Health Care Reform - A Modest Proposal

[Christian Graus]

Sure. I don't disagree. You're saying the poor don't get health care now, but the rich but brain dead, do ?

Christian Graus Driven to the arms of OSX by Vista. Please read this[^] if you don't like the answer I gave to your question. "! i don't exactly like or do programming and it only gives me a headache." - spotted in VB forums.

[Mike Gaskey]

Christian Graus wrote:

That worked fine, when the cost of medicine was to go in the yard and find some leeches. It doesn't work now, unless you mean, just accept that only the rich can afford medical care.

that is exactly what I mean. the adavnces in treatment have extended lives but access to that care is not a fucking right, the road we're heading down is simply government enforced charity and is no fucking business of the government.

Mike - typical white guy. The USA does have universal healthcare, but you have to pay for it. D'oh. Thomas Mann - "Tolerance becomes a crime when applied to evil." The NYT - my leftist brochure. Calling an illegal alien an “undocumented immigrant” is like calling a drug dealer an “unlicensed pharmacist”. God doesn't believe in atheists, therefore they don't exist.

[Rob Graham]

I never suggested it was a "human right". We limit many rights, however, and in this case we are only talking about limiting taxpayer funding of medical care to that which is reasonable and economic. No one suggests disallowing those who want to from paying for additional care on their own. You don't get unlimited retirement support from Social Security either, but are allowed to save whatever you want to supplement that. Your argument, as usual, is pure B.S. And nothing in the Constitution prohibits us from choosing to fund medical care through taxes, in fact, since we already fund it for some (medicaid and medicare) one could argue that the Constitution mandates that we extend it to all (equal protection clause of the 14th amendment - if it's good for schools, then it's also good for this).

[Christian Graus]

Mike Gaskey wrote:

the adavnces in treatment have extended lives but access to that care is not a f***ing right, the road we're heading down is simply government enforced charity and is no f***ing business of the government.

Do you have an insurance policy ? Health care works the same, it's shared risk. The difference is, we let our government organise it, and you let private companies use it as a means of preying on the weak, while robbing the strong. You explain to me why the cost of care is so much more in the US compared to here ?

Christian Graus Driven to the arms of OSX by Vista. Please read this[^] if you don't like the answer I gave to your question. "! i don't exactly like or do programming and it only gives me a headache." - spotted in VB forums.

[Mike Gaskey]

Christian Graus wrote:

You explain to me

how many innovations your drug companies have developed. how many innovations your durable medical equipment companies have developed. something other than the military that is done better because our government controls it.

Christian Graus wrote:

you let private companies use it as a means of preying on the weak

bullshit. but back to my point, it is no fucking business of the government, healthcare is not a "right" any more than is food, clothing, shelter - all are personal responsibilities.

Mike - typical white guy. The USA does have universal healthcare, but you have to pay for it. D'oh. Thomas Mann - "Tolerance becomes a crime when applied to evil." The NYT - my leftist brochure. Calling an illegal alien an “undocumented immigrant” is like calling a drug dealer an “unlicensed pharmacist”. God doesn't believe in atheists, therefore they don't exist.

[Christian Graus]

Mike Gaskey wrote:

how many innovations your drug companies have developed

Don't get me started on the BS that is the drug industry in the US

Mike Gaskey wrote:

how many innovations your durable medical equipment companies have developed.

See, you're american, so I don't blame you that there's little to no chance of you seeing any reportage on medical breakthroughs outside the US. However, Australian teams produce their fair share of medical innovation. http://www.whitehat.com.au/Australia/Inventions/InventionsA.html[^]

Mike Gaskey wrote:

but back to my point, it is no f***ing business of the government, healthcare is not a "right" any more than is food, clothing, shelter - all are personal responsibilities.

And that is still only true in a society that preys on the weak, and feasts on their bones. I go back to my core point - the cost of modern medicine, especially in the USA, is far too high for most people to afford. If you have any sort of insurance, then you are buying into the concept of shared risk. The health of the members of a society, affects that society, and so it is not just out of compassion that it makes sense for society to engage in shared risk to make health care within the reach of it's members.

Christian Graus Driven to the arms of OSX by Vista. Please read this[^] if you don't like the answer I gave to your question. "! i don't exactly like or do programming and it only gives me a headache." - spotted in VB forums.

[Stan Shannon]

Rob Graham wrote:

I never suggested it was a "human right". We limit many rights, however, and in this case we are only talking about limiting taxpayer funding of medical care to that which is reasonable and economic. No one suggests disallowing those who want to from paying for additional care on their own. You don't get unlimited retirement support from Social Security either, but are allowed to save whatever you want to supplement that. Your argument, as usual, is pure B.S. And nothing in the Constitution prohibits us from choosing to fund medical care through taxes, in fact, since we already fund it for some (medicaid and medicare) one could argue that the Constitution mandates that we extend it to all (equal protection clause of the 14th amendment - if it's good for schools, then it's also good for this).

Well, if you believe that, all I can say is live and learn. You will find out the hard way what the pure B.S. was all along. What we are attempting to do simply cannot be done. Just as with Social Security, the system will degrade over time and more and more people will find themselves on the wrong side of some bureaucrats slide rule. And, as far as the constitution is concerned, if it can be used to justify providing health care for all, than it is so far from the original purpose it was created to achieve that for all intents and purposes it is entirely unnecessary. If the federal government can do this, there are essentially no limits on its power at all.

Chaining ourselves to the moral high ground does not make us good guys. Aside from making us easy targets, it merely makes us idiotic prisoners of our own self loathing.

[Stan Shannon]

Christian Graus wrote:

And that is still only true in a society that preys on the weak, and feasts on their bones.

Why didn't that happen to my family? We were weak, vulnerable and nobody feasted on our bones. We recieved help from the community.

Chaining ourselves to the moral high ground does not make us good guys. Aside from making us easy targets, it merely makes us idiotic prisoners of our own self loathing.

[Christian Graus]

Because you're talking 50 years ago. The concept of community that existed then, doesn't exist to the same degree today. It *can* do, of course, but by and large, it does not appear to. Either way, you can't take a single personal example, because Americans are, by and large, amongst the most generous people I have ever met. And I've met a lot of them, all over the country ( I am talking in person here, discounting the web ). That doesn't change that a societal structure that does not offer access to health care, is one that locks people out, and lets them die. And, going back to the point I made earlier, the cost of medicine back then was far less than it is today. It's the escalating cost that makes it more imperative that some sort of safety net is offered.

Christian Graus Driven to the arms of OSX by Vista. Please read this[^] if you don't like the answer I gave to your question. "! i don't exactly like or do programming and it only gives me a headache." - spotted in VB forums.

[Stan Shannon]

Christian Graus wrote:

Because you're talking 50 years ago.

It still refutes your central point that there is or was anything inherently uncivil in American society.

Christian Graus wrote:

The concept of community that existed then, doesn't exist to the same degree today. It *can* do, of course, but by and large, it does not appear to. Either way, you can't take a single personal example, because Americans are, by and large, amongst the most generous people I have ever met. And I've met a lot of them, all over the country ( I am talking in person here, discounting the web ).

Only becuase it has been intentionally attacked and made dysfunctional for the express purpose of making people more dependent upon government. That was the entire point of the last 50 year assault on the christian community in the US - demonizing it and marginalzing it by continuously publicizing every negative and ignoring every positive.

Christian Graus wrote:

That doesn't change that a societal structure that does not offer access to health care, is one that locks people out, and lets them die.

Some one is going to be allowed to die under any system. If you tell me that isn't true under the Australian system, that I'm afraid I will have to ask an obvious question: Does no one die in Australia? If they do, who is it that is keeping statistics on how much effort was expended on their behalf to keep them alive?

Christian Graus wrote:

And, going back to the point I made earlier, the cost of medicine back then was far less than it is today. It's the escalating cost that makes it more imperative that some sort of safety net is offered.

But you don't seem to be in the least bit curious about why that might be. You seem to believe that there is some completely incomprehensible reason why medical care would out pace every other sector of the economy. The answer is all the very money that government is pumping into the system, and the fact that we are supporting not only government bureaucracies but two entirely independent industries with our health care dollars. You simply cannot compare the system as it existed before government involvment became so pervasive, and the systeem afterwards and not see the negative effect that it has had.

Chain

[Tim Craig]

Christian Graus wrote:

The cost of a basic doctors visit in the USA is beyond obscene, I can only imagine what surgery costs.

My last visit to the hospital, last fall, included a minimally invasive procedure and ran right around $1700 an hour.

"Republicans are the party that says government doesn't work and then they get elected and prove it." -- P.J. O'Rourke

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ACCEPT NO SUBSTITUTES!!!

[John Carson]

Rob Graham wrote:

Point taken, although that still says a majority of the expense is in the final year (27-30% of PROGRAM spending in medicare is on that 5-6% of the population that is in their final year, from your link), or more than 5x annual expense of individuals not in their final year.

Not sure how you get to "a majority" from 27-30%. Note that the figure for total spending on health care (as opposed to medicare spending) is 10-12% in the last year of life, i.e., if you gave people no medical care at all in what would be the last year of their life with medical care, you would only cut 10-12% off the total cost of medical care.

Rob Graham wrote:

That still seems excessively expensive, particularly when coupled with the statement that 46% of that 5-6% received NO medical care at all in their final year (doing the math, that means that 2.8% of the population accounted for 27-30% of the annual PROGRAM cost).

Not sure where you are getting 2.8% from. In any event, I don't think you can make judgements about being "excessively expensive" based on figures alone. You need to know what the money was spent on. For example, if death in 6 months is inevitable, then I would think that pain relief should be the main focus. But suppose that what actually happens is that, following a particular procedure, 80% live for less than a year, but 20% live for an average of 5 years and it is impossible to predict in advance which patients will fall in to which category. That makes it very difficult to deny the procedure --- all the more so when the field is in a state of development and doctors are learning from the use of the procedure. One of the things I have seen is that "end of life" costs don't go up with age, i.e., a 30 year old in the last year of life costs more than an 80 year old. You will have a hard time making a case for skimping on expenditures to save the life of a 30 year old.

Rob Graham wrote:

Looks to me like your article actually ends up pretty much making my point, once you look past the artful presentation of statistics that don't really bear out the conclusion they claim to support.

If your point is that people in the last year of their life cost disproportionately more, then you are right. This is not surprising. They are much more likely to be sick. If your point is that such expenses are the major source of medi

[John Carson]

Oakman wrote:

Absolutely. The page you refrred to doesn't address in any way, shape, manner or form, the issue at hand.

Pure BS.

Oakman wrote:

Here's a couple of other yhings I've learned: 80% of all healthcare costs in the US are incurred by 20% of the population. 70% of the healthcare costs in the U.S. are created by the treatment of chronic deseases and folks over 65 and ten time more likely to have a chronic disease than those under 45.

So let's change the subject.

Oakman wrote:

Fact: A 20 year-old smoker has less risk of developing cancer in the next 10 years than does a 80 year-old who never smoked in his life. And a 20-year old who eats a poor diet and rarely exercises has a greater chance of living another decade than does an 80 year-old who eats a good diet and exercises every day. The impact of smoking and inactivity pale in comparison to the impact a few extra decades of senescence has on a person's health prospects.

Congratulations. You have discovered that people die when they get old. The issue is the cost of medical care and what might be done to reduce it. People in the last year of their life account for 10-12% of national medical expenses, which gives an upper limit to the potential savings from denying funding to people who are "going to die anyway". Yeah, older people consume more medical care (the other group that consumes a lot is pregnant women). Unless you have found a (low cost) cure for aging, then there is not a lot that can be done about that.

John Carson

[Oakman]

Mike Gaskey wrote:

healthcare is not a "right"

Face it, Mike, there's no government in the world that only protects basic rights. If I had to choose between Stan's "right not to be offended by gay marriage," and Christian's "right to have basic healthcare," I'd certainly select the latter.

Jon Smith & Wesson: The original point and click interface Both democrats and republicans are playing for the same team and it's not us. - Chris Austin

[Oakman]

Christian Graus wrote:

You're saying the poor don't get health care now, but the rich but brain dead, do ?

Nope, I just want to make sure that public funds aren't used to provide healthcare to breathing corpses like whatshername that has all the Republican senators passing laws to keep the machines from being turned off.

Jon Smith & Wesson: The original point and click interface Both democrats and republicans are playing for the same team and it's not us. - Chris Austin

[Oakman]

John Carson wrote:

Pure BS.

What, you're playing I can say anything you can? Well I called your stuff B.S. first ;P

John Carson wrote:

So let's change the subject

I'll be glad to stick with 80% of all healcare costs are incurred in the last six months of life. Why don't you try to refuste that, rather than bringing in an article that, as Rob says, uses headlines to lie about the results of the studies done?

John Carson wrote:

Congratulations. You have discovered that people die when they get old.

I also discovered that chronic diseases are what costs us the most money, and that the old are ten times more likely to have chronic diseases than the young. I can do the math, why can't you?

Jon Smith & Wesson: The original point and click interface Both democrats and republicans are playing for the same team and it's not us. - Chris Austin

[Oakman]

John Carson wrote:

If your point is that people in the last year of their life cost disproportionately more, then you are right. This is not surprising. They are much more likely to be sick.

Well, duh, that was my point in the first place. I wasn't suggesting that people in the last months of their life spent money on health care because they were well. But maybe you'll be the Canadians: Or you can just start yelling at them as well. The high cost of dying has more to do with soaring health care costs than the aging population does, according to the Canadian Institute of Actuaries. In its submission to the Romanow commission on the future of health care, the institute said that 30 to 50 per cent of total lifetime health care expenditures occur in the last six months of life. Noting the sensitivity of the subject, the group suggested greater use of less expensive palliative care and living wills. The debate on health care cannot move forward without a recognition that about 30 ... [^] The figure is lower than the one i was quoting but a helluvalot higher than you claim of ten percent.

Jon Smith & Wesson: The original point and click interface Both democrats and republicans are playing for the same team and it's not us. - Chris Austin

modified on Sunday, June 7, 2009 9:27 PM

[John Carson]

Oakman wrote:

I'll be glad to stick with 80% of all healcare costs are incurred in the last six months of life. Why don't you try to refuste that, rather than bringing in an article that, as Rob says, uses headlines to lie about the results of the studies done?

Your 80% figure is pulled out of your arse and barely merits refutation, but I'll say something as a courtesy. Back of an envelope calculation...lets say everyone lives for 80 years. 20% of an individual's medical costs are incurred in the first 79 years and 80% in the 80th year. Assume for simplicity a stationary population, so that there are equal numbers at each age. Then the 79/80 of the population that is less than 80 years old will account for just 20% of total medical expenses and the 1/80 of the population will account for 80%. This is so far removed from the actual figures of 10-12% in the last year of life that the simplifications involved in my calculations can't possibly explain it. The original premise of 80% in the last year of life must be BS.

Oakman wrote:

I also discovered that chronic diseases are what costs us the most money, and that the old are ten times more likely to have chronic diseases than the young. I can do the math, why can't you?

I don't see any math from you that draws on that data, nor any method for stopping people from getting old. The "old" is a much larger group than those in the last year of life. <edit> My remarks assume that the costs of treatment for any given age don't change over time. If one is interested in history, this is not appropriate. If one is interested in assessing the current burden of health costs with a view to cutting current expenditures, then it is. </edit>

John Carson

modified on Sunday, June 7, 2009 9:48 PM

[Rob Graham]

John Carson wrote:

Not sure where you are getting 2.8% from. In any event, I don't think you can make judgements about being "excessively expensive" based on figures alone

The article youy linked to states that 46% of those in their final year of life got no medical care, and that the proportion of the medicare popluation in that last year was 5-6% of the total population. So, 6% x (1.0 -.46) = 6 * .64 = 3.84 (I must have incorrectly used 6 * .46 to get 2.8% - My bad). Even so, 3.8% of the medicare population using 30% of the program funds is a rather disproportionate share that is difficult to justify.

[John Carson]

Oakman wrote:

The high cost of dying has more to do with soaring health care costs than the aging population does, according to the Canadian Institute of Actuaries. In its submission to the Romanow commission on the future of health care, the institute said that 30 to 50 per cent of total lifetime health care expenditures occur in the last six months of life. Noting the sensitivity of the subject, the group suggested greater use of less expensive palliative care and living wills. The debate on health care cannot move forward without a recognition that about 30 ... [^] The figure is lower than the one i was quoting but a helluvalot higher than you claim of ten percent

Have you noticed that the first sentence seems to be at odds with the rest of it? I am guessing that the high figure comes from looking at historical data and is an artifact of comparing year 2000 expenses when old with 1930s to 1950s expenses when young. Thus it is not aging that is responsible for most of the discrepancy, it is the change in the general cost of medical care. Thus, in your relentless quest for cost savings, not only are you going to need a cure for aging, you will also need a time machine.

John Carson