentives are pulling one way and ethical incentives are pulling in a
different way, ethical considerations are going to lose some, if not most,
of the battles. In the end, profit is the most demanding incentive, and the
ways to achieve it are mostly counter-productive to the goal of better and
more cost-efficient care. As the system is structured now, there is no
benefit to coming up with a solution that's 95% as good, but at half the
price. Only killing 5 people out of 100 is not a good advertising slogan in
the health care business.

Again, you fail to make the comparison with the alternative. The
government has *no* respect for ethics - only power. The government
innately works for the "group not the individual - I can think of
no more terrifying place to apply this than healthca "Since, on average,
people your age don't get strokes, we're not obligated to do much about
yours." The government operates by compromise not principle and it will
always be worse, therefore, than the most debauched profit-motivated
private sector actor (except those that act fraudulently).


Whether the system is mostly private or mostly government-run matters much
less than how well the incentives can be aligned with the goals of producing
the best service at the lowest cost. Unlike most industries, health care is
inherently resistant to the benefits of competition, for the reasons I cited
above. It isn't that competition and beneficial incentive structures are
impossible; it's just that no one has figured out how to accomplish them.

Wal-Mart has. Some of my local drugstore chains have. The freestanding
"quicky clinic" on the corner has. The real problem here in IL is that
the liability laws are insane and are driving medical practitioners out of
the state. When a newly minted Ob/Gyn has to pay upwards of a half million
dollars (give or take) per year for liability insurance, it's hard to
keep those folks in state.


----------------------------------------------------------------------------
Tim Daneliuk
PGP Key: http://www.tundraware.com/PGP/

On Jun 15, 10:29*am, "HeyBub" wrote:
rangerssuck wrote:

Public policy made on the basis of ancedotal or apophrycal instances
or the "how would you feel if..." mantra is virtually guaranteed to
be bad public policy.

Guaranteed by whom? The entire concept of insurance is based on "what
if."

Guaranteed by the laws of unintended consequences. "How would you feel if
your grandmother was run over by an 18-wheeler?" would be a ghastly reason
to ban interstate trucking.

Insurance is NOT based on single episodes (unless you're talking about a
Lloyd's policy on the size of Pam Anderson's tits).

But the scenarios that Hawke was talking about are not at all
uncommon. People DO have their policies canceled as soon as they get
sick, they DO pay rates that are untenably high, they DO lose their
policies because their employer refuses to pay it any longer.

These things may not have happened to you, yet, but they have happened
to many, many people.

Han wrote:
"Hawke" wrote in
:

So would you rather have the government be involved in health care or
just leave it in the hands of people like used car salesmen? There are
private alternatives that are worse than the government. How about
having Bernie Madoff handling your health care or the management of
AIG? Think they would be better than the government? I don't. The
greed of businessmen is what makes them unacceptable for making
decisions on people's health care. You need people that aren't going
to profit from your health problems making the decisions. Hopefully,
medical professionals without a financial interest would decide what
you need.

Hawke

That is a refreshing point of view, and I would love to 100% support it.
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. To find the right balance between
reasonably profitable and not losing money is the problem, both from the
doctors' point of view and the patients'.


How about a non-profit organization. Take a close look at Kaiser
Permanente. DAGS. Here's a place to start
https://www.kaiserpermanente.org/. I've been a satisfied customer for
40 years. The company sees patients/consumers as their customers rather
than the stockholders.
mahalo,
jo4hn

HeyBub wrote:
rangerssuck wrote:
Well I think you've hit the nail on the head. The problem here is that
those on the right really don't believe that there is such a thing as
"common good." They believe that the good of individuals is the only
goal. As long as I am doing well, it doesn't really matter how you are
doing - that's your problem.

Right. Adam Smith settled this hash in the 18th Century with the publication
of "The Wealth of Nations." In that work, he posited the "Invisible Hand"
(viz.) concept which, briefly, says that when all act in their own best
interests, the community, as a whole, prospers.

Conversely, history has demonstrated that when all are compelled to work for
the "common good" the community suffers.


Or to paraphrase Greenspan (The Age of Turbulence), "when all act in
their own best interests with honesty and transparency..." History has
also demonstrated that honesty is not the normal situation.

HeyBub wrote:
rangerssuck wrote:

Public policy made on the basis of ancedotal or apophrycal instances
or the "how would you feel if..." mantra is virtually guaranteed to
be bad public policy.

Guaranteed by whom? The entire concept of insurance is based on "what
if."

Guaranteed by the laws of unintended consequences. "How would you
feel if your grandmother was run over by an 18-wheeler?" would be a
ghastly reason to ban interstate trucking.

Insurance is NOT based on single episodes (unless you're talking
about a Lloyd's policy on the size of Pam Anderson's tits).

A real world example was the guy who took out a policy with Lloyds that paid
off if they put a man on the Moon the year the Mets won the pennant. Who'da
thunk . . .

"rangerssuck" wrote:

===================================
Well I think you've hit the nail on the head. The problem here is that
those on the right really don't believe that there is such a thing as
"common good." They believe that the good of individuals is the only
goal. As long as I am doing well, it doesn't really matter how you are
doing - that's your problem.
=======================================

AKA: The Reagen doctrine.

I got mine, you're on your own.

Lew

jo4hn wrote:
HeyBub wrote:
rangerssuck wrote:
Well I think you've hit the nail on the head. The problem here is that
those on the right really don't believe that there is such a thing as
"common good." They believe that the good of individuals is the only
goal. As long as I am doing well, it doesn't really matter how you are
doing - that's your problem.

Right. Adam Smith settled this hash in the 18th Century with the
publication of "The Wealth of Nations." In that work, he posited the
"Invisible Hand" (viz.) concept which, briefly, says that when all act
in their own best interests, the community, as a whole, prospers.

Conversely, history has demonstrated that when all are compelled to
work for the "common good" the community suffers.

Or to paraphrase Greenspan (The Age of Turbulence), "when all act in
their own best interests with honesty and transparency..." History has
also demonstrated that honesty is not the normal situation.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ ^^^^^^^^^^^

I'm not sure that's really true. For example, most individuals I know
of every flavor, political persuasion, ethnicity, etc. are
fundamentally pretty honest folks. It follows that when acting in
larger groups, they will similarly be (mostly) honest.

I think something rather different is afoot here. Government (at least
in the U.S.) was chartered to protect liberty. It was given the power
to act in matters of force, fraud, and/or threat because these three
areas are the ways that people steal each others freedoms. Now, for
some almost 100 years, the U.S. government has been off busy doing all
manner of other things: trying to run education, trying to run
healthcare, trying to make business 'fair', sticking its nose into the
private business of its citizens' bedrooms, boardrooms, and family
rooms, meddling in the affairs of other nations around the world, and
so forth.

I would suggest that our government is so busy doing things is is NOT
supposed to do, it has insufficient resources focused on what it *is*
supposed to do. So, when those few people that are dishonest are
lying, cheating, and stealing, they get away with more often than they
should. Here's a real good example from current times: Today's
Congress Critters and the various bilious blowhards in the
Administration will tell you that the centerpiece of our current
economic woe lies with the Eeeeeeeeeevil Bankers (tm). But they're
kidding themselves and you/me. The politicians are so bent on trying
to meddle with market forces that they are *not* focusing on a number
of other clear contributors to the problem, some of which were/are
flat out fraud:


1) The government's own contribution to the problem in the form
of CRA and its ilk undermining yet more government run
nonsense - Fanny/Freddie. At the very least this was terrible
judgment, and in the case of some people like Barney Frank it
borders on outright fraud.

2) The individual borrowers that flat out lied about their incomes
to get interest only mortgages as they speculated in a (they thought)
always rising market.

3) The unequivocal fraud precipitated by some hedge funds when they
traded "naked" short options - something that has been illegal
(for very good reasons) for decades.

In each of these (and many other citeable cases), the government has
been so busy do-gooding and fiddling in ways it was never chartered to
in the first place, that these kinds of abuses and/or fraud
go untouched. Despite what the tax-the-rich schemers think, there
are a finite resources available to fund government. I'd much
prefer those were directed at going after the few scammers than
trying to interdict in virtually every other aspect of business
and personal life (and this goes in about equal amounts for the
conservatives and the libs).

--
----------------------------------------------------------------------------
Tim Daneliuk
PGP Key: http://www.tundraware.com/PGP/

On Sun, 14 Jun 2009 12:27:23 -0400, "J. Clarke"
wrote:


You and Obama and your "compulsory insurance". So now you are putting
people who are already having to choose between paying the rent and buying
food in the position of having to pay for insurance or be punished by the
government. Sorry, but you and Obama are really out of touch with the
notion of "poor".


Obama..the fellow that wears $540 tennis shoes when he does a publicity
stunt to "help the poor"


"Lenin called them "useful idiots," those people living in
liberal democracies who by giving moral and material support
to a totalitarian ideology in effect were braiding the rope that
would hang them. Why people who enjoyed freedom and prosperity worked
passionately to destroy both is a fascinating question, one still with us
today. Now the useful idiots can be found in the chorus of appeasement,
reflexive anti-Americanism, and sentimental idealism trying to inhibit
the necessary responses to another freedom-hating ideology, radical Islam"

Bruce C. Thornton, a professor of Classics at American University of Cal State Fresno

On Mon, 15 Jun 2009 11:58:23 -0500, Tim Daneliuk
wrote:

Ed Huntress wrote:
SNIP

There is no real competition in the health care insurance industry, except
for the management of large corporate accounts. Large corporations are not
actually insured by insurance companies; they're self-insured, with the big
insurance companies managing the account for a fee. Corporations have the
best set of incentives to drive health care effectively and efficiently but
it isn't like buying iron ore or accounting services for them, and they,
too, are limited in how much they can shape the overall system.

Nonsense. Take a look at what is going on in places like Wal-Mart
and other large chain clinics that are operating on a no-insurance
basis (at least some of them are) and compare their prices to the
costs assessed in traditional government-supported care facilities.
It's not even close. Take a look at what happens to pharma prices
when the regulatory bozos get out of the way and let people
order their meds over the internet.


The 5 meds I take every day, if purchased from other than Walmart/Target
cost $385

At Walmart/Target, they total $45 a month. One of them is the $25
one..the other 4 equal less than $20/month

Gunner

"Lenin called them "useful idiots," those people living in
liberal democracies who by giving moral and material support
to a totalitarian ideology in effect were braiding the rope that
would hang them. Why people who enjoyed freedom and prosperity worked
passionately to destroy both is a fascinating question, one still with us
today. Now the useful idiots can be found in the chorus of appeasement,
reflexive anti-Americanism, and sentimental idealism trying to inhibit
the necessary responses to another freedom-hating ideology, radical Islam"

Bruce C. Thornton, a professor of Classics at American University of Cal State Fresno

Lew Hodgett wrote:
"rangerssuck" wrote:

===================================
Well I think you've hit the nail on the head. The problem here is that
those on the right really don't believe that there is such a thing as
"common good." They believe that the good of individuals is the only
goal. As long as I am doing well, it doesn't really matter how you are
doing - that's your problem.
=======================================

AKA: The Reagen doctrine.

I got mine, you're on your own.

Lew



No, the doctrine is called 'individual liberty'.

Outside some very narrow areas like the so-called "commons" (air,
water, risk of pandemic disease ...) there is no such thing as the
"common good". The "common good" is a pernicious notion invented by
people seeking power so that you'll follow them. They appeal to the
"but its good for everyone" argument, neglecting the fact that such
schemes inevitably require people to give up some or all of their
liberty. Such schemes benefit some to the detriment of others.
Such schemes place the few in charge of the many. Such schemes
are essentially totalitarian, dishonest, at least dangerous,
and at worst murderous. Such schemes cripple political, religious,
intellectual, and economic freedom.

I struggle sometimes to know what's good for me. I am pretty sure I
don't know what's good for you and I am *certain* that I do not know
what's good for other larger groups of people, the "common good". So
long as people do not steal, use force, or threaten each other, it is
simply no one else's business how they live their lives (as adults).

"The Common Good" in many forms has been the basic argument put forth
by every thug, gang, tin pot dictator, genocidal maniac, and human
rights violater throughout history. The argument took on many forms:

- Do it for the good of the tribe
- Do if for in the name of God
- Do it for the good of your Sovereign
- Do if for the good of your nation/community/race/ethnicity/cause

Every single one of these Common Good arguments always boils down to,
"You the many shall be forced to do what we the few dictate." The last
100 years alone is littered with the results of people forcing the
"Common Good" down their neighbors' throats. Here's just a few
memories from the Common Good Hit Parade

- The Bolshevik Revolution
- 1930s starvation of the Ukrainians by the Russians
- The attack of Nanking by Japan
- 1935 and following in Germany, Japan, and Italy
- Viet Nam, Cambodia, Laos
- The Chinese Maoist era
- The Castro Era
- Muslim-on-Muslim violence in the Middle East
- Congo, Somalia, Mauretania, South Africa, and Darfur
- Hussein's Iraq

*Every one of these* were genocidal nightmares (Hitler, Stalin,
and Tojo alone top something staggering like 100M dead at their
hands. Pol Pot was good for 1.7M. The Tutsi-Huttus another 1+M.
The Muslims of the Middle East, some 3+ M.). *Every one of these*
argued that they were working for the "common good" of their
people/nation/tribe/religion ...

You can keep your common good and the attendant villagers with
torches. I want my freedom ...




--
----------------------------------------------------------------------------
Tim Daneliuk
PGP Key: http://www.tundraware.com/PGP/

"Tim Daneliuk" wrote in message
...
Ed Huntress wrote:
SNIP

There is no real competition in the health care insurance industry,
except
for the management of large corporate accounts. Large corporations are
not
actually insured by insurance companies; they're self-insured, with the
big
insurance companies managing the account for a fee. Corporations have the
best set of incentives to drive health care effectively and efficiently
but
it isn't like buying iron ore or accounting services for them, and they,
too, are limited in how much they can shape the overall system.

Nonsense. Take a look at what is going on in places like Wal-Mart
and other large chain clinics that are operating on a no-insurance
basis (at least some of them are) and compare their prices to the
costs assessed in traditional government-supported care facilities.
It's not even close. Take a look at what happens to pharma prices
when the regulatory bozos get out of the way and let people
order their meds over the internet.

Nonsense back at you. g If you select a few treatments, drugs, and tests
that you're going to supply to the exclusion of all others, and don't have
to carry the full overhead of a regular medical facility, you can make them
as cheap as you want to. It all depends on what you're going to do.

As for letting the regulatory bozos get out of the way, Wal-Mart's clinics
are fully government regulated, and they are in most, if not all cases,
co-sponsored by local hospitals. If someone shows up with something more
serious they send them on to the hospital:

http://walmartstores.com/FactsNews/NewsRoom/6419.aspx

Wal-Mart's initiative is a good one, but it's a part of the existing
system -- licensing, regulation, and so on. They're regulated the same as
any other pharmacy or treatment facility. They just concentrate on the least
expensive kinds of work. As for high pharma prices, they're the result of
the US having the world's only major drug market with no price regulation.
When you buy patented drugs or generics, you're paying the free-market price
for either one. The high prices are not the result of regulation; they're
the result of LACK of regulation. Just look at what the same drugs cost in
other countries, where prices are regulated to beat hell.


Prices are artificially high today
precisely because the providers are guaranteed government payment
for some part of the service or pharma vended.

How does that explain the fact that health care prices in Europe run
around
1/2 - 2/3 of ours, even where the government guarantees *all* of the
payment
there?

Now compare the depth, completeness, and speed of care here and there.
Care can cost more in the U.S. because everyone wants - and mostly gets -
instant, very high quality care on-demand. This is decidedly not the
case in the socialized systems with which I am most familiar (Canada and
the UK leap to mind). Also, those European "prices" often to not
fairly reflect the actual tax burden associated with them. Something
can only be "cheap" or "free" in that world if someone is propping it
up with Other People's Money.

There have been endless studies that show that simply isn't true. Those are
mostly myths. Of course European costs are paid with taxes. But the
accounting for costs has been done by the best professionals in the field.



Medicare pays only about 80% of what private insurance pays; Medicaid
pays
even less. The price standards are set by private managed-care insurers,
not
by the government. If it was government-pay only, prices would be at
least
20% less just by that fact alone. And corporate benefits managers in
Fortune
500 companies are the ones who are determining the managed-care rates.

No they wouldn't - the *apparent* price would fall because - like I said -
the collectivists never want to express the real cost of burdensome
taxation,
government bureaucracy, and picking up the tab for the various kinds
of self-inflicted wounds so popular among today's professional victims.
You're an economist (or very well educated therein). You should know this
better than anyone: Price is a measure of scarcity that directs
resources.
Without a fair and transparent market, price/scarcity cannot be
ascertained.
When government is in charge, it artificially decides what is- and is not
scarce and who should get what. This is inefficient, expensive, and
ultimately
ineffective, at least by comparison to the alternatives.

ho! Economics is one of my two lifelong academic hobbies, the other being
constitutional law, although I did study it some in college. My son is a
senior economics major and math minor, and he's already disgusted with my
inability to follow the econometric models he works with. I don't do
third-semester calculus or linear algebra. g

I'm a writer and editor. Before I went freelance again, I spent five years
in medical editing, winding up as Senior Medical Editor in the managed care
(HMOs, PPOs, Medicare) division of a medical communications company. That
was a full-body immersion in the economics of health care, and I worked with
some top experts in medical economics.

As for competition in the field, of course it would be the best way to
handle it and is always to be preferred, IMO, if the pieces align to produce
the benefits we all associate with real competition. But, as I said,
competition is pretty much an illusion in health care. We're the only
developed country with no price regulation on drugs -- it's a free-market
free-for-all. And we have the highest drug prices in the world, by far. It
seems that people will pay anything they can to prolong their lives. That's
why Europe has lost so much of their pharma infrastructure to the US; this
is where the real money is. Within 25 miles of my house, our clients
included Pfizer, Sanofi-Aventis, Bayer, Merck, Wyeth, Novartis, and too many
others to list.


SNIP

You can, however, get much better results by aligning incentives properly
so
that all health care management is driven toward a goal of providing
better
care for less money. That won't happen as long as the system is mostly
private, because the financial incentives for health care insurers, for
example, are to deny coverage as much as possible; to pay providers as
little as possible; and to exploit the vast statistical and actuarial
complications of health care, along with an advertising and promotion
program in an effective cost benefit ratio, to give the impression of
better
service while actually providing as little as they can get away with.
Financial incentives for other providers in the system are similarly
twisted
and perverted, although the case is most obvious on the insurance side.

IOW, the only way to fix the incentives is by the point of the
government's
gun. You want to replace voluntary private sector commercial arrangements
with the coercive power of an institution than can't run the DMV properly,
can't manage to appoint a cabinet full of people that have all paid their
own taxes, can't manage to balance a budget, and mostly works like a
large scale version of villagers with torches. Wonderful.

I'd disagree with your characterization of government. If you want to see a
screw-up, you should see the way Sanofi handled the last drug I worked on,
spending $110 million on pre-approval marketing alone, and then having the
drug fail FDA approval -- for a good reason that S-A should have known going
in.



That's not to say health care providers are so cynical that they're
driven
only by money, or that they'll always grab the opportunity to deceive. I
worked in that industry long enough to know better. But if financial
incentives are pulling one way and ethical incentives are pulling in a
different way, ethical considerations are going to lose some, if not
most,
of the battles. In the end, profit is the most demanding incentive, and
the
ways to achieve it are mostly counter-productive to the goal of better
and
more cost-efficient care. As the system is structured now, there is no
benefit to coming up with a solution that's 95% as good, but at half the
price. Only killing 5 people out of 100 is not a good advertising slogan
in
the health care business.

Again, you fail to make the comparison with the alternative. The
government has *no* respect for ethics - only power. The government
innately works for the "group not the individual - I can think of
no more terrifying place to apply this than healthca "Since, on
average,
people your age don't get strokes, we're not obligated to do much about
yours." The government operates by compromise not principle and it will
always be worse, therefore, than the most debauched profit-motivated
private sector actor (except those that act fraudulently).

The relative success of other countries' systems suggests that is so much
bunk. I worked in the health care industry. I have no faith in its structure
of motivations, incentives, or results, taken as a whole. The system, as it
really works, doesn't give a damn about you -- unless you have a lot of
money, in which case you're all set.



Whether the system is mostly private or mostly government-run matters
much
less than how well the incentives can be aligned with the goals of
producing
the best service at the lowest cost. Unlike most industries, health care
is
inherently resistant to the benefits of competition, for the reasons I
cited
above. It isn't that competition and beneficial incentive structures are
impossible; it's just that no one has figured out how to accomplish them.

Wal-Mart has. Some of my local drugstore chains have.

Right. For flu shots and blood pressure testing, and to dispense cheap,
50-year-old drugs whose patents have long expired.

The freestanding
"quicky clinic" on the corner has. The real problem here in IL is that
the liability laws are insane and are driving medical practitioners out of
the state. When a newly minted Ob/Gyn has to pay upwards of a half
million
dollars (give or take) per year for liability insurance, it's hard to
keep those folks in state.

That's the free market for you. Nobody is regulating tort lawyers. It's a
free-enterprise system, with a democratic selection of juries. d8-)

Now, if the quicky clinic was so bold as to get into the riskier aspects of
medicine, they wouldn't be so cheap. But ask for an arterial stent and
they'll send you away.

--
Ed Huntress

"Gunner Asch" wrote in message
...
On Mon, 15 Jun 2009 11:58:23 -0500, Tim Daneliuk
wrote:

Ed Huntress wrote:
SNIP

There is no real competition in the health care insurance industry,
except
for the management of large corporate accounts. Large corporations are
not
actually insured by insurance companies; they're self-insured, with the
big
insurance companies managing the account for a fee. Corporations have
the
best set of incentives to drive health care effectively and efficiently
but
it isn't like buying iron ore or accounting services for them, and they,
too, are limited in how much they can shape the overall system.

Nonsense. Take a look at what is going on in places like Wal-Mart
and other large chain clinics that are operating on a no-insurance
basis (at least some of them are) and compare their prices to the
costs assessed in traditional government-supported care facilities.
It's not even close. Take a look at what happens to pharma prices
when the regulatory bozos get out of the way and let people
order their meds over the internet.


The 5 meds I take every day, if purchased from other than Walmart/Target
cost $385

At Walmart/Target, they total $45 a month. One of them is the $25
one..the other 4 equal less than $20/month

Gunner

Not likely. You're probably taking something like the generics for Altace
(ramipril); Toprol (metoprolol succinate); and some rough substitutes for
Plavix and Lipitor. Then you're taking coated 325 mg aspirin.

Or some similar set of generic equivalents. Those are all cheap. The
patented ones -- the Altace, Toprol, Plavix and Lipitor -- cost a bundle,
anywhere.

Wal-Mart and Target are not in the business of giving away drugs. They're in
the business of finding cheap generics.

--
Ed Huntress

J. Clarke wrote:
HeyBub wrote:
rangerssuck wrote:
Public policy made on the basis of ancedotal or apophrycal instances
or the "how would you feel if..." mantra is virtually guaranteed to
be bad public policy.
Guaranteed by whom? The entire concept of insurance is based on "what
if."
Guaranteed by the laws of unintended consequences. "How would you
feel if your grandmother was run over by an 18-wheeler?" would be a
ghastly reason to ban interstate trucking.

Insurance is NOT based on single episodes (unless you're talking
about a Lloyd's policy on the size of Pam Anderson's tits).

A real world example was the guy who took out a policy with Lloyds that paid
off if they put a man on the Moon the year the Mets won the pennant. Who'da
thunk . . .


Like most of the Credit Default Swaps, this isn't really insurance. It
is pure gambling and should be handled through bookies.

If a person wants insurance, they ought to be required to show how the
event they are insuring against can actually hurt them. And the degree
to which they can be hurt should be the limit of their insurability.

Otherwise they should see a bookie.

On Mon, 15 Jun 2009 14:33:54 -0500, Tim Daneliuk
wrote:


*Every one of these* were genocidal nightmares (Hitler, Stalin,
and Tojo alone top something staggering like 100M dead
175 million, plus when you include Mao.


"Lenin called them "useful idiots," those people living in
liberal democracies who by giving moral and material support
to a totalitarian ideology in effect were braiding the rope that
would hang them. Why people who enjoyed freedom and prosperity worked
passionately to destroy both is a fascinating question, one still with us
today. Now the useful idiots can be found in the chorus of appeasement,
reflexive anti-Americanism, and sentimental idealism trying to inhibit
the necessary responses to another freedom-hating ideology, radical Islam"

Bruce C. Thornton, a professor of Classics at American University of Cal State Fresno

jo4hn wrote:
HeyBub wrote:
rangerssuck wrote:
Well I think you've hit the nail on the head. The problem here is
that those on the right really don't believe that there is such a
thing as "common good." They believe that the good of individuals
is the only goal. As long as I am doing well, it doesn't really
matter how you are doing - that's your problem.

Right. Adam Smith settled this hash in the 18th Century with the
publication of "The Wealth of Nations." In that work, he posited the
"Invisible Hand" (viz.) concept which, briefly, says that when all
act in their own best interests, the community, as a whole, prospers.

Conversely, history has demonstrated that when all are compelled to
work for the "common good" the community suffers.


Or to paraphrase Greenspan (The Age of Turbulence), "when all act in
their own best interests with honesty and transparency..." History
has also demonstrated that honesty is not the normal situation.

Greenspan was a government toady.

Greenspan was wrong - way wrong. The entire commercial universe is built
upon voluntary contracts, compliance with those contracts, and trust.

GOVERNMENTS must deceive to exist, commercial interests must tell the truth
or die.

Oh, there are times when governments tell the truth and there are instances
of corporations lying. But in general, those are rare.

Ed Huntress wrote:


Nonsense. Take a look at what is going on in places like Wal-Mart
and other large chain clinics that are operating on a no-insurance
basis (at least some of them are) and compare their prices to the
costs assessed in traditional government-supported care facilities.
It's not even close. Take a look at what happens to pharma prices
when the regulatory bozos get out of the way and let people
order their meds over the internet.

Nonsense back at you. g If you select a few treatments, drugs, and
tests that you're going to supply to the exclusion of all others, and
don't have to carry the full overhead of a regular medical facility,
you can make them as cheap as you want to. It all depends on what
you're going to do.
As for letting the regulatory bozos get out of the way, Wal-Mart's
clinics are fully government regulated, and they are in most, if not
all cases, co-sponsored by local hospitals. If someone shows up with
something more serious they send them on to the hospital:

http://walmartstores.com/FactsNews/NewsRoom/6419.aspx

Wal-Mart's initiative is a good one, but it's a part of the existing
system -- licensing, regulation, and so on. They're regulated the
same as any other pharmacy or treatment facility. They just
concentrate on the least expensive kinds of work. As for high pharma
prices, they're the result of the US having the world's only major
drug market with no price regulation. When you buy patented drugs or
generics, you're paying the free-market price for either one. The
high prices are not the result of regulation; they're the result of
LACK of regulation. Just look at what the same drugs cost in other
countries, where prices are regulated to beat hell.

Right. The U.S. is subsidizing the drugs for the rest of the world. If a
drug company manufacturers a drug they probably plan on recouping their
investment by sales in the U.S. Discounted sales to other countries (greater
than manufacturing costs) are gravy.

Conversely, it's a balance of terror situation. If a drug company declines
to sell its patented drug to, say, Canada at a steep discount, Canada can
simply say we won't recognize the patent on the drug - it's for the
children. This will set off massive retaliatory measures on both sides,
probably leading to war and pestilence.

In that case, one can only hope for the popcorn concession.

On Mon, 15 Jun 2009 03:52:29 -0700 (PDT), rangerssuck
wrote:

On Jun 14, 10:48*pm, "William Wixon" wrote:
"Han" wrote in message

...

That is a refreshing point of view, and I would love to 100% support it.
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. *To find the right balance between
reasonably profitable and not losing money is the problem, both from the
doctors' point of view and the patients'.

--
Best regards
Han

i'm not an expert. *i'm wondering why do hospitals need to be profitable?
just had a thought, when the government builds a road i don't think there's
any expectation it's going to turn a profit, it surely profits us all, and
it enables businesses to profit, but (non-toll, and probably a good many
toll) roads, i don't think, earn a profit. *infrastructure. *can't the
health of citizens, by some stretch of the imagination, be considered
"infrastructure"? *or toward some common good?

b.w.

Well I think you've hit the nail on the head. The problem here is that
those on the right really don't believe that there is such a thing as
"common good." They believe that the good of individuals is the only
goal. As long as I am doing well, it doesn't really matter how you are
doing - that's your problem.

Society only functions when the good of the individual and the good of
the society are parallel. Both lose if their interests aren't in
common. *THAT* is the only purpose of government.

In rec.woodworking HeyBub wrote:
: rangerssuck wrote:
:
: Well I think you've hit the nail on the head. The problem here is that
: those on the right really don't believe that there is such a thing as
: "common good." They believe that the good of individuals is the only
: goal. As long as I am doing well, it doesn't really matter how you are
: doing - that's your problem.

: Right. Adam Smith settled this hash in the 18th Century with the publication
: of "The Wealth of Nations." In that work, he posited the "Invisible Hand"
: (viz.) concept which, briefly, says that when all act in their own best
: interests, the community, as a whole, prospers.

Didn't Adam Smith also posit the need for regulation of the market
(as most discussions of his theory fail to note)?

--- Andy Barss

"Tim Daneliuk" wrote in message
...
William Wixon wrote:
"Han" wrote in message
...

That is a refreshing point of view, and I would love to 100% support
it.
However, hospitals and doctors need to be profitable, at least to the
extent they aren't losing money. To find the right balance between
reasonably profitable and not losing money is the problem, both from
the
doctors' point of view and the patients'.


--
Best regards
Han

i'm not an expert. i'm wondering why do hospitals need to be
profitable?
just had a thought, when the government builds a road i don't think
there's
any expectation it's going to turn a profit, it surely profits us all,
and
it enables businesses to profit, but (non-toll, and probably a good many
toll) roads, i don't think, earn a profit. infrastructure. can't the
health of citizens, by some stretch of the imagination, be considered
"infrastructure"? or toward some common good?

b.w.



I do not wish our hospitals to be run at the same levels as the DMV or
the Highway Department...


Would you prefer if they were run like General Motors or AIG, those paragons
of American business expertise?

Hawke

"Tim Daneliuk" wrote in message
...
Hawke wrote:
What's irritating is that no matter how many times you show these
numbers
to
right wing guys it just doesn't sink in

Hawke
Just to irritate you some more, it still has not sunk in. The
problem is while it is easy to come up with those numbers, it is a
lot harder to know why. Correlation does not mean cause and
effect.

An easy way to decrease the cost of healthcare in the US, would be
to eliminate all procedures which will only prolong someones life
by six months and also eliminate all procedures that do not have a
proven success record. If we had done this say thirty years ago,
we would not have any heart transplants , artificial heart valves,
etc.

Dan
Until you have been involved in the decision whether to treat a
loved one aggressively to prolong life or let go ("let nature take
its course"), you don't know what you are talking about.
It isn't a question of treatment or not. The question is payment.
There isn't any reason a person shouldn't be able to buy insurance to
cover anything they need.
Their needs, and the needs of their families for emotional placation,
are not the needs of society.

JC
If you think payment is the question, not treatment, then I have to
ask payment for what? The cost of (let's say) a liver transplant for
a patient who is going to die soon, whether or not the transplant
occurs, is WAY more than the cost of palliative treatment. I have to
ask what we are insuring against. A basic low(er) level of treatment
costs, or the costs of treating everything. IMNSHO, a asic level of
insurance (however defined) should be compulsory (yes, that bad word,
and whether the employee or the employer pays is ultimately only
semantics). On top of that a person should be allowed to insure
against the costs of more complex events/procedures. Freedom of
personal choice, etc., etc.

Society needs some kind of insurance, and the current system is
dysfunctional.
Government in the medical business is a permanent solution to a
temporary
problem. When I was a kid, when you got sick you went to the doctor
and
he
did what he could and it didn't cost much. Now he can do a lot more
but
it's all cutting edge and the costs are horrendous. A hundred years
from
now when the technologies have matured and an NMR scanner is a child's
plaything that you get at Toys R Us for 50 bucks it's going to be back
to
where most people can pay for most medical issues out of pocket without
it
hurting particularly.

But if we get government involved now then government will still be
involved
then.


So would you rather have the government be involved in health care or
just
leave it in the hands of people like used car salesmen? There are
private
alternatives that are worse than the government. How about having Bernie
Madoff handling your health care or the management of AIG? Think they
would
be better than the government? I don't. The greed of businessmen is what

False dichtomy and strawman. These are not the only choices.

makes them unacceptable for making decisions on people's health care.
You
need people that aren't going to profit from your health problems making
the
decisions. Hopefully, medical professionals without a financial interest
would decide what you need.

Hawke



This is hands-down the low point of this thread. If no one made a
profit in healthcare there would be NO healthcare. Why should gifted
people become doctors, pharma reseachers, nurses, or pharmacists?
Without profit where is the incentive to risk $500M - $1B *per new
drug* on the research side of things. In short, there would be few or
no "medical professionals without a financial interest [to] decide
what you need" without the opportunity for profit.

I'll take greedy business people over boneheaded collectivist ideology
any day of the week.


Of course you would but that is because of your short sightedness and
adherence to discredited right wing ideology, not because of the facts.
Plenty of organizations and businesses are non profit and they operate just
as efficiently and effectively as the for profit ones. But how can that be
when only profits make a business work? Or maybe your set in stone beliefs
are wrong.

Hawke